DIVINE SAVIOR HEALTHCARE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DIVINE SAVIOR HEALTHCARE INC (EIN 39-0806250)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202321329349305762
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T13:06:35-05:00 | 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 | 390806250 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIVINE SAVIOR HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DIVI | BusinessNameControlTxt |
| Phone | 6087424131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 387 2817 NEW PINERY ROAD | AddressLine1Txt |
| City | PORTAGE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53901 | 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 | 3 | 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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS DIVINE SAVIOR HOSPITAL & CLINICS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $97,565,302 | 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 | 1917 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 774 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $532,314 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,483,258 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $93,624,074 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $89,909,017 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,247,216 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,615,992 | CYInvestmentIncomeAmt |
| PY Other Revenue | $144,559 | PYOtherRevenueAmt |
| CY Other Revenue | $132,482 | CYOtherRevenueAmt |
| PY Total Revenue | $99,548,163 | PYTotalRevenueAmt |
| CY Total Revenue | $94,140,749 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,203,421 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $46,948,082 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,709,075 | PYOtherExpensesAmt |
| CY Other Expenses | $51,821,633 | CYOtherExpensesAmt |
| PY Total Expenses | $99,912,496 | PYTotalExpensesAmt |
| CY Total Expenses | $98,779,715 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$364,333 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,638,966 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $146,404,206 | TotalAssetsBOYAmt |
| Total Assets EOY | $138,487,582 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $60,304,271 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,226,517 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $86,099,935 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $90,261,065 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $61,999,659 | ExpenseAmt |
| Grant | $10,000 | GrantAmt |
| Revenue | $67,797,877 | RevenueAmt |
| Desc | ADS IS AN ACUTE CARE 73-BED HOSPITAL LOCATED IN PORTAGE, WI. INPATIENT SERVICES INCLUDED ADMISSIONS OF ADULTS AND PEDIATRIC PATIENTS WHICH TOTALED 5,146 PATIENT DAYS IN FISCAL YEAR 2022. ADS ALSO OFFERS A WIDE ARRAY OF OUTPATIENT SERVICES TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. EMERGENCY ROOM, URGENT CARE, SURGERY, AMBULANCE, RENAL DIALYSIS, AND REHABILITATION SERVICES ARE AMONG MANY OF THE OUTPATIENT SERVICES PROVIDED. KEY OUTPATIENT SERVICE STATISTICS IN FISCAL YEAR 2022 INCLUDED 15,038 EMERGENCY ROOM VISITS, 15,610 X-RAYS AND 4,058 INFUSION THERAPY VISITS WERE AMONG MANY OF THE PATIENT SERVICES AS NOTED. ADS ALSO PROVIDES SPECIALIZED HOME CARE SERVICES TO INDIVIDUALS WHO NEED CARE WITHIN THEIR OWN HOME. THESE PERSONALIZED SERVICES INCLUDE SKILLED NURSING SERVICES, HOME HEALTH AIDES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, IV THERAPY, AND PALLIATIVE CARE FOR TERMINAL ILLNESS.ADS PROMISES TO THE COMMUNITY TO PROVIDE HEALTHCARE SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY AS DEFINED IN THE HOSPITAL'S CHARITY AND COMMUNITY CARE POLICIES AND PROGRAMS. DURING FISCAL YEAR 2022, ADS'S CHARITY CARE PROGRAM AWARDED APPROXIMATELY $1,705,798 IN GROSS CHARGES FOR FINANCIAL ASSISTANCE TO PATIENTS WHO COULD NOT OTHERWISE AFFORD CARE.IN ADDITION TO INPATIENT AND OUTPATIENT HOSPITAL SERVICES, ADS ALSO PROVIDES EDUCATIONAL AND PREVENTATIVE SERVICES AT FREE OR REDUCED COSTS TO COMMUNITY MEMBERS. SOME OF THESE EVENTS OFFERED TO THE PUBLIC INCLUDE:LOW COST EXERCISE CLASSES, FREE BLOOD PRESSURE SCREENINGS, LOW COST CHOLESTEROL SCREENINGS, LOW COST CHILDBIRTH EDUCATION CLASSES, BLOOD DRIVES, FREE BREASTFEEDING WORKSHOPS, SUPPORT GROUPS, AND LOW-COST CPR AND FIRST AID CLASSES.IN FISCAL YEAR 2016, ADS OPENED A MEDICALLY INTEGRATED FITNESS CENTER IN RESPONSE TO THE COMMUNITY NEEDS ASSESSMENT PERFORMED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $18,735,280 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $15,742,839 | RevenueAmt |
| Desc | TOTAL CLINIC VISITS FOR FISCAL YEAR 2022 WERE 63,070. THESE CLINICS PROVIDE FAMILY PRACTICE, INTERNAL MEDICINE, PHYSIATRY, OB, ORTHOPEDICS, AND SURGICAL SERVICES, AMONG MANY OTHER CLINICAL SERVICES OFFERED TO PATIENTS IN THE COMMUNITY, AND WORK TOGETHER WITH THE HOSPITAL SERVICES OF ADS IN AN EFFORT TO COORDINATE HOSPITAL AND CLINICAL CARE TO PROVIDE CONVENIENT, COST-EFFECTIVE CARE TO MEMBERS OF THE COMMUNITY. THE RURAL OXFORD CLINIC IS IN A HEALTH SHORTAGE AREA TO BETTER MEET THE RESIDENTS OF THIS COMMUNITY CLOSER TO THEIR HOMES.THE CLINICS SERVICE A LARGE PORTION OF ELDERLY, DISABLED, AND LOW-INCOME PATIENTS WHO ARE COVERED UNDER THE MEDICARE AND WISCONSIN MEDICAL ASSISTANCE PROGRAMS. THE CLINICS ARE OFTEN REIMBURSED FROM THESE PROGRAMS AT RATES WELL BELOW THE COST OF CARING FOR THESE PATIENTS, HOWEVER, IT IS ADS'S MISSION IN THE COMMUNITY TO PROVIDE CARE TO THESE PATIENTS.PATIENTS OF THE ADS CLINICS ARE ALSO ELIGIBLE FOR THE ORGANIZATION'S CHARITY AND COMMUNITY CARE PROGRAMS WHICH PROVIDE FREE OR REDUCED CARE TO INDIVIDUALS AND FAMILIES BASED ON INCOME AND ASSET GUIDELINES. THE FIGURES PRESENTED IN STATEMENT 4A OF THE HOSPITAL PROGRAM SERVICE ACCOMPLISHMENTS INCLUDE CHARITY CARE AMOUNTS PROVIDED TO CLINIC PATIENTS AS WELL. ADDITIONAL INFORMATION ON THE CHARITY CARE POLICIES CAN ALSO BE FOUND IN SCHEDULE H (HOSPITALS) OF THE FORM 990. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,870,026 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,368,301 | RevenueAmt |
| Desc | ADS OWNS AND OPERATES AN 83-BED EXTENDED CARE FACILITY AND 40-BED ASSISTED LIVING FACILITY. THE EXTENDED CARE FACILITY OFFERS SKILLED AND INTERMEDIATE CARE NURSING FOR RESIDENTS WHO REQUIRE SHORT-TERM REHABILITATION PROGRAMS OR LONG-TERM CARE. THE FACILITY ALSO OFFERS MEDICATION MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, IV THERAPY, AND NUTRITION SERVICES, AS WELL AS ACCESS TO OTHER HEALTHCARE AND HOSPITAL SERVICES OFFERED BY ADS'S HOSPITAL PROGRAMS. IN 2022, 16,679 RESIDENT DAYS OF CARE AND 9,791 ASSISTED LIVING DAYS WERE PROVIDED BY THE EXTENDED CARE FACILITY. A MAJORITY OF THE RESIDENTS RECEIVE CARE UNDER THE WISCONSIN MEDICAL ASSISTANCE OR FAMILY CARE PROGRAMS. ADS RECOGNIZES THAT THE COST OF CARING FOR THESE INDIVIDUALS OFTEN EXTENDS BEYOND THE AMOUNT THAT IS PAID TO THE FACILITY BY THE MEDICAL ASSISTANCE PROGRAM. RESIDENTS OF THE EXTENDED CARE FACILITY AT ADS WHO HAVE EXHAUSTED ALL OTHER PROGRAMS SUCH AS MEDICAL ASSISTANCE OR THE WISCONSIN FAMILY CARE PROGRAM ARE ALSO ABLE TO APPLY FOR DISCOUNTED OR FREE CARE FOR HOSPITAL OR CLINICAL SERVICES UNDER THE ORGANIZATION'S CHARITY AND COMMUNITY CARE PROGRAMS AS DESCRIBED EARLIER NOTING THE HOSPITAL AND CLINIC PROGRAM SERVICE ACCOMPLISHMENTS. SINCE MOST EXTENDED CARE CHARGES ARE COVERED UNDER WISCONSIN MEDICAL ASSISTANCE PROGRAMS WHEN INCOME LEVELS ARE BELOW ESTABLISHED GOVERNMENT STANDARDS, THESE PROGRAMS ARE MOST OFTEN UTILIZED AS A SOURCE OF PAYMENTS FOR MANY RESIDENTS. IF THESE MEDICAL ASSISTANCE PROGRAMS ARE NOT AVAILABLE DUE TO A UNIQUE CIRCUMSTANCE, THE RESIDENT'S STAY MAY BE EVALUATED FOR CHARITY OR COMMUNITY CARE ON A CASE BY CASE BASIS BY ADMINISTRATION OF THE ORGANIZATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $90,604,965 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | 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 | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 774 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | 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 |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| 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 (34 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TRAVIS HAMELE | ||||||||||
| CHAIRPERSON | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| JUDY WARMUTH PHD | ||||||||||
| VICE CHAIRPERSON (THRU 09/21) | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| PETE WELSH | ||||||||||
| TREASURER (THRU 09/21) | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| LYNN VOGT | ||||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | ||||
| ROBERT CRAWFORD | ||||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| LOUIS HEITKE | ||||||||||
| BOARD MEMBER | 2.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| ROBIN KVALO | ||||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| KRISTEN SKOLARZ | ||||||||||
| BOARD MEMBER (THRU 12/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| CHAD STEVENSON | ||||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| ROB WALZ | ||||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| ERIC ANDERSON | ||||||||||
| BOARD MEMBER/SVP-SERV. & PATIENT EXP. | 2.00 | Yes (X) | $0 | $495,034 | $104,300 | 50.00 | ||||
| JESSE TISCHER | ||||||||||
| BOARD MEMBER/SVP & PRES. REG. MKTS. | 2.00 | Yes (X) | Yes (X) | $0 | $644,385 | $101,649 | 50.00 | |||
| SUSAN KRECKMAN | ||||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | Yes (X) | $332,022 | $0 | $40,626 | |||||
| JOSHUA POGORELEC | ||||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | Yes (X) | $694,305 | $0 | $42,225 | |||||
| CRYSTAL KIRSCHLING | ||||||||||
| INTERIM PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | 40.00 | ||||
| NANCY ROTH-MALLEK | ||||||||||
| VICE CHAIR/VP-FINANCE SOUTH REGION | 2.00 | Yes (X) | $0 | $263,519 | $46,838 | 50.00 | ||||
| MICHAEL HOLZHUETER | ||||||||||
| ASSIST. SEC./SVP-GENERAL COUNSEL | 2.00 | Yes (X) | $0 | $449,756 | $89,333 | 50.00 | ||||
| SIDNEY SCZYGELSKI | ||||||||||
| ASSIST. TREASURER/SR. VP OF FIN./CFO | 2.00 | Yes (X) | $0 | $915,379 | $141,626 | 50.00 | ||||
| MATTHEW HEYWOOD | ||||||||||
| PRESIDENT & CEO ASPIRUS | 2.00 | Yes (X) | $0 | $2,684,221 | $266,094 | 50.00 | ||||
| MICHAEL DECKER | ||||||||||
| PRESIDENT & CEO ADS (THRU 05/22) | 40.00 | Yes (X) | $667,269 | $0 | $103,194 | |||||
| BENJAMIN BARSOTTI | ||||||||||
| VP-CHIEF MEDICAL INFORMATION OFFICER | 2.00 | $0 | $462,446 | $50,766 | 50.00 | Yes (X) | ||||
| BRETT DAVIS | ||||||||||
| PRESIDENT-ASPIRUS HEALTH PLAN | 2.00 | $0 | $394,127 | $62,857 | 50.00 | Yes (X) | ||||
| JAMES MATHESON | ||||||||||
| SVP-CHIEF STRATEGY OFFICER | 2.00 | $0 | $452,729 | $89,948 | 50.00 | Yes (X) | ||||
| JOHN HEISLER | ||||||||||
| BOARD MEM.(THRU 03/21)/CHIEF HR OFF. | 2.00 | $0 | $751,984 | $56,650 | 50.00 | Yes (X) | ||||
| RENEE SMITH | ||||||||||
| EXECUTIVE DIRECTOR-ANI | 2.00 | $0 | $460,002 | $93,775 | 50.00 | Yes (X) | ||||
| TODD RICHARDSON | ||||||||||
| SVP & CHIEF INFORMATION OFFICER | 2.00 | $0 | $516,494 | $97,286 | 50.00 | Yes (X) | ||||
| JENNIFER REDMAN-SCHELL | ||||||||||
| SVP & PRESIDENT-AMG | 2.00 | $0 | $572,454 | $92,664 | 50.00 | Yes (X) | ||||
| DOUGLAS ARNOLD | ||||||||||
| PHYSICIAN | 40.00 | $635,884 | $0 | $48,825 | Yes (X) | |||||
| BRAD ROGOWSKI | ||||||||||
| PHYSICIAN | 40.00 | $590,973 | $0 | $44,477 | Yes (X) | |||||
| JOSEPH MUELLER | ||||||||||
| PHYSICIAN | 40.00 | $602,628 | $0 | $41,971 | Yes (X) | |||||
| KATHERINE MURPHY | ||||||||||
| PHYSICIAN | 40.00 | $422,555 | $0 | $10,903 | Yes (X) | |||||
| JAMES SELF | ||||||||||
| PHYSICIAN | 40.00 | $494,105 | $0 | $43,518 | Yes (X) | |||||
| MICHAEL MCGRAIL MD | ||||||||||
| FORMER SVP & SYSTEM CMO | 0.00 | $0 | $449,085 | $0 | 0.00 | Yes (X) | ||||
| MICHAEL WALTERS | ||||||||||
| FORMER KE/VP-SEN. SYS. PHYS. EXEC. | 2.00 | $0 | $604,827 | $43,884 | 50.00 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,439,741 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,116,442 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,713,409 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 46 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TOTAL MSP LLC | |||||
| 221 WEST COLLEGE AVE | APPLETON | WI | 54944 | STAFFING SERVICE | $1,545,026 |
| FOCUSONE SOLUTIONS LLC | |||||
| PO BOX 3037 | OMAHA | NE | 68103 | STAFFING SERVICE | $873,237 |
| ARCH ELECTRIC INC | |||||
| 1237 PILGRIM RD | PLYMOUTH | WI | 53073 | ELECTRIC SERVICES-SOLAR PANELS | $656,322 |
| CHG COMPANIES | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | STAFFING SERVICE | $650,986 |
| NOVUS WISCONSIN SERVICE CORP | |||||
| PO BOX 12766 | PENSACOLA | FL | 32591 | ANESTHESIOLOGY SERVICES | $479,770 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,476,755 | GovernmentGrantsAmt |
| All Other Contributions | $6,503 | AllOtherContributionsAmt |
| Total Contributions | $2,483,258 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | $66,505,669 | $66,505,669 |
| CLINIC REVENUE | 623000 | $15,742,839 | $15,742,839 |
| EXTENDED CARE FACILITY REVENUE | 621110 | $6,368,301 | $6,368,301 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,292,208 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,292,208 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $89,909,017 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,701,964 | TotalRevenueColumnAmt |
| Exclusion | $1,701,964 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,835 | 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 | $47,835 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,835 | TotalRevenueColumnAmt |
| Exclusion | $47,835 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,334,301 | SecuritiesAmt |
| Other | $4,280 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,396,512 | SecuritiesAmt |
| Other | $28,041 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$62,211 | SecuritiesAmt |
| Other | -$23,761 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$85,972 | TotalRevenueColumnAmt |
| Exclusion | -$85,972 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 722514 | BusinessCd |
| Total Revenue Column | $84,647 | TotalRevenueColumnAmt |
| Exclusion | $84,647 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $84,647 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94,140,749 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $89,909,017 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,748,474 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,222,300 | TotalAmt |
| Management And General | $1,222,300 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,993,664 | TotalAmt |
| Program Services | $31,832,462 | ProgramServicesAmt |
| Management And General | $5,161,202 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,297,383 | TotalAmt |
| Program Services | $940,452 | ProgramServicesAmt |
| Management And General | $356,931 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,762,173 | TotalAmt |
| Program Services | $5,015,423 | ProgramServicesAmt |
| Management And General | $746,750 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,672,562 | TotalAmt |
| Program Services | $1,188,037 | ProgramServicesAmt |
| Management And General | $484,525 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,241 | TotalAmt |
| Management And General | $174,241 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,819 | TotalAmt |
| Program Services | -$178 | ProgramServicesAmt |
| Management And General | $25,997 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,822 | TotalAmt |
| Management And General | $13,822 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,971 | TotalAmt |
| Management And General | $5,971 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,157,797 | TotalAmt |
| Program Services | $11,279,955 | ProgramServicesAmt |
| Management And General | $877,842 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,157 | TotalAmt |
| Management And General | $12,157 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,785 | TotalAmt |
| Program Services | $53,876 | ProgramServicesAmt |
| Management And General | $76,909 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,400 | TotalAmt |
| Program Services | $20,475 | ProgramServicesAmt |
| Management And General | $20,925 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,634,078 | TotalAmt |
| Program Services | $943 | ProgramServicesAmt |
| Management And General | $1,633,135 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,318 | TotalAmt |
| Program Services | $227,837 | ProgramServicesAmt |
| Management And General | $32,481 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,679 | TotalAmt |
| Program Services | $45,532 | ProgramServicesAmt |
| Management And General | $147 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $669,979 | TotalAmt |
| Management And General | $669,979 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,787,953 | TotalAmt |
| Program Services | $1,944,266 | ProgramServicesAmt |
| Management And General | $3,843,687 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,854 | TotalAmt |
| Program Services | $22,328 | ProgramServicesAmt |
| Management And General | $111,526 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CORPORATE ALLOCATIONS | $13,338,396 | $25,085,365 | -$11,746,969 |
| MEDICAL SUPPLIES | $11,757,673 | $11,471,492 | $286,181 |
| REPAIRS AND MAINTENANCE | $2,337,271 | $1,210,624 | $1,126,647 |
| BAD DEBT EXPENSE | $1,274,021 | $1,274,021 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,020,419 | TotalAmt |
| Program Services | $256,076 | ProgramServicesAmt |
| Management And General | $1,764,343 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,779,715 | TotalAmt |
| Program Services | $90,604,965 | ProgramServicesAmt |
| Management And General | $8,174,750 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,645,741 | BOYAmt |
| EOY | $961,292 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,225,742 | BOYAmt |
| EOY | $5,435,352 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,178,537 | BOYAmt |
| EOY | $13,605,299 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,727,368 | BOYAmt |
| EOY | $1,398,492 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,955 | BOYAmt |
| EOY | $614,181 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $143,133,861 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $73,902,681 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,693,330 | BOYAmt |
| EOY | $69,231,180 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,285,229 | BOYAmt |
| EOY | $42,105,546 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,117,304 | BOYAmt |
| EOY | $5,136,240 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,404,206 | BOYAmt |
| EOY | $138,487,582 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,033,497 | BOYAmt |
| EOY | $4,867,850 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,240,856 | BOYAmt |
| EOY | $664,096 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,324,876 | BOYAmt |
| EOY | $34,914,514 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,705,042 | BOYAmt |
| EOY | $7,780,057 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,304,271 | BOYAmt |
| EOY | $48,226,517 | 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 | $86,067,056 | BOYAmt |
| EOY | $90,230,825 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,879 | BOYAmt |
| EOY | $30,240 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,099,935 | BOYAmt |
| EOY | $90,261,065 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,404,206 | BOYAmt |
| EOY | $138,487,582 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,638,966 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$6,604,814 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $15,404,910 | OtherChangesInNetAssetsAmt |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,822 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,822 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | ADS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE WHA HAS NOTIFIED ADS THAT APPROXIMATELY $3,543 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. ADS IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, ADS PAYS MEMBERSHIP FEES TO THE RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS ON CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. RWHC DETERMINED THAT APPROXIMATELY $2,066 OF THE FEES PAID BY DIVINE SAVIOR HEALTHCARE IN FISCAL YEAR 2022 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. ADS PAID AHA DUES OF $31,027 OF WHICH 26.47% IS FOR LOBBYING OR $8,213. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,041,760 | OtherCostOrOtherBasisAmt |
| Book Value | $5,041,760 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,583,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,575,514 | DepreciationAmt |
| Book Value | $50,008,073 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,305,179 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,327,167 | DepreciationAmt |
| Book Value | $12,978,012 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,203,335 | OtherCostOrOtherBasisAmt |
| Book Value | $1,203,335 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $69,231,180 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| LONG TERM INSURANCE | $192,824 |
| MEDICARE ACCELERATED PAYMENTS | $6,104,278 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $901,539 |
| DEFERRED COMPENSATION | $581,416 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,780,057 | 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 H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $725,222 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,240 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $661,982 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,736,828 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,351,590 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,385,238 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,462,050 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,414,830 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,047,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08250 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 591 | PersonsServedCnt |
| Total Community Benefit Expns | $27,584 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 5 | PersonsServedCnt |
| Total Community Benefit Expns | $14,637 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,681,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,121,387 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,560,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08780 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 119 | PersonsServedCnt |
| Total Community Benefit Expns | $15,873 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 715 | PersonsServedCnt |
| Total Community Benefit Expns | $9,739,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,121,387 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,618,182 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08850 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 715 | PersonsServedCnt |
| Total Community Benefit Expns | $28,201,619 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,536,217 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,665,402 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17100 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 17 | PersonsServedCnt |
| Total Community Benefit Expns | $117 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 17 | PersonsServedCnt |
| Total Community Benefit Expns | $117 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $541,652 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,867,676 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,933,819 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,066,143 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIVINE SAVIOR HEALTHCARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2817 NEW PINERY ROAD | AddressLine1Txt |
| City | PORTAGE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ASPIRUS.ORG | WebsiteAddressTxt |
| State License | 80 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIVINE SAVIOR HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DIVINE SAVIOR HEALTHCARE, INC. | PART V, SECTION B, LINE 5: COLUMBIA COUNTY COMMUNITY MEMBERS PROVIDED FEEDBACK ON COMMUNITY HEALTH NEEDS THROUGH A COMMUNITY SURVEY AND KEY INFORMANT INTERVIEWS. APPROXIMATELY 650 PEOPLE RESPONDED TO THE COMMUNITY SURVEY AND TWENTY-SEVEN KEY INFORMANT INTERVIEWS WERE CONDUCTED. AN INTENTIONAL EFFORT WAS MADE TO ENSURE THAT THE INDIVIDUALS AND ORGANIZATIONS REPRESENTED THE NEEDS AND PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, LOW INCOME, OR ARE CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED. THE COMMUNITY SURVEY, DEVELOPED AND DISTRIBUTED BY ASPIRUS DIVINE SAVIOR AND COLUMBIA COUNTY HEALTH DEPARTMENT, WAS CONDUCTED IN FALL 2021. THE SURVEY WAS AVAILABLE IN SPANISH AND WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. NUMEROUS ORGANIZATIONS INCLUDING LIBRARIES, CHAMBERS OF COMMERCE, COLUMBIA COUNTY HEALTH DEPARTMENT, AGING AND DISABILITY RESOURCE CENTER, FOOD PANTRIES, COALITIONS AND MORE DISTRIBUTED THE SURVEY. KEY INFORMANTS PROVIDING INPUT ON THE TOP ISSUES INCLUDED REPRESENTATIVES FROM MULTIPLE SECTORS AND GROUPS: EDUCATION; AGING; SUBSTANCE USE AND RECOVERY; FAITH; RECREATION; HEALTH CARE; YOUTH SERVICES; MEDIA; ELECTED PUBLIC OFFICE; OTHER. |
| DIVINE SAVIOR HEALTHCARE, INC. | PART V, SECTION B, LINE 6B: ASPIRUS DIVINE SAVIOR COLLABORATED WITH THE COLUMBIA COUNTY HEALTH DEPARTMENT TO COMPLETE THIS WORK. COLUMBIA COUNTY HEALTH DEPARTMENT CONTRACTED WITH UNIVERSITY OF WISCONSIN-OSHKOSH FOR DATA ANALYSIS AND WISCONSIN COMMUNITY HEALTH ALLIANCE FOR PROCESS FACILITATION. |
| DIVINE SAVIOR HEALTHCARE, INC. | PART V, SECTION B, LINE 11: IN FY22, ASPIRUS DIVINE SAVIOR HOSPITAL WORKED TO ADDRESS THE HEALTH ISSUES IDENTIFIED IN ITS PREVIOUS CHNA. ALTHOUGH MANY EFFORTS HAVE BEEN SUCCESSFUL, THE HOSPITAL'S EFFORTS HAVE BEEN HAMPERED BY COVID-19 AND ITS RIPPLE EFFECT ON COMMUNITY OUTREACH AND PUBLIC EVENTS / PROGRAMS AS WELL AS ORGANIZATIONAL CHANGES IN STAFFING AND STRUCTURE.MANAGEMENT OF OBESITY & OTHER CHRONIC CONDITIONS IN THE PREVIOUS CHNA, THE MANAGEMENT OF OBESITY, ITS RELATED HEALTH RISKS, AND OTHER CHRONIC CONDITIONS WAS IDENTIFIED AS AN UNMET HEALTH NEED IN THE COMMUNITY. ASPIRUS DIVINE SAVIOR CONDUCTED THE FOLLOWING ACTIVITIES TO RESPOND TO THIS PRIORITY.INTERNAL EFFORTS ASPIRUS DIVINE SAVIOR PARTICIPATED IN THE SYSTEM WIDE FRUIT AND VEGGIE PRESCRIPTION PROGRAM FOR PATIENTS TO RECEIVE $20 VOUCHERS FOR THE LOCAL FARMER'S MARKET INCREASED PUBLIC ACCESSIBILITY TO PERSONAL WELLNESS SERVICES THROUGH LA VITA, ASPIRUS DIVINE SAVIOR'S MEDICALLY-INTEGRATED FITNESS CENTER THE PAVE THE WEIGH PROGRAM, AND OTHER TRANSITIONAL PROGRAMS, WERE OFFERED AT LAVITA AND INCLUDED FREE MEMBERSHIP FEES A VERTICAL GARDEN WAS STARTED AT ASPIRUS TIVOLI EXTERNAL EFFORTS FREE PRESENTATIONS ON DIABETES PREVENTION AND MANAGEMENT WERE OFFERED FREE BREAST CANCER SUPPORT WAS OFFERED BRAIN INJURY AND STROKE SUPPORT GROUP WAS OFFERED PARTICIPATED ON THE PLANNING COMMITTEE FOR A NEW BOYS AND GIRLS CLUBACCESS TO CARE ACCESSIBILITY TO HEALTH CARE REMAINS A SIGNIFICANT ISSUE IN THE COMMUNITY SERVED. ASPIRUS DIVINE SAVIOR CONTINUED TO PRIORITIZE ACCESS AND RECRUITMENT AS A KEY INITIATIVE OF THE ORGANIZATION AND HAS MADE STRIDES IN COMBATING THIS ISSUE. INTERNAL EFFORTS THE CLINIC ADDED NEW PROVIDERS FOR PAIN MANAGEMENT AND CARDIOLOGY PEDIATRIC AND ORTHOPEDIC PRACTITIONERS EXPANDED SERVICES TO OXFORD CLINIC TELEHEALTH AND VIRTUAL CARE VISITS WERE AVAILABLE TRAVEL VOUCHERS WERE PROVIDED TO PATIENTS THE ED2RECOVERY PROGRAM WAS UTILIZED IN THE EMERGENCY DEPARTMENT TO PROVIDE PEER SUPPORT FOR SUBSTANCE USE TWO PHYSICIANS ARE CERTIFIED TO PRESCRIBE SUBOXONE FOR SUBSTANCE ABUSE TREATMENT INTERPRETER/TRANSLATION SERVICES WERE UTILIZED; ADDITIONALLY, A PEDIATRICIAN SPEAKS SPANISH OVER THE NEXT THREE YEARS, AS IDENTIFIED IN ITS NEW CHNA, ASPIRUS DIVINE SAVIOR WILL FORMALLY ADDRESS MENTAL HEALTH AND SUBSTANCE USE. THE THREE NEEDS THAT WERE PRIORITIZED IN THE COMMUNITY STAKEHOLDER MEETING AND WILL NOT BE FORMALLY PURSUED BY THE HOSPITAL IN ITS IMPLEMENTATION STRATEGY ARE: LACK OF COMMUNICATION BETWEEN PARTNERS LACK OF HEALTH CARE PROVIDERS TRANSPORTATION THE HOSPITAL VIEWS COMMUNICATION, HEALTH CARE PROVIDERS AND TRANSPORTATION AS CONTRIBUTORS TO THE ISSUES OF MENTAL HEALTH AND SUBSTANCE USE. WHILE THESE ARE NOT THE HOSPITAL'S FORMAL PRIORITIES, THEY MAY BE PART OF THE STRATEGY TO ADDRESS THE PRIORITY NEEDS AROUND MENTAL HEALTH AND SUBSTANCE USE. |
| DIVINE SAVIOR HEALTHCARE, INC. | PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. |
| DIVINE SAVIOR HEALTHCARE, INC. | PART V, SECTION B, LINE 13H: THE CHARITABLE CARE POLICY OF DIVINE SAVIOR HEALTHCARE, INC. ALSO ALLOWS FOR AN ADMINISTRATIVE DETERMINATION FOR A PATIENT THAT MAY UNDERGO A CATASTROPHIC EVENT OR UNIQUE CIRCUMSTANCE. THIS ADDITIONAL PROVISION ALLOWS FOR ADMINISTRATION TO MAKE A DETERMINATION THAT MAY ASSIST A PATIENT IN A UNIQUE TIME OF FINANCIAL NEED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ASPIRUS PORTAGE CLINIC | ||||
| 2817 NEW PINERY ROAD | PORTAGE | WI | 53901 | PHYSICIAN CLINIC |
| 2 - ASPIRUS DIVINE SAVIOR WELLNESS CENTER | ||||
| 2815 NEW PINERY ROAD | PORTAGE | WI | 53901 | WELLNESS CENTER |
| 3 - ASPIRUS TIVOLI COMMUNITY | ||||
| 2805 HUNTERS TRAIL | PORTAGE | WI | 53901 | SKILLED NURSING FACILITY, ASSISTED LIVING FACILITY, AND HOME HEALTH PROGRAM |
| 4 - ASPIRUS OXFORD CLINIC | ||||
| N4390 CROSSROADS CLINIC ROAD | OXFORD | WI | 53952 | PHYSICIAN CLINIC |
| 5 - ASPIRUS PARDEEVILLE CLINIC | ||||
| 102 GILLETTE STREET | PARDEEVILLE | WI | 53954 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS 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 6A: | DIVINE SAVIOR HEALTHCARE, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S WEBSITE. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSE, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE ORGANIZATION. THE ORGANIZATION ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITABLE CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE ORGANIZATION. |
| PART I, LINE 7G: | THE ABOVE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE ASPIRUS SKILLED NURSING FACILITIES/EXTENDED CARE UNITS. DIVINE SAVIOR HEALTHCARE, INC. UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. SKILLED NURSING FACILITIES/EXTENDED CARE UNIT REPORTED COSTS OF $9,681,475 WITH OFFSETTING REVENUE OF $1,121,387. |
| 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 $1,274,021. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | ADS PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. ADS, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, URGENT CARE, HOME CARE, RENAL DIALYSIS, INFUSION SERVICES, SWING BED SERVICES, NURSING HOME SERVICES, ASSISTED LIVING SERVICES, CLINICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES, WOMEN'S SERVICES, AND AMBULANCE SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. |
| 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 3. COLLECTION PHONE CALLS 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 FIRST BILLING TO THE PATIENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. II. BAD DEBT RECOVERIES A. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. B. 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. C. 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 TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL 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, RADIOLOGY, AMBULANCE, AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, HOSPITALIST PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT DIVINE SAVIOR HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2022 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).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENT'S ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT. |
| PART VI, LINE 2: | DIVINE SAVIOR HEALTHCARE USES HEALTH AND SOCIAL DATA AND TRENDS FOR THE SAME TO DETERMINE POSSIBLE UNMET NEEDS WITH THE COMMUNITY IT SERVES. IT ALSO USES ITS TEAM MEMBERS' INVOLVEMENT IN COMMUNITY EVENTS TO USE AS A THERMOMETER FOR WHAT IS NEEDED. |
| 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. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AS WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE ORGANIZATION'S FINANCIAL COUNSELORS EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY AND COMMUNITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. |
| PART VI, LINE 4: | THE PRIMARY SERVICE AREA FOR ADS ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30-MILE RADIUS OF THE HOSPITAL. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE PORTAGE, PARDEEVILLE, WISCONSIN DELLS, LAKE DELTON, BRIGGSVILLE, WYOCENA, POYNETTE, AND ARLINGTON, WISCONSIN, AMONG MANY OTHERS. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT CARE SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS ESPECIALLY THOSE BENEFICIARIES WHO RESIDE IN THE ORGANIZATION'S EXTENDED AND LONG-TERM CARE FACILITIES OR PATIENTS WHO RECEIVE HOME HEALTH SERVICES FROM THE ORGANIZATION. |
| PART VI, LINE 5: | DIVINE SAVIOR HEALTHCARE, INC. PROVIDES SERVICES AND EDUCATIONAL OPPORTUNITIES EITHER FREE OF CHARGE OR AT A NOMINAL FEE IN AN ATTEMPT TO PROVIDE THESE OPPORTUNITIES TO THOSE MEMBERS OF THE COMMUNITIES WHO OTHERWISE MAY NOT BE ABLE TO AFFORD OR HAVE ACCESS TO THESE PROGRAMS. THESE EFFORTS ARE PROVIDED THROUGH A VARIETY OF EDUCATIONAL SPEAKER FORUMS, SUPPORT GROUPS, HEALTH SCREENINGS, HEALTH EDUCATION FORUMS, AND OTHER EDUCATIONAL OPPORTUNITIES FOR STUDENTS. |
| PART VI, LINE 6: | DIVINE SAVIOR HEALTHCARE IS A PART OF THE ASPIRUS, INC. SYSTEM WITH THE MAIN BASE IN WAUSAU WI. TOGETHER WE PROMOTE THE MISSION AND WORK COLLABORATIVELY TO SHARE THE PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. THE COMBINED EFFORTS ARE ABLE TO PROVIDE THE SMALLER COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. ALSO, AS PART OF THIS SYSTEM ARE 3 OTHER UPPER PENINSULA OF MI HOSPITALS AND 11 OTHER HOSPITAL SYSTEMS IN WI ALONG WITH POST-ACUTE CARE PROGRAMS, MANY PROVIDER CLINICS, AMBULANCE SERVICE AND LONG-TERM CARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOYS & GIRLS CLUB OF WEST CENTRAL WI | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 105 WEST MILWAUKEE STREET | AddressLine1Txt |
| City | TOMAH | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54660 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391962065 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $10,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | BUILD A PORTAGE CLUB DONATION | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | SCHOLARSHIPS/LOANS ARE AWARDED BY THE DIVINE SAVIOR HEALTHCARE, INC. SCHOLARSHIP COMMITTEE. APPLICANTS WILL GENERALLY BE GRADUATING HIGH SCHOOL SENIORS, THOUGH OTHERS MAY BE ELIGIBLE, AS APPROVED BY THE COMMITTEE. THE COMMITTEE WILL INTERVIEW APPLICANTS, AND THE DECISION WILL BE BASED UPON INTERVIEW RESULTS, CHOICE OF PROGRAM, GRADE POINT AVERAGE, AND FINANCIAL NEED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (23 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 |
| SIDNEY SCZYGELSKI | ||||||||||||||
| ASSIST. TREASURER/SR. VP OF FIN./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 | ||||||||||||||
| BOARD MEM.(THRU 03/21)/CHIEF HR OFF. | $0 | $289,961 | $0 | $426,149 | $0 | $35,874 | $0 | $13,626 | $0 | $43,024 | $0 | $808,634 | $0 | $25,179 |
| MICHAEL DECKER | ||||||||||||||
| PRESIDENT & CEO ADS (THRU 05/22) | $470,862 | $0 | $106,791 | $0 | $89,616 | $0 | $9,832 | $0 | $93,362 | $0 | $770,463 | $0 | $86,828 | $0 |
| JESSE TISCHER | ||||||||||||||
| BOARD MEMBER/SVP & PRES. REG. MKTS. | $0 | $501,025 | $0 | $142,821 | $0 | $539 | $0 | $11,714 | $0 | $89,935 | $0 | $746,034 | $0 | $0 |
| JOSHUA POGORELEC | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $660,337 | $0 | $20,600 | $0 | $13,368 | $0 | $8,700 | $0 | $33,525 | $0 | $736,530 | $0 | $0 | $0 |
| DOUGLAS ARNOLD | ||||||||||||||
| PHYSICIAN | $607,020 | $0 | $10,600 | $0 | $18,264 | $0 | $8,700 | $0 | $40,125 | $0 | $684,709 | $0 | $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 | ||||||||||||||
| FORMER KE/VP-SEN. SYS. PHYS. EXEC. | $0 | $452,168 | $0 | $151,458 | $0 | $1,201 | $0 | $8,700 | $0 | $35,184 | $0 | $648,711 | $0 | $0 |
| JOSEPH MUELLER | ||||||||||||||
| PHYSICIAN | $565,527 | $0 | $20,600 | $0 | $16,501 | $0 | $8,700 | $0 | $33,271 | $0 | $644,599 | $0 | $0 | $0 |
| BRAD ROGOWSKI | ||||||||||||||
| PHYSICIAN | $557,880 | $0 | $20,600 | $0 | $12,493 | $0 | $8,700 | $0 | $35,777 | $0 | $635,450 | $0 | $0 | $0 |
| TODD RICHARDSON | ||||||||||||||
| SVP & CHIEF INFORMATION OFFICER | $0 | $357,568 | $0 | $105,424 | $0 | $53,502 | $0 | $17,346 | $0 | $79,940 | $0 | $613,780 | $0 | $50,634 |
| ERIC ANDERSON | ||||||||||||||
| BOARD MEMBER/SVP-SERV. & 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 | ||||||||||||||
| ASSIST. SEC./SVP-GENERAL COUNSEL | $0 | $399,152 | $0 | $25,600 | $0 | $25,004 | $0 | $8,700 | $0 | $80,633 | $0 | $539,089 | $0 | $0 |
| JAMES SELF | ||||||||||||||
| PHYSICIAN | $480,142 | $0 | $600 | $0 | $13,363 | $0 | $7,243 | $0 | $36,275 | $0 | $537,623 | $0 | $0 | $0 |
| BENJAMIN BARSOTTI | ||||||||||||||
| VP-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 |
| 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 MCGRAIL MD | ||||||||||||||
| FORMER SVP & SYSTEM CMO | $0 | $0 | $0 | $0 | $0 | $449,085 | $0 | $0 | $0 | $0 | $0 | $449,085 | $0 | $449,085 |
| KATHERINE MURPHY | ||||||||||||||
| PHYSICIAN | $406,269 | $0 | $600 | $0 | $15,686 | $0 | $8,700 | $0 | $2,203 | $0 | $433,458 | $0 | $0 | $0 |
| SUSAN KRECKMAN | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $320,187 | $0 | $600 | $0 | $11,235 | $0 | $7,441 | $0 | $33,185 | $0 | $372,648 | $0 | $0 | $0 |
| NANCY ROTH-MALLEK | ||||||||||||||
| VICE CHAIR/VP-FINANCE SOUTH REGION | $0 | $223,367 | $0 | $38,193 | $0 | $1,959 | $0 | $12,914 | $0 | $33,924 | $0 | $310,357 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION RELIED ON THE RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A NON-QUALIFIED 457(F) RETIREMENT PLAN AND REPORTED THE FOLLOWING INCREASE IN THEIR RESPECTIVE PLANS: MIKE DECKER $86,828 SCHEDULE J, PART I, LINE 4B RELATED PARTY INFORMATION - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $112,143 W. CARROLL $23,743 B. BARSOTTI $23,406 J. MATHESON $26,065 J. HEISLER $25,179 J. HARDESTY $21,288 L. ROWE-PEPLINSKI $22,695 M. BREWER $24,855 M. MCGRAIL $449,085 R. SMITH $53,547 R. RISLEY-GRAY $19,718 T. RICHARDSON $50,634 J. REDMAN-SCHELL $51,368 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 K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| Bond Issued | 2020-06-29 | BondIssuedDt |
| Issue Price | $39,808,745 | IssuePriceAmt |
| Purpose | REFINANCE OF 2006, 2009, 2012, 2014, 2016, 2019 REVENUE BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,420,460 | RetiredAmt |
| Total Proceeds | $39,808,745 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $139,675 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $39,669,070 | OtherSpentProceedsAmt |
| Substantial Completion | 2020 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | Yes (1) | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART VI: | THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY REVENUE BONDS, SERIES 2020 BONDS (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY DIVINE SAVIOR HEALTHCARE, INC. (EIN 39-0806250). THE PROCEEDS OF THE SERIES 2020 BONDS WERE USED TO REFINANCE THE DIVINE SAVIOR HEALTHCARE, INC., SERIES 2016 BONDS (REFINANCING OF SERIES 2006 BONDS) AND SERIES 2019 BONDS (REFINANCING OF SERIES 2009, 2012, 2014 BONDS). INFORMATION REGARDING THE SERIES 2020 BONDS IS REPORTED IN SCHEDULE K FOR THAT ORGANIZATION. FOR THE ENTITY THAT BORROWED FUNDS, THE INFORMATION REPORTED IN PART I, PART II AND PART III OF SCHEDULE K RELATES ONLY TO THE PORTION OF THE SERIES 2020 BONDS LOANED TO THE ORGANIZATION. FOR THE ENTITY THAT BORROWED FUNDS, THE INFORMATION REPORTED IN PART IV OF SCHEDULE K RELATES TO THE ENTIRE ISSUE OF THE SERIES 2020 BONDS. |
| PART III, LINES 2, 3A, AND 3B: | ASPIRUS, INC., THE PARENT ORGANIZATION OF DIVINE SAVIOR HEALTHCARE, 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 WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS TRAVIS HAMELE AND CHAD STEVENSON HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THERE SHALL BE A MINIMUM OF 11 VOTING DIRECTORS ALLOCATED AS FOLLOW. THERE SHALL BE FOUR CLASSES OF VOTING DIRECTORS: THE COMMUNITY CLASS, ASPIRUS CLASS, PROVIDER CLASS, AND SISTERS OF DIVINE SAVIOR (SDS) CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS (APPROVED BY MEMBER), TWO ASPIRUS CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., TWO PROVIDER CLASS DIRECTOR NOMINATED BY THE CORPORATION'S BOARD AND ELECTED BY ASPIRUS, INC. AND ONE SDS CLASS DIRECTOR NOMINATED AND ELECTED BY SDS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICER; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 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 IS MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR PURPOSES OF DETERMINING COMPENSATION, DIVINE SAVIOR HEALTHCARE, INC. RELIES 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 AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | LAB FEES: PROGRAM SERVICE EXPENSES 1,451,124. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,451,124. CONTRACT NURSING AND OTHER LABOR FEES: PROGRAM SERVICE EXPENSES 9,403,625. MANAGEMENT AND GENERAL EXPENSES 46,548. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,450,173. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 425,206. MANAGEMENT AND GENERAL EXPENSES 831,294. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,256,500. |
| FORM 990, PART XI, LINE 9: | INTERCOMPANY TRANSFERS - AWH 644,306. INTERCOMPANY TRANSFERS - AI 13,831,806. INTERCOMPANY TRANSFERS - ACI 906,924. INTERCOMPANY TRANSFERS - AOH -20. INTERCOMPANY TRANSFERS - VNA 307. INTERCOMPANY TRANSFERS - AIW 972. INTERCOMPANY TRANSFERS - AIR -240. INTERCOMPANY TRANSFERS - ARH 21,069. INTERCOMPANY TRANSFERS - AKH -210. INTERCOMPANY TRANSFERS - ASP 105. INTERCOMPANY TRANSFERS - ASH -54. INTERCOMPANY TRANSFERS - AMR 202. INTERCOMPANY TRANSFERS - ARN -279. INTERCOMPANY TRANSFERS - HYMC 22. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 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 MEDICAL GROUP INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391670223 | MEDICAL 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 | |
| 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 | |
| ASPIRUS MEDICAL GROUP - NORTHERN WISCONSIN | |||||||||||
| 2251 NORTH SHORE DRIVE | RHINELANDER | WI | 54501 | 391965593 | HOSPITAL | WI | 501 (C) 3 | LINE 3 | Yes (1) | ASPIRUS INC | |
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 |
|---|---|---|---|---|---|---|---|---|---|
| THE WESTWOOD CONFERENCE CENTER LLC | |||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 571184256 | REAL ESTATE INVESTMENT | WI | N/A | 0 | 0 |
| WESTERN UPPER MICHIGAN EYE CARE LLC | |||||||||
| 131 W GENESEE STREET | IRON RIVER | MI | 49935 | 272324957 | EYE CARE SERVICES | MI | 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 | 391931679 | HEALTH CARE NETWORK | WI | N/A | C | 0 |
| ASPIRUS KEWEENAW ENTERPRISES | |||||||||
| 205 OSCEOLA STREET | LAURIUM | MI | 49913 | 383390273 | PHARMACY | MI | N/A | C | 0 |
| ASPIRUS HEALTH VENTURES | |||||||||
| 3000 WESTHILL DRIVE 303 | WAUSAU | WI | 54401 | 474925640 | HEALTH INSURANCE PLAN | WI | N/A | C | 0 |
| ASPIRUS ARISE HEALTH PLAN OF WI INC | |||||||||
| 3000 WESTHILL DRIVE 303 | WAUSAU | WI | 54401 | 364832569 | HEALTH INSURANCE PLAN | WI | N/A | C | 0 |
| ASPIRUS ARISE HEALTH PLAN OF MI INC | |||||||||
| 3000 WESTHILL DRIVE 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (10 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ASPIRUS INC | ||
| M | $13,535,625 | COST |
| ASPIRUS INC | ||
| O | $48,415,777 | COST |
| ASPIRUS INC | ||
| P | $20,604,129 | COST |
| ASPIRUS INC | ||
| Q | $489,497 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| I | $125,638 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| O | $359,460 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| P | $167,195 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| Q | $322,873 | COST |
| ASPIRUS MEDICAL GROUP INC | ||
| O | $845,583 | COST |
| ASPIRUS MEDICAL GROUP INC | ||
| Q | $74,667 | COST |