2022-05-12T12:27:03-05:00 2021-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-07-01 390782130 ASPIRUS EXTENDED SERVICES INC ASPI 7158472250 425 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 7158472250 2022-05-06 1 SIDNEY SCZYGELSKI 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-04-29 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 4592675 0 X WWW.ASPIRUS.ORG X 1999 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 6 2 149 2 0 0 4084 3024 5066862 4567919 2617 3864 20338 17868 5093901 4592675 0 0 0 0 3797330 4226719 0 0 0 1897766 2081492 5695096 6308211 -601195 -1715536 4699871 3801407 1716294 2113366 2983577 1688041 WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 4023203 0 4567919 ASPIRUS EXTENDED SERVICES, INC. (AES) OPERATES A 50-BED SKILLED NURSING FACILITY (PLEASANT VIEW), A SENIOR APARTMENT COMPLEX, A 16-UNIT CBRF (COMMUNITY BASED RESIDENTIAL CARE FACILITY), AND TWO ADULT FAMILY HOMES IN PHILLIPS, WISCONSIN. 4023203 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 X TODD RICHARDSON SECRETARY/SVP & CIO AI 1.00 50.00 X X 0 455671 52263 JEANNINE NOSKO SECRETARY/VP-PATIENT CARE 1.00 50.00 X X 0 307358 46788 DALE HUSTEDT VICE CHAIR/PRESIDENT- AMH 1.00 50.00 X 0 314608 49199 LISA ROWE-PEPLINSKI TREASURER/VP-CORPORATE QLT 1.00 50.00 X X 0 322497 17989 PAUL RYBAK CHAIR (THRU JUN) 1.00 X X 0 0 0 BRIAN BARATKA MEMBER 1.00 X 0 0 0 COURTNEY GRAFF MEMBER 1.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1316596 71205 SIDNEY SCZYGELSKI SR. VP OF FINANCE/CFO 2.00 50.00 X 0 861658 62993 CYNTHIA RIDER VP- POST ACUTE CARE 1.00 50.00 X 0 277154 45877 PAUL DAVID INTERIM SVP & GENERAL COUNSEL 1.00 50.00 X 0 0 0 JOHN HEISLER SVP & CHIEF HUMAN RESOURCES OFFICER 2.00 50.00 X 0 571823 43247 RENEE SMITH EXECUTIVE DIRECTOR ANI 2.00 50.00 X 0 506661 49619 JESSE TISCHER SVP & PRESIDENT- REGIONAL MARKETS 2.00 50.00 X 0 551417 54431 ERIC ANDERSON SVP- SERVICE LINE & PATIENT EXP. 2.00 50.00 X 0 475604 56304 JENNIFER REDMAN-SCHELL SVP & PRESIDENT- ASPIRUS CLINICS 2.00 50.00 X 0 481240 39357 RUTH RISLEY-GRAY SVP & SYSTEM CHIEF NURSING OFFICER 2.00 50.00 X 0 419745 45966 MICHAEL MCGRAIL SVP & SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 426022 0 RICK NEVERS SVP- REG. OPS. SYSTEM INT. OFFICER 2.00 50.00 X 0 371883 30050 SCOTT REMMICH VP- CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 260585 39979 LORI PECK VP- REVENUE CYCLE 2.00 50.00 X 0 275069 15474 CARI LOGEMANN SVP & GENERAL COUNSEL (THRU 06/20) 2.00 50.00 X 0 437354 22668 0 8632945 743409 0 1 1 0 STAFFENCY 221 W COLLEGE AVENUE FLOOR 2 APPLETON WI 54911 STAFFING SERVICES 193260 PROLINK HEALTHCARE LLC 4600 MONTGOMERY ROAD SUITE 300 CINCINNATI OH 45212 STAFFING SERVICES 190517 2 3024 3024 PATIENT SERVICES REVEN 623000 4515838 4515838 52081 52081 4567919 3864 3864 17868 0 17868 17868 17868 4592675 4567919 0 21732 3150280 2424546 725734 130420 106012 24408 722056 586926 135130 223963 182049 41914 585 585 377168 318950 58218 376 376 6014 6014 715 715 174689 82016 92673 16057 12326 3731 21523 21523 281517 18991 262526 15491 15491 CORPORATE ALLOCATIONS 573105 573105 MEDICAL SUPPLIES 241633 212969 28664 FOOD 219812 55203 164609 WMAP ASSESSMENT 85000 85000 67807 23215 44592 6308211 4023203 2285008 0 1288375 917297 624465 349827 22665 29699 29211 3552 8757433 6322399 2705458 2435034 29697 65998 4699871 3801407 539404 965048 765802 696064 411088 452254 1716294 2113366 X 2983577 1688041 2983577 1688041 4699871 3801407 X -1715536 420000 X X 0 1 X 1 1 0 X 13339 3246 11137 4084 3024 34830 4992256 5006885 4917717 5066862 4567922 24551642 5005595 5010131 4928854 5070946 4570946 24586472 0 0 0 24586472 22695 22458 24164 22955 21732 114004 22695 22458 24164 22955 21732 114004 5028290 5032589 4953018 5093901 4592678 24700476 0.99540 0.99490 0.00460 0.00510 X 0 0 0 0 0 0 0 0 1 505 505 0 PART II-B, LINE 1: ASPIRUS EXTENDED SERVICES, INC. PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 326736 326736 6156599 5032469 1124130 2274098 1289930 984168 2435034 LONG TERM INSURANCE LIABILITY 53879 MEDICARE ACCELERATED PAYMENTS 168812 RELATED PARTY PAYABLES 178163 LONG TERM FICA TAX LIABILITY 6400 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 45000 452254 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, 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. 1 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 992466 0 321290 0 2840 0 17196 0 54009 0 1387801 0 0 SIDNEY SCZYGELSKI SR. VP OF FINANCE/CFO 0 571336 0 102719 0 187603 0 20046 0 42947 0 924651 0 174000 JOHN HEISLER SVP & CHIEF HUMAN RESOURCES OFFICER 0 339009 0 66240 0 166574 0 17196 0 26051 0 615070 0 152214 JESSE TISCHER SVP & PRESIDENT- REGIONAL MARKETS 0 458373 0 92613 0 431 0 11473 0 42958 0 605848 0 0 RENEE SMITH EXECUTIVE DIRECTOR ANI 0 381673 0 68268 0 56720 0 17196 0 32423 0 556280 0 55911 ERIC ANDERSON SVP- SERVICE LINE & PATIENT EXP. 0 399509 0 67809 0 8286 0 17196 0 39108 0 531908 0 0 JENNIFER REDMAN-SCHELL SVP & PRESIDENT- ASPIRUS CLINICS 0 411201 0 69616 0 423 0 17196 0 22161 0 520597 0 0 TODD RICHARDSON SECRETARY/SVP & CIO AI 0 341475 0 67414 0 46782 0 17196 0 35067 0 507934 0 43823 RUTH RISLEY-GRAY SVP & SYSTEM CHIEF NURSING OFFICER 0 309508 0 60518 0 49719 0 20046 0 25920 0 465711 0 41695 CARI LOGEMANN SVP & GENERAL COUNSEL (THRU 06/20) 0 228246 0 78456 0 130652 0 15527 0 7141 0 460022 0 129488 MICHAEL MCGRAIL SVP & SYSTEM CHIEF MEDICAL OFFICER 0 0 0 0 0 426022 0 0 0 0 0 426022 0 425671 RICK NEVERS SVP- REG. OPS. SYSTEM INT. OFFICER 0 263896 0 64103 0 43884 0 17172 0 12878 0 401933 0 39905 DALE HUSTEDT VICE CHAIR/PRESIDENT- AMH 0 247987 0 51787 0 14834 0 17196 0 32003 0 363807 0 0 JEANNINE NOSKO SECRETARY/VP-PATIENT CARE 0 246471 0 38395 0 22492 0 14486 0 32302 0 354146 0 21667 LISA ROWE-PEPLINSKI TREASURER/VP-CORPORATE QLT 0 266222 0 34165 0 22110 0 16562 0 1427 0 340486 0 20537 CYNTHIA RIDER VP- POST ACUTE CARE 0 239427 0 25296 0 12431 0 16890 0 28987 0 323031 0 0 SCOTT REMMICH VP- CHIEF COMPLIANCE OFFICER 0 228513 0 29932 0 2140 0 14573 0 25406 0 300564 0 0 LORI PECK VP- REVENUE CYCLE 0 242941 0 31177 0 951 0 14147 0 1327 0 290543 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS EXTENDED SERVICES, INC. RELIED UPON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, 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(F) DISTRIBUTION: J. NOSKO $21,667 L. ROWE-PEPLINSKI $20,537 T. RICHARDSON $43,823 S. SCZYGELSKI $174,000 J. HEISLER $152,214 C. LOGEMANN $129,488 M. MCGRAIL $425,671 R. NEVERS $39,905 R. RISLEY-GRAY $41,695 R. SMITH $55,911 457(F) RETIREMENT PLAN PROFILE: 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: 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. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS: THE PARENT ORGANIZATION, ASPIRUS, INC. (72.68&), AND MEMORIAL MEMBER ASSOCIATION, INC. (27.23%). FORM 990, PART VI, SECTION A, LINE 7A SEE COMMENTS FOR FORM 990, PART VI, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE MEMBERS OF THE ORGANIZATION: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICER; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS EXTENDED SERVICES, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, LINE 1A, EXPLANATION FOR HOURS WORKED: SOME OFFICERS AND DIRECTORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS EXTENDED SERVICES, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART XI, LINE 9: EQUITY TRANSFER AI 363,400. EQUITY TRANSFER MMA 136,600. SYSTEM MEMBERSHIP FEE -80,000. 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. ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE SYSTEM MANAGEMENT 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 BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING 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 HEALTHCARE 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 MEDICAL GROUP INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 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 IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 383236977 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS 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 PORTAGE WI 53901 390806250 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS 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 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 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF MI INC 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 ASPIRUS INC C 80000 COST ASPIRUS INC M 574570 COST ASPIRUS INC O 4055345 COST ASPIRUS INC P 121805 COST SCHEDULE R, PART V, LINE 1D: ALL OUTSTANDING OBLIGATED GROUP DEBT IS GUARANTEED BY ALL MEMBERS OF THE OBLIGATED GROUP.