ASPIRUS IRON RIVER HOSPITAL & CLINICS INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS IRON RIVER HOSPITAL & CLINICS INC (EIN 38-3236977)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-12
- IRS object ID
- 202201329349304045
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-12T12:41:17-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383236977 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS IRON RIVER HOSPITAL & CLINICS | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASPI | BusinessNameControlTxt |
| Phone | 9062656121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE RD | AddressLine1Txt |
| City | IRON RIVER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49935 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SIDNEY C SCZYGELSKI | PersonNm |
| Person Title | SENIOR VP OF FINANCE & CFO | PersonTitleTxt |
| Phone | 9062656121 | PhoneNum |
| Signature | 2022-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SIDNEY | PersonFirstNm |
| Person Last | SCZYGELSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2022-04-29 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SIDNEY C SCZYGELSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE RD | AddressLine1Txt |
| City | IRON RIVER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49935 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,259,105 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ASPIRUS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 253 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,959,952 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,495,474 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,399,290 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,586,219 | CYProgramServiceRevenueAmt |
| PY Investment Income | $443,948 | PYInvestmentIncomeAmt |
| CY Investment Income | $81,718 | CYInvestmentIncomeAmt |
| PY Other Revenue | $73,412 | PYOtherRevenueAmt |
| CY Other Revenue | $95,694 | CYOtherRevenueAmt |
| PY Total Revenue | $39,876,602 | PYTotalRevenueAmt |
| CY Total Revenue | $38,259,105 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $700 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,074,128 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,630,520 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,202,217 | PYOtherExpensesAmt |
| CY Other Expenses | $21,323,103 | CYOtherExpensesAmt |
| PY Total Expenses | $40,278,345 | PYTotalExpensesAmt |
| CY Total Expenses | $36,954,323 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$401,743 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,304,782 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $38,373,665 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,384,474 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $34,611,857 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,304,065 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,761,808 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,080,409 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,796,662 | ExpenseAmt |
| Grant | $700 | GrantAmt |
| Revenue | $35,586,297 | RevenueAmt |
| Desc | ASPIRUS IRON RIVER HOSPITAL (AIR) PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. IN 2020, AIR HAD 432 INPATIENT ADMISSIONS AND 1,130 INPATIENT DAYS ALONG WITH 5,870 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 18,456 PATIENT VISITS IN 2020. THE HOSPITAL ALSO PROVIDES ICU SERVICES ALONG WITH A SWING BED PROGRAM. THE HOSPITAL ALSO HAS A FULLY FUNCTIONING LAB AND RADIOLOGY DEPARTMENTS THAT ARE SUPPLEMENTED BY A MOBILE MRI UNIT THAT VISITS THE HOSPITAL CAMPUS WEEKLY. BECAUSE OF REGIONAL AFFILIATION, AIR IS ALSO ABLE TO PROVIDE ORTHOPEDIC, OB CLINIC VISITS, CARDIOLOGY, BEHAVIORAL HEALTH AND ONCOLOGY SERVICES. | Desc |
| Total Program Service Expenses | $24,796,662 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 29 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 253 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIDNEY C SCZYGELSKI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7158472250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 WESTWOOD DRIVE | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| JESSE TISCHER | ||||||||||
| DIRECTOR/SVP REGIONAL MARKETS | 2.00 | 50.00 | Yes (X) | $0 | $551,417 | $54,431 | ||||
| JENNY REDMAN-SCHELL | ||||||||||
| VICE-CHRM/SVP, PRES ASPIRUS CLINICS | 2.00 | 50.00 | Yes (X) | $0 | $481,240 | $39,357 | Yes (X) | |||
| JONATHAN N BRUEGGEMAN | ||||||||||
| DIRECTOR/CMO-UP REGION | 2.00 | 50.00 | Yes (X) | $0 | $453,924 | $52,824 | ||||
| CHRIS HARFF | ||||||||||
| PRESIDENT - REGIONAL UP | 2.00 | 50.00 | Yes (X) | $0 | $370,858 | $49,687 | Yes (X) | |||
| MARCUS SANTINI | ||||||||||
| DIRECTOR/PHYSICIAN | 2.00 | 50.00 | Yes (X) | $0 | $323,075 | $52,713 | ||||
| JENNIFER E WEAVER | ||||||||||
| DIRECTOR/FNP | 2.00 | 50.00 | Yes (X) | $0 | $109,982 | $36,518 | ||||
| KRISTEN MESKE | ||||||||||
| DIRECTOR/NP (THRU OCT) | 40.00 | Yes (X) | $127,716 | $0 | $5,917 | |||||
| JAMES LORENSON | ||||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| STEVEN TINTI | ||||||||||
| TREASURER | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| KATIE CLARK | ||||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||||
| JOHN D MATONICH | ||||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| KIRK R SCHOTT | ||||||||||
| DIRECTOR/PHYSICIAN | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| WILLIAM W WOOD | ||||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| ELIZABETH F TWARDZIK | ||||||||||
| DIRECTOR (THRU OCT) | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| RICHARD J KOUBEK | ||||||||||
| DIRECTOR (THRU OCT) | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| MATT HEYWOOD | ||||||||||
| PRESIDENT & CEO ASPIRUS | 2.00 | 50.00 | $0 | $1,316,596 | $71,205 | Yes (X) | ||||
| SIDNEY SCYZGELSKI | ||||||||||
| SR. VP OF FINANCE/CFO | 2.00 | 50.00 | $0 | $861,658 | $62,993 | Yes (X) | ||||
| GLENN E DOBSON | ||||||||||
| SENIOR FINANCIAL ANALYST | 40.00 | $161,146 | $0 | $35,247 | Yes (X) | |||||
| RAE KAARE | ||||||||||
| CHIEF ADMNISTRATIVE OFFICER - AIR | 40.00 | $98,459 | $52,915 | $36,325 | Yes (X) | |||||
| JOHN HEISLER | ||||||||||
| SVP, CHIEF HUMAN RESOURCES OFFICER | 2.00 | 50.00 | $0 | $571,823 | $43,247 | Yes (X) | ||||
| RENEE SMITH | ||||||||||
| SVP, SYSTEM CHIEF NURSING OFFICER | 2.00 | 50.00 | $0 | $506,661 | $49,619 | Yes (X) | ||||
| TODD RICHARDSON | ||||||||||
| SVP SYSTEM CMOS | 2.00 | 50.00 | $0 | $455,671 | $52,263 | Yes (X) | ||||
| RUTH RISLEY-GRAY | ||||||||||
| SVP, SYSTEM CHIEF NURSING OFFICER | 2.00 | 50.00 | $0 | $419,745 | $45,966 | Yes (X) | ||||
| MICHAEL MCGRAIL | ||||||||||
| SVP, SYSTEM CHIEF MEDICAL OFFICER | 2.00 | 50.00 | $0 | $426,022 | $0 | Yes (X) | ||||
| RICK NEVERS | ||||||||||
| SVP - REG. OPS. SYS. INT. OFFICER | 2.00 | 50.00 | $0 | $371,883 | $30,050 | Yes (X) | ||||
| PATRICK TINCHER JR | ||||||||||
| VP-FINANCE REGIONAL OPERATIONS | 2.00 | 50.00 | $0 | $294,390 | $54,241 | Yes (X) | ||||
| GRACE TOUSIGNANT | ||||||||||
| VP - REGIONAL PAT. CARE & CNO | 2.00 | 30.00 | $0 | $267,199 | $34,314 | Yes (X) | ||||
| ERIC ANDERSON | ||||||||||
| SVP- SERVICE LINE & PATIENT EXP. | 2.00 | 50.00 | $0 | $475,604 | $56,304 | Yes (X) | ||||
| JAMISON GOULD | ||||||||||
| CHIEF CRNA | 2.00 | 40.00 | $272,007 | $0 | $49,859 | Yes (X) | ||||
| MEDHAT FANOUS | ||||||||||
| PHYSICIAN | 40.00 | $627,420 | $0 | $44,284 | Yes (X) | |||||
| TAKI RIDA | ||||||||||
| PHYSICIAN | 40.00 | $325,880 | $0 | $29,587 | Yes (X) | |||||
| DONALD PATTON | ||||||||||
| PHYSICIAN | 40.00 | $276,413 | $0 | $39,589 | Yes (X) | |||||
| MARITES ANSAY | ||||||||||
| PHYSICIAN | 40.00 | $269,037 | $0 | $29,625 | Yes (X) | |||||
| MATTHEW SONGER | ||||||||||
| PHYSICIAN | 40.00 | $260,875 | $0 | $5,118 | Yes (X) | |||||
| CARI LOGEMANN | ||||||||||
| SVP-GEN. COUNSEL (THRU 06/20) | 2.00 | 50.00 | $0 | $437,354 | $22,668 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,418,953 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,748,017 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,083,951 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| INNOVA EMERGENCY SERVICES | |||||
| 700 N COLORADO BLVD SUITE 109 | DENVER | CO | 80206 | EMERGENCY DEPT PROVIDERS | $1,949,238 |
| ORTHOPEDIC SOLUTIONS | |||||
| N10565 GRANDVIEW LN | IRONWOOD | MI | 49938 | LOCUM DOCTOR | $475,000 |
| JOHN MAESAKA MD | |||||
| 15730 CTY RD 28 | GOSHEN | IN | 46528 | LOCUM DOCTOR | $382,700 |
| TELEHEALTH SOLUTIONS PLLC | |||||
| PO BOX 1813 | SPARTANBURG | SC | 29304 | ELECTRONIC MEDICAL SERVICES | $288,850 |
| UPPER PENINSULA HEALTH CARE SOLUTIONS | |||||
| 853 WEST WASHINGTON ST | MARQUETTE | WI | 49855 | MOBILE MRI SERVICES | $280,375 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,461,538 | GovernmentGrantsAmt |
| All Other Contributions | $33,936 | AllOtherContributionsAmt |
| Noncash Contributions | $32,936 | NoncashContributionsAmt |
| Total Contributions | $2,495,474 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $32,975,362 | $32,975,362 |
| PHARMACY REVENUE | 446110 | $2,012,559 | $2,012,559 |
| CONTRACT SERVICE REVENUE | 621110 | $44,824 | $44,824 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $553,474 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $553,474 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,586,219 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,988 | TotalRevenueColumnAmt |
| Exclusion | $3,988 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,401 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,401 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,401 | TotalRevenueColumnAmt |
| Exclusion | $54,401 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $77,730 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $77,730 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,730 | TotalRevenueColumnAmt |
| Exclusion | $77,730 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SALES | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $41,215 | TotalRevenueColumnAmt |
| Exclusion | $41,215 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $78 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $41,293 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,259,105 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,586,297 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $177,334 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700 | TotalAmt |
| Program Services | $700 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $488,865 | TotalAmt |
| Program Services | $425,904 | ProgramServicesAmt |
| Management And General | $62,961 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,196,380 | TotalAmt |
| Program Services | $9,411,068 | ProgramServicesAmt |
| Management And General | $2,785,312 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,369 | TotalAmt |
| Management And General | $63,369 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,055,651 | TotalAmt |
| Program Services | $1,553,086 | ProgramServicesAmt |
| Management And General | $502,565 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $826,255 | TotalAmt |
| Program Services | $625,017 | ProgramServicesAmt |
| Management And General | $201,238 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,719 | TotalAmt |
| Management And General | $78,719 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,157 | TotalAmt |
| Management And General | $5,157 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,619 | TotalAmt |
| Management And General | $1,619 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,855,509 | TotalAmt |
| Program Services | $5,596,367 | ProgramServicesAmt |
| Management And General | $259,142 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,316 | TotalAmt |
| Management And General | $14,316 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,857 | TotalAmt |
| Program Services | $25,231 | ProgramServicesAmt |
| Management And General | $25,626 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,660 | TotalAmt |
| Program Services | $10,547 | ProgramServicesAmt |
| Management And General | $2,113 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,739 | TotalAmt |
| Program Services | $95,197 | ProgramServicesAmt |
| Management And General | $627,542 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,453 | TotalAmt |
| Program Services | $16,556 | ProgramServicesAmt |
| Management And General | $16,897 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,908 | TotalAmt |
| Program Services | $358 | ProgramServicesAmt |
| Management And General | $333,550 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,899,928 | TotalAmt |
| Program Services | $500,485 | ProgramServicesAmt |
| Management And General | $1,399,443 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,387 | TotalAmt |
| Program Services | $28,777 | ProgramServicesAmt |
| Management And General | $112,610 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CORPORATE ALLOCATIONS | $5,411,314 | $1,120,265 | $4,291,049 |
| MEDICAL SUPPLIES | $4,334,257 | $4,295,425 | $38,832 |
| HOSPITAL TAX | $886,721 | $886,721 | |
| REPAIRS & MAINTENANCE | $800,587 | $526,416 | $274,171 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $739,972 | TotalAmt |
| Program Services | $565,263 | ProgramServicesAmt |
| Management And General | $174,709 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,954,323 | TotalAmt |
| Program Services | $24,796,662 | ProgramServicesAmt |
| Management And General | $12,157,661 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $906,229 | BOYAmt |
| EOY | $947,166 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,866 | BOYAmt |
| EOY | $254,895 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,990,850 | BOYAmt |
| EOY | $3,097,557 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $690,350 | BOYAmt |
| EOY | $748,090 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,559 | BOYAmt |
| EOY | $931,677 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $47,419,501 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,208,638 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,919,674 | BOYAmt |
| EOY | $21,210,863 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,561,137 | BOYAmt |
| EOY | $10,194,226 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,373,665 | BOYAmt |
| EOY | $37,384,474 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,354,829 | BOYAmt |
| EOY | $3,426,008 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,119,883 | BOYAmt |
| EOY | $298,923 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,653,404 | BOYAmt |
| EOY | $17,200,700 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,483,741 | BOYAmt |
| EOY | $10,378,434 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,611,857 | BOYAmt |
| EOY | $31,304,065 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,761,808 | BOYAmt |
| EOY | $6,080,409 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,761,808 | BOYAmt |
| EOY | $6,080,409 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,373,665 | BOYAmt |
| EOY | $37,384,474 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,304,782 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $34,625 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $979,194 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,157 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,157 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | 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 18.5% OF $10,490 ($1,941) GOES FOR LOBBYING ON INVOICE COVERING THE PERIOD OF 7/1/20-6/30/21. SIMILARLY, AHA DUES COMMITTED TO LOBBYING WAS 25.56% OF $12,583 ($3,216). | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $210,026 | OtherCostOrOtherBasisAmt |
| Book Value | $210,026 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,007,754 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,294,951 | DepreciationAmt |
| Book Value | $17,712,803 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,851,907 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,871,558 | DepreciationAmt |
| Book Value | $2,980,349 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $349,814 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,129 | DepreciationAmt |
| Book Value | $307,685 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,210,863 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RELATED PARTY RECEIVABLES | $9,747,142 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $35,000 |
| INVESTMENT IN UNCOLSOLIDATD AFFILIATES | $394,408 |
| NONCURRENT ASSETS LIMITED AS TO USE - DEFERRED COMPENSATION | $1,045 |
| OPERATING LEASE ROU ASSET | $16,631 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,194,226 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)
| DescDesc | AmtAmt |
|---|---|
| RELATED PARTY PAYABLES | $4 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $1,737,440 |
| MEDICARE REFUNDABLE ADVANCES | $8,057,517 |
| FINANCE LEASE LIABILITY | $126,561 |
| DEFERRED COMPENSATION | $1,045 |
| OPERATING LEASE LIABILITY | $16,170 |
| LONG TERM FICA | $213,914 |
| LONG TERM INSURANCE | $32,000 |
| LONG TERM PENSION | $181,324 |
| DEFERRED POSTRETIREMENT BENEFITS | $12,459 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,378,434 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2021. ASPIRUS' FEDERAL INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR ENDED JUNE 30, 2017, AND PRIOR YEARS. ASPIRUS' WISCONSIN AND MICHIGAN STATE INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR ENDED JUNE 30, 2016, AND PRIOR YEARS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $272,778 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $272,778 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,487,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,036,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,451,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06700 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,760,057 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,036,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,723,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07450 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,375 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,375 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,375 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,375 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,761,432 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,036,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,725,261 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07450 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $146,001 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,606,234 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,593,898 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $12,336 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS IRON RIVER HOSPITAL & CLINICS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W ICE LAKE ROAD | AddressLine1Txt |
| City | IRON RIVER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49935 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ASPIRUS.ORG | WebsiteAddressTxt |
| State License | 732-410 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS IRON RIVER HOSPITAL & CLINICS I | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.ASPIRUS.ORG/FINANCIALAID | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ASPIRUS.ORG/FINANCIALAID | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.ASPIRUS.ORG/FINANCIALAID | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 3J: IMPLEMENTATION STRATEGY AND BUDGET PROJECTIONS. |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 5: DATA FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS GATHERED FROM A WIDE ARRAY OF PUBLISHED SOURCES, FROM A SURVEY OF 4,820 RESIDENTS OF THE 15 COUNTIES, AND FROM HEALTH CARE PROVIDERS. EXTERNAL, OR SECONDARY, DATA SOURCES INCLUDE THE US CENSUS BUREAU AND ITS AMERICAN COMMUNITY SURVEY, AS WELL AS STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE FEDERAL CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER GOVERNMENT AND PRIVATE AGENCIES. |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 6A: ASPIRUS KEWEENAW HOSPITAL AND ASPIRUS IRONWOOD HOSPITAL |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 7D: WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 11: USING A SET OF CATEGORIES AND THE DATA WITHIN, ASPIRUS IRON RIVER IDENTIFIED FOUR MAJOR PRIORITY AREAS THAT IMPACT EACH OF THE UPPER PENINSULA COUNTIES AND IRON COUNTY, WI. FOR THE PURPOSES OF THE ASPIRUS IRON RIVER CHNA, AND TO FULFILL THE REQUIREMENTS SET FORTH BY THE PPACA, ASPIRUS IRON RIVER HAS TAKEN THE FOUR OVERALL PRIORITIES AND WILL BE ADDRESSING THESE NEEDS AND LOOKING TO MAKE AN IMPACT ON THE FUTURE OF OUR COMMUNITIES. THE FOUR MAJOR PRIORITY AREAS THAT WILL BE THE FOCUS ARE: 1. HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES, 2. DRUG ABUSE, 3. LACK OF HEALTH INSURANCE, 4. UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONS. BASED ON THE INDIVIDUAL DATA FOR IRON COUNTY, ASPIRUS IRON RIVER HOSPITAL WILL CONTINUE TO FOCUS ON THE FOLLOWING IN ORDER TO MAKE THE GREATEST COMMUNITY IMPACT: 1. THE IMPACT ON AN AGING POPULATION, 2. THE IMPORTANCE OF PREVENTION, 3. THE POWERFUL CORRELATION BETWEEN SOCIO-ECONOMIC STATUS AND POOR HEALTH, 4. EXPANDED ACCESS TO CARE VIA THE EVOLVING AFFORDABLE CARE ACT. ASPIRUS IRON RIVER ALSO HAD THE FOLLOWING IMPLEMENTATION STRATEGIES: 1. FOCUS HUMAN RESOURCE AND LOCAL PUBLIC RELATIONS RESOURCES ON HEALTHY EATING, NUTRITION COMMUNITY OUTREACH AND WELLNESS, 2. SUPPORT THE DIABETES EDUCATION PROGRAM TO GROW PATIENT ENCOUNTERS BY 5% ANNUALLY OVER 3 YEARS ALONG WITH A FOCUS ON STROKE AWARENESS AND PREVENTION, 3. REACH 50% OF IRON COUNTY POPULATION ANNUALLY WITH "HOW TO" INFORMATION REGARDING POSITIVE DISEASE PREVENTION BEHAVIORS AND ACCESS TO SERVICES, 4. CONTINUE TO SUPPORT SMOKING AND RUN CESSATION EDUCATION WITH A DIRECTED EFFORT TOWARDS ADOLESCENTS AND FAMILIES. |
| ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. | PART V, SECTION B, LINE 13H: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ASPIRUS IRON RIVER CLINIC | ||||
| 814 S ICE LAKE ROAD | IRON RIVER | MI | 49935 | PHYSICIAN PRACTICES, REHAB AND OUTPATIENT CLINIC |
| 2 - CRYSTAL FALLS CLINIC | ||||
| 1328 US HWY 2 | CRYSTAL FALLS | MI | 49920 | FAMILY PRACTICE |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED WAS A COST-TO-CHARGE RATIO. |
| PART I, LN 7 COL(F): | IN CALCULATING THE PERCENTAGES IN PART 1, LINE 7 BAD DEBT EXPENSE OF $374,361 WAS EXCLUDED FROM THE DENOMINATOR. |
| 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 RECEIVABLE 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 8: | THE COSTING METHODOLOGY USED TO DETERMINE ALLOWABLE COSTS REPORTED ABOVE IS THE COST TO CHARGE RATIO. |
| PART III, LINE 9B: | UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENT'S ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT. |
| PART VI, LINE 2: | ASPIRUS IRON RIVER HOSPITAL & CLINICS USES HEALTH AND SOCIAL DATA AND TRENDS FOR THE SAME TO DETERMINE POSSIBLE UNMET NEEDS WITH THE COMMUNITY IT SERVES. IT ALSO USES ITS TEAM MEMBERS' INVOLVEMENT IN COMMUNITY EVENTS TO USE AS A THERMOMETER FOR WHAT IS NEEDED. |
| PART VI, LINE 3: | ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. |
| PART VI, LINE 4: | THE CHNA GIVES A DETAILED BREAKDOWN OF THE COMMUNITY THAT ASPIRUS IRON RIVER SERVES ALONG WITH THE DETAILS ABOUT THE SEVERE CHALLENGES TO A RURAL COMMUNITY WITH A SIGNIFICANT AGING POPULATION. |
| PART VI, LINE 5: | ASPIRUS IRON RIVER HAS A REGIONAL BOARD OF DIRECTORS THAT INCLUDES SEVERAL INDIVIDUALS FROM THE COMMUNITY WITH A FOCUS ON HAVING THEM BE INDEPENDENT (I.E., HAVING NO DIRECT TIES TO THE HOSPITAL SYSTEM). MEDICAL PRIVILEGES ARE EXTENDED TO ALL LOCAL, QUALIFIED PROVIDERS. THROUGH MANY OPPORTUNITIES IN THE COMMUNITIES THAT WE SERVE, INVESTMENTS ARE MADE BACK INTO THE COMMUNITY INCLUDING DONATIONS TO SUPPORT LOCAL, HEALTH INSPIRED ACTIVITIES ANNUALLY. THESE OPPORTUNITIES RELATE TO THE SCHOOLS, ELDERLY CARE SERVICES, AMERICAN CANCER SOCIETY, HEALTH SCREENING, AND OTHERS. |
| PART VI, LINE 6: | ASPIRUS IRON RIVER IS A PART OF THE ASPIRUS, INC. SYSTEM WITH THE MAIN BASE IN WAUSAU WI. TOGETHER WE PROMOTE THE MISSION AND WORK COLLABORATIVELY TO SHARE THE PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. THE COMBINED EFFORTS ARE ABLE TO PROVIDE THE SMALLER COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. ALSO, AS PART OF THIS SYSTEM ARE 3 OTHER UPPER PENINSULA OF MI HOSPITALS AND 4 OTHER HOSPITAL SYSTEMS IN WI ALONG WITH POST-ACUTE CARE PROGRAMS, MANY PROVIDER CLINICS, AMBULANCE SERVICE AND LONG-TERM CARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATT HEYWOOD | ||||||||||||||
| PRESIDENT & CEO ASPIRUS | $0 | $992,466 | $0 | $321,290 | $0 | $2,840 | $0 | $17,196 | $0 | $54,009 | $0 | $1,387,801 | $0 | $0 |
| SIDNEY SCYZGELSKI | ||||||||||||||
| SR. VP OF FINANCE/CFO | $0 | $571,336 | $0 | $102,719 | $0 | $187,603 | $0 | $20,046 | $0 | $42,947 | $0 | $924,651 | $0 | $174,000 |
| MEDHAT FANOUS | ||||||||||||||
| PHYSICIAN | $562,440 | $0 | $53,108 | $0 | $11,872 | $0 | $11,232 | $0 | $33,052 | $0 | $671,704 | $0 | $0 | $0 |
| JOHN HEISLER | ||||||||||||||
| SVP, CHIEF HUMAN RESOURCES OFFICER | $0 | $339,009 | $0 | $66,240 | $0 | $166,574 | $0 | $17,196 | $0 | $26,051 | $0 | $615,070 | $0 | $152,214 |
| JESSE TISCHER | ||||||||||||||
| DIRECTOR/SVP REGIONAL MARKETS | $0 | $458,373 | $0 | $92,613 | $0 | $431 | $0 | $11,473 | $0 | $42,958 | $0 | $605,848 | $0 | $0 |
| RENEE SMITH | ||||||||||||||
| SVP, SYSTEM CHIEF NURSING OFFICER | $0 | $381,673 | $0 | $68,268 | $0 | $56,720 | $0 | $17,196 | $0 | $32,423 | $0 | $556,280 | $0 | $55,911 |
| ERIC ANDERSON | ||||||||||||||
| SVP- SERVICE LINE & PATIENT EXP. | $0 | $399,509 | $0 | $67,809 | $0 | $8,286 | $0 | $17,196 | $0 | $39,108 | $0 | $531,908 | $0 | $0 |
| JENNY REDMAN-SCHELL | ||||||||||||||
| VICE-CHRM/SVP, PRES ASPIRUS CLINICS | $0 | $411,201 | $0 | $69,616 | $0 | $423 | $0 | $17,196 | $0 | $22,161 | $0 | $520,597 | $0 | $0 |
| TODD RICHARDSON | ||||||||||||||
| SVP SYSTEM CMOS | $0 | $341,475 | $0 | $67,414 | $0 | $46,782 | $0 | $17,196 | $0 | $35,067 | $0 | $507,934 | $0 | $43,823 |
| JONATHAN N BRUEGGEMAN | ||||||||||||||
| DIRECTOR/CMO-UP REGION | $0 | $423,385 | $0 | $25,000 | $0 | $5,539 | $0 | $17,196 | $0 | $35,628 | $0 | $506,748 | $0 | $0 |
| RUTH RISLEY-GRAY | ||||||||||||||
| SVP, SYSTEM CHIEF NURSING OFFICER | $0 | $309,508 | $0 | $60,518 | $0 | $49,719 | $0 | $20,046 | $0 | $25,920 | $0 | $465,711 | $0 | $41,695 |
| CARI LOGEMANN | ||||||||||||||
| SVP-GEN. COUNSEL (THRU 06/20) | $0 | $228,246 | $0 | $78,456 | $0 | $130,652 | $0 | $15,527 | $0 | $7,141 | $0 | $460,022 | $0 | $129,488 |
| MICHAEL MCGRAIL | ||||||||||||||
| SVP, SYSTEM CHIEF MEDICAL OFFICER | $0 | $0 | $0 | $0 | $0 | $426,022 | $0 | $0 | $0 | $0 | $0 | $426,022 | $0 | $425,671 |
| CHRIS HARFF | ||||||||||||||
| PRESIDENT - REGIONAL UP | $0 | $309,269 | $0 | $59,238 | $0 | $2,351 | $0 | $15,293 | $0 | $34,394 | $0 | $420,545 | $0 | $0 |
| RICK NEVERS | ||||||||||||||
| SVP - REG. OPS. SYS. INT. OFFICER | $0 | $263,896 | $0 | $64,103 | $0 | $43,884 | $0 | $17,172 | $0 | $12,878 | $0 | $401,933 | $0 | $39,905 |
| MARCUS SANTINI | ||||||||||||||
| DIRECTOR/PHYSICIAN | $0 | $301,396 | $0 | $5,555 | $0 | $16,124 | $0 | $17,196 | $0 | $35,517 | $0 | $375,788 | $0 | $0 |
| TAKI RIDA | ||||||||||||||
| PHYSICIAN | $287,450 | $0 | $33,000 | $0 | $5,430 | $0 | $10,720 | $0 | $18,867 | $0 | $355,467 | $0 | $0 | $0 |
| PATRICK TINCHER JR | ||||||||||||||
| VP-FINANCE REGIONAL OPERATIONS | $0 | $253,982 | $0 | $33,626 | $0 | $6,782 | $0 | $16,372 | $0 | $37,869 | $0 | $348,631 | $0 | $0 |
| JAMISON GOULD | ||||||||||||||
| CHIEF CRNA | $261,552 | $0 | $5,000 | $0 | $5,455 | $0 | $13,730 | $0 | $36,129 | $0 | $321,866 | $0 | $0 | $0 |
| DONALD PATTON | ||||||||||||||
| PHYSICIAN | $261,273 | $0 | $15,140 | $0 | $0 | $0 | $13,187 | $0 | $26,402 | $0 | $316,002 | $0 | $0 | $0 |
| GRACE TOUSIGNANT | ||||||||||||||
| VP - REGIONAL PAT. CARE & CNO | $0 | $191,897 | $0 | $24,789 | $0 | $50,513 | $0 | $10,975 | $0 | $23,339 | $0 | $301,513 | $0 | $48,116 |
| MARITES ANSAY | ||||||||||||||
| PHYSICIAN | $261,236 | $0 | $0 | $0 | $7,801 | $0 | $15,660 | $0 | $13,965 | $0 | $298,662 | $0 | $0 | $0 |
| MATTHEW SONGER | ||||||||||||||
| PHYSICIAN | $255,875 | $0 | $5,000 | $0 | $0 | $0 | $5,118 | $0 | $0 | $0 | $265,993 | $0 | $0 | $0 |
| GLENN E DOBSON | ||||||||||||||
| SENIOR FINANCIAL ANALYST | $151,584 | $0 | $375 | $0 | $9,187 | $0 | $8,865 | $0 | $26,382 | $0 | $196,393 | $0 | $0 | $0 |
| RAE KAARE | ||||||||||||||
| CHIEF ADMNISTRATIVE OFFICER - AIR | $81,429 | $52,434 | $16,314 | $481 | $716 | $0 | $6,430 | $5,070 | $13,392 | $11,433 | $118,281 | $69,418 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, LINES 4A-B | SCHEDULE J, PART I, LINE 4A - SEVERANCE PAY MICHAEL MCGRAIL RECEIVED SEVERANCE PAY TOTALING $426,022 FOR CALENDAR YEAR 2020. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(7) DISTRIBUTION: S. SCZYGELSKI $174,000 C. LOGEMANN $129,488 J. HEISLER $152,214 M. MCGRAIL $425,671 R. NEVERS $39,905 T. RICHARDSON $43,823 R. RISLEY-GRAY $41,695 R. SMITH $55,911 G. TOUSIGNANT $48,116 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 9% FOR VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL, AND 15% FOR THE CEO. 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; THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| CUSIP | 463003AA1 | CUSIPNum |
| Bond Issued | 2015-05-07 | BondIssuedDt |
| Issue Price | $19,765,185 | IssuePriceAmt |
| Purpose | REFUND 2008 ISSUE | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $315,000 | RetiredAmt |
| Total Proceeds | $19,765,185 | TotalProceedsAmt |
| Substantial Completion | 2010 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | 0 | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | Yes (1) | GrossProceedsInvestedInGICInd |
| Regulatory Safe Harbor Stsfd | 0 | RegulatorySafeHarborStsfdInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART VI | THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2015 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. (EIN 38-3236977); AND ASPIRUS KEWEENAW HOSPITAL (EIN 38-1443361). INFORMATION REGARDING THE SERIES 2015 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2015 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2015 BONDS.] |
| PART III, LINES 3A AND 3B | ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS IRON RIVER 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. |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | 2 VENTILATORS | Desc |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $32,936 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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 | 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 HOSPITAL'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS 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 | A COPY OF THE FILE FORM 990 IS AVAILABLE TO THE PUBLIC THROUGH REQUEST FROM ANY MEMBER OF THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,159,266. MANAGEMENT AND GENERAL EXPENSES 259,142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,418,408. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 287,842. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 287,842. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 722,587. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 722,587. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,426,672. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,426,672. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFERS - AWH 370,816. EQUITY TRANSFERS - AI 321,209. EQUITY TRANFERS - AMG 339,013. EQUITY TRANSFERS - AOH -2,597. EQUITY TRANSFERS - VNA -38,171. EQUITY TRANSFERS - AIW -340,425. EQUITY TRANSFERS - ARH 42,422. EQUITY TRANSFERS - ADS 125. EQUITY TRANSFERS - AKH 286,802. |
| FORM 990, PART XII, LINE 3B | THE ORGANIZATION IS REQUIRED TO BE INCLUDED IN A SINGLE AUDIT FOR THE YEAR ENDED 06/30/2021. THE DEADLINE FOR THIS FILING FALLS AFTER THE DEADLINE FOR THE 990 FOR THE SAME FISCAL YEAR END. THE SINGLE AUDIT WILL NOT BE FINALIZED AT THE TIME OF THIS SUBMISSION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASPIRUS INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391328331 | HEALTHCARE | WI | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| ASPIRUS WAUSAU HOSPITAL INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391138241 | HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS BUILDINGS INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391406537 | PROPERTY LEASING | WI | 501(C)(3) | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS EXTENDED SERVICES INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 390782130 | NURSING HOME SERVICES | WI | 501(C)(3) | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS MEDICAL GROUP INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391670223 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS ONTONAGON HOSPITAL INC | |||||||||||
| 601 SEVENTH STREET | ONTONAGON | MI | 49953 | 260806477 | HOSPITAL | MI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS VNA HOME HEALTH INC | |||||||||||
| 520 N 32ND AVENUE | WAUSAU | WI | 54401 | 390808511 | HOME HEALTH CARE SERVICES | WI | 501(C)(3) | LINE 10 | Yes (1) | ASPIRUS INC | |
| ASPIRUS VNA EXTENDED CARE INC | |||||||||||
| 520 N 32ND AVENUE | WAUSAU | WI | 54401 | 391597350 | PERSONAL CARE SERVICES | WI | 501(C)(3) | LINE 10 | Yes (1) | ASPIRUS VNA HOME HEALTH INC | |
| ASPIRUS HEALTH FOUNDATION INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391256656 | CHARITABLE FOUNDATION | WI | 501(C)(3) | LINE 7 | Yes (1) | ASPIRUS INC | |
| ASPIRUS IRONWOOD HOSPITAL & CLINICS INC | |||||||||||
| N 10561 GRAND VIEW LANE | IRONWOOD | MI | 49938 | 382908586 | HOSPITAL | MI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC | |||||||||||
| 410 DEWEY STREET | WISCONSIN RAPIDS | WI | 54494 | 390868982 | HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS KEWEENAW HOSPITAL | |||||||||||
| 205 OSCEOLA STREET | LAURIUM | MI | 49913 | 381443361 | HOSPITAL | MI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
| ASPIRUS IRON AREA HEALTH FOUNDATION | |||||||||||
| 1400 WEST ICE LAKE ROAD | IRON RIVER | MI | 49935 | 383762132 | CHARITABLE FOUNDATION | MI | 501(C)(3) | LINE 3 | N/A | 0 | |
| DIVINE SAVIOR HEALTHCARE INC | |||||||||||
| 2817 NEW PINERY ROAD | PORTGAGE | WI | 53901 | 390806250 | HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | ASPIRUS INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | CONFERENCE CENTER | WI | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ASPIRUS NETWORK INC | |||||||||
| 3000 WESTHILL DRIVE 202 | WAUSAU | WI | 54401 | 391931678 | HEALTH CARE SERVICES | WI | N/A | C | Yes (1) |
| ASPIRUS KEWEENAW ENTERPRISES INC | |||||||||
| 205 OSCEOLA STREET | LAURIUM | MI | 49913 | 383390273 | PHARMACY | MI | N/A | C | Yes (1) |
| ASPIRUS HEALTH VENTURES | |||||||||
| 3000 WESTHILL DR SUITE 303 | WAUSAU | WI | 54401 | 474925640 | HEALTH INSURANCE PLAN | WI | N/A | C | Yes (1) |
| ASPIRUS ARISE HEALTH PLAN OF WI INC | |||||||||
| 300 WESTHILL DR SUITE 303 | WAUSAU | WI | 54401 | 364832569 | HEALTH INSURANCE PLAN | WI | N/A | C | Yes (1) |
| ASPIRUS ARISE HEALTH PLAN OF MI INC | |||||||||
| 300 WESTHILL DR SUITE 303 | WAUSAU | WI | 54401 | 475448266 | HEALTH INSURANCE PLAN | MI | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (9 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ASPIRUS WAUSAU HOSPITAL INC | ||
| O | $160,455 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| P | $335,414 | COST |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| Q | $121,133 | COST |
| ASPIRUS INC | ||
| M | $5,497,123 | COST |
| ASPIRUS INC | ||
| O | $15,772,658 | COST |
| ASPIRUS INC | ||
| P | $643,574 | COST |
| ASPIRUS MEDICAL GROUP INC | ||
| O | $352,788 | COST |
| ASPIRUS IRONWOOD HOSPITAL & CLINICS INC | ||
| M | $133,854 | COST |
| ASPIRUS KEWEENAW HOSPITAL | ||
| O | $258,803 | COST |