2025-05-15T09:01:38-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 383236977 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC ASPI 9062656121 1400 W ICE LAKE RD IRON RIVER MI 49935 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 1400 W ICE LAKE RD IRON RIVER MI 49935 41169739 0 X WWW.ASPIRUS.ORG X 1995 MI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 15 8 198 22 0 0 1215742 465337 37724801 40468536 63451 99402 151230 136464 39155224 41169739 5192 242 0 0 16241666 16468739 0 0 0 24778729 25314957 41025587 41783938 -1870363 -614199 29017921 27103194 20624065 19698790 8393856 7404404 X WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 28655525 242 40464420 ASPIRUS IRON RIVER HOSPITAL (AIR) PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. AIR HAD 364 INPATIENT DISCHARGES AND 1,081 INPATIENT DAYS ALONG WITH 7,872 EMERGENCY DEPARTMENT VISITS WITH AN EMERGENCY PROVIDER STAFFED 24/7. AIR HAS 2 PROVIDER CLINICS, ONE ON THE HOSPITAL CAMPUS AND ONE LOCATED 15 MILES AWAY IN CRYSTAL FALLS, MI., BOTH PROVIDED 20,470 PATIENT VISITS IN 2023. THE HOSPITAL PROVIDES ICU SERVICES ALONG WITH A SWING BED PROGRAM. THE HOSPITAL ALSO HAS FULLY FUNCTIONING LAB AND RADIOLOGY DEPARTMENTS THAT ARE SUPPLEMENTED BY A MOBILE MRI UNIT THAT VISITS THE HOSPITAL CAMPUS TWO TIMES A WEEK. BOTH IP AND OP SURGERIES ARE PERFORMED WITH TOTAL OR CASES OF 740 IN 2023. BECAUSE OF REGIONAL AFFILIATION, AIR IS ALSO ABLE TO PROVIDE ORTHOPEDIC, CARDIOLOGY, BEHAVIORAL HEALTH, WOUND CARE, VASCULAR, PODIATRY AND ONCOLOGY SERVICES. 28655525 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 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 198 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JOHN D MATONICH CHAIR 1.00 3.00 X X 0 0 0 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 1.00 50.00 X X 0 607634 94564 KIRK R SCHOTT OD TREASURER 1.00 3.00 X X 0 0 0 STEVEN TINTI TREASURER (THRU 10/23) 1.00 3.00 X X 0 0 0 KATIE L CLARK SECRETARY 1.00 3.00 X X 0 0 0 HANNAH L GOODMAN BOARD MEMBER 1.00 3.00 X 0 0 0 RICHARD J KOUBEK PHD BOARD MEMBER 1.00 3.00 X 0 0 0 CHARLY A LOPER BOARD MEMBER 1.00 3.00 X 0 0 0 ROBIN MENEZUGGO BOARD MEMBER 1.00 3.00 X 0 0 0 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 40.00 1.00 X 168066 0 4169 JAMES R RICHARDSON BOARD MEMBER 1.00 3.00 X 0 0 0 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 1.00 40.00 X 0 893837 48035 JESSE TISCHER B.M. (THRU 01/24)/SVP & PRESIDENT- AWH 1.00 50.00 X 0 764397 116000 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 1.00 50.00 X 0 818140 38809 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS. 1.00 50.00 X 0 489478 90167 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 1.00 50.00 X 0 425295 48633 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 1.00 50.00 X 0 392551 48430 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 1.00 50.00 X 0 435705 90755 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 688935 115911 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 522951 102957 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 498735 99668 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 510162 34165 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 CRYSTAL KIRSCHLING VP-SYSTEM INTEGRATION OFFICER 1.00 X 0 310701 47434 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 1.00 X 0 316286 37986 ANDREA ALLARD VP-OPERATIONS 1.00 X 0 293965 10421 MEDHAT FANOUS PHYSICIAN 40.00 X 668964 0 43818 ANDREW COSTIC VP-FINANCE UP REGION 40.00 X 0 262230 22463 KRISTINE FLOWERS PHYSICIAN 40.00 X 237249 0 44480 DONALD PATTON PHYSICIAN 40.00 X 240571 0 40979 JEFFREY HERSH REGISTERED NURSE 40.00 X 191421 0 43700 1506271 12386887 1801264 29 0 1 0 INNOVA EMERGENCY SERVICES 700 N COLORADO BLVD SUITE 109 DENVER CO 80206 EMERGENCY DEPT PROVIDERS 2910649 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE SUITE 185 IRVINE CA 92614 EQUIPMENT PREVENTATIVE MAINTENANCE 440362 ORTHOPEDIC SOLUTIONS N10565 GRANDVIEW LN IRONWOOD MI 49938 LOCUM DOCTOR 408211 LAKE SUPERIOR NURSING SERVICES 801 LEXINGTON BLVD NEGAUNEE MI 49866 CONTRACTED RN STAFFING 373879 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACTED RN STAFFING 318545 10 465337 465337 PATIENT SERVICE REVENUE 621110 39411105 39411105 PHARMACY REVENUE 456110 847792 847792 CONTRACT SERVICE REVENUE 621110 53120 53120 156519 152403 4116 40468536 96269 96269 78387 0 78387 78387 78387 3133 0 3133 3133 3133 CAFETERIA SALES 621990 58077 58077 58077 41169739 40464420 0 239982 X 242 242 169169 169169 13323470 11126032 2197438 360051 280629 79422 1782185 1376560 405625 833864 644077 189787 3000 3000 49733 49733 4093 4093 1904 1904 5503320 3448931 2054389 3853 2415 1438 45407 44322 1085 25102 15731 9371 601982 65917 536065 66374 41597 24777 2623 1644 979 892108 892108 1882127 608303 1273824 196751 21544 175207 MEDICAL SUPPLIES 6448829 6294702 154127 CORPORATE ALLOCATIONS 6123581 3837648 2285933 HOSPITAL TAX 1574256 1574256 BAD DEBT EXPENSE 683119 683119 1206795 842231 364564 41783938 28655525 13128413 0 3040393 1647884 150847 186982 5500879 6479023 824680 910664 427252 141671 49120450 31900561 18660187 17219889 413683 517081 29017921 27103194 1735012 768597 15915000 15915000 2974053 3015193 20624065 19698790 X 8393856 7404404 8393856 7404404 29017921 27103194 X -614199 31377 -406630 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 4093 4093 0 PART II-B, LINE 1: MEMBERSHIP DUES ARE PAID TO THE MICHIGAN HOSPITAL ASSOCIATION (MHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THOSE DUES ARE COMMITTED TO LOBBYING PURPOSES. MHA INVOICE STATES 9.10% OF $10,644 ($987) GOES FOR LOBBYING ON INVOICE COVERING THE PERIOD OF 7/1/23-6/30/24. SIMILARLY, AHA DUES COMMITTED TO LOBBYING WAS 32.00% OF $9,705 ($3,106). 210026 210026 35487836 20893885 14593951 13388861 11006676 2382185 33727 33727 17219889 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2765000 FINANCE LEASE LIABILITY 122673 LONG TERM PENSION 125713 DEFERRED POSTRETIREMENT BENEFITS 1807 3015193 X PART X, LINE 2: ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2024. 1 1 X 1 X 1 X 1 1 0 1 1 306003 306003 0.00740 8808534 9650925 0 0.00000 9114537 9650925 306003 0.00740 15794 15794 0.00040 6453 6453 0.00020 5969074 5880542 88532 0.00220 3797 3797 0.00010 5995118 5880542 114576 0.00290 15109655 15531467 420579 0.01030 1 238476 0 7682784 7759328 -76544 X 1 1 1 1 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 WWW.ASPIRUS.ORG 1060000150 X X X X ASPIRUS IRON RIVER HOSPITAL & CLINICS I 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 22 1 WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: THE FOLLOWING DESCRIPTION IS FOR THE CHNA COMPLETED IN FY22 (SPRING 2022). THROUGHOUT THE PLANNING AND PRODUCTION OF THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT, A STEERING COMMITTEE OF COMMUNITY LEADERS AND SUBJECT MATTER EXPERTS MET REGULARLY TO DIRECT THE REPORTING PROCESS, WHICH INCLUDED THE CREATION AND DISTRIBUTION OF A SURVEY TO A RANDOM SELECTION OF RESIDENTS. FOR ASPIRUS IRON RIVER, THIS INCLUDES INPUT FROM THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT AS WELL AS OTHER ASPIRUS UP HOSPITALS. REPRESENTATIVES FROM EACH ORGANIZATION COMMUNICATED IN REGULAR MEETINGS. THE KEY DATA ELEMENT IN THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT IS THE COMMUNITY SURVEY, WHICH IDENTIFIED IMPORTANT ISSUES REGARDING QUALITY OF LIFE THAT HAD NOT BEEN MEASURED BEFORE THE SURVEY WAS CONDUCTED. THE SURVEY WAS MAILED TO THOUSANDS OF HOUSEHOLDS ACROSS THE ENTIRE UPPER PENINSULA, WITH NEARLY 5,000 RESPONSES BACK FROM RESIDENTS. THE UPPER PENINSULA 2021 REGIONAL HEALTH ASSESSMENT ALSO INCLUDES A SIGNIFICANT AMOUNT OF DATA INDICATORS ACROSS MULTIPLE CATEGORIES RELATING TO HEALTH AND HEALTH FACTORS. THIS DATA WAS COMPILED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM HEALTH CARE PROVIDERS. PUBLISHED SOURCES INCLUDED THE U.S. CENSUS, THE AMERICAN COMMUNITY SURVEY, AND STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), THE HOSPITAL COLLABORATED WITH ASPIRUS KEWEENAW HOSPITAL, ASPIRUS IRONWOOD HOSPITAL AND ASPIRUS ONTONAGON HOSPITAL. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), ASPIRUS IRON RIVER HOSPITAL COLLABORATED WITH THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT. ASPIRUS IRON RIVER HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS IRON RIVER HOSPITAL. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. ASPIRUS IRON RIVER HOSPITAL IS ONE OF FOUR ASPIRUS HOSPITALS IN THE UPPER PENINSULA OF MICHIGAN. THE AREA IS VERY RURAL. ASPIRUS IRON RIVER IMPLEMENTED STRATEGIES LOCALLY AND REGIONALLY, WITH THE HELP OF STAFF MEMBERS, BUT ALSO PARTNERING WITH OTHERS IN THE COMMUNITY. THE HOSPITAL'S SIGNIFICANT NEEDS ARE: MENTAL HEALTH; SUBSTANCE USE; CHRONIC DISEASES. TO ADDRESS THESE NEEDS, THE HOSPITAL AND/OR CLINIC: - CONDUCT DEPRESSION SCREENING WITH PATIENTS. - PROVIDE ACCESS TO ADDICTION-RELATED TREATMENT, INCLUDING SUBOXONE. - FACILITATE REFERRALS TO LOCAL NON-PROFIT BEHAVIORAL HEALTH SERVICES ORGANIZATIONS FOR PATIENTS WITH SIGNIFICANT MENTAL HEALTH AND SUBSTANCE USE ISSUES. - FACILITATE A MONTHLY DIABETES SUPPORT GROUP. THE GROUP STARTED IN FEBRUARY 2023 AND AVERAGES ABOUT FIVE PEOPLE PER SESSION. - CONTRIBUTE IN-KIND TIME TO THE IRON AREA HEALTH FOUNDATION AND THE IRON COUNTY SCHOOL DISTRICT'S COLOR RUN. - - - - - - - - - - - - - - - FROM THE COMMUNITY SURVEY, THE TOP-SELECTED ISSUES WERE: - HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES- DRUG ABUSE- LACK OF HEALTH INSURANCE- UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONSFROM THIS LIST, THE HOSPITAL IS ADDRESSING DRUG ABUSE (SUBSTANCE USE). THE OTHER THREE ISSUES WERE NOT SELECTED FOR THE FOLLOWING REASONS. - THE LACK OF AFFORDABLE HEALTH INSURANCE IS OF HIGH CONCERN FOR MANY PEOPLE IN THE UPPER PENINSULA. ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE THE AVAILABILITY AND THE AFFORDABILITY OF HEALTH INSURANCE, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. - UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONS ARE IMPORTANT ISSUES FOR ASPIRUS. ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE BENEFITS PACKAGES. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 2 1 - ASPIRUS IRON RIVER CLINIC 814 S ICE LAKE ROAD IRON RIVER MI 49935 PHYSICIAN PRACTICES, REHAB, LAB AND XRAY 2 - CRYSTAL FALLS CLINIC 1328 US HWY 2 CRYSTAL FALLS MI 49920 PHYSICIAN PRACTICES, LAB AND XRAY 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, LINE 7G: THE ABOVE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE EMERGENCY DEPARTMENT. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE EMERGENCY DEPARTMENT REPORTED COSTS OF $5,969,074 WITH OFFSETTING REVENUE OF $5,800,542. PART I, LN 7 COL(F): IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $683,119 WAS EXCLUDED FROM THE DENOMINATOR. PART I, LINE 7B THERE WAS A SIGNIFICANT INCREASE IN PAYMENTS FROM STATE PROGRAMS CAUSING LINE 7A, COLUMN (D) TO BE MUCH HIGHER THAN PREVIOUS AND EXPECTED YEARS. THIS IS CAUSING A DECREASE OF TOTAL COLUMN (F) FOR FY 2024 OF APPROXIMATELY 5% FROM THE PRIOR YEAR. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2. PART III, LINE 3: THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. PART III, LINE 4: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE:POLICY: I. ASPIRUS' FINANCIAL POLICY REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET: A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF: 1. MONTHLY STATEMENTS 2. COLLECTION LETTERS INCLUDING PLAIN LANGUAGE SUMMARY (PLS) 3. COLLECTION PHONE CALLS 4. VERIFICATION THAT CHARITY CARE WAS OFFERED WITHIN THE PAST 12-MONTHS AS RECORDED IN THE ELECTRONIC HEALTH RECORD (EMR) WITH STAFF HAVING THE DISCRETION TO OFFER AGAIN WITHIN THE 12-MONTHS. III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE LAST PATIENT PAYMENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. B. BAD DEBT RECOVERIES 1. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. 2. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. 3. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2024 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: IN ADDITION TO ASSESSING NEEDS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL:- SYSTEMATICALLY REVIEWS PATIENT EXPERIENCE DATA TO UNDERSTAND OPPORTUNITIES TO ADDRESS PATIENT CONCERNS. - MAINTAINS AN INVOLVED LOCAL / REGIONAL BOARD OF DIRECTORS, WHICH MEETS QUARTERLY. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS, INCLUDING ACADEMIC, LAW AND MEDICAL FIELDS.- SUPPORTS ITS STAFF IN PARTICIPATING ON COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- REVIEWS FUNDING REQUESTS TO THE HOSPITAL (AND THE LOCAL HEALTH FOUNDATION) AS AN INDICATOR OF LOCAL NEEDS.HEALTHCARE SYSTEMS AND HOSPITALS HAVE NEW REQUIREMENTS TO SCREEN PATIENTS FOR SOCIAL NEEDS, IDENTIFY ANY NEEDS, AND REFER TO COMMUNITY RESOURCES. ASPIRUS CONTRACTS WITH A RESOURCE PLATFORM TO BETTER CONNECT PATIENTS WITH RESOURCES. OVER TIME, THE RESULTS OF THE SCREENING PROCESS WILL PROVIDE INSIGHT INTO PATIENT NEEDS (BEYOND THEIR IMMEDIATE CARE). PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. IF ASPIRUS FINANCIAL COUNSELORS NOTICE THE PATIENT HAS NOT BEEN OFFERED AN APPLICATION WITHIN THE PAST YEAR, THEY WILL ALSO ASK IF THE PATIENT WOULD LIKE ONE MAILED OR IF THE PATIENT SHOWS FINANCIAL DISTRESS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: ASPIRUS IRON RIVER HOSPITAL IS ONE OF FOUR ASPIRUS SYSTEM HOSPITALS IN A 5-COUNTY RURAL REGION OF THE UPPER PENINSULA OF MICHIGAN. THE 5-COUNTY REGION INCLUDES HOUGHTON, KEWEENAW, ONTONAGON, IRON AND GOGEBIC COUNTIES. ASPIRUS IRON RIVER HOSPITAL IS LOCATED IN IRON COUNTY. IRON COUNTY COVERS 1166 SQUARE MILES, WITH 10.1 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 11,635 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18: 16.8%PERSONS 65 YEARS AND OVER: 31.2%WHITE PERSONS: 95.8%AFRICAN AMERICAN PERSONS: 0.4%AMERICAN INDIAN PERSONS: 1.6%ASIAN PERSONS: 0.5%TWO OR MORE RACES: 1.7%HISPANIC OR LATINO: 2.4%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 1.7%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 92.1% PERSONS IN POVERTY: 14.2%MEDIAN HOUSEHOLD INCOME: $44,183 PERCENT WITHOUT HEALTHCARE COVERAGE: 6%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 53.2% NUMBER OF HOSPITALS IN THE COUNTY: 1 (ONLY ASPIRUS) THE COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. THE COUNTY IS ALSO DESIGNATED AS MEDICALLY UNDERSERVED. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH ITS COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITAL: - MAINTAINS A REGIONAL BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY AND THE REGION. - PROVIDES HIGH QUALITY SERVICES AND IMPLEMENTS ONGOING QUALITY IMPROVEMENT INITIATIVES. - BRINGS ITS EXPERTISE INTO THE COMMUNITY THROUGH PROGRAMS, SCREENINGS, AND COMMUNITY BOARD AND ADVISORY COMMITTEE MEMBERSHIP.- BUDGETS FOR CUTTING EDGE TECHNOLOGIES AND EQUIPMENT THAT SUPPORT PATIENT HEALTH.- OFFERS RESOURCES AND/OR REFERRALS FOR TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - HOSTS ON-SITE BLOOD DRIVES. AS PART OF A LARGER NETWORK OF ASPIRUS HEALTHCARE FACILITIES, THE HOSPITAL HAS ACCESS TO: - LOW-COST TEMPORARY LODGING AT ASPIRUS' FLAGSHIP TERTIARY CARE HOSPITAL PARTNER (IN WAUSAU, WI) SO THAT PATIENTS AND/OR THEIR FAMILY NEEDING EXTENDED SPECIALTY CARE HAVE ACCOMMODATIONS. - PROFESSIONAL DEVELOPMENT FOR STAFF, ASSURING THE CARE PROVIDED INCORPORATES THE MOST UP-TO-DATE BEST PRACTICES. - CROSS-TRAINING OPPORTUNITIES. FOR INSTANCE, A WAUSAU-BASED BEREAVEMENT COORDINATOR TRAINS STAFF ACROSS THE SYSTEM ON NORMAL GRIEF RESPONSE, RESILIENCE AND HOSPICE CARE AND SUPPORT. THE COORDINATOR TRAINS THROUGH THE NURSE RESIDENCY PROGRAM AS WELL AS IN UNIT/DEPARTMENT MEETINGS. UNIT/DEPARTMENT LEADERS CAN REQUEST BEREAVEMENT INFORMATION AND SUPPORT FOR THEIR TEAM. SIMILARLY, HOSPITALS HAVE ACCESS TO INJURY PREVENTION EXPERTISE AND RESOURCES THROUGH THE LEVEL 2 TRAUMA CENTER IN WAUSAU. - A MARKETING/COMMUNICATIONS TEAM THAT SUPPORTS THE ONLINE ASPIRUS MEDIA CENTER FEATURING MEDICAL EXPERTS. THE TEAM DEVELOPS AND PROMOTES HEALTH EDUCATION INFORMATION (E.G., ON DIABETES, TICK BITES, SNOWMOBILE SAFETY) FOR PATIENTS AND THE GENERAL PUBLIC. PART VI, LINE 6: ASPIRUS HEALTH IS A NONPROFIT, COMMUNITY-DIRECTED HEALTH SYSTEM BASED IN WAUSAU, WISCONSIN, SERVING NORTHEASTERN MINNESOTA, NORTHERN AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. THE HEALTH SYSTEM OPERATES 18 HOSPITALS AND 130 OUTPATIENT LOCATIONS WITH NEARLY 14,000 TEAM MEMBERS, INCLUDING 1,300 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE CLINICIANS. ASPIRUS SERVES COMMUNITIES THROUGH HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, AND ADULT LIVING AND CARE FACILITIES. THE COMBINED EFFORTS PROVIDE RURAL COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. FOR MORE INFORMATION, VISIT ASPIRUS.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MI 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1252366 0 353673 0 12078 0 9900 0 294286 0 1922303 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 0 862473 0 0 0 31364 0 9900 0 38135 0 941872 0 0 JESSE TISCHER B.M. (THRU 01/24)/SVP & PRESIDENT- A 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 DANIEL J LUKES DO BOARD MEMBER/PHYSICIAN 0 810818 0 0 0 7322 0 9900 0 28909 0 856949 0 0 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 MEDHAT FANOUS PHYSICIAN 662700 0 0 0 6264 0 4133 0 39685 0 712782 0 0 0 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 0 509155 0 94839 0 3640 0 9900 0 84664 0 702198 0 0 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 405912 0 73047 0 43992 0 8193 0 94764 0 625908 0 32339 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 0 423444 0 72853 0 2438 0 9358 0 90310 0 598403 0 0 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRESIDENT-REG. MKTS 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 CHRISTINE HARFF (NV)BOARD MEMBER/PRESIDENT-UP REG. 0 346782 0 49598 0 39325 0 9294 0 81461 0 526460 0 34464 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 0 416035 0 8941 0 319 0 9900 0 38733 0 473928 0 0 PATRICK TINCHER JR BOARD MEMBER/VP-FINANCE REG. OPS. 0 289467 0 95289 0 7795 0 9132 0 39298 0 440981 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 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 ANDREW COSTIC VP-FINANCE UP REGION 0 233777 0 21911 0 6542 0 7869 0 14594 0 284693 0 0 KRISTINE FLOWERS PHYSICIAN 201932 0 24000 0 11317 0 6169 0 38311 0 281729 0 0 0 DONALD PATTON PHYSICIAN 230166 0 0 0 10405 0 6003 0 34976 0 281550 0 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 JEFFREY HERSH REGISTERED NURSE 190191 0 0 0 1230 0 6073 0 37627 0 235121 0 0 0 KRISTEN D MESKE NP-C BOARD MEMBER/NURSE PRACTITIONER 165647 0 0 0 2419 0 3313 0 856 0 172235 0 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRON RIVER HOSPITAL & CLINIC, 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 C. HARFF $34,464 J. TISCHER $50,242 J. MATHESON $32,339 M. HOLZHUETER $55,822 T. RICHARDSON $39,964 M. WALTERS $56,806 C. BRADLEY $24,444 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; 24 MONTHS FROM THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. DONALD PATTON MD DONALD PATTON AND KRISTEN MESKE (BOARD MEMBER) HAVE A FAMILY RELATIONSHIP 281550 PAYROLL 0 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 9 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 FOUR INDEPENDENT COMMUNITY CLASS DIRECTORS, THREE 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 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, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS THEN REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. AN INTERESTED PERSON IS A DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. AFTER DISCLOSURE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING MEMBERS SHALL DECIDE IF A CONFLICT EXISTS. THE MEMBER WILL ABSTAIN FROM VOTING ON THIS ISSUE IF A CONFLICT OF INTEREST IS DISCOVERED. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CHIEF ADMINISTRATIVE OFFICER, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION HAS DEEMED THAT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 363,371. MANAGEMENT AND GENERAL EXPENSES 216,445. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 579,816. PHARMACY FEES: PROGRAM SERVICE EXPENSES 56,406. MANAGEMENT AND GENERAL EXPENSES 33,598. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 90,004. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,324,203. MANAGEMENT AND GENERAL EXPENSES 1,384,435. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,708,638. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 115,088. MANAGEMENT AND GENERAL EXPENSES 68,554. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 183,642. OTHER SERVICES: PROGRAM SERVICE EXPENSES 589,863. MANAGEMENT AND GENERAL EXPENSES 351,357. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 941,220. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS -406,630. 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 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 RHINELANDER & TOMAHAWK HOSPITAL & CLINICS INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391390638 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EAGLE RIVER HOSPITAL & CLINICS INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HEALTHCARE WI 501(C)(3) LINE 12B, II ASPIRUS INC 1 ASPIRUS MEDICAL GROUP - NORTHERN WISCONSIN INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391965593 MEDICAL SERVICES WI 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S HOSPITAL OF DULUTH 915 EAST 1ST STREET DULUTH MN 55805 410714079 HOSPITAL MN 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S FOUNDATION 1000 EAST 1ST STREET NO 102 DULUTH MN 55805 411448118 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL INC 325 11TH AVENUE TWO HARBORS MN 55616 410786046 HOSPITAL MN 501(C)(3) LINE 3 ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL FOUNDATION OF NORTHEAST MINNESOTA 325 11TH AVENUE TWO HARBORS MN 55616 411700972 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I LAKE VIEW MEMORIAL HOSPITAL INC 1 WESTERN UPPER MICHIGAN EYE CARE LLC 131 W GENESEE STREET IRON RIVER MI 49935 272324957 EYE CARE SERVICES MI N/A 0 0 THE WESTWOOD CONFERENCE CENTER LLC 333 PINE RIDGE BLVD WAUSAU WI 54401 571184256 REAL ESTATE INVESTMENT WI N/A 0 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931678 HEALTH CARE SERVICES WI N/A C 1 ASPIRUS KEWEENAW ENTERPRISES INC 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 1 ASPIRUS HEALTH VENTURES 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 474925640 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF WI INC 300 WESTHILL DR SUITE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF MI INC 300 WESTHILL DR SUITE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 1 ASPIRUS CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC 2200 WESTWOOD DRIVE WAUSAU WI 54401 842513742 ASSOCIATION WI N/A C 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 ASPIRUS INC M 6268389 COST ASPIRUS INC O 15316519 COST ASPIRUS INC P 17540626 COST ASPIRUS INC S 4069635 COST ASPIRUS KEWEENAW HOSPITAL Q 106234 COST ASPIRUS MEDICAL GROUP INC O 972322 COST ASPIRUS WAUSAU HOSPITAL INC Q 133576 COST