TY 2024 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/1099-NEC)
(1) JOHN ANNEAR...................................................................... CHAIR	3.00 .................	X	X	0	0
(2) LAURA MELBY...................................................................... DIRECTOR-VICE CHAIR	1.00 .................	X	X	0	0
(3) STEVE BAUER...................................................................... VICE CHAIR- TREASURER	1.00 .................	X	X	0	0
(4) MARILYN RINEHART...................................................................... TREASURER (THRU 4/24)	1.00 .................	X	X	0	0
(5) ED LEINEWEBER...................................................................... DIRECTOR - SECRETARY	1.00 .................	X	X	0	0
(6) ROBERT SMITH MD...................................................................... CHIEF OF STAFF (THRU 12/24)	3.00 .................	X		15,860	634
(7) KAY BALINK MD...................................................................... DIRECTOR (& EMPLOYEE)	26.00 .................	X		120,650	10,514
(8) RYAN BOEBEL...................................................................... DIRECTOR	1.00 .................	X		0	0
(9) TRACI PETERSON...................................................................... DIRECTOR (THRU 4/24)	1.00 ................. 1.00	X		0	0
(10) JOHN POOLE...................................................................... DIRECTOR (THRU 4/24)	1.00 .................	X		0	0
(11) KARN SCHAUF...................................................................... DIRECTOR	1.00 .................	X		0	0
(12) SHELLY SCHMIDT...................................................................... SECRETARY-DIRECTOR	1.00 .................	X		0	0
(13) PETER WALSH...................................................................... DIRECTOR	1.00 .................	X		0	0
(14) BRUCE ROESLER...................................................................... CEO	40.00 .................		X	355,881	41,379
(15) ELIZABETH MOORE...................................................................... CFO (THRU 4/24)	40.00 .................		X	207,043	38,182
(16) JEFF LONGBRAKE...................................................................... INTERIM CFO (BEG. 4/24 - THRU 11/24)	40.00 .................		X	133,065	0
(17) TROY WALKER...................................................................... CFO (BEG. 11/24)	40.00 .................		X	40,907	3,093

(A) Name and business address	(B) Description of services	(C) Compensation
FASTAFF LLC 5700 S QUEBEC STSUITE 300 GREENWOOD VILLAGE,CO80111	CONTRACTED LABOR-NURSING	932,643
RURAL PHYSICIANS GROUP 5575 DTC PKWY/STE 225 GREENWOOD VILLAGE,CO80111	HOSPITALIST PROVIDER	921,812
MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS,MN554850737	CONTRACTED LABOR-NURSING	681,477
PSYCHIATRIC MEDICAL CARE LLC 8 CADILLAC DRIVE/SUITE 230 BRENTWOOD,TN37027	PSYCHIATRIC SERVICES & STAFFING	611,626
ONSTAFF MEDICAL LLC 10802 FARNAM DR OMAHA,NE68154	CONTRACTED LABOR-NURSING	199,550
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 11

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public
Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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 12, 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 (Form 990).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2024

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. 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—2023. 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—2024. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2023. 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 VI 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) 2024

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. 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—2023. 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) 2024

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2024

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2024

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2024

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2024 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Right Arrow

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025) Page 2

Name of organization THE RICHLAND HOSPITAL 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	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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 3

Name of organization THE RICHLAND HOSPITAL INC		Employer identification number 39-0808498

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 4


Name of organization THE RICHLAND HOSPITAL INC			Employer identification number 39-0808498
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c) (7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ 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) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public
Inspection

If the organization answered "Yes" on 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.
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Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
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Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2024

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 right arrow

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 right arrow

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2021	(b) 2022	(c) 2023	(d) 2024	(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) 2024

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 on 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

11,103

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

11,103

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	THE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAD NOTIFIED THE HOSPITAL THAT APPROXIMATELY $2,713 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN SECURING GRANT FUNDING FOR NEW OR EXISTING HEALTHCARE PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON BEHALF OF THE MEMBER ORGANIZATIONS. IT WAS DETERMINED THAT APPROXIMATELY $1,979 OF THE FEES PAID BY THE HOSPITAL IN 2024 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. THE HOSPITAL IS ALSO A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) IN WHICH $6,411 OF THEIR MEMBERSHIP DUES IS DEVOTED TO LOBBYING AND ADVOCATION AT A NATIONAL LEVEL.

Return Reference

Explanation

PART II-B, LINE 1:

THE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAD NOTIFIED THE HOSPITAL THAT APPROXIMATELY $2,713 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN SECURING GRANT FUNDING FOR NEW OR EXISTING HEALTHCARE PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON BEHALF OF THE MEMBER ORGANIZATIONS. IT WAS DETERMINED THAT APPROXIMATELY $1,979 OF THE FEES PAID BY THE HOSPITAL IN 2024 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. THE HOSPITAL IS ALSO A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) IN WHICH $6,411 OF THEIR MEMBERSHIP DUES IS DEVOTED TO LOBBYING AND ADVOCATION AT A NATIONAL LEVEL.

Schedule C (Form 990) 2024

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," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) (Rev. 1-2025)

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	77,645	74,907	75,411	76,264	75,098
b	Contributions ...
c	Net investment earnings, gains, and losses	2,857	2,738	-504	-853	1,166
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	80,502	77,645	74,907	75,411	76,264

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

74.532 %

Term endowment right arrow

25.468 %

The percentages on 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" on 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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	2,521,995		2,521,995
b	Buildings ....	46,451,720	32,793,174	13,658,546
c	Leasehold improvements	609,073	609,073	0
d	Equipment ....	24,464,517	19,899,498	4,565,019
e	Other .....	2,511,981		2,511,981
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				23,257,541

Schedule D (Form 990) (Rev. 1-2025)

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)INVESTMENT IN UNCONSOLIDATED AFFILIATE				268,320
(2)INTEREST IN NET ASSETS OF SUPPORTING ORGANIZATIONS				1,402,039
(3)DEFERRED COMPENSATION PLAN ASSETS				937,752
(4)RIGHT OF USE ASSETS - OPERATING LEASES				3,335,784
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				5,943,895

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DEFERRED COMPENSATION PLAN LIABILITY	937,752








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	937,752
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) (Rev. 1-2025)

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	79,459,862
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	792,884
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	116,103
e	Add lines 2a through 2d .....................			2e	908,987
3	Subtract line 2e from line 1..................			3	78,550,875
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	2,525,596
c	Add lines 4a and 4b....................			4c	2,525,596
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	81,076,471

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	73,907,853
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	29,834
e	Add lines 2a through 2d....................			2e	29,834
3	Subtract line 2e from line 1...................			3	73,878,019
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b	2,464,362
c	Add lines 4a and 4b.....................			4c	2,464,362
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	76,342,381

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 V, LINE 4:	THE ENDOWMENT FUNDS MAINTAINED BY THE RICHLAND HOSPITAL, INC. HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT SCHOLARSHIP PROGRAMS OF THE HOSPITAL.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 29,834. CHANGE IN NET ASSETS OF UNCONSOLIDATED AFFILIATES 86,269.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	OTHER EXPENSES NET AGAINST REVENUE ON FINANCIAL STATEMENTS 212,769. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 2,251,593. INVESTMENT INCOME RECORDED TO UNRESTRICTED NET ASSETS 2,857. CONTRIBUTIONS FROM FOUNDATION 58,377.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 29,834.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	OTHER EXPENSES NET AGAINST REVENUE ON FINANCIAL STATEMENTS 212,769. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 2,251,593.

Schedule D (Form 990) (Rev. 1-2025)

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" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2024

Open to Public Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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 criteria used 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? . . . . . .

Yes

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) . . .	767,688		767,688	1.040 %
b	Medicaid (from Worksheet 3, column a) . . . . .	10,432,937	5,430,719	5,002,218	6.750 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	11,200,625	5,430,719	5,769,906	7.790 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	33,505		33,505	0.050 %
f	Health professions education (from Worksheet 5) . . .	744,153		744,153	1.000 %
g	Subsidized health services (from Worksheet 6) . . . .	6,169,610	3,921,354	2,248,256	3.030 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	21,769		21,769	0.030 %
j	Total. Other Benefits . .	6,969,037	3,921,354	3,047,683	4.110 %
k	Total. Add lines 7d and 7j .	18,169,662	9,352,073	8,817,589	11.900 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2024

Schedule H (Form 990) 2024

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support			69,602		69,602	0.090 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total			69,602		69,602	0.090 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

954,082

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. ......

477,041

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).....

22,758,606

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

22,715,146

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

43,460

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) 2024

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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	THE RICHLAND HOSPITAL INC 333 EAST SECOND STREET RICHLAND CENTER,WI53581 WWW.RICHLANDHOSPITAL.COM 1045	X	X	X	X

Schedule H (Form 990) 2024

Page 4

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)

	THE RICHLAND HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

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 significant 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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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): SEE PART V, SECTION C, LINE 7D

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C, LINE 7D

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2024

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE RICHLAND HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.RICHLANDHOSPITAL.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/

The FAP application form was widely available on a website (list url):

HTTPS://WWW.RICHLANDHOSPITAL.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.RICHLANDHOSPITAL.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2024

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE RICHLAND HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

Schedule H (Form 990) 2024

Page 7

Part VFacility Information (continued)

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

	THE RICHLAND HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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 Section C.

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 Section C.

Schedule H (Form 990) 2024

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 5: IN 2022, THE RICHLAND HOSPITAL'S DIRECTOR OF COMMUNITY RELATIONS AND MARKETING, RICHLAND COUNTY PUBLIC HEALTH'S LOCAL HEALTH OFFICER, UW-MADISON DIVISION OF EXTENSION RICHLAND COUNTY EXTENSION EDUCATOR, RICHLAND COUNTY DRUG-FREE COMMUNITIES PROJECT DIRECTOR, AND RICHLAND CENTER HIGH SCHOOL PUPIL SERVICES PRINCIPAL PARTNERED TO CONDUCT A COMBINED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPROVEMENT PLAN. THIS GROUP IS KNOWN AS THE HEALTH ASSESSMENT AND WELLNESS COMMISSION (HAWC).MEMBERS OF THIS COMMISSION INCLUDED: 1. SHAWNA CONNOR, RICHLAND HOSPITAL, DIRECTOR OF COMMUNITY RELATIONS & MARKETING2. CINDY CHICKER, PRESIDENT, PARTNERS OF THE RICHLAND HOSPITAL3. CHELSEA WUNNICKE, UW-MADISON DIVISION OF EXTENSION RICHLAND COUNTY, EXTENSION EDUCATOR4. ROSE KOHOUT, RICHLAND COUNTY HEALTH AND HUMAN SERVICES, PUBLIC HEALTH, COUNTY OFFICER5. ELIZABETH PERKINS, PUPIL SERVICES PRINCIPAL, RICHLAND CENTER HIGH SCHOOL6. CARLENE SHAW, PUBLIC HEALTH NURSE, RICHLAND COUNTY HEALTH & HUMAN SERVICES7. BETSY ROESLER, DRUG-FREE COMMUNITIES PROJECT DIRECTOR, PARTNERS FOR PREVENTION COALITION OF RICHLAND COUNTY8. MEGAN RYAN, RICHLAND HOSPITAL, ADMINISTRATIVE ASSISTANT DATA COLLECTION METHODOLOGY:AT EARLY MEETINGS OF THE HAWC'S IT WAS DETERMINED BY CONSENSUS TO COLLECT CHNA DATA IN 3 WAYS. THE COMMISSION ENVISIONED THIS AS A 3-LEGGED STOOL THAT WOULD SUPPORT OUR RECOMMENDATIONS OF THE TOP HEALTH NEEDS.1. SECONDARY DATA - PURPOSE: UNDERSTAND THE HEALTH ENVIRONMENT & DOCUMENTED REALITIES. HAWC MEMBERS CURATED PUBLISHED & PRIVATE HEALTH DATA.2. COMMUNITY SURVEY - PURPOSE: COLLECT OPINIONS THAT CAN STATISTICALLY REPRESENT RICHLAND COUNTY. THIS SURVEY WAS AVAILABLE ELECTRONICALLY AND IN PRINT; IN BOTH ENGLISH AND SPANISH. .3. STAKEHOLDER DATA WALK AND FOCUS GROUPS - PURPOSE: MULTI-SECTOR STAKEHOLDERS REVIEW COUNTY DATA, THE RESULTS OF THE COMMUNITY SURVEY AND PRIORITIZE NEEDS. BOTH MEETINGS WERE OPEN TO THE PUBLIC.
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 6B: RICHLAND COUNTY HEALTH AND HUMAN SERVICES
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 7D: SCHEDULE H, PART V, LINE 7AHTTPS://WWW.RICHLANDHOSPITAL.COM/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENT/SCHEDULE H, PART V, LINE 10AHTTPS://WWW.RICHLANDHOSPITAL.COM/2023-CHIP-DOCUMENT/
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 11: IN 2022, THE RICHLAND HOSPITAL AND CLINICS (TRHC) COLLABORATED WITH COUNTY AND AREA AGENCIES, NON-PROFIT ORGANIZATIONS, AND MEMBERS OF THE COMMUNITY IN ORDER TO PRIORITIZE HEALTH NEEDS IN THE GREATER RICHLAND COUNTY, WISCONSIN AREA. WHAT RESULTED WAS OUR 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. THE PURPOSE OF THE CHNA IS TO PROVIDE DATA-DRIVEN DIRECTION TO OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS. THIS COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) SUMMARIZES TRHC'S ACTION PLAN. IT SHOULD BE NOTED THAT TRHC INTENDS TO ENACT ELEMENTS OF THIS PLAN IN COOPERATION WITH THE AFOREMENTIONED COUNTY AND AREA AGENCIES, NON-PROFIT ORGANIZATIONS, SCHOOL DISTRICTS, AND THE GREATER RICHLAND COUNTY COMMUNITY. BASED ON THE RESULTS OF OUR 2022 CHNA REPORT, THREE COMMUNITY HEALTH PRIORITIES ARE IDENTIFIED BELOW. THE FOLLOWING PLAN WILL UTILIZE THE LETTER CODES FOR EACH:M = MENTAL HEALTH S = SUBSTANCE ABUSE TREATMENT AND PREVENTION O = OVERWEIGHT/OBESITY TREATMENT AND PREVENTIONTHE TRHC DIRECTOR OF COMMUNITY RELATIONS AND MARKETING OVERSEES THE RICHLAND HOSPITAL AND CLINICS CHIP. THE FOLLOWING PAGES OUTLINE THE GOALS, MEASUREMENTS, AND DESCRIPTIONS ADDRESSING EACH OF THE HEALTH PRIORITIES IN THIS ACTION PLAN. M = ADDRESSING MENTAL HEALTHDURING THE 2022 DATA WALK EVENTS AND THE SUBSEQUENT CHIP PLANNING EVENT IN APRIL 2023, PARTICIPANTS SHARED THAT THERE IS STIGMA AROUND MENTAL HEALTH ISSUES, A DEFICIT IN MENTAL HEALTH SERVICES AVAILABLE, AND A LACK OF KNOWLEDGE ABOUT EXISTING RESOURCES AVAILABLE THAT CAN IMPROVE MENTAL HEALTH IN THE GREATER RICHLAND COUNTY AREA. 1. INCREASE MENTAL HEALTH SERVICESM1A = EXPLORE EXPANSION OF MENTAL HEALTH SERVICES AT TRHCGOAL: EXPLORE OFFERING SPECIALIZED MENTAL HEALTH SERVICES AT THE RURAL HEALTH CLINICS; EXPAND SERVICES AT TRHC IN RICHLAND CENTERMEASURES: IN 2023: COMPLETE A PRO FORMA FOR MENTAL HEALTH SERVICES AT THE RHCS. IN 2024: EXPLORE OFFERING MENTAL HEALTH VISITS THROUGH A TELEHEALTH PROVIDER. CONTINUE SUPPORT OF THE EXISTING COLLABORATIVE PRACTICE WITH DR. CULLEN. EXPLORE THE OPPORTUNITY TO ADD AN ADDITIONAL PSYCHIATRIC NP AND PHYSICIAN AS CONSULTANTS TO PRIMARY CARE PROVIDERS. DESCRIPTION: THE CLINIC LEADERSHIP TEAM WILL ASSESS THE VIABILITY & NEED FOR ADDITIONAL MENTAL SERVICES IN OUR SERVICE AREA. M1B = CONTINUE TO GROW THE SENIOR LIFE SOLUTIONS (SLS) PROGRAMGOAL: TO GROW THE PROGRAM TO PROVIDE MAXIMUM ACCESS AND INCREASE THE RESILIENCE AND COPING SKILLS OF THE SENIOR POPULATIONMEASURES: PARTICIPATION WILL CONSISTENTLY SHOW AN ADC OF 10 (INCREASED FROM 8 IN 2021). DESCRIPTION: THE RICHLAND HOSPITAL AND CLINICS' SENIOR LIFE SOLUTIONS (SLS) PROGRAM IS AN INTENSIVE OUTPATIENT GROUP COUNSELING PROGRAM THAT IS DESIGNED TO MEET THE UNIQUE NEEDS OF INDIVIDUALS OVER THE AGE OF 65 STRUGGLING WITH ANXIETY AND DEPRESSION, OFTEN RELATED TO AGING. AFTER GROWING THE PROGRAM TO THE MAXIMUM NUMBER OF PATIENTS FOR THE EXISTING MENTAL HEALTH TEAM, TRHC'S GOAL IS TO SUPPORT THE NEED FOR ADDITIONAL STAFF AND FACILITY SPACE. M1C = IMPROVE ACCESS TO INFORMATION ABOUT EXISTING LOCAL MENTAL HEALTH RESOURCESGOAL: PROMOTE LOCAL MENTAL HEALTH RESOURCES AVAILABLE TO COMMUNITY MEMBERS: THE CREATION OF A PROCESS AND PROCEDURE WHERE AGENCIES, ORGANIZATIONS, AND GROUPS CAN EASILY SUBMIT INFORMATION ABOUT SERVICES OR EVENTS TO THE HOSPITAL WITH THE UNDERSTANDING THAT EACH WILL BE ASSESSED AND, IF APPROPRIATE, PROMOTED VIA THE RICHLAND HOSPITAL AND CLINICS' WEBSITE, INTRANET, AND SOCIAL MEDIA PLATFORMS. TRHC IS CURRENTLY PLANNING A WEBSITE AND INTRANET REBUILD PROJECT FOR 2024-25. THE NEXT ITERATION OF OUR WEBSITE WILL CONTAIN EXTENSIVE INFORMATION REGARDING MENTAL HEALTH RESOURCES AVAILABLE TO INDIVIDUALS IN THE GREATER RICHLAND COUNTY AREA. TRHC WILL SERVE AS THE HUB FROM WHICH AREA HEALTH CARE, STATE HEALTH AGENCIES, AND COALITIONS SERVING MENTAL HEALTH SOLUTIONS ORGANIZE EFFORTS IN OUR GREATER SERVICE AREA. THIS HEARKENS BACK TO M1B. TRHC WILL FURTHER EXPAND THE TRANSLATION OF KEY DOCUMENTS INTO SPANISH. CONSISTENT SHARING OF MENTAL HEALTH SUPPORT MESSAGING ON TRHC SOCIAL MEDIA PLATFORMS, YEAR-ROUND. CONSISTENT SPONSORSHIP OF EVENTS HOSTED BY NON-PROFITS ADDRESSING THE MENTAL HEALTH NEEDS OF THE GREATER RICHLAND COUNTY AREA. OFFER QUARTERLY OPPORTUNITIES FOR NON-PROFITS ADDRESSING MENTAL HEALTH NEEDS IN OUR NEW, QUARTERLY, EXTERNAL-FACING 'PATIENTS FIRST' NEWSLETTER, TO INCLUDE NEWS PERTINENT TO RESIDENTS OF THE GREATER RICHLAND COUNTY AREA. TRHC ADVERTISING AND SPONSORSHIP FUNDS WILL BE DEDICATED, IN PART, TO THIS PURPOSEMEASURES: IDENTIFY THE OPPORTUNITIES TO PROMOTE THE LIST OF PROCESSES AND PROCEDURES DEVELOPED IN THE 2019 CHIP (DELAYED DUE TO COVID-19 PANDEMIC) PROMOTE STIGMA ELIMINATION EDUCATION AND MESSAGING SLS MAINTAINS A BINDER CONTAINING A LIST OF LOCAL RESOURCES REGARDING MENTAL HEALTH THIS WILL BE UPDATED FOR 2023-25 PROMOTE AND SPONSOR ESTABLISHED EVENTS MANAGED BY AREA MENTAL HEALTH AGENCIES AND ORGANIZATIONS BE CONSIDERED A SOLID RESOURCE FOR LOCAL MENTAL HEALTH INFORMATION BY THE END OF 2025 SUPPORT REGIONAL AND COMMUNITY PARTNERSHIPS AIMED AT IMPROVING MENTAL HEALTH AND WELL-BEINGDESCRIPTION: TRHC INTENDS TO ENRICH THE HEALTH AND WELLNESS INFORMATION ALREADY AVAILABLE ON OUR WEBSITE AT RICHLANDHOSPITAL.COM TO INCLUDE INFORMATION ABOUT LOCAL MENTAL HEALTH RESOURCES. 2. INCREASE MENTAL HEALTH CONTINUING EDUCATIONM2A = FACILITATION AND SUPPORT FOR CONTINUING EDUCATION OF TRHC PROVIDERS, STAFF, AND MEMBER OF THE GREATER COMMUNITY SEEKING ADDITIONAL FORMAL EDUCATION REGARDING MENTAL ILLNESS/HEALTHGOAL: ALLOCATE EXISTING SPONSORSHIP FUNDING IN THE MARKETING DEPARTMENT TO SUPPORT SAFETALK EDUCATION IN ORDER TO IMPROVE THE MENTAL HEALTH OF THE COMMUNITY. MEASURES: TRHC WILL SPONSOR A MINIMUM OF TWO SAFETALK EDUCATION EVENTS ANNUALLY IN THE GREATER RICHLAND COUNTY AREADESCRIPTION: IN COOPERATION WITH THE TRHC SENIOR LIFE SOLUTIONS, SUICIDE PREVENTION TASK FORCE AND THE WELLNESS COMMITTEE, THE MARKETING DEPARTMENT WILL ENSURE FUNDING TO CONTINUE THE SUCCESSFUL SAFETALK PROGRAM INITIATED IN 2020. THIS SERVICE PROVIDES CONTINUING EDUCATION TO TRHC STAFF AND COMMUNITY MEMBERS ABOUT SUICIDE PREVENTION AWARENESS AND COINCIDES WITH M2B. M2B = SUPPORT THE 2023 PATIENT SAFETY PLAN (PHASE 1)GOAL: PROVIDE INCREASED EDUCATIONAL OPPORTUNITIES TO STAFF AND COMMUNITY MEMBERS FOR IMPROVED SUICIDE PREVENTION AWARENESS MEASURES: YEAR ONE (2023): UPDATE HOSPITAL POLICY AND IN-HOUSE PROCESSES FOR COMPLIANCE WITH TRHC'S NEW ACCREDITING BODY (DNV) AND IMPROVED SUICIDE PREVENTION SCREENING/TREATMENT OF PATIENTS, FOLLOWED BY TRAINING FOR STAFF IN THE IMPLEMENTATION OF NEW PROCESSES. YEAR TWO (2024): PROVIDE ADDITIONAL SUICIDE PREVENTION TRAINING TO PERTINENT STAFF MEMBERS OF INCREASED AWARENESS AND IDENTIFICATION OF THOSE AT RISK FOR SUICIDE, LIKELY VIA LIVINGWORKS YEAR THREE (2025): PROVIDE SUICIDE PREVENTION TRAINING TO COMMUNITY MEMBERS FOR INCREASED AWARENESS AND IDENTIFICATION OF THOSE AT RISK FOR SUICIDE AND HOW TO DIRECT THOSE AT RISK TO APPROPRIATE HELP, LIKELY VIA LIVINGWORKS.DESCRIPTION: THE SUICIDE PREVENTION TASK FORCE IS PLANNING SUPPLEMENTAL EDUCATIONAL OPPORTUNITIES FOR STAFF AND COMMUNITY MEMBERS TO INCREASE AWARENESS OF SIGNS/SYMPTOMS OF SUICIDE RISK AND HOW TO GET THOSE AT RISK APPROPRIATE HELP, IN ADDITION TO PROMOTING REGULARLY OCCURRING MENTAL HEALTH AND SUICIDE PREVENTION AWARENESS DATES. M2C = SUPPORT THE 2023 PATIENT SAFETY PLAN (PHASE 2)GOAL: REFINE AND EDIT NEW POLICY SUICIDE RISK PROTOCOL BASED ON FEEDBACK AND SUPPORTING DATAMEASURES: YEAR ONE (2023): GATHER AND INTERPRET FEEDBACK FROM TEAM MEMBERS AS WELL AS DATA TO ASSESS THE EFFECTIVENESS OF THE NEW PROTOCOL AND SCREENING TOOL (C-SSRS) YEAR TWO (2024): EDIT AND REFINE PROTOCOL AS NEEDED BASED ON ASSESSMENT RESULTS YEAR THREE (2025): CONTINUE TO ASSESS DATA AND REFINE POLICY AS NEEDED TO REMAIN UP TO DATE WITH BEST PRACTICES AND DNV REQUIREMENTSDESCRIPTION: THE SUICIDE PREVENTION TASK FORCE WAS ESTABLISHED AND IS WORKING TO FACILITATE IMPROVED SCREENING AND MANAGEMENT OF PATIENTS AND COMMUNITY MEMBERS AT RISK FOR SUICIDE WHILE SUPPORTING THE CHIP AND DNV COMPLIANCE. AN UPDATED POLICY APPLICABLE TO THE ORGANIZATION AS A WHOLE HAS BEEN IMPLEMENTED. S ADDRESSING SUBSTANCE ABUSE TREATMENT AND PREVENTIONSUBSTANCE ABUSE AND ADDICTION INCLUDE ALL EXCESSIVE USE OF SUBSTANCES INCLUDING ALCOHOL, TOBACCO, PRESCRIPTION DRUGS, E-CIGARETTES, OPIOIDS, AND OTHER DRUGS THAT ARE HARMFUL.1. INCREASE AND SUPPORT MAINTAINING AND CREATING MORE ACCESS TO RESOURCES FOR THOSE BATTLING SUBSTANCE ABUSE. IN THE CHIP FOCUS GROUP MEETINGS HELD AT HHS ON APRIL 11, 2023, PARTICIPANTS IDENTIFIED THAT ADDITIONAL RESOURCES NEED TO BE SUPPORTED.DESCRIPTION CONTINUED AT END OF SCHEDULE H, PART V.
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 13H: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE RICHLAND HOSPITAL, INC. CONSIDERS THE FOLLOWING WHEN DETERMINING ELIGIBILITY FOR PROVIDING "FREE OR "DISCOUNTED" CARE TO INDIVIDUALS:- PATIENT IS HOMELESS- PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED- PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT- PATIENT IS DECEASED, AND WITHOUT A SPOUSE, AND NO ESTATE HAS BEEN FILED WITH THE COURT SYSTEM WITHIN 12 MONTHS OF EXPIRATION OR IF IT DETERMINED PATIENT DOES NOT HAVE ASSETS REQUIRING THE FILING OF AN ESTATE- PATIENT RECEIVES A BANKRUPTCY DETERMINATION WITHIN THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION DATE IF APPLICANT IS LOOKING FOR CONSIDERATION ON ANY ACTIVE ACCOUNT NOT DISCHARGED AS A PART OF THE BANKRUPTCY DETERMINATION- PATIENT'S VALID ADDRESS IS CONSIDERED LOW INCOME OR SUBSIDIZED HOUSING AND PATIENT AUTHORIZES THE APPLICABLE HOUSING AUTHORITY TO VALIDATE INCOME LEVEL DIRECTLY TO THE HOSPITAL- ACCOUNTS RETURNED BY COLLECTION AGENCY- ACCOUNTS CLOSED AS A RESULT OF A COURT-ORDER- PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM
THE RICHLAND HOSPITAL, INC.	PART V, SECTION B, LINE 16J: PLAIN LANGUAGE SUMMARY IS INCLUDED IN WRITTEN ACCOUNT COMMUNICATION, PLAIN LANGUAGE SUMMARY IS OFFERED AT REGISTRATION, PLAIN LANGUAGE SUMMARY IS INCLUDED ON STATEMENTS.
PART V, SECTION B, LINE 11 (CONTINUED):	S1A = SUPPORT/PROMOTE THE AVAILABILITY OF NARCOTICS ANONYMOUS IN RICHLAND CENTERGOAL: ASSIST IN PROVIDING INFORMATION ABOUT THIS PROGRAM TO THOSE WHO WOULD BENEFIT FROM IT. MEASURES: PROVIDE INFORMATION FROM THE PROGRAM THROUGH MATERIALS DISSEMINATION IN THE TRHC EMERGENCY DEPARTMENT AND ON THE TRHC WEBSITE. TRHC CONTINUES TO SUPPORT DRUG TAKE BACK DAY VIA INTERNAL NEWS SHARING AND VIA OUR SOCIAL MEDIA PLATFORMS TRHC SUPPORTS ALL PROGRAMS OF PARTNERS 4 PREVENTION THROUGH SPONSORSHIP, NEWS SHARING AND ATTENDANCE AT EVENTS TRHC WILL CONTINUE TO SUPPORT ALL OTHER NON-PROFIT ORGANIZATIONS WHOSE EFFORTS POSITIVELY AFFECT SUBSTANCE USE TREATMENT AND PREVENTION IN THE GREATER RICHLAND COUNTY AREA.DESCRIPTION: RICHLAND COUNTY HEALTH AND HUMAN SERVICES (RCHHS) BEGAN THIS PROGRAM IN 2017. NARCOTICS ANONYMOUS (NA) IS PATTERNED AFTER ALCOHOLICS ANONYMOUS (AA). GROUPS CONSIST OF INDIVIDUALS ENCOURAGING ONE ANOTHER TO DISCONTINUE DRUG USE AND REMAIN DRUG-FREE. NA UTILIZES A 12-STEP PROCESS TO REFLECT THE DISEASE CONCEPT OF ADDICTION. THROUGH THIS 12-STEP PROGRAM, NA PROVIDES A RECOVERY PROCESS AND SUPPORT GROUP FOR PEOPLE WHO ARE QUITTING SUBSTANCE ABUSE. S1B = PROVIDE ADDICTION MEDICINE IN PRIMARY CARE SETTINGS AT TRHCGOAL: MAINTAIN CURRENT ROSTER OF PROVIDERS WHO ARE MEDICATION ASSISTED TREATMENT (MAT) CERTIFIED; CURRENTLY FOUR PROVIDERS (UP FROM 1 IN 2021)MEASURES: MAT-CERTIFIED PROVIDERS WILL MAINTAIN A BALANCED PRACTICE PROVIDING ACCESS TO PATIENTS SEEKING FAMILY MEDICINE AND TREATMENT OF SUBSTANCE USE DISORDERS (SUDS)DESCRIPTION: PRIMARY MEDICAL FACILITIES PROVIDE A SAFE PLACE FOR INDIVIDUALS WITH SUDS TO ENGAGE IN TREATMENT WITHOUT STIGMA ATTACHED. IN ADDITION, THE PRIMARY CARE SETTING PRESENTS PROVIDERS AN OPPORTUNITY TO BETTER IDENTIFY, ASSESS, INTERVENE, AND SUPPORT PATIENTS WITH SUDS. PHYSICIANS INVOLVED IN THE MAT PROGRAM STRIVE TO HELP RECOVERING HEROIN ADDICTS BUILD A LIFE WORTHY OF LIVING SOBER. IN AN EFFORT TO ADDRESS THE GROWING CONCERN OF HEROIN AND PRESCRIPTION DRUG ADDICTION, INCLUDING OVERDOSES. S2A = INCREASE AWARENESS OF THE ISSUES SURROUNDING SUBSTANCE ABUSE AND HELP CREATE AN ENVIRONMENT OF COLLABORATION FOR INCREASED CHANGE. GOAL: INCREASE EDUCATION AROUND THE SCIENCE OF THE EFFECTS OF SUBSTANCE USE, ESPECIALLY BY YOUTHMEASURES: PROVIDE FINANCIAL SUPPORT AND INCREASED ACCESS FOR NON-PROFIT ORGANIZATIONS SUPPORTING THIS GOAL IN THE GREATER RICHLAND COUNTY AREA SCHOOL DISTRICT-HOSTED EVENTS FAMILY EVENTS HOSTED BY RICHLAND AREA SCHOOL DISTRICT AT THE SMART FARM SPONSORSHIP OF POST-PROM PARTIES AT RICHLAND CENTER HIGH SCHOOL, RIVER VALLEY HIGH SCHOOL, RIVERDALE HIGH SCHOOL AND KICKAPOO HIGH SCHOOL PARTNERS 4 PREVENTION COLLABORATION ON MULTIPLE CAMPAIGNS INCLUDING NARCAN TRAINING, NATIONAL NIGHT OUT, ALCOHOL AWARENESS MONTH EDUCATION, DRUG TAKE BACK DAY, ETC. SUPPORT OF RICHLAND COUNTY CHILDREN AND FAMILY ADVOCACY COUNCIL'S (RCCFAC) EFFORTS IN DECREASING SUBSTANCE ABUSE PROMOTE EDUCATION ABOUT USING ALCOHOL RESPONSIBLY AROUND YOUTH SUPPORT EVENTS THAT ARE SAFEST FOR CHILDRENDESCRIPTION: TRHC WILL INFLUENCE CHANGE IN COMMUNITY EDUCATION REGARDING SUBSTANCE USE AND ABUSE THROUGH INCREASED EDUCATION, AND PROMOTION AND FINANCIAL SUPPORT OF ENDORSED EVENTS ADDRESSING OVERWEIGHT & OBESITY TREATMENT AND PREVENTION ADULT OBESITY IS THE PERCENTAGE OF THE ADULT POPULATION (AGE 20 AND OLDER) THAT REPORTS A BODY MASS INDEX (BMI) GREATER THAN OR EQUAL TO 30 KG/M2.1. PROVIDE OPPORTUNITIES FOR TRHC STAFF AND THEIR FAMILIES TO BE PHYSICALLY ACTIVE AND EAT HEALTHY INCREASE BY 10% EMPLOYEE AND FAMILY PARTICIPATION IN ORGANIZED ACTIVITIES THAT INVOLVE BEING PHYSICALLY ACTIVE AND PROVIDE INFORMATION ON HEALTHY EATING GOAL: THROUGHOUT 2019, THE RICHLAND HOSPITAL AND CLINICS ENCOURAGED ALL EMPLOYEES AND THEIR FAMILIES TO ATTEND AT LEAST TWO HOSPITAL-PROMOTED EVENTS THAT ENCOURAGED PHYSICAL ACTIVITY. AN ESTIMATED 90 EMPLOYEES AND FAMILY MEMBERS TOOK PART IN THESE ACTIVITIES. OUR GOAL DURING 2023-25 IS TO CONTINUE THIS STRATEGY AND IMPROVE RATES OF PARTICIPATION BY 10%.MEASURES: TRACK EMPLOYEE AND FAMILY ATTENDANCE AT HOSPITAL-SPONSORED WALK/RUN EVENTS DURING 2023-25. THE RICHLAND HOSPITAL AND CLINICS WILL SPONSOR A 5K RUN/WALK FOR EMPLOYEES AND COMMUNITY IN FALL OF 2024 AND 2025. DESCRIPTION: MAINTAIN ATTENDANCE AND PROMOTION OF EVENTS THAT ENCOURAGE INCREASED PHYSICAL ACTIVITY FOR STAFF AND THEIR FAMILIES. 1. ENCOURAGE INCREASED PHYSICAL ACTIVITY AND HEALTHY EATING THROUGHOUT OUR COMMUNITYO2A = SUPPORT SUMMER ATHLETIC PROGRAMSGOAL: TRHC ATHLETIC TRAINERS ASSIST RICHLAND CENTER AND MUSCODA SCHOOL DISTRICTS WITH SUMMER STRENGTH TRAINING PROGRAMS. MEASURES: NUMBER OF STUDENTS WHO ATTEND THESE PROGRAMSDESCRIPTION: ATHLETIC TRAINERS OFFER EXPERTISE IN AGE APPROPRIATE STRENGTH TRAINING FOR EACH SCHOOL DISTRICT. O2B = HOST/PARTICIPATE/VOLUNTEER AT COMMUNITY EVENTS THAT PROMOTE ACTIVITY OR HEALTHY EATINGGOAL: IMPROVE AWARENESS ABOUT AVAILABLE OPPORTUNITIES TO BE PHYSICALLY ACTIVE OR TO LEARN ABOUT HEALTHY EATING. TO PROMOTE AND CELEBRATE TRHC'S INVOLVEMENT IN THEM.MEASURES: PROVIDE FREQUENT INFORMATION TO THE PUBLIC ON HEALTH AND FITNESS-RELATED ACTIVITIES VIA MULTIPLE MEDIA SOURCES, INCLUDING RADIO, WEBSITE, FACEBOOK AND PRINT MEDIA.DESCRIPTION: 1. CREATE A PROCESS BY WHICH IT IS EASY FOR SERVICES, GROUPS, GOVERNMENT AGENCIES, AND CLUBS TO SHARE INFORMATION.2. TRHC STAFF GUEST ON WRCO FREQUENTLY.3. WORD OF MOUTH PROMOTION (WOMP): SHARE INFORMATION, WHEN APPROPRIATE, WITH STAFF AND ASK THEM TO SHARE THE INFORMATION WITH THREE PEOPLE.4. RECORD AND DOCUMENT ATTENDANCE AT EVENTS

Schedule H (Form 990) 2024

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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?3
Name and address		Type of Facility (describe)
1	1 - RICHLAND HOSPITAL CLINIC 333 EAST SECOND STREET RICHLAND CENTER,WI53581	RURAL HEALTH CLINIC
2	2 - MUSCODA HEALTH CENTER 1075 NORTH WISCONSIN AVENUE MUSCODA,WI53573	RURAL HEALTH CLINIC
3	3 - SPRING GREEN MEDICAL CENTER 150 EAST JEFFERSON STREET SPRING GREEN,WI53588	RURAL HEALTH CLINIC
4
5
6
7
8
9
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Schedule H (Form 990) 2024

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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
PART I, LINE 3C:	ADDITIONALLY, THE RICHLAND HOSPITAL, INC. MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES IN THE CASE OF PATIENTS LACKING DOCUMENTATION THAT SUPPORTS ELIGIBILITY OR INDIVIDUAL CIRCUMSTANCE. AT ITS SOLE DISCRETION, WHEN A PATIENT IS UNABLE TO PROVIDE NECESSARY DOCUMENTATION TO SUPPORT AN ELIGIBILITY DETERMINATION, THE RICHLAND HOSPITAL, INC. MAY PROVIDE FREE OR DISCOUNTED SERVICES UNDER THIS PROGRAM WHEN PATIENT: - IS HOMELESS - IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED - IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM - IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT - IS DECEASED, WITHOUT A SPOUSE, AND NO ESTATE HAS BEEN FILED WITH THE COURT SYSTEM WITHIN 12 MONTHS OF EXPIRATION OR AT THE TIME IT CAN BE DETERMINED PATIENT DOES NOT HAVE ASSETS REQUIRING THE FILING OF AN ESTATE. - RECEIVES A BANKRUPTCY DETERMINATION WITHIN THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION DATE IF APPLICANT IS LOOKING FOR CONSIDERATION ON ANY ACTIVE ACCOUNT NOT DISCHARGED AS A PART OF THE BANKRUPTCY DETERMINATION. - VALID ADDRESS IS CONSIDERED LOW INCOME OR SUBSIDIZED HOUSING AND PATIENT AUTHORIZES THE APPLICABLE HOUSING AUTHORITY TO VALIDATE INCOME LEVEL DIRECTLY TO THE HOSPITAL.
PART I, LINE 6A:	THE RICHLAND HOSPITAL, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE.
PART I, LINE 7:	THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES AT THE RICHLAND HOSPITAL, INC. INCLUDES THE OPERATION OF THE HOSPITAL EMERGENCY ROOM DEPARTMENT AND THE INTENSIVE CARE INPATIENT UNIT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH THE RICHLAND HOSPITAL, INC. AND ARE PRIMARILY UTILIZED FOR EMERGENCY SERVICES. THE EMERGENCY ROOM DEPARTMENT OPERATES 24-HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED PRIMARILY BY BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS. AS PART OF THE PATIENT SERVICES PROVIDED TO THE COMMUNITY, THE HOSPITAL HAS DESIGNATED A PORTION OF ITS INPATIENT UNIT AS A CERTIFIED INTENSIVE CARE UNIT KNOWN AS THE "SPECIAL CARE UNIT." THIS UNIT REQUIRES A HIGHER ACUITY OF NURSING AND HAS DEDICATED STAFF TO PROVIDE THIS CARE TO PATIENTS. A SIGNIFICANT PORTION OF THE ADMISSIONS TO THE UNIT COME FROM EMERGENCY ADMISSIONS TO THE HOSPITAL SO IT IS CONSIDERED A SUBSIDIZED HEALTH SERVICE PROVIDED TO THE COMMUNITY BY THE HOSPITAL. IT IS THE GOAL OF THE RICHLAND HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,251,593.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE RICHLAND HOSPITAL, INC. IS ACCREDITED THROUGH DNV. THE DNV ACCREDITATION PROCESS DIRECTLY ADDRESSES REGULATORY REQUIREMENTS FOR HOSPITALS, SUCH AS THE US GOVERNMENT'S CENTERS FOR MEDICARE AND MEDICAID (CMS). THE ACCREDITATION PROGRAM IS DESIGNED TO SUPPORT THE DEVELOPMENT AND CONTINUAL IMPROVEMENT OF HEALTHCARE QUALITY AND PATIENT SAFETY IN HEALTHCARE ORGANIZATIONS. IT ALSO ADDRESSES GENERAL SAFETY FOR WORKERS, PATIENTS AND OTHER VISITORS. DNV'S ANNUAL SURVEYS PROVIDE INSIGHT AND UNDERSTANDING ON WHAT IS WORKING EFFECTIVELY AND WHAT CAN BE IMPROVED, AND THE ACCREDITATION PROVIDES ASSURANCE TO YOUR PATIENTS, STAFF AND STAKEHOLDERS THAT YOUR HOSPITAL IS WORKING IN ACCORDANCE TO ESTABLISHED BEST PRACTICES. ALL DNV SURVEYORS HAVE A HEALTHCARE BACKGROUND AND SPECIALIZE IN ONE OF THREE AREAS: MANAGEMENT SYSTEMS, CLINICAL CARE, OR THE PHYSICAL ENVIRONMENT. THEY EMPLOY VARIOUS ASSESSMENT METHODS, INCLUDING STAFF INTERVIEWS, MEDICAL RECORD REVIEW, ORGANIZATIONAL DOCUMENT REVIEW, BUILDING AND OFFSITE VISITS, AND PATIENT INTERVIEWS AND FEEDBACK.THE RICHLAND HOSPITAL, INC. COMMUNITY RELATIONS AND MARKETING STAFF TAKE RESPONSIBILITY FOR SPONSORING AND/OR DEVELOPING COMMUNITY EVENTS. WHEN SOLICITED FOR SPONSORSHIPS FROM COMMUNITY EVENT ORGANIZERS THE DEPARTMENT CONSIDERS WHETHER THE PROPOSED SPONSORSHIP WOULD SUPPORT THE COMMUNITY HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED IN THE 2022 CHNA. EVENTS OR ORGANIZATIONS SUPPORTING OUR CHNA NEEDS RECEIVE PRIORITY OVER OTHERS. TRHC DISTRIBUTES APPROXIMATELY $20K IN SPONSORSHIP DOLLARS ANNUALLY USING THIS VETTING PROCESS. THE VAST MAJORITY OF TRHC ADVERTISING CAMPAIGNS VIA RADIO, BILLBOARD, SOCIAL MEDIA AND PRINT ARE DEDICATED TO PUBLIC SERVICE ANNOUNCEMENTS GEARED TOWARD EDUCATION, ACCESS TO INFORMATION, AND IMPROVEMENT OF PUBLIC HEALTH.THE FREE COMMUNITY EVENTS DEVELOPED BY TRHC ARE ALSO GEARED TOWARD PHYSICAL ACTIVITY FOR FAMILIES, INCLUDING PROPER NUTRITION AND HEALTH EDUCATION. IN 2024, TRHC HOSTED A FREE 5K FOR ALL AGES AS PART OF OUR CENTENNIAL CELEBRATION. MORE THAN 175 COMMUNITY MEMBERS REGISTERED FOR THIS EVENT, WHICH IS THE HIGHEST OF ANY 5K IN THE RICHLAND CENTER AREA HISTORICALLY.
PART III, LINE 2:	THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL.
PART III, LINE 3:	MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTS PATIENTS WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE.
PART III, LINE 4:	IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8:	THE RICHLAND HOSPITAL, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND, AS SUCH, A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES ONLY A PORTION OF THE TOTAL MEDICARE REVENUE OF THE HOSPITAL. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, RADIOLOGIST SERVICES, AND SURGICAL ANESTHESIA SERVICES AT THE RICHLAND HOSPITAL, INC. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND, AS SUCH, THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE RICHLAND HOSPITAL, INC. PROVIDES TO THE COMMUNITIES IT SERVES. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:	AT THE TIME OF PATIENT PRESENTATION, THE RICHLAND HOSPITAL, INC. WILL GATHER DEMOGRAPHIC AND INSURANCE INFORMATION THAT SUPPORTS THE TIMELY GENERATION AND RELEASE OF INSURANCE CLAIM FORMS AND /OR SELF-PAY STATEMENTS FOR SERVICES RENDERED. SUBJECT TO COMPLIANCE WITH THE PROVISIONS OF THIS POLICY, THE RICHLAND HOSPITAL, INC. MAY TAKE ANY AND ALL LEGAL ACTIONS, INCLUDING EXTRAORDINARY COLLECTION ACTIONS (ECA'S), TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED. THE RICHLAND HOSPITAL, INC. WILL NOT ENGAGE IN ECA'S, EITHER DIRECTLY OR BY ANY DEBT COLLECTIONS AGENCY OR OTHER PARTY TO WHICH THE HOSPITAL HAS REFERRED THE PATIENT'S DEBT, BEFORE REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER A RESPONSIBLE INDIVIDUAL^) IS ELIGIBLE FOR ASSISTANCE UNDER THE COMMUNITY CARE PROGRAM, FINANCIAL ASSISTANCE POLICY. AT THE POINT A RESPONSIBLE INDIVIDUAL REQUESTS A COMMUNITY CARE PROGRAM APPLICATION, THE ABOVE PROCEDURE WILL CEASE, AND THE FOLLOWING PROCEDURE WILL TAKE EFFECT.UPON REQUEST, A COMMUNITY CARE PROGRAM APPLICATION WILL BE SENT/GIVEN TO THE RESPONSIBLE INDIVIDUAL ALONG WITH A COVER LETTER DETAILING DOCUMENTATION REQUIRED TO PROCESS THE APPLICATION.APPLICATION MUST BE RETURNED WITHIN 30 DAYS FROM THE DATE THE RESPONSIBLE INDIVIDUAL IS GIVEN OR MAILED THE APPLICATION.IF INCOMPLETE OR INSUFFICIENT DOCUMENTATION IS RECEIVED, RESPONSIBLE INDIVIDUAL WILL BE NOTIFIED IN WRITING OF THE MISSING OR INCOMPLETE DOCUMENTATION. RESPONSIBLE INDIVIDUAL WILL HAVE 30 DAYS FROM THE DATE OF THE NOTIFICATION TO PROVIDE THE MISSING INFORMATION OR DOCUMENTATION. FAILURE TO SUBMIT A COMPLETED APPLICATION OR SUBSEQUENTLY REQUESTED DOCUMENTATION WITHIN 30 DAYS MAY RESULT IN THE APPLICATION BEING DENIED, THE ACCOUNT BEING REFERRED TO AN EXTERNAL COLLECTION AGENCY AND ECA'S MAY COMMENCE. IF A COMMUNITY CARE PROGRAM APPLICATION IS RECEIVED AFTER AN ACCOUNT HAS BEEN REFERRED TO AN EXTERNAL COLLECTION AGENCY, BUT PRIOR TO 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT, THE EXTERNAL COLLECTION AGENCY WILL BE INSTRUCTED TO DISCONTINUE COLLECTION ACTIVITY UNTIL THE COMMUNITY CARE PROGRAM APPLICATION HAS BEEN PROCESSED. IF THE APPLICATION IS APPROVED FOR A FULL OR PARTIAL DISCOUNT, THE EXTERNAL COLLECTION AGENCY WILL BE NOTIFIED AND INSTRUCTED TO REMOVE OR REVERSE ANY ECAS THAT MAY HAVE BEEN TAKEN AND THE ACCOUNT WILL BE REFERRED BACK TO THE RICHLAND HOSPITAL, INC. RESPONSIBLE INDIVIDUALS APPROVED FOR A PARTIAL DISCOUNT WILL BE NOTIFIED IN WRITING OF THEIR APPROVAL FOR A PARTIAL DISCOUNT AND AN UPDATED STATEMENT REFLECTING THE NEW DISCOUNTED AMOUNT DUE WILL BE INCLUDED. RESPONSIBLE INDIVIDUALS DETERMINED TO BE INELIGIBLE FOR A COMMUNITY CARE PROGRAM DISCOUNT WILL BE NOTIFIED IN WRITING OF THEIR INELIGIBILITY. THE NOTIFICATION TO RESPONSIBLE INDIVIDUALS DETERMINED TO BE INELIGIBLE FOR A COMMUNITY CARE PROGRAM DISCOUNT OR ELIGIBLE FOR A PARTIAL DISCOUNT WILL BE NOTIFIED THEY NEED TO PAY ACCOUNT(S) IN FULL OR SET UP A PAYMENT PLAN. HOSPITAL AND EXTERNAL COLLECTION AGENCIES MAY ALSO TAKE ANY AND ALL LEGAL ACTIONS INCLUDING BUT NOT LIMITED TO TELEPHONE CALLS, EMAILS, TEXTS, MAILING NOTICES AND SKIP TRACING TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED.
PART VI, LINE 2:	IN ADDITION TO THE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2022, THE RICHLAND HOSPITAL, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY IT SERVES BY LOOKING AT LOCAL AND SURROUNDING COMMUNITY DEMOGRAPHICS TO DETERMINE THE SERVICES THAT ARE MOST NECESSARY IN ORDER TO FULFILL ITS MISSION. THE HOSPITAL ACTIVELY SEEKS INPUT FROM MEMBERS OF THE MEDICAL STAFF REGARDING EXISTING SERVICES, THE POTENTIAL NEED FOR EXPANDED SERVICES, AND THE POTENTIAL NEED FOR NEW SERVICE LINES NOT OFFERED LOCALLY. THE HOSPITAL MONITORS THE LOSS OF SPECIALTY PROVIDERS IN THE AREA AND, COLLABORATIVELY WORKING WITH OUR RURAL HEALTH CLINICS (RICHLAND HOSPITAL CLINICS, SPRING GREEN MEDICAL CENTER, AND MUSCODA HEALTH CENTER), PARTICIPATES IN A DETERMINATION OF WHETHER AND HOW THIS NEW NEED CAN BEST BE MET. THE HOSPITAL ALSO REVIEWS HOSPITAL STATISTICS OF PATIENT VISITS TO DETERMINE WHAT TYPES OF SERVICES OFFERED BY THE HOSPITAL ARE BEING UTILIZED.
PART VI, LINE 3:	CONSISTENT WITH THE MISSION OF THE RICHLAND HOSPITAL, INC., HEALTH-RELATED SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL IS COMMITTED TO PROVIDING FREE OR DISCOUNTED CARE TO QUALIFIED INDIVIDUALS THAT ARE IN NEED OF MEDICALLY NECESSARY TREATMENT EVEN IF THAT PERSON IS UNINSURED, UNDERINSURED, INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS, OR UNABLE TO PAY BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. WHEN AN UNINSURED OR UNDERINSURED PATIENT REQUESTS FINANCIAL ASSISTANCE AND HAS AN ADJUSTED GROSS INCOME THAT IS AT OR BELOW 150% OF THE FEDERAL POVERTY LEVEL, THEY ARE ELIGIBLE FOR A 100% DISCOUNT ON ANY PATIENT BALANCE. WHEN AN UNINSURED PATIENT'S ADJUSTED GROSS INCOME IS 151 TO 300% OF THE FEDERAL POVERTY LEVEL, THEY ARE PROVIDED CARE AT THE AMOUNT GENERALLY BILLED OR LESS. FOR UNDERINSURED PATIENTS WITH AN ADJUSTED GROSS INCOME OF 151 TO 300%, THE AMOUNT PATIENT IS CHARGED AND RESPONSIBLE FOR PAYING (CO-INSURANCE, DEDUCTIBLES, ETC.) AFTER APPLYING DEDUCTIONS, DISCOUNTS AND PAYMENTS APPLIED BY THE THIRD PARTY PAYER WILL NOT BE GREATER THAN THE AGB. TO BE ELIGIBLE UNDER THIS PROGRAM, PATIENTS MUST COOPERATE WITH THE HOSPITAL TO EXPLORE ALTERNATIVE MEANS OF ASSISTANCE AND IF NECESSARY, INCLUDING APPLICATION OR ACTIONS NEEDED TO SECURE COVERAGE BY MEDICARE, MEDICAID, AND THE MARKETPLACE. PATIENTS WILL BE REQUIRED TO PROVIDE NECESSARY INFORMATION AND DOCUMENTATION WHEN APPLYING FOR A PROGRAM DISCOUNT, OR FOR OTHER PRIVATE OR PUBLIC PAYMENT PROGRAMS. THE FACILITY'S FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS WITH THE APPLICATION PROCESS. APPLICATIONS AND ALL SUPPORTING DOCUMENTATION IS REVIEWED BY THE FACILITY'S FINANCIAL COUNSELOR FOR ELIGIBILITY AND APPROVED BY THE PATIENT ACCOUNTING SUPERVISOR. FREE LABORATORY, LIMITED RADIOLOGY SERVICES, AND OTHER DIAGNOSTIC ANCILLARY SERVICES ARE ALSO PROVIDED TO PATIENTS WHO ARE REFERRED TO THE HOSPITAL BY THE RICHLAND CENTER FREE CLINIC. THE HOSPITAL ALSO OFFERS A 20% PROMPT PAY DISCOUNT FOR UNINSURED PATIENTS.THE RICHLAND HOSPITAL INC. COMMUNICATES THE AVAILABILITY AND TERMS OF THE PROGRAM TO ALL PATIENTS, THROUGH MEANS WHICH INCLUDE, BUT ARE NOT LIMITED TO:1. POSTED SIGNS WITHIN WAITING ROOMS, EMERGENCY ROOMS, AND PATIENT ACCOUNTING AREAS.2. COMMUNITY CARE PROGRAM APPLICATION AND PLAIN LANGUAGE SUMMARY OFFERED TO INDIVIDUALS AT TIME OF REGISTRATION AND DISCHARGE FROM AN INPATIENT ADMISSION. THE COMMUNITY CARE PROGRAM POLICY, COMMUNITY CARE PROGRAM APPLICATION AND THE PLACEMENT FOR COLLECTION POLICY ARE AVAILABLE UPON REQUEST. SPANISH VERSIONS WILL ALSO BE AVAILABLE UPON REQUEST.3. PLAIN LANGUAGE SUMMARY, COMMUNITY CARE PROGRAM POLICY, COMMUNITY CARE PROGRAM APPLICATION AND PLACEMENT FOR COLLECTIONS POLICY INCLUDING SPANISH VERSIONS CAN BE OBTAINED BY: A. REQUESTING IN PERSON AT THE RICHLAND HOSPITAL, INC., RICHLAND HOSPITAL CLINIC, RICHLAND RURAL HEALTH CLINIC, SPRING GREEN MEDICAL CENTER AND MUSCODA HEALTH CENTER B. CONTACTING THE RICHLAND HOSPITAL, INC. PATIENT FINANCIAL SERVICES DEPARTMENT AT 608-647-6321. C. ACCESSING THE RICHLAND HOSPITAL, INC. WEBSITE D. SUBMITTING A WRITTEN REQUEST TO THE RICHLAND HOSPITAL, INC.4. PLAIN LANGUAGE SUMMARY PROVIDED WITH WRITTEN CORRESPONDENCE.5. CONSPICUOUS MESSAGE ON PATIENT STATEMENTS.6. PLAIN LANGUAGE SUMMARY AVAILABLE AT THE LOCAL AGING AND DISABILITY RESOURCE CENTER AND AT THE RICHLAND COMMUNITY FREE CLINIC.7. DESIGNATED STAFF KNOWLEDGEABLE ON THE PROGRAM WILL BE AVAILABLE TO ANSWER PATIENT QUESTIONS AND/OR REFER PATIENTS TO THE PROGRAM.REGISTRATION STAFF AT THE RICHLAND HOSPITAL INC.& RICHLAND HOSPITAL CLINICS ARE TRAINED TO INQUIRE WITH PATIENTS UPON REGISTRATION IF THEY WOULD LIKE INFORMATION ON THIS PROGRAM. DURING THE COLLECTION PROCESS, THE RICHLAND HOSPITAL PROVIDES INFORMATION AND INCLUDES COMMUNITY CARE PROGRAM MATERIALS WITH CORRESPONDENCE. SOCIAL SERVICES AND BUSINESS OFFICE STAFF AT THE HOSPITAL ARE ALSO AVAILABLE TO PROVIDE INFORMATION TO PATIENTS ON OTHER GOVERNMENT PROGRAMS SUCH AS THE MEDICAID PROGRAM OR TO REFER PATIENTS TO PERSONNEL AT RICHLAND COUNTY OR OTHER STATE OF WISCONSIN OR COUNTY AGENCIES THAT MAY PROVIDE ACCESS TO CARE.
PART VI, LINE 4:	THE RICHLAND HOSPITAL, INC. IS LOCATED IN RICHLAND CENTER, WISCONSIN, WHICH IS A COMMUNITY OF APPROXIMATELY 5,000 PEOPLE AND IS LOCATED 50 MINUTES FROM MADISON, WISCONSIN. THE FACILITY OPERATES A 25-BED, ACUTE CARE CRITICAL ACCESS HOSPITAL AND THREE RURAL HEALTH CLINICS LOCATED IN RICHLAND CENTER AND NEIGHBORING COMMUNITIES. THE RICHLAND HOSPITAL OFFERS A WIDE VARIETY OF SERVICES IN ORDER TO FULFILL MANY OF THE NEEDS OF THE INDIVIDUALS IN THE LOCAL COMMUNITY. AMONG SERVICES PROVIDED ARE: DIAGNOSTIC CARE, 24-HOUR EMERGENCY ROOM, OBSTETRICS, REHABILITATION, SURGICAL CARE, AND DIABETES SELF-CARE PROGRAMS, ALONG WITH OTHER SPECIALTY SERVICES, WHICH INCLUDE: AUDIOLOGY, CARDIOLOGY, ORTHOPEDICS, CHEMOTHERAPY, CLINICAL SERVICES, AMONG OTHERS. CARE IS OFFERED TO PATIENTS REGARDLESS OF PAY SOURCE AND REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE COMMUNITIES SERVED BY THE RICHLAND HOSPITAL AS PRIMARY SERVICE AREA ARE DEFINED BY THE FOLLOWING ZIP CODES: 53556 - LONE ROCK53518 - BLUE RIVER53573 - MUSCODA53581 - RICHLAND CENTER53588 - SPRING GREENTHEY ARE GEOGRAPHICALLY CONTIGUOUS COMMUNITIES. ACCORDING TO 2021 DATA PUBLISHED BY KAAVIO, THE RICHLAND HOSPITAL, INC. HAD AN OVERALL INPATIENT MARKET SHARE OF 70.75 PERCENT AND OUTPATIENT MARKET SHARE OF 71.83 PERCENT IN THESE ZIP CODES. NO OTHER HEALTHCARE PROVIDER PROVIDING THE SAME SERVICES HAD A MARKET SHARE AS HIGH AS OR HIGHER THAN THE RICHLAND HOSPITAL, INC. (KAAVIO COMBINES STATEWIDE HEALTHCARE DATA FROM WISCONSIN HOSPITAL ASSOCIATION IN A WEB-BASED SUPPORT ENGINE THAT ALLOWS US TO ANALYZE OUR MARKET.)SOCIO-DEMOGRAPHIC PROFILE OF THE MARKET AREA SERVED BY THE RICHLAND HOSPITAL, INC. SERVES PERSONS WHO ARE REPRESENTATIVE OF THE POPULATION OF THE MARKET AREA. A HIGHER PERCENTAGE OF THE POPULATION SERVED IS ELDERLY; THIS IS DUE TO THE FACT THAT PERSONS 65 YEARS OF AGE AND OLDER ARE HOSPITALIZED AT NEARLY THREE TIMES THE OVERALL RATE. SOME THINGS TO NOTE RELATED TO PLANNING FOR MEETING COMMUNITY HEALTH NEEDS INCLUDES THE FOLLOWING:- THE OVERALL POPULATION OF THE MARKET AREA IS PROJECTED TO REMAIN VERY STABLE, WITH NEGLIGIBLE GROWTH OR DECLINE PROJECTED OVER THE NEXT FIVE YEARS.- THE OVERALL POPULATION OF RICHLAND COUNTY IS 17,160 AND IS PROJECTED TO REMAIN VERY STABLE, WITH NEGLIGIBLE DECLINE OVER THE NEXT FIVE YEARS. CENSUSREPORTER.ORG ACS2020 DATA TELLS US THAT 45% OF OUR POPULATION IS 50+. DURING 2022, MEDICARE AND MEDICARE ADVANTAGE PLAN BENEFICIARIES ACCOUNTED FOR OVER 52 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE AT THE RICHLAND HOSPITAL, INC. AND MEDICAID BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 16 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE. MEDICARE AND MEDICAID BENEFICIARIES MADE UP THE LARGEST PORTION OF PATIENTS THAT ARE SERVED BY THE RICHLAND HOSPITAL, INC. OVER THE PREVIOUS FEW YEARS.
PART VI, LINE 5:	THE ACTIVITIES OF THE RICHLAND HOSPITAL, INC. ARE SUPPORTED LOCALLY BY A VOLUNTEER BOARD OF DIRECTORS WHICH OVERSEE THE OPERATIONS OF THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF COMMUNITY MEMBERS THAT RESIDE IN RICHLAND CENTER, WI, AND THE SURROUNDING AREA WHICH IS THE HOSPITAL'S PRIMARY PATIENT SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO A MAJORITY OF ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS WHO WISH TO BETTER SERVE THEIR PATIENTS BY PROVIDING CARE AT THE RICHLAND HOSPITAL, INC.ANY SURPLUSES IN OPERATIONS THAT ARE ACHIEVED BY THE HOSPITAL OPERATING IN AN EFFECTIVE MANNER AND CONTROLLING THE COST OF HEALTHCARE ARE PRIMARILY RESERVED FOR FUTURE BUILDING AND CAPITAL PURCHASE NEEDS. THE RICHLAND HOSPITAL, INC. RECOGNIZES THAT IT IS IMPORTANT TO SAVE THESE RESERVES DURING YEARS OF SURPLUS SO THAT IN TIMES OF ECONOMIC DOWNTURN, IF A LARGE CAPITAL ADDITION IS NEEDED, THE HOSPITAL WILL NOT HAVE TO PASS HIGHER COSTS ON TO MEMBERS OF THE COMMUNITY. THE HOSPITAL FURTHER ACHIEVES ITS GOAL OF PROVIDING TRUE COMMUNITY SUPPORT BY PROVIDING CHARITY CARE AS DESCRIBED THROUGHOUT SCHEDULE H AND PROVIDING SERVICES TO MEMBERS OF OTHER PROGRAMS WHICH OFTEN REIMBURSE THE HOSPITAL BELOW THE COST OF PROVIDING THIS CARE SUCH AS CHAMPUS AND TRICARE.FINALLY, THE RICHLAND HOSPITAL, INC. COMMUNITY RELATIONS DEPARTMENT MANAGES ALL SPONSORSHIP DOLLARS ANNUALLY AND ALLOCATES TO AREA NON-PROFIT ORGANIZATIONS BASED ON THAT ORGANIZATION'S OR EVENT'S POSITIVE IMPACT ON OUR IDENTIFIED COMMUNITY HEALTH NEEDS. LIKEWISE, ADVERTISING DOLLARS AND EARNED MEDIA PROMOTIONS POSITIVELY AFFECTING IDENTIFIED COMMUNITY HEALTH NEEDS TAKE PRECEDENCE OVER GENERAL 'AWARENESS' CAMPAIGNS (MENTAL HEALTH MONTH, NUTRITION MONTH, OVERDOSE AWARENESS).
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule H (Form 990) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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 on 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 on 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 on 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 on 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? .............

Yes

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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" on 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) (Rev. 1-2025)

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 on 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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on 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)
1THOMAS BECK SURGEON	(i) (ii)	443,584 ------------- 0	114,400 ------------- 0	6,467 ------------- 0	13,800 ------------- 0	13,661 ------------- 0	591,912 ------------- 0	0 ------------- 0
2SHAWN O' BRIEN ER DOCTOR	(i) (ii)	528,464 ------------- 0	0 ------------- 0	2,556 ------------- 0	13,800 ------------- 0	41,455 ------------- 0	586,275 ------------- 0	0 ------------- 0
3BRYAN MCCARVEL CRNA	(i) (ii)	475,047 ------------- 0	0 ------------- 0	1,420 ------------- 0	12,289 ------------- 0	42,517 ------------- 0	531,273 ------------- 0	0 ------------- 0
4ANDREW WRIGHT FAMILY PRACTICE DOCTOR	(i) (ii)	269,901 ------------- 0	181,427 ------------- 0	1,877 ------------- 0	13,800 ------------- 0	34,928 ------------- 0	501,933 ------------- 0	0 ------------- 0
5NATHANIEL SCHWARTZ CRNA	(i) (ii)	400,287 ------------- 0	0 ------------- 0	9,620 ------------- 0	13,159 ------------- 0	2,777 ------------- 0	425,843 ------------- 0	0 ------------- 0
6BRUCE ROESLER CEO	(i) (ii)	319,393 ------------- 0	32,666 ------------- 0	3,822 ------------- 0	12,363 ------------- 0	29,016 ------------- 0	397,260 ------------- 0	0 ------------- 0
7ELIZABETH MOORE CFO (THRU 4/24)	(i) (ii)	72,617 ------------- 0	0 ------------- 0	134,426 ------------- 0	3,639 ------------- 0	34,543 ------------- 0	245,225 ------------- 0	0 ------------- 0

Schedule J (Form 990) (Rev. 1-2025)

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 I, LINE 4A	ELIZABETH MOORE RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $123,458 DURING CALENDAR YEAR 2024.

Schedule J (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

Return Reference	Explanation
FORM 990, PART III, LINE 2	THE RICHLAND HOSPITAL, INC. OPENED A RETAIL PHARMACY WITHIN THE HOSPITAL TO PROVIDE CONVENIENCE FOR PATIENTS. THE PHARMACY OPENED 12/09/2024.
FORM 990, PART VI, SECTION B, LINE 11B	THE ORGANIZATION'S MANAGEMENT AND FINANCE TEAM WORKS WITH THEIR PAID PREPARER TO ACCUMULATE AND ASSEMBLE THE IRS FORM 990. A COPY OF THE COMPLETED FORM WAS EMAILED OR MAILED TO ALL MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS BEFORE IT WAS FILED. ALL BOARD MEMBERS WERE GIVEN THE OPPORTUNITY TO RESPOND WITH COMMENTS PRIOR TO THE FINAL SUBMISSION OF THE FORM 990 TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	THE RICHLAND HOSPITAL, INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO COMPLETE ITS ANNUAL DISCLOSURE STATEMENT. THESE QUESTIONNAIRES ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. ANY INDIVIDUALS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING OR ACTING ON THOSE MATTERS.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO ANNUALLY REVIEW THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND TO DEFINE APPROPRIATE MARKET AND PERFORMANCE-BASED ADJUSTMENTS. COMPARATIVE DATA IS OBTAINED FROM EITHER THE WISCONSIN HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION SURVEY OR OTHER REPUTABLE THIRD-PARTY HEALTHCARE DATA SOURCES TO USE IN THE ESTABLISHMENT OF A MARKET FOR THIS KEY POSITION. THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS FULFILLS THIS ROLE. THE BOARD OF DIRECTORS HAS DELEGATED THE AUTHORITY AND RESPONSIBILITY FOR THE ONGOING MAINTENANCE OF OTHER KEY EMPLOYEES AND THE OVERALL ORGANIZATIONAL COMPENSATION MODEL TO THE CHIEF EXECUTIVE OFFICER AND HUMAN RESOURCE DIRECTOR. COMPARATIVE MARKET DATA IS OBTAINED VIA THE RURAL WISCONSIN HEALTH COOPERATIVE AND THE WISCONSIN SOCIETY OF HOSPITAL HUMAN RESOURCE ADMINISTRATORS VIA INDEPENDENT SALARY SURVEYS THAT PROVIDE BENCHMARK INFORMATION FOR HEALTHCARE JOB CLASSES. THIS DATA IS USED TO ESTABLISH SALARY RANGES FOR ALL JOB CLASSES WITHIN THE ORGANIZATION. THE BOARD OF DIRECTORS ANNUALLY AUTHORIZES THE OVERALL INCREASE TO THE SALARY BUDGET FOR THE ORGANIZATION WITH THE CEO MAINTAINING DELEGATED AUTHORITY FOR IMPLEMENTATION WITHIN THE ORGANIZATIONAL COMPENSATION MODEL. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS.
FORM 990, PART VI, SECTION C, LINE 19	THE RICHLAND HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS HOSPITAL BUSINESS LOCATION DURING NORMAL BUSINESS HOURS.
FORM 990, PART IX, LINE 11G	OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,814,287. MANAGEMENT AND GENERAL EXPENSES 2,804,331. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,618,618. MEDICAL IMAGING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,757,340. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,757,340. CLINICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 82,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 82,230. LABORATORY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 614,460. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 614,460. SURGICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,465,888. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,465,888. HOSPITALIST PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 924,110. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 924,110. BEHAVIORAL HEALTH PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 611,832. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 611,832.
FORM 990, PART IX, LINE 24E	STATE HOSPITAL ASSESSMENTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 300,581. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,581. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 20,918. MANAGEMENT AND GENERAL EXPENSES 219,323. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,241.
FORM 990, PART XI, LINE 9:	NET CHANGE IN RESTRICTED NET ASSETS OF SUPPORTING ORGANIZATIONS 69,203. INCREASE IN EQUITY OF UNCONSOLIDATED AFFILIATE 86,269.

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)
(Rev. January 2025)

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

Open to Public Inspection

Name of the organization

THE RICHLAND HOSPITAL INC

Employer identification number

39-0808498

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)RICHLAND HOSPITAL FOUNDATION INC 333 EAST SECOND STREET RICHLAND CENTER,WI53581 39-1567249	FOUNDATION	WI	501(C)(3)	LINE 7	THE RICHLAND HOSPITAL INC	Yes
(2)PARTNERS OF RICHLAND HOSPITAL INC 333 EAST SECOND STREET RICHLAND CENTER,WI53581 39-1693458	AUXILIARY	WI	501(C)(3)	LINE 10	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Part IV

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

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

Schedule R (Form 990) (Rev. 1-2025)

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) ............................

Yes

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) ............................

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) (Rev. 1-2025)

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) (Rev. 1-2025)

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) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OUR PATIENTS, ABOVE ALL ELSE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2024 (Part V, line 2a) ......	5	518
6	Total number of volunteers (estimate if necessary) .............	6	37
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	386
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	91,548	73,145
9	Program service revenue (Part VIII, line 2g) .........	72,762,581	78,939,624
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	941,222	1,247,974
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	510,795	815,728
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	74,306,146	81,076,471
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)	41,200,766	43,350,694
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 122,673
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	34,459,327	32,991,687
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	75,660,093	76,342,381
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,353,947	4,734,090
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	94,077,997	101,334,301
21	Total liabilities (Part X, line 26).............	11,728,079	13,301,937
22	Net assets or fund balances. Subtract line 21 from line 20.....	82,349,918	88,032,364

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 51,469,048 including grants of $ 0 ) (Revenue $ 60,914,526 )
	THE RICHLAND HOSPITAL, INC. (THE HOSPITAL) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN RICHLAND CENTER, WI. PATIENTS SERVED BY THE RICHLAND HOSPITAL IN 2024 INCLUDED 3,329 ADULTS AND PEDIATRICS INPATIENT DAYS, 329 SWING BED PATIENT DAYS, 253 NEWBORN PATIENT DAYS, 68,457 TOTAL OUTPATIENT VISITS, AND 6,861 EMERGENCY ROOM VISITS. THE HOSPITAL ALSO OPERATES A PHYSICIAN CLINIC PROVIDING PRIMARY CARE PROCEDURES SUCH AS CARDIAC TESTS AND ULTRASOUNDS. THE HOSPITAL ENGAGES IN SEVERAL EFFORTS THAT ARE DESCRIBED IN DETAIL ON THE SCHEDULE H ATTACHED TO THE RETURN.

4b	(Code: ) (Expenses $ 12,355,182 including grants of $ 0 ) (Revenue $ 17,728,983 )
	THE RICHLAND HOSPITAL, INC. ALSO OPERATES THREE RURAL HEALTH CLINICS LOCATED IN RICHLAND CENTER, SPRING GREEN AND MUSCODA, WI. THESE CLINICS PROVIDED OVER 41,430 VISITS TO PATIENTS IN THESE COMMUNITIES. THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH BY DEFINITION ARE LOCATED IN DESIGNATED RURAL OR UNDERSERVED AREAS OF THE COUNTRY BY HEALTH CARE PRACTITIONERS. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO WITHOUT ACCESS TO CARE LOCALLY WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE.

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses63,824,230

(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/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) THOMAS BECK........................................................................ SURGEON	40.00 .......................	X	564,451	0	27,461
(19) ANDREW WRIGHT........................................................................ FAMILY PRACTICE DOCTOR	40.00 .......................	X	453,205	0	48,728
(20) BRYAN MCCARVEL........................................................................ CRNA	40.00 .......................	X	476,467	0	54,806
(21) NATHANIEL SCHWARTZ........................................................................ CRNA	40.00 .......................	X	409,907	0	15,936
(22) SHAWN O' BRIEN........................................................................ ER DOCTOR	40.00 .......................	X	531,020	0	55,255

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	3,308,456	0	295,988

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	58,378
e	Government grants (contributions)		1e	14,767

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g	3,713

h Total. Add lines 1a-1f.......		73,145

		Business Code
2a	PATIENT SERVICE REVENUE	621990	77,486,370	77,485,984	386
b	PHARMACY 340B REVENUE	456110	1,157,525	1,157,525
c	MEALS	722320	182,879			182,879
d	CONTRACTED THERAPY	621990	101,100			101,100
e
f	All other program service revenue.		11,750			11,750
g	Total. Add lines 2a–2f .....		78,939,624

3 Investment income (including dividends, interest, and othersimilar amounts) ......			917,446			917,446
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	814,728
b	Less: rental expenses	6b	29,834
c	Rental income or (loss)	6c	784,894
d	Net rental income or (loss).......			784,894			784,894
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	1,939,530	6,500
b	Less: cost or other basis and sales expenses	7b	1,576,856	38,646
c	Gain or (loss)	7c	362,674	-32,146
d	Net gain or (loss).........			330,528			330,528
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	BAD DEBT RECOVERIES		900099	30,834			30,834
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			30,834
12	Total revenue. See instructions.....			81,076,471	78,643,509	386	2,359,431

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	967,206		967,206
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........	33,893,173	29,267,302	4,529,051	96,820
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,160,903	978,118	179,493	3,292
9	Other employee benefits .......	5,061,747	4,248,061	799,388	14,298
10	Payroll taxes ...........	2,267,665	1,876,246	385,104	6,315
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	98,430		98,430
d	Lobbying ...........	11,103		11,103
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	12,074,478	9,270,147	2,804,331
12	Advertising and promotion ....	185,325	121,014	64,311
13	Office expenses .......	443,590	238,050	203,932	1,608
14	Information technology ......	772,391		772,391
15	Royalties ..
16	Occupancy ...........	852,808	847,802	5,006
17	Travel ............	50,235	44,445	5,790
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	336,354	181,006	155,008	340
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,458,877	2,814,245	644,632
23	Insurance ...	191,454		191,454
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	SUPPLIES	10,307,776	10,259,712	48,064
b	BAD DEBT EXPENSE	2,251,593	2,251,593
c	EQUIPMENT RENTAL & MAIN	1,083,288	1,072,408	10,880
d	DIETARY EXPENSE	333,163	333,163
e	All other expenses	540,822	20,918	519,904
25	Total functional expenses. Add lines 1 through 24e	76,342,381	63,824,230	12,395,478	122,673
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).

1	Cash–non-interest-bearing ........			1,538	1	2,713
2	Savings and temporary cash investments .........			29,631,417	2	15,390,086
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			12,411,234	4	11,162,494
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,019,116	8	2,167,932
9	Prepaid expenses and deferred charges ......			347,439	9	406,528
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	76,559,286
b	Less: accumulated depreciation	10b	53,301,745	23,953,861	10c	23,257,541
11	Investments—publicly traded securities .			17,884,764	11	43,003,112
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 ...........			7,828,628	15	5,943,895
16	Total assets. Add lines 1 through 15 (must equal line 33)...			94,077,997	16	101,334,301

17	Accounts payable and accrued expenses .....	6,639,943	17	8,607,008
18	Grants payable ...		18
19	Deferred revenue .........	13,394	19	4,544
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	4,363,542	23	3,752,633
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	711,200	25	937,752
26	Total liabilities. Add lines 17 through 25..	11,728,079	26	13,301,937

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	80,937,230	27	86,547,616
28	Net assets with donor restrictions ...........	1,412,688	28	1,484,748
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	82,349,918	32	88,032,364
33	Total liabilities and net assets/fund balances ........	94,077,997	33	101,334,301