2025-05-15T10:51:25-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 391390638 ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS INC ASPI 7153612000 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7158472250 2025-05-15 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-05-15 2023 2025-03-06 01:10:19Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 302023264 0 X WWW.ASPIRUS.ORG X 1981 WI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 10 6 1005 3 0 0 758211 367827 232268990 299138812 -849647 -68537 365481 406394 232543035 299844496 43638 33704 0 0 115490766 115781260 0 0 0 125321824 179759050 240856228 295574014 -8313193 4270482 133447495 138612489 80866363 75537952 52581132 63074537 X WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 258096920 33704 299138812 ASPIRUS RHINELANDER HOSPITAL IS A 49-BED HOSPITAL CAMPUS, AND ASPIRUS TOMAHAWK HOSPITAL IS A 15-BED CAMPUS, BOTH OF WHICH PROVIDE SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2024, ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS SERVICED THE COMMUNITY THROUGH A TOTAL OF APPROXIMATELY 12,086 PATIENT DAYS OF SERVICE AND 612 SWING BED DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES FOR APPROXIMATELY 239,470 OUTPATIENT VISITS, WHICH INCLUDED APPROXIMATELY 4,552 OUTPATIENT SURGERIES AND APPROXIMATELY 19,474 EMERGENCY ROOM VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS.BEGINNING IN DECEMBER OF 2021, THE VARIOUS ASPIRUS CLINICS IN THE REGION WERE ALL REORGANIZED SO THAT THEY WERE INCLUDED UNDER ASPIRUS RHINELANDER HOSPITAL. 258096920 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1005 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JESSE TISCHER V.C. (THRU 01/24)/SVP & PRES.-AWH 1.00 50.00 X X 0 764397 116000 ERIC ANDERSON BOARD MEMBER/CHIEF COMPL. OFFICER 1.00 50.00 X 0 498735 99668 CONSTANCE BRADLEY VICE CHAIR/SVP & PRES. REG. MRKTS. 1.00 50.00 X X 0 489478 90167 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X X 0 222942 12956 AMY SLETTE MD BOARD MEMBER (THRU 09/23)/PHYSICIAN 1.00 40.00 X 0 186437 32505 HOLLY BEEDE-MCKINNEY NP BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 161284 5346 JUDY SMOLAREK CHAIR 1.00 2.00 X X 0 0 0 KELLY COURT SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 KATE FERREL BOARD MEMBER 1.00 2.00 X 0 0 0 FATHER JIM FOSDICK BOARD MEMBER (THRU 09/23) 1.00 2.00 X 0 0 0 ARTHUR C HELGERSON DDS BOARD MEMBER (THRU 07/23) 1.00 2.00 X 0 0 0 RYAN HUSEBY BOARD MEMBER 1.00 2.00 X 0 0 0 RON PATTERSON BOARD MEMBER 1.00 2.00 X 0 0 0 DEAN POLLNOW MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 394693 0 38643 AMY VANNEY BOARD MEMBER 1.00 2.00 X 0 0 0 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 TERESA THEILER (NV) PRESIDENT-ASPIRUS N. WI DIV. 1.00 50.00 X 0 368058 77114 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 688935 115911 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 522951 102957 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 510162 34165 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 2.00 50.00 X 0 310701 47434 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 316286 37986 ANDREA ALLARD VP-OPERATIONS 2.00 50.00 X 0 293965 10421 ANTHONY RUTKOWSKI RADIOLOGIST 40.00 X 1005294 0 47939 STEVEN BROWN RADIOLOGIST 40.00 X 881887 0 47832 JOHNATHAN CURRIE RADIOLOGIST 40.00 X 854240 0 49375 SANDIP GHUGE MEDICAL DIRECTOR 40.00 X 834479 0 53394 ABIGAIL TAUB PHYSICIAN 40.00 X 841774 0 35381 4812367 9267274 1619958 176 0 1 0 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACT LABOR 4377086 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PHYSICIAN SERVICES 2297604 DAILY CARE LLC 323 N MORRISON ST STE 100 APPLETON WI 54911 PHYSICIAN SERVICES 1328227 HAYES LOCUMS LLC PO BOX 844543 DALLAS TX 752844543 PHYSICIAN SERVICES 1167093 MEDICAL STAFFING SOLUTIONS INC PO BOX 101 RICE LAKE WI 54868 CONTRACT LABOR 1047715 20 9000 312495 46332 367827 PATIENT SERVICE REVENUE 621990 242846688 242846688 PHARMACY REVENUE 456110 55475459 55475459 CONTRACT SERVICE REVENUE 900099 755724 755724 60941 60941 299138812 203838 0 203838 203838 203838 2110231 2178768 -68537 -68537 -68537 CAFETERIA/VENDING REVENUE 722514 202556 202556 202556 299844496 299138812 0 337857 X 33704 33704 468067 468067 96207184 89280986 6926198 2910592 2578201 332391 10960277 9702915 1257362 5235140 4633130 602010 21400 21400 33655034 26291533 7363501 35022 27979 7043 313857 305510 8347 122292 98018 24274 3491192 399671 3091521 256920 200772 56148 27606 17961 9645 2430818 642114 1788704 11498271 5188464 6309807 268595 28473 240122 MEDICAL SUPPLIES 77737671 76403310 1334361 CORPORATE ALLOCATIONS 35278747 29138045 6140702 BAD DEBT 5706747 5701975 4772 REPAIRS AND MAINTENANCE 4499937 3471615 1028322 4414941 3484477 930464 295574014 258096920 37477094 0 11507 11507 483297 481395 28802082 32802562 5078758 6407640 289761 114172 108272659 22494344 89711623 85778315 272756 286973 8797711 12729925 133447495 138612489 10011497 5644171 69559538 67914385 1295328 1979396 80866363 75537952 X 52308376 62756449 272756 318088 52581132 63074537 133447495 138612489 X 4270482 6222923 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 21400 21400 0 PART II-B, LINE 1: ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND WHA HAVE NOTIFIED THE HOSPITAL THAT APPROXIMATELY $21,400 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 6037016 6037016 77995496 8658718 69336778 17944 15497 2447 22627782 13820129 8807653 1594421 1594421 85778315 340B RECEIVABLE 188549 OPERATING LEASE ASSET 22320 DUE FROM AFFILIATES 154303 ESTIMATED THIRD PARTY PAYOR SETTELEMENTS RECEIVABLE 11110254 FINANCE LEASE ASSET 1254499 12729925 DUE TO AFFILIATES 328091 ESTIMATED THIRD PARTY PAYOR PAYABLES 332661 FINANCE LEASE LIABILITY 1318644 1979396 X PART X, LINE 2: ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2024. 1 1 X 1 X 1 X 1 1 1 0 1 1 1015293 1015293 0.00350 32663682 16304167 16359515 0.05640 33678975 16304167 17374808 0.05990 78233 78233 0.00030 99339 99339 0.00030 33704 33704 0.00010 211276 211276 0.00070 33890251 16304167 17586084 0.06060 1 1927062 0 31277563 34905544 -3627981 X 1 1 2 1 ASPIRUS RHINELANDER HOSPITAL 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 138 X X X 2 ASPIRUS TOMAHAWK HOSPITAL 401 WEST MOHAWK DRIVE TOMAHAWK WI 54487 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 1016 X X X X ASPIRUS RHINELANDER HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 23 1 WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS TOMAHAWK HOSPITAL 2 1 0 1 X X X X X X X X X 22 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 23 1 WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS RHINELANDER HOSPITAL PART V, SECTION B, LINE 5: AS PART OF THE ASPIRUS EAGLE RIVER HOSPITAL, ASPIRUS RHINELANDER HOSPITAL AND HOWARD YOUNG MEDICAL CENTER'S FY23 (SPRING 2023) COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, MULTIPLE OPPORTUNITIES FOR COMMUNITY INPUT WERE CONDUCTED. ALL INPUT OPPORTUNITIES WERE LED BY ONEIDA COUNTY HEALTH DEPARTMENT WITH COLLABORATION BY VILAS COUNTY HEALTH DEPARTMENT, FOREST COUNTY HEALTH DEPARTMENT, MARSHFIELD CLINIC HEALTH SYSTEM AND ASPIRUS. THE UNIVERSITY OF WISCONSIN-STOUT WAS CONTRACTED FOR SOME OF THE COMMUNITY INPUT OPPORTUNITIES. COMMUNITY SURVEYA COMMUNITY SURVEY WAS CONDUCTED IN WINTER 2022-23. THE SURVEY WAS DEVELOPED AND DISSEMINATED BY THE COMMUNITY PARTNERS LISTED ABOVE. SPECIFIC OUTREACH WAS MADE TO INDIVIDUALS: IN THE LGBTQ+ COMMUNITY; WHO ARE HISPANIC; IN RECOVERY; ACCESSING FOOD PANTRIES; ACCESSING HOMELESS SHELTERS; ACCESSING AGING AND DISABILITY RESOURCE CENTER SERVICES; ATTENDING THE LOCAL COLLEGE; ACCESSING DAY CARE SERVICES; ACCESSING LIBRARY SERVICES; ACCESSING WIC NUTRITION SERVICES; AND OTHERS. KEY INFORMANT INTERVIEWSAPPROXIMATELY 35 KEY INFORMANT INTERVIEWS WERE CONDUCTED IN EARLY 2023. INTERVIEW QUESTIONS FOCUSED ON THE ORGANIZATIONS' LEADERS' PERCEPTIONS OF NEEDS AND BARRIERS FOR THE POPULATION THEY SERVED. KEY INFORMANTS WERE FROM SCHOOLS, LAW ENFORCEMENT, HUMAN SERVICE CENTERS, SUBSTANCE USE RECOVERY ORGANIZATIONS, HEALTH DEPARTMENTS, LIBRARIES, FOOD PANTRIES, JOB SERVICES, HEALTH CARE, ELECTED OFFICIALS AND MORE. LEADERS FROM MULTIPLE BANDS OF AMERICAN INDIANS WERE ALSO INTERVIEWED. FOCUS GROUPS NINE FOCUS GROUPS WERE COMPLETED AND RESULTS WERE ANALYZED BY UW-STOUT, HOWEVER, THE FOCUS GROUP RESULTS WERE NOT AVAILABLE AT THE TIME OF THE HOSPITALS' PRIORITIZATION PROCESS. ASPIRUS TOMAHAWK HOSPITAL PART V, SECTION B, LINE 5: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), COMMUNITY MEMBERS FROM LINCOLN COUNTY PROVIDED INPUT ON THE TOP COMMUNITY HEALTH NEEDS THROUGH A COMMUNITY SURVEY, KEY INFORMANT INTERVIEWS, A COMMUNITY FORUM AND A COALITION PRIORITIZATION PROCESS. THE COMMUNITY SURVEY WAS COMPLETED BY 752 ADULTS IN FALL 2022 (SEPTEMBER-OCTOBER). THE SURVEY WAS DISTRIBUTED BY MULTIPLE COMMUNITY PARTNERS INCLUDING THE HEALTH DEPARTMENT, SOCIAL SERVICE AGENCIES, AND MORE. RESPONDENTS WERE ASKED ABOUT THEIR TOP COMMUNITY HEALTH CONCERNS AS WELL AS THE STRENGTHS OF THE COMMUNITY. TO FILL SOME GAPS NOTICED IN THE SURVEY, FIVE KEY INFORMANT INTERVIEW RESULTS WERE CONDUCTED IN NOVEMBER 2022. REPRESENTED SECTORS INCLUDED MANUFACTURING, AGENCIES SERVING VULNERABLE POPULATIONS, COMMUNITY ORGANIZATIONS, YOUTH GROUP, AND COMMUNITY LEADER. INTERVIEW QUESTIONS WERE ABOUT COMMUNITY STRENGTHS, CHALLENGES, OPPORTUNITIES AND THREATS. A COMMUNITY FORM WAS HELD IN JANUARY 2023 TO REVIEW DATA AND ROOT CAUSES OF HEALTH ISSUES. OVER 60 COMMUNITY STAKEHOLDERS WERE INVITED. THE LINCOLN COUNTY HEALTH DEPARTMENT FACILITATED AND CONTRIBUTED TO THE DISCUSSION. LASTLY, THE LIVE WILL LINCOLN PARTNERS LINCOLN COUNTY HEALTH DEPARTMENT, UNIVERSITY OF WISCONSIN-EXTENSION, ASPIRUS, LINCOLN COUNTY DEPARTMENT OF SOCIAL SERVICES AND THE AGING AND DISABILITY RESOURCE CENTER MET REGULARLY TO REVIEW DATA, SHAPE THE PROCESS AND FINALIZE THE RESULTS. ASPIRUS RHINELANDER HOSPITAL PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), THE HOSPITAL COLLABORATED WITH ASPIRUS EAGLE RIVER HOSPITALS, HOWARD YOUNG MEDICAL CENTER (PART OF ASPIRUS), AND MARSHFIELD MEDICAL CENTER-MINOCQUA. ASPIRUS TOMAHAWK HOSPITAL PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), ASPIRUS TOMAHAWK HOSPITAL COLLABORATED WITH ASPIRUS MERRILL HOSPITAL. ASPIRUS RHINELANDER HOSPITAL PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), ASPIRUS RHINELANDER HOSPITAL COLLABORATED WITH THE FOREST COUNTY HEALTH DEPARTMENT, THE ONEIDA COUNTY HEALTH DEPARTMENT AND THE VILAS COUNTY HEALTH DEPARTMENT. ASPIRUS RHINELANDER HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS RHINELANDER HOSPITAL. ASPIRUS TOMAHAWK HOSPITAL PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY23 (SPRING 2023), ASPIRUS TOMAHAWK HOSPITAL COLLABORATED WITH THE LINCOLN COUNTY HEALTH DEPARTMENT. ASPIRUS TOMAHAWK HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS TOMAHAWK HOSPITAL. ASPIRUS RHINELANDER HOSPITAL PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. THE HOSPITAL IS IN RURAL NORTHERN WISCONSIN. BECAUSE OF THAT SETTING, COMMUNITY HEALTH EFFORTS ARE FREQUENTLY COMPLETED WITH OTHER REGIONAL PARTNERS, INCLUDING OTHER ASPIRUS HOSPITALS. THE FOLLOWING DESCRIPTIONS ARE REFLECTIVE OF ASPIRUS RHINELANDER, ASPIRUS EAGLE RIVER AND HOWARD YOUNG MEDICAL CENTER (ALSO WITH ASPIRUS) UNLESS OTHERWISE INDICATED. IN FY24, ASPIRUS RHINELANDER'S SIGNIFICANT NEEDS WERE: MENTAL HEALTH; SUBSTANCE USE. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. IN PART DUE TO THE KNOWLEDGE AND CAPACITY THAT THE RHINELANDER-BASED ASPIRUS KOLLER BEHAVIORAL HEALTH UNIT (PART OF THE HEALTH CARE SYSTEM) BRINGS TO THE AREA, THE HOSPITALS ARE A STRONG AND VALUED RESOURCE FOR COMMUNITY MENTAL HEALTH AND SUBSTANCE USE PREVENTION EFFORTS. STAFF EXPERTISE IS SHARED INTERNALLY AS WELL AS EXTERNALLY. EFFORTS ARE DESCRIBED BELOW. COALITION: ASPIRUS STAFF PARTICIPATED IN COMMUNITY OUTREACH PREVENTION EDUCATION (COPE), WHICH IS THE REGION'S MENTAL HEALTH AND SUBSTANCE USE COALITION. ASPIRUS KOLLER BEHAVIORAL HEALTH STAFF CO-CHAIR THE MENTAL HEALTH AND SUICIDE PREVENTION SUBCOMMITTEE OF THE COALITION. SUBCOMMITTEE ACTIVITIES ARE DESCRIBED BELOW. - THE SUBCOMMITTEE CONDUCTED A NUMBER OF ACTIVITIES, INCLUDING: DEVELOPING A STRATEGY AROUND REDUCED ACCESS TO SUICIDE MEANS; PROMOTING AWARENESS (E.G., FOR MAY MENTAL HEALTH MONTH, SEPTEMBER SUICIDE PREVENTION WEEK, AND WORLD MENTAL HEALTH DAY (OCTOBER). - QUESTION, PERSUADE, REFER (QPR) TRAININGS FOCUSED ON SUICIDE PREVENTION WERE COORDINATED BY THE SUBCOMMITTEE. OVER 80 PEOPLE WERE TRAINED IN QPR IN FY24. SOME OF THE PEOPLE TRAINED DURING THIS YEAR INCLUDED PHARMACY STAFF, MEDICAL STAFF, AND COMMUNITY MEMBERS. - THE SUBCOMMITTEE CREATED AND DISTRIBUTED 988 STICKERS TO PHARMACIES IN THE NORTHERN REGION. 988 IS THE NATIONAL MENTAL HEALTH CRISIS LINE NUMBER. THE STICKERS WERE PLACED ON EACH PHARMACY BAG TO PROMOTE THE NEW 988 CRISIS LINE WITH THE QR CODE FOR MENTAL AND HEALTH AND SUBSTANCE USE/ABUSE SUPPORT AVAILABLE 24/7. - THE COALITION LEADERS COLLABORATED WITH HEADS UP GUYS (AN ONLINE PLATFORM WITH TOOLS AND RESOURCES FOCUSED ON MEN'S MENTAL HEALTH) AND THE WISCONSIN 988 MANAGER TO CREATE BAR COASTERS FOR NORTHERN WISCONSIN. THE COASTERS ARE A WAY TO REACH MEN 25 AND OLDER TO PROVIDE THEM WITH A RESOURCE WHEN THEY ARE IN NEED OF SUPPORT. THE COASTERS HAVE A QR CODE FOR HEADS UP GUYS AND WILL BRING THE INDIVIDUALS DIRECTLY TO THE HEADS UP GUYS WEBSITE. PRIOR TO INITIATING THE CAMPAIGN, LEADERS FROM THE COALITION (INCLUDING FROM ASPIRUS) MET WITH EACH OF THE TAVERN LEAGUE PRESIDENTS IN FOREST, ONEIDA, AND VILAS TO SHARE THE IDEA AND OBTAIN THEIR SUPPORT. THE COALITION LEADERS THEN ATTENDED EACH OF THE TAVERN LEAGUE MEETINGS TO DISCUSS THE CAMPAIGN AND THE RESOURCE. THE COALITION LEADERS ALSO SHARED MENTAL HEALTH AND SUICIDE WARNING SIGNS, RISK FACTORS, AND RESOURCES TO SUPPORT ANY PATRON THE TAVERN LEAGUE MEMBERS MAY BE CONCERNED ABOUT. IN FY24, ASPIRUS KOLLER BEHAVIORAL HEALTH STAFF ALSO:- WORKED WITH THE LOCAL AFFILIATE OF A MAJOR NEWS NETWORK TO PROVIDE INTERVIEWS, CREATE A SERIES OF PSAS AND CREATE YOUTUBE REEL ANNOUNCEMENTS ON MENTAL HEALTH CONCERNS.- INTERVIEWED WITH A LOCAL MEDIA AFFILIATE ON MENTAL HEALTH INITIATIVES/TOPICS.- INITIATED PLANNING FOR THE MENTAL HEALTH SUMMIT TO BE HELD IN MAY 2025. THE SUMMIT FEATURES NATIONAL AND LOCAL PRESENTERS. THE SUMMIT IS OPEN TO PROFESSIONALS AND COMMUNITY MEMBERS.- IMPLEMENTED 988 STICKERS ON ASPIRUS PHARMACY BAGS AS A WAY TO OFFER HOPE IN THE EVENT THAT SOMEONE WAS INTENDING TO USE MEDICATIONS AS A MEANS OF SUICIDE. THIS MESSAGE WAS PERMANENTLY BRANDED ON ASPIRUS PHARMACY BAGS IN WISCONSIN.- APPLIED FOR AND RECEIVED A COUNSELING ON ACCESS TO LETHAL MEANS (CALM) GRANT. THE GRANT FOCUSES ON MEN AGED 25 AND OVER. GRANT ACTIVITIES INCLUDE PROVIDING EDUCATION TO BEHAVIORAL HEALTH STAFF IN THE NORTH AND SOUTH REGIONS ON SAFE STORAGE OF WEAPONS. THE GRANT INCLUDED FUNDING FOR LOCK BOXES AND CABLE LOCKS. ASPIRUS WILL APPLY FOR THE SECOND YEAR OF FUNDING. -PROVIDED DIALECTICAL BEHAVIOR THERAPY (DBT) GROUPS TO ADOLESCENTS AND ADULTS AT KOLLER BEHAVIORAL HEALTH AND NOW HAS AN ACTIVE DBT GROUP AT RHINELANDER HIGH SCHOOL FOR STUDENTS.ASPIRUS HEALTH OFFERS THE RAISE YOUR VOICE PROGRAM IN MULTIPLE COMMUNITIES, INCLUDING IN THIS REGION. RAISE YOUR VOICE IS A STUDENT CLUB THAT INCREASES THE AWARENESS OF MENTAL HEALTH. THE PROGRAM IS CO-SPONSORED BY THE NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI). WITH ASPIRUS FUNDING OVER THE LAST FEW YEARS, MANY CLUBS WERE ACTIVE IN THE REGION DURING THE 2023-24 SCHOOL YEAR. OTHER- EACH OF THE THREE HOSPITALS OFFERED 'FIT FOR LIFE' EXERCISE CLASSES IN A SUPERVISED SETTING FOR CARDIAC REHAB PATIENTS WHO HAVE COMPLETED THEIR TREATMENT PLAN. - ASPIRUS OFFERS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM FOR ELIGIBLE PATIENTS IN THIS REGION. A VOUCHER IS GIVEN TO PATIENTS TO PURCHASE FRUITS AND VEGETABLES FROM LOCAL FARMERS. THE PROGRAM ALSO PROVIDES NUTRITION INFORMATION AND ACCESS TO RECIPES. DURING THE 2024 SEASON, OVER 700 VOUCHERS WERE DISTRIBUTED ACROSS THE SYSTEM. - HEALTHCARE SYSTEMS AND HOSPITALS HAVE NEW REQUIREMENTS TO SCREEN PATIENTS FOR SOCIAL NEEDS, IDENTIFY ANY NEEDS, AND REFER TO COMMUNITY RESOURCES. ASPIRUS CONTRACTS WITH A RESOURCE PLATFORM TO BETTER CONNECT PATIENTS WITH RESOURCES. - ASPIRUS RHINELANDER HOSPITAL BEGAN DONATING FOOD FROM THE CAFETERIA TO THE FOOD PANTRY. ASPIRUS RHINELANDER HOSPITAL HAS A BIRTHING CENTER. IN ADDITION TO PROVIDING CLINICAL SERVICES, THE BIRTHING CENTER AND CLINIC STAFF ALSO PROVIDE COMMUNITY PROGRAMS.- CAR SEAT SAFETY. TWO STAFF ARE CHILD PASSENGER SAFETY TECHNICIANS (CPST). STAFF PROVIDE CAR SEAT EDUCATION, INSPECTION/INSTALLATION, SAFETY BROCHURES AND SAFETY CHECKS. THE CLINIC AND BIRTHING CENTER ARE ABLE TO PROVIDE FREE CAR SEATS TO THOSE WHO MEET ELIGIBILITY (THIS IS THROUGH A GRANT SHARED WITH THE ONEIDA COUNTY HEALTH DEPARTMENT).- BREASTFEEDING. THE BIRTHING CENTER HAS ONE INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT (IBCLC) AND ONE CERTIFIED LACTATION CONSULTANT (CLC) AVAILABLE TO MEET WITH PATIENTS TO ASSIST WITH LACTATION NEEDS/QUESTIONS. ALL REMAINING BIRTHING CENTER STAFF HAVE BREASTFEEDING EDUCATION AND ARE ABLE TO ASSIST WITH BREASTFEEDING. ALL BIRTHING CENTER PATIENTS ARE PROVIDED WITH AN INJOY BOOKLET ON BREASTFEEDING (ASPIRUS SYSTEM STANDARD). THE BIRTHING CENTER HAS A SUPPLY OF BREAST PUMPS THAT THEY ARE ABLE TO PROVIDE AND SUBMIT TO PATIENT INSURANCE TO ENSURE PATIENTS HAVE THE NECESSARY EQUIPMENT NEEDED FOR LACTATION IF NEEDED. STAFF ATTENDED A COMMUNITY EVENT TO SHARE INFORMATION ON NUTRITION AND BREASTFEEDING TO NEW AND EXPECTING PARENTS. *****************************************OVER THE NEXT THREE YEARS, ASPIRUS EAGLE RIVER, ASPIRUS RHINELANDER AND HOWARD YOUNG MEDICAL CENTER WILL FORMALLY ADDRESS THE FOLLOWING ISSUES THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION STRATEGY: MENTAL HEALTH; SUBSTANCE USE.THE HOSPITAL EXECUTIVE TEAM DISCUSSED TWO ADDITIONAL POTENTIAL PRIORITIES. THESE ISSUES WERE IDENTIFIED AS TOP ISSUES IN THE KEY INFORMANT INTERVIEWS AND THE SURVEY. THE ISSUES WERE: ACCESS TO CARE; AGING ISSUES. THESE ISSUES WERE NOT PRIORITIZED FOR THE FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE FOLLOWING REASONS. - MOMENTUM AND ALIGNMENT. THE TWO AREAS WITH THE HIGHEST MOMENTUM AND ALIGNMENT WITH OTHERS ARE MENTAL HEALTH AND SUBSTANCE USE. - CAPACITY. THE HOSPITALS AND CLINICS HAVE LIMITED CAPACITY. CHOOSING ONLY TWO PRIORITY AREAS ALLOWS ASPIRUS TO FOCUS ITS EFFORTS. ADDITIONALLY, ASPIRUS HAS A STRONG BEHAVIORAL HEALTH SERVICE LINE. - CURRENT ACTIVITY. ACCESS TO CARE IS WHAT ASPIRUS DOES AS ITS MAIN SERVICE. THE HOSPITALS AND CLINICS WILL CONTINUE TO PROVIDE ACCESS TO CARE REGARDLESS OF IT BEING A CHNA PRIORITY. - INTERSECTION. THERE ARE SOME MENTAL HEALTH AND SUBSTANCE USE ISSUES THAT INTERSECT WITH AGING AND ACCESS TO CARE. ASPIRUS WILL CONTINUE TO ADVANCE THOSE EFFORTS. ASPIRUS TOMAHAWK HOSPITAL PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. IN FY24, ASPIRUS TOMAHAWK HOSPITAL'S SIGNIFICANT NEEDS WERE: COMMUNITY-CENTERED RESOURCES FOR THE 55+ POPULATION; HEALTHY LIFESTYLES; MENTAL AND EMOTIONAL WELL-BEING. THESE NEEDS WERE IDENTIFIED THROUGH THE MOST RECENT CHNA, COMPLETED IN JUNE 2023. THE HOSPITAL ADDRESSED THOSE NEEDS IN THE FOLLOWING WAYS. COMMUNITY-CENTERED RESOURCES FOR THE 55+ POPULATION THE HOSPITAL OFFERED 'FIT FOR LIFE' EXERCISE CLASSES IN A SUPERVISED SETTING FOR CARDIAC REHAB PATIENTS WHO HAVE COMPLETED THEIR TREATMENT PLAN. HEALTHY LIFESTYLESASPIRUS TOMAHAWK ACTIVELY PARTICIPATED IN THE LINCOLN COUNTY NUTRITION COALITION. THE HOSPITAL AND/OR COALITION CONDUCTED A NUMBER OF NUTRITION AND HEALTHY FOOD-RELATED EFFORTS IN FY24, INCLUDING TWO HEALTHY COOKING DEMONSTRATIONS. APPROXIMATELY 20 FAMILIES WITH CHILDREN ENROLLED IN HEADSTART AND FAMILIES WHO WERE WIC (WOMEN, INFANT, CHILDREN)-ELIGIBLE, PARTICIPATED. PARTICIPANTS RECEIVED APPLIANCES (E.G., HAND MIXERS) AS PART OF THE DEMONSTRATIONS. A FEW COOKBOOKS WERE ALSO GIVEN AWAY. ASPIRUS TOMAHAWK HOSPITAL CONTINUES TO SUPPORT THE- TRIPLE-YOUR-BUCKS COUPONS AND THE ELECTRONIC BENEFIT TRANSFER (EBT) MACHINE FEES AT THE LOCAL FARMERS MARKET. THE COUPONS ARE SPECIFICALLY FOR INDIVIDUALS WHO PARTICIPATE IN THE FOODSHARE PROGRAM. THE AVAILABILITY OF THE EBT MACHINE INCREASES THE ACCESSIBILITY OF THE MARKET FOR INDIVIDUALS PARTICIPATING IN FOODSHARE. ASPIRUS TOMAHAWK OFFERS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM FOR ELIGIBLE PATIENTS. A VOUCHER IS GIVEN TO PATIENTS TO PURCHASE FRUITS AND VEGETABLES FROM LOCAL FARMERS. THE PROGRAM ALSO PROVIDES NUTRITION INFORMATION AND ACCESS TO RECIPES. DURING THE 2024 SEASON, OVER 700 VOUCHERS WERE DISTRIBUTED ACROSS THE SYSTEM. MENTAL AND EMOTIONAL WELL-BEINGASPIRUS TOMAHAWK IS AN ACTIVE PARTICIPANT IN THE COUNTY'S MENTAL HEALTH AND AODA COALITION. THE COALITION PARTNERS HAVE COMPLETED MANY ACTIVITIES, SOME OF WHICH THE HOSPITAL FUNDED. ACTIVITIES INCLUDED: - PUBLIC AWARENESS AND SOCIAL NORMS CAMPAIGNS (E.G., HOPELINE, SMALL TALKS, KNOW METH, ADVERSE CHILDHOOD EXPERIENCES [ACES], PARENT PACT, SOCIAL HOST AWARENESS). THE NEW NATIONAL MENTAL HEALTH HOTLINE 988 WAS PROMOTED. THE HOSPITAL FUNDED THE BILLBOARD PROMOTION OF THE COUNTY MENTAL HEALTH RESOURCE GUIDE. - COMMUNITY PRESENTATIONS ABOUT MENTAL HEALTH AND SUBSTANCE ABUSE. - THE DISTRIBUTION OF POSTERS, CARDS, AND RELATED VISUAL MATERIALS (E.G., SUICIDE PREVENTION HOTLINE POSTERS). - FAMILY FUN PACKS THAT PROVIDED FAMILIES WITH ACTIVITIES AND RESOURCES. ORIGINALLY DEVELOPED IN RESPONSE TO SOCIAL ISOLATION NEEDS EARLY IN THE PANDEMIC, THE FAMILY FUN PACKS CONTINUED TO BE IN DEMAND AND WERE DISTRIBUTED IN SUMMER 2022, 2023 AND SUMMER 2024. ASPIRUS TOMAHAWK PROVIDED FUNDING:- FOR THE TOMAHAWK SCHOOL DISTRICT'S 6TH AND 8TH GRADERS' GRIT AND RESILIENCE PROGRAM.- TO TRAIN A TOMAHAWK SCHOOL DISTRICT STAFF PERSON TO BE A CERTIFIED YOUTH MENTAL HEALTH FIRST AID TRAINING INSTRUCTOR. - TO START A RAISE YOUR VOICE MENTAL HEALTH CLUB IN THE TOMAHAWK SCHOOL DISTRICT. RAISE YOUR VOICE IS A STUDENT CLUB THAT INCREASES THE AWARENESS OF MENTAL HEALTH. THE PROGRAM IS CO-SPONSORED BY THE NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI).- FOR THE STRENGTHENING FAMILIES TRAINING AND YOUTH MENTAL HEALTH TRAINING AT KINSHIP. KINSHIP IS A NON-PROFIT ORGANIZATION THAT SUPPORTS AT-RISK YOUTH. - - - - - - - - - - - -FOR THE CHNA COMPLETED IN JUNE 2023 (FY23), THE NEEDS PRIORITIZED BY THE HOSPITAL WERE THE SAME NEEDS LIVE WELL LINCOLN AND THE COMMUNITY STAKEHOLDERS IDENTIFIED. ASPIRUS RHINELANDER HOSPITAL PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. ASPIRUS TOMAHAWK HOSPITAL PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 16 1 - ASPIRUS STEVENS POINT CLINIC 824 ILLINOIS AVENUE STEVENS POINT WI 54481 OUTPATIENT PHYSICIAN CLINIC 2 - ASPIRUS RHINELANDER CLINIC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 OUTPATIENT PHYSICIAN CLINIC 3 - ASPIRUS PLOVER CLINIC-VERN HOLMES DR 5409 VERN HOLMES DRIVE STEVENS POINT WI 54482 OUTPATIENT PHYSICIAN CLINIC 4 - ASPIRUS RHINELANDER CLINIC-CHIPPEWA DR 1630 CHIPPEWA DRIVE RHINELANDER WI 54501 OUTPATIENT PHYSICIAN CLINIC 5 - ASPIRUS PLOVER CLINIC-PLOVER RD 2401 PLOVER ROAD PLOVER WI 54467 OUTPATIENT PHYSICIAN CLINIC 6 - ASPIRUS KOLLER BEHAVIORAL HEALTH CLINIC 1020 KABEL AVENUE RHINELANDER WI 54501 BEHAVIORAL HEALTH CLINIC 7 - ASPIRUS WOODRUFF CLINIC 240 MAPLE STREET WOODRUFF WI 54568 OUTPATIENT PHYSICIAN CLINIC 8 - ASPIRUS EAGLE RIVER CLINIC 930 EAST WALL STREET EAGLE RIVER WI 54521 OUTPATIENT PHYSICIAN CLINIC 9 - ASPIRUS OUTPATIENT THERAPIES-RHINELANDER 2003 EAST WINNEBAGO STREET RHINELANDER WI 54501 OUTPATIENT REHABILITATION 10 - ASPIRUS CRANDON CLINIC 400 WEST GLEN STREET CRANDON WI 54520 OUTPATIENT PHYSICIAN CLINIC 11 - ASPIRUS TOMAHAWK CLINIC 401 WEST MOHAWK TOMAHAWK WI 54487 OUTPATIENT PHYSICIAN CLINIC 12 - ASPIRUS STEVENS POINT CLINIC-HOOVER RD 3500 HOOVER ROAD STEVENS POINT WI 54481 OUTPATIENT PHYSICIAN CLINIC 13 - ASPIRUS WITTENBERG CLINIC 1660 SUE ALAN DRIVE WITTENBERG WI 54499 OUTPATIENT PHYSICIAN CLINIC 14 - ASPIRUS OUTPATIENT THERAPIES - TOMAHAWK 202 W MOHAWK DRIVE TOMAHAWK WI 54487 OUTPATIENT REHABILITATION 15 - ASPIRUS IOLA CLINIC 205 S MAIN STREET IOLA WI 54945 OUTPATIENT PHYSICIAN CLINIC 16 - ASPIRUS AMHERST CLINIC 272 CHRISTY ST AMHERST WI 54406 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY). SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS WHERE RETIREMENT WITHDRAWALS HAVE NOT BEGUN AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990, SCHEDULE H IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR FORM 990. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $5,706,747. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2. PART III, LINE 3: THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. PART III, LINE 4: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE:POLICY: I. ASPIRUS' FINANCIAL POLICY REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET: A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF: 1. MONTHLY STATEMENTS 2. COLLECTION LETTERS INCLUDING PLAIN LANGUAGE SUMMARY (PLS) 3. COLLECTION PHONE CALLS 4. VERIFICATION THAT CHARITY CARE WAS OFFERED WITHIN THE PAST 12-MONTHS AS RECORDED IN THE ELECTRONIC HEALTH RECORD (EMR) WITH STAFF HAVING THE DISCRETION TO OFFER AGAIN WITHIN THE 12-MONTHS. III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE LAST PATIENT PAYMENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. B. BAD DEBT RECOVERIES 1. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. 2. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. 3. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2024 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: IN ADDITION TO ASSESSING NEEDS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITALS:- SYSTEMATICALLY REVIEW PATIENT EXPERIENCE DATA TO UNDERSTAND OPPORTUNITIES TO ADDRESS PATIENT CONCERNS. - MAINTAIN AN INVOLVED LOCAL BOARD OF DIRECTORS, WHICH MEETS EVERY OTHER MONTH. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING FINANCE, EDUCATION, BANKING, GOVERNMENTAL PUBLIC HEALTH, HIGHER EDUCATION AND HEALTH CARE. - SUPPORT ITS STAFF IN VOLUNTEERING AT AN AREA FOOD PANTRY (RHINELANDER ONLY). - REVIEW FUNDING REQUESTS (TO THE HOSPITAL AND/OR HOSPITAL FOUNDATION) AS AN INDICATOR OF LOCAL NEEDS.- INITIATED A SOCIAL NEEDS SCREENING PROCESS THAT, OVER TIME, WILL PROVIDE INSIGHT INTO PATIENT NEEDS IN ADDITION TO THEIR IMMEDIATE CARE. PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. IF ASPIRUS FINANCIAL COUNSELORS NOTICE THE PATIENT HAS NOT BEEN OFFERED AN APPLICATION WITHIN THE PAST YEAR, THEY WILL ALSO ASK IF THE PATIENT WOULD LIKE ONE MAILED OR IF THE PATIENT SHOWS FINANCIAL DISTRESS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: ASPIRUS RHINELANDER HOSPITAL AND ASPIRUS TOMAHAWK HOSPITAL PRIMARILY SERVE THE RESIDENTS OF ONEIDA COUNTY (RHINELANDER) AND LINCOLN COUNTY (TOMAHAWK) AND SURROUNDING COUNTIES IN RURAL NORTHERN WISCONSIN.ONEIDA COUNTY COVERS 1113 SQUARE MILES, WITH 34 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 38,259 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18: 17.1%PERSONS 65 YEARS AND OVER: 27.3%WHITE PERSONS: 95.9%AFRICAN AMERICAN PERSONS: 0.7%AMERICAN INDIAN PERSONS: 1.3%ASIAN PERSONS: 0.5%TWO OR MORE RACES: 1.6%HISPANIC OR LATINO: 1.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 1.6%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 94.7% PERSONS IN POVERTY: 9.2%MEDIAN HOUSEHOLD INCOME: $62,660PERCENT WITHOUT HEALTHCARE COVERAGE: 5.0%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 45.2%NUMBER OF HOSPITALS IN ONEIDA COUNTY: 3 (INCLUDING ASPIRUS RHINELANDER HOSPITAL AND (ASPIRUS) HOWARD YOUNG MEDICAL CENTER) ONEIDA COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA FOR MENTAL HEALTH. ASPIRUS TOMAHAWK HOSPITAL PRIMARILY SERVES THE RESIDENTS OF LINCOLN COUNTY AND SURROUNDING COUNTIES IN RURAL NORTH CENTRAL WISCONSIN. LINCOLN COUNTY IS A RURAL COUNTY IN CENTRAL WISCONSIN. IT COVERS 878 SQUARE MILES, WITH 32.3 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 27,687 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS 14 YEARS AND UNDER: 14.6%PERSONS 65 YEARS AND OVER: 21.6%WHITE PERSONS: 98.4%AFRICAN AMERICAN PERSONS: 1.4%AMERICAN INDIAN PERSONS: 0.9%ASIAN PERSONS: 0.8%HISPANIC OR LATINO: 1.9%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 2.7%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 92%HOUSEHOLDS IN POVERTY: 10%MEDIAN HOUSEHOLD INCOME: $61,100PERCENT WITHOUT HEALTHCARE COVERAGE: 4.8%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 40.3%NUMBER OF HOSPITALS IN THE COUNTY: 2 (INCLUDING ASPIRUS MERRILL HOSPITAL AND ASPIRUS TOMAHAWK HOSPITAL) LINCOLN COUNTY IS A DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR MENTAL HEALTH. PART VI, LINE 5: THE HOSPITALS PROMOTE THE HEALTH OF THE COMMUNITY THROUGH THEIR COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITALS: - MAINTAIN A BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY. - BRING EXPERTISE INTO THE COMMUNITY THROUGH PROGRAMS, SCREENINGS, AND COMMUNITY BOARD AND ADVISORY COMMITTEE MEMBERSHIP.- PROVIDE HIGH QUALITY SERVICES AND IMPLEMENTS ONGOING QUALITY IMPROVEMENT INITIATIVES. - BUDGET FOR CUTTING EDGE TECHNOLOGIES AND EQUIPMENT THAT SUPPORT PATIENT HEALTH.- OFFER TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDE PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - PROVIDE ATHLETIC TRAINING TO LOCAL YOUTH ATHLETES. - OFFER MEETING SPACE TO LOCAL NON-PROFIT ORGANIZATIONS. - SUPPORT PROJECT SEARCH, WHICH ENGAGES YOUNG ADULTS WITH DISABILITIES IN WORKFORCE CAREER EXPLORATION AND TRAINING. (RHINELANDER)- PROVIDE 'STOP THE BLEED' TRAININGS. (RHINELANDER)- PROVIDE CHILD CAR SEAT INSTALLATION AND INSPECTION. (RHINELANDER) AS PART OF A LARGER NETWORK OF ASPIRUS HEALTHCARE FACILITIES, THE HOSPITALS HAVE ACCESS TO: - LOW-COST TEMPORARY LODGING AT ASPIRUS' FLAGSHIP TERTIARY CARE HOSPITAL PARTNER (IN WAUSAU, WI) SO THAT PATIENTS AND/OR THEIR FAMILY NEEDING EXTENDED SPECIALTY CARE HAVE ACCOMMODATIONS. - PROFESSIONAL DEVELOPMENT FOR STAFF, ASSURING THE CARE PROVIDED INCORPORATES THE MOST UP-TO-DATE BEST PRACTICES. - CROSS-TRAINING OPPORTUNITIES. FOR INSTANCE, A WAUSAU-BASED BEREAVEMENT COORDINATOR TRAINS STAFF ACROSS THE SYSTEM ON NORMAL GRIEF RESPONSE, RESILIENCE AND HOSPICE CARE AND SUPPORT. THE COORDINATOR TRAINS THROUGH THE NURSE RESIDENCY PROGRAM AS WELL AS IN UNIT/DEPARTMENT MEETINGS. UNIT/DEPARTMENT LEADERS CAN REQUEST BEREAVEMENT INFORMATION AND SUPPORT FOR THEIR TEAM. SIMILARLY, HOSPITALS HAVE ACCESS TO INJURY PREVENTION EXPERTISE AND RESOURCES THROUGH THE LEVEL 2 TRAUMA CENTER IN WAUSAU. - A MARKETING/COMMUNICATIONS TEAM THAT SUPPORTS THE ONLINE ASPIRUS MEDIA CENTER FEATURING MEDICAL EXPERTS. THE TEAM DEVELOPS AND PROMOTES HEALTH EDUCATION INFORMATION (E.G., ON DIABETES, TICK BITES, SNOWMOBILE SAFETY) FOR PATIENTS AND THE GENERAL PUBLIC. PART VI, LINE 6: ASPIRUS HEALTH IS A NONPROFIT, COMMUNITY-DIRECTED HEALTH SYSTEM BASED IN WAUSAU, WISCONSIN, SERVING NORTHEASTERN MINNESOTA, NORTHERN AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. THE HEALTH SYSTEM OPERATES 18 HOSPITALS AND 130 OUTPATIENT LOCATIONS WITH NEARLY 14,000 TEAM MEMBERS, INCLUDING 1,300 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE CLINICIANS. ASPIRUS SERVES COMMUNITIES THROUGH HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, AND ADULT LIVING AND CARE FACILITIES. THE COMBINED EFFORTS PROVIDE RURAL COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. FOR MORE INFORMATION, VISIT ASPIRUS.ORG. 1 SCHOOL DISTRICT OF TOMAHAWK 1048 EAST KING ROAD TOMAHAWK WI 54487 390992650 GOVERNMENT 11700 0 MULTIPLE MENTAL HEALTH AND SUBSTANCE USE PROGRAMS AND CLUBS. 1 0 PART I, LINE 2: WHEN COMMUNITY BENEFIT FUNDS ARE DONATED TO LOCAL AGENCIES TO COMPLETE COMMUNITY HEALTH IMPROVEMENT EFFORTS, ASPIRUS REQUESTS A FORMAL REPORT AT THE CONCLUSION OF THE FISCAL YEAR. 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1252366 0 353673 0 12078 0 9900 0 294286 0 1922303 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 ANTHONY RUTKOWSKI RADIOLOGIST 999484 0 0 0 5810 0 9900 0 38039 0 1053233 0 0 0 STEVEN BROWN RADIOLOGIST 870029 0 0 0 11858 0 9900 0 37932 0 929719 0 0 0 JOHNATHAN CURRIE RADIOLOGIST 848700 0 0 0 5540 0 9900 0 39475 0 903615 0 0 0 SANDIP GHUGE MEDICAL DIRECTOR 829060 0 0 0 5419 0 9900 0 43494 0 887873 0 0 0 JESSE TISCHER V.C. (THRU 01/24)/SVP & PRES.-AWH 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 ABIGAIL TAUB PHYSICIAN 836288 0 0 0 5486 0 9900 0 25481 0 877155 0 0 0 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 405912 0 73047 0 43992 0 8193 0 94764 0 625908 0 32339 ERIC ANDERSON BOARD MEMBER/CHIEF COMPL. OFFICER 0 423444 0 72853 0 2438 0 9358 0 90310 0 598403 0 0 CONSTANCE BRADLEY VICE CHAIR/SVP & PRES. REG. MRKTS. 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 TERESA THEILER (NV) PRESIDENT-ASPIRUS N. WI DIV. 0 324978 0 41528 0 1552 0 15299 0 61815 0 445172 0 0 DEAN POLLNOW MD BOARD MEMBER/PHYSICIAN 386177 0 0 0 8516 0 9090 0 29553 0 433336 0 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 0 280048 0 30050 0 603 0 9581 0 37853 0 358135 0 0 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 280398 0 33439 0 2449 0 9592 0 28394 0 354272 0 0 ANDREA ALLARD VP-OPERATIONS 0 267134 0 26259 0 572 0 8802 0 1619 0 304386 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 AMY SLETTE MD BOARD MEMBER (THRU 09/23)/PHYSICIAN 0 181947 0 0 0 4490 0 5628 0 26877 0 218942 0 0 HOLLY BEEDE-MCKINNEY NP BOARD MEMBER/NURSE PRACTITIONER 0 159204 0 0 0 2080 0 4552 0 794 0 166630 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $337,358 M. WALTERS $56,806 M. HOLZHUETER $55,822 J. TISCHER $50,242 T. RICHARDSON $39,964 J. MATHESON $32,339 C. BRADLEY $24,444 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; 24 MONTHS FROM THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97712JDN0 2021-11-10 69386269 REVENUE BONDS SERIES 2021 0 0 0 A 69386269 494301 68891968 2021 0 0 1 1 A 0 1 1 1 0 0.00800 0.00800 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2021 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL & CLINICS, INC. (EIN 39-1138241); ASPIRUS BUILDINGS, INC. (EIN 39-1406537); ASPIRUS STEVENS POINT HOSPITAL & CLINICS, INC. (EIN 39-0808443); ASPIRUS STANLEY HOSPITAL & CLINICS, INC. (EIN 39-0807065); ASPIRUS MERRILL HOSPITAL & CLINICS, INC. (EIN 39-0808503); ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS, INC. (EIN 39-1390638); ASPIRUS EAGLE RIVER HOSPITAL & CLINICS, INC. (EIN 39-0985690); AND THE HOWARD YOUNG MEDICAL CENTER, INC. (EIN 39-0873606). INFORMATION REGARDING THE SERIES 2021 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2021 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2021 BONDS.] PART III, LINES 3A AND 3B ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS, INC., HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW MANAGEMENT AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. 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 FOLLOWS. 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., AND TWO PROVIDER CLASS DIRECTORS NOMINATED BY THE CORPORATION'S BOARD AND ELECTED BY ASPIRUS, INC. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHARMACY FEES: PROGRAM SERVICE EXPENSES 573,937. MANAGEMENT AND GENERAL EXPENSES 143,933. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 717,870. OTHER FEES: PROGRAM SERVICE EXPENSES 6,960,389. MANAGEMENT AND GENERAL EXPENSES 1,779,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,739,848. LAB FEES: PROGRAM SERVICE EXPENSES 2,332,269. MANAGEMENT AND GENERAL EXPENSES 679,456. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,011,725. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 934,861. MANAGEMENT AND GENERAL EXPENSES 270,561. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,205,422. CONTRACT NURSING AND OTHER LABOR: PROGRAM SERVICE EXPENSES 15,490,077. MANAGEMENT AND GENERAL EXPENSES 4,490,092. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,980,169. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 6,222,923. ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTHCARE WI 501(C)(3) LINE 12B, II N/A 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EXTENDED SERVICES INC 333 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS MEDICAL GROUP INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTH CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS VNA EXTENDED CARE INC 520 N 32ND AVENUE WAUSAU WI 54401 391597350 PERSONAL CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS VNA HOME HEALTH INC 1 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 383236977 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382908586 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LAURIUM MI 49913 381443361 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 DIVINE SAVIOR HEALTHCARE INC 2817 NEW PINERY ROAD PORTGAGE WI 53901 390806250 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MEDFORD HOSPITAL & CLINICS INC 135 S GIBSON STREET MEDFORD WI 54451 390964813 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MEDFORD FOUNDATION INC 135 S GIBSON STREET MEDFORD WI 54451 391777081 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL & CLINICS INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 390808443 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL FOUNDATION INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 391657410 CHARITABLE FOUNDATION WI 501(C)(3) LINE 12A, I ASPIRUS INC 1 ASPIRUS STANLEY HOSPITAL & CLINICS INC 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MERRILL HOSPITAL & CLINICS INC 601 S CENTER AVENUE MERRILL WI 54452 390808503 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MERRILL HOSPITAL FOUNDATION INC 601 S CENTER AVENUE MERRILL WI 54452 391627755 CHARITABLE FOUNDATION WI 501(C)(3) LINE 12A, I ASPIRUS INC 1 ASPIRUS EAGLE RIVER HOSPITAL & CLINICS INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HEALTHCARE WI 501(C)(3) LINE 12B, II ASPIRUS INC 1 ASPIRUS MEDICAL GROUP - 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