2022-05-12T12:40:23-05:00 2021-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-07-01 382908586 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC ASPI 9069322525 N10561 GRAND VIEW LANE IRONWOOD MI 49938 SIDNEY C SCZYGELSKI CFO/SENIOR VP OF FINANCE 9069322525 2022-05-06 1 SIDNEY SCZYGELSKI 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-05-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SIDNEY C SCZYGELSKI 2200 WESTWOOD DRIVE WAUSAU WI 54401 75271105 0 X WWW.ASPIRUS.ORG X 1989 MI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 15 7 386 60 0 0 704744 5084027 60235103 68196849 1650972 751240 358743 228903 62949562 74261019 2375 2182 0 0 29563053 29040235 0 0 0 31793802 33741905 61359230 62784322 1590332 11476697 76634283 77443317 43880240 36289526 32754043 41153791 X WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 44453785 2182 68273349 ASPIRUS IRONWOOD HOSPITAL AND CLINICS IS A 25-BED CRITICAL ACCESS HOSPITAL WHICH PROVIDES HEALTH CARE SERVICES TO RESIDENTS OF IRONWOOD, MICHIGAN AND ITS SURROUNDING COMMUNITIES. SOME OF THE SERVICES PROVIDED BEYOND TRADITIONAL INPATIENT HOSPITALIZATIONS INCLUDE SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, THERAPIES, EYE CARE, ONCOLOGY, SLEEP LAB, AND CARDIOLOGY, AMONG VARIOUS OTHER HEALTH CARE SERVICES.ASPIRUS IRONWOOD HOSPITAL AND CLINICS PROVIDES HEALTH CARE SERVICES TO ALL PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. FOR THOSE INDIVIDUALS UNABLE TO PAY FOR THEIR HEALTH CARE NEEDS, ASPIRUS IRONWOOD HOSPITAL AND CLINICS OFFERS SERVICES FOR FREE OR AT A REDUCED PRICE THROUGH THE FINANCIAL AID DISCOUNT POLICY. PLEASE REFER TO SCHEDULE H OF THE FORM 990 FOR ADDITIONAL INFORMATION ON THE COST OF FINANCIAL AID DISCOUNTS PROVIDED TO PATIENTS DURING FISCAL YEAR 2021.ASPIRUS IRONWOOD HOSPITAL AND CLINICS ALSO PROVIDES HEALTH CARE SERVICES TO INDIVIDUALS COVERED UNDER GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID WHICH OFTEN REIMBURSE THE HOSPITAL AT AMOUNTS SUBSTANTIALLY LOWER THAN THE USUAL AND CUSTOMARY CHARGE. THOSE PEOPLE COVERED BY THESE TYPES OF PROGRAMS NEED ACCESS TO HEALTH CARE BUT ARE OFTEN TIMES UNABLE TO TRAVEL LONG DISTANCES TO RECEIVE THIS CARE. ASPIRUS IRONWOOD HOSPITAL AND CLINICS PROVIDES THIS LOCAL, QUALITY HEALTH CARE TO MANY ELDERLY AND LOW-INCOME INDIVIDUALS THAT ARE IN NEED OF HEALTH CARE. DURING FISCAL YEAR 2021, MORE THAN 71.5% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM BENEFICIARIES OF MEDICARE AND MEDICAID. 44453785 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 74 0 386 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JESSE TISCHER SVP & PRESIDENT-REGIONAL 1.00 50.00 X 0 551417 54431 JENNIFER REDMAN-SCHELL SVP & PRESIDENT-ASPIRUS CLINICS 1.00 50.00 X X 0 481240 39357 JONATHAN BRUEGGEMAN DIRECTOR/PHYSICIAN 1.00 50.00 X 0 453924 52824 CHRISTINE HARFF DIRECTOR/PRESIDENT-REGIONAL UP 1.00 50.00 X 0 370858 49687 MARCUS SANTINI DIRECTOR/PHYSICIAN 40.00 X 323075 0 52713 PATRICK TINCHER JR VP-FINANCE REGIONAL OPERATIONS 1.00 50.00 X 0 294390 54241 JENNIFER WEAVER DIRECTOR/NURSE PRACTITIONER 2.00 40.00 X 0 109982 36518 KRISTEN MESKE DIRECTOR/NURSE PRACTITIONER 2.00 40.00 X 0 127716 5917 KATIE L CLARK SECRETARY 1.00 X X 0 0 0 JAMES LORENSON CHAIRPERSON 1.00 X X 0 0 0 STEVEN TINTI TREASURER 1.00 X X 0 0 0 RICHARD KOUBEK DIRECTOR 1.00 X 0 0 0 JOHN MATONICH DIRECTOR 1.00 X 0 0 0 CHRISTOPHER J PATRITTO DIRECTOR (THRU SEPTEMBER) 1.00 X 0 0 0 KIRK R SCHOTT DIRECTOR/PHYSICIAN 40.00 X 0 0 0 WILLIAM W WOOD DIRECTOR 1.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 1.00 50.00 X 0 1316596 71205 SIDNEY SCZYGELSKI SR. VP OF FINANCE/CFO 1.00 50.00 X 0 861658 62993 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 ERIC ANDERSON SVP-SERVICE LINE & PATIENT EXP. 2.00 50.00 X 0 475604 56304 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 2.00 50.00 X 0 455671 52263 RUTH RISLEY-GRAY SVP & SYSTEM CNO 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 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 2.00 50.00 X 0 303898 26541 GRACE TOUSIGNANT VP-REGIONAL PATIENT CARE & CNO 2.00 50.00 X 0 267199 34314 ENRICO BRAUCHER PHYSICIAN 40.00 X 691357 0 38330 JAMES HUBBARD PHYSICIAN 40.00 X 689481 0 31494 DANIEL LUKES PHYSICIAN 40.00 X 619700 0 43695 TATYANA BOMBARD RADIOLOGIST 40.00 X 519948 0 49911 DUSTIN WASYLIK PHYSICIAN 40.00 X 497435 0 31608 CARI LOGEMANN SVP & GEN. COUNSEL (THRU 06/20) 2.00 50.00 X 0 437354 22668 3340996 8803641 1035896 48 1 1 0 MICHIGAN EMERGENCY PHYSICIANS PO BOX 677979 DALLAS TX 752677979 ER PHYSICIAN COVERAGE 2084868 UPPER PENINSULA HEALTH CARE SOLUTIONS W WASHINGTON ST MARQUETTE MI 498554330 MRI SERVICES 495982 SHARED MEDICAL SERVICES 209 LIMESTONE PASS COTTAGE GROVE WI 53527 RADIOLOGY 195490 TOTAL MSP LLC 10 E COLLEGE AVE APPLETON WI 54911 CONTRACT LABOR 159572 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA ST SUITE 420 OMAHA NE 68154 CONTRACT PROVIDER 115950 5 5039903 44124 32936 5084027 NET PATIENT SERVICE REVENUE 621990 62600153 62600153 PHARMACY 340B 900099 3951568 3951568 RELATED PARTY RENTAL 531120 166832 166832 1478296 1478296 68196849 405927 405927 70330 0 70330 70330 70330 1355199 200 1010086 0 345113 200 345313 345313 CAFETERIA 722514 80704 80704 EHR INCENTIVE PAYMENTS 621990 76500 76500 1369 1369 158573 74261019 68273349 0 903643 X 2182 2182 208344 208344 23516566 19847795 3668771 1078933 678372 400561 2783498 2390783 392715 1452894 1156252 296642 203182 203182 400 400 2103 2103 7503510 5865738 1637772 21077 205 20872 97112 32703 64409 19373 4305 15068 603876 454616 149260 134911 80959 53952 574187 425 573762 2699507 1005183 1694324 302744 302744 DRUGS AND MEDICAL SUPPL 9227908 8451011 776897 CORPORATE ALLOCATIONS 8450034 2252465 6197569 QAAP EXPENSES 1416989 1416989 BAD DEBT EXPENSE 1213635 1203678 9957 1271357 818769 452588 62784322 44453785 18330537 0 1512864 2911415 11393197 12208705 6247801 6828423 1229105 1175968 910202 250348 69008421 41881959 28841150 27126462 9718280 10434793 6121393 6230764 236607 236607 10423684 10039832 76634283 77443317 4875109 4473775 5109922 299922 14340574 14138098 19554635 17377731 43880240 36289526 X 32130385 40541124 623658 612667 32754043 41153791 76634283 77443317 X 11476697 1726648 -4803597 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5967 5967 0 PART II-B, LINE 1: ASPIRUS IRONWOOD HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND MHA HAVE NOTIFIED ASPIRUS IRONWOOD HOSPITAL & CLINICS THAT APPROXIMATELY $5,967 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 421754 421754 41018150 18504194 22513956 71035 66349 4686 27176114 23243534 3932580 321368 67882 253486 27126462 DEFERRED COMPENSATION PLAN ASSETS 5186114 F INVESTMENTS IN UNCONSOLIDATED AFFILIATES 1044650 F 6230764 CSV LIFE INSURANCE 229479 OPERATING LEASE ROU ASSET 289960 RELATED PARTY RECEIVABLE 9520393 10039832 DEFERRED COMPENSATION 5186114 LONG-TERM INSURANCE LIABILITY 257946 DUE TO OTHER 500 ACC INSURANCE DEDUCTIBLES 295715 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 3265000 FINANCE LEASE LIABILITY 180646 OPERATING LEASE LIABILITY 283464 MEDICARE REFUNDABLE ADVANCES 7908346 17377731 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 X 1 X 1 X 1 1 1 0 1 1 557011 557011 0.00890 11862153 5429388 6432765 0.10250 12419164 5429388 6989776 0.11140 8714 300 8414 0.00010 1461025 1219578 241447 0.00380 1469739 1219878 249861 0.00390 13888903 6649266 7239637 0.11530 1 452909 14877927 14702699 175228 X 1 1 1 WESTERN UPPER MICHIGAN EYE CARE LLC EYE CLINIC 0.51000 0.00000 0.49000 1 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS N10561 GRAND VIEW LANE IRONWOOD MI 49938 WWW.ASPIRUS.ORG X X X X ASPIRUS IRONWOOD HOSPITAL & CLINICS INC 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PART V, SECTION C, LINE 7D X X 1 18 1 HTTP://WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.ASPIRUS.ORG/FINANCIALAID X WWW.ASPIRUS.ORG/FINANCIALAID X WWW.ASPIRUS.ORG/FINANCIALAID X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: THROUGHOUT THE PLANNING AND PRODUCTION OF THE UPPER PENINSULA 2018 REGIONAL HEALTH ASSESSMENT, A STEERING COMMITTEE OF COMMUNITY LEADERS AND SUBJECT MATTER EXPERTS MET REGULARLY TO DIRECT THE REPORTING PROCESS, WHICH INCLUDED THE CREATION AND DISTRIBUTION OF A SURVEY TO A RANDOM SELECTION OF RESIDENTS. FOR ASPIRUS IRONWOOD, THIS INCLUDES INPUT FROM THE WESTERN UPPER PENINSULA HEALTH DEPARTMENT AS WELL AS OTHER ASPIRUS UP HOSPITALS. REPRESENTATIVES FROM EACH ORGANIZATION COMMUNICATED IN REGULAR MEETINGS. THE KEY DATA ELEMENT IN THE UPPER PENINSULA 2018 REGIONAL HEALTH ASSESSMENT IS THE COMMUNITY SURVEY, WHICH IDENTIFIED IMPORTANT ISSUES REGARDING QUALITY OF LIFE THAT HAD NOT BEEN MEASURED BEFORE THE SURVEY WAS CONDUCTED. THE SURVEY WAS MAILED TO THOUSANDS OF HOUSEHOLDS ACROSS THE ENTIRE UPPER PENINSULA, WITH NEARLY 5,000 RESPONSES BACK FROM RESIDENTS. THE UPPER PENINSULA 2018 REGIONAL HEALTH ASSESSMENT ALSO INCLUDES A SIGNIFICANT AMOUNT OF DATA INDICATORS ACROSS MULTIPLE CATEGORIES RELATING TO HEALTH AND HEALTH FACTORS. THIS DATA WAS COMPILED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM HEALTH CARE PROVIDERS. PUBLISHED SOURCES INCLUDED THE U.S. CENSUS, THE AMERICAN COMMUNITY SURVEY, AND STATISTICS COMPILED BY THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, THE WISCONSIN DIVISION OF PUBLIC HEALTH, AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:- ASPIRUS ONTONAGON HOSPITAL, INC.- U.P. HEALTH SYSTEM - BARAGA COUNTY MEMORIAL HOSPITAL- ASPIRUS KEWEENAW HOSPITAL- ASPIRUS IRON RIVER HOSPITAL- COPPER COUNTRY MENTAL HEALTH SERVICES- GOGEBIC COUNTY COMMUNITY MENTAL HEALTH- UPPER GREAT LAKES FAMILY HEALTH CENTER ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTP://ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: ASPIRUS IRONWOOD HOSPITAL COLLABORATED WITH SEVERAL GOGEBIC COUNTY AGENCIES TO CONDUCT THE 2018 COMMUNITY NEEDS ASSESSMENT. THE ASPIRUS IRONWOOD HOSPITAL AND CLINICS, INC. SELECTED FOUR AREAS OF FOCUS: 1, THE IMPACT OF AGING POPULATION: GERIATRIC BEHAVIORAL HEALTH PROGRAM WAS OPENED IN OCTOBER, 2021 TO ADDRESS MENTAL HEALTH NEEDS OF OLDER ADULTS. THIS IS AN OUTPATIENT DAY TREATMENT PROGRAM WHICH ASSISTS OLDER ADULTS IMPROVE THEIR BEHAVIORAL HEALTH, AVOID CRISIS INTERVENTION FOR MENTAL HEALTH NEEDS, AND BETTER MANAGE THEIR OTHER CHRONIC CONDITIONS.2, THE IMPORTANCE OF PREVENTION: CHRONIC DISEASES SUCH AS CANCER, HEART DISEASE, DIABETES AND STROKE ARE THE LEADING CAUSES OF DEATH IN THE U.P. AND ACROSS MUCH OF THE GLOBE. THE OUTPATIENT DIABETES PROGRAM WAS EXPANDED TO INCLUDE FOCUSED CLINICS AND GUIDANCE FOR PATIENTS WITH DIABETES. THE TREATMENT TEAM INCLUDES A NURSE PRACTITIONER, NURSE CARE MANAGER AND DIETICIAN.TEL E HEALTH SERVICES WERE EXPANDED IN THE CLINIC TO ENABLE PATIENTS TO ACCESS PROVIDERS IN THE SPECIALTIES OF CARDIOLOGY, PULMONARY MEDICINE, NEUROLOGY AND ELECTRO PHYSIOLOGY.TEL E NEUROLOGY WAS ADDED TO THE EMERGENCY ROOM TO ASSIST WITH DETECTION AND EARLY TREATMENT OF PATIENTS WITH STROKE SYMPTOMS.THE WOUND CLINIC PROGRAM WAS EXPANDED TO INCLUDE A PODIATRIST AND APC AND IT WAS RELOCATED TO THE HOSPITAL FROM THE CLINIC.THE HURLEY CLINIC STARTED A SUBOXONE CLINIC FOR THE TREATMENT OF PATIENTS WITH DRUG ADDICTION. PROVIDERS ADDRESS PATIENTS WITH OBESITY, SMOKING, DRUG AND ALCOHOL ISSUES DURING THE CLINIC VISITS AND REFER TO RESOURCES TO ASSIST WITH ADDRESSING THESE ISSUES.COVID VACCINATION CLINICS WERE HELD FOR THE GENERAL POPULATION. ASPIRUS IRONWOOD CONTRIBUTED TO MANY COMMUNITY EVENTS FOCUSED ON WELL-BEING, NUTRITION AND PHYSICAL ACTIVITY.DIETICIAN PROVIDED EDUCATIONAL SERVICES ON NUTRITION TO MANY SCHOOL CHILDREN, BOOTH AT THE FARMERS MARKET WITH COOKING DEMONSTRATIONS AND COUPONS TO PURCHASE FOOD. 3. THE POWERFUL CORRELATION BETWEEN SOCIO-ECONOMIC STATUS AND POOR HEALTHSOCIAL WORKER SERVICES ARE PROVIDED TO PATIENTS NEEDING RESOURCES INCLUDING TRANSPORTATION, FOOD, SHELTER, CLOTHING, ETC.SOCIAL WORKER ASSISTS PATIENTS WITH OPEN ENROLLMENT TO PROVIDE HEALTH INSURANCE FOR MEDICAL NEEDSSOCIAL WORKER ASPIRUS REVENUE CYCLE STAFF HELP PATIENTS WITH APPLICATIONS FOR HEALTH CARE SUBSIDIES OR ACCESS TO MEDICAID.4. EXPANDED ACCESS TO CARE VIA THE EVOLVING AFFORDABLE CARE ACT: SOCIAL WORKER ASSISTS PATIENTS WITH OPEN ENROLLMENT TO PROVIDE HEALTH INSURANCE FOR MEDICAL NEEDSSOCIAL WORKER ASPIRUS REVENUE CYCLE STAFF HELP PATIENTS WITH APPLICATIONS FOR HEALTH CARE SUBSIDIES OR ACCESS TO MEDICAID.5. AS A HEALTHCARE SYSTEM, ASPIRES WILL BE WORKING COLLABORATIVELY TO ADDRESS DRUG ADDICTION.THE HURLEY CLINIC STARTED A SUBOXONE CLINIC FOR THE TREATMENT OF PATIENTS WITH DRUG ADDICTION. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 3 1 - ASPIRUS EYE CENTER E6112 BLUFF VIEW ROAD IRONWOOD MI 49938 EYE CLINIC 2 - ASPIRUS IRONWOOD CLINIC N10565 GRAND VIEW LANE IRONWOOD MI 49938 PROVIDER BASED CLINIC 3 - ASPIRUS HURLEY CLINIC 501 GRANITE STREET HURLEY WI 54534 PROVIDER BASED CLINIC PART I, LINE 6A: ASPIRUS IRONWOOD HOSPITAL & CLINICS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC THROUGH MHA'S DATABASE AND WEBSITE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FROM THE FORM 990. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT ASPIRUS IRONWOOD HOSPITAL & CLINICS INCLUDE THE OPERATION OF THE HOSPITAL'S INPATIENT MEDICAL/SURGICAL NURSING UNIT AS WELL AS THE INTENSIVE CARE UNIT. THE HOSPITAL INPATIENT AND INTENSIVE CARE UNITS OPERATE 24 HOURS PER DAY SEVEN DAYS PER WEEK AND ARE STAFFED BY A GROUP OF HIGHLY TRAINED NURSING STAFF INCLUDING REGISTERED NURSES, LICENSED PRACTICAL NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL INPATIENT AND INTENSIVE CARE UNITS COME FROM THE HOSPITAL'S EMERGENCY DEPARTMENT WHICH IS OPERATED TO PROVIDE EMERGENCY CARE TO PATIENTS OF THE COMMUNITY AND SURROUNDING AREAS. THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF ASPIRUS IRONWOOD HOSPITAL & CLINICS AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF ASPIRUS IRONWOOD HOSPITAL & CLINICS TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE INPATIENT UNIT REPORTED COMMUNITY BENEFIT COSTS OF $1,327,823 WITH DIRECT OFFSETTING REVENUE OF $1,108,389. THE INTENSIVE CARE UNIT REPORTED COMMUNITY BENEFIT COSTS OF $133,202 WITH DIRECT OFFSETTING REVENUE OF $111,189. PART II, COMMUNITY BUILDING ACTIVITIES: ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE THE HEALTH OF THE COMMUNITY BY ALLOCATING TIME AND FUNDING INTO DEVELOPING PROGRAMS THAT FOCUS ON HEALTHY LIFESTYLES FOR FAMILIES AND INDIVIDUALS. COALITION BUILDING IS A LARGE PART OF THIS. THROUGH COALITIONS SUCH AS INTEGRATED FAMILY SERVICES AND A SUBSTANCE ABUSE NETWORK, ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE HEALTHY BEHAVIORS AND REGULAR PHYSICAL ACTIVITY. ECONOMIC DEVELOPMENT IS PROMOTED THROUGH COLLABORATION WITH LOCAL CHAMBERS OF COMMERCE AND KIWANIS. PART III, LINE 2: THE BAD DEBT RECORDED MULTIPLIED BY THE COST TO CHARGE RATIO. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2019 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: ASPIRUS IRONWOOD HOSPITAL & CLINICS ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY EXAMINING THE NEEDS OF THE PATIENT. THIS IS DONE THROUGH ANALYSIS OF PATIENT VOLUMES IN DEPARTMENTS, SPECIALISTS, AND THE DIFFERENT CLINIC LOCATIONS WITHIN THE ORGANIZATION'S AREAS OF SERVICE. INFORMATION IS ALSO GATHERED DIRECTLY FROM THE PATIENTS TO SEE WHAT AREAS THEY WOULD LIKE TO SEE ADDITIONAL SUPPORT. INFORMATION REGARDING THE NEEDS OF THE GENERAL COMMUNITY IS OBTAINED FROM THE MICHIGAN HOSPITAL ASSOCIATION AND THE WISCONSIN HOSPITAL ASSOCIATION AND ANALYZED FOR POTENTIAL NEW SERVICE AREAS. ASPIRUS IRONWOOD HOSPITAL & CLINICS HAS COLLABORATED WITH OTHER AREA HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IS AN IMPORTANT TOOL IN IDENTIFYING THE HEALTH NEEDS OF THE COMMUNITY AND RESULTS OF THE PROJECT ASSIST IN PRIORITIZING HEALTH NEEDS THAT LEAD TO THE ALLOCATION OF APPROPRIATE RESOURCES AND THE CREATION OF NEW PARTNERSHIPS TO IMPROVE THE HEALTH OF THE POPULATION. PART VI, LINE 3: A SUMMARY OF FINANCIAL ASSISTANCE CONTACT INFORMATION IS AVAILABLE IN THE FORM OF A BROCHURE IN THE WAITING AREAS THROUGHOUT ASPIRUS IRONWOOD HOSPITAL & CLINICS. PATIENT FINANCIAL SERVICES PERSONNEL ARE AVAILABLE TO DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROCEDURES AND PROGRAMS WITH PATIENTS. ASPIRUS IRONWOOD HOSPITAL & CLINICS ALSO HAS A SECTION ON ITS WEBSITE THAT PROVIDES CONTACT INFORMATION FOR FINANCIAL ASSISTANCE FOR THOSE HAVING DIFFICULTY MEETING THEIR FINANCIAL OBLIGATIONS. PART VI, LINE 4: THE COMMUNITIES THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS SERVE COVER AN APPROXIMATE 50-MILE RADIUS SURROUNDING THE IRONWOOD, MICHIGAN AREA. THIS AREA INCLUDES PORTIONS OF THE UPPER PENINSULA GOGEBIC COUNTY, UP TO THE ONTONAGON COUNTY REGION, INTO WISCONSIN COVERING IRON COUNTY, PARTS OF ASHLAND COUNTY, AND PARTS OF VILAS COUNTY. THE GEOGRAPHIC AREA THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS SERVE INCLUDES AN ECONOMICALLY DEPRESSED AREA THAT IS BASED ON A MAJORITY OF FAMILIES THAT DO NOT HAVE HEALTH INSURANCE, OR THAT ARE UTILIZING MEDICAID. PART VI, LINE 5: ASPIRUS IRONWOOD HOSPITAL & CLINICS HAVE NUMEROUS CONTINUING EDUCATION EVENTS THAT ARE SET UP TO HELP IMPROVE THE MEDICAL CARE AND KNOWLEDGE OF THE LOCAL POPULATION. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. ASPIRUS IRONWOOD HOSPITAL & CLINICS CONTINUE TO REINVEST IN EQUIPMENT, TRAINING, AND RESEARCH AREAS IN ORDER TO IMPROVE PATIENT CARE IN THE COMMUNITIES THAT IT SERVES, AS WELL AS PROVIDING RESEARCH TO HELP THE LOCAL COMMUNITIES. PART VI, LINE 6: ASPIRUS IRONWOOD HOSPITAL & CLINICS IS AN AFFILIATED HEALTH SYSTEM WHICH SERVES THE COMMUNITY SURROUNDING IRONWOOD, MICHIGAN. AFFILIATES OF ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE THE HEALTH OF THE COMMUNITY BY FULFILLING ASPIRUS' MISSION. ASPIRUS IRONWOOD HOSPITAL & CLINICS PROVIDES PHYSICIAN SERVICES IN AN OUTPATIENT CLINIC. ASPIRUS IRONWOOD HOSPITAL & CLINICS IS ALSO AN AFFILIATE OF ASPIRUS, INC. ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTH CARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES DEDICATED TO IMPROVING THE HEALTH OF ALL WE SERVE. WE WORK COLLABORATIVELY WITH OTHERS WHO SHARE OUR PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. PART VI, LINE 7, REPORTS FILED WITH STATES MI X X X X X 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 ENRICO BRAUCHER PHYSICIAN 614592 0 69927 0 6838 0 17196 0 21134 0 729687 0 0 0 JAMES HUBBARD PHYSICIAN 639239 0 44000 0 6242 0 17196 0 14298 0 720975 0 0 0 DANIEL LUKES PHYSICIAN 557419 0 55000 0 7281 0 17196 0 26499 0 663395 0 0 0 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 0 458373 0 92613 0 431 0 11473 0 42958 0 605848 0 0 TATYANA BOMBARD RADIOLOGIST 484408 0 30000 0 5540 0 17196 0 32715 0 569859 0 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 DUSTIN WASYLIK PHYSICIAN 381949 0 110000 0 5486 0 17196 0 14412 0 529043 0 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 SVP & CHIEF INFORMATION OFFICER 0 341475 0 67414 0 46782 0 17196 0 35067 0 507934 0 43823 JONATHAN BRUEGGEMAN DIRECTOR/PHYSICIAN 0 423385 0 25000 0 5539 0 17196 0 35628 0 506748 0 0 RUTH RISLEY-GRAY SVP & SYSTEM CNO 0 309508 0 60518 0 49719 0 20046 0 25920 0 465711 0 41695 CARI LOGEMANN SVP & GEN. 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 CHRISTINE HARFF DIRECTOR/PRESIDENT-REGIONAL UP 0 309269 0 59238 0 2351 0 15293 0 34394 0 420545 0 0 RICK NEVERS SVP-REG. OPS. SYSTEM INT. OFFICER 0 263896 0 64103 0 43884 0 17172 0 12878 0 401933 0 39905 MARCUS SANTINI DIRECTOR/PHYSICIAN 301396 0 5555 0 16124 0 17196 0 35517 0 375788 0 0 0 PATRICK TINCHER JR VP-FINANCE REGIONAL OPERATIONS 0 253982 0 33626 0 6782 0 16372 0 37869 0 348631 0 0 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 0 244032 0 59522 0 344 0 13276 0 13265 0 330439 0 0 GRACE TOUSIGNANT VP-REGIONAL PATIENT CARE & CNO 0 191896 0 24789 0 50514 0 10975 0 23339 0 301513 0 48116 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RELIED ON THE RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, 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: S. SCZYGELSKI $174,000 J. HEISLER $152,214 C. LOGEMANN $129,488 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 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. A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97710B7X4 2013-04-12 2998547 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 B WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97712DC53 2017-11-02 12000000 NEW CONSTRUCTION 0 0 0 A 470000 2848547 2998547 2015 0 0 1 1 B 12000000 12000000 2016 0 0 1 1 A 0 0 1 0 0 0.00700 0.00700 0 0 1 B 0 0 1 0 0 0.00300 0.00300 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WI HEALTH & EDUCATION FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/05/2018 SCHEDULE K, PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2013 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (EIN 39-0964813); ASPIRUS GRAND VIEW (EIN 38-2908586); AND LANGLADE HOSPITAL HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429). INFORMATION REGARDING THE SERIES 2013 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 2013 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2013 BONDS.] SCHEDULE K, PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2017 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND ASPIRUS ONTONAGON HOSPITAL, INC. (EIN 26-0806477). INFORMATION REGARDING THE SERIES 2017 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2017 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2017 BONDS.] PART III, LINES 3A AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS IRONWOOD HOSPITAL & CLINICS, 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 K, PART III, LINE 9: SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. X 2 VENTILATORS 2 32936 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A SEE EXPLANATION FOR FORM 990, PART VI, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR 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, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND IS 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 THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RELIED ON 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. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G LAB SERVICES: PROGRAM SERVICE EXPENSES 1,290,469. MANAGEMENT AND GENERAL EXPENSES 1,017. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,291,486. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 950,006. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 950,006. HOUSEKEEPING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 167,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 167,859. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 4,575,269. MANAGEMENT AND GENERAL EXPENSES 518,890. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,094,159. FORM 990, PART XI, LINE 9: UNRESTRICTED NET ASSET TRANSFERS - AWH 734,880. UNRESTRICTED NET ASSET TRANSFERS - AI -7,205,684. UNRESTRICTED NET ASSET TRANSFERS - AMG 1,100,824. UNRESTRICTED NET ASSET TRANSFERS - AOH 1,560. UNRESTRICTED NET ASSET TRANSFERS - VNA -33,975. UNRESTRICTED NET ASSET TRANSFERS - AIR 340,425. UNRESTRICTED NET ASSET TRANSFERS - ARH -1,735. UNRESTRICTED NET ASSET TRANSFERS - AKH 260,171. CHANGE IN NCI -15,993. OTHER CHANGE 22,455. OTHER CHANGE -6,525. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION, ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS IN THE PAST YEAR. 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 425 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 EXTENDED SERVICES INC 425 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 0 ASPIRUS MEDICAL GROUP INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME 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 IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE RD IRON RIVER MI 49935 383236977 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS 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 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 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC RELATED 0 1 0.51000 THE WESTWOOD CONFERENCE CENTER LLC 333 PINE RIDGE BLVD WAUSAU WI 54401 571184256 CONFERENCE CENTER WI N/A 0 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 1 ASPIRUS KEWEENAW ENTERPRISES 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 1 ASPIRUS HEALTH VENTURES 3000 WESTHILL DRIVE 303 WAUSAU WI 54401 474925640 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF WI INC 3000 WESTHILL DRIVE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF MI INC 3000 WESTHILL DRIVE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0 ASPIRUS WAUSAU HOSPITAL INC M 52374 COST ASPIRUS WAUSAU HOSPITAL INC O 178657 COST ASPIRUS WAUSAU HOSPITAL INC P 557375 COST ASPIRUS INC M 8421534 COST ASPIRUS INC O 28204021 COST ASPIRUS INC P 858736 COST ASPIRUS IRON RIVER HOSPITAL & CLINICS INC L 133854 COST ASPIRUS KEWEENAW HOSPITAL INC O 212821 COST ASPIRUS MEDICAL GROUP INC K 110622 COST ASPIRUS MEDICAL GROUP INC O 490655 COST ASPIRUS MEDICAL GROUP INC Q 50354 COST