TY 2013 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) SUSAN FRITZ........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(2) DAVID WHITTY DC........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(3) PAUL THULI........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(4) DAVID KURIHARA........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(5) ERIC STADER MD........................................................................ DIRECTOR	42.00 .......................	X			49,913	0	0
(6) ERIC SLANE MD........................................................................ DIRECTOR	38.00 .......................	X			54,915	0	0
(7) TOM VONDRUM........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(8) KELLEY ADAM........................................................................ DIRECTOR	.50 .......................	X			0	0	0
(9) STEVE SCHNEIDER........................................................................ CHAIR	1.00 .......................	X	X		0	0	0
(10) TERRI ABING........................................................................ VICE-CHAIR	1.00 .......................	X	X		0	0	0
(11) EDMUND TED SCHACHT III........................................................................ SECRETARY	1.00 .......................	X	X		0	0	0
(12) NICOLE CLAPP CONTRACTED EE........................................................................ CEO	47.00 .......................		X		0	209,251	0
(13) JENNIFER RUTKOWSKI........................................................................ VP OF PROFESSIONAL SERVICES	40.00 .......................		X		120,159	0	19,451
(14) DAWN BANDY........................................................................ CFO (EFFECTIVE 2/2013)	45.00 .......................		X		84,786	0	12,828
(15) DAVID BRITTON CONTRACTED EE........................................................................ INTERIM CFO (THROUGH 1/2013)	45.00 .......................		X		5,100	0	0
(16) ELIZABETH HINKLEY........................................................................ NURSE PRACTITIONER	40.00 .......................			X	137,961	0	13,927
(17) ROBERT SMITH MD........................................................................ PHYSICIAN	41.00 .......................			X	337,440	0	26,587

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
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	237,224		237,224
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	8,739,806	7,011,324	1,728,482
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	353,221	283,364	69,857
9	Other employee benefits .......	1,475,064	1,183,339	291,725
10	Payroll taxes ...........	600,692	470,851	129,841
11	Fees for services (non-employees):
a	Management ......	214,351		214,351
b	Legal .........	144,666		144,666
c	Accounting ...........	59,199		59,199
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	83,776		83,776
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	2,671,239	2,045,276	625,963
12	Advertising and promotion ....	115,064		115,064
13	Office expenses .......	1,103,591	756,370	347,221
14	Information technology ......	188,995	188,995
15	Royalties ..
16	Occupancy ...........	530,117	521,393	8,724
17	Travel ............	96,015	40,317	55,698
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	1,175,884	1,175,884
23	Insurance ..............	94,477		94,477
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	1,559,377	1,559,377
b	PROVISION FOR BAD DEBTS	771,710	771,710
c	REPAIRS & MAINTENANCE	384,199	383,397	802
d	STATE HOSPITAL ASSESSME	90,044	90,044
e	All other expenses	58,888	48,542	10,346
25	Total functional expenses. Add lines 1 through 24e	20,747,599	16,530,183	4,217,416	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 Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	1,320,242	1	2,554,047
2	Savings and temporary cash investments .........	500,141	2	943,968
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	3,044,464	4	2,832,588
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	462,810	8	481,119
9	Prepaid expenses and deferred charges ..........	153,410	9	260,918
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	23,650,385
b	Less: accumulated depreciation .....	10b	12,425,151	11,476,949	10c	11,225,234
11	Investments—publicly traded securities ..........	12,863,173	11	14,765,745
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	2,184,238	15	2,512,967
16	Total assets. Add lines 1 through 15 (must equal line 34)......	32,005,427	16	35,576,586
	17	Accounts payable and accrued expenses .........	1,785,730	17	2,130,883
18	Grants payable .................		18
19	Deferred revenue ................		19	223,878
20	Tax-exempt bond liabilities .............	7,110,774	20	6,887,359
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	654,849	23	775,884
24	Unsecured notes and loans payable to unrelated third parties ....		24
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....................	854,974	25	980,000
26	Total liabilities. Add lines 17 through 25.........	10,406,327	26	10,998,004
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	20,897,065	27	23,541,242
28	Temporarily restricted net assets ...........	702,035	28	1,037,340
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	21,599,100	33	24,578,582
34	Total liabilities and net assets/fund balances ........	32,005,427	34	35,576,586

- 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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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 described in 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. See section 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 - Non-functionally integrated

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. If the organization did not check a 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—2013. 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—2012. 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) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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.)..

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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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 for 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 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization GRANT REGIONAL HEALTH CENTER INC

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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization GRANT REGIONAL HEALTH CENTER INC

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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

4,433

Total. Add lines 1c through 1i ...............................

4,433

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	GRANT REGIONAL HEALTH CENTER, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE AHA AND WHA HAVE NOTIFIED GRANT REGIONAL THAT APPROXIMATELY $1,735 OF THE ANNUAL DUES PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. GRANT REGIONAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, GRANT REGIONAL PAYS MEMBERSHIP FEES TO THE RWHC AND IN RETURN, THE RWHC PROVIDES VARIOUS SERVICES FOR ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE: PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES AN ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. THESE EFFORTS ALSO INCLUDE LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT APPROXIMATELY $2,698 OF THE FEES PAID BY GRANT REGIONAL DURING 2013 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN.

Return Reference

Explanation

PART II-B, LINE 1:

GRANT REGIONAL HEALTH CENTER, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE AHA AND WHA HAVE NOTIFIED GRANT REGIONAL THAT APPROXIMATELY $1,735 OF THE ANNUAL DUES PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. GRANT REGIONAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, GRANT REGIONAL PAYS MEMBERSHIP FEES TO THE RWHC AND IN RETURN, THE RWHC PROVIDES VARIOUS SERVICES FOR ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE: PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES AN ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. THESE EFFORTS ALSO INCLUDE LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT APPROXIMATELY $2,698 OF THE FEES PAID BY GRANT REGIONAL DURING 2013 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN.

Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (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 current year end balance (line 1g, column (a)) 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 XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	506,717		506,717
b	Buildings ................	15,267,384	6,941,801	8,325,583
c	Leasehold improvements ............
d	Equipment ................	7,490,400	5,361,221	2,129,179
e	Other .................	385,884	122,129	263,755
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				11,225,234

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) INTEREST IN NET ASSETS OF FOUNDATION				1,037,340
(2) DEFERRED BOND ISSUANCE COSTS				123,255
(3) RECEIVABLE FROM FOUNDATION				1,352,372






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,512,967

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
AMOUNTS PAYABLE TO THIRD PARTY REIMBURSEMENT PROGRAMS		980,000








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		980,000
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	21,404,545
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	157,763
e	Add lines 2a through 2d .....................			2e	157,763
3	Subtract line 2e from line 1.....................			3	21,246,782
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	83,776
b	Other (Describe in Part XIII.) ...........	4b	771,710
c	Add lines 4a and 4b.......................			4c	855,486
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	22,102,268

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	20,049,876
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 XIII.) ............	2d	157,763
e	Add lines 2a through 2d......................			2e	157,763
3	Subtract line 2e from line 1.....................			3	19,892,113
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	83,776
b	Other (Describe in Part XIII.) ............	4b	771,710
c	Add lines 4a and 4b.......................			4c	855,486
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	20,747,599

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE ORGANIZATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). UBI IS NOT SIGNIFICANT. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2013 OR 2012. FEDERAL TAX RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES NET AGAINST RENTAL INCOME 157,763.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE NET AGAINST REVENUE 771,710.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES NET AGAINST RENTAL INCOME 157,763.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE NET AGAINST REVENUE 771,710.

Schedule D (Form 990) 2013

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.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

Part I

Financial Assistance 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) as a factor in determining 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 %

Did the organization use FPG as a factor in determining 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 used factors other than FPG in determining 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, as a factor in determining 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

Financial Assistance and Means-Tested Government Programs		(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) ..	58,152		58,152	0.290 %
b	Medicaid (from Worksheet 3, column a) ....	2,246,381	1,844,304	402,077	2.010 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	2,304,533	1,844,304	460,229	2.300 %
Other Benefits		103,590	23,353	80,237	0.400 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	103,590	23,353	80,237	0.400 %
f	Health professions education (from Worksheet 5) ..	150,595		150,595	0.750 %
g	Subsidized health services (from Worksheet 6) ..	2,141,871	1,783,812	358,059	1.790 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	18,655		18,655	0.090 %
j	Total. Other Benefits ..	2,414,711	1,807,165	607,546	3.030 %
k	Total. Add lines 7d and 7j .	4,719,244	3,651,469	1,067,775	5.330 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	11,410		11,410	0.060 %
3	Community support	32,170		32,170	0.160 %
4	Environmental improvements	750		750	0 %
5	Leadership development and training for community members	21,400		21,400	0.110 %
6	Coalition building	1,635		1,635	0.010 %
7	Community health improvement advocacy	46,785		46,785	0.230 %
8	Workforce development	84,000		84,000	0.420 %
9	Other	138,279	86,448	51,831	0.260 %
10	Total	336,429	86,448	249,981	1.250 %

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

403,754

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

201,877

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

7,129,244

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

7,144,375

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

-15,131

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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	GRANT REGIONAL HEALTH CENTER INC 507 SOUTH MONROE STREET LANCASTER,WI53813	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	GRANT REGIONAL HEALTH CENTER INC
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTP://WWW.GRANTREGIONAL.COM/PDFS/CHNAREP

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	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?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’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 Section C)
17	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 individual’s eligibility under the facility’s FAP?..........	17	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 Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENGAGED DIFFERENT SECTORS OF THE COMMUNITY AT VARIOUS LEVELS OF PARTICIPATION. COMMUNITY PARTICIPANTS WERE DEFINED AS KEY PARTNERS, STAKEHOLDERS, OR GENERAL COMMUNITY. DEFINITIONS AND PARTICIPATION LEVELS ARE DESCRIBED AS FOLLOWS:1. KEY PARTNERS - HOSPITALS, PUBLIC HEALTH, AND UW-EXTENSION: THIS GROUP MET REGULARLY TO CONDUCT THE CHNA. TASKS REQUIRED OF THIS GROUP INCLUDED IDENTIFYING PROCESSES, CREATING SURVEYS, IDENTIFYING TARGET AUDIENCES FOR PARTICIPATION IN THE SURVEYS, ASSEMBLING AND REVIEWING RESULTS OF DATA, IDENTIFYING COMMUNITIES FOR FOCUS GROUPS, AND CONDUCTING FOCUS GROUPS. 2. STAKEHOLDERS: INDIVIDUALS WITH A VESTED INTEREST IN THE COMMUNITY, AND INDIVIDUALS WHO REPRESENT A LARGER DEMOGRAPHIC (I.E.: SOCIAL WORKERS, FREE CLINIC WORKERS, SCHOOL PRINCIPALS, GOVERNMENT OFFICIALS). PARTICIPANTS WERE ASKED TO IDENTIFY THE SECTOR OR SECTORS OF THE POPULATION THEY REPRESENTED, INCLUDING: BUSINESS, HEALTH CARE, FAITH-BASED, EDUCATION, YOUTH-SERVING, AGRICULTURE, GOVERNMENT, AGING, DISABILITIES, LOW INCOME, MINORITY, EDUCATION, OR OTHER. 3. GENERAL COMMUNITY: INDIVIDUALS AND COMMUNITY MEMBERS REPRESENTING THEIR OWN INTERESTS WERE REACHED IN TWO WAYS: A GENERAL SURVEY COMPLETED AT PUBLIC EVENTS (COUNTY FAIRS, LOCAL FESTIVALS) AND FOCUS GROUPS. COMMUNITY MEMBERS COMPLETING THE WRITTEN SURVEY IDENTIFIED THEMSELVES BY AGE AND NUMBER OF CHILDREN IN THE HOUSEHOLD. FOCUS GROUP PARTICIPANTS WERE IDENTIFIED BY GENDER.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 4: THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. PRAIRIE DU CHIEN MEMORIAL HOSPITAL2. SOUTHWEST HEALTH CENTER, INC. 3. BOSCOBEL AREA HEALTH CARE
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 7: WHILE GRANT REGIONAL HEALTH CENTER, INC. IS COMMITTED TO ADDRESSING MANY OF THE UNMET COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA, SOME AREAS UNFORTUNATELY WILL NOT BE ADDRESSED. THOSE AREAS INCLUDE: DRUG/ALCOHOL INTERVENTION, LACK OF ACCESS TO DENTAL PROVIDERS, CANCER CARE, AND MENTAL HEALTH SERVICES. GRANT REGIONAL SIMPLY DOES NOT HAVE THE PROGRAMS OR RESOURCES TO IMPACT THESE AREAS EFFECTIVELY. GIVEN THE FACT THAT THESE AREAS RANKED HIGH IN THE CHNA, GRANT REGIONAL RECOGNIZES THE NEED TO CONTINUE TO LOOK FOR WAYS TO COLLABORATE OR INITIATE PROGRAMS AND SERVICES TO THE BEST OF ITS ABILITY. A FEW RECENT STRIDES TOWARD EFFECTIVELY ADDRESSING THESE NEEDS INCLUDE:1. GRANT REGIONAL NOW OFFERS RADIATION ONCOLOGY SERVICES THROUGH OUTREACH SPECIALISTS FROM DUBUQUE. THIS IS AN ATTEMPT TO PROVIDE MORE LOCAL ACCESS TO CANCER CARE.2. GRANT REGIONAL OFFERS A CANCER SUPPORT GROUP WITH MONTHLY SPEAKERS TO EDUCATE AND PROVIDE SUPPORT FOR AREA FAMILIES AFFECTED BY CANCER. 3. WHILE GRANT REGIONAL DOES NOT OFFER ANY SUBSTANCE ABUSE SERVICES, THE HOSPITAL IS A STRONG COMMUNITY PARTNER IN COORDINATING AND PROMOTING AWARENESS OF THE ANNUAL PLUNGE - UNDERAGE DRINKING PREVENTION CAMPAIGN. ADDITIONALLY, THERE ARE STATE AND NATIONAL PROGRAMS THAT HAVE DEDICATED RESOURCES FOR SMOKING CESSATION AND ALCOHOL ABUSE.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 14G: FOR ADDITIONAL INFORMATION, SEE EXPLANATION FOR SCHEDULE H, PART VI, LINE 3.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 16E: THE BILLING, COLLECTION, AND CHARITY/COMMUNITY CARE POLICIES AND PRACTICES OF GRANT REGIONAL HEALTH CENTER, INC. PROVIDE THAT REPRESENTATIVES OF THE ORGANIZATION MAY ONLY ENGAGE IN REPORTING OF ACCOUNTS TO A CREDIT OR COLLECTION AGENCY, LAWSUITS (I.E. SMALL CLAIMS COURT), OR LIENS ON RESIDENCES FOR PAST DUE PATIENT ACCOUNT BALANCES, IF A PATIENT IS UNRESPONSIVE TO A SERIES OF PATIENT STATEMENTS WHICH ARE SENT ON A MONTHLY CYCLE TO THE PATIENT AT THE ADDRESS THAT WAS PROVIDED UPON REGISTRATION FOR SERVICES AT GRANT REGIONAL HEALTH CENTER. THE STATEMENT SERIES WHICH PATIENTS RECEIVE MONTHLY IS SET UP SO INDIVIDUALS ARE NOTIFIED BY NOTICE ON THE STATEMENT THAT GRANT REGIONAL HEALTH CENTER, INC. DOES HAVE A CHARITY CARE PROGRAM IN PLACE THAT MAY BE AVAILABLE FOR ASSISTANCE TO THE PATIENTS IN ADVANCE OF THESE STATED COLLECTION PRACTICES. AS INDICATED IN THE RESPONSE TO SCHEDULE H, PART V, LINE 17, GRANT REGIONAL HEALTH CENTER MAKES EVERY EFFORT TO NOTIFY PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS IN PLACE PRIOR TO TAKING COLLECTION ACTIONS AGAINST THE PATIENTS. PATIENTS WHICH ARE UNRESPONSIVE TO STATEMENTS OR NOTICES FROM THE ORGANIZATION MAY STILL BE ELIGIBLE FOR AN ADMINISTRATIVE WRITE-OFF OF THEIR BALANCE DUE BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 17E: GRANT REGIONAL HEALTH CENTER, INC. OR ITS APPOINTED REPRESENTATIVES MAY ONLY ENGAGE IN REPORTING OF ACCOUNTS TO A CREDIT OR COLLECTION AGENCY, LAWSUITS (I.E. SMALL CLAIMS COURT), OR LIENS ON RESIDENCES FOR PAST DUE PATIENT ACCOUNT BALANCES, IF A PATIENT IS UNRESPONSIVE TO A SERIES OF PATIENT STATEMENTS WHICH ARE SENT ON A MONTHLY CYCLE TO THE PATIENT AT THE ADDRESS THAT WAS PROVIDED UPON REGISTRATION FOR SERVICES AT GRANT REGIONAL HEALTH CENTER, INC. THE STATEMENT SERIES WHICH PATIENTS RECEIVE MONTHLY IS SET UP SO INDIVIDUALS ARE NOTIFIED BY NOTICE ON THE STATEMENT THAT GRANT REGIONAL HEALTH CENTER DOES HAVE A CHARITY CARE PROGRAM IN PLACE THAT MAY BE AVAILABLE FOR ASSISTANCE TO THE PATIENTS IN ADVANCE OF THESE STATED COLLECTION PRACTICES. AS INDICATED IN THE RESPONSE TO SCHEDULE H, PART V, LINE 16, GRANT REGIONAL HEALTH CENTER MAKES EVERY EFFORT TO NOTIFY PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS IN PLACE PRIOR TO TAKING COLLECTION ACTIONS AGAINST THE PATIENTS. PATIENTS WHICH ARE UNRESPONSIVE TO STATEMENTS OR NOTICES FROM THE ORGANIZATION MAY STILL BE ELIGIBLE FOR AN ADMINISTRATIVE WRITE-OFF OF THEIR BALANCE DUE BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 20D: THE HOSPITAL FOLLOWS ITS NORMAL PROCEDURES FOR COLLECTION OF THESE ACCOUNTS, INCLUDING DISCOUNTS BASED ON INCOME/ASSET LEVELS, PROMPT PAYMENT, OR MEDICAL INDIGENCE. A PROMPT PAY DISCOUNT IS OFFERED ON ALL ACCOUNTS, HOWEVER, MANAGEMENT MAY ALSO GRANT AN ADMINISTRATIVE DISCOUNT BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENGAGED DIFFERENT SECTORS OF THE COMMUNITY AT VARIOUS LEVELS OF PARTICIPATION. COMMUNITY PARTICIPANTS WERE DEFINED AS KEY PARTNERS, STAKEHOLDERS, OR GENERAL COMMUNITY. DEFINITIONS AND PARTICIPATION LEVELS ARE DESCRIBED AS FOLLOWS:1. KEY PARTNERS - HOSPITALS, PUBLIC HEALTH, AND UW-EXTENSION: THIS GROUP MET REGULARLY TO CONDUCT THE CHNA. TASKS REQUIRED OF THIS GROUP INCLUDED IDENTIFYING PROCESSES, CREATING SURVEYS, IDENTIFYING TARGET AUDIENCES FOR PARTICIPATION IN THE SURVEYS, ASSEMBLING AND REVIEWING RESULTS OF DATA, IDENTIFYING COMMUNITIES FOR FOCUS GROUPS, AND CONDUCTING FOCUS GROUPS. 2. STAKEHOLDERS: INDIVIDUALS WITH A VESTED INTEREST IN THE COMMUNITY, AND INDIVIDUALS WHO REPRESENT A LARGER DEMOGRAPHIC (I.E.: SOCIAL WORKERS, FREE CLINIC WORKERS, SCHOOL PRINCIPALS, GOVERNMENT OFFICIALS). PARTICIPANTS WERE ASKED TO IDENTIFY THE SECTOR OR SECTORS OF THE POPULATION THEY REPRESENTED, INCLUDING: BUSINESS, HEALTH CARE, FAITH-BASED, EDUCATION, YOUTH-SERVING, AGRICULTURE, GOVERNMENT, AGING, DISABILITIES, LOW INCOME, MINORITY, EDUCATION, OR OTHER. 3. GENERAL COMMUNITY: INDIVIDUALS AND COMMUNITY MEMBERS REPRESENTING THEIR OWN INTERESTS WERE REACHED IN TWO WAYS: A GENERAL SURVEY COMPLETED AT PUBLIC EVENTS (COUNTY FAIRS, LOCAL FESTIVALS) AND FOCUS GROUPS. COMMUNITY MEMBERS COMPLETING THE WRITTEN SURVEY IDENTIFIED THEMSELVES BY AGE AND NUMBER OF CHILDREN IN THE HOUSEHOLD. FOCUS GROUP PARTICIPANTS WERE IDENTIFIED BY GENDER.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 4: THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. PRAIRIE DU CHIEN MEMORIAL HOSPITAL2. SOUTHWEST HEALTH CENTER, INC. 3. BOSCOBEL AREA HEALTH CARE
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 7: WHILE GRANT REGIONAL HEALTH CENTER, INC. IS COMMITTED TO ADDRESSING MANY OF THE UNMET COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA, SOME AREAS UNFORTUNATELY WILL NOT BE ADDRESSED. THOSE AREAS INCLUDE: DRUG/ALCOHOL INTERVENTION, LACK OF ACCESS TO DENTAL PROVIDERS, CANCER CARE, AND MENTAL HEALTH SERVICES. GRANT REGIONAL SIMPLY DOES NOT HAVE THE PROGRAMS OR RESOURCES TO IMPACT THESE AREAS EFFECTIVELY. GIVEN THE FACT THAT THESE AREAS RANKED HIGH IN THE CHNA, GRANT REGIONAL RECOGNIZES THE NEED TO CONTINUE TO LOOK FOR WAYS TO COLLABORATE OR INITIATE PROGRAMS AND SERVICES TO THE BEST OF ITS ABILITY. A FEW RECENT STRIDES TOWARD EFFECTIVELY ADDRESSING THESE NEEDS INCLUDE:1. GRANT REGIONAL NOW OFFERS RADIATION ONCOLOGY SERVICES THROUGH OUTREACH SPECIALISTS FROM DUBUQUE. THIS IS AN ATTEMPT TO PROVIDE MORE LOCAL ACCESS TO CANCER CARE.2. GRANT REGIONAL OFFERS A CANCER SUPPORT GROUP WITH MONTHLY SPEAKERS TO EDUCATE AND PROVIDE SUPPORT FOR AREA FAMILIES AFFECTED BY CANCER. 3. WHILE GRANT REGIONAL DOES NOT OFFER ANY SUBSTANCE ABUSE SERVICES, THE HOSPITAL IS A STRONG COMMUNITY PARTNER IN COORDINATING AND PROMOTING AWARENESS OF THE ANNUAL PLUNGE - UNDERAGE DRINKING PREVENTION CAMPAIGN. ADDITIONALLY, THERE ARE STATE AND NATIONAL PROGRAMS THAT HAVE DEDICATED RESOURCES FOR SMOKING CESSATION AND ALCOHOL ABUSE.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 14G: FOR ADDITIONAL INFORMATION, SEE EXPLANATION FOR SCHEDULE H, PART VI, LINE 3.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 16E: THE BILLING, COLLECTION, AND CHARITY/COMMUNITY CARE POLICIES AND PRACTICES OF GRANT REGIONAL HEALTH CENTER, INC. PROVIDE THAT REPRESENTATIVES OF THE ORGANIZATION MAY ONLY ENGAGE IN REPORTING OF ACCOUNTS TO A CREDIT OR COLLECTION AGENCY, LAWSUITS (I.E. SMALL CLAIMS COURT), OR LIENS ON RESIDENCES FOR PAST DUE PATIENT ACCOUNT BALANCES, IF A PATIENT IS UNRESPONSIVE TO A SERIES OF PATIENT STATEMENTS WHICH ARE SENT ON A MONTHLY CYCLE TO THE PATIENT AT THE ADDRESS THAT WAS PROVIDED UPON REGISTRATION FOR SERVICES AT GRANT REGIONAL HEALTH CENTER. THE STATEMENT SERIES WHICH PATIENTS RECEIVE MONTHLY IS SET UP SO INDIVIDUALS ARE NOTIFIED BY NOTICE ON THE STATEMENT THAT GRANT REGIONAL HEALTH CENTER, INC. DOES HAVE A CHARITY CARE PROGRAM IN PLACE THAT MAY BE AVAILABLE FOR ASSISTANCE TO THE PATIENTS IN ADVANCE OF THESE STATED COLLECTION PRACTICES. AS INDICATED IN THE RESPONSE TO SCHEDULE H, PART V, LINE 17, GRANT REGIONAL HEALTH CENTER MAKES EVERY EFFORT TO NOTIFY PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS IN PLACE PRIOR TO TAKING COLLECTION ACTIONS AGAINST THE PATIENTS. PATIENTS WHICH ARE UNRESPONSIVE TO STATEMENTS OR NOTICES FROM THE ORGANIZATION MAY STILL BE ELIGIBLE FOR AN ADMINISTRATIVE WRITE-OFF OF THEIR BALANCE DUE BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 17E: GRANT REGIONAL HEALTH CENTER, INC. OR ITS APPOINTED REPRESENTATIVES MAY ONLY ENGAGE IN REPORTING OF ACCOUNTS TO A CREDIT OR COLLECTION AGENCY, LAWSUITS (I.E. SMALL CLAIMS COURT), OR LIENS ON RESIDENCES FOR PAST DUE PATIENT ACCOUNT BALANCES, IF A PATIENT IS UNRESPONSIVE TO A SERIES OF PATIENT STATEMENTS WHICH ARE SENT ON A MONTHLY CYCLE TO THE PATIENT AT THE ADDRESS THAT WAS PROVIDED UPON REGISTRATION FOR SERVICES AT GRANT REGIONAL HEALTH CENTER, INC. THE STATEMENT SERIES WHICH PATIENTS RECEIVE MONTHLY IS SET UP SO INDIVIDUALS ARE NOTIFIED BY NOTICE ON THE STATEMENT THAT GRANT REGIONAL HEALTH CENTER DOES HAVE A CHARITY CARE PROGRAM IN PLACE THAT MAY BE AVAILABLE FOR ASSISTANCE TO THE PATIENTS IN ADVANCE OF THESE STATED COLLECTION PRACTICES. AS INDICATED IN THE RESPONSE TO SCHEDULE H, PART V, LINE 16, GRANT REGIONAL HEALTH CENTER MAKES EVERY EFFORT TO NOTIFY PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS IN PLACE PRIOR TO TAKING COLLECTION ACTIONS AGAINST THE PATIENTS. PATIENTS WHICH ARE UNRESPONSIVE TO STATEMENTS OR NOTICES FROM THE ORGANIZATION MAY STILL BE ELIGIBLE FOR AN ADMINISTRATIVE WRITE-OFF OF THEIR BALANCE DUE BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.
GRANT REGIONAL HEALTH CENTER, INC.	PART V, SECTION B, LINE 20D: THE HOSPITAL FOLLOWS ITS NORMAL PROCEDURES FOR COLLECTION OF THESE ACCOUNTS, INCLUDING DISCOUNTS BASED ON INCOME/ASSET LEVELS, PROMPT PAYMENT, OR MEDICAL INDIGENCE. A PROMPT PAY DISCOUNT IS OFFERED ON ALL ACCOUNTS, HOWEVER, MANAGEMENT MAY ALSO GRANT AN ADMINISTRATIVE DISCOUNT BASED ON UNIQUE CIRCUMSTANCES OF THE PATIENT AND THEIR FAMILY.

Schedule H (Form 990) 2013

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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 of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

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 (E) amounts for that individual.

(A) Name and Title		(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 and Title		(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)NICOLE CLAPP CONTRACTED EECEO	(i) (ii)	0 209,251	0 0	0 0	0 0	0 0	0 209,251	0 0
(2)ELIZABETH HINKLEYNURSE PRACTITIONER	(i) (ii)	137,961 0	0 0	0 0	7,691 0	6,236 0	151,888 0	0 0
(3)ROBERT SMITH MDPHYSICIAN	(i) (ii)	337,440 0	0 0	0 0	14,025 0	12,562 0	364,027 0	0 0
(4)DAVID BAINBRIDGECRNA	(i) (ii)	257,846 0	0 0	0 0	14,025 0	12,562 0	284,433 0	0 0
(5)MICHELLE BAINBRIDGECRNA	(i) (ii)	257,852 0	0 0	0 0	14,025 0	6,236 0	278,113 0	0 0
(6)KRYNN BUCKLEY-PECHOUSGYNECOLOGIST	(i) (ii)	264,735 0	0 0	0 0	0 0	5,147 0	269,882 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART II:

HEALTHTECH MANAGEMENT SERVICES, INC. IS AN UNRELATED ORGANIZATION WHICH COMPENSATES THE CEO, NICOLE CLAPP, ON BEHALF OF GRANT REGIONAL HEALTH CENTER, INC. SEE INFORMATION ON SCHEDULE O FOR ADDITIONAL INFORMATION RELATED TO THE MANAGEMENT SERVICES AGREEMENT WITH HEALTHTECH MANAGEMENT SERVICES BY GRANT REGIONAL HEALTH CENTER, INC. AMOUNTS REPORTED IN SCHEDULE J OF FORM 990 REPRESENT THE CONTRACTED SERVICES AMOUNT PAID TO HEALTHTECH MANAGEMENT SERVICES FOR CEO SERVICES.

Schedule J (Form 990) 2013

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.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
GRANT REGIONAL HEALTH CENTER INC

Employer identification number
39-1834962

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	CITY OF LANCASTER WISCONSIN	39-6005501		12-20-2007	8,000,000	HOSPITAL RENOVATION AND EXPANSION PROJECTS FOR OBSTETRICS AND REHAB		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	1,112,641
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	8,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	160,000
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	2,509,459
11 Other spent proceeds . . . . . . . . . . . . . .	5,330,541
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

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

Cat. No. 50193E

Schedule K (Form 990) 2013

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
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
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 . .
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 . . . . . . .	0.010 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0.010 %
7 Does the bond issue meet the private security or payment test? . . . . .		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X
b Exception to rebate? . . . . . . . .		X
c No rebate due? . . . . . . . .		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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?		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2013

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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

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

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

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) HIGH POINT FAMILY MEDICINE LLC	PROFESSIONAL CORPORATION OWNED MORE THAN 5%	31,855	DR. ERIC SLANE AND DR. ERIC STADER, BOARD MEMBERS FOR GRANT REGIONAL HEALTH CENTER, INC., ARE THE OWNERS OF THIS LOCAL FAMILY MEDICINE CLINIC. THE AMOUNT DISCLOSED RELATES TO LEASE PAYMENTS THAT WERE MADE BY THE CLINIC TO GRANT REGIONAL HEALTH CENTER, INC. DURING 2013. THE CLINIC LEASES SPACE IN THE HOSPITAL TO OPERATE ITS CLINIC PRACTICE.		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

Return Reference	Explanation
FORM 990, PART III, LINE 2	DURING 2013, GRANT REGIONAL EXPANDED ITS MEDICAL STAFF TO INCLUDE A NEW GYNECOLOGICAL SURGEON. THIS WILL ALLOW GRANT REGIONAL TO EXPAND SURGICAL SERVICES AND HEALTH/WELLNESS FOR WOMEN, INCLUDING INFERTILITY, URINARY, AND MENSTRUATION CONCERNS. EFFECTIVE OCTOBER 1, 2013, GRANT REGIONAL ASSUMED THE CLINICAL OPERATIONS OF THE GRANT REGIONAL COMMUNITY CLINIC, WHICH WAS PREVIOUSLY OPERATED BY AN UNRELATED ORGANIZATION. THE CLINIC IS LOCATED IN SPACE WITHIN THE HOSPITAL. THE PURCHASE OF THE CLINIC WILL ALLOW GRANT REGIONAL TO ACCEPT ADDITIONAL INSURANCE PROVIDERS AND TO RECRUIT ADDITIONAL PROVIDERS. THIS ENDEAVOR WILL POSITION GRANT REGIONAL AS A LEADER WITHIN THE REGION FOR OFFERING CONVENIENT FAMILY MEDICINE AND WILL KEEP LOCAL PROVIDERS IN THE AREA.
FORM 990, PART VI, SECTION A, LINE 2	DIRECTORS ERIC STADER, MD AND ERIC SLANE, MD ARE BOTH PHYSICIAN PARTNERS OF HIGH POINT FAMILY MEDICINE CLINIC. THE PHYSICIANS OPERATE THE CLINIC TO PROVIDE PRIMARY CARE TO THE RESIDENTS OF LANCASTER, WISCONSIN AND THE SURROUNDING AREA.
FORM 990, PART VI, SECTION A, LINE 7A	THE CITY OF LANCASTER DESIGNATES ONE BOARD MEMBER TO SERVE ON THE GRANT REGIONAL BOARD OF DIRECTORS. UNDER THE TERMS OF THE CORPORATE AND MEDICAL STAFF BYLAWS OF GRANT REGIONAL HEALTH CENTER, INC., THE MEDICAL STAFF ALSO APPOINTS ONE MEMBER OF THE BOARD OF DIRECTORS TO BE THE APPOINTED MEDICAL STAFF REPRESENTATIVE ON THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7B	AS A PART OF THE PRIVATIZATION OF THE HOSPITAL FROM THE CITY OF LANCASTER, THE CITY MAINTAINS CERTAIN RESERVE POWERS OVER GRANT REGIONAL HEALTH CENTER, INC. AS NOTED IN THE GOVERNING BYLAWS, PRIVATIZATION AGREEMENT WITH THE CITY, AND BUILDING LEASE AGREEMENT WITH THE CITY. THE CITY OF LANCASTER MUST APPROVE ANY CHANGES IN THE CHARITIBLE PURPOSES; ANY CHANGE IN THE NUMBER, TENURE, QUALIFICATIONS, OR APPOINTMENT/ELECTION PROCESS FOR MEMBERS OF THE BOARD OF DIRECTORS; AND APPROVAL OF COMPENSATION FOR ITS DIRECTORS AND OFFICERS FOR SERVICES TO THE CORPORATION AS DIRECTORS, OFFICERS, OR OTHERWISE. ANY FACILITY RENOVATIONS OR ISSUANCE OF NEW DEBT IN EXCESS OF $250,000 IS ALSO SUBJECT TO APPROVAL BY THE CITY OF LANCASTER.
FORM 990, PART VI, SECTION B, LINE 11	THE BOARD OF DIRECTORS RECEIVED A COPY OF THE FORM 990 PRIOR TO THE FILING OF THE RETURN WITH THE IRS. THE FORM 990 IS ALSO REVIEWED BY SENIOR MANAGEMENT OF GRANT REGIONAL PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICTS OF INTEREST ARE CONSIDERED TO EXIST IN SITUATIONS WHERE EMPLOYEE'S ACTIONS OR ACTIVITIES INVOLVE: - THE OBTAINING OF AN IMPROPER PERSONAL GAIN OR ADVANTAGE BY REASON OF AN EMPLOYEE'S POSITION WITH GRANT REGIONAL; - AN ADVERSE EFFECT UPON THE INTERESTS OF GRANT REGIONAL HEALTH CENTER, INC.; - THE OBTAINING BY A THIRD PARTY OF AN IMPROPER GAIN, OR OF AN ADVANTAGE TO THE DETRIMENT OF GRANT REGIONAL; OR - THE APPEARANCE OF ANY OF THE ABOVE. ANY RELATED ISSUES TO A CONFLICT OF INTEREST SHALL BE DISCLOSED TO THE APPROPRIATE SUPERVISOR, COMPLIANCE OFFICER, OR HOTLINE. COMPLIANCE WITH THE POLICY IS MONITORED BY HAVING BOARD MEMBERS, OFFICERS, AND EMPLOYEES DISCLOSE ANNUALLY IN A WRITTEN STATEMENT ANY ISSUES THAT MAY GIVE RISE TO A CONFLICT OF INTEREST. IF ANY CONFLICTS ARE KNOWN BY BOARD MEMBERS, THESE BOARD MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON ANY CONFLICTED MATTERS.
FORM 990, PART VI, SECTION B, LINE 15	GRANT REGIONAL HEALTH CENTER USES THE RURAL WISCONSIN HEALTH COOPERATIVE SURVEY TO DETERMINE PROPER COMPENSATION FOR ITS TOP MANAGEMENT PERSONNEL AND TO REVIEW FOR COMPARIBILITY FACTORS. THE RURAL WISCONSIN HEALTH COOPERATIVE SURVEY IS A COMPILATION OF AVERAGE SALARIES AND COMPENSATION AMOUNTS FOR VARIOUS POSITIONS AT ITS MEMBER HOSPITALS WHICH INCLUDE A LARGE NUMBER OF RURAL AND COMMUNITY HOSPITALS LOCATED THROUGHOUT WISCONSIN. GRANT REGIONAL HEALTH CENTER, INC. ALSO PARTICIPATES IN THE ANNUAL WISCONSIN HOSPITAL ASSOCIATION COMPENSATION SURVEY TO ALLOW ACCESS TO SALARY AND BENEFIT COMPARIBILITY DATA EACH YEAR. WHEN GRANT REGIONAL'S BUDGET PROCESS IS BEING REVIEWED EACH YEAR AN AVERAGE WAGE INCREASE IS COMPARED WITH THIS DATA AND PRESENTED TO THE BOARD OF DIRECTORS TO REVIEW BEFORE SETTING TARGET OR BUDGETED PERFORMANCE OR MARKET VALUE ADJUSTED TO COMPENSATION EACH YEAR. GRANT REGIONAL ALSO REVIEWS THIS DATA WHEN IT DETERMINES THAT NEW POSITIONS SHOULD BE ADDED TO BETTER MEET PATIENT SERVICE NEEDS IN THE COMMUNITY.
FORM 990, PART VI, SECTION C, LINE 19	GRANT REGIONAL HEALTH CENTER WILL MAKE A COPY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. SUMMARIZED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC AT ANY TIME FOLLOWING THE SUBMISSION OF THE WISCONSIN HOSPITAL SURVEY TO THE WISCONSIN HOSPITAL ASSOCIATION.
FORM 990, PART IX, LINE 11G	EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 452,674. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 452,674. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 474,576. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 474,576. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 514,664. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 514,664. CLINIC SERVICES: PROGRAM SERVICE EXPENSES 189,908. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,908. LAB SERVICES: PROGRAM SERVICE EXPENSES 166,547. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 166,547. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 246,907. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 246,907. ADMINSTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 625,963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 625,963.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN NET ASSETS OF GRHC FOUNDATION 335,305.
FORM 990, PART XII, LINE 2C	SELECTION OF INDEPENDENT ACCOUNTANT: GRANT REGIONAL HAS A COMMITTEE OF THE BOARD OF DIRECTORS THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE BOARD OF DIRECTORS PROVIDES ITSELF ANNUALLY AN OPPORTUNITY TO MEET WITH THE INDEPENDENT ACCOUNTANTS FOLLOWING THE AUDIT EACH YEAR TO REVIEW THE FINANCIAL STATEMENTS AND ITEMS NOTED DURING THE AUDIT WITHOUT MANAGEMENT PRESENT TO ALLOW EVEN MORE OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. MEMBERS OF THE BOARD OF DIRECTORS ALSO HAVE THE CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANT AND ARE ENCOURAGED TO CONTACT THE ACCOUNTANTS DURING THE YEAR WHEN QUESTIONS ARISE. AN INTERVIEW IS CONDUCTED BY A MEMBER OF THE INDEPENDENT ACCOUNTING FIRM'S STAFF WITH A BOARD MEMBER EACH YEAR AS WELL WITHOUT MANAGEMENT OR OTHER BOARD MEMBERS PRESENT. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR.
FORM 990, PART VI, SECTION 1, LINE 3	DELEGATION OF CONTROL/MANAGEMENT COMPANY EXPLANATION: GRANT REGIONAL HEALTH CENTER, INC.'S BOARD OF DIRECTORS MAINTAINS THE CONTROL OVER KEY DECISIONS OF GRANT REGIONAL INCLUDING REVIEW AND APPROVAL OF THE MONTHLY FINANCIAL STATEMENTS, STRATEGIC PLAN, BUDGETS, AND OTHER KEY OPERATING MEASURES AND GOALS. THE BOARD OF DIRECTORS HAS ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH HEALTHTECH MANAGEMENT SERVICES, INC. (HEALTHTECH), A HOSPITAL MANAGEMENT COMPANY WHICH CONTRACTS WITH HOSPITALS THROUGHOUT THE UNITED STATES TO PROVIDE MANAGEMENT SERVICES ON EITHER A LONG-TERM OR SHORT-TERM BASIS. UNDER THIS AGREEMENT, HEALTHTECH PROVIDES GENERAL ADMINISTRATIVE, CONSULTING, AND GROUP PURCHASING SERVICES TO GRANT REGIONAL HEALTH CENTER. UNDER THE MANAGEMENT AGREEMENT, HEALTHTECH IS ALSO RESPONSIBLE FOR THE SELECTION AND REVIEW OF THE ADMINISTRATOR OF GRANT REGIONAL HEALTH CENTER. THE ADMINISTRATOR OF GRANT REGIONAL HEALTH CENTER IS AN EMPLOYEE OF HEALTHTECH UNDER THE TERMS OF THE MANAGEMENT AGREEMENT.
FORM 990, PART VII, SECTION A, RELATED PARTY OFFICERS / OFFICERS' HOURS:	TWO OF THE DIRECTORS OF GRANT REGIONAL HEALTH CENTER, INC. PROVIDE EMERGENCY ROOM PHYSICIAN COVERAGE FOR GRANT REGIONAL IN ADDITION TO THE HOURS WORKED AS A DIRECTOR. THE HOURS LISTED FOR THESE TWO PHYSICIANS IN PART VII OF THE FORM 990 ALSO INCLUDES AN AVERAGE OF 0.50 HOURS PER WEEK FOR SERVICE ON GRANT REGIONAL'S BOARD OF DIRECTORS AS WELL AS TIME SPENT BOTH DIRECTLY PROVIDING PHYSICIAN SERVICES IN THE EMERGENCY ROOM AS WELL AS BEING AVAILABLE FOR ON-CALL AND SUPPORT SERVICES TO MID-LEVEL PRACTITIONERS WHEN PERFORMING SERVICES IN THE EMERGENCY DEPARTMENT SETTING.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

GRANT REGIONAL HEALTH CENTER INC

Employer identification number

39-1834962

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) GRANT REGIONAL HEALTH CENTER FOUNDATION INC 507 SOUTH MONROE STREET LANCASTER,WI53813 39-1834961	FUND RAISING	WI	501 (C) 3	11 TYPE III	N/A		No
(2) GRANT REGIONAL HEALTH CENTER AUXILIARY 507 SOUTH MONROE STREET LANCASTER,WI53813 75-3031038	VOLUNTEERS	WI	501 (C) 3	9	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE COMPREHENSIVE HOSPITAL AND CLINICAL SERVICES TO RESIDENTS OF SOUTHWEST WISCONSIN REGARDLESS OF A PATIENT'S ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	231
6	Total number of volunteers (estimate if necessary) .............	6	112
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	150,873
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-11,648

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	114,367	217,420
9	Program service revenue (Part VIII, line 2g) .........	20,389,789	20,957,087
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	467,987	789,286
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	210,235	138,475
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	21,182,378	22,102,268
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	10,638,264	11,406,007
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–24e)....	8,076,402	9,341,592
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	18,714,666	20,747,599
19	Revenue less expenses. Subtract line 18 from line 12.......	2,467,712	1,354,669
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	32,005,427	35,576,586
21	Total liabilities (Part X, line 26).............	10,406,327	10,998,004
22	Net assets or fund balances. Subtract line 21 from line 20.....	21,599,100	24,578,582

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 16,530,183 including grants of $ ) (Revenue $ 20,550,979 )
	GRANT REGIONAL HEALTH CENTER, INC. ("GRANT REGIONAL") PROVIDES HEALTH CARE SERVICES AND OTHER SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. GRANT REGIONAL OPERATES A CRITICAL ACCESS HOSPITAL WHICH PROVIDES INPATIENT ACUTE CARE AND SWING BED SERVICES; ALONG WITH AN EMERGENCY DEPARTMENT, WHICH IS OPEN TWENTY-FOUR HOURS PER DAY; AND OTHER OUTPATIENT SERVICES. AMONG THE SERVICES PROVIDED ARE DIAGNOSTIC CARE INCLUDING LABORATORY AND RADIOLOGY SERVICES, OBSTETRICS, REHABILITATION, SURGICAL SERVICES, AND WALK-IN CARE. GRANT REGIONAL ALSO HAS RELATIONSHIPS WITH REGIONAL CENTERS IN MADISON, WISCONSIN AND DUBUQUE, IOWA WHO COME TO THE FACILITY ON A REGULAR BASIS TO PROVIDE SPECIALTY SERVICES. SPECIALTY SERVICES PROVIDED INCLUDE, BUT ARE NOT LIMITED TO: AUDIOLOGY, CARDIOLOGY, DERMATOLOGY, OB/GYN SURGERY, GYNECOLOGY, OPHTHALMOLOGY, ORTHOPEDICS, PULMONOLOGY, AND UROLOGY. IN ADDITION TO THESE SERVICES, DURING 2013, GRANT REGIONAL HEALTH CENTER ASSUMED THE OPERATIONS OF THE GRANT REGIONAL COMMUNITY CLINIC AND BEGAN PROVIDING ADDITIONAL CLINICAL SERVICES. DURING 2013, GRANT REGIONAL HAD 1,315 ROUTINE MED/SURG PATIENT DAYS, 412 SWING BED DAYS, 299 NURSERY DAYS, 350 OBSTETRIC DAYS, AND 20 DAYS OF ROUTINE HOSPICE CARE FOR INPATIENT CARE AND PROVIDED 6,122 VISITS TO PATIENTS NEEDING EMERGENCY OR URGENT CARE IN THE EMERGENCY DEPARTMENT. CONSISTENT WITH THE MISSION OF GRANT REGIONAL, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE EITHER UNDERINSURED OR CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID HOSPITAL SERVICES, ARE ALSO CONSIDERED PART OF GRANT REGIONAL'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE.PATIENTS WHO MEET CERTAIN CRITERIA FOR CHARITY CARE, BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE AT A SIGNIFICANTLY REDUCED RATE, DETERMINATED BASED ON QUALIFYING CRITERIA AS DEFINED IN GRANT REGIONAL'S COMMUNITY CARE POLICY, AND FROM APPLICATIONS COMPLETED BY PATIENTS. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THIS POLICY FOR 2013 TOTALED APPROXIMATELY $105,000. IN ADDITION, PATIENT CHARGES TO BENEFICIARIES OF THE WISCONSIN MEDICAID PROGRAM WERE REDUCED BY APPROXIMATELY $2,212,000 IN DISCOUNTS IN 2013. (SEE ALSO SCHEDULE H TO THE FORM 990 FOR ADDITIONAL INFORMATION ON THE COST OF PROVIDING THESE MEDICAL SERVICES TO MEMBERS OF THE COMMUNITY.)IN ADDITION TO THE VARIOUS INPATIENT, OUTPATIENT, AND CHARITY CARE SERVICES, GRANT REGIONAL PROVIDED NUMEROUS BENEFITS TO ITS SURROUNDING COMMUNITIES. EDUCATIONAL PROGRAMS SUCH AS BREASTFEEDING, CANCER, DIABETES, HEART DISEASE, AND WOMEN'S HEALTH EDUCATION WERE PROVIDED TO THE COMMUNITY DURING 2013. HEALTH SCREENINGS INCLUDING BLOOD PRESSURE, CHOLESTEROL, DIABETES, HEARING, MAMMOGRAPHY, AND WOMEN'S HEALTH SCREENINGS WERE ALSO PROVIDED. (SEE ALSO SCHEDULE H TO THE FORM 990 FOR INFORMATION ON THE COST OF PROVIDING THESE SERVICES IN THE COMMUNITY AND SURROUNDING AREAS.)GRANT REGIONAL ALSO PROVIDES ON-THE-JOB EDUCATION TO COLLEGE STUDENTS PURSUING CAREERS IN HEALTH CARE. STUDENTS ARE MENTORED DURING THEIR TIME AT THE FACILITY BY EMPLOYEES OF GRANT REGIONAL AND GRANT REGIONAL PROVIDES PRACTICAL EXPERIENCE THROUGH ITS CARE ENVIRONMENT FOR STUDENTS TO USE THROUGHOUT THEIR FUTURE CAREERS IN THE NURSING SERVICES FIELD.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses16,530,183

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,570,707	209,251	124,788

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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
(18) DAVID BAINBRIDGE........................................................................ CRNA	43.00 .......................	X	257,846	0	26,587
(19) MICHELLE BAINBRIDGE........................................................................ CRNA	43.00 .......................	X	257,852	0	20,261
(20) KRYNN BUCKLEY-PECHOUS........................................................................ GYNECOLOGIST	33.00 .......................	X	264,735	0	5,147

(A) Name and business address	(B) Description of services	(C) Compensation
COMPREHENSIVE PHARMACY SERVICES LLCPO BOX 638316CINCINNATIOH45263	PHARMACY COVERAGE	430,883
DR MICHAEL ZEMAN, 1103 FRANKLIN STGALENAIL61036	EMERGENCY ROOM PHYSICIAN	121,670



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 2

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		47,270
e	Government grants (contributions)1e		170,150

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			217,420
			Business Code
2a	NET PATIENT REVENUE		621400	20,216,676	20,175,281	41,395
b	DIETARY		722210	140,707	140,707
c	THERAPEUTIC SERVICE REVENUE		812900	87,418		87,418
d	LIFELINE		621990	49,526	49,526
e	CONTRACT SERVICE REVENUE		621400	22,060		22,060
f	All other program service revenue .			440,700	185,465		255,235
g	Total. Add lines 2a–2f........			20,957,087
3	Investment income (including dividends, interest, and other similar amounts).......			311,913			311,913
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	296,238
b	Less: rental expenses	157,763
c	Rental income or (loss)	138,475
d	Net rental income or (loss).......			138,475			138,475
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	2,370,768	6,013
b	Less: cost or other basis and sales expenses	1,899,408	0
c	Gain or (loss)	471,360	6,013
d	Net gain or (loss)..........			477,373			477,373
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
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..
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			22,102,268	20,550,979	150,873	1,182,996


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			1,320,242	1	2,554,047
2	Savings and temporary cash investments .........			500,141	2	943,968
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			3,044,464	4	2,832,588
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			462,810	8	481,119
9	Prepaid expenses and deferred charges ..........			153,410	9	260,918
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	23,650,385
b	Less: accumulated depreciation .....	10b	12,425,151	11,476,949	10c	11,225,234
11	Investments—publicly traded securities ..........			12,863,173	11	14,765,745
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,184,238	15	2,512,967
16	Total assets. Add lines 1 through 15 (must equal line 34)......			32,005,427	16	35,576,586
17	Accounts payable and accrued expenses .........			1,785,730	17	2,130,883
18	Grants payable .................				18
19	Deferred revenue ................				19	223,878
20	Tax-exempt bond liabilities .............			7,110,774	20	6,887,359
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			654,849	23	775,884
24	Unsecured notes and loans payable to unrelated third parties ....				24
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....................			854,974	25	980,000
26	Total liabilities. Add lines 17 through 25.........			10,406,327	26	10,998,004
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			20,897,065	27	23,541,242
28	Temporarily restricted net assets ...........			702,035	28	1,037,340
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			21,599,100	33	24,578,582
34	Total liabilities and net assets/fund balances ........			32,005,427	34	35,576,586