2025-05-15T10:51:39-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 390807065 ASPIRUS STANLEY HOSPITAL & CLINICS INC ASPI 7156445571 1120 PINE STREET STANLEY WI 54768 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7156445571 2025-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-04-29 2023 2025-03-06 01:10:19Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 23980946 0 X WWW.ASPIRUS.ORG X 1921 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 10 4 114 8 10564 0 309269 91584 19938895 23782584 -8938 0 76936 106778 20316162 23980946 12000 24831 0 0 8667340 9546205 0 0 0 12085393 13554012 20764733 23125048 -448571 855898 23900227 24018442 19743277 18151827 4156950 5866615 X WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 1 0 15576056 24831 23772020 ASPIRUS STANLEY HOSPITAL, INC. IS A 12-BED HOSPITAL CAMPUS PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2024, ASPIRUS STANLEY HOSPITAL, INC. SERVICED THE COMMUNITY THROUGH A TOTAL OF APPROXIMATELY 787 INPATIENT DAYS, AND APPROXIMATELY 551 SWING BED DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES FOR APPROXIMATELY 26,992 OUTPATIENT VISITS, WHICH INCLUDED APPROXIMATELY 2,939 EMERGENCY ROOM VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 15576056 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 0 114 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 4 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 B.M. (THRU 01/24)/SVP & PRES.-AWH 1.00 50.00 X X 0 764397 116000 MICHAEL HOLZHUETER ASST. SEC./SVP-GEN. COUNSEL 2.00 50.00 X X 0 688935 115911 JAMES MATHESON VICE CHAIR/SVP-CHIEF STRATEGY OFF. 1.00 40.00 X X 0 522951 102957 CONSTANCE BRADLEY B.M./SVP & PRES. REG. MRKTS. 1.00 40.00 X 0 489478 90167 SUSAN SCHNEIDER B.M./VP-SENIOR SYS. PHYSICIAN EXEC. 1.00 40.00 X 0 510162 34165 DIANE ANDERSON BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 237692 35523 MATTHEW BREWER SEC./TREAS. (THRU 07/23)/VP-OPS 1.00 40.00 X X 0 248668 21417 RACHEL A DIXON BOARD MEMBER/PHYSICIAN ASSISTANT 1.00 40.00 X 0 101130 40565 RANDY L JUEDES CHAIR 1.00 1.00 X X 0 0 0 JOHNATHON R LANGE SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 LEONARD W HAMMAN BOARD MEMBER 1.00 1.00 X 0 0 0 JEFFREY A KOENIG BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM G ARCISCZEWSKI BOARD MEMBER (THRU 09/23) 1.00 1.00 X 0 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 SIDNEY C 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 DALE HUSTEDT (NV) PRESIDENT-ASPIRUS NW WI DIV. 1.00 40.00 X 0 424938 88900 ROBERT SMITH VP-STEVENS POINT CAMPUS 1.00 40.00 X 0 394256 54865 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 498735 99668 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 2.00 50.00 X 0 310701 47434 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 316286 37986 ANDREA ALLARD VP-OPERATIONS 2.00 50.00 X 0 293965 10421 JANELLE KOMMERS-MARKGRAF VP-HUMAN RESOURCES NORTH REGION 2.00 50.00 X 0 242495 37276 JOHNATHON JUSTICE PHYSICIAN 40.00 X 332599 0 47273 KATHERINE JACKSON-SCHNEIDER PHYSICIAN 40.00 X 292059 0 45923 PETER GINTNER PHYSICIAN ASSISTANT 40.00 X 245029 0 36755 WILL WEIDER SVP-CHIEF INFORMATION OFFICER 40.00 X 0 253165 11861 TYLER HACK VP-FINANCE NORTH REGION 40.00 X 0 241867 21299 869687 10695706 1674086 14 0 1 0 ACUTE CARE INC 1609 N ANKENY BLVD STE 200 ANKENY IA 50023 CLINICAL SERVICES 1971433 TOTAL MSP LLC (STAFFENCY) 221 W COLLEGE AVENUE FLOOR 2 APPLETON WI 54911 CLINICAL SERVICES 766813 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE STE 185 IRVINE CA 92614 CLINICAL SERVICES 333900 MEDICAL STAFFING SOLUTIONS PO BOX 101 RICE LAKE WI 54868 CLINICAL SERVICES 274975 SHARED MEDICAL TECHNOLOGY INC 202 WEST NEWTON STREET RICE LAKE WI 54868 CLINICAL SERVICES 215749 7 90381 1203 91584 PATIENT SERVICE REVENUE 621990 20721519 20721519 LAB REVENUE 621500 2832072 2821508 10564 PHARMACY REVENUE 900099 223868 223868 5125 5125 23782584 40156 0 40156 40156 40156 CAFETERIA REVENUE 722514 66622 66622 66622 23980946 23772020 10564 106778 X 24831 24831 7753453 6525306 1228147 211695 167853 43842 1093005 866644 226361 488052 386976 101076 3000 1671 1329 3264 3264 4181480 3773920 407560 1301 725 576 14503 13560 943 24000 13370 10630 345234 18056 327178 30407 16940 13467 531884 531884 1520624 340924 1179700 39667 2075 37592 CORPORATE ALLOCATIONS 3175118 327704 2847414 MEDICAL SUPPLIES 1913260 1788898 124362 BAD DEBT EXPENSE 662071 662071 REPAIRS AND MAINTENANCE 601027 334832 266195 507172 309700 197472 23125048 15576056 7548992 0 1545 1612 113185 109997 2959617 3623875 332327 306961 10090 8401 23182010 3308942 20431335 19873068 52128 94528 23900227 24018442 1266297 405700 17428953 17335379 1048027 410748 19743277 18151827 X 4156950 5866615 4156950 5866615 23900227 24018442 X 855898 853767 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 3264 3264 0 PART II-B, LINE 1: ASPIRUS STANLEY HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND WHA HAVE NOTIFIED THE HOSPITAL THAT APPROXIMATELY $3,264 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 2690000 2690000 17945412 2237518 15707894 1995019 1071424 923595 551579 551579 19873068 OPERATING LEASE LIABILITY 35281 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 375467 410748 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 215917 215917 0.00960 3746745 1529186 2217559 0.09870 1602923 1980291 0 0.00000 5565585 3509477 2433476 0.10830 51342 51342 0.00230 13893 13893 0.00060 24831 24831 0.00110 90066 90066 0.00400 5655651 3509477 2523542 0.11230 1 27 190 190 0.00000 1 27 190 190 0.00000 1 298720 0 4839873 4722712 117161 X 1 1 1 1 ASPIRUS STANLEY HOSPITAL 1120 PINE STREET STANLEY WI 54768 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 1013 X X X X ASPIRUS STANLEY HOSPITAL & CLINICS 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 STANLEY HOSPITAL & CLINICS PART V, SECTION B, LINE 5: ASPIRUS STANLEY HOSPITAL COLLABORATED WITH THE CLARK COUNTY HEALTH DEPARTMENT AND THE MARSHFIELD MEDICAL CENTER-NEILLSVILLE HOSPITAL TO CONDUCT THE ASSESSMENT. NO OUTSIDE CONTRACTORS OR VENDORS WERE PAID FOR SERVICES.THE COLLABORATORS CONDUCTED A COMMUNITY SURVEY IN SUMMER 2021. THE SURVEY CAPTURED SOME DEMOGRAPHIC DATA AS WELL AS RESPONDENTS' OPINIONS ON THE TOP HEALTH ISSUES FACING THE COMMUNITY. THE SURVEY WAS AVAILABLE ELECTRONICALLY (THROUGH A HYPERLINK) AND ON PAPER. PAPER SURVEYS WERE ENTERED INTO THE ONLINE SURVEY COLLECTOR. APPROXIMATELY 320 PEOPLE RESPONDED (THOUGH THE NUMBER VARIED BY QUESTION). DELIBERATE EFFORTS WERE MADE TO REACH MEMBERS OF THE PLAIN COMMUNITY (AMISH, MENNONITE), INDIVIDUALS WHO ARE IN THE JAIL AND ANY/ALL CLARK COUNTY RESIDENTS AT THE COUNTY FAIR. ASPIRUS STANLEY HOSPITAL & CLINICS PART V, SECTION B, LINE 6A: ASPIRUS STANLEY HOSPITAL COLLABORATED WITH THE MARSHFIELD MEDICAL CENTER-NEILLSVILLE HOSPITAL. ASPIRUS STANLEY HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS STANLEY HOSPITAL. ASPIRUS STANLEY HOSPITAL & CLINICS PART V, SECTION B, LINE 6B: ASPIRUS STANLEY HOSPITAL COLLABORATED WITH THE CLARK COUNTY HEALTH DEPARTMENT. ASPIRUS STANLEY HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS STANLEY HOSPITAL. ASPIRUS STANLEY HOSPITAL & CLINICS PART V, SECTION B, LINE 11: FACILITY NAME: ASPIRUS STANLEY HOSPITALIN 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. THE HOSPITAL IS IN RURAL NORTHERN WISCONSIN. BECAUSE OF THAT SETTING, COMMUNITY HEALTH EFFORTS ARE FREQUENTLY COMPLETED WITH OTHER REGIONAL PARTNERS. IN FY24, ASPIRUS STANLEY HOSPITAL'S SIGNIFICANT NEEDS WERE: CHRONIC DISEASE; MENTAL HEALTH; PHYSICAL ENVIRONMENT AND SAFETY. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. CHRONIC DISEASEFOOD GLEANING. ASPIRUS STANLEY HOSPITAL CONTINUED THE FOOD GLEANING PROGRAM IT STARTED IN FY21. THE FOOD GLEANING PROGRAM TAKES UNTOUCHED FOOD FROM THE HOSPITAL CAFETERIA, PACKAGES IT AND THEN DISTRIBUTES IT TO AN AREA FOOD PANTRY. THE HOSPITAL CONTRIBUTES BOTH THE CONTAINERS FOR THE FOOD AS WELL AS THE TIME THAT STAFF SPENDS PACKAGING THE FOOD. HOSPITAL STAFF SPENDS APPROXIMATELY 1 HOUR PER WEEK PACKAGING MEALS, TOTALING 52 HOURS OF STAFF TIME AND 1,581 POUNDS OF FOOD DONATED IN FY24. MEALS ON WHEELS. HOSPITAL FOOD AND NUTRITION STAFF SPENT 10 HOURS/WEEK (520 HOURS ANNUALLY) PACKAGING FOOD FOR MEALS ON WHEELS DELIVERIES TO HOMEBOUND INDIVIDUALS IN CHIPPEWA COUNTY (CADOTT, STANLEY, BOYD) TOTALING 4,416 MEALS DISTRIBUTED IN FY24. THIS IS A CONTRACT WITH THE AGING AND DISABILITY RESOURCE CENTER. ADDITIONALLY, ASPIRUS STANLEY HOSPITAL STAFF (ON WORK TIME) PERIODICALLY DELIVER THOSE MEALS. COALITIONS: ASPIRUS STANLEY HOSPITAL IS PART OF THE EAT RIGHT BE FIT COALITION IN CLARK COUNTY. THE GOAL OF THIS COALITION IS TO INCREASE HEALTHY NUTRITION AND PHYSICAL ACTIVITY IN THE COMMUNITY. IN ADDITION, THE HOSPITAL IS ALSO PART OF THE CHRONIC DISEASE PREVENTION COALITION IN CHIPPEWA COUNTY. ASPIRUS STANLEY HOSPITAL PROVIDED FUNDING TO THE CLARK COUNTY HEALTH DEPARTMENT TO PURCHASE THE NECESSARY EQUIPMENT TO PROVIDE DENTAL SERVICES (CLEANINGS) AT COMMUNITY EVENTS TO THOSE IN NEED THROUGH THEIR COMMUNITY ORAL HEALTH PROGRAM. ORAL HEALTH SERVICES ARE PROVIDED AT COMMUNITY HEALTH AND RESOURCE FAIRS ON A WALK-IN BASIS 6 TIMES A YEAR TO INDIVIDUALS OVER AGE 2. SINCE FEBRUARY OF 2024, 39 PATIENTS HAVE BEEN SEEN. THE HOSPITAL PROVIDED FUNDING TO THE CLARK COUNTY DEPARTMENT FOR THE PURCHASE OF MYPLATES PRINTED IN SPANISH TO BE DISTRIBUTED AT COMMUNITY EVENTS. MYPLATE IS A NUTRITION GUIDE PUBLISHED BY THE U.S. DEPARTMENT OF AGRICULTURE. TWO HUNDRED FIFTY PLATES HAVE BEEN GIVEN AWAY AT LOCAL RESOURCE FAIRS THAT REACH INDIVIDUALS WHO ARE HISPANIC. MENTAL HEALTH COALITIONS. THE HOSPITAL IS A MEMBER OF THE CLARK COUNTY PREVENTION PARTNERSHIP WHICH AIMS TO PROVIDE MENTAL HEALTH AWARENESS AND EDUCATION. AS PART OF THE CHIPPEWA COUNTY HEALTH IMPROVEMENT PARTNERSHIP, ASPIRUS PARTICIPATES ON THE MENTAL HEALTH SUBCOMMITTEE. THE HOSPITAL PROVIDED FUNDING TO THE PERSONAL DEVELOPMENT CENTER (PDC) TO SUPPORT MENTAL HEALTH PROGRAMS AND SERVICES TO BE PROVIDED TO THOSE IN NEED THROUGHOUT THE COMMUNITY/COUNTY. THE PERSONAL DEVELOPMENT CENTER IS A NON-PROFIT THAT PROVIDES ADVOCACY AND SUPPORT SERVICES FOR INDIVIDUALS WHO ARE AFFECTED BY DOMESTIC VIOLENCE, SEXUAL ASSAULT AND/OR ELDER ABUSE. FUNDS ARE USED TO MEET BASIC NEEDS SUCH AS TRANSPORTATION AND FOOD. IN CALENDAR 2023, PDC PROVIDED 5,459 NIGHTS OF SAFE SHELTER, SUPPORTED OVER 1,100 VICTIMS AND SURVIVORS, AND FACILITATED OVER 1,200 ADVOCACY CONTACTS. PHYSICAL ENVIRONMENT AND SAFETYCOALITION. AS PART OF THE CHIPPEWA COUNTY HEALTH IMPROVEMENT PARTNERSHIP, ASPIRUS PARTICIPATED IN THE HEALTHY KIDS DAY AT THE YMCA IN APRIL 2024, OFFERING CHILDREN AND FAMILIES SOME FUN WAYS TO IMPROVE NUTRITION AND PHYSICAL ACTIVITY. APPROXIMATELY 1000 PEOPLE ATTENDED THE EVENT. ASPIRUS STAFF ALSO PARTICIPATE IN THE WOOD AND CLARK COUNTY SAFE KIDS COALITION. THE HOSPITAL HELPED FUND MULTIPLE SAFETY-RELATED ACTIVITIES AND ITEMS, INCLUDING: - AN AED DEVICE FOR THE CADOTT POLICE DEPARTMENT.- SAFE SITTER BOOKLETS FOR SAFE SITTER CLASSES. SEVENTY STUDENTS WERE TRAINED IN FIVE DIFFERENT CLASSES; THE CLASSES WERE HELD AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY.- UPDATED SAFETY EQUIPMENT FOR THE THORP AREA AMBULANCE DISTRICT.- SUPPORT FOR THE ANNUAL KICK OUT DOMESTIC ABUSE PREVENTION AND AWARENESS EVENT. OVER 120 PEOPLE ATTENDED THIS EVENT.- CAR SEATS. ASPIRUS STANLEY WORKED WITH ASPIRUS WAUSAU HOSPITAL'S SYSTEM INJURY PREVENTION COORDINATOR TO ASSURE THE FUNDING AND DISTRIBUTION OF CAR SEATS. THE CAR SEATS WERE ACCOMPANIED BY CAR SEAT CHECKS AT COMMUNITY EVENTS THAT BEGAN IN FY23. IN FY24, 82 CAR SEATS WERE DISTRIBUTED. - PACK 'N' PLAYS. THE HOSPITAL HELPED FUND 36 PACK 'N' PLAYS FOR SAFE INFANT SLEEP. OTHER ASPIRUS STAFF PARTICIPATE IN THE HMONG AND HISPANIC COMMUNICATION NETWORK (H2N). H2N WAS CREATED TO IMPROVE UNDERSTANDING OF HEALTH INFORMATION AND ACCESS TO HEALTHCARE THROUGHOUT RURAL CENTRAL WISCONSIN WITH MEMBERS OF THE HISPANIC AND HMONG POPULATIONS. H2N COLLABORATES WITH PUBLIC HEALTH ORGANIZATIONS, RESOURCE AGENCIES, AND COMMUNITY ORGANIZATIONS. ASPIRUS WORKS WITH H2N AND OTHERS TO IMPLEMENT A REGULAR RESOURCE EVENT THAT REACHES A SIGNIFICANT NUMBER OF INDIVIDUALS WHO ARE HISPANIC IN WESTERN CLARK COUNTY. FOR COMMUNITY PARTNERS' NEEDS ASSESSMENT, THE HOSPITAL HELPED FUND THE MAILING OF COMMUNITY HEALTH SURVEYS MEMBERS OF THE PLAIN COMMUNITY. SURVEYS WERE SENT TO 160 AMISH/MENNONITE HOUSEHOLDS AND INCLUDED A STAMPED RETURN ENVELOPE FOR CONVENIENCE.LOCKBOXES (TO HELP KEEP PRESCRIPTION DRUGS SECURE) THAT WERE PURCHASED IN FY22 WERE STILL MADE AVAILABLE IN FY24.ASPIRUS LAID THE GROUNDWORK FOR THE IMPLEMENTATION OF THE SYSTEM'S FRUIT AND VEGETABLE PRESCRIPTION PROGRAM (FVRX) AT THE CADOTT FARMERS MARKET. FULL IMPLEMENTATION IS ANTICIPATED IN SUMMER 2025. CONTINUED FROM FY23, ASPIRUS STANLEY HOSPITAL PARTICIPATED ON THE YOUTH PROGRAMMING SUBCOMMITTEE OF THE CENTRAL WISCONSIN PARTNERSHIP FOR RECOVERY (CWPR). THE CWPR WAS GIVEN A GRANT TO SUPPORT THE MATERIALS AND TRAINING FOR SUBSTANCE ABUSE PREVENTION AND EARLY INTERVENTION CURRICULUM IN SCHOOLS AND YOUTH-SERVING ORGANIZATIONS. THE CWPR OFFERS TECHNICAL ASSISTANCE, TRAINING AND DIRECT SERVICES TO SCHOOL DISTRICTS ON A VARIETY OF TOPICS, INCLUDING CURRICULUM, RECOVERY COACHES, MINDFULNESS GROUPS.IN ADDITION TO THE CHIPPEWA COUNTY HEALTH IMPROVEMENT PARTNERSHIP PARTICIPATION MENTIONED ABOVE, ASPIRUS STANLEY ALSO PARTICIPATES IN THE HEALTH EQUITY SUBCOMMITTEE.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. THE HOSPITAL'S FINAL PRIORITIES ARE: CHRONIC DISEASE MENTAL HEALTH PHYSICAL ENVIRONMENT AND SAFETYTHE THREE ISSUES THAT WERE NOT SELECTED AND THE CORRESPONDING RATIONALE ARE: SUBSTANCE USE - ALTHOUGH THIS WAS A PRIORITY IN THE PREVIOUS 3-YEAR CYCLE, THERE WAS VERY LITTLE MOMENTUM OR ENERGY AROUND IT FROM OTHER ORGANIZATIONS, RESULTING IN LITTLE PROGRESS. THE HOSPITAL FELT ITS RESOURCES WERE BETTER DIRECTED TO EFFORTS THAT COULD RESULT IN COLLECTIVE IMPACT. COMMUNICABLE DISEASES - THE HOSPITAL WILL WORK ON THIS ISSUE OUTSIDE OF THE FORMAL IMPLEMENTATION STRATEGY. SOCIAL DETERMINANTS OF HEALTH - THE HOSPITAL WILL WORK TO ADDRESS SOCIAL DETERMINANTS, PARTICULARLY THOSE DETERMINANTS THAT CONTRIBUTE TO HEALTH INEQUITIES, AS PART OF THEIR EFFORTS TO ADDRESS CHRONIC DISEASE, MENTAL HEALTH AND PHYSICAL ENVIRONMENT AND SAFETY. ASPIRUS STANLEY HOSPITAL & CLINICS PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 3 1 - ASPIRUS STANLEY CLINIC 1120 PINE STREET STANLEY WI 54768 PHYSICIANS CLINIC 2 - ASPIRUS THORP CLINIC 704 SOUTH CLARK STREET THORP WI 54771 PHYSICIANS CLINIC 3 - ASPIRUS OWEN CLINIC 6 JOHNSON STREET OWEN WI 54460 PHYSICIANS 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, 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 IS $662,071. PART II, COMMUNITY BUILDING ACTIVITIES: ASPIRUS STANLEY 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. 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 BANKING, LOCAL BUSINESSES, AND COMMUNITY SERVICE ORGANIZATIONS. - SUPPORTS ITS STAFF IN PARTICIPATING ON COMMUNITY BOARDS, COALITIONS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- REVIEWS FUNDING REQUESTS 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 CLARK COUNTY, ALTHOUGH IT DOES SERVE NEIGHBORING COUNTIES INCLUDING CHIPPEWA. CLARK COUNTY IS A RURAL COUNTY IN CENTRAL WISCONSIN. IT COVERS 1,209 SQUARE MILES, WITH 28.7 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 34,751 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS 14 YEARS AND UNDER: 24.5%PERSONS 65 YEARS AND OVER: 17.7%WHITE PERSONS: 97.7%AFRICAN AMERICAN PERSONS: 0.9%AMERICAN INDIAN PERSONS: 0.8%ASIAN PERSONS: 0.6%HISPANIC OR LATINO: 5.2%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 17.3%HIGH SCHOOL GRADUATE OR HIGHER: 82.3%PERSONS BELOW POVERTY LEVEL: 13.1%MEDIAN HOUSEHOLD INCOME: $54,012PERCENT WITHOUT HEALTHCARE COVERAGE: 20.9%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERAN'S BENEFITS, ETC.) 33.4%NUMBER OF HOSPITALS IN THE COUNTY: 2 (INCLUDING ASPIRUS STANLEY HOSPITAL)CLARK COUNTY IS A DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR MENTAL HEALTH, DENTAL CARE, AND PRIMARY CARE.ANOTHER GROUP WITHIN OUR COMMUNITY IS "THE PLAIN PEOPLE," CONSISTING OF INDIVIDUALS FROM THE AMISH, MENNONITE, GERMAN BAPTIST, AND OLD GERMAN BAPTIST RELIGIONS. THE PLAIN PEOPLE ALSO REQUIRE SPECIAL CONSIDERATION BY ASPIRUS STANLEY AND THE HEALTH DEPARTMENTS BECAUSE OF THEIR NON-MAINSTREAM LIFESTYLE. DEPENDING ON THE GROUP, BELIEFS MAY INFLUENCE THEIR USE OF PREVENTIVE HEALTH CARE, TREATMENT FOR ILLNESSES AND INJURIES, USE OF INSURANCE, USE OF ELECTRICITY, TRANSPORTATION, AND VARIOUS OTHER FACETS OF DAILY LIFE. 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.- PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - IN ADDITION, SEVERAL COMMUNITY EFFORTS ARE SUPPORTED BY ASPIRUS STANLEY.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 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 CLARK COUNTY HEALTH DEPARTMENT 517 COURT STREET NEILLSVILLE WI 54456 396005679 GOV'T 11705 0 FUNDS SUPPORTED: THE SEAL-A-SMILE PROGRAM AND THE COMMUNITY ORAL HEALTH PROGRAM (EQUIPMENT); CRIBS-FOR-KIDS PROGRAM; EDUCATION MATERIALS FOR SAFE SITTER CLASSES; NUTRITION EDUCATION IN SPANISH; COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY MAILING SUPPLIES. PERSONAL DEVELOPMENT CENTER INC 505 EAST DEPOT STREET MARSHFIELD WI 54449 391287527 501C3 5300 0 FUNDS SUPPORTED: PROGRAMMING AND SERVICES FOR COMMUNITY MEMBERS WHO ARE VICTIMS OF DOMESTIC VIOLENCE AND THEIR FAMILIES. 2 0 PART I, LINE 2: GRANTS ARE PROVIDED TO SUPPORT COMMUNITY PARTNERS AND NON-PROFITS THAT THE HOSPITAL AND ASPIRUS INC DETERMINES. GRANTS PROVIDED ARE GENERAL SUPPORT SO THERE IS NOT A FORMAL PROCESS FOR MONITORING USE OF GRANT FUNDS HOWEVER, PRIOR TO PROVIDING ANY GRANT THE HOSPITAL IS AWARE OF WHAT THE INTENDED USE WILL BE. 1 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 C SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 JESSE TISCHER B.M. (THRU 01/24)/SVP & PRES.-AWH 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 MICHAEL HOLZHUETER ASST. SEC./SVP-GEN. COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 JAMES MATHESON VICE CHAIR/SVP-CHIEF STRATEGY OFF. 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 B.M./SVP & PRES. REG. MRKTS. 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 SUSAN SCHNEIDER B.M./VP-SENIOR SYS. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 DALE HUSTEDT (NV) PRESIDENT-ASPIRUS NW WI DIV. 0 289376 0 63525 0 72037 0 9900 0 79000 0 513838 0 64077 ROBERT SMITH VP-STEVENS POINT CAMPUS 0 316347 0 68932 0 8977 0 5475 0 49390 0 449121 0 5807 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 JOHNATHON JUSTICE PHYSICIAN 327067 0 0 0 5532 0 9368 0 37905 0 379872 0 0 0 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 0 280048 0 30050 0 603 0 9581 0 37853 0 358135 0 0 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 280398 0 33439 0 2449 0 9592 0 28394 0 354272 0 0 KATHERINE JACKSON-SCHNEIDER PHYSICIAN 285672 0 0 0 6387 0 7300 0 38623 0 337982 0 0 0 ANDREA ALLARD VP-OPERATIONS 0 267134 0 26259 0 572 0 8802 0 1619 0 304386 0 0 PETER GINTNER PHYSICIAN ASSISTANT 238007 0 0 0 7022 0 7318 0 29437 0 281784 0 0 0 JANELLE KOMMERS-MARKGRAF VP-HUMAN RESOURCES NORTH REGION 0 216363 0 20315 0 5817 0 6708 0 30568 0 279771 0 0 DIANE ANDERSON BOARD MEMBER/NURSE PRACTITIONER 0 231254 0 0 0 6438 0 6195 0 29328 0 273215 0 0 MATTHEW BREWER SEC./TREAS. (THRU 07/23)/VP-OPS 0 146938 0 25386 0 76344 0 811 0 20606 0 270085 0 0 WILL WEIDER SVP-CHIEF INFORMATION OFFICER 0 226655 0 0 0 26510 0 0 0 11861 0 265026 0 0 TYLER HACK VP-FINANCE NORTH REGION 0 218574 0 19103 0 4190 0 6762 0 14537 0 263166 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, ASPIRUS STANLEY HOSPITAL & CLINICS, 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, LINES 4A-B SCHEDULE J, PART I, LINE 4A - SEVERANCE PAYMENT: M. BREWER $64,563 SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $337,358 D. HUSTEDT $64,077 J. MATHESON $32,339 J. TISCHER $50,242 M. HOLZHUETER $55,822 T. RICHARDSON $39,964 R. SMITH $5,807 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 & EDUCATIONAL FACILITIES AUTH 391337855 97712JDN0 2021-11-10 17711082 REVENUE BONDS SERIES 2021 0 0 0 A 17711082 126172 17584910 2021 0 0 1 1 A 0 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, 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 ASPIRUS STANLEY HOSPITAL 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 III, LINE 2 NEW CARDIAC REHABILITATION PROGRAM. 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 AND 990-T INFORMATION, INCLUDING THE UBIT CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND 990-T ARE 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 STANLEY HOSPITAL & CLINICS, 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 FEES: PROGRAM SERVICE EXPENSES 535,796. MANAGEMENT AND GENERAL EXPENSES 407,560. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 943,356. LAB FEES: PROGRAM SERVICE EXPENSES 213,574. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 213,574. CONTRACT NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 3,024,550. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,024,550. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 853,767. 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