2024-2025 RWHC in Reivew : simplebooklet.com

RWHC IN REVIEW 2024-25 3 It is an honor to serve as the President of the Rural Wisconsin Health Cooperative, and I am proud to present this report that showcases the great work of the Cooperative at this critical juncture for rural healthcare organizations. There are many economic and sociodemographic changes that are challenging hospitals and clinics, now more than ever before. And with each of these challenges, rural facilities and the caregivers who serve our rural communities are disproportionately impacted. Consider the following:  Healthcare organizations are constantly being asked to become more eﬃcient in order to bring down the cost of healthcare in the United States. Rural communities with lower populations have lower patient volumes and by design are challenged to decrease unit costs compared to our urban counterparts.  A record 17.3% of the United States population is over the age of 65, and rural communities face an even higher portion of senior citizens. Patients over the age of 65 demand more services and Medicare pays hospitals and physicians much less than commercial insurance would pay for the same services. Therefore, rural hospitals are facing unprecedented demand for services but are being reimbursed less per unit of service with every passing year.  All healthcare organizations face the demand to update their facilities and equipment, and rural facilities are older on the whole and require more investment per patient than urban and suburban facilities.  Maintaining essential services that are less proﬁtable in the healthcare sector is challenging everywhere, as evidenced by the closure of birthing centers in hospitals across the country spanning many diﬀerent types of settings. However, maintaining birthing centers in rural facilities is even more challenging with low volumes, a high percentage of moms and babies covered by the state Medicaid system, and challenges in recruiting physicians to our rural practices.  Faced with so many challenges, it would be natural to assume that rural facilities provide lower quality services, are more expensive, and are less reliable. Nothing could be further from the truth in Wisconsin, where our rural healthcare organizations serve as a model for other parts of the country. Wisconsin rural hospitals provide high quality services, continue to recruit some of the best physicians in the state, and have employee cultures that promote empowerment and career development. Letter from the President by Brian Stephens RWHC President At the center of this success is the Rural Wisconsin Health Cooperative! Comprised of 40 Member hospitals and many more aﬃliate hospitals and strategic partners, the Cooperative promotes collaboration and shared success amongst both system-owned and independent rural facilities throughout the state. Thanks to a strong internal leadership team and the active participation of Member hospitals, the Rural Wisconsin Health Cooperative advocates for local, state, and federal policies that support healthy communities, supports our rural hospitals and clinics as economic drivers throughout the state, and establishes shared services to ensure that rural hospitals can achieve many of the same economies of scale that beneﬁt larger facilities. At its core, the Cooperative is a group of like-minded healthcare leaders who are laser focused on delivering high quality, aﬀordable, and sustainable healthcare in communities where it would otherwise be unexpected. Throughout the pages of this report, you will ﬁnd numerous examples of this work in action. We are proud of our facilities, of our caregiver teams, of the communities we serve, and of our cooperative work to ensure that Wisconsin remains a beacon of hope for rural healthcare for years to come! "Thanks to a strong internal leadership team and the active participation of Member hospitals, the Rural Wisconsin Health Cooperative advocates for local, state, and federal policies that support healthy communities, supports our rural hospitals... "

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5 RWHC IN REVIEW 2024-25 The Rural Wisconsin Health Cooperative (RWHC) was begun in 1979 by six visionary rural hospital CEOs in southwestern Wisconsin as a means to share services and exercise a collective rural voice. It was one of the ﬁrst, if not the ﬁrst, such collaborative initiatives in America. The co-op model was chosen in order to be clear that the Members were in charge of their own fate. In addition, if you are familiar with agriculture cooperatives, we work the same way–one member/one vote. Our original bylaws, largely unchanged, were from a dairy co-op–we just crossed out the word “dairy” and wrote in “hospital.” RWHC is now owned and operated by a diverse statewide array of 40 rural hospitals– Critical Access Hospitals and other acute medical-surgical hospitals, both independent and system aﬃliated. After 45 years, I continue to have the incredible honor to serve as RWHC’s Executive Director. When hired, my biggest concern was that a board of administrators would tend to micromanage staﬀ and their fear was that coming from a university hospital, their ﬁrst Executive would only stay around for a few years–we were both proved very wrong. I believe the synergy between Board and Staﬀ has never been stronger. Our shared advocacy has always been about what will make rural health and communities stronger. People listen not so much because of anything RWHC staﬀ say, but because local rural hospital and community leaders across our state speak up about the importance of strong local health care. RWHC advocacy continues to focus on: (1) fair reimbursement from government and private sector payers, (2) addressing workforce shortages and (3) developing stronger rural communities. RWHC (Members and Staﬀ) assist each other to oﬀer high quality, cost-eﬀective healthcare. RWHC continues to address the ever-evolving dimensions of rural health care–developing and managing shared services in multiple domains: professional, technical, educational and quality improvement. Services are developed by the Members and primarily for the Members but also oﬀered to non-Members as appropriate to further spread our ﬁxed costs. RWHC (Members and Staﬀ) are leading the country in demonstrating the importance of community economic development. We understand it is not the job of the local hospital to solve community problems alone but to be at the table and actively part of seeking solutions. Good examples amongst RWHC Members are their growing involvement in aﬀordable childcare and housing initiatives. RWHC believes in the power of strategic alliances and partnerships in almost everything we do. It is our intent to inﬂuence and to learn from a diverse array of organizations with the potential to impact Wisconsin’s rural communities. The central goals that drive RWHC’s partnership are: Access to Cost-Eﬀective and Quality Rural Healthcare A Suﬃcient Healthcare Workforce to Support Local Care  Growing Rural Healthcare’s Community and Economic Impact  Addressing Intra- and Inter-Community Health Disparities The state of rural health in Wisconsin is strong but not without its challenges. Funding and workforce shortages, along with necessary community and economic development, have already been mentioned. In addition, there has been an increasing decline in trust in healthcare–both rural and urban–over recent years. “People who mistrust health care put their health and lives at risk–they are less likely to visit a physician, less forthcoming in conversations with clinicians, and less likely to comply with medical advice and prescriptions. Mistrust leads to deteriorating patient outcomes and increased clinician burnout.” (Harvard Business Review, 9/8/22). This is a challenge we must address. Due to these challenges across the nation, more than 700 rural hospitals–over 30% of all rural hospitals–are at risk of closing in the next six to seven years. In Wisconsin, the number is much lower, but still a real concern–10% of rural hospitals in Wisconsin are thought to be at risk of closing. (Center for Healthcare Quality and Payment Reform, 11/22/24). In addition, there is an epidemic of maternity services closing across the country– fortunately, less so in Wisconsin. However, we are not immune. RWHC Members have started a Maternity Services Workgroup to do everything we can to maintain access to and quality of rural maternity and obstetric care. We should celebrate rural health care every day while continuing to work to make it even better and more secure. Rural healthcare must never be taken for granted. We must continue to ﬁght for the resources to keep quality cost-eﬀective care local. Ongoing public and private investments are absolutely critical to the future of rural health and rural community and economic development. As Albert Einstein once said, “Learn from yesterday, live for today, hope for tomorrow.” Moving Forward on a Strong Foundation " ...across the nation, more than 700 rural hospitals- over 30% of all rural hospitals– are at risk of closing in the next six to seven years" by Tim Size RWHC Executive Director

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RWHC Board of Directors 6 RWHC IN REVIEW 2024-25 Dan ROHRBACH Southwest Health Center - Platteville Luke BEIRL Tamarack Health - Ashland Medical Center Gordy LEWIS Burnett Medical Center - Grantsburg Chris BROPHY Crossing Rivers Health - Prairie du Chien Eilidh PEDERSON Western Wisconsin Health - Baldwin Luke BEIRL Tamarack Health Hayward Medical Center Shawn LERCH Sauk Prairie Healthcare - Prairie du Sac DeAnn THURMER SSM Health St. Clare Hospital - Baraboo Kristie MCCOIC Gundersen St. Joseph’s Hospital & Clinics - Hillsboro Bob VAN MEETEREN Reedsburg Area Medical Center Tammy BENDING ThedaCare Medical Center - Berlin Michele SEATOR Marshﬁeld Medical Center - Ladysmith Bruce ROESLER The Richland Hospital, Inc. - Richland Center Black River Health - Black River Falls Carl SELVICK Grant Regional Health Center - Lancaster Tami CHAMBERS ThedaCare Medical Center - Shawano Kellie DIEDRICK Gundersen Boscobel Area Hospital & Clinics Theresa BRAUDT Froedtert Holy Family Memorial - Manitowoc Ryan NEVILLE Spooner Health Mike SCHAFER Prairie Ridge Health - Columbus John RUSSELL Dara BARTELS Mile Bluﬀ Medical Center - Mauston Mike YOUSO St. Croix Regional Medical Center - St. Croix Falls Cumberland Healthcare Emily DILLEY SSM Health Monroe Clinic Hospital Jane CURRAN-MEULI Stoughton Health Chris BRABANT Lisa SCHNEDLER Upland Hills Health - Dodgeville Julie BULIN Bellin Health Oconto Hospital & Clinic Derek DALY Tomah Health Marc AUGSBURGER Edgerton Hospital & Health Services Colleen KOSKI HSHS St. Clare Memorial Hospital - Oconto Falls David HARTBERG Vernon Memorial Healthcare - Viroqua Michael ANDERSON Fort HealthCare - Fort Atkinson Kelly MACKEN-MARBLE Osceola Medical Center Jenny DERKS ThedaCare Medical Center - Waupaca Frank PÉREZ-GUERRA Gundersen Moundview Hospital & Clinics - Friendship Ty ERICKSON Marshﬁeld Medical Center-Park Falls Dan COENEN Gundersen Tri-County Hospital & Clinics - Whitehall Memorial Hospital of Lafayette County - Darlington Marie WAMSLEY Marshﬁeld Medical Center - Neillsville Sally ZILLMAN Door County Medical Center - Sturgeon Bay Brian STEPHENS

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8 RWHC IN REVIEW 2024-25 Advocacy has long been important for RWHC. In the early ‘80s, we led the charge, starting at the Al Ringling Theatre in Baraboo against a proposal from a federally funded Health Planning Council to close or merge every rural hospital in southern Wisconsin. Long story short, rural hospitals are still here, and that agency is long forgotten. However, 2024 has been a diﬃcult year on rural healthcare, with a continued inﬂationary environment and natural disasters restraining supplies, healthcare payers increasingly suppressing the reimbursements to providers and the closure of two hospitals in the Chippewa Valley and other hospitals forced to discontinue certain services. The world has come to adjust to and live with COVID. However, there seems to be a wake left of mistrust in medical science and healthcare providers. This further exacerbates our healthcare workforce shortage as providers continue to retire, decide to seek other professions or young people decide not to pursue a career in healthcare. The pandemic brought some ﬂexibilities in the provision of services allowed by the removal or relaxation of regulatory provisions. This included telehealth, average length of stay, requiring a 3-day hospital stay before qualifying for a nursing home, EMTALA waivers and more. The end of the Public Health Emergency in the spring of 2023 ended these ﬂexibilities, but we must continue to seek to reinstate those ﬂexibilities that provide for the better provision of high-quality care. Federal support for healthcare workforce took a hit when the Health Resources and Services Administration (HRSA) removed 89 Health Professional Shortage Area (HPSA) designations across Wisconsin going into 2024. The HPSA designation is extra support for the healthcare workforce in the areas of Primary Care, Dental and Mental Health, both rural and urban. A bright spot for rural healthcare occurred with the signing of 2023 WI Act 185, The Graduate Medical Education (GME) Grant Program Reform Legislation (SB 643). This bill helped enumerate many of the investments made under the 2023-25 biennial budget. Additionally, as previewed in his 2024 State of the State address, Governor Evers created the Governor’s Task Force on the Healthcare Workforce. Lt Gov. Sara Rodriguez, a registered nurse with a master’s degrees in nursing and public health, chaired the task force and traveled around the state to talk with healthcare leaders, including many RWHC Members. Much of our advocacy going forward will continue to focus on the challenges and multitude of solutions that can aﬀect rural healthcare workforce shortages and rural workforce shortages across the rural economy. The Presidential election brought change in governing philosophies, which may be more supportive of removing or relaxing unnecessary regulatory provisions, but also needs to assist in restoring trust in medical science and healthcare providers. Additionally, Federal Agency support and oversight is crucial to support rural healthcare. On the State level, the Wisconsin Legislature will see the closest margins in both houses in more than a decade. State policymakers need to continue to focus on increasing payment to providers for government-run healthcare programs so that they come closer to covering the costs incurred and continue to focus on growing and supporting the healthcare workforce. RWHC will look to maintain and improve reimbursement for rural hospitals and support expanding access and enhancing quality; continue to work with education partners to expand the resources and output of healthcare workers across the spectrum, making sure Wisconsin is an attractive place to come practice and receive a license in a timely fashion; and rural community needs to empower our workforce. The State continues to maintain a budget surplus in the billions, investing in our current and future workforce needs and services to support the healthcare workforce needs to be a priority. CONTACT: Jeremy Levin jlevin@RWHC.com Highlights of our Services Advocacy Advocacy

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RWHC Healthy Wisconsin 9 RWHC IN REVIEW 2024-25 In the domains of diabetes and hypertensive disease care, RWHC has worked with our Members and the Wisconsin Collaborative for Healthcare Quality to develop the Rural Wisconsin Chronic Disease Toolkit, which contains a compendium of tools and best practices designed to improve blood pressure management, increase the number of diabetic patients receiving timely diabetic-focused visits, and provide patients with collaborative self-management training. The Toolkit is updated annually and can be accessed at: https://www.hipxchange.org/ RuralChronicDisease. In the domain of care coordination, RWHC has worked to develop roadmaps, along with various tools and resources, to help our Members implement and sustain CMS and commercial payer reimbursable care coordination services, including Chronic Care Management, Transitional Care Management, Medicare Wellness Visit, and others. These roadmaps are available in the Chronic Disease Toolkit, and assistance with their use is provided by RWHC staﬀ. Looking forward, RWHC is in the process of expanding our chronic disease management eﬀorts to the domain of cancer prevention. In mid-2023, RWHC started working with our Members and Partners to develop and implement cancer prevention tools and resources intended to help rural healthcare organizations increase cancer screening rates, reduce screening disparities, and decrease cancer mortality rates. CONTACT: Cheryl DeVault cdevault@RWHC.com RWHC Healthy Wisconsin, Inc., is the 501(c)3 arm of RWHC. RWHC Healthy Wisconsin, Inc., fosters the community conditions and human capital necessary to ensure Wisconsin communities will be the healthiest in America. Much of RWHC’s workforce development and community economic development work is supported by RWHC Healthy Wisconsin, Inc. If you are interested in making a contribution to this non-proﬁt, please contact Marie. CONTACT: Marie Barry mbarry@RWHC.com Chronic Disease Management Initiatives

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What participants are saying about our Clinical Education Programs... Hands down this is great information! I am in a lead role and some of my biggest struggles are communication with the team. The information that is given out that I can tuck into my toolbox is going to be so helpful in growing and learning. After day 1, I had already reached out to my friends at diﬀerent facilities and told them they HAD to sign-up for this class, that it was going to be life-changing. -- Ashley, Platteville Cella’s knowledge in the ﬁeld of nursing is beyond compare. She has an exceptionally innovative approach which empowers and creates a safe space for participants to share and learn from her and each other. Cella is extremely committed to the profession of nursing and everyone who has the privilege of participating in her workshops has been gifted an invaluable experience and resource for their own nursing journey. 10 RWHC IN REVIEW 2024-25 RWHC oﬀers a Clinical Education Series for both new and experienced nurses, as well as nursing ancillary support staﬀ. The workshops are designed to enhance the clinician’s knowledge and improve critical thinking at the bedside for overall improved patient care within your organization. All our clinical workshops are designed to be highly engaging and interactive educational opportunities based upon the principle that there is no learning without action, so facilitation of learning is a key component of this series. The series is open to both RWHC Members and non-members. Most of the clinical workshops are oﬀered throughout the year at RWHC and can also be customized and brought onsite. In 2025, we will be oﬀering some of the clinical workshops virtually. Stay tuned for this. Our Boot Camp series continues to be very successful (ER Boot Camp, OB Boot Camp, and Nursing Supervision Boot Camp) and are oﬀered twice a year. These extensive programs were developed to help nursing personnel develop a solid foundation from the core principles and standards of care and practice perspective in hopes of helping the nurse to practice solo in the department or their supervision role more quickly. This past year, our most popular clinical workshops delivered in-person or onsite were:  Engaging Critical Thinking through Case Studies OB Assessment and Emergencies Pediatric Assessment and Emergencies ER, OB, and Nursing Supervision Boot Camp Series Preceptor Training Program (skill development of the person responsible for onboarding new employees to be successful in their roles) We have hired two new Nursing Clinical Development Educators to our team over the past few months, Sarah Ewers and Ronda Pennekamp. Our clinical education workshop menu will be expanding in 2025 with new topics. The ﬁrst new 2-day workshop to launch will be Caring for the Sicker Patient in February, 2025. CONTACT: Cella Janisch-Hartline chartline@RWHC.com Erin Smital esmital@RWHC.com Clinical Education This program was EXCELLENT! The presenters are TERRIFIC! This program was through Zoom and I felt just as much engaged as I do when I at tend face-to-face classes. Great Job! -- Kristin, Thedacare -- Jackie, Thedacare

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Clinical Services Physical and Occupational Therapy Services were the ﬁrst clinical services oﬀered by RWHC to support the needs of Members. At that time, minimal therapy services were oﬀered in the rural hospitals due to a lack of therapists willing to work in a small practice setting. The RWHC model oﬀered services to a hospital at an appropriate level for their caseload, yet created a network of therapists, thus eliminating the isolation concerns many therapists feared. This model laid the groundwork for these professionals to collaborate on program development, bringing expertise and services to the rural communities that they had previously not enjoyed. Currently, therapists provide a wide range of expertise to accommodate the speciﬁc needs of a hospital and its community. Therapists work with a variety of patients and in a variety of settings including hospital inpatients, outpatients, home health, schools, and in-home pediatric therapy (Birth to Three program). Currently, these services are not available for expansion. The Speech Pathology Service continues to grow while providing direct patient care services to ten of our member hospitals in addition to their aﬃliated Birth to Three programs, nursing homes and home health agencies. RWHC employs 10 speech pathologists with a wide range of expertise and advanced certiﬁcations. The RWHC Speech Pathology Staﬀ are provided the opportunity to network with therapists from other Member hospitals through the RWHC Speech Pathology Roundtable and Dysphagia Grand Rounds. Sixty three percent of our Members are represented in these networking opportunities and participate in the peer review oﬀered through Dysphagia Grand Rounds. Therapists practicing in the rural settings must be qualiﬁed to provide speech, language, cognitive and swallowing evaluation and treatment to patients of all ages. These groups allow the therapists in a solo practice to beneﬁt from the expertise represented in the group and apply it to their patient care. Audiology Physical Therapy & Occupational Therapy Like many of the RWHC Services, the Audiology Service is a successful, longstanding service for several RWHC Members. RWHC employs ﬁve experienced audiologists that provide care to patients of all ages. This includes diagnostic testing and evaluations, hearing aid consultations and dispensing, and follow-up to newborn hearing screenings. In addition to working with primary care providers within the communities, the Audiology Team works alongside ear, nose and throat (ENT) physicians by providing care to their patients that are being evaluated for many diverse problems such as hearing loss, ear infections, and vertigo. The audiologists meet regularly to enhance their professional skills, complete continuing education, and review their quality improvement plan and results. All Members are serviced with state of the art diagnostic equipment and have access to multiple hearing aid companies through our centralized accounts. Along with being licensed by the State of Wisconsin and enrolled Medicaid providers, the audiologists are all members of the American Speech-Language & Hearing Association (ASHA) and the American Academy of Audiology (AAA). Speech Pathology CONTACT: Bonnie Laﬀey blaﬀey@RWHC.com CONTACT: Raechel Kosler rkosler@RWHC.com CONTACT: Bonnie Laﬀey blaﬀey@RWHC.com 11 RWHC IN REVIEW 2024-25

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The RWHC Community Economic Development (CED) Program was started in 2021 to help Members address issues surrounding social determinants of health in their community including but not limited to: housing, childcare, broadband, economic opportunity, education, transportation, etc. The CED program has 4 pillars that guide its work: ■ Increasing rural hospital engagement with local community economic development eﬀorts ■ Increasing the eﬃcacy of rural hospital engagement with community economic development eﬀorts ■ Bringing a rural health perspective into local, regional and statewide community economic development conversations ■ Bringing a community economic development perspective into rural health conversations The program will be oﬀering professional development opportunities for RWHC Members, partnering with UW-Extension to complete Community Economic Analyses of willing Members’ communities, compiling and disseminating relevant local economic data for RWHC Members, developing a toolkit of eﬀective CED strategies for Member use, serving as a liaison to Wisconsin’s existing network of economic development professionals and resources, and generally acting as an accessible resource for members on community economic development issues as they organically arise. In short, the CED Program acts on the idea that RWHC Members can only be as economically viable as their communities. The CED Program aims to bolster the vitality and sustainability of rural Wisconsin communities for both the health of the community and the health of the RWHC provider within that community. Members are encouraged to reach out to the contact below if interested in engaging with the program’s oﬀerings. CONTACT: Marie Barry mbarry@RWHC.com Today, more than ever ensuring accurate coding for claims submission is essential to your facility’s bottom line as re-imbursement systems are typically code-dependent. This is why RWHC oﬀers comprehensive Coding Consultation Service that will allow your staﬀ to meet the heightened awareness for correct coding and demand for correct claims data, as well as compliance. The RWHC Coding Consultation Service is designed to furnish education and regulatory updates, as well as act as a resource for coding and reporting applications. Our goals is to ensure your staﬀ has the necessary tools and knowledge to handle any coding and reporting challenge that may arise in a hospital or clinic setting. Services include: Coding Audits (onsite or oﬀsite), ICD, CPT, EM professional as well as facility fees, Inpatient, Ambulatory Surgery, Emergency Department, as well as Clinics. Education and Training (onsite of oﬀsite). Various requested topics, staﬀ training, mentoring, advancing coder to the next level as well as provider documentation education. Reimbursement Hotline (web-based tool for coding/billing related questions) and Per Diem Coding support (available for staﬃng emergencies, short term support or employment coding tests, updates biannually). RWHC, Manager of Coding and Reimbursement, also facilitates relevant roundtables, maintains, awareness of CMS reporting and Conditions of Participation regulations, provides pertinent CMS updates as appropriate furnishes expertise to other RWHC Services and participates in other associates Wisconsin associations and coding groups. CONTACT: Renee Friesen rfriesen@RWHC.com Coding Consultation Services Community Economic Development Program 12 RWHC IN REVIEW 2024-25

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What customers are saying about our Leadership Programs... 14 RWHC IN REVIEW 2024-25 To be a leader means to be a lifelong learner. RWHC’s experiential workshops are created to equip rural health care supervisors, managers, directors and administration to lead their organizations to reach their goals. Consistently receiving the highest ratings from participants, “learning by doing” nudges allow even experienced leaders to hone their skills. All courses are created and taught by experienced facilitators who have extensive rural health care experience and are passionate about the success of their learners. Numerous topics are oﬀered throughout the year at RWHC and can be customized and brought onsite for your whole leadership team. As healthcare complexity continues to increase, topics of consistent high interest include leading change, project management and communication topics like conﬂict mediation, speaking skills and coaching others. Every year new topics are added to address the changing needs of new learners: Emerging Leaders, In the Moment Responses to Patient Concerns, Hospital Finance for the Non-Financial Manager, Successful Onboarding for Improved Retention and Team Dynamics: Phases of Development & Navigating Struggle are a few of the newest topics. In addition to in-person workshops, our team oﬀers one-on-one coaching, webinars, and a hybrid combination of in-person and virtual participation to meet the needs of learners both near and far. Sign-up for our monthly leadership blog ﬁlled with timely coaching tips for leading with eﬀectiveness. Customized customer service education programs for all employees are also available. CONTACT: Cella Janisch-Hartline chartline@RWHC.com Erin Smital esmital@RWHC.com Corrie Searles csearles@RWHC.com Leadership Programs Lateral Violence: Dealing with Disruptive Behaviors The open environment of sharing real life experiences impacted me on a personal level & allowed me to feel comfortable. The information gained will impact not only my work life, but my personal life as well! I highly recommend thisT workshop! — Dana Loos, Western Wisconsin Health Stepping into Supervision The biggest take away for me was realizing that, as a supervisor, I can start delegating technical tasks to others so I can focus on supporting the team and growing people. That was very clarifying to me as I have been struggling to diﬀerentiate between being a frontline worker and a supervisor. — G. Aslin, Vernon Memorial

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15 RWHC IN REVIEW 2024-25 I’ve had the pleasure of attending many RWHC courses over the past 2 years and I’ve left every one feeling empowered to continue the path of developing my skills. Leadership Residency gave me an opportunity to come together with other leaders who were feeling many of the same growing pains as I was. I found equal value in hearing my peers talk about the small wins they had tackled since we last met, as I did from the expertise shared by our facilitators. I keep my workbooks close at all times so that I can reference the “highlighter” statements. Leadership Residency has given me a toolbox that I can lean into that keeps me motivated to become the best servant leader than I can be. — Siera Williams, Tomah Health RWHC again took the Leadership Residency to Minnesota in 2024, partnering with Wilderness Health, a collaborative of rural hospitals in Northern Minnesota. The Minnesota Wilderness Health Leadership Residency covers similar content as the Wisconsin class with a slightly diﬀerent structure. It included an all virtual, shorter and more frequent meeting schedule. Minnesota Wilderness Health Leadership Residency Leadership Bites & Communication Cornerstones This leadership residency gave us valuable skills while also highlighting that leadership is a continuous learning process. By connecting with others, I saw that everyone faces challenges and none of us are perfect, yet we are in our roles for a reason. — Katrina Fishnick, Southwest Health What our participants are saying about Leadership Residency... Leadership Residency Program Built on the successful Nurse Residency Program model, the year-long RWHC Leadership Residency Program brings together ﬁrst year leaders in health care to increase— and expedite—the likelihood of success in the leadership role. New leaders in health care often come from the ranks—employees with good potential for leadership and management but with little training or support. The Leadership Residency Program targets priority skills that leaders need: leading change, coaching a diverse team, transitioning from peer to leader role, working systematically, engaging employees, improving quality, reducing risk, managing projects and so much more. Just a few of the outcomes of the program, as reﬂected by the participants’ ﬁnal evaluations, showed growth in conﬁdence in their role, successful project results, and improved teamwork through their coaching skill development. The residency is taught in six, two-day learning sessions and includes three coaching phone calls with course instructors and use of an email listserve for ongoing dialogue with classmates. CONTACT: Cella Janisch-Hartline chartline@RWHC.com Erin Smital esmital@RWHC.com Corrie Searles csearles@RWHC.com Today’s healthcare employees and leaders need more than just the occasional opportunity to develop or preserve their eﬀective interaction skills. Healthcare is a human-to-human business. While employees and leaders alike enjoy the pleasure and opportunity of inﬂuencing and making a genuine positive impact on the lives of others, it can be taxing work to maintain the high level of compassion and understanding necessary to continue delivering service excellence. Thus, RWHC responded to our members’ requests to provide regular support for employees across the spectrum in maintaining their strength of empathy, leadership, and service. We are now in our second year of the Leadership Bites program, which is open to any new or experienced healthcare leader. Each month we oﬀer unique topics to hone the leadership skillset—topics not typically covered in our other workshops. This 45-minute webinar is oﬀered the third Tuesday of each month during the lunch hour, or is available as a recording for the duration of the annual subscription. Individuals can begin their subscription at any time. After a successful inaugural year, we will be launching Year 2 of our Communication Cornerstones program in February. With topics catered towards serving any healthcare worker, it oﬀers a 45-minute webinar during lunch on the third Thursday of every other month. Unlike Leadership Bites which is an individual subscription, Communication Cornerstones allows access for an entire facility, permitting participation for the live or recorded sessions by anyone associated with the subscribing organization. Renewals occur at the start of each calendar year. See our website page to learn more about either program: https://www.rwhc. com/Services/ Educational-Services CONTACT: Cella Janisch-Hartline chartline@RWHC.com Corrie Searles csearles@RWHC.com

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This has been very informative, interacitve, and educational. The training is showing me how to be a better leader and communicator. — Andrea Kinch, Upland Hills Health What customers are saying about the Mystery Shopper Program... 16 RWHC IN REVIEW 2024-25 Lean Residency Program The intent of the Lean Residency Program is to help leaders understand the basic principles of Lean including its impact on problem solving, leadership, engagement and culture. Following the completion of this program, leaders will be able to identify waste, manage projects eﬃciently, utilize Lean tools, engage and empower their staﬀ, and develop a team of change agents. The impact of this program has potential to spark positive change within departments across various levels of patient care and ultimately your overall culture. CONTACT: Erin Smital esmital@RWHC.com Mystery Shopper Program Lean Residency Program testimonial... “We love being part of this program to help us celebrate the great communication and customer service we oﬀer, and also identifying opportunities for improvement that we may not be aware of in our day-to-day activities. It is also a great opportunity for some of our front-line staﬀ to participate in making phone calls to another facility. We are also going to implement our own mystery shopper call program mid-year to help us validate improvements. We will continue to participate in this valuable program with RWHC.” RWHC oﬀers a Mystery Shopper Program for members who are willing to “mystery shop” one another’s facilities to assess and improve their customer service experience. RWHC monitors and assigns shoppers to ensure that anonymity is maintained and that any non-negotiables are identiﬁed for the hospital. There are three components to the program: a Live Shopper experience at the hospital, where a staﬀ person from another member hospital arrives to learn more about the hospital's services; a Phone Shopper experience used to determine consistency of branding and staﬀ interactions during phone calls with their hospital; and a Website Shopper experience to evaluate the hospital’s website in terms of ease of navigation, consistency of branding, overall appearance, relevant/current information, etc. Each hospital participating in the shopping experience receives a summary of the ﬁndings. Thirty-six members have participated from one to eleven times over the thirteen years the program has been available. The next round will be announced in March. The program will kick oﬀ with an orientation session for the shoppers in late May, and and shopping will occur in June/July. CONTACT: Carrie Ballweg cballweg@RWHC.com We‘ve used the information received back annually to make adjustments/changes that need to be made to better address issues that we might be missing. We take the program seriously and put some of our best people on it to make sure that we are giving the same TLC to the facility we are screening! — Anonymous — Anonymous

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RWHC continues its partnership with Acme Nerd Games (ANG), Area Health Education Centers (AHEC) and the WI Department of Public Instruction (DPI) to create an interactive computer game for rural Wisconsin high school students to explore rural health careers. The goal of the game is to increase awareness and interest in choosing this career path. Its purpose is to address the current and looming workforce shortages in rural healthcare by engaging teens where their interests already are: through games. Funded by RWHC’s Healthy Wisconsin foundation, the project also partners with Basil Data to include an evaluation component to measure the impact of the game on students’ interests and intentions. Students will explore realistic scenarios through the lens of various healthcare professionals with an emphasis on the team-based nature of care in rural areas. This project oﬀers an opportunity to open up the pathway for students who may not have considered these careers without this exposure and the opportunity to make choices within the no-risk environment of a game. Rural Roads to Health Careers 17 RWHC IN REVIEW 2024-25 RWHC Nurse Residency Program is a one-year program structured around monthly learning sessions where the new graduate is highly engaged in an interactive, reﬂective and enriched learning environment. The sessions are designed around an eﬀective standard curriculum for the nurse who is often isolated on the unit or in the organization with minimal resources. Learning needs are identiﬁed by the participants on a monthly basis and are weaved into the content. Networking with peers who are going through the same challenges is a powerful experience for the new nurse. Small group breakout sessions are incorporated into each learning day and are facilitated with the action reﬂection practice model incorporating the accepted standards of care and practice. Each session of the curriculum is designed to work toward the program goals which include: choosing the kind of nurse they want to be, enhanced critical thinking and decision making, and transitioning to a competent, highly professional practitioner. In 2024, we kicked oﬀ Year 21 of this program at RWHC. Our program has been so successful that we are required to run two cohorts per year—two sessions per month. CONTACT: Erin Smital esmital@RWHC.com Cella Janisch-Hartline chartline@RWHC.com Nurse Residency Program What customers are saying about the Nurse Residency Program... What I valued about the Nurse Residency Program was a safe place to share both struggles and successes that I was experiencing as a new nurse. I was able to learn from my peers as they shared their experiences as well. I learned how to stand up for myself and to own my own actions, and to deal with workplace conﬂicts in a positive way.” — Tammy T., Nurse Residency Participant "RWHC is the reason that I am still in nursing. While nurse residency helped with the day to day stress of taking your knowledge and actually applying it to real patients without supervision, for me it was so much more. It was a place to laugh, a place to commiserate, a place to cry and a place to feel safe with people who were going through the same things I was." —Nikki S., Nurse Residency Participant

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18 RWHC IN REVIEW 2024-25 Working in collaboration with Hospital Educators and Human Resources Managers, RWHC has developed an online orientation program that can be used by students and agency staﬀ to complete their training requirements. The Orientation Portfolio Program emerged out of discussions at the Human Resources and Education roundtables over growing concerns of managing both the practical aspects of orientation for these individuals and meeting all of the documentation requirements. Many Human Resources Managers felt that this is their greatest vulnerability in The Joint Commission surveys. The system is housed at RWHC’s secure data center and only an internet connection is needed to gain access. Students pay a one-time $12 fee and are able to self-register; participating agencies enter their employees into the system, keeping the work for the hospital coordinator to a minimum. The facility coordinator can monitor the activity and program completion, ensuring that these tasks are completed before these individuals arrive onsite and to provide proof of compliance during surveys. Completing these programs ahead of time allows the student’s clinical onsite time to be more productive. Another major advantage of this program is that the basic/general orientation concepts need to only be reviewed once by a student or agency personnel. Completion of this general information is credited to each facility to which the individual is going. Facility-speciﬁc information can also be added onto the site so that the site-speciﬁc training can be completed as well. The information is provided via PowerPoint presentations, and there is a quiz for each program in order to document a certain level of understanding. A second component of the Orientation Portfolio Program is the Documentation Module. It provides the ability to upload and track documentation requirements for things such as vaccinations and licensing. All documents are archived in the system. The Orientation Portfolio Program’s greatest advantage is that it was developed by its users. It improves eﬃciency, decreases staﬀ time, and creates consistency and reliability. CONTACT: Carrie Ballweg cballweg@RWHC.com Orientation Portfolio Program Following futurist Leland Kaiser’s keynote at Wisconsin’s 2005 Annual Rural Health Conference, the RWHC Board grappled with one of Dr. Kaiser’s primary recommendations—that rural hospital leadership should routinely seek out and visit other hospitals in order to gain additional insight to enhance their organization’s performance. The Board’s discussion over several months led to the RWHC Hospital to Hospital (H2H) program, an annual member favorite ever since. All sessions are recorded and archived online for members not able to attend in-person. Mini H2H sessions of about ﬁfteen minutes are presented by Members throughout the year at RWHC board meetings. CONTACT: Tim Size timsize@RWHC.com Hospital to Hospital (H2H)

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19 RWHC IN REVIEW 2024-25 The Preceptor Training Program started for nursing preceptors as a component of support to the Nurse Residency Program but has grown to include employees across the healthcare continuum. It is open to anyone interested in supporting new hires including nursing, lab, pharmacy, therapies, radiology, nutrition, admissions, etc. The successful preceptor model of pairing experienced healthcare professionals with new employees works to quickly bring classroom learning to real life competence no matter what area of expertise. Being skilled in one’s technical role and being an able teacher are two diﬀerent roles. This two-day program facilitates the teaching and mentoring skills necessary to engage new employees in a way that builds competence and conﬁdence for both learner and preceptor. It provides opportunities for practice and feedback related to the essential skillset for preceptors through simulation learning and role-playing scenarios. RWHC hosts this program at the RWHC Training Center, onsite at your location, and virtually for mixed healthcare groups. Bringing this program onsite for your organization is an excellent way to build a strong preceptor culture. When preceptors across the healthcare continuum can learn together, it jump starts a culture change in a way that increases retention. CONTACT: Cella Janisch-Hartline chartline@RWHC.com Erin Smital esmital@RWHC.com Preceptor Training Program Participants leave the two days of Preceptor Training with a fully stocked toolkit, but ongoing support and education for precepting is a best practice to keep programs and preceptors fully functioning. Instructors continue to create fresh content to support preceptors as they run into challenges in bringing their toolkit into practice. The 2.0 sessions drill down on some of the toughest parts of precepting including holding tough conversations, navigating the stress of teaching and addressing individualized learning needs of a diverse workforce. CONTACT: Cella Janisch-Hartline chartline@RWHC.com Preceptor Training 2.0Taking it to the Next Level! The class/information has me excited to improve not only a preceptee’s experience, but also myself as a preceptor. I look forward to implementing new skills to empower and inspire new nurses during orientation and throughout their career. — Hazen Keller, Crossing Rivers Health What customers are saying about our Preceptor Training Program... Loved how both teachers used so many personal examples to demonstrate techniques/strategies. — Jessica , Southwest Health

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20 RWHC IN REVIEW 2024-25 The opportunity to network with one’s peers is one of the key advantages to membership in RWHC. RWHC oﬀers 49 Professional Roundtables, representing a wide range of clinical and non-clinical disciplines—additional groups are considered on a regular basis. Most of the roundtables meet 4-6 times per year, typically for 2-4 hours per meeting. The roundtables are an opportunity for members to discuss topical issues, exchange ideas and implement special projects. In fact, many of the programs and services that RWHC provides started ﬁrst as roundtables. CONTACT: All Roundtable Facilitators can be reached via: oﬃce@RWHC.com Professional Roundtables Accounting Manager  Ambulatory Care Quality Anesthesia  Behavorial Health  Care Coordination  Chief Financial Oﬃcer  Chief Operating Oﬃcers  Clinic Managers  Clinical Documentation Improvement  Coding  Community Economic Development  Community Relations  Corporate Compliance Plan  Diabetes Educator  Education  Emergency Preparedness  Employee Health Environment of Care  ER RN Ethics  Executive Assistant  Foundation Director  Health Information Management (HIM)  Human Resources  ICU RN  Infection Prevention  Information Technology  Lab  Med/Surg RN  Medical Staﬀ Coordinator  Nurse Executive  Nutrition Services  OB RN Patient Access  Patient Business Manager Patient Experience  Perioperative RN  Pharmacy  Preceptor/Onboarding  QI Coordinator  Radiology  Rehab Manager  Respiratory Therapy  Risk Management  Social Work  Speech Pathology  Supply Chain  Utilization Review Coordinator  Wound Care I would not be able keep up with all of my responsibilities without the resources available from RWHC. The roundtables help me stay abreast of current issues and trends and the educational resources help push our organization to higher levels. I would highly recommend RWHC as a necessary resource for rural health care providers. — Shelly, MASL, RN, Director of Quality/Compliance, Tomah Health Currently, RWHC facilitates the following Roundtable meetings:

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21 RWHC IN REVIEW 2024-25 Whether the hospital is a Prospective Payment System or Critical Access Hospital, the RWHC Quality Indicators Program helps clients from around the nation participate in clinical quality measures that meet regulatory and accreditation requirements while making sense for their stakeholder’s quality strategy. RWHC oﬀers a secured web-based environment for data collection and reporting. Our hosted software has built-in alerts and our timely transmission schedules allow clients to make any last minute changes and edits without a panic. We have developed clear, concise, at-a-glance, and on-demand reports to clearly identify areas of strong performance as well as opportunities for improvement. Our friendly and knowledgeable staﬀ provide exceptional customer service. CONTACT: Janet Wagner jwagner@RWHC.com Wisconsin Quality Residency Program There are many things to learn when starting a new position as a health care quality leader. Regulatory and accreditation requirements, basic risk management skills, quality data reporting methods, and useful quality improvement methods and tools are just a few! The Wisconsin Quality Residency Program provides a comprehensive curriculum of core quality improvement concepts and leadership essentials instructed by experts in the ﬁeld. The program, using a virtual learning platform, oﬀers monthly learning modules, adult learning strategies, engaging discussion, and applied practice exercises. Each module is aligned with at least one pillar of the National Association for Healthcare Quality’s Certiﬁed Professional in Healthcare Quality certiﬁcation. This program will help prepare you for the certiﬁcation exam. The Wisconsin Quality Residency Program is being oﬀered through a partnership between the Wisconsin Hospital Association (WHA) and RWHC and is co-sponsored by the Wisconsin Oﬃce of Rural Health. CONTACT: Janet Wagner jwagner@RWHC.com Quality Indicators Program Many RWHC Members and other rural organizations submit professional fees for the services provided by their practitioners. This is a complex process as most rural organizations have 10 or more health plan contracts. Each health plan has its own requirements and process for enrolling new practitioners as health plan providers. In addition, practitioners must be enrolled as a Medicare and Medicaid provider with yet a diﬀerent set of requirements and processes. The RWHC Reimbursement Credentialing Services can assist organizations with provider enrollment and maintenance of enrollment for each of their health plan contracts. To accomplish this, RWHC works with a contact at the organization and/or with the practitioner directly, along with identifying speciﬁc contacts and weblinks for each health plan, RWHC clariﬁes what each payer requires, completes the required screening and subsequent applications, and provides all necessary follow-up including conﬁrmation of enrollment and the eﬀective date. A similar process is established for the recredentialing process typically every three years that each health plan requires. This Service also includes establishing and maintaining the national CAQH application now required by most of the larger health plans. In addition, RWHC manages any demographic changes that may occur for each of the individual practitioners. The RWHC Reimbursement Credentialing Services is limited to those organizations contracting for the RWHC Credentials Veriﬁcation Service. This is to assure that RWHC has the current and accurate data to complete and maintain the provider enrollment process for each health plan. The RWHC Reimbursement Credentialing Services has an initial enrollment fee for new practitioners that includes all tasks for provider enrollment and an annual subscription fee for established practitioners that provides the ongoing maintenance required by many plans (e.g., CAQH updates) and recredentialing requirements. CONTACT: Bonnie Laﬀey blaﬀey@RWHC.com Reimbursement Credentialing Services

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Technical Solutions RWHC partners with ZixCorp to oﬀer an enterprise email encryption solution to protect facilities from the exposures of releasing Protected Health Information or we can provide an individual gateway appliance to install locally. CONTACT: Darrell Statz dstatz@RWHC.com While many options are available for tape-based systems, the reliability and oﬀ-site storage requirements make this cumbersome and leave you wondering if you can actually recover the data you think you have backed-up. RWHC has partnered with Arcserve to oﬀer disk-to-disk systems with automated oﬀ-site vaulting to our secure data center. This is oﬀered on a monthly subscription agreement and is sized appropriately to your needs. Alternatively, we also are a reseller for facilities that would prefer to purchase their own hardware. RWHC provides solutions for healthcare providers to comply with HIPAA and HITECH requirements, including data protection systems and email encryption. Email Encryption Services Data Protection Systems 22 RWHC IN REVIEW 2024-25 Refueling Your Heart for Registered Nurses Nursing is not an easy profession, sometimes. Many nurses are now asking themselves this question, “Where oh where did the passion go, oh where oh where can it be?” Burnout is at an all-time high in healthcare. Never before have so many nurses dreamed of an exit strategy. This is causing lots of turnover which is creating staﬃng challenges, which brings more stress to those who remain in their roles. This cycle continues to go round and round. Caregivers typically give and give of themselves, caring for everyone else’s needs before taking care of themselves. There are so many responsibilities and so little time to meet them all. Many have lost sight of the importance of self-care and taking time to refuel their own hearts. To this end, they have less to give to others. The Refueling Your Heart program is an 8-module online course which includes a training video for each speciﬁc module and a handy workbook for each section. Each workbook has designed activities and multiple self-reﬂective questions to deepen the learning and personal awareness. The RWHC Network reviews payor contracts on behalf of RWHC Network members and suggests revisions and negotiation strategies Refueling Your Heart Newsletter/Blog There is also a monthly newsletter/blog option for all healthcare personnel who would like to have a monthly dose of reﬂection on Refueling Your Heart. Choose to subscribe today! CONTACT: Cella Janisch-Hartline chartline@rwhc.com The RWHC Network is a subsidiary of RWHC dedicated to payor-provider contracting. After considerable eﬀort by RWHC in 1996, the U.S. Department of Justice issued a business advisory letter that allows collaboration in negotiating with health plans and other third-party payers. As a result of this business advisory letter, RWHC Network, Inc., was created in 1997. Membership in RWHC Network, Inc., is limited to RWHC Members. with regard to non-sensitive terms and posts these reviews on the member portal for use by individual hospitals in ﬁnalizing negotiations with a given payor. Depending on the circumstances, the reviews are handled by RWHC’s Director of Health Plan Contracting coordinating any legal review with Quarles & Brady, LLP, as necessary. The RWHC Network will negotiate common non-sensitive terms with payers where appropriate, but the ﬁnal negotiation of ﬁnancial and other facility-speciﬁc terms of each contract rests with the individual member. The RWHC Network also provides education on managed care, clinical integration, antitrust parameters and other payor issues at regular RWHC Network meetings. The RWHC Network also provides a forum for discussion at meetings and through an RWHC Network listserve. CONTACT: Michael Ballinger mballinger@RWHC.com RWHC Network

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23 RWHC IN REVIEW 2024-25 Founded in 2007, the RWHC Information Technology Network (ITN) is a not-for-proﬁt consortium that supports rural hospital technology projects. RWHC ITN Services include a fully-hosted ONC-certiﬁed Medhost electronic health record environment, a Merge Picture Archive and Communications System (PACS), a Harris Enterprise Resource Planning (ERP) system, and related implementation and 24/7 helpdesk services provided by a staﬀ of HIT professionals. These systems are served from a dual data center environment that is highly redundant with real-time data replication and layers of storage and back-up protecting participant health information. RWHC ITN is also a Healthcare Connect Fund (HCF) consortium through which over 20 rural hospitals receive subsidized broadband services. Whether consortium participants are connecting to the RWHC ITN’s network or other locations such as remote clinics, the RWHC ITN HCF program serves its members by competitively bidding for cost-eﬀective telecommunication services, contracting with selected vendors, and then managing the USAC/HCF subsidy process that results in over 50% savings on participant-eligible telecommunications costs. CONTACT: Louis Wenzlow lwenzlow@RWHC.com RWHC Information Technology Network (ITN) RWHC ITN has partnered with Digicorp to provide healthcare organizations with a variety of cybersecurity solutions, several of which are being mandated by insurance underwriters. We recognize that depending upon organizational size, staﬀ and ﬁnancial resources, each RWHC Member hospital is distinctly diﬀerent in how they will address the challenge of IT security. This is why we’ve designed a model that provides a menu of solution, implementation and support options. The following is a list of service oﬀerings. For each oﬀering, we can serve in a myriad of capacities – from system designer/ recommenders to a fully outsourced solution. Service Categories  SIEM (Security Information and Event Management): This tool aggregates log data, security alerts and system events across all monitored elements  EDR (End Point Detection and Response): An end point protection solution that incorporates traditional signature analysis with advanced analytical/ behavioral reasoning. Firewall Management: Ongoing software and ﬁrmware management of this critical resource  System Monitoring: Data gathering on any critical gateway, switch or server, uses standard SNMP protocol User Awareness Testing and Training: Supports organizational user behavior management. File Structure Security Management: A cost-eﬀective tool for protecting organizational data structures CONTACT: Louis Wenzlow lwenzlow@RWHC.com Joe Plonka jplonka@RWHC.com RWHC ITN/Digicorp Security Solutions Vulnerability Scanning: A security tool/process that is directed at critical organizational elements such as ﬁrewalls, core switches and internal servers— a valuable last step in any change management protocol 

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24 RWHC IN REVIEW 2024-25 WCRGME The Wisconsin Collaborative for Rural Graduate Medical Education (WCRGME) was developed to address the rural physician shortage through expansion and support of rural graduate medical education (GME). WCRGME was established in 2012 as a partnership of RWHC, the Wisconsin Rural Physician Residency Assistance Program, UW Baraboo Rural Residency Program, and several rural hospitals and residency partners. Today, the group includes over 60 partners. WCRGME oﬀers technical assistance in support of rural GME in the following areas:  Administration & Accreditation Assistance  Best Practice Resources  Faculty Development Conferences  Rural Education Coordinators Training & Committee  Marketing Rural GME Opportunities to Medical Students WCRGME has grown to over 20 rural training programs (RTPs) and fellowships with a total of 65 GME positions ﬁlled each year. Programs include family medicine, psychiatry, obstetrics/ gynecology, surgery, pediatrics, dermatology, internal medicine, emergency medicine, hospitalist, and medicine/pediatrics. Change to rural residency programs include both rurally located programs, rural track programs, and programs with signiﬁcant rural training emphasis. Wisconsin consistently places over 60% of rural residency graduates in rural communities after completion of training. In addition to supporting rural GME programs, WCRGME was a key partner in establishing the Wisconsin Northern & Central GME (WiNC GME) Consortium. WiNC is an ACGME– accredited sponsoring institution and plays a critical role in expanding GME training in northern Wisconsin communities where physician shortages are more signiﬁcant. WCRGME also partners with urban residencies in identiﬁcation of rural rotation sites. There are 35 sites available for training residents in a variety of specialty areas. Highlights from the past year include the following: GME Expansion: Collaborated with Tamarack Health and WiNC on development of a new family medicine residency that will launch in 2026. The team is also working closely with Thedacare to grow several residency programs that will include rural training with various critical access hospitals within the region. Rural GME Leadership Program: In partnership with WiNC and MCW-Central Wisconsin, WCRGME oﬀered a 6-month faculty development program virtually to 27 physician faculty and residents. Recruitment is underway for the 2025 cohort.  Residency Recruitment Workshop: This workshop was held in partnership with WWAMI and RRPD to support program leaders in successful planning for the 2024-2025 recruitment cycle. Over 110 attended the event which featured both national and Wisconsin program leaders.  Rural Coordinator Leadership Institute: In partnership with coordinators from rural programs around the country, a 12-month curriculum is being planned to support experienced rural education coordinators focusing on leadership and professional development. The kick-oﬀ is being planned in conjunction with the annual RTTC annual meeting. Rural Residency Recruitment Fair and Spotlight on Rural Poster Fair: More than 65 students, residents, and faculty participated in a combined recruitment fair and poster fair at the MCW– Central Wisconsin Campus. A total of 12 Wisconsin GME programs were represented including family medicine residency, internal medicine residency, pediatrics residency, hospitalist fellowship, emergency medicine fellowship and OB fellowship program. Outreach to Wisconsin and Regional Medical School Campuses: Staﬀ continue to present to students sharing opportunities to train in Wisconsin. This past year, visits included University of Wisconsin, Medical College of Wisconsin, University of Minnesota, and University of Minnesota Duluth. A student advisory committee was recently formed with students representing all Wisconsin medical school campuses as well as Midwestern University in Chicago. Rural Resident "Day in the Life" Video Series: The WCRGME YouTube channel and social media presence continues to grow with new videos launching over the past year partially funded by WEDC. These include a Wisconsin Rural Program Video and videos featuring the UW Rural Surgery Track, Health Partners Western Wisconsin Rural Program, and the Marshﬁeld Internal Medicine Program.  Rural Residency Planning and Development (RRPD) HRSA Technical Assistance Center: WCRGME is a partner in supporting GME expansion nationally providing access to training resources, technical assistance expertise and sharing of best practice resources.  Staﬀ continue to partner with both rural hospitals and residency programs interested in expanding rural training. CONTACT: Lori Rodefeld lrodefeld@RWHC.com Jennifer Crubel jcrubel@RWHC.com

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26 RWHC IN REVIEW 2024-25 RWHC Spotlight with Jo Anne Preston What made you want to pursue a career in healthcare? How did you get your start? My initial career goal started simply with just wanting to be a helper. My ﬁrst job was as a counselor working with children experiencing abuse, whose parents were court ordered into counseling. I became intrigued with the question of, “how could this have been prevented in the ﬁrst place?” This led to working in the ﬁeld of substance abuse prevention with each job ﬁnding myself in leadership roles, coaching and mentoring others. What is the best part of your job? What is the worst? Best part of the work is when someone responds to me with an aha moment, “I never thought of it like that before,” and creating a shift that leads to positive change. Best part of the job is the exceptional people I have been privileged to work with over the years who I love and admire, with the ﬂexibility to do what I love to do. Worst part: being away from home, on the road logging the tens of thousands of miles in the car, mostly by myself, and yucky hotel rooms. What do you think healthcare needs to do to improve? How do we get there? Embrace more creativity to get to eﬃciency. I get excited about ideas like self-rooming clinics with no waiting rooms and group treatment programs for folks with similar conditions (like diabetes). Try more pilots of innovative ways of delivering healthcare services and always ask, “Why are we doing what we have always done, especially when it’s not really worked well?” Do more actual listening to the customer—most of us, when we become patients ourselves, have a whole new insight into the confusing maze of healthcare. That’s one reason I love the Patient Family Advisory Council idea! What do you like to do outside of RWHC? I love being in the woods hiking (Ice Age Trail—here I come!). I also love buying yarn and knitting it up into beautiful things whether anyone wants them or not, cooking new recipes with my husband and spending time with him and our grandkids, friends and siblings. Where did you grow up? I grew up in Lovington, Illinois, pop. 1100. But I’ve lived in beautiful WI now longer than I lived in Illinois, so I feel like I ﬁnally belong. Illinois dirt smells better though. FREEBIE: Is there some fun fact we need to know about you? I have been a professional singer and have recorded several music CDs from my own original folk music with a singing partner, to rock and roll, lullabies, and classical choral group recordings. You won’t ﬁnd these in the record stores, hence why I always kept my day job. Now I just sing silly songs to the grandkids (my favorite genre by far).

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27 RWHC IN REVIEW 2024-25 Meet Our Senior Staﬀ & Managers Tim Size Execuve Director msize@RWHC.com Darrell Statz Director of Finance & Support Services dstatz@RWHC.com Betsy Wiegel HIS Manager bwiegel@RWHC.com Janet Wagner Quality Services Senior Manager jwagner@RWHC.com Louis Wenzlow Director of HIT/CIO of RWHC ITN lwenzlow@RWHC.com Director of Programs & Services blaﬀey@RWHC.com Bonnie Laffey Raechel Kosler Speech Pathology Manager rkosler@RWHC.com Nursing & Leadership Development Senior Manager chartline@RWHC.com Cella Janisch-Hartline Manager of Coding & Reimbursement rfreisen@RWHC.com Renee Freisen Rural GME Development & Support Manager jcrubel@RWHC.com Jennifer Crubel Director of Community Economic & Workforce Development mbarry@RWHC.com Marie Barry Michael Ballinger Director of Insurance Contracng mballinger@RWHC.com Educaon Services Manager cballweg@RWHC.com Carrie Ballweg Director of GME Development lrodefeld@RWHC.com Lori Rodefeld Primary Care Program Manager cdevault@RWHC.com Cheryl DeVault Jeremy Levin IT Manager jplonka@RWHC.com Joe Plonka Director of Advocacy jlevin@RWHC.com

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The Monato Best Rural Health Essay Prize, established in 1993, is open to anyone who has been a student in any program or campus of the University of Wisconsin within the preceding year. It honors the memory of Hermes Monato, Jr., a December 1990 graduate of the UW-Madison College of Engineering, and highlights the importance of rural health. Monato worked at the RWHC for only a few years, but his infectious spirit and creative mind left an enduring legacy. Information about the contest, including the prize fund, past winners and future dates, is available at https://www.rwhc.com/Awards/Annual-Monato-Essay. The 32nd Annual $2,500 Monato Rural Health Essay Prize was awarded to Molly K. Rolfe for her essay "Addressing Rural Health Inequities Through Policy Changes ." To encourage and share organizational changes that have made a diﬀerence for rural healthcare in Wisconsin. Some examples of “Champion of Change” recognition include service oﬀerings that increase access in rural communities, enhancements to current revenue streams, strategies that reduce the cost of healthcare, changes to staﬃng and recruitment initiatives, etc., any change that deserves a shout-out. • First Place ($1,500): Dawn Shaw, Material Management Manager at Edgerton Hospital and Health Services (EHHS), for implementation of an "Automated Data Submission (ADS) feed. ” • Honorable Mention ($500): Dr. Kathleen Kindlay, Lifestyle Medicine Physician, Lynn Huiskamp, Health Program Specialist, and Cheri Rott, Registered Dietitian Nutritionist, at Western Wisconsin Health (WWH) for "enhancement to their Simple Health Program (SHP).” • Honorable Mention ($1,500): Brian Allen, Director of Emergency Medical Services & Emergency Management, and Amanda Reilly, Director of Qualify Services at Southwest Health Center (SWHC), Inc., for "the establishment of a clinical simulation lab.” RWHC has established the Rural Health Ambassador Award to recognize employees at Member hospitals who have gone above the call of duty in promoting their respective organizations and made signiﬁcant contributions to rural health care in general. Quarles & Brady and RWHC jointly sponsor this one of a kind Community Engagement Award. The purpose of the award is to recognize an RWHC Member Hospital demonstrating exemplary leadership and service to strengthen community partnerships. An annual award of $2,500 is made possible by the generous support of Quarles & Brady, LLP. The 9th Annual Quarles & Brady–RWHC Community Engagement $2,500 Award was awarded to Grant Regional Health Center. An honorable mention and $500 grants were awarded to both Fort HealthCare and Southwest Health Center. ■ Oconto Hospital & Clinic, Lori Ecklund Walsh ■ Black River Memorial Hospital, Jordan Powell ■ Cumberland Healthcare, Ashley Knutson ■ Door County Medical Center, Imelda Delchambre ■ Edgerton Hospital & Health Services, Marissa Hanson ■ Fort HealthCare, Christopher Barron, RPh, MBA ■ Froedtert Holy Family Memorial Hospital, Scott McConnaha ■ Grant Regional Health Center, Shelly Taylor-Hampton ■ Gundersen Boscobel Area Hospital & Clinics, Cameron Novy ■ Gundersen Moundview Hospital & Clinics, Tammy Lowrey ■ Gundersen Tri-County Hospital & Clinics, Joni Olson ■ Marshﬁeld Medical Center Neillsville, Dr. Stacy Donnelly ■ Memorial Hospital of Lafayette County, Matthew Solverson, MD ■ Mile Bluﬀ Medical Center, Erin Stanila, BSN, RN ■ Prairie Ridge Health, Lynn Annen ■ Sauk Prairie Healthcare, Lisa Pickarts ■ Southwest Health Center, Shannon Millin ■ SSM Health Monroe Clinic Hospital, Dr. Eli Burks ■ SSM Health St. Clare Hospital, Maureen Ann Murphy, MD ■ Stoughton Health-*Stoughton Health Community Health & Wellness Center Team: Kelly Perna, Andy Saul, Linda Schaefer, Kate Stanard, Teressa Pellett ■ Tamarack Health (Ashland), Lance Ritola ■ Tamarack Health (Hayward), Karyn Tiﬀany ■ The Richland Hospital & Clinics, Michele Brewer ■ Tomah Health, Eric Prise ■ Upland Hills Health, Troy Marx ■ Vernon Memorial Healthcare, Megan Swiggum, RN ■ Western Wisconsin Health, Katie Carstens Annual Monato Rural Health Essay Prize Wipﬂi–RWHC Champion of Change Award Rural Health Ambassador Award Quarles & Brady–RWHC Community Engagement Award RWHC IN REVIEW 2024-25 29 RWHC Award Winners

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30 RWHC IN REVIEW Our Corporate Members CORPORATE PARTNERS CORPORATE SPONSORS 1100 Partners We partner with our clients to create exceponal results – in strategy, customer experience, employee engagement, lean process improvement, operaons, informaon systems, and leadership. Capstone Leadership Solutions, Inc. Capstone Leadership Soluons unites employees and leaders on a common pathway of ongoing improvement and innovaons - leading to posive eﬀects on the organizaon's culture, results, and strategies. Delta Medical Systems Specializing in equipment sales and service for medical imaging. Mobile Neurodiagnostics, LLC A top insurance broker and risk management ﬁrm in America. Our world-class resources help you manage risk, purchase insurance, and provide employee beneﬁts. Mobile Neurodiagnostics, LLC Electrodiagnosc Tesng Services, specializing in Nerve Conducon Studies & Electromyography EPC USA/ Arctic Wolf Networks We partner with our clients to create exceponal results – in strategy, customer experience, employee engagement, lean process improvement, operaons, informaon systems, and leadership. Fifth Third Bank Commied team of Commercial and Investment Banking and Advisory experts with deep ﬁnancial and healthcare industry experse who deliver customized soluons to meet your goals. Alliant Insurance Services, Inc Alliant provides insurance and consulng services including employee beneﬁts, property/casualty insurance, underwring, surety, and ﬁnancial services driven by experts who understand our clients' unique needs. Ni2 Health 100% Chare Capture Audit using AI plaorm ChargeView. No client IT help needed. Experts handle data extracon, report generaon and medical record reviews. OS inc. A full service accounts receivable management ﬁrm that provides outsourced hospital business oﬃce services. Dependable Solutions, Inc. Dependable Soluons strengthens client operaons with reliable, comprehensive outsourced IT support in La Crosse. Intellimed Healthcare data analycs company that supports strategic planning, business development and markeng for hospitals. PreSearch Background Services, Inc. Presearch provides pre-employment and ongoing background screening services. ProAssurance Insurance Product Placement, Risk Management, Compliance, and Audit Services for Wisconsin Hospitals Quartz Group and Individual Health Insurance Risk Administration Services (RAS) We are more than an insurance provider, we are a proacve partner in prevenng injuries. Wisconsin Association of Nurse Anesthetists As advanced pracce nurses, we provide the full spectrum of anesthesia care in every seng. WisMed Assure/ WisMed Financial Providing a full range of Insurance and Financial Planning: Dental, health, life, disability, vision, medical malpracce, business owners, cyber liability, 401k, IRA. Risk StrategiesRisk Strategies is the 9th largest privately held US brokerage ﬁrm oﬀering comprehensive risk management advice, insurance and reinsurance placement. von Briesen & Roper, s.c. von Briesen’s Health Law Secon provides comprehensive legal services to the health care industry as both general counsel and special project counsel. Assured Partners Formerly LMC Insurance & Risk Management, provides insurance and risk management, employee beneﬁts, and rerement plan services to Wisconsin's health care providers. Pain Management Group Pain Management Group (PMG) is a leading provider of balanced, quality, hospital-based pain management centers. Wisconsin Biomedical Services, Inc Wisconsin Biomedical Services, Inc. provides comprehensive maintenance, repair and installaon services for medical equipment. Through preventave maintenance, troubleshoong and our cerﬁed biomedical technicians we maintain compliance with regulatory requirements and standards. Multiview Corporation Financial ERP for Hospitals & Health Systems, Including Reporng, General Ledger, Accounts Payable, Budgeng, and Materials Management. Quarles & Brady, LLP Legal Services MAGMUTUAL MagMutual is a leading provider of healthcare liability Insurance, delivering comprehensive coverage for the pracce, business and regulaon of medicine to 30,0000+ healthcare providers naonwide. North American Mechanical Inc. (NAMI) North American Mechanical, Inc. is Wisconsin's premier Mechanical Contractor. With over 40 years of mechanical experience in design, fabricaon, installaon, controls and service. Eneration Eneraon helps hospitals cut energy costs and emissions-with no upfront costs or ﬁnancial risk-delivering 10-20% savings that advance sustainability, margins, and community health. For new construcon, Eneraon is the expert partner from building concept to post-occupancy, ensuring energy Wisconsin Collaborative for Healthcare Quality Wisconsin Collaborave for Healthcare Quality (WCHQ) collects ambulatory care measures that enable medical groups to collect and report data, drive internal improvements and foster collaboraon. Wisconsin Statewide Health Information Network (WISHIN) Wisconsin's designated enty for health informaon exchange (HIE). Our soluons support the ﬂow of clinical data across the care connuum, enabling health care providers to make more informed treatment decisions, beer coordinate a paent's care, reduce costs, and improve the quality of care delivered.

2024-2025 RWHC in Reivew

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