2025-05-15T10:51:12-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 390808503 ASPIRUS MERRILL HOSPITAL & CLINICS INC ASPI 7155365511 601 SOUTH CENTER AVENUE MERRILL WI 54452 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7158472250 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 33091226 0 X WWW.ASPIRUS.ORG X 1950 WI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 10 4 107 30 0 0 214176 54496 27064256 32898077 -10603 -1156 128152 138653 27395981 33090070 22282 31550 0 0 10666173 11581113 0 0 0 12853684 15127306 23542139 26739969 3853842 6350101 13025345 13921170 10281510 8909192 2743835 5011978 WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 17736997 31550 32898077 ASPIRUS MERRILL HOSPITAL & CLINICS INC. PROVIDES HOSPITAL SERVICES FOR RESIDENTS OF MERRILL, WAUSAU, AND SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 17736997 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 1 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 1 107 1 0 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 JAMES M CYGAN MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 953637 45713 ELIZABETH RENAKER-JANSEN DO BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 760881 47132 LAWRENCE G LEIBERT MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 480959 37228 JENNIFER R ENMAN-BOURGON DO BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 393526 44939 MICHAEL A UMLAND MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 284382 45883 TOU SHOUA LOR MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 286715 42240 JEREMY A LEWITZKE CHAIR 1.00 3.00 X X 0 0 0 KYLE N PAGE VICE CHAIR 1.00 2.00 X X 0 0 0 MARCO A ESPINOZA SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 BRYAN B BORRELL BOARD MEMBER 1.00 2.00 X 0 0 0 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 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 JEFFREY WICKLANDER SVP & CENTRAL REGION PRESIDENT 1.00 50.00 X 0 684346 127237 JENNIFER REDMAN-SCHELL (NV) SVP & PRESIDENT-AMG 1.00 50.00 X 0 607634 94564 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 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 CONSTANCE BRADLEY SVP & PRES. REG. MRKTS. 2.00 50.00 X 0 489478 90167 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 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 316286 37986 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 2.00 50.00 X 0 310701 47434 CHOON P'NG REGIONAL MEDICAL DIRECTOR 40.00 X 573762 0 46535 JOSEPH ROBERTS PHYSICIAN 40.00 X 476846 0 46594 MICHAEL CLARK PHYSICIAN 40.00 X 453924 0 44561 JEANNINE NOSKO PHYSICIAN 2.00 50.00 X 0 310562 32321 ANDREA ALLARD VP-OPERATIONS 2.00 50.00 X 0 293965 10421 1504532 12549740 1771376 19 0 1 0 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACT LABOR 1186795 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIR 185 IRVINE CA 92614 ASSET MANAGEMENT SERVICES 501853 MIRON CONSTRUCTION CO INC 1471 MCMAHON DR NEENAH WI 54956 CONSTRUCTION SERVICES 433476 AJES EMERGENCY PHYSICIANS 145 CLINTON STREET NEW YORK NY 10002 CONTRACT LABOR 352434 HANS ERIKSSON MD SC 132 RAINBOW DRIVE LIVINGSTON TX 77399 CONTRACT LABOR 222685 16 54496 54496 PATIENT SERVICE REVENUE 621990 32880949 32880949 CONTRACT SERVICE REVENUE 621990 17128 17128 32898077 107978 0 107978 107978 107978 1156 -1156 -1156 -1156 CAFETERIA/VENDING REVENUE 900099 30675 30675 30675 33090070 32898077 0 137497 X 25550 25550 6000 6000 9651587 8508839 1142748 276483 229647 46836 1081916 898639 183277 571127 474378 96749 3000 3000 4645 4645 3957122 3036961 920161 709 327 382 26823 24897 1926 634162 3424 630738 46869 21607 25262 27599 12723 14876 170592 170592 2479210 620546 1858664 44830 242 44588 CORPORATE ALLOCATIONS 3519241 414286 3104955 MEDICAL SUPPLIES 2344458 2176126 168332 REPAIRS & MAINTENANCE 1079475 497638 581837 BAD DEBT EXPENSE 630205 630205 158366 154962 3404 26739969 17736997 9002972 0 620 620 456 1330 3671874 4748791 200164 191001 19948 17021 13870107 4958478 9088630 8911629 43653 50778 13025345 13921170 2017984 1434547 5610042 5579923 2653484 1894722 10281510 8909192 X 2743835 5011978 2743835 5011978 13025345 13921170 X 6350101 -4081958 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 4645 4645 0 PART II-B, LINE 1: A PORTION OF OUR ANNUAL WISCONSIN HOSPITAL ASSOCIATION (WHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ARE USED FOR LOBBYING ACTIVITIES. THE AMOUNTS THAT ARE SPECIFIC TO LOBBYING PURPOSES ARE: WISCONSIN HOSPITAL ASSOCIATION $3,035 AND AMERICAN HOSPITAL ASSOCIATION $1,610. 1370000 1370000 7010681 2726625 4284056 4824332 2231853 2592479 665094 665094 8911629 OTHER LIABILITIES 678400 COST REPORT PAYABLE 1216322 1894722 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 231489 231489 0.00890 4419875 2848133 1571742 0.06020 1069373 1037015 32358 0.00120 5720737 3885148 1835589 0.07030 83947 83947 0.00320 11312 11312 0.00040 129134 129134 0.00490 224393 224393 0.00850 5945130 3885148 2059982 0.07880 1 218366 0 4272481 4287374 -14893 X 1 1 1 1 ASPIRUS MERRILL HOSPITAL & CLINICS INC 601 SOUTH CENTER MERRILL WI 54452 WWW.ASPIRUS.ORG 1043 X X X X ASPIRUS MERRILL HOSPITAL & CLINICS INC 0 0 1 X X X X X X X X X 22 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 MERRILL HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), COMMUNITY MEMBERS FROM LINCOLN COUNTY PROVIDED INPUT ON THE TOP COMMUNITY HEALTH NEEDS THROUGH A COMMUNITY SURVEY, KEY INFORMANT INTERVIEWS, A COMMUNITY FORUM AND A COALITION PRIORITIZATION PROCESS. THE COMMUNITY SURVEY WAS COMPLETED BY 752 ADULTS IN FALL 2022 (SEPTEMBER-OCTOBER). THE SURVEY WAS DISTRIBUTED BY MULTIPLE COMMUNITY PARTNERS INCLUDING THE HEALTH DEPARTMENT, SOCIAL SERVICE AGENCIES, AND MORE. RESPONDENTS WERE ASKED ABOUT THEIR TOP COMMUNITY HEALTH CONCERNS AS WELL AS THE STRENGTHS OF THE COMMUNITY. TO FILL SOME GAPS NOTICED IN THE SURVEY, FIVE KEY INFORMANT INTERVIEW RESULTS WERE CONDUCTED IN NOVEMBER 2022. REPRESENTED SECTORS INCLUDED MANUFACTURING, AGENCIES SERVING VULNERABLE POPULATIONS, COMMUNITY ORGANIZATIONS, YOUTH GROUP, AND COMMUNITY LEADER. INTERVIEW QUESTIONS WERE ABOUT COMMUNITY STRENGTHS, CHALLENGES, OPPORTUNITIES AND THREATS. A COMMUNITY FORUM WAS HELD IN JANUARY 2023 TO REVIEW DATA AND ROOT CAUSES OF HEALTH ISSUES. OVER 60 COMMUNITY STAKEHOLDERS WERE INVITED. THE LINCOLN COUNTY HEALTH DEPARTMENT FACILITATED AND CONTRIBUTED TO THE DISCUSSION. LASTLY, THE LIVE WELL LINCOLN PARTNERS LINCOLN COUNTY HEALTH DEPARTMENT, UNIVERSITY OF WISCONSIN-EXTENSION, ASPIRUS, LINCOLN COUNTY DEPARTMENT OF SOCIAL SERVICES AND THE AGING AND DISABILITY RESOURCE CENTER MET REGULARLY TO REVIEW DATA, SHAPE THE PROCESS AND FINALIZE THE RESULTS. ASPIRUS MERRILL HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: FOR THE CHNA THAT WAS COMPLETED IN SPRING 2023, THE HOSPITAL COLLABORATED WITH ASPIRUS TOMAHAWK HOSPITAL. ASPIRUS MERRILL HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS MERRILL HOSPITAL. ASPIRUS MERRILL HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6B: FOR THE CHNA THAT WAS COMPLETED IN SPRING 2023, ASPIRUS MERRILL HOSPITAL COLLABORATED WITH THE LINCOLN COUNTY HEALTH DEPARTMENT. ASPIRUS MERRILL HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS MERRILL HOSPITAL. ASPIRUS MERRILL 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 MERRILL HOSPITAL'S SIGNIFICANT NEEDS WERE: COMMUNITY-CENTERED RESOURCES FOR THE 55+ POPULATION; HEALTHY LIFESTYLES; MENTAL AND EMOTIONAL WELL-BEING. THESE NEEDS WERE IDENTIFIED THROUGH THE MOST RECENT CHNA, COMPLETED IN JUNE 2023. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. COMMUNITY-CENTERED RESOURCES FOR THE 55+ POPULATIONTHE HOSPITAL FUNDS AND FACILITATES THE COMMUNITY CARE PARAMEDIC PROGRAM, WHICH UTILIZES PARAMEDICS TO CONDUCT HOME VISITS. THE PROGRAM SERVED INDIVIDUALS WHO WERE DISCHARGED FROM THE HOSPITAL WHO MAY BE AT RISK FOR NUTRITION OR MENTAL HEALTH ISSUES, INCLUDING PATIENTS WHO HAD COVID. THE PROGRAM ALSO SERVED INDIVIDUALS WITH COVID WHO WERE NOT ADMITTED TO THE HOSPITAL BUT WOULD BENEFIT FROM ADDITIONAL MONITORING. IN FY24, THE PROGRAM EXPANDED IN THREE WAYS. FIRST, PATIENTS DISCHARGED FROM THE HOSPITAL WHO HAD DIABETES WERE ELIGIBLE FOR THE PROGRAM. SECOND, THE PROGRAM BEGAN WORKING WITH THE ASPIRUS WAUSAU HOSPITAL MED/SURG DEPARTMENT TO CONNECT PATIENTS WHO ARE FROM MERRILL (BUT IN THE WAUSAU HOSPITAL) TO BE PART OF THE PROGRAM UPON DISCHARGE. THIRD, THE MERRILL HOSPITAL COMMUNITY HEALTH LEAD BEGAN WORKING WITH THE WAUSAU FIRE DEPT TO REPLICATE THE COMMUNITY CARE PARAMEDIC PROGRAM IN MARATHON COUNTY AND CONTINUES TO PROVIDE EXPERTISE TO THE PROGRAM.HEALTHY LIFESTYLES ASPIRUS MERRILL HOSPITAL ACTIVELY PARTICIPATED IN THE LINCOLN COUNTY HEALTHY LIFESTYLES COALITION. THE HOSPITAL AND/OR COALITION CONDUCTED A NUMBER OF NUTRITION AND HEALTHY FOOD-RELATED EFFORTS. AFTER BEING ON PAUSE FOR THE THREE YEARS OF THE PANDEMIC, HEALTHY COOKING DEMONSTRATIONS WERE AGAIN CONDUCTED IN FY24. TWO DEMONSTRATIONS (FALL 2023 AND SPRING 2024) WERE HELD WITH FAMILIES WITH CHILDREN ENROLLED IN HEADSTART. APPROXIMATELY 25 PEOPLE PARTICIPATED IN EACH. APPLIANCES (E.G., HAND MIXERS) WERE GIVEN OUT AT THE DEMONSTRATIONS, ALONG WITH INSULATED BAGS AND REFRIGERATOR MAGNETS (WITH HEALTHY FOOD SUBSTITUTION INFORMATION). A FEW COOKBOOKS WERE ALSO GIVEN AWAY AT THE DEMONSTRATIONS. ASPIRUS MERRILL HOSPITAL CONTINUES TO PROVIDE FUNDING TO INCREASE ACCESS TO FRESH FRUITS AND VEGETABLES. FUNDING SUPPORTED: - TRIPLE-YOUR-BUCKS COUPONS AND THE ELECTRONIC BENEFIT TRANSFER (EBT) MACHINE FEES AT THE LOCAL FARMERS MARKET. THE COUPONS ARE SPECIFICALLY FOR INDIVIDUALS WHO PARTICIPATE IN THE FOODSHARE PROGRAM. THE AVAILABILITY OF THE EBT MACHINE INCREASES THE ACCESSIBILITY OF THE MARKET FOR INDIVIDUALS PARTICIPATING IN FOODSHARE. - A FRUIT AND VEGETABLE PRESCRIPTION PROGRAM. ASPIRUS MERRILL 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 SYSTEM. MENTAL AND EMOTIONAL WELL-BEINGASPIRUS MERRILL IS AN ACTIVE PARTICIPANT IN THE COUNTY'S MENTAL HEALTH AND AODA COALITION. THE COALITION PARTNERS HAVE COMPLETED MANY ACTIVITIES, SOME OF WHICH THE HOSPITAL FUNDED. ACTIVITIES INCLUDED: - PUBLIC AWARENESS AND SOCIAL NORMS CAMPAIGNS (E.G., HOPELINE, SMALL TALKS, KNOW METH, ADVERSE CHILDHOOD EXPERIENCES [ACES], PARENT PACT, SOCIAL HOST AWARENESS). THE NEW NATIONAL MENTAL HEALTH HOTLINE 988 WAS PROMOTED. THE HOSPITAL FUNDED THE BILLBOARD PROMOTION OF THE COUNTY MENTAL HEALTH RESOURCE GUIDE. THE ASPIRUS MERRILL HOSPITAL PROVIDED FINANCIAL SUPPORT TO IMPLEMENT THE SOFT START PROGRAM. THE SOFT START PROGRAM AT MERRILL HIGH SCHOOL HAS DEMONSTRATED SIGNIFICANT SUCCESS IN IMPROVING STUDENT ATTENDANCE. BY OFFERING INCENTIVES AND CREATING A SUPPORTIVE ENVIRONMENT FOR STUDENTS WHO PREVIOUSLY STRUGGLED WITH CONSISTENT SCHOOL ATTENDANCE, THE PROGRAM HAS HELPED FOSTER BETTER HABITS, INCREASED ENGAGEMENT, AND PROVIDED A CRITICAL STEP TOWARD ACADEMIC SUCCESS. ASPIRUS HEALTH SUPPORTS THE RAISE YOUR VOICE PROGRAM IN MULTIPLE COMMUNITIES, INCLUDING IN MERRILL. RAISE YOUR VOICE IS A STUDENT CLUB THAT INCREASES THE AWARENESS OF MENTAL HEALTH. THE PROGRAM IS CO-SPONSORED BY THE NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI). ASPIRUS MERRILL HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 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 $603,205. 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, WHICH MEETS NEARLY MONTHLY. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING MEDICINE, INDUSTRY AND LEGAL. - 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. - INVOLVES CARE COORDINATION IN PATIENT DISCHARGE PLANNING (WHICH, OVER TIME, BUILDS AN UNDERSTANDING OF PATIENTS' NEEDS). 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 LINCOLN COUNTY, ALTHOUGH IT DOES SERVE NEIGHBORING COUNTIES. LINCOLN COUNTY IS A RURAL COUNTY IN CENTRAL WISCONSIN. IT COVERS 878 SQUARE MILES, WITH 32.3 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 27,687 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS 14 YEARS AND UNDER: 14.6%PERSONS 65 YEARS AND OVER: 21.6%WHITE PERSONS: 98.4%AFRICAN AMERICAN PERSONS: 1.4%AMERICAN INDIAN PERSONS: 0.9%ASIAN PERSONS: 0.8%HISPANIC OR LATINO: 1.9%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 2.7%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 92%HOUSEHOLDS IN POVERTY: 10%MEDIAN HOUSEHOLD INCOME: $61,100PERCENT WITHOUT HEALTHCARE COVERAGE: 4.8%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 40.3%NUMBER OF HOSPITALS IN THE COUNTY: 2 (INCLUDING ASPIRUS MERRILL HOSPITAL AND ASPIRUS TOMAHAWK HOSPITAL) LINCOLN COUNTY IS A DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR MENTAL HEALTH. 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. 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 LINCOLN COUNTY HEALTH DEPARTMENT 607 N SALES ST SUITE 101 MERRILL WI 54452 396005714 501(C)(3) 12550 0 FUNDS FOR HEALTHY MINDS FOR LINCOLN COUNTY COALITION, DENTAL SEALANT PROGRAM, AND SEAL-A-SMILE MERRILL AREA PUBLIC SCHOOLS 1111 N SALES ST MERRILL WI 54452 391421865 GOVERNMENT 8000 0 VARIOUS PROGRAM FUNDING 2 0 SCHOLARSHIPS 6 6000 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. 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 JAMES M CYGAN MD BOARD MEMBER/PHYSICIAN 0 946315 0 0 0 7322 0 9900 0 35813 0 999350 0 0 JEFFREY WICKLANDER SVP & CENTRAL REGION PRESIDENT 0 544955 0 68729 0 70662 0 9152 0 118085 0 811583 0 68358 ELIZABETH RENAKER-JANSEN DO BOARD MEMBER/PHYSICIAN 0 710341 0 5000 0 45540 0 9900 0 37232 0 808013 0 0 MICHAEL HOLZHUETER SVP-GENERAL 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 JENNIFER REDMAN-SCHELL (NV) 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 CHOON P'NG REGIONAL MEDICAL DIRECTOR 565198 0 0 0 8564 0 9900 0 36635 0 620297 0 0 0 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 0 423444 0 72853 0 2438 0 9358 0 90310 0 598403 0 0 CONSTANCE BRADLEY SVP & PRES. REG. MRKTS. 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 JOSEPH ROBERTS PHYSICIAN 471441 0 0 0 5405 0 9900 0 36694 0 523440 0 0 0 LAWRENCE G LEIBERT MD BOARD MEMBER/PHYSICIAN 0 472395 0 0 0 8564 0 7257 0 29971 0 518187 0 0 MICHAEL CLARK PHYSICIAN 448660 0 0 0 5264 0 6867 0 37694 0 498485 0 0 0 JENNIFER R ENMAN-BOURGON DO BOARD MEMBER/PHYSICIAN 0 364309 0 8731 0 20486 0 9900 0 35039 0 438465 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 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 JEANNINE NOSKO PHYSICIAN 0 203301 0 17584 0 89677 0 5166 0 27155 0 342883 0 0 MICHAEL A UMLAND MD BOARD MEMBER/PHYSICIAN 0 277560 0 0 0 6822 0 6794 0 39089 0 330265 0 0 TOU SHOUA LOR MD BOARD MEMBER/PHYSICIAN 0 281233 0 0 0 5482 0 5789 0 36451 0 328955 0 0 ANDREA ALLARD VP-OPERATIONS 0 267134 0 26259 0 572 0 8802 0 1619 0 304386 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 MERRILL 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, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $337,358 J. WICKLANDER $68,358 M. WALTERS $56,806 M. HOLZHUETER $55,822 T. RICHARDSON $39,964 J. MATHESON $39,964 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 5700854 REVENUE BONDS SERIES 2021 0 0 0 A 5700854 40612 5660242 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 MERRILL HOSPITAL & CLINICS, INC., 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 THE BOARD OF DIRECTORS IS COMPRISED OF TEN DIRECTORS. THERE SHALL BE TWO CLASSES OF VOTING DIRECTORS: THE COMMUNITY CLASS AND THE PROVIDER CLASS. NO LESS THAN FOUR INDEPENDENT COMMUNITY CLASS DIRECTORS, SIX PROVIDER CLASS DIRECTOR FROM EACH HOSPITAL, CONSISTING OF PHYSICIANS IN THE ACTIVE CATEGORY OF THE MEDICAL STAFF AT THE HOSPITAL, NOMINATED BY THE CORPORATION'S BOARD AND ELECTED BY ASPIRUS, INC. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MERRILL 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 CONTRACT NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 2,085,361. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,085,361. FOOD SERVICE FEES: PROGRAM SERVICE EXPENSES 48,170. MANAGEMENT AND GENERAL EXPENSES 56,321. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 104,491. LAB FEES: PROGRAM SERVICE EXPENSES 155,981. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 155,981. OTHER FEES: PROGRAM SERVICE EXPENSES 684,306. MANAGEMENT AND GENERAL EXPENSES 790,013. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,474,319. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 63,143. MANAGEMENT AND GENERAL EXPENSES 73,827. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,970. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS -4,081,958. ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTHCARE WI 501(C)(3) LINE 12B, II N/A 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EXTENDED SERVICES INC 333 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS MEDICAL GROUP INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTH CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS VNA EXTENDED CARE INC 520 N 32ND AVENUE WAUSAU WI 54401 391597350 PERSONAL CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS VNA HOME HEALTH INC 1 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 383236977 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382908586 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LAURIUM MI 49913 381443361 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 DIVINE SAVIOR HEALTHCARE INC 2817 NEW PINERY ROAD PORTGAGE WI 53901 390806250 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MEDFORD HOSPITAL & CLINICS INC 135 S GIBSON STREET MEDFORD WI 54451 390964813 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MEDFORD FOUNDATION INC 135 S GIBSON STREET MEDFORD WI 54451 391777081 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL & CLINICS INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 390808443 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL FOUNDATION INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 391657410 CHARITABLE FOUNDATION WI 501(C)(3) LINE 12A, I ASPIRUS INC 1 ASPIRUS STANLEY HOSPITAL & CLINICS INC 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MERRILL HOSPITAL FOUNDATION INC 601 S CENTER AVENUE MERRILL WI 54452 391627755 CHARITABLE FOUNDATION WI 501(C)(3) LINE 12A, I ASPIRUS INC 1 ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391390638 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EAGLE RIVER HOSPITAL & CLINICS INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HEALTHCARE WI 501(C)(3) LINE 12B, II ASPIRUS INC 1 ASPIRUS MEDICAL GROUP - NORTHERN WISCONSIN INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391965593 MEDICAL SERVICES WI 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S HOSPITAL OF DULUTH 915 EAST 1ST STREET DULUTH MN 55805 410714079 HOSPITAL MN 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S FOUNDATION 1000 EAST 1ST STREET NO 102 DULUTH MN 55805 411448118 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL INC 325 11TH AVENUE TWO HARBORS MN 55616 410786046 HOSPITAL MN 501(C)(3) LINE 3 ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL FOUNDATION OF NORTHEAST MINNESOTA 325 11TH AVENUE TWO HARBORS MN 55616 411700972 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I LAKE VIEW MEMORIAL HOSPITAL INC 1 WESTERN UPPER MICHIGAN EYE CARE LLC 131 W GENESEE STREET IRON RIVER MI 49935 272324957 EYE CARE SERVICES MI N/A 0 0 THE WESTWOOD CONFERENCE CENTER LLC 333 PINE RIDGE BLVD WAUSAU WI 54401 571184256 REAL ESTATE INVESTMENT WI N/A 0 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931678 HEALTH CARE SERVICES WI N/A C 0 ASPIRUS KEWEENAW ENTERPRISES INC 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 0 ASPIRUS HEALTH VENTURES 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 474925640 HEALTH INSURANCE PLAN WI N/A C 0 ASPIRUS ARISE HEALTH PLAN OF WI INC 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 0 ASPIRUS ARISE HEALTH PLAN OF MI INC 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 0 ASPIRUS CAMPUS PROPERTY CONDOMINIUM OWNERS ASSOCIATION INC 2200 WESTWOOD DRIVE WAUSAU WI 54401 842513742 ASSOCIATION WI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 ASPIRUS WAUSAU HOSPITAL INC M 91380 COST ASPIRUS WAUSAU HOSPITAL INC Q 89932 COST ASPIRUS WAUSAU HOSPITAL INC S 86154 COST ASPIRUS INC M 3999164 COST ASPIRUS INC O 11697782 COST ASPIRUS INC P 14611532 COST ASPIRUS INC S 980319 COST ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS INC P 151790 COST THE HOWARD YOUNG MEDICAL CENTER INC M 71000 COST ASPIRUS MEDICAL GROUP INC O 67564 COST