TY 2011 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Metropolitan Watertown LLC 225 S Executive Dr BROOKFIELD,WI53005	Anesthesia Services	2,194,060
University of Wisconsin Med Founda 1685 Highland Ave MADISON,WI53705	Physician	1,606,546
MASS Brothers Construction Co Inc 410 Water Tower Court WATERTOWN,WI530940108	Construction	955,234
Eppstein Uhen Architects 333 East Chicago St MILWAUKEE,WI53202	Architects	980,736
University of WI Hospital Clinics PO Box 3006 MILWAUKEE,WI53201	Lab Services	900,922
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 24

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 United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	13,369	13,369
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,344,316		1,344,316
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	40,348,260	35,304,728	5,043,532
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,590,385	2,266,587	323,798
9	Other employee benefits .......	6,962,748	6,092,405	870,343
10	Payroll taxes ...........	2,770,906	2,424,543	346,363
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	12,177,000	10,654,875	1,522,125
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	1,859,000	1,626,625	232,375
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	5,470,000	4,786,250	683,750
23	Insurance ..............	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	LICENSES AND TAXES	1,911,783	1,672,810	238,973
b	MEDICAL SUPPLIES	9,745,000	8,526,875	1,218,125
c	FISCAL AND ADMIN SERVICE	9,705,848	8,492,617	1,213,231
d	PROVISION FOR BAD DEBT	4,147,000	3,628,625	518,375
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	99,045,615	85,490,309	13,555,306	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	8,538,188	1	6,950,710
2	Savings and temporary cash investments .......	0	2	0
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	12,837,461	4	12,629,182
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
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 ..........	0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	2,051,745	8	2,003,803
9	Prepaid expenses and deferred charges ............	2,841,089	9	2,712,633
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	114,272,273
b	Less: accumulated depreciation. .....	10b	62,433,000	51,431,348	10c	51,839,273
11	Investments—publicly traded securities ..........	48,748,865	11	76,399,922
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	773,202	13	792,622
14	Intangible assets .........	126,768	14	77,045
15	Other assets. See Part IV, line 11 ...........	295,000	15	144,001
16	Total assets. Add lines 1 through 15 (must equal line 34)...	127,643,666	16	153,549,191
	17	Accounts payable and accrued expenses .	11,276,307	17	14,116,399
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	566,959	19	1,201,561
20	Tax-exempt bond liabilities ..........	29,989,549	20	47,467,345
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	5,216,097	25	4,935,131
26	Total liabilities. Add lines 17 through 25.....	47,048,912	26	67,720,436
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	80,483,526	27	85,803,890
28	Temporarily restricted net assets .....	111,228	28	24,865
29	Permanently restricted net assets .....	0	29	0
	Organizations that do not follow SFAS 117, check here 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 .....	80,594,754	33	85,828,755
34	Total liabilities and net assets/fund balances .....	127,643,666	34	153,549,191

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization Watertown Regional Medical Center Inc
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization Watertown Regional Medical Center Inc
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

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 .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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 ....
b	Contributions ........
c	Net investment earnings, gains, and losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,230,407		1,230,407
b	Buildings ................	49,149,952	20,586,289	28,563,663
c	Leasehold improvements ............
d	Equipment ................	56,708,259	39,198,099	17,510,160
e	Other .................	7,183,655	2,648,612	4,535,043
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				51,839,273

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
RESIDENT DEPOSIT PAYABLE		4,935,135








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		4,935,135
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) 2011

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	102,120,113
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	99,045,615
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	3,074,498
4	Net unrealized gains (losses) on investments ..........................	4	2,730,907
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8	-571,404
9	Total adjustments (net). Add lines 4 through 8 .........................	9	2,159,503
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	5,234,001

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	104,276,000
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	2,730,907
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d	-575,020
e	Add lines 2a through 2d .....................			2e	2,155,887
3	Subtract line 2e from line 1.....................			3	102,120,113
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
c	Add lines 4a and 4b.......................			4c
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	102,120,113

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1	99,045,615
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
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3	99,045,615
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
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	99,045,615

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
RECONCILIATION ITEMS	FORM 990, SCHEDULE D, PART XI, LINE 8	Interest Rate Swap 23,000 EXTRAORDINARY LOSS ON REFINANCED BOND -575,167 TEMP RESTRICTED UNREALIZED GAIN -19,000 ROUNDING -237 --------- Total -571,404 Form 990, Schedule D, Part XII, Line 2D: EXTRAORDINARY LOSS ON REFINANCED BOND -575,167 ROUNDING 147

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2011

Open to Public Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 125 %

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..		905,770		905,770	0.950 %
b Medicaid (from Worksheet 3, column a) .....		6,260,269		6,260,269	6.600 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....		7,166,039		7,166,039	7.550 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	26,178	665,707	64,625	601,082	0.630 %
f Health professions education (from Worksheet 5) ..	179	37,660		37,660	0.040 %
g Subsidized health services (from Worksheet 6) ..		652,484		652,484	0.690 %
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....		394,310		394,310	0.420 %
jTotal Other Benefits ...	26,357	1,750,161	64,625	1,685,536	1.780 %
kTotal. Add lines 7d and 7j. ..	26,357	8,916,200	64,625	8,851,575	9.330 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	3,973	3,973
3	Community support	19,369	19,369	0.020 %
4	Environmental improvements
5	Leadership development and training for community members	37,950	37,950	0.040 %
6	Coalition building	1,192	1,192
7	Community health improvement advocacy	7,232	7,232	0.010 %
8	Workforce development	1,339	1,339
9	Other
10	Total	71,055	71,055	0.070 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense........

2,052,864

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

410,573

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

Enter total revenue received from Medicare (including DSH and IME).....

14,314,428

Enter Medicare allowable costs of care relating to payments on line 5.....

20,480,240

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-6,165,812

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	UWHP Watertown Regional Medical Center 125 Hospital Dr Watertown,WI53098	X	X	X

Schedule H (Form 990) 2011

Page

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)

UWHP Watertown Regional Medical Center

Name of Hospital Facility:

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 2011)
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
	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 the community health 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 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
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
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
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained 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?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 125.% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.% If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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 why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care 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) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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
BAD DEBT	PART 1, LINE 7, COLUMN (F)	The amount of bad debt expense excluded from the the total expenses used to calculate Part I, Line 7, Column (f) was $4,147,000. This reduced the total expenses to $94,898,615.
COST CALCULATION	Part I, Line 7	Costs included in part i, line 7 were calculated using the cost to charge ratio. PART II WRMC is actively involved in promoting the health of the communities it serves. WRMC actively develops partnerships with community organizations with similar missions of improving community health and safety. As a board member of the Dodge Jefferson Healthier Community Partnership (DJHCP), we work with two other hospitals, Dodge and Jefferson County Health Departments and the Watertown Health Departments to complete regular community health assessments and to develop ongoing community health improvement plans. DJHCP serves as an ambassador for community health by supporting health-related activities in addition to organizing efforts targeted toward community health priorities (i.e. diet, exercise, mental health and substance abuse). DJHCP founded and oversees our local free clinic, the Watertown Area Cares Clinic. Another example of this group's work is the founding of Get Healthy Watertown, a community wellness coalition which sponsors weekly community walks. Our long-term relationship with Rainbow Hospice provides high-quality access to a continuum of services that WRMC does not offer on its own. Our collaboration helps to maintain hospice as a strong, high-quality community resource. WRMC's relationship with the Watertown police department supports safety and domestic violence awareness education as well as the development of a "clean sweep" safe medication disposal program.
BAD DEBT EXPENSE CALCULATION	Part III, Line 4	The hospital cost to charge ratio, computed from the 9/30/2012 Medicare Cost Report, was used to compute the cost of the bad debt expense. The hospital estimated that 20% of its bad debt expense would be classified as charity care if the forms were filled out with proper documentation. When accounts are transferred to collection the hospital does not know if the patients may possibly qualify for Community Care because they may have neglected their bills. Many accounts go to collection because the hospital never has any contact with the patient. The hospital sends them statements and calls them, but the patients never pay or respond. The Hospital provides care without charge or at amounts less than the Hospital's established rates to patients who meet certain criteria under its charity care policy. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The following information measures the level of charity care provided for the years ended September 30: Charges Foregone, based on established rates 2012=2,052,864 2011=$1,841,622
SHORTFALL AS COMMUNITY BENEFIT	Part III, Line 8	100% of the Medicare shortfall should be treated as community benefit. Watertown Regional Medical Center is committed to serving all patients, regardless of ability to pay or if the payments to be received will be less than the cost to provide the service, which is the case for Medicare and Medicaid patients. The figures on line 6 of part iii come from the 9/30/2012 Medicare Cost Report.
CHARITY CARE	Part III, Line 9b	When patients qualify for charity care, the Hospital gives up collection efforts on the amount that is classified as charity care. If a patient receives partial charity care, the non-charity portion of their bill is still subject to normal collection efforts, which can include being sent to a collection agency if the patient fails to make payments to the Hospital.
BILLING OF UNINSURED	Part V, line 19d	Charge all patients the same. Selfpay ("SP") patients are then given an automatic 10% "SP" discount. Then an additional 15% prompt pay discount if paid within 30 days.
NEEDS ASSESSMENT	Part VI, Line 2	Using public health data provided by the State of Wisconsin, local health departments and the University of Wisconsin, UW Health Partners Watertown Regional Medical Center (WRMC) completes regular community health assessments. These assessments are performed in cooperation the local public health offices. Public health data is used to identify the region's top health and safety needs. Priorities are identified in collaboration with our public health partners, community leaders, other health providers and community members representing diverse needs of the community. The following have been identified as our regions' greatest health needs: a. Healthy Diet b. Physical Activity c. Mental Health d. Alcohol/substance abuse
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	Part VI, Line 3	WRMC uses multiple methods to educate patients about eligibility for financial assistance. Local referring providers are familiar with WRMC's charity care policies and often get patients in contact with WRMC financial counselors as the care process is initiated. Our front office/reception staff at each point of entry is educated on billing and assistance procedures and can serve as an immediate resource for patients, referring patients to financial counselors to provide personalized counseling when necessary. Our financial assistance policies are available on our website, and the numbers for our financial counselors are readily publicized in phone books and other directories. Once admitted to the medical center, each patient receives a Patient Handbook, which outlines billing procedures and financial assistance resources. These policies and resources are also available 24/7 on our website at uwhpwatertown.com.
COMMUNITY INFORMATION	Part VI, Line 4	WRMC serves the residents of Dodge and Jefferson counties in a service area of roughly 120,000 lives. Basic county demographic information is as follows: Dodge County Jefferson County - Residents below Poverty 8.1% 7.6% - with HS Diploma 82.3% 84.7% - Speak Language other than English 4.6% 6.1% - Residents over age 65 13.6% 12.5% - Residents uninsured 7.4% 3.0%
COMMUNITY BUILDING ACTIVITIES	Part VI, Line 5	WRMC has an open medical staff and a generous charity care program. Annually, we donate a percentage of net revenue to a Community Health Fund which is used to support local non-profits with health, wellness and safety related missions. A Community Benefit sub-committee of the board oversees the Community Health Fund and WRMC charitable activities. WRMC is active in community health improvement in the region. An active member of the Dodge Jefferson Healthy Community Partnership, we work in partnership with local health departments to develop community health improvement plans. We provide ongoing support (in the form of financial funding and donated diagnostic and lab testing services) to our local free clinic, the Watertown Area Cares Clinic (WACC). WRMC also provides lab and diagnostic services to a second free clinic, the Rock River Free Clinic. WRMC develops active partnerships with community providers to ensure quality care across the continuum. Support of our local hospice provider, Rainbow Hospice, has been a significant priority. Two WRMC leaders serve on the Rainbow Hospice board. Three WRMC physicians provide medical direction for Hospice, and WRMC has made sizable financial donations to enhance the hospice services available locally. Obesity is a key health concern for our region, and WRMC is active in promoting lifestyle change. Ready.Set.Fit is an example of our youth obesity prevention efforts. Annually, our providers teach a healthy lifestyle curriculum in local schools which focuses on nutrition and exercise. This past year, efforts have focused around transforming our Dietary (or food service function) to Nourishment. With this work, WRMC hopes to serve as an example of healthy eating, making it easy for employees, patients and guests to "choose health" with affordable, fresh and scratch meals made with nutritious local ingredients.
AFFILIATED HEALTHCARE SYSTEM		WRMC is governed by a community board of directors who represent the diverse needs of the Watertown region. We have a board of directors sub-committee which oversees our community benefit plan and activities. This committee also oversees our Community Health Fund. This committee is made up of community members who represent underserved populations, such as the elderly, low-income, Spanish speaking population and youth. Each fiscal year, our board allocates a percentage of net revenue to a Community Health Fund. Community non-profits with health and safety related missions apply for and receive grant funds to further their missions of enhancing the health of the community.
STATE FILING OF COMMUNITY BENEFIT REPORT	990 SCHEDULE H, PART VI	WI,

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
Watertown Regional Medical Center Inc

Employer identification number
39-1030310

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance
(1) SCHOLARSHIP AWARDS (SEE PART IV FOR DETAILS)	14	13,369	N/A	N/A

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES	Schedule I, Part I, Line 2	Annually, a team develops and submits a grant request to granting organizations to request funding for initiatives which meet identified health needs. The team develops a proposal with objectives, tactics and budget outlined. The team monitors progress toward stated objectives and budget and sends quarterly updates to the granting organization. In addition, the grant outcomes are reviewed annually with Community Benefit Committee members.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Yes

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? ....

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) Kathleen Hargarten	(i) (ii)	96,092	0	11	0	961	97,064
(2) Ron Sokovich	(i) (ii)	309,252	0	38,542	19,627	20,279	387,700
(3) John Graf	(i) (ii)	145,284	17,988	38,621	16,449	16,436	234,778
(4) Duane Floyd	(i) (ii)	102,257	8,382	21,979	10,968	17,087	160,673
(5) Tahmina Aafreen	(i) (ii)	207,464	183,678	16,518	19,323	13,128	440,111
(6) T Mark Roman	(i) (ii)	596,684		18	7,846	16,463	621,011
(7) Edward Hoy	(i) (ii)	217,842	85,519	38,621	26,601	16,726	385,309
(8) Jacklynn Lesniak	(i) (ii)	137,126	14,495	6,490	11,300	16,073	185,484
(9) Steven Rhodes	(i) (ii)	383,501	35,105	38,542	20,983	21,013	499,144
(10) Katherine Skaggs	(i) (ii)	358,377		42	12,127	19,193	389,739
(11) John Kosanovich	(i) (ii)	274,119	56,171	22,272	36,301	17,255	406,118
(12) Jeff Meade MD	(i) (ii)	114,873	8,916	11,265	10,593	13,157	158,804

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
Watertown Regional Medical Center Inc

Employer identification number
39-1030310

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710B2V3	08-23-2012	28,861,000	Hospital Expansion & Renovation		X		X		X
B	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855		11-18-2010	2,250,000	Clinic Building Purchase		X		X		X
C	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710VP36	10-26-2006	15,000,000	Hospital Expansion		X		X		X
D	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710VQW1	12-11-2003	4,400,000	Hospital Remodeling		X		X		X
	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710vap3	07-27-2001	13,260,190	Hospital CLINIC EXPANSION	X			X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	0		135,000		0		1,760,000
2 Amount of bonds legally defeased . . . . . . . . . .	0		0		0		0
3 Total proceeds of issue . . . . . . . . . . . . .	28,861,001		2,250,000		15,000,000		4,400,000
4 Gross proceeds in reserve funds . . . . . . . .	17,318,799		0		1,258,570		0
5 Capitalized interest from proceeds . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . .	0		707,005		0		0
7 Issuance costs from proceeds . . . . . . . . . . .	459,517		25,995		300,000		88,000
8 Credit enhancement from proceeds . . . . . . . . . .	0		0		624,944		22,779
9 Working capital expenditures from proceeds . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . .	1,554,139		1,517,000		12,816,486		4,289,221
11 Other spent proceeds . . . . . . . . . . .	9,419,259		0		0		0
12 Other unspent proceeds . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . .	2010		2010		2008		2004
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .	X		X			X		X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . .		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2011

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .		X		X		X		X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0.00000%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0.00000%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0.00000%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X		X		X		X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .	X		X		X		X
2 Is the bond issue a variable rate issue?		X	X		X		X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X	X			X
b Name of provider . . . . . . . .	0		0		JP MORGAN CHASE
c Term of hedge . . . . . . . .	28.				28.
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .		X		X		X		X
b Name of provider . . . . . .	0		0		0		0
c Term of GIC . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .		X		X		X		X
6 Did the bond issue qualify for an exception to rebate? .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . . YesNo

Part VI

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
Watertown Regional Medical Center Inc

Employer identification number
39-1030310

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710B2V3	08-23-2012	28,861,000	Hospital Expansion & Renovation		X		X		X
B	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855		11-18-2010	2,250,000	Clinic Building Purchase		X		X		X
C	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710VP36	10-26-2006	15,000,000	Hospital Expansion		X		X		X
D	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710VQW1	12-11-2003	4,400,000	Hospital Remodeling		X		X		X
	WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR	39-1337855	97710vap3	07-27-2001	13,260,190	Hospital CLINIC EXPANSION	X			X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	0		135,000		0		1,760,000
2 Amount of bonds legally defeased . . . . . . . . . .	0		0		0		0
3 Total proceeds of issue . . . . . . . . . . . . .	28,861,001		2,250,000		15,000,000		4,400,000
4 Gross proceeds in reserve funds . . . . . . . .	17,318,799		0		1,258,570		0
5 Capitalized interest from proceeds . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . .	0		707,005		0		0
7 Issuance costs from proceeds . . . . . . . . . . .	459,517		25,995		300,000		88,000
8 Credit enhancement from proceeds . . . . . . . . . .	0		0		624,944		22,779
9 Working capital expenditures from proceeds . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . .	1,554,139		1,517,000		12,816,486		4,289,221
11 Other spent proceeds . . . . . . . . . . .	9,419,259		0		0		0
12 Other unspent proceeds . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . .	2010		2010		2008		2004
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .	X		X			X		X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . .		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2011

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .		X		X		X		X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0.00000%		0%		0%		0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0.00000%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0.00000%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X		X		X		X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .	X		X		X		X
2 Is the bond issue a variable rate issue?		X	X		X		X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X	X			X
b Name of provider . . . . . . . .	0		0		JP MORGAN CHASE
c Term of hedge . . . . . . . .	28.				28.
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .		X		X		X		X
b Name of provider . . . . . .	0		0		0		0
c Term of GIC . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .		X		X		X		X
6 Did the bond issue qualify for an exception to rebate? .	X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X		X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

Part VI

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2011

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Meade Medical Clinic	Officer is owner	276,462	SEE PART V		No
(2) University of Wisconsin Health Care	Board member is officer	100,000	SEE PART V		No
(3) Nadine Kosanovich	Daughter of president	19,563	SEE PART V		No
(4) Cynthia Schuler	Spouse of board member	40,177	SEE PART V		No
(5) Roberta Graf	Spouse of treasurer	56,631	SEE PART V		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation
DESCRIPTION OF RELATED PARTY TRANSACTIONS		MEADE MEDICAL CLINIC: DR. MEADE PROVIDED RENTAL PROPERTY TO WATERTOWN REGIONAL MEDICAL CENTER, INC. UNIVERSITY OF WISCONSIN HEALTH CARE, INC.: MR.DALLMAN IS VICE PRESIDENT OF REGIONAL DEVELOPMENT FOR UNIVERSITY OF WISCONSIN HEALTH CARE, INC. WHICH HAS AN AFFILIATION AGREEMENT WITH WATERTOWN REGIONAL MEDICAL CENTER, INC. NADINE KOSANOVICH: NADINE KOSANOVICH, EMPLOYEE OF WRMC, IS THE DAUGHTER OF JOHN KOSANOVICH, PRESIDENT OF THE BOARD OF DIRECTORS. CYNTHIA SCHULER: CYNTHIA SCHULER, EMPLOYEE OF WRMC, IS THE WIFE OF TIM SCHULER WHO IS A BOARD OF DIRECTOR. ROBERTA GRAF: ROBERTA GRAF, EMPLOYEE OF WRMC, IS THE SPOUSE OF JOHN GRAF, SENIOR VICE PRESIDENT AND TREASURER.

Schedule L (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization

Watertown Regional Medical Center Inc

Employer identification number

39-1030310

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	TO PROVIDE THE BEST IN HEALTHCARE TO OUR PATIENTS. HOSPITAL, OPERATES A COMMUNITY HOSPITAL WITH 95 APPROVED BEDS PROVIDING A FULL RANGE OF ACUTE CARE AND HOME HEALTH SERVICES IN WATERTOWN, WISCONSIN AND SURROUNDING COMMUNITIES. THE HOSPITAL ALSO OWNS AND OPERATES PHYSICIAN PRACTICE CLINICS AND SENIOR HOUSING CAMPUSES. THE HOSPITAL HAS A COMMITMENT TO PROVIDE SERVICES TO ALL, INCLUDING THE UNDERSERVED AND THOSE AFFECTED BY POVERTY. THE HOSPITAL PROVIDES A WIDE RANGE OF COMMUNITY OUTREACH SERVICES SUCH AS IMMUNIZATION CLINICS, HEALTH EDUCATION PROGRAMS, HEALTH SCREENINGS, AND VARIOUS HEALTHCARE SUPPORT GROUPS.
GOVERNING BODY AND MANAGEMENT	FORM 990, PART VI, LINE 9	Jeff Baum (Board Chairman) Wisconsin Aviation, Inc. 1741 River Drive Watertown, WI 53094 Tim Schuler N452 Beverly Drive Watertown, WI 53098 Mike Sullivan, MD Watertown Family Practice Associates, SC 127 Hospital Drive Watertown, WI 53098 Fred Albertz 508 Highland Blvd. Johnson Creek, WI 53038 John P. Kosanovich Watertown Regional Medical Center, Inc. 125 Hospital Drive Watertown, WI 53098 Emily Stoddard, MD Regional General &Vascular Surgeons, SC MOB-West, Suite 2000 123 Hospital Drive Watertown, WI 53098 Marcy Tessmann W8913 Martins Way Watertown, WI 53094 Diane Heatley, MD UW Hospital and Clinics 600 Highland Avenue K4/765 Madison, WI 53792-7375 Lyle Wuestenberg (Board Vice Chairman) J & L Tire 855Linmar Lane PO Box 497 Johnson Creek, WI 53038 Daphne Holterman Rosy-Lane Holsteins LLC W3757 Ebenezer Drive Watertown, WI 53094 Ron Sokovich, MD Urology Clinic Medical Office Building-West, Suite 2002 123 Hospital Drive Watertown, WI 53098 Michael Dallman University Health Care Inc. 301 S. Westfield Road Suite 320 Madison, WI 53717 John Bauer Bethesda Lutheran Communities 600 Hoffman Drive Watertown, WI 53094 Fred Gremmels, MD 1517 Country Club Lane Watertown, WI 53098 Tricia Voigt 206 East Spaulding Watertown, WI 53098 Sandhya Garg, MD UWHC 600 Highland Avenue H4/837 Madison, WI 53792-8310
FORM 990 REVIEW PROCESS	FORM 990, PART VI, LINE 11B	The finance committee reviews the 990 in detail and a copy of the 990 is mailed to all board members before it is filed.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, LINE 12C	EACH YEAR THE HOSPITAL'S CONFLICT OF INTEREST POLICY, ALONG WITH THE CONFLICT OF INTEREST FORM, IS SENT TO EACH BOARD MEMBER. BOARD MEMBERS ARE ASKED TO REVIEW THE POLICY, COMPLETE THE FORM, AND RETURN THEM TO ADMINISTRATION WHERE THEY ARE KEPT ON FILE.
COMPENSATION PROCESS	FORM 990, PART VI, LINE 15B	To determine the compensation of each officer of the corporation, a compensation committee and external data are used to determine a fair and reasonable salary. Outside sources include the opinion of an independent compensation consultant, use of a compensation survey, and the written employment contract for each officer, if applicable. The salary must be approved each year by the compensation committee.
GOVERNING DOCUMENTS AVAILABLE TO PUBLIC	FORM 990, PART VI, LINE 19	Audited financial statements are available to the public through the EMMA website: http://emma.msrb.org/. The governing documents, conflict of interest policies, and audited financial statements are available for public inspection upon request.
RECONCILIATION OF NET ASSETS		FORM 990, PART XI, LINE 5 EXTRAORDINARY LOSS ON REFINANCED BONDS (575,167) UNREALIZED GAIN ON INVESTMENTS 2,730,907 INTEREST RATE SWAP 23,000 TEMPORARILY RESTRICTED UNREALIZED GAIN (19,000) ROUNDING (237) TOTAL 2,159,503

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE THE BEST HEALTHCARE TO OUR PATIENTS WITH STATE OF THE ART TECHNOLOGY, ADVANCED EXPERTISE, AND PERSONALIZED COMPASSIONATE CARE IN A HEALING ENVIRONMENT THAT IS CONVENIENT TO HOME AND WORK.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	11
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	942
6	Total number of volunteers (estimate if necessary) ....	6	166
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	204,723
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	90,923	56,197
9	Program service revenue (Part VIII, line 2g) .........	95,231,858	100,241,920
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,587,683	1,756,492
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	583,786	65,504
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	97,494,250	102,120,113
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	20,500	13,369
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)	48,551,505	54,016,615
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	43,524,930	45,015,631
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	92,096,935	99,045,615
19	Revenue less expenses. Subtract line 18 from line 12.......	5,397,315	3,074,498
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	127,643,666	153,549,191
21	Total liabilities (Part X, line 26).............	47,048,912	67,720,436
22	Net assets or fund balances. Subtract line 21 from line 20.....	80,594,754	85,828,755

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 63,016,853 including grants of $ ) (Revenue $ 84,074,092 )
	Operations of an acute care hospital facility including inpatient, emergency room, surgery and outpatient with a full array of ancillary services.

4b	(Code: ) (Expenses $ 20,863,979 including grants of $ ) (Revenue $ 14,659,683 )
	Operations of clinics in Watertown and surrounding communities.

4c	(Code: ) (Expenses $ 1,609,477 including grants of $ ) (Revenue $ 1,508,145 )
	Operations of senior living facilities.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 85,490,309

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(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
(A) Name and Title
(1) Jeff Baum Board Chairman	2.0	X	X	0	0	0
(2) Lyle Wuestenberg Board Vice-Chair	2.0	X	X
(3) Fred Albertz Board of Director	2.0	X
(4) Ron Sokovich Board of Director & Physician-	40.0	X		347,794		38,340
(5) Michael Dallman Board of Director	2.0	X
(6) Mike Sullivan MD Board of Director	2.0	X
(7) John Bauer Board of Director	2.0	X		0	0	0
(8) Emily Stoddard MD Board of Director	2.0	X
(9) Fred Gremmels MD Board of Director	2.0	X
(10) Tim Schuler Board of Director	2.0	X
(11) Marcy Tessmann Board of Director	2.0	X
(12) Tricia Voigt Board of Director	2.0	X
(13) Diane Heatley MD Board Vice-Chair	2.0	X	X
(14) John Kosanovich President	40.0	X	X	352,562		51,593
(15) Daphne Holterman Board of Director	2.0	X
(16) Sandhya Garg MD Board of Director	2.0	X
(17) John Graf Vice President & Treasurer	40.0		X	201,893		31,355

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Jennifer Laughlin Vice President & CIO	40.0	X			123,042	21,709
(19) Duane Floyd Vice President of Human Resour	40.0	X			132,618	26,951
(20) Lori Schwenkner Secretary	40.0	X			49,972	18,176
(21) Tina Crave Chief Experience Officer	40.0	X			99,334	29,075
(22) Jacklynn Lesniak VP of Patient Services	40.0	X			158,111	26,113
(23) Jeff Meade MD Chief Medical Officer	24.0	X			135,054	22,696
(24) Tahmina Aafreen Physician OBGYN	40.0		X		407,660	30,885
(25) T Mark Roman Physician	40.0		X		596,702	22,743
(26) Edward Hoy Physician	40.0		X		341,982	41,761
(27) Steven Rhodes Physician	40.0		X		457,148	40,430
(28) Katherine Skaggs Physician	40.0		X		358,419	29,754
(29) Kathleen Hargarten Board Of Director	0.0			X	96,103	822

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,858,394	0	432,403

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
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		56,197
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			56,197
			Business Code
2a	HOSPITAL		621,110	84,074,092	83,869,369	204,723
b	WATERTOWN AREA CLINCS		621,300	14,659,683	14,659,683
c	SENIOR LIVING FACILITIES		621,300	1,508,145	1,508,145
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			100,241,920
3	Investment income (including dividends, interest
	and other similar amounts).....			1,665,696			1,665,696
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents	1,412,975
b	Less: rental expenses	1,226,333
c	Rental income or (loss)	186,642
d	Net rental income or (loss).......			186,642			186,642
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	149,565
b	Less: cost or other basis and sales expenses	58,769
c	Gain or (loss)	90,796
d	Net gain or (loss)..........			90,796			90,796
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a		10,314
b	Less: direct expenses ...b		2,062
c	Net income or (loss) from fundraising events..			8,252			8,252
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...			0
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..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA REVENUE		900,099	238,586			238,586
b	MEALMOBILE		624,210	64,086	64,086
c	CANCER CENTER		541,610	79,866	79,866
d	All other revenue ....			-511,928	-511,928
e	Total. Add lines 11a–11d ......			-129,390
12	Total revenue. See Instructions....			102,120,113	99,669,221	204,723	2,189,972


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			8,538,188	1	6,950,710
2	Savings and temporary cash investments .......			0	2	0
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			12,837,461	4	12,629,182
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
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 ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			2,051,745	8	2,003,803
9	Prepaid expenses and deferred charges ............			2,841,089	9	2,712,633
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	114,272,273
b	Less: accumulated depreciation. .....	10b	62,433,000	51,431,348	10c	51,839,273
11	Investments—publicly traded securities ..........			48,748,865	11	76,399,922
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			773,202	13	792,622
14	Intangible assets .........			126,768	14	77,045
15	Other assets. See Part IV, line 11 ...........			295,000	15	144,001
16	Total assets. Add lines 1 through 15 (must equal line 34)...			127,643,666	16	153,549,191
17	Accounts payable and accrued expenses .			11,276,307	17	14,116,399
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			566,959	19	1,201,561
20	Tax-exempt bond liabilities ..........			29,989,549	20	47,467,345
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			5,216,097	25	4,935,131
26	Total liabilities. Add lines 17 through 25.....			47,048,912	26	67,720,436
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			80,483,526	27	85,803,890
28	Temporarily restricted net assets .....			111,228	28	24,865
29	Permanently restricted net assets .....			0	29	0
	Organizations that do not follow SFAS 117, check here 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 .....			80,594,754	33	85,828,755
34	Total liabilities and net assets/fund balances .....			127,643,666	34	153,549,191