2025-05-15T10:49:12-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 390868982 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC ASPI 7154229292 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7158472250 2025-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-04-29 2023 2025-03-06 01:10:19Z ASPIRUS WISCONSIN RAPIDS HOSPITAL MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 178670752 0 X WWW.ASPIRUS.ORG X 1912 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 13 7 703 132 99957 0 1718109 597781 168194581 174440904 2854593 2610777 708196 534213 173475479 178183675 27090 7500 0 0 59157929 60186676 0 0 0 83740241 95138275 142925260 155332451 30550219 22851224 172257457 179314426 41548521 36741810 130708936 142572616 WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 125428499 7500 174420452 ASPIRUS RIVERVIEW HOSPITAL & CLINICS IS A 39-STAFF BED HOSPITAL CAMPUS, LOCATED IN WISCONSIN RAPIDS, WI, PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2024, ASPIRUS RIVERVIEW HOSPITAL & CLINICS TREATED APPROXIMATELY 2,360 ADULTS AND CHILDREN FOR A TOTAL OF APPROXIMATELY 8,912 PATIENT DAYS OF SERVICE. THE HOSPITAL AND ASSOCIATED CLINICS ALSO PROVIDED SERVICES FOR APPROXIMATELY 245,620 OUTPATIENT VISITS, WHICH INCLUDED APPROXIMATELY 5,722 OUTPATIENT SURGERIES AND APPROXIMATELY 17,559 EMERGENCY ROOM VISITS DURING FISCAL YEAR 2024. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 125428499 1 1 0 1 0 0 0 0 0 0 1 0 0 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 0 703 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 7 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 MARY D IRONSIDE CHAIR 1.00 2.00 X X 0 0 0 DANIEL J BURNS VICE CHAIR 1.00 2.00 X X 0 0 0 JESSE TISCHER V. CHAIR (THRU JAN '24)/SVP&PRES. AWH 1.00 50.00 X X 0 764397 116000 CRAIG BROEREN TREASURER (THRU JUNE '24) 1.00 2.00 X X 0 0 0 LYNN M VOGT TREASURER 1.00 2.00 X X 0 0 0 CONSTANCE BRADLEY SECRETARY/SVP-PRES REG MKTS 1.00 50.00 X X 0 489478 90167 MICHAEL J BOVEE BOARD MEMBER 1.00 2.00 X 0 0 0 TRINA DANIELS MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 543092 39371 JUSTIN HUEBNER BOARD MEMBER 1.00 2.00 X 0 0 0 SUSAN KRECKMAN MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 342440 38090 BONITA KOLRUD MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 358304 40188 SHELLY MONDEIK EDD BOARD MEMBER 1.00 2.00 X 0 0 0 JOSHUA POGORELEC DO BOARD MEMBER/REGIONAL MED. DIRECTOR 1.00 40.00 X 0 704638 45626 JENNIFER REDMAN-SCHELL BOARD MEMBER/SVP & PRES. -AMG 1.00 40.00 X 0 607634 94564 REBECCA SOMMER PHD BOARD MEMBER 1.00 2.00 X 0 0 0 MARY MERDAN APNP BOARD MEMBER (THRU JUNE '23)/NURSE PRACTIONER 1.00 40.00 X 0 110124 32824 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 0 0 ROBERT SMITH (NV) PRESIDENT-ASPIRUS SE 1.00 40.00 X 0 394255 54865 BRIAN KIEF (NV) PRESIDENT-ADS & ARH 1.00 40.00 X 0 373274 44481 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 522951 102957 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 498735 99668 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 510162 34165 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 688935 115911 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 SEAN CASHIN PHYSICIAN 40.00 X 689153 0 46336 RICHARD WESSLING PHYSICIAN 40.00 X 598415 0 45594 THOMAS FERK PHYSICIAN 40.00 X 599648 0 39652 JOEL CARLSON PHYSICIAN 40.00 X 553800 0 41809 ANNA OLSON PHYSICIAN 40.00 X 541340 0 49167 2982356 11064304 1749155 77 0 1 0 MEA EMERGENCY MANAGEMENT PO BOX 634850 CINCINNATI OH 452634850 ER PROFESSIONAL SERVICES 7419484 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACT LABOR 2960020 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE STE 185 IRVINE CA 92614 MAINTENANCE CONTRACTS 1367467 CHG COMPANIES INC PO BOX 972651 DALLAS TX 753972651 CONTRACT LABOR 1124659 TWEET GAROT MECHANICAL INC PO BOX 8706 CAROL STREAM IL 601978706 REPAIR AND INSTALLATION 581681 26 6975 60124 500000 30682 597781 PATIENT SERVICES 621500 158753685 158753685 LAB REVENUE 621500 15632081 15611298 20783 55138 55469 -331 174440904 2610777 2610777 826770 487077 339693 339693 339693 CAFETERIA 722514 194520 79505 115015 194520 178183675 174420452 99957 3065485 X 7500 7500 49600689 43802368 5798321 1424297 1197976 226321 6245083 5252739 992344 2916607 2453158 463449 3000 3000 66767 66767 20748 20748 17500 17500 23224285 16862267 6362018 25981 17904 8077 204101 200223 3878 232638 160311 72327 2428039 333370 2094669 126910 87454 39456 14801 10199 4602 2138680 6844 2131836 7132062 5090866 2041196 241326 33134 208192 MEDICAL SUPPLIES 27884797 27354986 529811 CORPORATE ALLOCATIONS 22618040 15586091 7031949 REPAIRS & MAINTENANCE 3183467 2193727 989740 BAD DEBT EXPENSE 3009186 3009186 2565947 1768196 797751 155332451 125428499 29903952 0 58058 76585 796647 716042 21559640 21663738 2996563 3364607 373061 261922 199291893 128821627 71503949 70470266 74681920 82168084 287619 593182 172257457 179314426 6738364 5034582 35951031 35020303 10085000 10085000 -11225874 -13398075 41548521 36741810 X 129405889 141441529 1303047 1131087 130708936 142572616 172257457 179314426 X 22851224 6629442 -17616986 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 20748 20748 0 PART II-B, LINE 1: ASPIRUS RIVERVIEW HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA), THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $13,751 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. WHA HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $5,021 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. RWHC HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $1,976 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. IN TOTAL, $20,748 OF THE ANNUAL DUES THE HOSPITAL PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 3765872 3765872 108013314 60526937 47486377 80775835 67322041 13453794 6736872 972649 5764223 70470266 RETIREE HEALTHCARE BENEFITS 4826 DEFERRED COMPENSATION 65262 FINANCE LEASE LIABILITY 326442 MEDICARE REFUNDABLES ADVANCES -16185000 ASBESTOS LIABILITY 2390395 -13398075 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 834528 834528 0.00550 23857950 12734765 11123185 0.07300 24692478 12734765 11957713 0.07850 54194 1336 52858 0.00030 134188 134188 0.00090 4936099 3592922 1343177 0.00880 284463 79505 204958 0.00130 5408944 3673763 1735181 0.01130 30101422 16408528 13692894 0.08980 1 3665 3665 0.00000 1 99 9374 9374 0.00010 2 99 13039 13039 0.00010 1 909104 0 19681808 22658439 -2976631 X 1 1 1 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54495 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU WI #11 X X X ASPIRUS RIVERVIEW HOSPITAL & CLINICS IN 1 0 0 1 X X X X X X X X X 23 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 23 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 RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: FOR THE CHNA COMPLETED IN FY24 (SPRING 2024), WOOD COUNTY COMMUNITY MEMBERS PROVIDED THEIR VOICE TO THE COMMUNITY HEALTH NEEDS THROUGH (1) A COMMUNITY SURVEY AND (2) KEY STAKEHOLDER INPUT. A CONCERTED EFFORT WAS MADE TO ENSURE THAT THE INDIVIDUALS AND ORGANIZATIONS REPRESENTED THE NEEDS AND PERSPECTIVES OF: PUBLIC HEALTH PRACTICE; INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, HAVE LOW INCOME, OR ARE CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED. (1) COMMUNITY SURVEY: THE COMMUNITY SURVEY WAS DEVELOPED BY THE THREE CORE PARTNERS WOOD COUNTY HEALTH DEPARTMENT, MARSHFIELD CLINIC HEALTH SYSTEM AND ASPIRUS. THE SURVEY DEVELOPMENT PROCESS INCLUDED REVIEWING OTHER HEALTH DEPARTMENTS' SURVEYS, IDENTIFYING THE DATA FROM PREVIOUS SURVEYS THAT WAS MOST UTILIZED AND DETERMINING WHAT KINDS OF RESULTS WOULD BE MOST BENEFICIAL FOR NEXT STEPS. SURVEY DISTRIBUTION IN FALL 2023 WAS LED BY THE HEALTH DEPARTMENT. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. IN ORDER TO HELPS ASSURE THAT OFTEN-UNDER-REPRESENTED VOICES WERE HEARD THROUGH THE SURVEY, INTENTIONAL OUTREACH WAS MADE TO INDIVIDUALS WHO ARE: YOUNGER; INDIGENOUS / NATIVE AMERICAN; HISPANIC/LATINX; LGBTQ+; FORMERLY INCARCERATED; EXPERIENCING HOMELESSNESS. INTENTIONAL OUTREACH WAS ALSO MADE TO FAMILIES WITH CHILDREN AND INDIVIDUALS WITH LOW INCOME. OVER 3000 PEOPLE RESPONDED TO THE SURVEY. TOP-IDENTIFIED ISSUES INCLUDED: DRUG USE; MENTAL HEALTH AND SUICIDE; NOT ENOUGH JOBS WITH LIVABLE WAGES; NOT ENOUGH MENTAL HEALTH PROVIDERS; DENTAL CARE. (2) KEY STAKEHOLDER MEETINGS: IN JANUARY 2024, OVER 140 COMMUNITY STAKEHOLDERS WERE INVITED TO PRIORITIZATION MEETINGS. INVITATIONS WERE EXTENDED TO REPRESENTATIVES FROM MULTIPLE SECTORS, INCLUDING PUBLIC HEALTH, LAW ENFORCEMENT, HEALTHCARE, K-12 EDUCATION AND MORE. COMMUNITY SURVEY AND SECONDARY DATA WERE PRESENTED TO THE ATTENDEES. ATTENDEES WERE ASKED TO RESPOND TO THREE QUESTIONS: TOP ISSUE; MOMENTUM; STRATEGIES. TOP ISSUES WERE: MENTAL HEALTH; SUBSTANCE USE; POVERTY AND FINANCIAL STABILITY; HOUSING. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY24 (SPRING 2024), THE HOSPITAL COLLABORATED WITH MARSHFIELD CLINIC HEALTH SYSTEM (MARSHFIELD MEDICAL CENTER - MARSHFIELD). ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY24 (SPRING 2024), ASPIRUS RIVERVIEW HOSPITAL COLLABORATED WITH THE WOOD COUNTY HEALTH DEPARTMENT. ASPIRUS RIVERVIEW HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS RIVERVIEW HOSPITAL. ASPIRUS RIVERVIEW 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. IN FY24, ASPIRUS RIVERVIEW HOSPITAL'S SIGNIFICANT NEEDS (FROM THE CHNA AND IMPLEMENTATION STRATEGY APPROVED IN FY22 AND INITIATED/EFFECTIVE IN FY23) WERE: MENTAL HEALTH AND SUBSTANCE USE. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. THE ASPIRUS BEHAVIORAL HEALTH CLINIC IN WISCONSIN RAPIDS HAS CONTINUED TO GROW, AND THE CLINIC IS NOW AT FULL CAPACITY FOR PROVIDERS FOR THE FIRST TIME SINCE IT OPENED. THE CLINIC INCLUDES AN ADULT PSYCHIATRIST, CHILD PSYCHIATRIST, ADULT PSYCHOLOGIST (PROVIDING COUNSELING AND PSYCHOLOGICAL TESTING), TWO ADVANCE PRACTICE PROVIDERS, ONE FULL-TIME PEDIATRIC THERAPIST, ONE FULL-TIME ADULT THERAPIST AND ONE PART-TIME ADULT THERAPIST. IN TERMS OF SERVICES: - ASPIRUS BEHAVIORAL HEALTH CONTINUES TO SEE A HIGH NUMBER OF REFERRALS DAILY; ON AVERAGE THE ASPIRUS SYSTEM IS RECEIVING OVER 100 REFERRALS A DAY (MONDAY-FRIDAY; MINIMAL AMOUNTS ON THE WEEK) AND OVER 2000 REFERRALS A MONTH.- THE ASPIRUS BEHAVIORAL HEALTH CLINIC AND THE WOOD COUNTY JAIL CONTINUE TO HAVE A PARTNERSHIP FOR MENTAL HEALTH SERVICES. ONE FULL-TIME AND ONE PART-TIME THERAPIST PROVIDE SERVICE ONSITE AT THE WOOD COUNTY JAIL.- FOUR TELEHEALTH ROOMS ARE AVAILABLE FOR PATIENT TELEHEALTH APPOINTMENTS AND MYASPIRUS VIDEO VISITS ARE AVAILABLE TO PATIENTS FROM THEIR HOMES. - THE BEHAVIORAL HEALTH CLINIC IS CONTINUING TO GROW THE MEDICATION ASSISTED TREATMENT (MAT) PROGRAM. THE PROGRAM SUPPORTS A FULL-TIME MAT NURSE, WHO PROVIDES CASE MANAGEMENT FOR PATIENTS WITH AODA CONCERNS WHO ARE PRESCRIBED SUBOXONE, VIVITROL AND OTHER TREATMENTS FOR ADDICTIONS. ASPIRUS CONTRACTS WITH THREE BRIDGES RECOVERY TO PROVIDE PEER SUPPORT SPECIALIST SERVICES, WHICH INCLUDES RECOVERY COACHING FOR PATIENTS IN NEED OF SUBSTANCE USE SUPPORT. THESE SERVICES INCREASE BOTH AVAILABILITY AND ACCESSIBILITY TO VARIOUS PATHWAYS OF SUBSTANCE USE RECOVERY THROUGH COACHING, MENTORING, ACCOUNTABILITY, AND PEER BEHAVIOR MODELING AT NO COST TO THOSE THEY SERVE. COACHES ARE AVAILABLE 24/7 TO RESPOND TO CALLS AND ARE ADVOCATES FOR VULNERABLE PATIENTS TO HELP THEM RECEIVE THE TREATMENT THEY WANT AND NEED. FOR THE TIME PERIOD JANUARY 2024 SEPTEMBER 2024: 136 INDIVIDUALS WITH ALCOHOL USE DISORDER RECEIVED PEER SUPPORT SERVICES FROM THREE BRIDGES RECOVERY COACHES AND CERTIFIED PEER SPECIALISTS UNDER THE ASPIRUS FUNDING. 117 INDIVIDUALS WITH ALCOHOL USE DISORDER IN A RESIDENTIAL SETTING (ASPIRUS BEHAVIOR HEALTH AND KOINONIA) RECEIVED PEER SUPPORT SERVICES IN A GROUP SETTING. ASPIRUS CONTRIBUTED FUNDING TO THE COUNTY SUBSTANCE USE PREVENTION COALITION, IMPACT. THE COALITION USED THE FUNDS TO CONDUCT TWO EVENTS: A SCREENING OF SCREENAGERS UNDER THE INFLUENCE AND A COMMUNITY ENGAGEMENT EVENT. SCREENAGERS UNDER THE INFLUENCE IS A DOCUMENTARY ABOUT DIGITAL MEDIA AND ITS IMPACT ON YOUTH AROUND ALCOHOL, VAPING AND DRUGS. THE TWO EVENTS REACHED 69 PEOPLE. THE COALITION ALSO RECEIVED NUMEROUS INQUIRIES ABOUT FUTURE EVENTS AND COALITION PARTICIPATION. THE HOSPITAL PROVIDED FUNDING FOR THE BOYS AND GIRLS CLUB OF THE WISCONSIN RAPIDS AREA FOR TRANSPORTATION. TRANSPORTATION CAN BE A SIGNIFICANT BARRIER FOR YOUTH WHO WANT TO PARTICIPATE IN PROGRAMMING. THE BOYS AND GIRLS CLUB SERVES OVER 1000 YOUTH THROUGH THEIR BEFORE SCHOOL PROGRAMMING, AFTER SCHOOL PROGRAMMING, SUMMER PROGRAMMING AND OUTREACH SERVICES. THE HOSPITAL PROVIDED FUNDING TO RISE UP FOR A COMMUNITY MURAL ART PROJECT IN WISCONSIN RAPIDS. RISE UP BRINGS COMMUNITY MEMBERS TOGETHER FOR A SHARED ART DEVELOPMENT EXPERIENCE. ASPIRUS RIVERVIEW HOSPITAL FINANCIALLY SUPPORTED THE FAMILIES AND SCHOOLS TOGETHER (FAST) PROGRAM IN THE 2023-24 SCHOOL YEAR. FAST -- ELEMENTARY SCHOOL LEVEL IS AN EVIDENCE-BASED PROGRAM THAT PROMOTES CHILDREN'S SUCCESS THROUGH STRENGTHENED FAMILY RELATIONSHIPS. FAST WAS HELD AT FOUR DIFFERENT SCHOOLS, WITH TWENTY-SIX FAMILIES GRADUATING FROM THE PROGRAM. IN TWO OR MORE OF THE FOUR PROGRAMS, PARENTS REPORTED POSITIVE SIGNIFICANT IMPROVEMENT ON THEIR PARENT-CHILD RELATIONSHIP, CHILDREN'S SOCIAL COMPETENCE AND FAMILY SATISFACTION. OTHERASPIRUS RIVERVIEW OFFERS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM FOR ELIGIBLE PATIENTS. 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 ASPIRUS SYSTEM. ASPIRUS PROVIDES FUNDING AND IN-KIND TIME FOR TWO COMMUNITY MEALS PER YEAR THROUGH FOCUS FEEDING OUR COMMUNITY THROUGH UNITED SERVICES. AS ONE STRATEGY TO ADDRESS FOOD INSECURITY, THE PROGRAM PROVIDES MEALS ONCE A WEEK AND SERVES APPROXIMATELY 100 PEOPLE EACH WEEK. ASPIRUS RIVERVIEW NUTRITION SERVICES PROVIDES OVER 1200 MEALS TO COMMUNITY MEMBERS EACH MONTH. THE FOOD IS PREPARED BY THE HOSPITAL'S FOOD AND NUTRITION SERVICES DEPARTMENT AND IS DELIVERED BY VOLUNTEERS FROM THE COMMUNITY. MEALS ARE CHARGED AT A NOMINAL FEE. 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).- - - - - - - - - - - - - - - - -FROM THE CHNA AND IMPLEMENTATION STRATEGY APPROVED IN FY22 AND INITIATED/EFFECTIVE IN FY23, THE FOUR NEEDS THAT WERE NOT PRIORITIZED BY THE HOSPITAL ARE: - SOCIAL DETERMINANT SOCIAL CONNECTEDNESS. - SOCIAL DETERMINANT TRANSPORTATION - SOCIAL DETERMINANT FOOD SECURITY - ACCESS TO CARE ORAL, MEDICAL, MENTAL THESE FOUR ISSUES WERE NOT SELECTED FOR A NUMBER OF REASONS. HOSPITAL LEADERS, IN REVIEWING THE TOP-IDENTIFIED ISSUES FROM THE STAKEHOLDER MEETING (MENTAL HEALTH, SUBSTANCE USE AND SOCIAL CONNECTEDNESS) NOTED THAT WHILE SOCIAL CONNECTEDNESS IS A SUBSTANTIAL ISSUE, HOSPITAL CAPACITY WAS LIMITED AND THAT SOCIAL CONNECTEDNESS CAN BE ADDRESSED AS PART OF THE STRATEGY TO IMPROVE MENTAL HEALTH AND SUBSTANCE USE. THE ISSUES OF TRANSPORTATION, FOOD SECURITY AND ACCESS TO CARE WERE RANKED MUCH LOWER BY COMMUNITY STAKEHOLDERS. STRATEGIES TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE MAY INCLUDE EFFORTS TO MEET TRANSPORTATION, FOOD INSECURITY AND ACCESS NEEDS. FOR THE CHNA AND IS THAT ARE EFFECTIVE JULY 1, 2024 (FOR FY25 AND THE SUBSEQUENT YEARS), THE HOSPITAL'S PRIORITIES ARE MENTAL HEALTH AND SUBSTANCE USE. THE HEALTH DEPARTMENT PRIORITIES ARE: MENTAL HEALTH; SUBSTANCE USE; ACCESS TO CARE; BUILT ENVIRONMENT (E.G., HOUSING, TRANSPORTATION); FINANCIAL STABILITY. ASPIRUS RIVERVIEW IS NOT ADDRESSING THE FOLLOWING NEEDS FOR THE FOLLOWING REASONS: ACCESS TO CARE (MENTAL, MEDICAL AND DENTAL) ACCESS TO CARE WAS NOT SELECTED AS A FORMAL PRIORITY BECAUSE MAINTAINING HIGH QUALITY CARE AND IMPROVING ACCESS TO CARE IS ALREADY THE CORE BUSINESS ASPIRUS IMPLEMENTS TO LIVE OUR MISSION TO HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. BUILT ENVIRONMENT AND FINANCIAL STABILITY BUILT ENVIRONMENT AND FINANCIAL STABILITY WERE NOT SELECTED BECAUSE THE HOSPITAL DOES NOT HAVE EXPERTISE IN THOSE AREAS. ALTHOUGH ASPIRUS WILL NOT BE LEADING INITIATIVES IN THESE AREAS, ASPIRUS IS COMMITTED TO BEING A COMMUNITY PARTNER AT THE TABLE TO CONTRIBUTE TO SOLUTIONS. ONE WAY ASPIRUS WILL CONTRIBUTE IS BY SCREENING FOR HEALTH-RELATED SOCIAL NEEDS. ASPIRUS IS MONITORING THE RESULTS OF SCREENING AND USING THE FINDHELP PLATFORM TO REFER PATIENTS. OVER TIME, DATA WILL BE ANALYZED AND INCORPORATED INTO THE CHNA IN IDENTIFYING TOP HEALTH PRIORITIES AND CORRESPONDING STRATEGIES. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 8 1 - ASPIRUS DOCTORS CLINIC 2031 PEACH STREET WISCONSIN RAPIDS WI 54494 OUTPATIENT PHYSICIAN CLINIC 2 - ASPIRUS CANCER CARE WISCONSIN RAPIDS 410 DEWEY STREET WISCONSIN RAPIDS WI 54495 CANCER CENTER 3 - ASPIRUS RIVERVIEW CLINIC WI RAPIDS 420 DEWEY STREET PO BOX 8080 WISCONSIN RAPIDS WI 54495 OUTPATIENT PHYSICIAN CLINIC 4 - ASPIRUS RIVERVIEW WOUND CLINIC 410 DEWEY STREET WISCONSIN RAPIDS WI 54495 OUTPATIENT PHYSICIAN CLINIC 5 - APIRUS RIVERVIEW CLINIC NEKOOSA 1015 ANGELUS DRIVE NEKOOSA WI 54457 OUTPATIENT PHYSICIAN CLINIC 6 - ASPIRUS RIVERVIEW CLINIC MARSHFIELD 146 N CENTRAL AVENUE MARSHFIELD WI 54449 OUTPATIENT PHYSICIAN CLINIC 7 - ASPIRUS RIVERVIEW CLINIC ADAMS 419 N OAK STREET ADAMS WI 53910 OUTPATIENT PHYSICIAN CLINIC 8 - ASPIRUS RIVERVIEW DENTAL 820 TWO MILE AVENUE WISCONSIN RAPIDS WI 54494 DENTAL 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 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, LINE 7G: THE ABOVE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE ASPIRUS RIVERVIEW CLINIC ADAMS, ASPIRUS RIVERVIEW CLINIC NEKOOSA, AND BEHAVIORAL HEALTH CLINIC. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE ASPIRUS RIVERVIEW CLINIC ADAMS REPORTED COSTS OF $949,299 WITH OFFSETTING REVENUE OF $665,543. THE ASPIRUS RIVERVIEW CLINIC NEKOOSA REPORTED COSTS OF $1,713,364 WITH OFFSETTING REVENUE OF $1,512,891. THE BEHAVIORAL HEALTH CLINIC REPORTED COSTS OF $2,273,436 WITH OFFSETTING REVENUE OF $1,414,488. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $3,009,186. PART II, COMMUNITY BUILDING ACTIVITIES: ONE OF THE PRIMARY FACTORS IMPACTING A PERSON'S HEALTH IS THEIR INCOME. IN GENERAL, INDIVIDUALS WITH LOW INCOME HAVE SHORTER LIFESPANS AND LOWER QUALITY OF LIFE (FROM A PHYSICAL HEALTH PERSPECTIVE). ASPIRUS' INVOLVEMENT IN WORKFORCE AND/OR ECONOMIC DEVELOPMENT BOARDS HELPS THE COMMUNITY GAIN STRENGTH IN TERMS OF A DIVERSE ECONOMY, WELL-PAYING JOBS (TO SUPPORT A HIGHER INCOME) AND THE INFRASTRUCTURE (E.G., CHILDCARE) NEEDED FOR A ROBUST ECONOMY. ASPIRUS RIVERVIEW HOSPITAL PROVIDES A SHARPS DISPOSAL PROGRAM FOR THE COMMUNITY. BY SAFELY REMOVING SHARPS FROM THE ENVIRONMENT, WE MAKE THE COMMUNITY SAFER IN TERMS OF INJURY AND INFECTION.PROJECT SEARCH IS "A BUSINESS LED COLLABORATION THAT ENABLES YOUNG ADULTS WITH DISABILITIES TO GAIN AND MAINTAIN EMPLOYMENT THROUGH TRAINING AND CAREER EXPLORATION." (HTTPS://DWD.WISCONSIN.GOV/DVR/PROGRAMS/PROJECT-SEARCH/) THE HOSPITAL SUPPORTS ON-SITE PROJECT SEARCH EFFORTS, THEREBY INCREASING THE CAPACITY OF THE LOCAL WORKFORCE AND ALSO HELPING INDIVIDUALS GAIN SKILLS THAT CAN LEAD TO GAINFUL EMPLOYMENT. EMPLOYMENT AND INCOME ARE ECONOMIC DETERMINANTS OF HEALTH. EVERY COMMUNITY DESERVES STRONG HEALTH CARE SERVICES. IN ORDER TO HAVE A STRONG HEALTH CARE SYSTEM, A STRONG HEALTH CARE WORKFORCE IS NEEDED. ONE WAY TO EXPAND THE PIPELINE OF HEALTH CARE WORKERS IS TO OFFER OPPORTUNITIES ABOUT HEALTH CARE CAREERS TO YOUTH STILL IN SCHOOL. HEALTH CAREERS INFORMATION CAN INCREASE YOUNG PEOPLE'S INTEREST IN HEALTH CAREERS AND INCREASE THE NUMBER OF NEW HEALTH CARE WORKERS IN THE FIELD. 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 REGIONAL BOARD OF DIRECTORS, WITH LOCAL REPRESENTATION. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING ACADEMIA, INDUSTRY/BUSINESS, PHILANTHROPY, FINANCE, AND HEALTHCARE.- SUPPORTS ITS STAFF IN PARTICIPATING ON COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- 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: THE PRIMARY SERVICE AREA OF THE HOSPITAL IS WOOD COUNTY, ALTHOUGH IT DOES SERVE NEIGHBORING COUNTIES. WOOD COUNTY IS A RURAL COUNTY IN CENTRAL WISCONSIN. IT COVERS 793 SQUARE MILES, WITH 93.6 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 74,516 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER 14 YEARS OLD: 17.3%PERSONS 65 YEARS AND OVER: 21.6%WHITE PERSONS: 95.4%AFRICAN AMERICAN PERSONS: 1.4%AMERICAN INDIAN PERSONS: 1.1%ASIAN PERSONS: 2.1%HISPANIC OR LATINO: 3.4%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 4.6%HIGH SCHOOL GRADUATE OR HIGHER: 92.7%PERSONS BELOW POVERTY LEVEL: 9.4%MEDIAN HOUSEHOLD INCOME: $54,913PERCENT WITHOUT HEALTHCARE COVERAGE: 3.8%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 41.6%NUMBER OF HOSPITALS IN THE COUNTY: 2 (INCLUDING ASPIRUS RIVERVIEW HOSPITAL)WOOD COUNTY HAS THE FOLLOWING DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS): DENTAL; MENTAL HEALTH; PRIMARY CARE. 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 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 HEALTH CAREER EXPLORATION OPPORTUNITIES (E.G., SHADOWING, VOLUNTEERING) AND PRESENTATIONS TO AREA YOUTH. - SUPPORTS PROJECT SEARCH, WHICH ENGAGES YOUNG ADULTS WITH DISABILITIES IN WORKFORCE CAREER EXPLORATION AND TRAINING. - PROMOTES AREA 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 WI 1 BOYS & GIRLS CLUB OF THE WISCONSIN RAPIDS AREA 501 W GRAND AVE WISCONSIN RAPIDS WI 54495 391745942 501(C)(3) 7500 0 THE FUNDS WERE USED TO HELP SUPPORT THE COST OF TRANSPORTATION FOR THE BOYS AND GIRLS CLUB MEMBERS. BECAUSE THE LACK OF TRANSPORTATION CAN BE A BARRIER, THE FUNDING HELPS INCREASE THE ACCESSIBILITY OF THE PROGRAMS AND SERVICES AVAILABLE AT THE CLUB. 1 0 PART I, LINE 2: WHEN COMMUNITY BENEFIT FUNDS ARE DONATED TO LOCAL AGENCIES TO COMPLETE COMMUNITY HEALTH IMPROVEMENT EFFORTS, ASPIRUS REQUESTS A FORMAL REPORT AT THE CONCLUSION OF THE FISCAL YEAR. 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 JESSE TISCHER V. CHAIR (THRU JAN '24)/SVP&PRES. AW 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 JOSHUA POGORELEC DO BOARD MEMBER/REGIONAL MED. DIRECTOR 0 678838 0 0 0 25800 0 9900 0 35726 0 750264 0 0 SEAN CASHIN PHYSICIAN 683343 0 0 0 5810 0 9713 0 36623 0 735489 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 BOARD MEMBER/SVP & PRES. -AMG 0 509155 0 94839 0 3640 0 9900 0 84664 0 702198 0 0 RICHARD WESSLING PHYSICIAN 591134 0 0 0 7281 0 9900 0 35694 0 644009 0 0 0 THOMAS FERK PHYSICIAN 593489 0 0 0 6159 0 650 0 39002 0 639300 0 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 JOEL CARLSON PHYSICIAN 545180 0 0 0 8620 0 9900 0 31909 0 595609 0 0 0 ANNA OLSON PHYSICIAN 503816 0 0 0 37524 0 9728 0 39439 0 590507 0 0 0 TRINA DANIELS MD BOARD MEMBER/PHYSICIAN 0 537474 0 0 0 5618 0 9900 0 29471 0 582463 0 0 CONSTANCE BRADLEY SECRETARY/SVP-PRES 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 ROBERT SMITH (NV) PRESIDENT-ASPIRUS SE 0 316346 0 68932 0 8977 0 5475 0 49390 0 449120 0 5807 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 BRIAN KIEF (NV) PRESIDENT-ADS & ARH 0 314196 0 56117 0 2961 0 9900 0 34581 0 417755 0 0 BONITA KOLRUD MD BOARD MEMBER/PHYSICIAN 0 349740 0 0 0 8564 0 8183 0 32005 0 398492 0 0 SUSAN KRECKMAN MD BOARD MEMBER/PHYSICIAN 0 335159 0 0 0 7281 0 8678 0 29412 0 380530 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS RIVERVIEW 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: J. TISCHER $50,242 S. SCZYGELSKI $337,358 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 WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DC53 2017-11-02 15000000 NEW CONSTRUCRTION 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DMG8 2015-05-07 26748065 REFINANCE 2008 BOND 1 0 0 A 980000 15000000 167011 14832989 2019 0 0 0 1 B 3960000 26748065 26380444 367621 2011 0 1 1 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART III - LINE 3A AND 3B: ASPIRUS, INC. THE PARENT ORGANIZATION OF ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. HAS POLICY 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. PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2015 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982) AND ASPIRUS KEWEENAW HOSPITAL (EIN 38-1443361). INFORMATION REGARDING THE SERIES 2015 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION, RESPECTIVELY. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2015 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2015 BONDS.] 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, LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. PART IV: FOR BOND A, THE DATE THE LAST REBATE COMPUTATION WAS PERFORMED WAS 05/01/2021. 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 10 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 SIX INDEPENDENT COMMUNITY CLASS DIRECTORS, TWO 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 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 AND FORM 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE FORM 990 AND FORM 990-T ARE 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 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 DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS RIVERVIEW 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 AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 1,693,775. MANAGEMENT AND GENERAL EXPENSES 764,178. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,457,953. FOOD SERVICE: PROGRAM SERVICE EXPENSES 124,265. MANAGEMENT AND GENERAL EXPENSES 56,065. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,330. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 170,423. MANAGEMENT AND GENERAL EXPENSES 76,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 247,312. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,992,051. MANAGEMENT AND GENERAL EXPENSES 104,217. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,096,268. CONTRACTED NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 11,881,753. MANAGEMENT AND GENERAL EXPENSES 5,360,669. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,242,422. FORM 990, PART XI, LINE 9: POSTRETIREMENT BENEFIT ADJUSTMENT -7,673. INTERCOMPANY TRANSFERS -17,609,313. 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