2025-05-15T09:04:30-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 382908586 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC ASPI 9069322525 N10561 GRAND VIEW LANE IRONWOOD MI 49938 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 9069322525 2025-05-15 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-05-15 2023 2025-03-06 01:10:19Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 78255493 0 X WWW.ASPIRUS.ORG X 1989 MI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 15 8 304 30 0 0 1873453 481655 71859105 77526923 353146 160213 103807 86702 74189511 78255493 7860 8973 0 0 29628474 28242977 0 0 0 40169082 44635201 69805416 72887151 4384095 5368342 48096338 52664906 25609430 20982490 22486908 31682416 X WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 52055907 8973 77526923 ASPIRUS IRONWOOD HOSPITAL AND CLINICS IS A 25-BED CRITICAL ACCESS HOSPITAL WHICH PROVIDES HEALTH CARE SERVICES TO RESIDENTS OF IRONWOOD, MICHIGAN AND ITS SURROUNDING COMMUNITIES. SOME OF THE SERVICES PROVIDED BEYOND TRADITIONAL INPATIENT HOSPITALIZATIONS INCLUDE SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, THERAPIES, EYE CARE, ONCOLOGY, AND CARDIOLOGY, AMONG VARIOUS OTHER HEALTH CARE SERVICES.INPATIENT PHARMACY: PROVIDES NAME-BRAND AND GENERIC PHARMACEUTICALS TO PATIENTS. DISPENSED 1,123,922 DOSES OF MEDICATION IN FY24.IRONWOOD CLINIC: PROVIDES PATIENT SERVICES INCLUDING FAMILY MEDICINE, ORTHOPEDICS, SURGERY, BEHAVIORAL HEALTH, AND VARIOUS OTHER HEALTH CARE SERVICES. PROVIDED CARE TO 57,433 VISITORS IN FY24.SURGERY: AIW OFFERS IP AND OP SURGERIES IN CARDIAC, GASTROENTEROLOGY, GENERAL, OB/GYN, OPHTHALMOLOGY, ORTHOPEDICS, AND PODIATRY AREAS. PERFORMED 1,806 OPERATIONS IN FY24. PROCEDURES WERE HIGHEST IN GASTROENTEROLOGY (665), ORTHOPEDICS (656), AND GENERAL SURGERY (275). 52055907 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 304 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 1.00 50.00 X 0 818140 38809 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 168066 4169 JESSE TISCHER BOARD MEMBER (THRU 01/24)/SVP & PRESIDENT- AWH 1.00 50.00 X 0 764397 116000 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 1.00 50.00 X X 0 607634 94564 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 1.00 40.00 X 0 893837 48035 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 1.00 50.00 X 0 392551 48430 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 1.00 50.00 X 0 425295 48633 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS. 1.00 50.00 X 0 489478 90167 JOHN D MATONICH CHAIR 1.00 3.00 X X 0 0 0 KIRK R SCHOTT OD TREASURER 1.00 3.00 X X 0 0 0 STEVEN TINTI TREASURER (THRU 10/23) 1.00 3.00 X X 0 0 0 KATIE L CLARK SECRETARY 1.00 3.00 X X 0 0 0 HANNAH L GOODMAN BOARD MEMBER 1.00 3.00 X 0 0 0 RICHARD J KOUBEK PHD BOARD MEMBER 1.00 3.00 X 0 0 0 CHARLY A LOPER BOARD MEMBER 1.00 3.00 X 0 0 0 ROBIN MENEZUGGO BOARD MEMBER 1.00 3.00 X 0 0 0 JAMES R RICHARDSON BOARD MEMBER 1.00 3.00 X 0 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 1.00 50.00 X 0 435705 90755 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 498735 99668 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 522951 102957 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 688935 115911 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 510162 34165 TATYANA BOMBARD RADIOLOGIST 40.00 X 845339 0 45838 JAMES HUBBARD PHYSICIAN 40.00 X 698111 0 46464 ENRICO BRAUCHER PHYSICIAN 40.00 X 697945 0 36265 ZACHARY AHOLA PHYSICIAN 40.00 X 393834 0 40664 FRANKLIN VILLANUEVA PHYSICIAN 40.00 X 343892 0 32023 2979121 11371771 1711237 41 0 1 0 MICHIGAN EMERGENCY PHYSICIANS PO BOX 677979 DALLAS TX 752677979 ER PHYSICIAN COVERAGE 2734202 WAPITI MEDICAL LIMITED COMPANY 107 FLYNN DRIVE SUITE 600 MILBANK SD 57252 CONTRACT PROVIDERS 1435037 TOTAL MSP LLC 10 E COLLEGE AVE APPLETON WI 54911 CONTRACT LABOR 1277735 SYNERGY ANESTHESIA MI PLLC 5504 E 12 MILE RD WARREN MI 48092 CRNA PROVIDERS 724942 UPPER PENINSULA HEALTH CARE SOLUTIONS 853 W WASHINGTON ST MARQUETTE MI 49855 MRI SERVICES 530581 10 480395 1260 481655 NET PATIENT SERVICE REVENUE 621990 74098683 74098683 PHARMACY 340B 456110 2841993 2841993 RELATED PARTY RENTAL 531120 91218 91218 495029 495029 77526923 76659 76659 83554 0 83554 83554 83554 CAFETERIA 722514 86702 86702 86702 78255493 77526923 0 246915 X 8973 8973 23326237 19811202 3515035 662256 531340 130916 2835485 2274962 560523 1418999 1138489 280510 3000 3000 7691 7691 194 194 12155960 7872080 4283880 21799 14091 7708 134479 130152 4327 36268 23443 12825 786474 122678 663796 108460 70107 38353 7651 4945 2706 551946 551946 2394075 1114035 1280040 501633 78247 423386 DRUGS AND MEDICAL SUPPL 11634783 11260397 374386 CORPORATE ALLOCATIONS 10403338 6724561 3678777 QAAP EXPENSES 2986330 2986330 BAD DEBT EXPENSE 1383436 1383436 1517684 873205 644479 72887151 52055907 20831244 0 4823898 8575601 180 582770 9305619 11916618 1627494 1372874 622960 592078 76811189 48560885 25801358 28250304 20244 2704 5411069 953164 236607 236607 246909 182186 48096338 52664906 3122862 2441914 0 269282 13708145 13480669 8778423 4790625 25609430 20982490 X 21923178 31171331 563730 511085 22486908 31682416 48096338 52664906 X 5368342 3827166 X 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 7691 7691 0 PART II-B, LINE 1: MEMBERSHIP DUES ARE PAID TO THE MICHIGAN HOSPITAL ASSOCIATION (MHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THOSE DUES ARE COMMITTED TO LOBBYING PURPOSES. MHA INVOICE STATES 9.10% OF $17,004 ($1,547) GOES FOR LOBBYING ON INVOICE COVERING THE PERIOD OF 7/1/23-6/30/24. SIMILARLY, AHA DUES COMMITTED TO LOBBYING WAS 32% OF $19,200 ($6,144). 421754 421754 41978712 22849004 19129708 71035 71035 0 28138881 25640846 2498035 6200807 6200807 28250304 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 4390000 FINANCE LEASE LIABILITY 144385 OPERATING LEASE LIABILITY 44240 ASBESTOS LIABILITY 212000 4790625 X 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, 2024. 1 1 X 1 X 1 X 1 1 1 0 1 1 675256 675256 0.00940 15727472 14384417 1343055 0.01880 16402728 14384417 2018311 0.02820 17598 17598 0.00020 14350 14350 0.00020 12409 12409 0.00020 44357 44357 0.00060 16447085 14384417 2062668 0.02880 1 429481 0 15729810 15623644 106166 X 1 1 1 WESTERN UPPER MICHIGAN EYE CARE LLC EYE CLINIC 0.51000 0.00000 0.49000 1 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS N10561 GRAND VIEW LANE IRONWOOD MI 49938 WWW.ASPIRUS.ORG 270022 X X X X ASPIRUS IRONWOOD HOSPITAL & CLINICS INC 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 22 1 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 ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: THE FOLLOWING DESCRIPTION IS FOR THE CHNA COMPLETED IN FY22 (SPRING 2022). THROUGHOUT THE PLANNING AND PRODUCTION OF THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT, A STEERING COMMITTEE OF COMMUNITY LEADERS AND SUBJECT MATTER EXPERTS MET REGULARLY TO DIRECT THE REPORTING PROCESS, WHICH INCLUDED THE CREATION AND DISTRIBUTION OF A SURVEY TO A RANDOM SELECTION OF RESIDENTS. FOR ASPIRUS IRONWOOD, THIS INCLUDES INPUT FROM THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT AS WELL AS OTHER ASPIRUS UP HOSPITALS. REPRESENTATIVES FROM EACH ORGANIZATION COMMUNICATED IN REGULAR MEETINGS. THE KEY DATA ELEMENT IN THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT IS THE COMMUNITY SURVEY, WHICH IDENTIFIED IMPORTANT ISSUES REGARDING QUALITY OF LIFE THAT HAD NOT BEEN MEASURED BEFORE THE SURVEY WAS CONDUCTED. THE SURVEY WAS MAILED TO THOUSANDS OF HOUSEHOLDS ACROSS THE ENTIRE UPPER PENINSULA, WITH NEARLY 5,000 RESPONSES BACK FROM RESIDENTS. THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT ALSO INCLUDES A SIGNIFICANT AMOUNT OF DATA INDICATORS ACROSS MULTIPLE CATEGORIES RELATING TO HEALTH AND HEALTH FACTORS. THIS DATA WAS COMPILED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM HEALTH CARE PROVIDERS. PUBLISHED SOURCES INCLUDED THE U.S. CENSUS, THE AMERICAN COMMUNITY SURVEY, AND STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), THE HOSPITAL COLLABORATED WITH ASPIRUS IRON RIVER HOSPITAL, ASPIRUS ONTONAGON HOSPITAL, ASPIRUS KEWEENAW HOSPITAL. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), ASPIRUS IRONWOOD HOSPITAL COLLABORATED WITH THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT. ASPIRUS IRONWOOD HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS IRONWOOD HOSPITAL. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. ASPIRUS IRONWOOD HOSPITAL IS ONE OF FOUR ASPIRUS HOSPITALS IN THE UPPER PENINSULA OF MICHIGAN. THE AREA IS VERY RURAL. ASPIRUS IRONWOOD IMPLEMENTED STRATEGIES LOCALLY AND REGIONALLY, WITH THE HELP OF STAFF MEMBERS, BUT ALSO PARTNERING WITH OTHERS IN THE COMMUNITY. THE HOSPITAL'S SIGNIFICANT NEEDS ARE: MENTAL HEALTH; SUBSTANCE USE; CHRONIC DISEASES. TO ADDRESS THESE NEEDS, THE HOSPITAL AND/OR CLINIC: - FACILITATED A REGULAR VIRTUAL DEMENTIA CAREGIVER SUPPORT GROUP. BETWEEN 1 AND 3 INDIVIDUALS PARTICIPATED IN THE SESSIONS. - CONDUCTED A SENIOR WELLNESS PROGRAM. THE PROGRAM IS AVAILABLE TO OLDER ADULTS WITH TRADITIONAL MEDICARE PART B AND AN UNRESOLVED MENTAL HEALTH NEED. A MULTIDISCIPLINARY TEAM PROVIDES ONGOING SUPPORT. - PROVIDED FUNDING TO SUPPORT MEDIA PROMOTION AROUND POSITIVE MENTAL HEALTH, MENTAL HEALTH AWARENESS AND SUICIDE PREVENTION. - PROVIDED ACCESS TO ADDICTION-RELATED TREATMENT, INCLUDING SUBOXONE. - FACILITATED REFERRALS TO LOCAL NON-PROFIT BEHAVIORAL HEALTH SERVICES ORGANIZATIONS FOR PATIENTS WITH SIGNIFICANT MENTAL HEALTH AND SUBSTANCE USE ISSUES. - PROVIDED FUNDING FOR MULTIPLE SKI EVENTS/PROGRAMS THROUGHOUT THE YEAR. - IMPLEMENTED A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM. FISCAL YEAR 2024 WAS THE SECOND YEAR THAT ASPIRUS' FRUIT AND VEGETABLE PRESCRIPTION PROGRAM (FVRX) WAS AVAILABLE IN THIS AREA. A VOUCHER IS GIVEN TO PATIENTS TO PURCHASE FRUITS AND VEGETABLES FROM LOCAL FARMERS. THE PROGRAM ALSO PROVIDES NUTRITION INFORMATION AND ACCESS TO RECIPES. DURING THE 2024 SEASON, OVER 700 VOUCHERS WERE DISTRIBUTED ACROSS THE SYSTEM. - PROVIDED MULTIPLE NUTRITION-RELATED PRESENTATIONS AND SERVICES IN THE COMMUNITY, INCLUDING TO STUDENTS. ASPIRUS STAFF PROVIDED TIME AND EXPERTISE TO THE GOGEBIC RANGE HEALTH FOUNDATION BOARD. ASPIRUS IRONWOOD IS ONE OF MANY ASPIRUS HOSPITALS THAT PROVIDES SEXUAL ASSAULT NURSE EXAMINER SERVICES. ASPIRUS IRONWOOD PROVIDED IN-KIND RESOURCES TO SENIORS AT TWO HEALTH AND WELLNESS EVENTS. - - - - - - - - - - - - -FROM THE COMMUNITY SURVEY, THE TOP-SELECTED ISSUES WERE: - HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES- DRUG ABUSE- LACK OF HEALTH INSURANCE- UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONSFROM THIS LIST, THE HOSPITAL IS ADDRESSING DRUG ABUSE (SUBSTANCE USE). THE OTHER THREE ISSUES WERE NOT SELECTED FOR THE FOLLOWING REASONS. - THE LACK OF AFFORDABLE HEALTH INSURANCE IS OF HIGH CONCERN FOR MANY PEOPLE IN THE UPPER PENINSULA. ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE THE AVAILABILITY AND THE AFFORDABILITY OF HEALTH INSURANCE, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. - UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONS ARE IMPORTANT ISSUES FOR ASPIRUS. ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE BENEFITS PACKAGES. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 4 1 - ASPIRUS IRONWOOD CLINIC N10565 GRAND VIEW LANE IRONWOOD MI 49938 PROVIDER BASED CLINIC 2 - ASPIRUS EYE CENTER - IRONWOOD E6112 BLUFF VIEW ROAD IRONWOOD MI 49938 EYE CLINIC 3 - ASPIRUS HURLEY CLINIC 501 GRANITE STREET HURLEY WI 54534 PROVIDER BASED CLINIC 4 - ASPIRUS EYE CENTER - IRON RIVER 229 W GENESEE STREET IRON RIVER MI 49935 EYE CLINIC 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 RETIREMENT WITHDRAWALS 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 6A: ASPIRUS IRONWOOD HOSPITAL & CLINICS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC THROUGH MHA'S DATABASE AND WEBSITE. 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): IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $1,383,436 WAS EXCLUDED FROM THE DENOMINATOR. PART I, LINE 7B THERE WAS A SIGNIFICANT INCREASE IN PAYMENTS FROM STATE PROGRAMS CAUSING LINE 7A, COLUMN (D) TO BE MUCH HIGHER THAN PREVIOUS AND EXPECTED YEARS. THIS IS CAUSING A DECREASE OF TOTAL COLUMN (F) FOR FY 2024 OF APPROXIMATELY 5% FROM THE PRIOR YEAR. 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 COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE LAST 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, 2024 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 QUARTERLY. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING ACADEMIC, LAW AND MEDICAL FIELDS.- SUPPORTS ITS STAFF IN PARTICIPATING ON COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- REVIEWS FUNDING REQUESTS TO THE HOSPITAL AND THE LOCAL HEALTH FOUNDATION AS AN INDICATOR OF LOCAL NEEDS.HEALTHCARE SYSTEMS AND HOSPITALS HAVE NEW REQUIREMENTS TO SCREEN PATIENTS FOR SOCIAL NEEDS, IDENTIFY ANY NEEDS, AND REFER TO COMMUNITY RESOURCES. ASPIRUS CONTRACTS WITH A RESOURCE PLATFORM TO BETTER CONNECT PATIENTS WITH RESOURCES. OVER TIME, THE RESULTS OF THE SCREENING PROCESS WILL PROVIDE INSIGHT INTO PATIENT NEEDS (BEYOND 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: ASPIRUS IRONWOOD HOSPITAL IS ONE OF FOUR ASPIRUS SYSTEM HOSPITALS IN A 5-COUNTY RURAL REGION OF THE UPPER PENINSULA OF MICHIGAN. THE 5-COUNTY REGION INCLUDES HOUGHTON, KEWEENAW, ONTONAGON, IRON AND GOGEBIC COUNTIES. ASPIRUS IRONWOOD HOSPITAL IS LOCATED IN GOGEBIC COUNTY. GOGEBIC COUNTY COVERS 1102 SQUARE MILES, WITH 14.9 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 14,361 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18: 16.8%PERSONS 65 YEARS AND OVER: 28.6%WHITE PERSONS: 93.6%AFRICAN AMERICAN PERSONS: 0.6%AMERICAN INDIAN PERSONS: 3.4%ASIAN PERSONS: 0.5%TWO OR MORE RACES: 1.9%HISPANIC OR LATINO: 1.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 2.4%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 94.2% PERSONS IN POVERTY: 12.5%MEDIAN HOUSEHOLD INCOME: $38,625 PERCENT WITHOUT HEALTHCARE COVERAGE: 5.1%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 53.9% NUMBER OF HOSPITALS IN THE COUNTY: 1 (ONLY ASPIRUS) THE COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. THE COUNTY IS ALSO DESIGNATED AS MEDICALLY UNDERSERVED. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH ITS COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITAL: - MAINTAINS A REGIONAL BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY AND THE REGION. - 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 RESOURCES AND/OR REFERRALS FOR TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - HOSTS ON-SITE BLOOD DRIVES.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 NONPROFIT, COMMUNITY-DIRECTED HEALTH SYSTEM BASED IN WAUSAU, WISCONSIN, SERVING NORTHEASTERN MINNESOTA, NORTHERN AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. THE HEALTH SYSTEM OPERATES 18 HOSPITALS AND 130 OUTPATIENT LOCATIONS WITH NEARLY 14,000 TEAM MEMBERS, INCLUDING 1,300 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE CLINICIANS. ASPIRUS SERVES COMMUNITIES THROUGH HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, AND ADULT LIVING AND CARE FACILITIES. THE COMBINED EFFORTS PROVIDE RURAL 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 MI 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1252366 0 353673 0 12078 0 9900 0 294286 0 1922303 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 0 862473 0 0 0 31364 0 9900 0 38135 0 941872 0 0 TATYANA BOMBARD RADIOLOGIST 839958 0 0 0 5381 0 9900 0 35938 0 891177 0 0 0 JESSE TISCHER BOARD MEMBER (THRU 01/24)/SVP & PRES 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 0 810818 0 0 0 7322 0 9900 0 28909 0 856949 0 0 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 JAMES HUBBARD PHYSICIAN 647869 0 0 0 50242 0 9900 0 36564 0 744575 0 0 0 ENRICO BRAUCHER PHYSICIAN 691123 0 0 0 6822 0 9900 0 26365 0 734210 0 0 0 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 0 509155 0 94839 0 3640 0 9900 0 84664 0 702198 0 0 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 405912 0 73047 0 43992 0 8193 0 94764 0 625908 0 32339 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 0 423444 0 72853 0 2438 0 9358 0 90310 0 598403 0 0 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 0 346782 0 49598 0 39325 0 9294 0 81461 0 526460 0 34464 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 0 416035 0 8941 0 319 0 9900 0 38733 0 473928 0 0 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 0 289467 0 95289 0 7795 0 9132 0 39298 0 440981 0 0 ZACHARY AHOLA PHYSICIAN 348413 0 0 0 45421 0 6554 0 34110 0 434498 0 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 FRANKLIN VILLANUEVA PHYSICIAN 314343 0 0 0 29549 0 8708 0 23315 0 375915 0 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 0 165647 0 0 0 2419 0 3313 0 856 0 172235 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RELIED ON THE RELATED ORGANIZATIONS TO ESTABLISH 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. PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $337,358 C. HARFF $34,464 J. TISCHER $50,242 J. MATHESON $32,339 M. HOLZHUETER $55,822 T. RICHARDSON $39,964 M. WALTERS $56,806 C. BRADLEY $24,444 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 WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97710B7X4 2013-04-12 2998547 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 B WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97712DC53 2017-11-02 12000000 NEW CONSTRUCTION 0 0 0 A 1015000 2998547 35270 2963277 2015 0 0 1 1 B 12000000 113564 11866436 2016 0 0 1 1 A 0 0 1 0 0 0.00700 0.00700 0 0 1 B 0 0 1 0 0 0.00300 0.00300 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WI HEALTH & EDUCATION FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/05/2018 SCHEDULE K, PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2013 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (EIN 39-0964813); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND LANGLADE HOSPITAL HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429). INFORMATION REGARDING THE SERIES 2013 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 2013 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2013 BONDS.] SCHEDULE K, PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2017 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND ASPIRUS ONTONAGON HOSPITAL, INC. (EIN 26-0806477). INFORMATION REGARDING THE SERIES 2017 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 2017 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2017 BONDS.] PART III, LINES 3A AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS IRONWOOD HOSPITAL & CLINICS, HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW 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 THERE SHALL BE A MINIMUM OF 11 VOTING DIRECTORS ALLOCATED AS FOLLOW. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN FIVE INDEPENDENT COMMUNITY CLASS DIRECTORS, FOUR ASPIRUS CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., TWO PROVIDER CLASS DIRECTOR 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 OFFICER; 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 IS 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 ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. AN INTERESTED PERSON IS A DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. AFTER DISCLOSURE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING MEMBERS SHALL DECIDE IF A CONFLICT EXISTS. THE MEMBER WILL ABSTAIN FROM VOTING ON THIS ISSUE IF A CONFLICT OF INTEREST IS DISCOVERED. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH 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 LAB SERVICES: PROGRAM SERVICE EXPENSES 741,778. MANAGEMENT AND GENERAL EXPENSES 405,802. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,147,580. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 693,760. MANAGEMENT AND GENERAL EXPENSES 379,533. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,073,293. HOUSEKEEPING SERVICES: PROGRAM SERVICE EXPENSES 119,524. MANAGEMENT AND GENERAL EXPENSES 65,387. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 184,911. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,234,643. MANAGEMENT AND GENERAL EXPENSES 652,764. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,887,407. CRNA FEES: PROGRAM SERVICE EXPENSES 5,082,375. MANAGEMENT AND GENERAL EXPENSES 2,780,394. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,862,769. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 3,879,811. NET INCOME ATTRIBUTABLE TO NCI -52,645. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION, ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS IN THE PAST YEAR. 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