2025-05-15T09:11:19-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 381443361 ASPIRUS KEWEENAW HOSPITAL ASPI 9063376500 205 OSCEOLA STREET LAURIUM MI 49913 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 74209839 0 X WWW.ASPIRUS.ORG X 1939 MI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 15 8 333 15 3229873 36120 1525132 467001 68571234 72781089 602768 737473 160667 186048 70859801 74171611 27162 2535 0 0 28443360 29359311 0 0 0 39001145 46604375 67471667 75966221 3388134 -1794610 50262818 58506177 21919609 21962822 28343209 36543355 X WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 1 0 59753191 2535 69551216 ASPIRUS KEWEENAW HOSPITAL PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, PHYSICIAN CLINIC SERVICES, PHARMACY AND EYE CLINIC SERVICES.LAURIUM RETAIL PHARMACY: GREW SPECIALTY PHARMACY SERVICES TO CONTINUE TO FILL MORE COMPLICATED MEDICATIONS FOR SOME SPECIALTY DISEASE STATES SUCH AS CANCER, CROHN'S AND PSORIATIC ARTHRITIS, AND EXPANDED OPIATE USE DISORDER MEDICATION TREATMENT DISPENSING PROCESSES. BEGAN SUPPORTING TWO REMOTE DISPENSING SITES IN RURAL LOCATIONS IN MICHIGAN TO EXPAND PATIENT OUTREACH. FILLED A TOTAL OF 74,092 PRESCRIPTIONS IN FY24.IP PHARMACY: REMODELED HAZARDOUS DRUG ROOM TO MEET USP800 REQUIREMENTS. CONTINUED TO PROVIDE CHEMOTHERAPY INFUSION SERVICES FOR SOME OF OUR MOST VULNERABLE POPULATION. DISPENSED 973,019 DOSES OF MEDICATION IN FY24.EMERGENCY: STAFFED BY PHYSICIANS 24/7, WITH MED-EVAC ACCESS TO LARGER HOSPITALS IN THE EVENT OF ACUITY TOO HIGH FOR THE RESOURCES OF A RURAL HOSPITAL. PROVIDED 6,174 VISITORS WITH CARE. 59753191 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 333 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JOHN D MATONICH CHAIR 1.00 3.00 X X 0 0 0 KIRK R SCHOTT OD TREASURER 1.00 3.00 X X 0 0 0 STEVEN TINTI TREASURER (THRU 10/23) 1.00 3.00 X X 0 0 0 KATIE L CLARK SECRETARY 1.00 3.00 X X 0 0 0 HANNAH L GOODMAN BOARD MEMBER 1.00 3.00 X 0 0 0 RICHARD J KOUBEK PHD BOARD MEMBER 1.00 3.00 X 0 0 0 CHARLY A LOPER BOARD MEMBER 1.00 3.00 X 0 0 0 ROBIN MENEZUGGO BOARD MEMBER 1.00 3.00 X 0 0 0 JAMES R RICHARDSON BOARD MEMBER 1.00 3.00 X 0 0 0 JESSE TISCHER B.M. (THRU 01/24)/SVP & PRESIDENT- AWH 1.00 50.00 X 0 764397 116000 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 1.00 40.00 X 0 893837 48035 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 1.00 50.00 X 0 818140 38809 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 1.00 50.00 X X 0 607634 94564 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS. 1.00 50.00 X 0 489478 90167 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 1.00 50.00 X 0 425295 48633 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 1.00 50.00 X 0 392551 48430 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 168066 4169 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 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 1.00 50.00 X 0 435705 90755 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 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 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 NATHAN MCPARLAN RADIOLOGIST 40.00 X 1105528 0 45852 TOM RAISANEN PHYSICIAN 40.00 X 638132 0 44347 RACHEL LASZKO PHYSICIAN 40.00 X 510231 0 35564 ADNAN MALIK PHYSICIAN 40.00 X 466392 0 45322 SHALINI JOHNSON PHYSICIAN 40.00 X 369400 0 32918 3089683 11371771 1713986 48 0 1 0 WAPITI MEDICAL GROUP LIMITED 107 FLYNN DRIVE SUITE 600 MILBANK SD 57252 CONTRACT LABOR - PROVIDERS 2910406 SOUND PHYSICIANS OF MICHIGAN 1498 PACIFIC AVENUE SUITE 400 TACOMA WA 98402 CONTRACT LABOR - PROVIDERS 1134174 CHG COMPANIES PO BOX 972651 DALLAS TX 753972651 CONTRACT LABOR - PROVIDERS 854343 DAILY CARE LLC 323 N MORRISON ST SUITE 100 APPLETON WI 54911 CONTRACT LABOR - PROVIDERS 765364 STAFFENCY LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACT LABOR 686970 19 466818 183 467001 NET PATIENT SERVICE REVENUE 621990 61235776 61235776 PHARMACY REVENUE/340B 456110 10781951 7552078 3229873 CONTRACT SERVICE REVENUE 621110 97568 97568 665794 665794 72781089 770401 770401 62819 0 62819 62819 62819 5300 38228 -32928 -32928 -32928 CAFETERIA REVENUE 624200 123229 123229 123229 74171611 69551216 3229873 923521 X 2535 2535 24262484 20677094 3585390 660859 563201 97658 2934536 2500885 433651 1501432 1279558 221874 3126 3000 126 35600 35600 6316 6316 194 194 10497362 9432779 1064583 34104 21464 12640 219612 214220 5392 36249 22814 13435 724309 47287 677022 119782 75389 44393 517 325 192 697766 697766 2846827 1487556 1359271 359584 23476 336108 MEDICAL SUPPLIES 15274245 14899205 375040 CORPORATE ALLOCATIONS 9908155 6236020 3672135 HOSPITAL ASSESSMENT PAY 2994603 2994603 BAD DEBT EXPENSE 1282036 1282036 1563988 984347 579641 75966221 59753191 16213030 0 13556181 18118744 2444681 2449588 10056144 11381953 1493790 1892797 120581 34216 61112485 42469128 19059844 18643357 1763939 1948701 1767658 4036821 50262818 58506177 2935254 2515641 16706713 16540551 2277642 2906630 21919609 21962822 X 28055263 36255409 287946 287946 28343209 36543355 50262818 58506177 X -1794610 184762 9809994 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 6316 6316 0 PART II-B, LINE 1: ASPIRUS KEWEENAW HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND MHA HAVE NOTIFIED ASPIRUS KEWEENAW THAT APPROXIMATELY $6,316 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 920889 920889 40166607 25870945 14295662 18808281 16598183 2210098 1216708 1216708 18643357 DUE FROM ASPIRUS KEWEENAW ENTERPRISES 3982233 DUE FROM ASPIRUS INC. -10 FINANCE LEASE ROU ASSET 139598 RHC MEDICAID RECEIVABLE -85000 4036821 ASBESTOS LIABILITY 304220 FINANCE LEASE OBLIGATIONS 142710 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2465000 ASSET DISPOSAL CLEARING -5300 2906630 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 0 1 1 392924 392924 0.00530 14094941 8943257 5151684 0.06900 14487865 8943257 5544608 0.07430 16209 16209 0.00020 20687 20687 0.00030 74216 74216 0.00100 111112 111112 0.00150 14598977 8943257 5655720 0.07580 1 5539 5539 0.00010 1 631 631 0.00000 2 6170 6170 0.00010 1 513926 0 10200084 9883697 316387 X 1 1 1 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LAURIUM MI 49913 WWW.ASPIRUS.ORG 1060000151 X X X X PHYSICIAN CLINIC & PHARMACY ASPIRUS KEWEENAW HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 22 1 WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 5: THE FOLLOWING DESCRIPTION IS FOR THE CHNA COMPLETED IN FY22 (SPRING 2022). THROUGHOUT THE PLANNING AND PRODUCTION OF THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT, A STEERING COMMITTEE OF COMMUNITY LEADERS AND SUBJECT MATTER EXPERTS MET REGULARLY TO DIRECT THE REPORTING PROCESS, WHICH INCLUDED THE CREATION AND DISTRIBUTION OF A SURVEY TO A RANDOM SELECTION OF RESIDENTS. FOR ASPIRUS KEWEENAW, THIS INCLUDES INPUT FROM THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT AS WELL AS OTHER ASPIRUS UP HOSPITALS. REPRESENTATIVES FROM EACH ORGANIZATION COMMUNICATED IN REGULAR MEETINGS. THE KEY DATA ELEMENT IN THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT IS THE COMMUNITY SURVEY, WHICH IDENTIFIED IMPORTANT ISSUES REGARDING QUALITY OF LIFE THAT HAD NOT BEEN MEASURED BEFORE THE SURVEY WAS CONDUCTED. THE SURVEY WAS MAILED TO THOUSANDS OF HOUSEHOLDS ACROSS THE ENTIRE UPPER PENINSULA, WITH NEARLY 5,000 RESPONSES BACK FROM RESIDENTS. THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT ALSO INCLUDES A SIGNIFICANT AMOUNT OF DATA INDICATORS ACROSS MULTIPLE CATEGORIES RELATING TO HEALTH AND HEALTH FACTORS. THIS DATA WAS COMPILED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM HEALTH CARE PROVIDERS. PUBLISHED SOURCES INCLUDED THE U.S. CENSUS, THE AMERICAN COMMUNITY SURVEY, AND STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), THE HOSPITAL COLLABORATED WITH ASPIRUS IRON RIVER HOSPITAL, ASPIRUS ONTONAGON HOSPITAL, ASPIRUS IRONWOOD HOSPITAL. ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), ASPIRUS KEWEENAW HOSPITAL COLLABORATED WITH THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT. ASPIRUS KEWEENAW HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS KEWEENAW HOSPITAL. ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. ASPIRUS KEWEENAW HOSPITAL IS ONE OF FOUR ASPIRUS HOSPITALS IN THE UPPER PENINSULA OF MICHIGAN. THE AREA IS VERY RURAL. ASPIRUS KEWEENAW IMPLEMENTED STRATEGIES LOCALLY AND REGIONALLY, WITH THE HELP OF STAFF MEMBERS, BUT ALSO PARTNERING WITH OTHERS IN THE COMMUNITY. THE HOSPITAL'S SIGNIFICANT NEEDS ARE: MENTAL HEALTH; SUBSTANCE USE; CHRONIC DISEASES. TO ADDRESS THESE NEEDS, THE HOSPITAL AND/OR CLINIC: - FACILITATES REFERRALS TO LOCAL NON-PROFIT BEHAVIORAL HEALTH SERVICES ORGANIZATIONS FOR PATIENTS WITH SIGNIFICANT MENTAL HEALTH AND SUBSTANCE USE ISSUES. - PROVIDES ADDICTION-RELATED TREATMENT, INCLUDING SUBOXONE, WITH MULTIPLE PROVIDERS. - PROVIDES 5 FREE FITNESS FACILITY MEMBERSHIPS FOR MEN WHO ARE IN A SUBSTANCE USE RESIDENTIAL TREATMENT FACILITY. THIS ENABLES THE MEN AND THEIR COUNSELOR TO BE PHYSICALLY ACTIVE AS PART OF THEIR RECOVERY. - FACILITATES A DIABETES SUPPORT GROUP. THE DIABETES SUPPORT GROUP MEETS SEPTEMBER -- MAY. EACH MEETING IS AN HOUR AND IS FACILITATED BY A REGISTERED DIETICIAN AT KEWEENAW. - IMPLEMENTED A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM. FISCAL YEAR 2024 WAS THE SECOND YEAR THAT ASPIRUS' FRUIT AND VEGETABLE PRESCRIPTION PROGRAM (FVRX) WAS AVAILABLE IN THIS AREA. A VOUCHER IS GIVEN TO PATIENTS TO PURCHASE FRUITS AND VEGETABLES FROM LOCAL FARMERS. THE PROGRAM ALSO PROVIDES NUTRITION INFORMATION AND ACCESS TO RECIPES. DURING THE 2024 SEASON, OVER 700 VOUCHERS WERE DISTRIBUTED ACROSS THE SYSTEM.ASPIRUS STAFF PROVIDE TIME AND EXPERTISE TO A NUMBER OF LOCAL BOARDS AND COMMITTEES, INCLUDING THE MICHIGAN WORKS WORKFORCE DEVELOPMENT BOARD, KEWEENAW HEALTH FOUNDATION BOARD, MERCY EMERGENCY SERVICES BOARD AND OTHERS. ASPIRUS STAFF ALSO CONTRIBUTED TIME TO A BABYSITTER TRAINING AND BIKE-TO-SCHOOL DAY. ASPIRUS KEWEENAW SUPPORTS WORKFORCE DEVELOPMENT THROUGH CAREER CAMPS AND OTHER STRATEGIES. THE HOSPITAL CONTRIBUTED FUNDS TO THE KEWEENAW COMMUNITY FOUNDATION. THE FOUNDATION'S VISION AND MISSION IS TO SEE A THRIVING COMMUNITY BY CONNECTING THE NEEDS OF THE COMMUNITY WITH RESOURCES TO COLLABORATIVELY IMPROVE QUALITY OF LIFE. - - - - - - - - - - - - -FROM THE COMMUNITY SURVEY, THE TOP-SELECTED ISSUES WERE: - HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES- DRUG ABUSE- LACK OF HEALTH INSURANCE- UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONSFROM THIS LIST, THE HOSPITAL IS ADDRESSING DRUG ABUSE (SUBSTANCE USE). THE OTHER THREE ISSUES WERE NOT SELECTED FOR THE FOLLOWING REASONS. - THE LACK OF AFFORDABLE HEALTH INSURANCE IS OF HIGH CONCERN FOR MANY PEOPLE IN THE UPPER PENINSULA. ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE THE AVAILABILITY AND THE AFFORDABILITY OF HEALTH INSURANCE, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. - UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONS ARE IMPORTANT ISSUES FOR ASPIRUS. ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE BENEFITS PACKAGES. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 5 1 - ASPIRUS HOUGHTON CLINIC 1000 CEDAR STREET HOUGHTON MI 49931 CLINIC & OUTPATIENT THERAPY 2 - ASPIRUS KEWEENAW OUTPATIENT THERAPIES 25680 COPPER KING WAY LAURIUM MI 49913 OUTPATIENT THERAPY 3 - ASPIRUS KEWEENAW LAKE LINDEN CLINIC 110 CALUMET STREET LAKE LINDEN MI 49945 CLINIC 4 - ASPIRUS OUTPATIENT THERAPIES - ONTONAGON 730 S 7TH ST ONTONAGON MI 49953 OUTPATIENT THERAPY 5 - ASPIRUS ONTONAGON CLINIC 601 S 7TH ST ONTONAGON MI 49953 CLINIC & PHARMACY 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 24E, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $1,282,036. 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., CHILD CARE) NEEDED FOR A ROBUST ECONOMY.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 LOCAL BOARD OF DIRECTORS, WHICH MEETS QUARTERLY. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING ACADEMIC, LAW AND MEDICAL FIELDS.- SUPPORTS ITS STAFF IN PARTICIPATING ON COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- REVIEWS FUNDING REQUESTS TO THE HOSPITAL AND THE LOCAL HEALTH FOUNDATION AS AN INDICATOR OF LOCAL NEEDS.HEALTHCARE SYSTEMS AND HOSPITALS HAVE NEW REQUIREMENTS TO SCREEN PATIENTS FOR SOCIAL NEEDS, IDENTIFY ANY NEEDS, AND REFER TO COMMUNITY RESOURCES. ASPIRUS CONTRACTS WITH A RESOURCE PLATFORM TO BETTER CONNECT PATIENTS WITH RESOURCES. OVER TIME, THE RESULTS OF THE SCREENING PROCESS WILL PROVIDE INSIGHT INTO PATIENT NEEDS (BEYOND THEIR IMMEDIATE CARE). PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. IF ASPIRUS FINANCIAL COUNSELORS NOTICE THE PATIENT HAS NOT BEEN OFFERED AN APPLICATION WITHIN THE PAST YEAR, THEY WILL ALSO ASK IF THE PATIENT WOULD LIKE ONE MAILED OR IF THE PATIENT SHOWS FINANCIAL DISTRESS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: ASPIRUS KEWEENAW HOSPITAL IS ONE OF FOUR ASPIRUS SYSTEM HOSPITALS IN A 5-COUNTY RURAL REGION OF THE UPPER PENINSULA OF MICHIGAN. THE 5-COUNTY REGION INCLUDES HOUGHTON, KEWEENAW, ONTONAGON, IRON AND GOGEBIC COUNTIES. ASPIRUS KEWEENAW HOSPITAL PRIMARILY SERVES HOUGHTON COUNTY AND KEWEENAW COUNTY. HOUGHTON COUNTY COVERS 1,009 SQUARE MILES, WITH 36.3 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 37,313 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18 20.3%PERSONS 65 YEARS AND OVER 17.9%WHITE PERSONS 93.5%AFRICAN AMERICAN PERSONS 0.9%AMERICAN INDIAN PERSONS 0.8%ASIAN PERSONS 3.0%TWO OR MORE RACES 1.7%HISPANIC OR LATINO 1.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME 6.9%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT 92.8% PERSONS IN POVERTY 15.0%MEDIAN HOUSEHOLD INCOME $44,839PERCENT WITHOUT HEALTHCARE COVERAGE:6.3%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.) 37.7%HOUGHTON COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. THE COUNTY IS ALSO DESIGNATED AS MEDICALLY UNDERSERVED. ****KEWEENAW COUNTY COVERS 540 SQUARE MILES, WITH 4.0 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 2107 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18: 14.3%PERSONS 65 YEARS AND OVER: 38.1%WHITE PERSONS: 97.3%AFRICAN AMERICAN PERSONS: 0.4%AMERICAN INDIAN PERSONS: 0.4%ASIAN PERSONS: 0.1%TWO OR MORE RACES: 1.9%HISPANIC OR LATINO: 1.7%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 1.5%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 97.1% PERSONS IN POVERTY: 11.2%MEDIAN HOUSEHOLD INCOME: $51,750PERCENT WITHOUT HEALTHCARE COVERAGE: 7.5%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 53.6%KEWEENAW COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. THE COUNTY IS ALSO DESIGNATED AS MEDICALLY UNDERSERVED. NUMBER OF HOSPITALS IN THE 2-COUNTY REGION: 2 (INCLUDING ASPIRUS KEWEENAW HOSPITAL) PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH ITS COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITAL: - MAINTAINS A REGIONAL BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY AND THE REGION. - BRINGS ITS EXPERTISE INTO THE COMMUNITY THROUGH PROGRAMS, SCREENINGS, AND COMMUNITY BOARD AND ADVISORY COMMITTEE MEMBERSHIP.- PROVIDES HIGH QUALITY SERVICES AND IMPLEMENTS ONGOING QUALITY IMPROVEMENT INITIATIVES. - BUDGETS FOR CUTTING EDGE TECHNOLOGIES AND EQUIPMENT THAT SUPPORT PATIENT HEALTH.- OFFERS RESOURCES AND/OR REFERRALS FOR TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - HOSTS ON-SITE BLOOD DRIVES.AS PART OF A LARGER NETWORK OF ASPIRUS HEALTHCARE FACILITIES, THE HOSPITAL HAS ACCESS TO: - LOW-COST TEMPORARY LODGING AT ASPIRUS' FLAGSHIP TERTIARY CARE HOSPITAL PARTNER (IN WAUSAU, WI) SO THAT PATIENTS AND/OR THEIR FAMILY NEEDING EXTENDED SPECIALTY CARE HAVE ACCOMMODATIONS. - PROFESSIONAL DEVELOPMENT FOR STAFF, ASSURING THE CARE PROVIDED INCORPORATES THE MOST UP-TO-DATE BEST PRACTICES. - CROSS-TRAINING OPPORTUNITIES. FOR INSTANCE, A WAUSAU-BASED BEREAVEMENT COORDINATOR TRAINS STAFF ACROSS THE SYSTEM ON NORMAL GRIEF RESPONSE, RESILIENCE AND HOSPICE CARE AND SUPPORT. THE COORDINATOR TRAINS THROUGH THE NURSE RESIDENCY PROGRAM AS WELL AS IN UNIT/DEPARTMENT MEETINGS. UNIT/DEPARTMENT LEADERS CAN REQUEST BEREAVEMENT INFORMATION AND SUPPORT FOR THEIR TEAM. SIMILARLY, HOSPITALS HAVE ACCESS TO INJURY PREVENTION EXPERTISE AND RESOURCES THROUGH THE LEVEL 2 TRAUMA CENTER IN WAUSAU. - A MARKETING/COMMUNICATIONS TEAM THAT SUPPORTS THE ONLINE ASPIRUS MEDIA CENTER FEATURING MEDICAL EXPERTS. THE TEAM DEVELOPS AND PROMOTES HEALTH EDUCATION INFORMATION (E.G., ON DIABETES, TICK BITES, SNOWMOBILE SAFETY) FOR PATIENTS AND THE GENERAL PUBLIC. PART VI, LINE 6: ASPIRUS HEALTH IS A NONPROFIT, COMMUNITY-DIRECTED HEALTH SYSTEM BASED IN WAUSAU, WISCONSIN, SERVING NORTHEASTERN MINNESOTA, NORTHERN AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. THE HEALTH SYSTEM OPERATES 18 HOSPITALS AND 130 OUTPATIENT LOCATIONS WITH NEARLY 14,000 TEAM MEMBERS, INCLUDING 1,300 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE CLINICIANS. ASPIRUS SERVES COMMUNITIES THROUGH HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, AND ADULT LIVING AND CARE FACILITIES. THE COMBINED EFFORTS PROVIDE RURAL COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. FOR MORE INFORMATION, VISIT ASPIRUS.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MI 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1252366 0 353673 0 12078 0 9900 0 294286 0 1922303 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 NATHAN MCPARLAN RADIOLOGIST 1099863 0 0 0 5665 0 9900 0 35952 0 1151380 0 0 0 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 0 862473 0 0 0 31364 0 9900 0 38135 0 941872 0 0 JESSE TISCHER B.M. (THRU 01/24)/SVP & PRESIDENT- A 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 0 810818 0 0 0 7322 0 9900 0 28909 0 856949 0 0 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 0 509155 0 94839 0 3640 0 9900 0 84664 0 702198 0 0 TOM RAISANEN PHYSICIAN 592686 0 0 0 45446 0 9900 0 34447 0 682479 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 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 RACHEL LASZKO PHYSICIAN 464745 0 0 0 45486 0 6846 0 28718 0 545795 0 0 0 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 0 346782 0 49598 0 39325 0 9294 0 81461 0 526460 0 34464 ADNAN MALIK PHYSICIAN 460863 0 0 0 5529 0 9370 0 35952 0 511714 0 0 0 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 0 416035 0 8941 0 319 0 9900 0 38733 0 473928 0 0 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 0 289467 0 95289 0 7795 0 9132 0 39298 0 440981 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 SHALINI JOHNSON PHYSICIAN 363600 0 0 0 5800 0 9900 0 23018 0 402318 0 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 0 165647 0 0 0 2419 0 3313 0 856 0 172235 0 0 PART I, LINE 3 FOR THE PURPOSE OF DETERMINING COMPENSATION, ASPIRUS KEWEENAW HOSPITAL 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 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: J. TISCHER $50,242 S. SCZYGELSKI $337.358 C. HARFF $34,464 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 97712DMG9 2015-05-07 16997543 NEW CONSTRUCTION 0 0 0 A 615000 17005943 242015 16763928 2017 0 0 1 1 A 0 1 1 0 0 0.00500 0.00500 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 2015 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. (EIN 38-3236977); AND ASPIRUS KEWEENAW HOSPITAL (EIN 38-1443361). INFORMATION REGARDING THE SERIES 2015 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 2015 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2015 BONDS.] PART III - LINE 3A AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS KEWEENAW 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. 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, LINE 2C: THE DATE OF THE LAST REBATE COMPUTATION WAS PERFORMED ON 05/01/2021. FORM 990, PART III, LINE 2 BECAME OWNER OF RETAIL PHARMACY, OUTPATIENT THERAPY FACILITY, AND TWO-NURSE PRACTITIONER FAMILY PRACTICE CLINIC IN ONTONAGON, MICHIGAN (PREVIOUSLY OWNED BY ASPIRUS ONTONAGON HOSPITAL). 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 A REGIONAL BOARD FOR THE UP. THE BOARD OF DIRECTORS IS COMPRISED OF 7 DIRECTORS FROM ASPIRUS, INC. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN EIGHT INDEPENDENT COMMUNITY CLASS DIRECTORS (TWO FROM EACH OF THE FOUR HOSPITALS IN THE UP REGION), CONSISTING OF THREE NOMINATED BY THE FOUNDATION BOARD OF TRUSTEES AND THREE NOMINATED BY ASPIRUS, INC. WITH CONSIDERATION TO INPUT FROM THE CORPORATION'S BOARD, AND ELECTED BY ASPIRUS, INC., THREE ASPIRUS CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., ONE 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 DIRECTORS 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 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 ACCUMULATED ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 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 ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. AN INTERESTED PERSON IS A DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. AFTER DISCLOSURE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING MEMBERS SHALL DECIDE IF A CONFLICT EXISTS. THE MEMBER WILL ABSTAIN FROM VOTING ON THIS ISSUE IF A CONFLICT OF INTEREST IS DISCOVERED. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS KEWEENAW HOSPITAL 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 HAS DEEMED THAT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 758,129. MANAGEMENT AND GENERAL EXPENSES 446,431. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,204,560. PHARMACY FEES: PROGRAM SERVICE EXPENSES 57,982. MANAGEMENT AND GENERAL EXPENSES 34,143. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,125. CONTRACT NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 8,542,483. MANAGEMENT AND GENERAL EXPENSES 540,324. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,082,807. LINEN CONTRACT: PROGRAM SERVICE EXPENSES 74,185. MANAGEMENT AND GENERAL EXPENSES 43,685. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 117,870. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 9,809,994. 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 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 & CLINICS INC 601 S CENTER AVENUE MERRILL WI 54452 390808503 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 - 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