ASPIRUS MEDICAL GROUP NORTHERN WISCONSIN INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS MEDICAL GROUP NORTHERN WISCONSIN INC (EIN 39-1965593)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202301329349304870
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T12:18:51-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391965593 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS MEDICAL GROUP | BusinessNameLine1Txt |
| Business Name Line2 | - NORTHERN WISCONSIN INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASPI | BusinessNameControlTxt |
| Phone | 7158472250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 WESTWOOD DRIVE | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SIDNEY C SCZYGELSKI | PersonNm |
| Person Title | SENIOR VP OF FINANCE & CFO | PersonTitleTxt |
| Phone | 7158472250 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SIDNEY | PersonFirstNm |
| Person Last | SCZYGELSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2023-05-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Change | Yes (X) | NameChangeInd |
| Principal Officer | MATTHEW HEYWOOD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 WESTWOOD DRIVE | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,492,728 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ASPIRUS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 1579 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $435,650 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $53,927,306 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,457,799 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$332,950 | PYInvestmentIncomeAmt |
| CY Investment Income | $70 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,874 | PYOtherRevenueAmt |
| CY Other Revenue | $34,859 | CYOtherRevenueAmt |
| PY Total Revenue | $54,059,880 | PYTotalRevenueAmt |
| CY Total Revenue | $7,492,728 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,223,597 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,020,984 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,402,335 | PYOtherExpensesAmt |
| CY Other Expenses | $2,175,575 | CYOtherExpensesAmt |
| PY Total Expenses | $71,625,932 | PYTotalExpensesAmt |
| CY Total Expenses | $11,196,559 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$17,566,052 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,703,831 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,980,422 | TotalAssetsBOYAmt |
| Total Assets EOY | $470,034 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,298,653 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $456,193 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,681,769 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,841 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,095,950 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,485,992 | RevenueAmt |
| Desc | TO PROVIDE HEALTH CARE AND EDUCATION SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE COMPANY PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS COMMUNITY CARE POLICY. THE CLINIC ALSO PROVIDES SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS WHICH OFTEN REIMBURSE THE CLINIC BASED ON PREDETERMINED FEE SCHEDULES WHICH ARE OFTEN BELOW THE COST OF PROVIDING CARE TO THESE INDIVIDUALS. THESE PROGRAMS REPRESENT A LARGE PORTION OF THE ELDERLY, LOW INCOME, AND DISABLED MEMBERS OF THE COMMUNITY WHO NEED ACCESS TO HIGH QUALITY CARE. | Desc |
| Total Program Service Expenses | $8,095,950 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 71 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1579 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SIDNEY C SCZYGELSKI | PersonNm |
| Phone | 7158472250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 WESTWOOD DRIVE | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAMES CYGAN MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 2.00 | Yes (X) | $0 | $1,135,180 | $50,871 | ||
| KRISTA SCHARER MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 2.00 | Yes (X) | $0 | $231,782 | $51,696 | ||
| LAWERNCE G LEIBERT MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 2.00 | Yes (X) | $0 | $448,124 | $46,117 | ||
| MICHAEL UMLAND MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 2.00 | Yes (X) | $0 | $326,592 | $53,283 | ||
| TOU SHOUA LOR MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 2.00 | Yes (X) | $0 | $288,855 | $48,142 | ||
| RANDY L BALK | ||||||||
| VICE CHAIR (THRU OCT. '21) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHAD H RADKE DO | ||||||||
| SECRETARY/TREASURER | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARY JO WENDLING MD | ||||||||
| BOARD MEMBER/PHYS. (THRU OCT. '21) | 40.00 | 1.00 | Yes (X) | $0 | $252,619 | $15,838 | ||
| KATHY KELSEY FOLEY | ||||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JEREMY LEWITZKE | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARCO ESPINOZA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KYLE PAGE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK HORNEFFER | ||||||||
| CHAIR (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHOON HEONG P'NG MD | ||||||||
| VICE CHAIR/PHYSICIAN (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MONICA A HILT | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN BUTLER | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| PASQUALE BERNARDI | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| GREGORY BRUSKO DO | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES S WATSON | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| THERESA K HAYSSEN | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL MASON | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER BRITTIG | ||||||||
| BOARD MEMBER (THRU JUL 21) | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER REDMAN-SCHELL | ||||||||
| SVP & PRESIDENT - AMG | 2.00 | 50.00 | $0 | $572,454 | $92,664 | Yes (X) | ||
| MATTHEW HEYWOOD | ||||||||
| PRESIDENT & CEO ASPIRUS | 2.00 | 50.00 | $0 | $2,684,221 | $266,094 | Yes (X) | ||
| SIDNEY SCZYGELSKI | ||||||||
| SENIOR VP OF FINANCE & CFO | 2.00 | 50.00 | $0 | $915,379 | $141,626 | Yes (X) | ||
| JEFFREY WICKLANDER | ||||||||
| BOARD MEMBER/PRESIDENT-CENTRAL WI | 2.00 | 40.00 | $0 | $591,106 | $108,445 | Yes (X) | ||
| ROBERT CULLING DO | ||||||||
| PRESIDENT CLINICAL AMG (THRU JUL 21) | 2.00 | 50.00 | $0 | $0 | $0 | Yes (X) | ||
| BENJAMIN BARSOTTI | ||||||||
| CHIEF MEDICAL INFORMATION OFFICER | 2.00 | 50.00 | $0 | $462,446 | $50,766 | Yes (X) | ||
| BRETT DAVIS | ||||||||
| PRESIDENT-ASPIRUS HEALTH PLAN | 2.00 | 50.00 | $0 | $394,127 | $62,857 | Yes (X) | ||
| ERIC ANDERSON | ||||||||
| SVP-SERVICE LINE & PATIENT EXP. | 2.00 | 50.00 | $0 | $495,034 | $104,300 | Yes (X) | ||
| JAMES MATHESON | ||||||||
| SVP-CHIEF STRATEGY OFFICER | 2.00 | 50.00 | $0 | $452,729 | $89,948 | Yes (X) | ||
| JESSE TISCHER | ||||||||
| SVP & PRESIDENT-REGIONAL MARKETS | 2.00 | 50.00 | $0 | $644,385 | $101,649 | Yes (X) | ||
| JOHN HEISLER | ||||||||
| SVP & CHIEF HUMAN RESOURCES OFFICER | 2.00 | 50.00 | $0 | $751,984 | $56,650 | Yes (X) | ||
| MICHAEL HOLZHUETER | ||||||||
| SVP-GENERAL COUNSEL | 2.00 | 50.00 | $0 | $449,756 | $89,333 | Yes (X) | ||
| MICHAEL WALTERS | ||||||||
| VP-SENIOR SYS. PHYSICIAN EXEC. | 50.00 | 2.00 | $0 | $604,827 | $43,884 | Yes (X) | ||
| RENEE SMITH | ||||||||
| EXECUTIVE DIRECTOR-ANI | 2.00 | 50.00 | $0 | $460,002 | $93,775 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,161,602 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,567,938 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENU | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $7,453,816 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,453,816 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,983 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,382 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $601 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,457,799 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70 | TotalRevenueColumnAmt |
| Exclusion | $70 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,065 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,065 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,065 | TotalRevenueColumnAmt |
| Exclusion | $6,065 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RECOVERING OF BAD DEBT | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $28,794 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,794 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,794 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,492,728 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,485,992 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,736 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,793,037 | TotalAmt |
| Program Services | $4,247,337 | ProgramServicesAmt |
| Management And General | $3,545,700 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,457 | TotalAmt |
| Program Services | $38,488 | ProgramServicesAmt |
| Management And General | $20,969 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,614 | TotalAmt |
| Program Services | $660,028 | ProgramServicesAmt |
| Management And General | $359,586 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,876 | TotalAmt |
| Program Services | $96,372 | ProgramServicesAmt |
| Management And General | $52,504 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,860,945 | TotalAmt |
| Program Services | $1,860,945 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,071 | TotalAmt |
| Program Services | $7,443 | ProgramServicesAmt |
| Management And General | $628 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,869 | TotalAmt |
| Program Services | $1,869 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530,485 | TotalAmt |
| Program Services | $430,903 | ProgramServicesAmt |
| Management And General | $99,582 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,657 | TotalAmt |
| Program Services | $39,157 | ProgramServicesAmt |
| Management And General | $2,500 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2 | TotalAmt |
| Management And General | $2 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,892 | TotalAmt |
| Program Services | $300,004 | ProgramServicesAmt |
| Management And General | $62,888 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,447 | TotalAmt |
| Program Services | $50 | ProgramServicesAmt |
| Management And General | $9,397 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| EQUIPMENT RENTALS | $438,316 | $438,316 | |
| MEDICAL SUPPLIES | $112,212 | $112,049 | $163 |
| CORPORATE ALLOCATIONS | -$1,189,335 | -$146,203 | -$1,043,132 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$986 | TotalAmt |
| Program Services | $9,192 | ProgramServicesAmt |
| Management And General | -$10,178 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,196,559 | TotalAmt |
| Program Services | $8,095,950 | ProgramServicesAmt |
| Management And General | $3,100,609 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,130 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,804 | BOYAmt |
| EOY | $428,168 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,199,357 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,471,647 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,352,339 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,629 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,848,516 | BOYAmt |
| EOY | $41,866 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,980,422 | BOYAmt |
| EOY | $470,034 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,825,492 | BOYAmt |
| EOY | $132,202 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $282,125 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,473,161 | BOYAmt |
| EOY | $41,866 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,298,653 | BOYAmt |
| EOY | $456,193 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,681,769 | BOYAmt |
| EOY | $13,841 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,681,769 | BOYAmt |
| EOY | $13,841 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,980,422 | BOYAmt |
| EOY | $470,034 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,703,831 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$6,964,097 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATES | Desc |
| Book Value | $41,866 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $41,866 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $41,866 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $41,866 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2022. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW HEYWOOD | ||||||||||||||
| PRESIDENT & CEO ASPIRUS | $0 | $1,051,076 | $0 | $1,629,342 | $0 | $3,803 | $0 | $17,346 | $0 | $248,748 | $0 | $2,950,315 | $0 | $0 |
| JAMES CYGAN MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $0 | $1,127,323 | $0 | $600 | $0 | $7,257 | $0 | $17,346 | $0 | $33,525 | $0 | $1,186,051 | $0 | $0 |
| SIDNEY SCZYGELSKI | ||||||||||||||
| SENIOR VP OF FINANCE & CFO | $0 | $610,115 | $0 | $177,495 | $0 | $127,769 | $0 | $20,196 | $0 | $121,430 | $0 | $1,057,005 | $0 | $112,143 |
| JOHN HEISLER | ||||||||||||||
| SVP & CHIEF HUMAN RESOURCES OFFICER | $0 | $289,961 | $0 | $426,149 | $0 | $35,874 | $0 | $13,626 | $0 | $43,024 | $0 | $808,634 | $0 | $25,179 |
| JESSE TISCHER | ||||||||||||||
| SVP & PRESIDENT-REGIONAL MARKETS | $0 | $501,025 | $0 | $142,821 | $0 | $539 | $0 | $11,714 | $0 | $89,935 | $0 | $746,034 | $0 | $0 |
| JEFFREY WICKLANDER | ||||||||||||||
| BOARD MEMBER/PRESIDENT-CENTRAL WI | $0 | $472,230 | $0 | $93,354 | $0 | $25,522 | $0 | $8,700 | $0 | $99,745 | $0 | $699,551 | $0 | $0 |
| JENNIFER REDMAN-SCHELL | ||||||||||||||
| SVP & PRESIDENT - AMG | $0 | $405,520 | $0 | $113,119 | $0 | $53,815 | $0 | $17,346 | $0 | $75,318 | $0 | $665,118 | $0 | $51,368 |
| MICHAEL WALTERS | ||||||||||||||
| VP-SENIOR SYS. PHYSICIAN EXEC. | $0 | $452,168 | $0 | $151,458 | $0 | $1,201 | $0 | $8,700 | $0 | $35,184 | $0 | $648,711 | $0 | $0 |
| ERIC ANDERSON | ||||||||||||||
| SVP-SERVICE LINE & PATIENT EXP. | $0 | $382,299 | $0 | $111,001 | $0 | $1,734 | $0 | $17,346 | $0 | $86,954 | $0 | $599,334 | $0 | $0 |
| RENEE SMITH | ||||||||||||||
| EXECUTIVE DIRECTOR-ANI | $0 | $315,463 | $0 | $89,914 | $0 | $54,625 | $0 | $17,346 | $0 | $76,429 | $0 | $553,777 | $0 | $53,547 |
| JAMES MATHESON | ||||||||||||||
| SVP-CHIEF STRATEGY OFFICER | $0 | $322,706 | $0 | $94,649 | $0 | $35,374 | $0 | $16,347 | $0 | $73,601 | $0 | $542,677 | $0 | $26,065 |
| MICHAEL HOLZHUETER | ||||||||||||||
| SVP-GENERAL COUNSEL | $0 | $399,152 | $0 | $25,600 | $0 | $25,004 | $0 | $8,700 | $0 | $80,633 | $0 | $539,089 | $0 | $0 |
| BENJAMIN BARSOTTI | ||||||||||||||
| CHIEF MEDICAL INFORMATION OFFICER | $0 | $367,202 | $0 | $65,298 | $0 | $29,946 | $0 | $17,346 | $0 | $33,420 | $0 | $513,212 | $0 | $23,406 |
| LAWERNCE G LEIBERT MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $0 | $439,059 | $0 | $600 | $0 | $8,465 | $0 | $18,905 | $0 | $27,212 | $0 | $494,241 | $0 | $0 |
| BRETT DAVIS | ||||||||||||||
| PRESIDENT-ASPIRUS HEALTH PLAN | $0 | $260,587 | $0 | $127,333 | $0 | $6,207 | $0 | $16,557 | $0 | $46,300 | $0 | $456,984 | $0 | $0 |
| MICHAEL UMLAND MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $0 | $318,641 | $0 | $600 | $0 | $7,351 | $0 | $16,755 | $0 | $36,528 | $0 | $379,875 | $0 | $0 |
| TOU SHOUA LOR MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $0 | $282,783 | $0 | $600 | $0 | $5,472 | $0 | $14,457 | $0 | $33,685 | $0 | $336,997 | $0 | $0 |
| KRISTA SCHARER MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $0 | $225,710 | $0 | $600 | $0 | $5,472 | $0 | $13,437 | $0 | $38,259 | $0 | $283,478 | $0 | $0 |
| MARY JO WENDLING MD | ||||||||||||||
| BOARD MEMBER/PHYS. (THRU OCT. '21) | $0 | $245,812 | $0 | $600 | $0 | $6,207 | $0 | $13,635 | $0 | $2,203 | $0 | $268,457 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | JEFFREY WICKLANDER ($200) HAD A TAXABLE HOUSING ALLOWANCE. |
| PART I, LINE 3 | FOR THE PURPOSES OF DETERMINING COMPENSATION, THE ORGANIZATION 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. SCZYGESLSKI $112,143 J. REDMAN-SCHELL $51,368 B. BARSOTTI $23,406 J. MATHESON $26,065 J. HEISLER $25,179 R. SMITH $53,547 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. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHOON HEONG P'NG | PersonNm |
| Relationship With Org | BOARD DIRECTOR & EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | RETENTION LOAN | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $100,000 | OriginalPrincipalAmt |
| Balance Due | $0 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION MADE SIGNIFICANT CHANGES TO ITS ORGANIZATIONAL DOCUMENTS DURING FY21. |
| FORM 990, PART VI, SECTION A, LINE 6 | EFFECTIVE AUGUST 1, 2021., THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. PRIOR TO THAT, MINISTRY HEALTH CARE INC WAS THE CORPORATE MEMBER. FURTHER DETAILS ARE PROVIDED THROUGHOUT THE FORM. |
| 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 BY LAWS, 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, AND 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, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS MEDICAL GROUP - NORTHERN WISCONSIN, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONTRACT PHYSICIAN AND NURSING: PROGRAM SERVICE EXPENSES 1,832,790. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,832,790. OTHER FEES: PROGRAM SERVICE EXPENSES 28,155. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,155. |
| FORM 990, PART XI, LINE 9: | NET ASSET ADJUSTMENT FROM ACQUISITION OF NEW PARENT -6,964,097. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION RELIED ON THEIR NEW PARENT MEMBER, ASPIRUS INC, IN THE SELECTION OF THE INDEPENDENT AUDITORS. THEY WERE INCLUDED IN THEIR CONSOLIDATED AUDIT. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) | ASPIRUS INC | |
| ASPIRUS BUILDINGS INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391406537 | PROPERTY LEASING | WI | 501 (C) 3 | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS EXTENDED SERVICES INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 390782130 | NURSING HOME SERVICES | WI | 501 (C) 3 | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS ONTONAGON INC | |||||||||||
| 601 SEVENTH STREET | ONTONAGON | MI | 49953 | 260806477 | HOSPITAL | MI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS VNA HOME HEALTH INC | |||||||||||
| 520 N 32ND AVENUE | WAUSAU | WI | 54401 | 390808511 | HOME HEALTH CARE SERVICES | WI | 501 (C) 3 | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS VNA EXTENDED CARE INC | |||||||||||
| 520 N 32ND AVENUE | WAUSAU | WI | 54401 | 391597350 | PERSONAL CARE SERVICES | WI | 501 (C) 3 | LINE 10 | Yes (1) | ASPIRUS VNA HOME HEALTH INC | |
| ASPIRUS HEALTH FOUNDATION INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391256656 | CHARITABLE FOUNDATION | WI | 501 (C) 3 | LINE 7 | Yes (1) | ASPIRUS INC | |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS INC | |||||||||||
| 1400 W ICE LAKE ROAD | IRON RIVER | MI | 49935 | 383236977 | HOSPITAL | MI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS IRONWOOD HOSPITAL & CLINICS INC | |||||||||||
| N 10561 GRAND VIEW LANE | IRONWOOD | MI | 49938 | 382908586 | HOSPITAL | MI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC | |||||||||||
| 410 DEWEY STREET | WISCONSIN RAPIDS | WI | 54494 | 390868982 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS KEWEENAW HOSPITAL | |||||||||||
| 205 OSCEOLA STREET | LAURIUM | MI | 49913 | 381443361 | HOSPITAL | MI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| DIVINE SAVIOR HEALTHCARE INC | |||||||||||
| 2817 NEW PINERY ROAD | PORTGAGE | WI | 53901 | 390806250 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS MEDFORD HOSPITAL & CLINICS INC | |||||||||||
| 135 S GIBSON STREET | MEDFORD | WI | 54451 | 390964813 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS MEDFORD FOUNDATION INC | |||||||||||
| 135 S GIBSON STREET | MEDFORD | WI | 54451 | 391777081 | CHARITABLE FOUNDATION | WI | 501 (C) 3 | LINE 7 | Yes (1) | ASPIRUS INC | |
| ASPIRUS STEVENS POINT HOSPITAL & CLINICS INC | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 390808443 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS STEVENS POINT HOSPITAL FOUNDATION INC | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391657410 | CHARITABLE FOUNDATION | WI | 501 (C) 3 | LINE 12A, I | Yes (1) | ASPIRUS INC | |
| ASPIRUS STANLEY HOSPITAL & CLINICS INC | |||||||||||
| 1120 PINE STREET | STANLEY | WI | 54768 | 390807065 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS MERRILL HOSPITAL & CLINICS INC | |||||||||||
| 601 S CENTER AVENUE | MERRILL | WI | 54452 | 390808503 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS MERRILL HOSPITAL FOUNDATION INC | |||||||||||
| 601 S CENTER AVENUE | MERRILL | WI | 54452 | 391627755 | CHARITABLE FOUNDATION | WI | 501 (C) 3 | LINE 12A, I | Yes (1) | ASPIRUS INC | |
| ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS INC | |||||||||||
| 2251 NORTH SHORE DRIVE | RHINELANDER | WI | 54501 | 391390638 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS EAGLE RIVER HOSPITAL & CLINICS INC | |||||||||||
| 201 HOSPITAL ROAD | EAGLE RIVER | WI | 54521 | 390985690 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| THE HOWARD YOUNG MEDICAL CENTER INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 390873606 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
| HOWARD YOUNG HEALTH CARE INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391499115 | HEALTHCARE | WI | 501 (C) 3 | LINE 12B, II | Yes (1) | ASPIRUS INC | |
| MINISTRY HEALTH CARE INC | |||||||||||
| C/O TAX DEPARTMENT PO BOX 45998 | ST LOUIS | MO | 631455998 | 391490371 | PARENT (FORMER) | MO | 501 (C) 3 | LINE 12A, I | Yes (1) | ASCENSION HEALTH | |
| ASCENSION HEALTH | |||||||||||
| C/O TAX DEPARTMENT PO BOX 45998 | ST LOUIS | MO | 631455998 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501 (C) 3 | LINE 12A, I | Yes (1) | ASCENSION HEALTH ALLIANCE | |
| ASCENSION HEALTH ALLIANCE | |||||||||||
| C/O TAX DEPARTMENT PO BOX 45998 | ST LOUIS | MO | 631455998 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501 (C) 3 | LINE 12A, I | N/A | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 CONDOMINIUM OWNERS ASSOCIATION INC | |||||||||
| 2200 WESTWOOD DRIVE | WAUSAU | WI | 54401 | 842513742 | ASSOCIATION | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, PART III AND PART IV: | FormAndLineReferenceDesc |
| Explanation | IN AUGUST 2021, THE ORGANIZATION'S PARENT BECAME ASPIRUS INC, WHO IS THE SOLE PARENT MEMBER OF THE ORGANIZATIONS REPORTED ON SCHEDULE R ATTACHED. THE FIRST MONTH OF THE FISCAL YEAR (JULY) THE ORGANIZATION WAS A PART OF A RELATED PARTY STRUCTURE WITH THE OVERARCHING PARENT BEING ASCENSION HEALTH ALLIANCE (45-3358926). THE DIRECT PARENT BEING MINISTRY HEALTH CARE INC. (39-1490371) WHO IS OWNED BY ASCENSION HEALTH (31-1662309) WHICH IS OWNED BY ASCENSION HEALTH ALLIANCE (45-3358926). THE RELATED PARTY STRUCTURE OF ASCENSION HEALTH ALLIANCE/ASCENSION HEALTH/MINISTRY HEALTH CARE CAN BE PROVIDED UPON REQUEST. ALL COMPENSATION FROM BOTH RELATED PARTY STRUCTURES HAS BEEN REPORTED ON THE FORM 990. TRANSACTIONS AS REPORTED ON SCHEDULE R, PART V, LINE 2 TRANSACTIONS ARE NOT INCLUDING TRANSACTIONS WITH ASCENSION HEALTH ENTITIES FOR THE ONE MONTH OF RELATIONSHIP. | ExplanationTxt |