2024-05-15T10:35:41-05:00 2023-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-07-01 390873606 THE HOWARD YOUNG MEDICAL CENTER INC HOWA 7153568000 240 MAPLE STREET WOODRUFF WI 54568 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7158472250 2024-05-14 1 JERRY YANG 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-05-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 31129579 0 X WWW.ASPIRUS.ORG X 1948 WI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 9 5 228 53 0 0 7930584 407195 29379803 27557268 3076154 2781566 254712 383550 40641253 31129579 24000 24000 0 0 19294016 17593374 0 0 0 23285769 19661382 42603785 37278756 -1962532 -6149177 83126047 84474154 21802020 20445889 61324027 64028265 WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 23965752 24000 27557268 THE HOWARD YOUNG MEDICAL CENTER, INC. IS A 99-BED HOSPITAL CAMPUS (42-BED PHYSICAL CAPACITY DURING THE FISCAL YEAR) PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2023, THE HOWARD YOUNG MEDICAL CENTER HAD DISCHARGES OF 925 ADULTS AND CHILDREN FOR A TOTAL OF 4,390 PATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED A VARIETY OF OUTPATIENT SERVICES FOR 50,253 OUTPATIENT TESTS/VISITS, WHICH INCLUDED 513 OUTPATIENT SURGERIES AND 4,824 EMERGENCY ROOM VISITS. ALSO INCLUDED WERE A RANGE OF RADIOLOGY TESTS AND THERAPY VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 23965752 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 228 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JESSE TISCHER VICE CHAIR/SVP & PRESIDENT-REG. MARKETS 2.00 50.00 X X 0 781575 128595 ERIC ANDERSON BOARD MEMBER/SVP-SERVICE LINE & PATIENT EXP. 2.00 50.00 X X 0 519926 106843 AMY SLETTE MD BOARD MEMBER/PHYSICIAN 1.00 50.00 X 0 236921 42607 HOLLY BEEDE-MCKINNEY NP BOARD MEMBER/NURSE PRACTITIONER 1.00 50.00 X 0 154588 8884 JUDY SMOLAREK CHAIR 1.00 2.00 X 0 0 0 KELLY COURT SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 STEVE LAKING SECRETARY/TREASURER (THRU 09/22) 1.00 4.00 X 0 0 0 SISTER ELIZABETH AMMAN OP BOARD MEMBER (THRU 04/23) 1.00 4.00 X 0 0 0 KATE FERREL BOARD MEMBER 1.00 2.00 X 0 0 0 FATHER JIM FOSDICK BOARD MEMBER 1.00 4.00 X 0 0 0 ARTHUR C HELGERSON DDS BOARD MEMBER 1.00 2.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1799938 311110 SIDNEY SCZYGELSKI SR. VP OF FINANCE/CFO 2.00 50.00 X 0 1911464 144118 TERESA THEILER (NV) PRESIDENT-ASPIRUS NORTH DIVISION 2.00 50.00 X 0 359198 75497 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 672916 123676 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 539401 110893 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 2.00 50.00 X 0 534868 104438 CONSTANCE BRADLEY SVP-SYSTEM CHIEF NURSING EXEC 2.00 50.00 X 0 502032 95550 DEBRA BALL SVP & CHIEF HR OFFICER 2.00 50.00 X 0 458839 103553 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 321116 49427 JANELLE KOMMERS-MARKGRAF VP-HUMAN RESOURCES NORTH REGION 2.00 50.00 X 0 236917 44327 TYLER HACK VP-FINANCE NORTH REGION 2.00 50.00 X 0 246807 27314 CRYSTAL KIRSCHLING VP-REGIONAL INTEGRATION OFFICER 2.00 50.00 X 0 348443 48718 GREG SHAW VP-FINANCE NORTH REGION 2.00 50.00 X 0 220782 30975 LORI KNITT VP-PAITENT CARE & CNO 2.00 50.00 X 0 220343 27280 JASON TROXELL VP-CHIEF ADMIN OFFICER 2.00 50.00 X 0 182836 40204 JAMES RICHARDS PHYSICIAN 40.00 X 0 504966 46226 MICHAEL CLARK PHYSICIAN 40.00 X 0 476699 42347 PHILIP CONRARDY PHYSICIAN 40.00 X 0 473045 39010 HEATH MEYER PHYSICIAN 40.00 X 0 453932 47621 ALISON MARCINIAK PHYSICIAN 40.00 X 0 436868 34401 0 12594420 1833614 22 0 1 0 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 MEDICAL STAFFING 1786385 DELTA LOCUM TENENS LLC PO BOX 202940 DALLAS TX 753202940 MEDICAL STAFFING 974180 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE STE 185 IRVINE CA 92614 MEDICAL EQUIPMENT SERVICE CONTRACTS 948834 THE SAMUELS GROUP INC 311 FINANCIAL WAY STE 300 WAUSAU WI 54401 BUILDING CONSTRUCTION/REMODELING 804911 COMPASS GROUP USA INC PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICES STAFFING SERVICES 712152 19 400000 7195 407195 PATIENT SERVICE REVENUE 621990 26853987 26853987 CONTRACTED SERVICE REVENUE 900099 439033 439033 PHARMACY REVENUE 456110 2919 2919 261329 261329 27557268 2711801 2711801 306636 0 306636 306636 306636 69765 0 69765 69765 69765 CAFETERIA/VENDING REVENUE 900099 76914 76914 76914 31129579 27557268 0 3165116 X 24000 24000 407036 407036 14005017 11575062 2429955 346277 306049 40228 1974506 1340460 634046 860538 729447 131091 6988 6988 5035721 4700548 335173 34933 28400 6533 42851 19595 23256 36521 6188 30333 1008844 10 1008834 69982 54291 15691 538357 538357 1971683 575523 1396160 52204 52204 CORPORATE ALLOCATIONS 4993401 4993401 MEDICAL SUPPLIES 3372977 3292678 80299 REPAIRS AND MAINTENANCE 1455047 949990 505057 HOSPITAL TAX 468112 468112 573761 363511 210250 37278756 23965752 13313004 0 1702 550 -14756 23895 5065473 4528138 1262793 1054889 47691 69563 27608523 4652285 22115884 22956238 54126797 55804678 520463 36203 83126047 84474154 2942776 2022713 355636 0 17799376 17704323 704232 718853 21802020 20445889 X 7463831 8223586 53860196 55804679 61324027 64028265 83126047 84474154 X -6149177 1944483 6908932 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6988 6988 0 PART II-B, LINE 1: MEMBERSHIP DUES ARE PAID TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THOSE DUES ARE COMMITTED TO LOBBYING PURPOSES. WHA INVOICE STATES 11.1% OF $30,170 ($3,349) GOES FOR LOBBYING ON INVOICE COVERING THE PERIOD OF 1/1/23-12/31/23. SIMILARLY, AHA DUES COMMITTED TO LOBBYING WAS 27.29% OF $13,336 ($3,639). 54126797 4644739 2711440 255418 55804678 62364981 -5286593 2606290 345301 54126797 49930019 15137220 2393442 308816 62364981 51085092 1388115 2296766 246422 49930019 50942861 2954250 2595594 216425 51085092 0.00000 1.00000 0.00000 1 0 2560000 2560000 21155907 2615603 18540304 3892616 2036682 1855934 22956238 HYMC TRUST INDENTURE 55804678 F 55804678 DEFERRED COMPENSATION 31286 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS LIABILITY 137567 ASBESTOS LIABILITY 550000 718853 X PART V, LINE 4: THE HOWARD YOUNG TRUST WAS ESTABLISHED BY S. HOWARD YOUNG IN 1975 AS A MECHANISM TO ENSURE THE HOSPITAL CONTINUES TO HAVE ACCESS TO FUNDING FOR CAPITAL NEEDS, MEDICAL SERVICE CONTINUATION AND SERVICE GROWTH TO MEET THE COMMUNITY'S NEEDS. PART X, LINE 2: ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2023. 1 1 X 1 X 1 X 1 1 0 1 1 225094 225094 0.00610 6021076 2227513 3793563 0.10260 6246170 2227513 4018657 0.10870 23359 6192 17167 0.00050 11050 11050 0.00030 13159 13159 0.00040 47568 6192 41376 0.00120 6293738 2233705 4060033 0.10990 24000 24000 0.00060 24000 24000 0.00060 1 39982 0 6265235 10026277 -3761042 X 1 1 1 1 THE HOWARD YOUNG MEDICAL CENTER 240 MAPLE STREET WOODRUFF WI 54568 WWW.ASPIRUS.ORG/FIND-A-LOCATION/HOWARD 201 X X X THE HOWARD YOUNG MEDICAL CENTER 1 0 1 1 X X X X X X X X X 22 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES X 1 22 1 HTTPS://WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 2: THE HOSPITAL WAS ACQUIRED BY ASPIRUS, INC. IN AUGUST 2021 (FY22). THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE ASPIRUS EAGLE RIVER HOSPITAL, ASPIRUS RHINELANDER HOSPITAL AND HOWARD YOUNG MEDICAL CENTER'S FY23 (SPRING 2023) COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, MULTIPLE OPPORTUNITIES FOR COMMUNITY INPUT WERE CONDUCTED. ALL INPUT OPPORTUNITIES WERE LED BY ONEIDA COUNTY HEALTH DEPARTMENT WITH COLLABORATION BY VILAS COUNTY HEALTH DEPARTMENT, FOREST COUNTY HEALTH DEPARTMENT, MARSHFIELD CLINIC HEALTH SYSTEM AND ASPIRUS. THE UNIVERSITY OF WISCONSIN-STOUT WAS CONTRACTED FOR SOME OF THE COMMUNITY INPUT OPPORTUNITIES. COMMUNITY SURVEYA COMMUNITY SURVEY WAS CONDUCTED IN WINTER 2022-23. THE SURVEY WAS DEVELOPED AND DISSEMINATED BY THE COMMUNITY PARTNERS LISTED ABOVE. SPECIFIC OUTREACH WAS MADE TO INDIVIDUALS: IN THE LGBTQ+ COMMUNITY; WHO ARE HISPANIC; IN RECOVERY; ACCESSING FOOD PANTRIES; ACCESSING HOMELESS SHELTERS; ACCESSING AGING AND DISABILITY RESOURCE CENTER SERVICES; ATTENDING THE LOCAL COLLEGE; ACCESSING DAY CARE SERVICES; ACCESSING LIBRARY SERVICES; ACCESSING WIC NUTRITION SERVICES; AND OTHERS. KEY INFORMANT INTERVIEWSAPPROXIMATELY 35 KEY INFORMANT INTERVIEWS WERE CONDUCTED IN EARLY 2023. INTERVIEW QUESTIONS FOCUSED ON THE ORGANIZATIONS' LEADERS' PERCEPTIONS OF NEEDS AND BARRIERS FOR THE POPULATION THEY SERVED. KEY INFORMANTS WERE FROM SCHOOLS, LAW ENFORCEMENT, HUMAN SERVICE CENTERS, SUBSTANCE USE RECOVERY ORGANIZATIONS, HEALTH DEPARTMENTS, LIBRARIES, FOOD PANTRIES, JOB SERVICES, HEALTH CARE, ELECTED OFFICIALS AND MORE. LEADERS FROM MULTIPLE BANDS OF AMERICAN INDIANS WERE ALSO INTERVIEWED. FOCUS GROUPS NINE FOCUS GROUPS WERE COMPLETED AND RESULTS WERE ANALYZED BY UW-STOUT, HOWEVER, THE FOCUS GROUP RESULTS WERE NOT AVAILABLE AT THE TIME OF THE HOSPITALS' PRIORITIZATION PROCESS. THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), THE HOSPITAL COLLABORATED WITH ASPIRUS RHINELANDER HOSPITAL, ASPIRUS EAGLE RIVER HOSPITAL, AND MARSHFIELD MEDICAL CENTER-MINOCQUA. THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), HOWARD YOUNG MEDICAL CENTER COLLABORATED WITH THE FOREST COUNTY HEALTH DEPARTMENT, THE ONEIDA COUNTY HEALTH DEPARTMENT AND THE VILAS COUNTY HEALTH DEPARTMENT. THE HOWARD YOUNG MEDICAL CENTER'S CHNA WAS AUTHORED BY HOWARD YOUNG MEDICAL CENTER. THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 11: IN FY23, ASPIRUS HEALTH CONTINUED TO COME TOGETHER AS A SYSTEM. THE ADDITION OF SEVEN HOSPITALS IN FY22 RESULTED IN CHANGES IN PROCESSES, TEAM STRUCTURE AND RELATED IMPACTS. ASPIRUS HEALTH IS WORKING TO STRATEGICALLY BUILD STRONG, EFFECTIVE COMMUNITY HEALTH EFFORTS THAT MEET LOCAL NEEDS WHILE ACCOMMODATING ECONOMIC AND OTHER PRESSURES FACING HEALTH SYSTEMS. THE HOSPITAL IS IN RURAL NORTHERN WISCONSIN. BECAUSE OF THAT SETTING, COMMUNITY HEALTH EFFORTS ARE FREQUENTLY COMPLETED WITH OTHER REGIONAL PARTNERS, INCLUDING OTHER ASPIRUS HOSPITALS. THE FOLLOWING DESCRIPTIONS ARE REFLECTIVE OF ASPIRUS RHINELANDER, ASPIRUS EAGLE RIVER AND HOWARD YOUNG MEDICAL CENTER (ALSO WITH ASPIRUS) UNLESS OTHERWISE INDICATED. IN FY23, HOWARD YOUNG MEDICAL CENTER'S SIGNIFICANT NEEDS WERE: MENTAL HEALTH; ALCOHOL AND OTHER DRUG USE; CHRONIC DISEASE. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. MENTAL HEALTH AND ALCOHOL AND OTHER DRUG USE IN PART DUE TO THE KNOWLEDGE AND CAPACITY THAT THE RHINELANDER-BASED ASPIRUS KOLLER BEHAVIORAL HEALTH UNIT (PART OF THE HEALTH CARE SYSTEM) BRINGS TO THE AREA, THE HOSPITALS ARE A STRONG AND VALUED RESOURCE FOR COMMUNITY MENTAL HEALTH AND SUBSTANCE USE PREVENTION EFFORTS. STAFF EXPERTISE IS SHARED INTERNALLY AS WELL AS EXTERNALLY. EFFORTS ARE DESCRIBED BELOW. COALITION: ASPIRUS STAFF PARTICIPATED IN THE COMMUNITY OUTREACH PREVENTION EDUCATION (COPE) COALITION, WHICH IS THE REGION'S MENTAL HEALTH PROMOTION AND SUBSTANCE USE PREVENTION COALITION. ASPIRUS KOLLER BEHAVIORAL HEALTH STAFF CO-CHAIR THE MENTAL HEALTH AND SUICIDE PREVENTION SUBCOMMITTEE OF THE COALITION. SUBCOMMITTEE ACTIVITIES ARE DESCRIBED BELOW. - THE SUBCOMMITTEE CONDUCTED A NUMBER OF ACTIVITIES, INCLUDING: DEVELOPING A STRATEGY AROUND REDUCED ACCESS TO SUICIDE MEANS; PROMOTING AWARENESS (E.G., FOR MAY MENTAL HEALTH MONTH, SEPTEMBER SUICIDE PREVENTION WEEK, AND WORLD MENTAL HEALTH DAY (OCTOBER)). - QUESTION, PERSUADE, REFER (QPR) TRAININGS FOCUSED ON SUICIDE PREVENTION WERE COORDINATED BY THE SUBCOMMITTEE. OVER 150 PEOPLE WERE TRAINED IN QPR IN FY23. - THE SUBCOMMITTEE CREATED AND DISTRIBUTED STICKERS PROMOTING THE NEW 988 CRISIS LINE WITH THE QR CODE FOR MENTAL AND HEALTH AND SUBSTANCE USE/ABUSE SUPPORT AVAILABLE 24/7. IN FY23, ASPIRUS KOLLER BEHAVIORAL HEALTH STAFF ALSO: - PROVIDED MEDIA INTERVIEWS ON MENTAL HEALTH ISSUES. - ORGANIZED A MENTAL HEALTH SUMMIT, HELD IN MAY 2023. OVER 65 PEOPLE ATTENDED. THE KEYNOTE SPEAKER FOCUSED ON LGBTQ+. THE SUMMIT FEATURED NATIONAL AND LOCAL PRESENTERS. - PARTICIPATED IN THE ZERO SUICIDE MEETINGS. THE PURPOSE OF ZERO SUICIDE IS TO REDUCE THE RISK OF BEHAVIORAL HEALTH PATIENTS COMMITTING SUICIDE AFTER BEING DISCHARGED. CHRONIC DISEASEPRIOR TO THE PANDEMIC, THE REGION HAD A STRONG CHRONIC DISEASE PREVENTION COALITION. THE BACKBONE OF THAT COALITION WAS A HEALTH DEPARTMENT. WITH THE PANDEMIC DEMANDS ON THE HEALTH DEPARTMENT, THE COALITION WAS PAUSED AND HAS NOT RESUMED. THE HOSPITALS' OWN EFFORTS ARE OUTLINED BELOW. - ASPIRUS RHINELANDER HOSPITAL BIRTH CENTER STAFF CONTINUED TO SUPPORT BREASTFEEDING. BREASTFEEDING IS KNOWN TO REDUCE THE RISK OF OBESITY AND SOME CHRONIC DISEASES. LACTATION CONSULTANTS ARE ON-STAFF. THE DEPARTMENT MONITORS THE BREASTFEEDING RATE TO ENSURE THEY ARE CONTINUING TO MEET THEIR CORE MEASURE GOAL. DEVELOPMENT OF COMMUNITY EDUCATION IS IN THE PLANNING STAGES, WITH THE HOPE THAT SOME OFFERINGS, ALONG WITH SOME SUPPORT GROUPS, WILL BE AVAILABLE SOON. - EACH OF THE THREE HOSPITALS OFFERED 'FIT FOR LIFE' EXERCISE CLASSES IN A SUPERVISED SETTING FOR CARDIAC REHAB PATIENTS WHO HAVE COMPLETED THEIR TREATMENT PLAN. THE HOSPITALS OFFER THE CLASSES AT A REDUCED RATE, INCURRING LOSSES ON THE OFFERING. EACH HOSPITAL CONTRIBUTED HUNDREDS OF IN-KIND HOURS EVERY YEAR FOR THIS PROGRAM. - ASPIRUS HEALTH, PRIMARILY THROUGH CARE MANAGEMENT, IMPLEMENTS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM ACROSS THE SYSTEM. PATIENTS WITH CHRONIC DISEASE ARE SCREENED FOR FOOD INSECURITY AND 'PRESCRIBED' FRUITS AND VEGETABLES. THE FVRX CAN BE USED LIKE CASH AT THE LOCAL FARMERS MARKET. (EAGLE RIVER FARMERS MARKET ONLY.) FOR THE CHNA AND IMPLEMENTATION STRATEGY BEING IMPLEMENTED IN FY23, THE HOSPITAL CHOSE TO FOCUS ITS EFFORTS ON THE PRIORITIES LISTED ABOVE (MENTAL HEALTH, AODA, CHRONIC DISEASE). IN THE PRIORITIZATION PROCESS, THE FOLLOWING HEALTH ISSUES WERE RANKED LOWER: CHILD ABUSE AND GRADUATION RATES. THESE WERE NOT NAMED AS PRIORITIES SO EFFORTS COULD BE FOCUSED ON THE TOP THREE SELECTED. IN ADDITION, IT WAS SUGGESTED THAT THE YOUTH COMPONENTS SHOULD BE WOVEN INTO THE SELECTED PRIORITIES WHEN POSSIBLE, WHICH COULD HAVE AN IMPACT ON CHILD ABUSE AND GRADUATION RATES. THE HOWARD YOUNG MEDICAL CENTER PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. PART V, SECTION B, LINE 7A HTTPS://WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS PART I, LINE 3C: THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY). SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS WHERE RETIRMENT WITHDRAWLS HAVE NOT BEGUN AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990, SCHEDULE H IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS 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 FORM 990. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN $287,302. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2. PART III, LINE 3: THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. PART III, LINE 4: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE:POLICY: I. ASPIRUS' FINANCIAL POLICY REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET: A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF: 1. MONTHLY STATEMENTS 2. COLLECTION LETTERS INCLUDING PLAIN LANGUAGE SUMMARY (PLS) 3. COLLECTION PHONE CALLS 4. VERIFICATION THAT CHARITY CARE WAS OFFERED WITHIN THE PAST 12-MONTHS AS RECORDED IN THE ELECTRONIC HEALTH RECORD (EMR) WITH STAFF HAVING THE DISCRETION TO OFFER AGAIN WITHIN THE 12-MONTHS. III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTIBLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE LAST FIRST BILLING TO THE PATIENT PAYMENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. B. BAD DEBT RECOVERIES 1. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. 2. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. 3. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2023 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: IN ADDITION TO ASSESSING NEEDS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL:- SYSTEMATICALLY REVIEWS PATIENT EXPERIENCE DATA TO UNDERSTAND OPPORTUNITIES TO ADDRESS PATIENT CONCERNS. - MAINTAINS AN INVOLVED LOCAL BOARD OF DIRECTORS, WHICH MEETS EVERY OTHER MONTH. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING FINANCE, EDUCATION, BANKING, GOVERNMENTAL PUBLIC HEALTH, HIGHER EDUCATION AND HEALTH CARE. - SUPPORTS ITS STAFF IN PARTICIPATING ON AND PRESENTING TO COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES. - SUPPORTS ITS STAFF IN VOLUNTEERING AT AN AREA FOOD PANTRY. - REVIEWS FUNDING REQUESTS (TO THE HOSPITAL AND/OR HOSPITAL FOUNDATION) AS AN INDICATOR OF LOCAL NEEDS.- INITIATED A SOCIAL NEEDS SCREENING PROCESS THAT, OVER TIME, WILL PROVIDE INSIGHT INTO PATIENT NEEDS IN ADDITION TO THEIR IMMEDIATE CARE. PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. IF ASPIRUS FINANCIAL COUNSELORS NOTICE THE PATIENT HAS NOT BEEN OFFERED AN APPLICATION WITHIN THE PAST YEAR, THEY WILL ALSO ASK IF THE PATIENT WOULD LIKE ONE MAILED OR IF THE PATIENT SHOWS FINANCIAL DISTRESS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: HOWARD YOUNG MEDICAL CENTER (PART OF THE ASPIRUS SYSTEM) IS ONE OF THREE ASPIRUS SYSTEM HOSPITALS IN A 3-COUNTY RURAL REGION OF FAR NORTHERN WISCONSIN. THE 3-COUNTY REGION INCLUDES FOREST, ONEIDA AND VILAS COUNTIES. HOWARD YOUNG MEDICAL CENTER IS LOCATED IN ONEIDA COUNTY NEAR THE VILAS COUNTY LINE.ONEIDA COUNTY COVERS 1113 SQUARE MILES, WITH 34 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 38,259 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18 17.1%PERSONS 65 YEARS AND OVER 27.3%WHITE PERSONS 95.9%AFRICAN AMERICAN PERSONS 0.7%AMERICAN INDIAN PERSONS 1.3%ASIAN PERSONS 0.5%TWO OR MORE RACES 1.6%HISPANIC OR LATINO 1.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME 1.6%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT 94.7% PERSONS IN POVERTY 9.2%MEDIAN HOUSEHOLD INCOME $62,660PERCENT UNINSURED 7%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.) 45.2%NUMBER OF HOSPITALS IN ONEIDA COUNTY: 3 (INCLUDING ASPIRUS RHINELANDER HOSPITAL AND (ASPIRUS) HOWARD YOUNG MEDICAL CENTER) ONEIDA COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) FOR MENTAL HEALTH. VILAS COUNTY COVERS 857 SQUARE MILES, WITH 26.9 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 23,520 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18 16.8%PERSONS 65 YEARS AND OVER 30.9%WHITE PERSONS 86.9%AFRICAN AMERICAN PERSONS 0.4%AMERICAN INDIAN PERSONS 10.5%ASIAN PERSONS 0.6%TWO OR MORE RACES 1.6%HISPANIC OR LATINO 2.7%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME 3.0%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT 95.1% PERSONS IN POVERTY 11.5%MEDIAN HOUSEHOLD INCOME $56,837PERCENT UNINSURED 11%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.) 48.0%NUMBER OF HOSPITALS IN VILAS COUNTY: 1 (ASPIRUS EAGLE RIVER HOSPITAL) VILAS COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) FOR MENTAL HEALTH, DENTAL HEALTH AND PRIMARY CARE. VILAS COUNTY IS ALSO A DESIGNATED MEDICALLY UNDERSERVED AREA. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH IT'S COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITAL: - MAINTAINS A BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY. - BRINGS ITS EXPERTISE INTO THE COMMUNITY THROUGH PROGRAMS, SCREENINGS, AND COMMUNITY BOARD AND ADVISORY COMMITTEE MEMBERSHIP.- PROVIDES HIGH QUALITY SERVICES AND IMPLEMENTS ONGOING QUALITY IMPROVEMENT INITIATIVES. - BUDGETS FOR CUTTING EDGE TECHNOLOGIES AND EQUIPMENT THAT SUPPORT PATIENT HEALTH.- OFFERS TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - PROVIDES ATHLETIC TRAINING TO LOCAL YOUTH ATHLETES. - OFFERS MEETING SPACE TO LOCAL NON-PROFIT ORGANIZATIONS. - PROVIDES BLOOD PRESSURE CHECKS AT THE LOCAL FOOD PANTRY. AS PART OF A LARGER NETWORK OF ASPIRUS HEALTHCARE FACILITIES, THE HOSPITAL HAS ACCESS TO: - LOW-COST TEMPORARY LODGING AT ASPIRUS' FLAGSHIP TERTIARY CARE HOSPITAL PARTNER (IN WAUSAU, WI) SO THAT PATIENTS AND/OR THEIR FAMILY NEEDING EXTENDED SPECIALTY CARE HAVE ACCOMMODATIONS. - PROFESSIONAL DEVELOPMENT FOR STAFF, ASSURING THE CARE PROVIDED INCORPORATES THE MOST UP-TO-DATE BEST PRACTICES. - CROSS-TRAINING OPPORTUNITIES. FOR INSTANCE, A WAUSAU-BASED BEREAVEMENT COORDINATOR TRAINS STAFF ACROSS THE SYSTEM ON NORMAL GRIEF RESPONSE, RESILIENCE AND HOSPICE CARE AND SUPPORT. THE COORDINATOR TRAINS THROUGH THE NURSE RESIDENCY PROGRAM AS WELL AS IN UNIT/DEPARTMENT MEETINGS. UNIT/DEPARTMENT LEADERS CAN REQUEST BEREAVEMENT INFORMATION AND SUPPORT FOR THEIR TEAM. SIMILARLY, HOSPITALS HAVE ACCESS TO INJURY PREVENTION EXPERTISE AND RESOURCES THROUGH THE LEVEL 2 TRAUMA CENTER IN WAUSAU. - A MARKETING/COMMUNICATIONS TEAM THAT SUPPORTS THE ONLINE ASPIRUS MEDIA CENTER FEATURING MEDICAL EXPERTS. THE TEAM DEVELOPS AND PROMOTES HEALTH EDUCATION INFORMATION (E.G., ON DIABETES, TICK BITES, SNOWMOBILE SAFETY) FOR PATIENTS AND THE GENERAL PUBLIC. PART VI, LINE 6: ASPIRUS HEALTH IS A NON-PROFIT, COMMUNITY-DIRECTED HEALTHCARE SYSTEM BASED IN WAUSAU, WISCONSIN. ITS 11,000 EMPLOYEES ARE FOCUSED ON IMPROVING THE HEALTH AND WELL-BEING OF PEOPLE THROUGHOUT WISCONSIN AND UPPER MICHIGAN. ASPIRUS SERVES COMMUNITIES THROUGH FOUR HOSPITALS IN MICHIGAN AND 13 HOSPITALS IN WISCONSIN, 75 CLINICS, HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, NURSING HOMES AND A BROAD NETWORK OF PHYSICIANS. THE COMBINED EFFORTS ARE ABLE TO PROVIDE SMALLER COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. FOR MORE INFORMATION, VISIT ASPIRUS.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 TOWN OF WOODRUFF PO BOX 560 WOODRUFF WI 54568 GOV 24000 0 MUNICIPAL SERVICES DONATION MUNICIPAL SERVICES DONATION 1 0 1 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1228335 0 567185 0 4418 0 18619 0 292491 0 2111048 0 0 SIDNEY SCZYGELSKI SR. VP OF FINANCE/CFO 0 649845 0 1057600 0 204019 0 20794 0 123324 0 2055582 0 195109 JESSE TISCHER VICE CHAIR/SVP & PRESIDENT-REG. MARK 0 580082 0 150199 0 51294 0 18561 0 110034 0 910170 0 50242 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 479018 0 135622 0 58276 0 18672 0 105004 0 796592 0 55822 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 386985 0 110566 0 41850 0 17683 0 93210 0 650294 0 32339 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 0 378807 0 112026 0 44035 0 18079 0 86359 0 639306 0 39964 ERIC ANDERSON BOARD MEMBER/SVP-SERVICE LINE & PATI 0 399954 0 117991 0 1981 0 17740 0 89103 0 626769 0 0 CONSTANCE BRADLEY SVP-SYSTEM CHIEF NURSING EXEC 0 385875 0 113420 0 2737 0 16421 0 79129 0 597582 0 0 DEBRA BALL SVP & CHIEF HR OFFICER 0 349805 0 106987 0 2047 0 13179 0 90374 0 562392 0 0 JAMES RICHARDS PHYSICIAN 0 482057 0 16667 0 6242 0 9150 0 37076 0 551192 0 0 MICHAEL CLARK PHYSICIAN 0 453759 0 0 0 22940 0 7185 0 35162 0 519046 0 0 PHILIP CONRARDY PHYSICIAN 0 464133 0 0 0 8912 0 9150 0 29860 0 512055 0 0 HEATH MEYER PHYSICIAN 0 448316 0 0 0 5616 0 11459 0 36162 0 501553 0 0 ALISON MARCINIAK PHYSICIAN 0 402327 0 16667 0 17874 0 9150 0 25251 0 471269 0 0 TERESA THEILER (NV) PRESIDENT-ASPIRUS NORTH DIVISIO 0 310350 0 47497 0 1351 0 14314 0 61183 0 434695 0 0 CRYSTAL KIRSCHLING VP-REGIONAL INTEGRATION OFFICER 0 291308 0 56573 0 562 0 12036 0 36682 0 397161 0 0 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 267466 0 51102 0 2548 0 18436 0 30991 0 370543 0 0 JANELLE KOMMERS-MARKGRAF VP-HUMAN RESOURCES NORTH REGION 0 203520 0 29058 0 4339 0 14791 0 29536 0 281244 0 0 AMY SLETTE MD BOARD MEMBER/PHYSICIAN 0 231159 0 0 0 5762 0 7517 0 35090 0 279528 0 0 TYLER HACK VP-FINANCE NORTH REGION 0 214263 0 28807 0 3737 0 13090 0 14224 0 274121 0 0 GREG SHAW VP-FINANCE NORTH REGION 0 191783 0 27247 0 1752 0 12702 0 18273 0 251757 0 0 LORI KNITT VP-PAITENT CARE & CNO 0 212364 0 0 0 7979 0 5771 0 21509 0 247623 0 0 JASON TROXELL VP-CHIEF ADMIN OFFICER 0 171834 0 0 0 11002 0 5386 0 34818 0 223040 0 0 HOLLY BEEDE-MCKINNEY NP BOARD MEMBER/NURSE PRACTITIONER 0 152573 0 0 0 2015 0 8111 0 773 0 163472 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE HOWARD YOUNG MEDICAL CENTER, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGESLSKI $195,109 M. HOLZHUETER $55,822 J. TISCHER $50,242 T. RICHARDSON $39,964 J. MATHESON $32,339 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; 24 MONTHS FROM THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97712JDN0 2021-11-10 17990909 REVENUE BONDS SERIES 2021 0 0 0 A 17990909 128165 2021 0 0 1 1 A 0 1 1 1 0 0.02900 0.02900 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2021 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL & CLINICS, INC. (EIN 39-1138241); ASPIRUS BUILDINGS, INC. (EIN 39-1406537); ASPIRUS STEVENS POINT HOSPITAL & CLINICS, INC. (EIN 39-0808443); ASPIRUS STANLEY HOSPITAL & CLINICS, INC. (EIN 39-0807065); ASPIRUS MERRILL HOSPITAL & CLINICS, INC. (EIN 39-0808503); ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS, INC. (EIN 39-1390638); ASPIRUS EAGLE RIVER HOSPITAL & CLINICS, INC. (EIN 39-0985690); AND THE HOWARD YOUNG MEDICAL CENTER, INC. (EIN 39-0873606). INFORMATION REGARDING THE SERIES 2021 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2021 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2021 BONDS.] PART III, LINES 3A AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF THE HOWARD YOUNG MEDICAL CENTER INC., HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW LEASE AGREEMENTS, MANAGEMENT, AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. SCHEDULE K, PART III, LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS COMPRISED OF TEN DIRECTORS. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS MEMBER CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS, CONSISTING OF THREE NOMINATED BY THE NOMINATING COMMITTEE AND THREE NOMINATED BY ASPIRUS, INC. WITH CONSIDERATION TO INPUT FROM THE CORPORATION'S BOARD, AND ELECTED BY ASPIRUS, INC., TWO ASPIRUS MEMBER CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., TWO PROVIDER CLASS DIRECTOR FROM EACH HOSPITAL, CONSISTING OF PHYSICIANS IN THE ACTIVE CATEGORY OF THE MEDICAL STAFF AT THE HOSPITAL, NOMINATED BY THE CORPORATION'S BOARD AND ELECTED BY ASPIRUS, INC. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 800,537. MANAGEMENT AND GENERAL EXPENSES 228,436. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,028,973. LAB SERVICES: PROGRAM SERVICE EXPENSES 279,846. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 279,846. CONTRACT NURSING AND OTHER SERVICES: PROGRAM SERVICE EXPENSES 3,605,799. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,605,799. MEDICAL DIRECTORS FEES: PROGRAM SERVICE EXPENSES 14,366. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,366. FOOD SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 17,658. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,658. HOUSEKEEPING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 89,079. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,079. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS - AWH 79,090. INTERCOMPANY TRANSFERS - AI 8,263,490. INTERCOMPANY TRANSFERS - AMG 38,587. INTERCOMPANY TRANSFERS - AOH -14. INTERCOMPANY TRANSFERS - AVNA -9,344. INTERCOMPANY TRANSFERS - AIW -3,740. INTERCOMPANY TRANSFERS - AIR 232. INTERCOMPANY TRANSFERS - ARH -47,767. INTERCOMPANY TRANSFERS - ADS -25,787. INTERCOMPANY TRANSFERS - AMH -26,437. INTERCOMPANY TRANSFERS - AKH -14. INTERCOMPANY TRANSFERS - ASP 116,402. INTERCOMPANY TRANSFERS - ASH -49,387. INTERCOMPANY TRANSFERS - AMR -212,805. INTERCOMPANY TRANSFERS - ARN -489,466. INTERCOMPANY TRANSFERS - ATH -269,936. INTERCOMPANY TRANSFERS - AER -419,135. INTERCOMPANY TRANSFERS - HYHC -35,610. INTERCOMPANY TRANSFERS - AMNW 573. 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