2023-05-12T13:01:57-05:00 2022-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2021-07-01 390868982 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC ASPI 7154229292 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 7158472250 2023-05-12 1 SIDNEY SCZYGELSKI 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2023-05-12 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 174536441 0 X WWW.ASPIRUS.ORG X 1912 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 11 6 710 168 212582 0 5159052 4007873 154137095 164894307 5755598 4739236 560346 638315 165612091 174279731 425 1349 0 0 59078431 61321351 0 0 0 77001852 79560453 136080708 140883153 29531383 33396578 202900701 174264879 62928981 52005256 139971720 122259623 X WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 111287694 1349 164771400 ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. OWNS AND OPERATES THE FOLLOWING ENTITIES: (1) ASPIRUS RIVERVIEW HOSPITAL, ESTABLISHED IN 1912; (2) THE OUTPATIENT ASPIRUS RIVERVIEW THERAPIES; (3) ASPIRUS RIVERVIEW CLINICS - THIS SERVICE INCLUDES CLINICS IN WISCONSIN RAPIDS, NEKOOSA, ADAMS CLINIC, AND THE MARSHFIELD CLINIC ESTABLISHED IN 2021; (4) THE ASPIRUS CANCER CARE WISCONSIN RAPIDS; (5) ASPIRUS RIVERVIEW DENTAL CLINIC. ASPIRUS RIVERVIEW ESTABLISHED THIS CLINIC IN 2009 TO SERVE RESIDENTS OF SOUTH WOOD COUNTY WHO ARE COVERED BY BADGER CARE/MEDICAID; (6) ASPIRUS RIVERVIEW WOUND AND HYPERBARIC CENTER. THE CENTER OPENED IN 2010 AND IS MANAGED BY HEALOGICS; (7) ASPIRUS HEART & VASCULAR CLINIC. ASPIRUS RIVERVIEW ESTABLISHED THE CLINIC IN 2016, STAFFING IT WITH A FULL-TIME CARDIOLOGIST AND NURSE PRACTITIONER; (8) ASPIRUS DOCTORS CLINIC WAS PURCHASED AS OF 1/1/17. (9) ASPIRUS RIVERVIEW BEHAVIORAL HEALTH CLINIC WAS ESTABLISHED IN 2018. IT PROVIDES MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AND IS STAFFED BY PSYCHIATRISTS, NURSE PRACTITIONERS AND LICENSED CLINICAL SOCIAL WORKERS.ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS REGARDLESS OF SOURCE OR AVAILABILITY OF PAYMENT, AND IT PROVIDES MEASURABLE IMPROVEMENT IN HEALTH ACCESS, HEALTH STATUS, AND THE USE OF HEALTH CARE RESOURCES. IN ADDITION, THE PROGRAMS AND SERVICES CONSIDERED COMMUNITY BENEFITS SHOULD MEET ONE OR MORE OF THE FOLLOWING CRITERIA: *SUPPORTS THE ORGANIZATION'S COMMUNITY-BASED MISSION *TARGETS THE PROBLEMS OF THE POOR OR MEDICALLY UNDERSERVED *IMPACTS THE HEALTH STATUS OF THE IDENTIFIED COMMUNITY *REDUCES COMMUNITY HEALTH COSTS *IS ACCESSIBLE TO THE ENTIRE TARGET COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY *STIMULATES EXTERNAL COMMUNITY PARTNERSHIPS *IMPROVES THE ACCESS TO NEEDED HEALTH CARE SERVICESFONEMED IS A FREE, CONFIDENTIAL TELEPHONE SERVICE THE COMMUNITY CAN CALL AFTER THE CLINICS ARE CLOSED TO GET ROUTINE HEALTH ADVICE OR GENERAL HEALTH INFORMATION FROM A REGISTERED NURSE. APPROXIMATELY 1,870 PERSONS BENEFITED FROM THIS PROGRAM.ASPIRUS RIVERVIEW DENTAL CLINIC IN WISCONSIN RAPIDS IS OPEN TO PATIENTS WHO HAVE MEDICAID OR BADGER CARE INSURANCE COVERAGE. THIS INSURANCE IS NOT TYPICALLY ACCEPTED BY INDEPENDENT DENTAL CLINICS. THERE WERE APPROXIMATELY 2,144 VISITS FROM THIS PROGRAM IN 2022. VULNERABLE PEOPLE OF ALL AGES INCLUDING THE ELDERLY CAN REMAIN IN THEIR HOME AND BE SELF-SUFFICIENT BY RECEIVING A HOME DELIVERED MEAL THAT MEETS THEIR SPECIFIC NUTRITION REQUIREMENTS. HEALTH CONDITIONS OR PHYSICAL DISABILITIES RESTRICT THE ABILITY OF INDIVIDUALS TO REMAIN INDEPENDENT. THE HOME DELIVERED MEALS PROGRAM PROVIDES NUTRITION THAT IS MEDICALLY THERAPEUTIC TO ADDRESS THE SPECIAL NEEDS OF CLIENTS DIAGNOSED WITH DIABETES, CARDIAC AND PULMONARY ISSUES, RETINAL DISEASE, GLUTEN INTOLERANCE, WEIGHT LOSS DUE TO CANCER AND CHEWING AND SWALLOWING PROBLEMS. THE PROGRAM ALSO MEETS THE NEEDS OF CARETAKERS OF THE MENTALLY AND PHYSICALLY HANDICAPPED OR ALZHEIMER'S OR OTHER DEMENTIA DISORDERS BY PROVIDING MEALS TO ALLOW THEM TO CARE FOR THEIR LOVED ONES. NUTRITION EDUCATION IS ALSO OFFERED. COMMUNITY VOLUNTEERS DELIVER HOT LUNCHES MONDAY - FRIDAY AS WELL AS BROWN BAG MEALS FOR WEEKENDS. FOOD IS PREPARED WITH CONSIDERATION FOR EACH CLIENT'S PERSONAL PREFERENCES AS WELL AS DIETARY RESTRICTIONS. IN 2022, 20,450 MEALS WERE DELIVERED. ASPIRUS RIVERVIEW COORDINATES AND FACILITATES SEVERAL SUPPORT GROUPS FOR INDIVIDUALS AND THEIR LOVED ONES WHO ARE DEALING WITH CHRONIC DISEASE, CANCER, OR LOSS. THE SUPPORT GROUPS INCLUDE BOTH MEN'S AND WOMEN'S CANCER, DIABETES, CELIAC DISEASE, ARTHRITIS, AND LOSS. IN ADDITION, LACTATION SPECIALISTS FROM THE ASPIRUS RIVERVIEW FAMILY BIRTHPLACE OFFER BREASTFEEDING SUPPORT TO NEW MOTHERS. APPROXIMATELY, 340 INDIVIDUALS BENEFITED FROM THESE PROGRAMS.ASPIRUS RIVERVIEW OFFERS PRECEPTORSHIP OPPORTUNITIES TO STUDENTS ENROLLED IN AREA NURSING PROGRAMS. THIS STRUCTURED PROGRAM PROVIDES INSTRUCTION, DIRECTION AND GUIDANCE TO STUDENTS WHO ARE NOT EMPLOYEES OF ASPIRUS RIVERVIEW. THE PROGRAM MEETS THE REQUIREMENTS FOR COURSE CREDIT IN A HEALTHCARE SETTING. IN 2022, 6 STUDENTS BENEFITED FROM PRECEPTORSHIP OPPORTUNITIES.ASPIRUS RIVERVIEW HELD MONTHLY WORKSHOPS ON HOW TO COMPLETE AN ADVANCED DIRECTIVE AND APPOINT A HEALTHCARE POWER OF ATTORNEY. ADDITIONAL PRESENTATIONS WERE GIVEN TO THE WISCONSIN RAPIDS ROTARY CLUB IN AN EVENING SEMINAR. IN 2022, 64 PEOPLE RECEIVED THIS EDUCATION.ASPIRUS RIVERVIEW IS A BUSINESS SITE FOR PROJECT SEARCH - AN INTERNATIONAL PROGRAM THAT PROVIDES YOUNG ADULTS WITH COGNITIVE AND PHYSICAL DISABILITIES WITH ON-SITE INTERNSHIPS. ASPIRUS RIVERVIEW PROVIDES CLASSROOM SPACE AND 10-WEEK INTERNSHIPS IN VARIOUS DEPARTMENTS. AT THE END OF THE YEAR, STUDENTS HAVE GAINED VALUABLE SOCIAL AND EMPLOYMENT SKILLS THAT WILL HELP THEM FIND GAINFUL EMPLOYMENT IN THE COMMUNITY. IN 2022, 7 STUDENTS BENEFITED FROM THIS PROGRAM. 111287694 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 85 0 710 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 SIDNEY C SCZYGELSKI SVP & CHIEF FINANCIAL OFFICER 1.00 50.00 X X 0 915379 141626 JON HARDESTY VP-CORP. HUMAN RESOURCES 1.00 40.00 X X 0 325937 43270 CHRISTOPHER STINES PRESIDENT-ARH (THRU APR 22) 40.00 X X 0 425937 65434 BRIAN KIEF PRESIDENT-ARH 40.00 0.00 X X 0 0 0 MARY IRONSIDE BOARD CHAIR 1.00 X X 0 0 0 DAVID STARK BOARD CHAIR (THRU SEP 21) 1.00 X X 0 0 0 JESSE TISCHER VICE CHAIR/SVP & PRES.-REG. MKTS. 1.00 50.00 X X 0 644385 101649 JENNY REDMAN- SCHELL TREASURER/SVP & PRES.-AMG 1.00 50.00 X X 0 572454 92664 MARTIN J LOY BOARD SECRETARY (THRU SEP 21) 1.00 X X 0 0 0 SHELLY MONDEIK EDD BOARD SECRETARY 1.00 X X 0 0 0 STEVEN BERLYN BOARD MEMBER (THRU FEB 22) 1.00 X 0 0 0 MICHAEL BOVEE BOARD MEMBER 1.00 X 0 0 0 CRAIG BROEREN BOARD MEMBER 1.00 X 0 0 0 JUSTIN HUEBNER BOARD MEMBER 1.00 X 0 0 0 BONITA KOLRUD MD BOARD MEMBER/OB/GYN PHYSICIAN 1.00 40.00 X 0 388052 45721 MARY MERDAN APNP BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 103072 32927 REBECCA SOMMER PHD BOARD MEMBER 1.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 1.00 50.00 X 0 2684221 266094 BENJAMIN BARSOTTI CHIEF MEDICAL INFORMATION OFFICER 2.00 50.00 X 0 462446 50766 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 2.00 50.00 X 0 394127 62857 ERIC ANDERSON SVP-SERVICE LINE & PATIENT EXP. 2.00 50.00 X 0 495034 104300 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 452729 89948 JOHN HEISLER SVP & CHIEF HUMAN RES. OFFICER 2.00 50.00 X 0 751984 56650 LISA ROWE-PEPLINSKI VP-CARE QUALITY & PAT. SAFETY 2.00 50.00 X 0 367202 18878 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 449756 89333 PAUL VAN DEN HEUVEL VP-NETWORKS STRATEGY 2.00 50.00 X 0 340811 45098 RENEE SMITH EXECUTIVE DIRECTOR-ANI 2.00 50.00 X 0 460002 93775 RUTH RISLEY-GRAY SVP & SYSTEM CNO 2.00 50.00 X 0 329902 52673 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 2.00 50.00 X 0 516494 97286 WENDY ANGELO VP-CMO - POPULATION HEALTH 2.00 50.00 X 0 363857 42762 REBECCA PHILLIP DIRECTOR-PHARMACY 40.00 X 202137 0 24726 STACI SOVA NURSE PRACTITIONER 40.00 X 185455 0 40039 KIMBERLY JOHNSON VP-PATIENT CARE & CNO 40.00 X 226651 0 45751 LISA SKIBBA VP-ANCILLARY SERVICES 40.00 X 190171 0 38582 NANCY ROTH-MALLEK VP-FINANCE 40.00 X 263519 0 46838 MICHAEL MCGRAIL FORMER KE/SVP & SYSTEM CMO 0.00 0.00 X 0 449085 0 1067933 11892866 1789647 27 1 1 0 MEA EMERGENCY MANAGEMENT PO BOX 634850 CINCINNATI OH 452634850 ER SERVICE 10575883 ANESTHESIA ASSOCIATES OF WISCONSIN RAPID 225 S EXECUTIVE DRIVE BROOKFIELD WI 53005 ANESTHESIA SERVICE 1591264 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACT LABOR - SERVICES 1232294 PARK AND ASSOCIATES 3610 DEER ROAD WISCONSIN RAPIDS WI 54494 PATHOLOGY FEE 590667 HEALOGICS WOUND CARE PO BOX 551187 JACKSONVILLE FL 32255 SERVICE 464436 23 9425 3964555 33893 4007873 PATIENT SERVICES 621500 164666992 164666992 LAB SERVICE FOR NON PATIENTS 621500 52435 52435 174880 104408 70472 164894307 4783469 4783469 652930 211777 441153 441153 441153 700 44933 -44233 -44233 -44233 CAFETERIA 722514 197162 89675 107487 197162 174279731 164771400 212582 5287876 X 1349 1349 635712 635712 48588773 43691682 4897091 1763182 1763182 7429782 5810528 1619254 2903902 2901058 2844 3168 3168 74813 74813 11053 11053 17500 17500 16539050 15736207 802843 91871 962 90909 207873 134864 73009 149893 73317 76576 2478699 849784 1628915 126718 98486 28232 1689383 2304 1687079 8387371 7622694 764677 227321 58880 168441 MEDICAL SUPPLIES 23487026 23448679 38347 CORPORATE ALLOCATIONS 19582863 5657196 13925667 REPAIRS & MAINTENANCE 2982833 2288153 694680 HOSPITAL TAX 2037008 2037008 1466010 1148369 317641 140883153 111287694 29595459 0 68880 48940 641155 782139 19932802 21456669 2793453 3031993 226264 116052 189620751 114988742 80252549 74632009 78866082 68602163 20119516 5594914 202900701 174264879 10123731 8335409 397291 199421 50431758 48210257 1976201 -4739831 62928981 52005256 X 138644358 121030909 1327362 1228714 139971720 122259623 202900701 174264879 X 33396578 -14705193 -36403482 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11053 11053 0 PART II-B, LINE 1: THE PERCENTAGES THAT ARE SPECIFIC FOR LOBBYING PURPOSES ARE AS FOLLOWS: 26.5% OF THE AMERICAN HOSPITAL ASSOCIATION TOTALING $5,153, 15.3% OF THE WISCONSIN HOSPITAL ASSOCIATION TOTALING $4,351 AND OTHER MINOR ACTIVITY OF $1,549 MAKING THE GRAND TOTAL OF DUES DIRECTED TOWARDS LOBBYING $11,053. 3765872 3765872 103565761 53252073 50313688 79102857 60608049 18494808 3186261 1128620 2057641 74632009 RETIREE HEALTHCARE BENEFITS 5656 DEFERRED COMPENSATION 1707722 LONG TERM INSURANCE 729377 FINANCE LEASE LIABILITY 300533 MEDICARE REFUNDABLES ADVANCES -7524762 DUE TO RELATED PARTIES 41643 -4739831 X PART X, LINE 2: ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 1008832 71906 936926 0.00670 23489392 15074786 8414606 0.05990 24498224 15146692 9351532 0.06660 7 811 208684 35696 172988 0.00120 2 6 13346 13346 0.00010 4 5078089 2288798 2789291 0.01990 1 11755 11755 0.00010 2 152800 89831 62969 0.00040 16 817 5464674 2414325 3050349 0.02170 16 817 29962898 17561017 12401881 0.08830 1 4619 4619 0.00000 1 382 4628 4628 0.00000 2 382 9247 9247 0.00000 167028 0 15328805 16679220 -1350415 X 1 1 1 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54495 ASPIRUS.ORG/FIND-A-LOCATION/ASPIRUS-RI WI #11 X X X ASPIRUS RIVERVIEW HOSPITAL & CLINICS IN 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES X 1 21 1 WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: INPUT WAS GATHERED FROM PERSONS WHO REPRESENT THE COMMUNITY IN THE FOLLOWING WAYS: (1) COMMUNITY-WIDE SURVEY. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. NUMEROUS ORGANIZATIONS INCLUDING UNITED WAY, YMCA, CHAMBERS OF COMMERCE, WOOD COUNTY HEALTH DEPARTMENT, AGING AND DISABILITY RESOURCE CENTER, SCHOOL DISTRICTS, COMMUNITY FOUNDATIONS, FOOD PANTRIES, COALITIONS AND MORE DISTRIBUTED THE SURVEY. ADDITIONALLY, COMMUNITY HEALTH WORKERS WORKING WITH COMMUNITIES OF COLOR AND AT MASS VACCINATION CLINICS DISTRIBUTED THE SURVEY. (2) KEY INFORMANT INTERVIEWS. NINE COMMUNITY LEADERS REPRESENTING GOVERNMENTAL PUBLIC HEALTH, YOUTH, OLDER INDIVIDUALS, INDIVIDUALS IN RECOVERY, INDIVIDUALS WHO ARE MORE VULNERABLE AND OTHER SECTORS WERE INTERVIEWED.(3) COMMUNITY STAKEHOLDER MEETINGS. TWO MEETINGS OF COMMUNITY STAKEHOLDERS WERE HELD. INVITED STAKEHOLDERS INCLUDED REPRESENTATIVES FROM THE HEALTH DEPARTMENT, EDUCATION, LAW ENFORCEMENT, BUSINESS, YOUTH PROGRAMMING, RECOVERY, UNIVERSITY OF WISCONSIN-EXTENSION, PUBLIC OFFICE AND OTHERS. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: MARSHFIELD CLINIC HEALTH SYSTEM (MARSHFIELD MEDICAL CENTER - MARSHFIELD) ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6B: WOOD COUNTY HEALTH DEPARTMENT ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT EFFORTS IN FY22 WERE SIGNIFICANTLY IMPACTED BY COVID-19 AND ITS RIPPLE EFFECT ON COMMUNITY OUTREACH AND PUBLIC EVENTS / PROGRAMS.MENTAL HEALTH AND SUBSTANCE USE (PREVIOUS CHNA AND MOST RECENT CHNA):THE ASPIRUS BEHAVIORAL HEALTH CLINIC IN WISCONSIN RAPIDS HAS CONTINUED TO GROW SINCE ITS SEPTEMBER 2018 START. IN 2022 AN ADDITIONAL PSYCHIATRIC PHYSICIAN ASSISTANT AND AN ADULT PSYCHIATRIST WERE ADDED TO THE TEAM TO ASSIST IN ADDRESSING THE INCREASING MENTAL HEALTH NEEDS IN THE COMMUNITY. MEDICATION ASSISTED TREATMENT (MAT) IS NOW PROVIDED BY THE ADULT PSYCHIATRIST THAT JOINED THE TEAM THIS PAST YEAR; A MEDICATION ASSISTED TREATMENT NURSE ALSO ASSISTS WITH CASE MANAGING THE MAT PATIENTS. A PLANNING GRANT TO EXPLORE THE OPTION OF A MOBILE MAT VAN/BUS WAS RECEIVED. SINCE COVID THE SYSTEM BEHAVIORAL HEALTH TEAM HAS SEEN REFERRALS DOUBLE IN NUMBERS. LEGACY FOUNDATION HAS PROVIDED TWO GRANTS TO THE CLINIC TO SUPPORT MENTAL HEALTH NEEDS IN THE WISCONSIN RAPIDS REGION; ONE GRANT FOR THE STARTUP OF THE CLINIC AND THE SECOND GRANT TO FUND MEDICATION ASSISTED TREATMENT STARTUP COSTS AND A PATIENT CARE FUND TO ASSIST WITH PATIENT'S FINANCIAL CONCERNS LIKE NOT BEING ABLE TO AFFORD MEDICATIONS. THE CLINIC HAS A PARTNERSHIP WITH THE WISCONSIN RAPIDS SCHOOL DISTRICT THAT PROVIDES ONSITE MENTAL HEALTH THERAPY ONE DAY A WEEK AND A MENTAL HEALTH NAVIGATOR FROM THE CLINIC ALSO SUPPORTS THE SCHOOL DISTRICT. THE CLINIC ALSO HAS A PARTNERSHIP WITH THE WOOD COUNTY JAIL; THE PARTNERSHIP PROVIDES TWO ONSITE THERAPISTS FIVE TO SIX DAYS A WEEK TO SUPPORT THE MENTAL HEALTH NEEDS OF INMATES.BOTH AN OUTSIDE GRANT AND THE ASPIRUS HEALTH FOUNDATION FINANCIALLY SUPPORTS RECOVERY COACHES. ASPIRUS ALSO PARTICIPATES IN THE COUNTY SUBSTANCE USE PREVENTION COALITION, IMPACT. ASPIRUS RIVERVIEW PROVIDES BEREAVEMENT SUPPORT. DURING THE PANDEMIC, SUPPORT WAS PROVIDED THROUGH A PRE-RECORDED BEREAVEMENT SERVICE, CARE PACKAGES AND REGULAR MAILINGS. ACTIVE COMMUNITIES AND COMMUNITY FOOD SYSTEMS (PREVIOUS CHNA):STARTING IN SPRING 2022, ASPIRUS BEGAN PARTICIPATING IN A NEW, COLLABORATIVE REGIONAL GRANT PROJECT THAT IS FOCUSED ON INCREASING FOOD EQUITY AT FARMERS MARKETS. ASPIRUS PROVIDES FUNDING FOR TWO COMMUNITY MEALS PER YEAR THROUGH THE NEIGHBORHOOD TABLE AND ALSO PROVIDES OVER A THOUSAND MEALS PER MONTH THROUGH ITS FOOD AND NUTRITION SERVICES DEPARTMENT. ASPIRUS PROVIDED SUPPORT TO THE WOOD COUNTY HEALTH DEPARTMENT (A) TO EXPAND CURRENT INITIATIVES AT THE FARMERS MARKET TO INCLUDE THE DOUBLE YOUR BUCKS PROGRAM WHICH ALLOWS THOSE WITH FOOD SHARE BENEFITS TO INCREASE THEIR SPENDING ON FRESH PRODUCE IN EFFORT TO INCREASE ACCESS TO HEALTHY FOOD AND (B) TO IMPLEMENT A FRUIT AND VEGETABLE PRESCRIPTION PROGRAM. ASPIRUS HEALTH, PRIMARILY THROUGH CARE MANAGEMENT, IMPLEMENTS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM ACROSS THE SYSTEM. PATIENTS WITH CHRONIC DISEASE ARE SCREENED FOR FOOD INSECURITY AND 'PRESCRIBED' FRUITS AND VEGETABLES. THE FVRX CAN BE USED LIKE CASH AT THE LOCAL FARMER'S MARKET. OVERALL: ASPIRUS RIVERVIEW HOSPITAL AND ASPIRUS RIVERVIEW FOUNDATION CONTRIBUTED TO THE PLANNING FOR A HMONG LEADERSHIP PROGRAM. THE PURPOSE OF THE PROGRAM WAS TO BUILD LEADERSHIP CAPACITY AND CONFIDENCE WITHIN INDIVIDUALS WHO ARE HMONG AND TO HOLD A SAFE SPACE FOR HMONG PROFESSIONALS, ASPIRING LEADERS, AND CURRENT LEADERS TO CONNECT. OVER THE NEXT THREE YEARS, ASPIRUS RIVERVIEW WILL FORMALLY ADDRESS THE FOLLOWING ISSUES THROUGH ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION STRATEGY: MENTAL HEALTH SUBSTANCE USE THE FOUR NEEDS THAT WERE NOT PRIORITIZED BY THE HOSPITAL ARE: SOCIAL DETERMINANT SOCIAL CONNECTEDNESS SOCIAL DETERMINANT TRANSPORTATION SOCIAL DETERMINANT FOOD SECURITY ACCESS TO CARE ORAL, MEDICAL, MENTAL THESE FOUR ISSUES WERE NOT SELECTED FOR A NUMBER OF REASONS. HOSPITAL LEADERS, IN REVIEWING THE TOP-IDENTIFIED ISSUES FROM THE STAKEHOLDER MEETING (MENTAL HEALTH, SUBSTANCE USE AND SOCIAL CONNECTEDNESS) NOTED THAT WHILE SOCIAL CONNECTEDNESS IS A SUBSTANTIAL ISSUE, HOSPITAL CAPACITY WAS LIMITED AND THAT SOCIAL CONNECTEDNESS CAN BE ADDRESSED AS PART OF THE STRATEGY TO IMPROVE MENTAL HEALTH AND SUBSTANCE USE. THE ISSUES OF TRANSPORTATION, FOOD SECURITY AND ACCESS TO CARE WERE RANKED MUCH LOWER BY COMMUNITY STAKEHOLDERS. STRATEGIES TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE MAY INCLUDE EFFORTS TO MEET TRANSPORTATION, FOOD INSECURITY AND ACCESS NEEDS. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 7 1 - ASPIRUS DOCTORS CLINIC 2031 PEACH STREET WISCONSIN RAPIDS WI 54494 CLINIC 2 - ASPIRUS CANCER CARE WISCONSIN RAPIDS 410 DEWEY STREET WISCONSIN RAPIDS WI 54495 CANCER CENTER 3 - ASPIRUS RIVERVIEW CLINIC WI RAPIDS 420 DEWEY STREET PO BOX 8080 WISCONSIN RAPIDS WI 54495 CLINIC 4 - APIRUS RIVERVIEW CLINIC NEKOOSA 1015 ANGELUS DRIVE NEKOOSA WI 54457 CLINIC 5 - ASPIRUS RIVERVIEW CLINIC ADAMS 419 N OAK STREET ADAMS WI 53910 CLINIC 6 - ASPIRUS RIVERVIEW CLINIC MARSHFIELD 146 N CENTRAL AVENUE MARSHFIELD WI 54449 CLINIC 7 - ASPIRUS RIVERVIEW DENTAL 820 TWO MILE AVENUE WISCONSIN RAPIDS WI 54494 DENTAL CLINIC PART I, LINE 3C: THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF: 1) 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. 2) 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. 3) TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 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 RIVERVIEW CLINIC ADAMS, ASPIRUS RIVERVIEW CLINIC NEKOOSA, AND BEHAVIORAL HEALTH CLINIC. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE ASPIRUS RIVERVIEW CLINIC ADAMS REPORTED COSTS OF $1,200,728 WITH OFFSETTING REVENUE OF $343,324. THE ASPIRUS RIVERVIEW CLINIC NEKOOSA REPORTED COSTS OF $1,841,105 WITH OFFSETTING REVENUE OF $1,357,725. THE BEHAVIORAL HEALTH CLINIC REPORTED COSTS OF $2,036,256 WITH OFFSETTING REVENUE OF $587,749. 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 $500,426. PART II, COMMUNITY BUILDING ACTIVITIES: ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. 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. ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC., 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 ORGANIZATION PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES INCLUDING: CARDIOLOGY, CANCER CENTER, CLINIC SERVICES, DENTAL SERVICES, DIAGNOSTIC IMAGING, BIRTHING CENTER, LABORATORY SERVICES, RESPIRATORY CARE, SLEEP LAB, WOMEN'S SERVICES, SURGICAL SERVICES, AND REHABILITATION SERVICES. 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 AMOUNT OF MEDICARE ALLOWABLE COSTS WAS TAKEN DIRECTLY FROM THE MEDICARE COST REPORT.WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY 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 HAVE THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNT LISTED FOR MEDICARE REVENUE DOES NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT ASPIRUS RIVERVIEW HOSPITAL, PHYSICIAN SERVICES PROVIDED AT THE OUTLYING CLINIC LOCATIONS, AND A SIGNIFICANT PORTION OF LAB SERVICES WHICH ARE REIMBURSED BY THE MEDICARE PROGRAM UNDER ANOTHER METHODOLOGY. PHYSICIAN COVERAGE AND OUTPATIENT LAB SERVICES ARE REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN 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 ASPIRUS RIVERVIEW HOSPITAL PROVIDES TO THE COMMUNITY AND THE SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY THE HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED BASED ON MEDICARE REGULATIONS. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES WOULD PRODUCE A LARGER LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR. 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: REPRESENTATIVES FROM ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. ACTIVELY PARTICIPATE IN HEALTHY PEOPLE WOOD COUNTY (HPWC). THE PURPOSE OF HPWC IS TO ESTABLISH PRIORITIES AND RECOMMEND STRATEGIES TO ENHANCE THE QUALITY OF LIFE, HEALTH STATUS, AND THE ENVIRONMENT IN WOOD COUNTY. IN ORDER TO ACCOMPLISH THIS, MULTIPLE PARTNERS WORK TOGETHER TO ANALYZE HEALTH DATA, QUALITY OF LIFE INDICATORS AND THE COMMUNITY'S PERCEPTION OF HEALTH. IN MARCH 2015, ASPIRUS RIVERVIEW BEGAN COLLABORATING WITH THE WOOD COUNTY PUBLIC HEALTH DEPARTMENT, MINISTRY SAINT JOSEPH'S HOSPITAL AND MARSHFIELD CLINIC ON A COMPREHENSIVE HEALTH NEEDS ASSESSMENT. HEALTH NEEDS ARE BEING DETERMINED AND PRIORITIZED THROUGH COMMUNITY SURVEYS, STAKEHOLDER FOCUS GROUPS AND RECENT HEALTH DATA. 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. PART VI, LINE 4: ASPIRUS RIVERVIEW HOSPITAL AND CLINICS OWNS AND OPERATES THE FOLLOWING ENTITIES: (1) ASPIRUS RIVERVIEW HOSPITAL; (2) THE OUTPATIENT ASPIRUS RIVERVIEW THERAPIES; (3) ASPIRUS RIVERVIEW CLINIC, THIS SERVICE INCLUDES CLINICS IN WISCONSIN RAPIDS, NEKOOSA, THE ROME-LAKES AREA, ADAMS CLINIC AND MARSHFIELD CLINIC ESTABLISHED IN 2021. (4) THE ASPIRUS CANCER CARE - WISCONSIN RAPIDS; AND (5) ASPIRUS RIVERVIEW DENTAL CLINIC. ASPIRUS RIVERVIEW ESTABLISHED THIS CLINIC IN 2009 TO SERVE RESIDENTS OF SOUTH WOOD COUNTY. RIVERVIEW DENTAL CLINIC IN WISCONSIN RAPIDS IS OPEN TO PATIENTS WHO HAVE MEDICAID OR BADGER CARE INSURANCE COVERAGE. THIS INSURANCE IS NOT TYPICALLY ACCEPTED BY INDEPENDENT DENTAL CLINICS. APPROXIMATELY 2,144 PERSONS BENEFITED FROM THIS PROGRAM IN FISCAL YEAR 2022. WHILE MANY RIVERVIEW PATIENTS COME FROM WOOD COUNTY, AN INCREASING NUMBER ARE COMING TO US FROM SURROUNDING COUNTIES - SPECIFICALLY THOSE ALONG THE INTERSTATE 39 CORRIDOR: MARATHON, PORTAGE, WAUPACA, ADAMS, JUNEAU, WAUSHARA, MARQUETTE, COLUMBIA, AND DANE. FOR THE UW CANCER CENTER-RIVERVIEW IN 2022, 25% OF ALL PATIENTS CAME FROM THESE SAME COUNTIES-NOT INCLUDING OUR "HOME" COUNTY OF WOOD. IN THE RIVERVIEW "SERVICE AREA" THERE ARE SEVERAL FEDERALLY DESIGNATED "MEDICALLY UNDERSERVED AREAS." THEY ARE WOOD COUNTY (THE CENTRAL PART BETWEEN MARSHFIELD AND WISC. RAPIDS), PORTAGE COUNTY (PART), ADAMS COUNTY (ALL), WAUSHARA COUNTY (ALL), MARQUETTE COUNTY (ALL), JUNEAU COUNTY (THE NORTHERN HALF), MARATHON COUNTY (PART), AND CLARK COUNTY (ALL). THERE ARE SCATTERED INDIAN TRIBAL LANDS IN WOOD COUNTY, JUNEAU COUNTY, AND ADAMS COUNTY (ALL HO CHUNK), THESE WOULD BE CONSIDERED "MEDICALLY UNDERSERVED POPULATIONS" PER FEDERAL DESIGNATION. OTHER HOSPITALS IN OUR SERVICE AREA INCLUDE MARSHFIELD MEDICAL CENTER IN MARSHFIELD, MINISTRY - ST. MICHAEL'S HOSPITAL IN STEVENS POINT, MOUNDVIEW MEMORIAL HOSPITAL IN FRIENDSHIP, AND HESS MEMORIAL HOSPITAL IN MAUSTON. PART VI, LINE 5: AS A COMMUNITY-BASED ORGANIZATION, ASPIRUS RIVERVIEW HOSPITAL & CLINICS 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 LOCAL ACCESS TO THESE PROGRAMS. THESE EFFORTS ARE PROVIDED THROUGH A VARIETY OF EDUCATIONAL SPEAKER FORUMS, SUPPORT GROUPS, HEALTH EDUCATION FORUMS, AND OTHER EDUCATIONAL OPPORTUNITIES FOR STUDENTS. PART VI, LINE 6: ASPIRUS RIVERVIEW 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 X 1 1 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1051076 0 1629342 0 3803 0 17346 0 248748 0 2950315 0 0 SIDNEY C SCZYGELSKI SVP & CHIEF FINANCIAL OFFICER 0 610115 0 177495 0 127769 0 20196 0 121430 0 1057005 0 112143 JOHN HEISLER SVP & CHIEF HUMAN RES. OFFICER 0 289961 0 426149 0 35874 0 13626 0 43024 0 808634 0 25179 JESSE TISCHER VICE CHAIR/SVP & PRES.-REG. MKTS. 0 501025 0 142821 0 539 0 11714 0 89935 0 746034 0 0 JENNY REDMAN- SCHELL TREASURER/SVP & PRES.-AMG 0 405520 0 113119 0 53815 0 17346 0 75318 0 665118 0 51368 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 0 357568 0 105424 0 53502 0 17346 0 79940 0 613780 0 50634 ERIC ANDERSON SVP-SERVICE LINE & PATIENT EXP. 0 382299 0 111001 0 1734 0 17346 0 86954 0 599334 0 0 RENEE SMITH EXECUTIVE DIRECTOR-ANI 0 315463 0 89914 0 54625 0 17346 0 76429 0 553777 0 53547 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 322706 0 94649 0 35374 0 16347 0 73601 0 542677 0 26065 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 399152 0 25600 0 25004 0 8700 0 80633 0 539089 0 0 BENJAMIN BARSOTTI CHIEF MEDICAL INFORMATION OFFICER 0 367202 0 65298 0 29946 0 17346 0 33420 0 513212 0 23406 CHRISTOPHER STINES PRESIDENT-ARH (THRU APR 22) 0 309424 0 109245 0 7268 0 12585 0 52849 0 491371 0 0 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 0 260587 0 127333 0 6207 0 16557 0 46300 0 456984 0 0 MICHAEL MCGRAIL FORMER KE/SVP & SYSTEM CMO 0 0 0 0 0 449085 0 0 0 0 0 449085 0 449085 BONITA KOLRUD MD BOARD MEMBER/OB/GYN PHYSICIAN 0 378987 0 600 0 8465 0 15759 0 29962 0 433773 0 0 WENDY ANGELO VP-CMO - POPULATION HEALTH 0 316829 0 44644 0 2384 0 7418 0 35344 0 406619 0 0 LISA ROWE-PEPLINSKI VP-CARE QUALITY & PAT. SAFETY 0 287310 0 55655 0 24237 0 17283 0 1595 0 386080 0 22695 PAUL VAN DEN HEUVEL VP-NETWORKS STRATEGY 0 302649 0 31790 0 6372 0 11252 0 33846 0 385909 0 0 RUTH RISLEY-GRAY SVP & SYSTEM CNO 0 213913 0 91534 0 24455 0 17417 0 35256 0 382575 0 19718 JON HARDESTY VP-CORP. HUMAN RESOURCES 0 249182 0 49445 0 27310 0 10120 0 33150 0 369207 0 21288 NANCY ROTH-MALLEK VP-FINANCE 223367 0 38193 0 1959 0 12914 0 33924 0 310357 0 0 0 KIMBERLY JOHNSON VP-PATIENT CARE & CNO 190082 0 35829 0 740 0 12930 0 32821 0 272402 0 0 0 LISA SKIBBA VP-ANCILLARY SERVICES 158371 0 30356 0 1444 0 10308 0 28274 0 228753 0 0 0 REBECCA PHILLIP DIRECTOR-PHARMACY 185112 0 16535 0 490 0 11321 0 13405 0 226863 0 0 0 STACI SOVA NURSE PRACTITIONER 180041 0 750 0 4664 0 6198 0 33841 0 225494 0 0 0 PART I, LINE 1A PAUL VAN DEN HEUVEL ($4,050) HAD A TAXABLE HOUSING ALLOWANCE. PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. 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 SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: J. HARDESTY $21,288 S. SCZYGELSKI $112,143 B. BARSOTTI $23,406 J. MATHESON $26,065 J. REDMAN-SCHELL $51,368 J. HEISLER $25,179 L. ROWE-PEPLINSKI $22,695 M. MCGRAIL $449,085 R. SMITH $53,547 R. RISLEY-GRAY $19,718 T. RICHARDSON $50,634 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; 24 MONTHS FROM THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DMG8 2015-05-07 26748065 REFINANCE 2008 BOND 1 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DMG9 2015-05-07 18738269 REFINANCE 2010 BOND 1 0 0 C WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DC53 2017-11-02 15000000 NEW CONSTRUCRTION 0 0 0 A 510000 26748065 26380444 367621 2011 0 1 1 1 B 960000 18738269 18615377 122892 2011 0 1 1 1 C 310000 15000000 167011 14832989 2019 0 0 0 1 A 0 0 1 0 0 0 0 1 B 0 1 1 0 0 0.00200 0.00200 0 0 1 C 0 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 PART III - LINE 3A AND 3B: ASPIRUS, INC. THE PARENT ORGANIZATION OF ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. HAS POLICY AND PROCEDURES IN PLACE TO REVIEW MANAGEMENT AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2015 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982), ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. (EIN 38-3236977), AND ASPIRUS KEWEENAW HOSPITAL (EIN 38-1443361). INFORMATION REGARDING THE SERIES 2015 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION, RESPECTIVELY. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2015 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2015 BONDS.] PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2017 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND ASPIRUS ONTONAGON HOSPITAL, INC. (EIN 26-0806477). INFORMATION REGARDING THE SERIES 2017 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2017 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2017 BONDS.] PART III, LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THERE SHALL BE A MINIMUM OF 10 VOTING DIRECTORS ALLOCATED AS FOLLOW. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS, 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. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE DIRECTORS OF THE ORGANIZATION: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR 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 ACCUMULATED ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 990-T ARE REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C 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, ASPIRUS RIVERVIEW HOSPITAL & CLINIC, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 281,733. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 281,733. LAB FEES: PROGRAM SERVICE EXPENSES 3,096,024. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,096,024. FOOD SERVICE: PROGRAM SERVICE EXPENSES 99,545. MANAGEMENT AND GENERAL EXPENSES 45,235. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 144,780. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 217,040. MANAGEMENT AND GENERAL EXPENSES 9,480. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,520. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,980,163. MANAGEMENT AND GENERAL EXPENSES 259,733. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,239,896. CONTRACTED NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 10,061,702. MANAGEMENT AND GENERAL EXPENSES 488,395. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,550,097. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS - AWH 1,140,031. INTERCOMPANY TRANSFERS - AI -39,559,967. INTERCOMPANY TRANSFERS - ACI 1,873,075. INTERCOMPANY TRANSFERS - VNA -10,727. INTERCOMPANY TRANSFERS - AIW 18,795. INTERCOMPANY TRANSFERS - AIR -180. INTERCOMPANY TRANSFERS - ADS -21,069. INTERCOMPANY TRANSFERS - AKH -7,927. INTERCOMPANY TRANSFERS - ASP 162,341. INTERCOMPANY TRANSFERS - ASH -276. INTERCOMPANY TRANSFERS - AMR 1,825. INTERCOMPANY TRANSFERS - ARN 7,422. INTERCOMPANY TRANSFERS - HYMC 988. INTERCOMPANY TRANSFERS - PNW BB -1,599. POSTRETIREMENT BENEFIT ADJUSTMENT -6,214. 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