STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ASPIRUS MEDFORD HOSPITAL & CLINICS INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
ASPIRUS MEDFORD HOSPITAL & CLINICS INC (EIN 39-0964813)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-06-04
IRS object ID
202021569349300812
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-06-04T10:31:24-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11502 LONDON ROAD SUITE 200AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55812ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390964813EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ASPIRUS MEDFORD HOSPITAL & CLINICS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlASPIBusinessNameControlTxt
Phone7157488100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH GIBSONAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREG SHAWPersonNm
Person TitleCFOPersonTitleTxt
Phone7157488100PhoneNum
Signature2020-06-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2020-06-01PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address71.13.38.61IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-06-01IPDt
IP Tm12:42:28IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDALE HUSTEDTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH GIBSON STREETAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$95,852,472GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ASPIRUS.ORG/ASPIRUSMEDFORDHOSPITALWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionWE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee711TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$1,773,378TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$455,392PYContributionsGrantsAmt
CY Contributions Grants$76,364CYContributionsGrantsAmt
PY Program Service Revenue$83,093,250PYProgramServiceRevenueAmt
CY Program Service Revenue$88,955,793CYProgramServiceRevenueAmt
PY Investment Income$2,826,301PYInvestmentIncomeAmt
CY Investment Income$4,450,024CYInvestmentIncomeAmt
PY Other Revenue$128,688PYOtherRevenueAmt
CY Other Revenue$126,761CYOtherRevenueAmt
PY Total Revenue$86,503,631PYTotalRevenueAmt
CY Total Revenue$93,608,942CYTotalRevenueAmt
PY Grants And Similar Paid$49,765PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$205,603CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,042,545PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,511,398CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$39,954,312PYOtherExpensesAmt
CY Other Expenses$41,281,959CYOtherExpensesAmt
PY Total Expenses$78,046,622PYTotalExpensesAmt
CY Total Expenses$81,998,960CYTotalExpensesAmt
PY Revenues Less Expenses$8,457,009PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,609,982CYRevenuesLessExpensesAmt
Total Assets BOY$133,752,399TotalAssetsBOYAmt
Total Assets EOY$143,860,673TotalAssetsEOYAmt
Total Liabilities BOY$26,196,259TotalLiabilitiesBOYAmt
Total Liabilities EOY$25,315,645TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$107,556,140NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$118,545,028NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$43,202,050ExpenseAmt
Grant$205,603GrantAmt
Revenue$59,475,883RevenueAmt
DescHOSPITAL SERVICES - ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN MEDFORD, WISCONSIN. DURING THE YEAR ENDED JUNE 30, 2019, THE HOSPITAL HAD 2,223 INPATIENT DAYS AND 77,768 OUTPATIENT VISITS. SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, CHEMOTHERAPY/INFUSION, DIALYSIS, AND THERAPIES ARE JUST SOME OF THE OTHER SERVICES THAT AMHC PROVIDES WITHIN THE HOSPITAL. AS A CRITICAL ACCESS HOSPITAL, AMHC PROVIDES ACCESS TO LOCAL HEALTH CARE FOR THE COMMUNITIES OF WHICH THEY SERVE.AMHC ALSO PROMISES TO THE COMMUNITY TO PROVIDE HEALTH CARE SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY AS DEFINED IN AMHC'S CHARITY AND COMMUNITY CARE POLICIES AND PROGRAMS. DURING FISCAL YEAR 2019, AMHC'S CHARITY CARE PROGRAM AWARDED APPROXIMATELY $1,720,195 IN FINANCIAL ASSISTANCE THROUGH CHARGE REDUCTIONS TO PATIENTS WHO COULD NOT OTHERWISE AFFORD CARE. ADDITIONAL INFORMATION ON THE COST OF PROVIDING CHARITY CARE TO PATIENTS CAN BE FOUND IN SCHEDULE H OF THE FORM 990. IN ADDITION TO PROVIDING CHARITY CARE SERVICES, AMHC ALSO PROVIDES A SIGNIFICANT AMOUNT OF SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS. DURING FISCAL YEAR 2019, APPROXIMATELY 58 PERCENT OF THE PATIENT SERVICES PROVIDED BY AMHC WERE PROVIDED TO MEDICARE AND MEDICAID PROGRAM BENEFICIARIES. THESE SERVICES ARE CONSIDERED A LARGE NEED IN THE COMMUNITY AND AMHC IS OFTEN REIMBURSED AT RATES BELOW THE COST OF PROVIDING THE CARE FOR THESE PATIENTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$15,083,164ExpenseAmt
Revenue$20,764,858RevenueAmt
DescCLINIC SERVICES - AMHC OPERATES SEVEN OUTPATIENT CLINICS IN THE COMMUNITIES OF ABBOTSFORD, ATHENS, GILMAN, MEDFORD, PHILLIPS, PRENTICE AND RIB LAKE (ALL LOCATED WITHIN THE STATE OF WISCONSIN). DURING THE YEAR ENDED JUNE 30, 2019, THE CLINICS HAD 61,147 VISITS. AMHC PROVIDES ACCESS TO PRIMARY CARE PHYSICIANS IN THESE RURAL AND MEDICALLY UNDERSERVED AREAS.THE CLINICS ALSO SERVES A LARGE PORTION OF ELDERLY, DISABLED, AND LOW INCOME PATIENTS WHO ARE COVERED UNDER THE MEDICARE AND WISCONSIN MEDICAID PROGRAMS. PATIENTS OF THE AMHC CLINICS ARE ALSO ELIGIBLE FOR CHARITY CARE AS DEFINED BY AMHC'S CHARITY CARE POLICY. CHARITY CARE AMOUNTS FOR THE CLINICS ARE INCLUDED IN THE TOTAL NOTED UNDER 4A ABOVE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$4,340,334ExpenseAmt
Revenue$5,975,299RevenueAmt
DescSENIOR CARE SERVICES - AMHC OPERATES A 99-BED SKILLED NURSING FACILITY (SNF), 10 CBRF APARTMENTS, AND A 28-UNIT RCAC. DURING THE YEAR ENDED JUNE 30, 2019, THE SNF HAD A DAILY CENSUS OF 52.26 AND THE RCAC HAD A DAILY CENSUS OF 24.73. THROUGH THESE SENIOR CARE SERVICES, AMHC PROVIDES CARE AND ASSISTANCE TO THE ELDERLY IN OUR COMMUNITY. A MAJORITY OF THE RESIDENTS RECEIVING SENIOR CARE SERVICES AT AMHC RECEIVE CARE UNDER THE WISCONSIN MEDICAID OR FAMILY CARE PROGRAMS. AMHC RECOGNIZES THAT THE COST OF CARING FOR THESE INDIVIDUALS OFTEN EXTENDS BEYOND THE AMOUNT THAT IS PAID TO AMHC BY THE MEDICAID PROGRAM. ADDITIONAL INFORMATION ON THE COST OF PROVIDING SERVICES TO MEDICAID PROGRAM BENEFICIARIES CAN BE FOUND IN SCHEDULE H OF THE FORM 990.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$62,625,548TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document84IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee711EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREG SHAW CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7157488100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH GIBSON STREETAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL RIGGLE
CHAIRPERSON1.002.00Yes (X)Yes (X)$0$0$0
RUTH RISLEY-GRAY
VICE CHAIRPERSON / SVP NURSING SYSTEM CNO AI2.0050.00Yes (X)Yes (X)$0$392,122$77,261
DEBBIE WOODS
TREASURER1.002.00Yes (X)Yes (X)$0$0$0
LEONARD HAMMAN
SECRETARY1.002.00Yes (X)Yes (X)$0$0$0
MATTHEW HEYWOOD
BOARD MEMBER2.000.00Yes (X)$0$1,156,743$195,564
SUSAN FRAZIER
PHYSICIAN / BOARD MEMBER32.002.00Yes (X)$288,495$0$22,343
RACHEL DIXON
PHYSICIAN / BOARD MEMBER40.000.00Yes (X)$75,598$0$30,609
MICHAEL PLOOY
BOARD MEMBER1.001.00Yes (X)$0$0$0
MATT BREWER
BOARD MEMBER / VP OF OPERATIONS AI2.0040.00Yes (X)$0$241,525$55,983
RICK NEVERS TERM 718
INTERIM CEO/BOARD MEMBER2.0050.00Yes (X)$0$456,553$79,281
DALE HUSTEDT
CEO/BOARD MEMBER40.000.00Yes (X)$120,423$0$15,345
GREG SHAW
CFO40.000.00Yes (X)$176,887$0$35,703
SID SCZYGELSKI
SVP OF FINANCE AND CFO OF2.0050.00Yes (X)$0$654,883$117,668
CARI LOGAMAN
SVP & GENERAL COUNSEL1.0050.00Yes (X)$0$452,398$81,636
ERIC ANDERSON
SVP SERVICE LINE & PATIENT EXPERIENCE1.0050.00$0$334,002$80,130Yes (X)
RENEE SMITH
EXECUTIVE DIRECTOR ANI1.0050.00$0$455,560$45,608Yes (X)
TODD RICHARDSON
SVP & CIO OF AI1.0050.00$0$395,288$88,380Yes (X)
MICHAEL MCGRAIL
SVP SYSTEM CMO OF AI1.0050.00$0$485,524$80,747Yes (X)
JOHN HEISLER
SVP & CHIEF HR OFFICER OF1.0050.00$0$416,068$40,142Yes (X)
F DEAN DANNER JR
SVP AMBULATORY SERVICES, PRES ACI (TERMED 6/29/18)1.0050.00$0$386,225$27,706Yes (X)
ERICK T BRANSTETTER
PHYSICIAN40.000.00$388,043$0$20,193Yes (X)
SUJATHA ROBERTS
PHYSICIAN40.000.00$697,689$0$36,676Yes (X)
TROY SENNHOLZ
PHYSICIAN40.000.00$443,425$0$39,294Yes (X)
CARY TAUCHMAN
PHYSICIAN40.000.00$376,986$0$34,012Yes (X)
DAVID VANDERKIN
PHYSICIAN40.000.00$459,135$0$29,063Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,026,681TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,826,891TotReportableCompRltdOrgAmt
Total Other Compensation$1,233,344TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K48IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MIRON CONSTRUCTION CO INC
PO BOX 1372GREENBAYWI54305CONTRACTED CONSTRUCTION COMPANY$2,317,317
FOCUSONE SOLUTIONS LLC
13609 CALIFORNIA STREETOMAHANE68154CONTRACTED SERVICES$611,487
AMERICAN RADIOLOGY SC
372 E16TH PLLOMBARDIL60148CONTRACTED EMPLOYMENT$393,985
WEATHERBY LOCUMS INC
6451 NORTH FEDERAL HIGHWAY SUITE 7FORT LAUDERDALEFL33308CONTRACT LABOR$379,725
ASSOCIATES IN PATHOLOGY SC
2800 WESTHILL DRIVE 208WAUSAUWI54401CONTRACTED LAB SERVICES$308,840
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Related Organizations$76,364RelatedOrganizationsAmt
Total Contributions$76,364TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621110$80,422,230$80,421,179$1,051
PHARMACY REVENUE446110$7,567,188$5,794,861$1,772,327
CONTRACT SERVICE REVENUE621110$552,567$552,567
CAFETERIA621990$222,461$222,461
OTHER OPERATING REVENUE621110$191,347$191,347
FieldValueIRS element (for citing)
Total Program Service Revenue$88,955,793TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,673,572TotalRevenueColumnAmt
Exclusion$3,673,572ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$142,933RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$16,371RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$126,562RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$126,562TotalRevenueColumnAmt
Exclusion$126,562ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,000,221SecuritiesAmt
Other$3,390OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,131,006SecuritiesAmt
Other$96,153OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$869,215SecuritiesAmt
Other-$92,763OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$776,452TotalRevenueColumnAmt
Exclusion$776,452ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescADMIN OTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$199TotalRevenueColumnAmt
Exclusion$199ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$199OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,608,942TotalRevenueColumnAmt
Related Or Exempt Func Income$86,216,040RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,773,378UnrelatedBusinessRevenueAmt
Exclusion$5,543,160ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$205,603TotalAmt
Program Services$205,603ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$772,791TotalAmt
Program Services$358,437ProgramServicesAmt
Management And General$414,354ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,313,094TotalAmt
Program Services$25,444,336ProgramServicesAmt
Management And General$4,868,758ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,515,283TotalAmt
Program Services$1,291,950ProgramServicesAmt
Management And General$223,333ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,899,245TotalAmt
Program Services$4,621,097ProgramServicesAmt
Management And General$1,278,148ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,010,985TotalAmt
Program Services$1,647,003ProgramServicesAmt
Management And General$363,982ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$12,602TotalAmt
Management And General$12,602ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,556,857TotalAmt
Program Services$5,366,279ProgramServicesAmt
Management And General$190,578ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$162,381TotalAmt
Program Services$21,768ProgramServicesAmt
Management And General$140,613ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$514,923TotalAmt
Program Services$342,761ProgramServicesAmt
Management And General$172,162ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$141,355TotalAmt
Program Services$113,000ProgramServicesAmt
Management And General$28,355ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,480,289TotalAmt
Program Services$1,054,585ProgramServicesAmt
Management And General$1,425,704ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$156,252TotalAmt
Program Services$112,398ProgramServicesAmt
Management And General$43,854ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$93,148TotalAmt
Program Services$64,481ProgramServicesAmt
Management And General$28,667ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$638,245TotalAmt
Program Services$21,481ProgramServicesAmt
Management And General$616,764ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,376,566TotalAmt
Program Services$3,082,437ProgramServicesAmt
Management And General$1,294,129ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$192,871TotalAmt
Program Services$58,184ProgramServicesAmt
Management And General$134,687ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$12,432,556$12,036,303$396,253
ALLOCATIONS$10,181,385$4,391,085$5,790,300
BAD DEBT EXPENSE$1,962,712$1,962,712
MGNT FEE$1,729,000$1,729,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$650,817TotalAmt
Program Services$429,648ProgramServicesAmt
Management And General$221,169ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$81,998,960TotalAmt
Program Services$62,625,548ProgramServicesAmt
Management And General$19,373,412ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$21,155,866BOYAmt
EOY$23,069,954EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,344,103BOYAmt
EOY$11,875,104EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$998,487BOYAmt
EOY$1,283,393EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$974,306BOYAmt
EOY$1,392,673EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$72,421,434LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$42,094,124LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,520,856BOYAmt
EOY$30,327,310EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$58,830,246BOYAmt
EOY$65,359,407EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,993,479BOYAmt
EOY$1,833,003EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,935,056BOYAmt
EOY$8,719,829EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$133,752,399BOYAmt
EOY$143,860,673EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,948,011BOYAmt
EOY$8,021,468EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,000,174BOYAmt
EOY$14,671,481EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,248,074BOYAmt
EOY$2,622,696EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,196,259BOYAmt
EOY$25,315,645EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$105,562,661BOYAmt
EOY$116,712,026EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,873,479BOYAmt
EOY$1,833,002EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$120,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$107,556,140BOYAmt
EOY$118,545,028EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$133,752,399BOYAmt
EOY$143,860,673EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$11,609,982ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$621,094NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$9,561OtherActivitiesAmt
Total Lobbying Expenditures$9,561TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES:FormAndLineReferenceDesc
ExplanationASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE AHA AND WHA HAVE NOTIFIED AMHC THAT A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE PERCENTAGES OF DUES ATTRIBUTED TO LOBBYING ARE 22.73% FOR THE AHA AND 13.6% FOR WHA FOR DOLLAR AMOUNTS OF $3,178 AND $2,315, RESPECTIVELY. AMHC IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND IMPROVE HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS INCLUDES SOME LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. $4,068 OR 19.1% OF THESE DUES WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$131,984BeginningYearBalanceAmt
Investment Earnings Or Losses$11,335InvestmentEarningsOrLossesAmt
End Year Balance$143,319EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$124,340BeginningYearBalanceAmt
Investment Earnings Or Losses$7,644InvestmentEarningsOrLossesAmt
End Year Balance$131,984EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$121,904BeginningYearBalanceAmt
Investment Earnings Or Losses$2,436InvestmentEarningsOrLossesAmt
End Year Balance$124,340EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$131,113BeginningYearBalanceAmt
Investment Earnings Or Losses-$9,209InvestmentEarningsOrLossesAmt
End Year Balance$121,904EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$129,531BeginningYearBalanceAmt
Investment Earnings Or Losses$1,582InvestmentEarningsOrLossesAmt
End Year Balance$131,113EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.83730PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.16270TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$227,478OtherCostOrOtherBasisAmt
Book Value$227,478BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$46,355,391OtherCostOrOtherBasisAmt
Depreciation$23,948,230DepreciationAmt
Book Value$22,407,161BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,975,597OtherCostOrOtherBasisAmt
Depreciation$16,138,993DepreciationAmt
Book Value$5,836,604BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,862,968OtherCostOrOtherBasisAmt
Depreciation$2,006,901DepreciationAmt
Book Value$1,856,067BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,327,310TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DEFERRED COMPENSATION$2,585,899
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$5,611,600
ACCOUNTS RECEIVABLE OTHER$517,533
CASH SURRENDER VALUE OF LIFE INSURANCE$4,797
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,719,829TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION$2,585,899
LONG-TERM INSURANCE LIABILITY$36,797
FieldValueIRS element (for citing)
Total Liability$2,622,696TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$91,130,143TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$621,094NetUnrealizedGainsInvstAmt
Revenue Not Reported-$621,094RevenueNotReportedAmt
Revenue Subtotal$91,751,237RevenueSubtotalAmt
Other Revenues Not Included$1,857,705OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,857,705RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$93,608,942TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$80,217,618TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$109,133OtherExpensesIncludedAmt
Expenses Not Reported$109,133ExpensesNotReportedAmt
Expenses Subtotal$80,108,485ExpensesSubtotalAmt
Other Expenses Not Included$1,890,475OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,890,475ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$81,998,960TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:TERM-ENDOWMENT FUNDS HELD BY ASPIRUS MEDFORD FOUNDATION, INC.; ANY AMOUNT ABOVE $120,000 MAY BE USED TO PURCHASE ITEMS FOR THE COUNTRY GARDENS ASSISTED LIVING FACILITY AT ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.
PART X, LINE 2:AMHC IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AMHC IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CHANGE IN INTEREST IN NET ASSETS OF AMHC FOUNDATION, INC. 76,364. LOSS ON SALE OF FIXED ASSETS -92,763. PROVISION FOR BAD DEBTS 1,890,475. RENTAL EXPENSES -16,371.
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON SALE OF FIXED ASSETS 92,763. RENT EXPENSE 16,370.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 1,890,475.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$856,479TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$856,479NetCommunityBenefitExpnsAmt
Total Expense0.01070TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,954,413TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,222,499DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,731,914NetCommunityBenefitExpnsAmt
Total Expense0.03410TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,301,649TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$849,291DirectOffsettingRevenueAmt
Net Community Benefit Expns$452,358NetCommunityBenefitExpnsAmt
Total Expense0.00570TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,112,541TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,071,790DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,040,751NetCommunityBenefitExpnsAmt
Total Expense0.05050TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$257,362TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$257,362NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,720TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,720NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,027,248TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$770,496DirectOffsettingRevenueAmt
Net Community Benefit Expns$256,752NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,773TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,773NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,375,103TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$770,496DirectOffsettingRevenueAmt
Net Community Benefit Expns$604,607NetCommunityBenefitExpnsAmt
Total Expense0.00750TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,487,644TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,842,286DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,645,358NetCommunityBenefitExpnsAmt
Total Expense0.05800TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$58,856TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$58,856NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$58,856TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$58,856NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$977,234BadDebtExpenseAmt
Reimbursed By Medicare$13,723,302ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,652,272CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$71,030MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ASPIRUS MEDFORD HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH GIBSON STREETAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd
FieldValueIRS element (for citing)
State License1027StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ASPIRUS MEDFORD HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.ASPIRUS.ORG/COMMUNITY-RESOURCESOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.ASPIRUS.ORG/COMMUNITY-RESOURCESStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.ASPIRUS.ORG/FINANCIALAIDFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.ASPIRUS.ORG/FINANCIALAIDFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.ASPIRUS.ORG/FINANCIALAIDFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ASPIRUS MEDFORD HOSPITALPART V, SECTION B, LINE 5: YES, DURING THE COURSE OF 2018, THE TAYLOR COUNTY HEALTH DEPARTMENT, PRICE COUNTY HEALTH DEPARTMENT AND ASPIRUS MEDFORD HOSPITAL & CLINICS EMBARKED ON A COLLABORATIVE EFFORT TO ASSESS AND PRIORITIZE THE HEALTH NEEDS OF THE REGION AND, IN TURN, CREATE AN ACTION PLAN TO CREATE REAL AND SUSTAINED CHANGE WITHIN THE COMMUNITIES WE SERVE.WE TURNED TO RESIDENTS WITHIN THE THREE COUNTIES TO UNDERSTAND THE IMPACT THESE ISSUES HAD WITHIN OUR LOCAL COMMUNITIES. THIS INCLUDED FEEDBACK COLLECTED DURING OUR COMMUNITY HEALTH IMPROVEMENT PLANNING SESSION HELD ON JANUARY 25, 2019. WE COMPILED THIS DATA AND PARTNERED WITH STATE EXPERTS FOR ADDITIONAL QUANTIFIABLE DATA ON THESE ISSUES. THIS INFORMATION WAS SHARED WITH LOCAL STAKEHOLDERS DURING A HALF-DAY SESSION THAT INCLUDED ANALYZING WHAT SERVICES ARE CURRENTLY AVAILABLE AND GAPS IN SERVICES, AND PRIORITIZING KEY HEALTH CONCERNS WITHIN TAYLOR AND PRICE COUNTIES. THE COLLABORATIVE ALSO CONSIDERED THE LOCAL ASSETS AND RESOURCES CURRENTLY AVAILABLE IN THE COUNTIES THAT CAN BE MOBILIZED TO ADDRESS HEALTH. THESE INCLUDED BOTH PHYSICAL AND NON-PHYSICAL ASSETS AND RESOURCES. PHYSICAL ASSETS INCLUDE PARKS, OPEN SPACE, MARKETS, CLINICS AND OTHER ASPECTS OF A COMMUNITY THAT CAN AFFECT A PERSON'S OPPORTUNITY TO ACHIEVE HEALTH. NON-PHYSICAL ASSETS INCLUDE THE SKILLS OF RESIDENTS; THE POWER OF LOCAL ASSOCIATIONS LIKE SERVICE OR PROFESSIONAL GROUPS; LOCAL INSTITUTIONS LIKE FAITH-BASED GROUPS, LOCAL FOUNDATIONS, GOVERNMENT INSTITUTIONS AND INSTITUTIONS OF HIGHER LEARNING; SOCIAL CAPITAL; COMMUNITY RESILIENCE; AND A STRONG BUSINESS COMMUNITY.COMMUNITY STAKEHOLDERS INCLUDED (TAYLOR COUNTY): NAME TITLE ORGANIZATIONALLEN LANG PHARMACIST HEALTHMART PHARMACYJUDY LANG EMPLOYEE HEALTHMART PHARMACYRACHEL DIXON PHYSICIAN ASSISTANT ASPIRUS MEDFORD HOSPITAL & CLINICSDIANE ALBRECHT BOARD MEMBER TAYLOR COUNTY PUBLIC HEALTHCATHERINE LEMKE BOARD MEMBER TAYLOR COUNTYJUDY LEMASTER DISTRICT SCHOOL NURSE RIB LAKE SCHOOL DISTRICTTAMMY TOM-STEINMETZ DIRECTOR OF HUMAN SERVICES TAYLOR COUNTY HUMAN SERVICES DEPT.ANDRIA FARRAND COUNTY CLERK TAYLOR COUNTYCOLLEEN HANDRICK TAYLOR COUNTY EMERGENCY MANAGEMENT DIRECTOR TAYLOR COUNTYMIKE WELLNER MAYOR CITY OF MEDFORDMICHELE ARMBRUST PUBLIC HEALTH COORDINATOR TAYLOR COUNTY HEALTH DEPARTMENTINGRID PURVIS PUBLIC HEALTH NURSE TAYLOR COUNTY HEALTH DEPARTMENTDERRICK FRITZ TAYLOR COUNTY DRUG OPPOSITION PARTNERS PROJECT DIRECTOR TAYLOR COUNTY HUMAN SERVICESKRISTA BLOMBERG ASSISTANT DIRECTOR RIB LAKE PUBLIC LIBRARYNATHANAEL BROWN DIRECTOR TAYLOR COUNTY COMMISSION ON AGINGJOSEPH GREGET DIRECTOR OF SPECIAL EDUCATION AND STUDENT SERVICES MEDFORD PUBLIC SCHOOL DISTRICTDALE HUSTEDT PRESIDENT ASPIRUS MEDFORD HOSPITAL & CLINICSPATRICIA MERTENS BOARD MEMBER TAYLOR COUNTY PUBLIC HEALTHMICHELLE GRIMM COMMUNITY DEVELOPMENT UW-EXTENSIONJUSTINE THICKE OUTREACH COORDINATOR HEALTHFIRSTJOHN LANGE AVP RETAIL BANKING OFFICER NICOLET NATIONAL BANKPATTY KRUG HEALTH OFFICER TAYLOR COUNTY HEALTH DEPARTMENTAMANDA LANGE DIRECTOR OF COMMUNITY HEALTH & FOUNDATION ASPIRUS MEDFORD HOSPITAL & CLINICSCOMMUNITY STAKEHOLDERS INCLUDED (PRICE COUNTY): ASCENSION WISCONSINCHEQUAMEGON SCHOOL DISTRICTCOMMUNITY MEMBERSEMBRACE (DOMESTIC VIOLENCE AND SEXUAL ASSAULT PROGRAM FOR WASHBURN, RUSK & PRICE COUNTIES)UW EXTENSION- PRICE COUNTYFLAMBEAU HOME HEALTH AND HOSPICEFLAMBEAU HOSPITALLIMBERG & ASSOCIATES COUNSELING, LLCMARSHFIELD CLINIC HEALTH SYSTEMNEW HORIZONS NORTH (NOT FOR PROFIT SOCIAL SERVICES & SUPPORT AGENCY)PARK FALLS POLICE DEPARTMENTPHILLIPS PUBLIC LIBRARYPHILLIPS SCHOOL DISTRICTPRICE COUNTY AGING AND DISABILITY RESOURCE CENTER UNITPRICE COUNTY BEHAVIORAL HEALTH UNITPRICE COUNTY BOARD OF SUPERVISORSPRICE COUNTY CHILDREN AND YOUTH UNITPRICE COUNTY PUBLIC HEALTH UNITPRICE COUNTY SHERRIFF DEPARTMENT
ASPIRUS MEDFORD HOSPITALPART V, SECTION B, LINE 6B: TAYLOR COUNTY HEALTH DEPARTMENTPRICE COUNTY HEALTH DEPARTMENT
ASPIRUS MEDFORD HOSPITALPART V, SECTION B, LINE 11: ASPIRUS MEDFORD HOSPITAL & CLINICS DEFINES SIGNIFICANT HEALTH NEEDS AS THE TOP 3 HEALTH PRIORITIES IDENTIFIED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT. AMHC HAS ADOPTED A PLAN TO ADDRESS THESE PRIORITIES THROUGH THE ESTABLISHMENT OF GOALS, OBJECTIVES AND STRATEGIES THAT TARGET SPECIFIC ISSUES IDENTIFIED BY THE PRIORITIES. MORE DETAILED INFORMATION REGARDING THESE GOALS, OBJECTIVES AND STRATEGIES CAN BE FOUND IN OUR COMMUNITY HEALTH IMPLEMENTATION PLAN LOCATED HERE: HTTPS://WWW.ASPIRUS.ORG/UPLOAD/PUBLIC/DOCUMENTS/CHNAS/AMH-CHNA-2109.PDF
ASPIRUS MEDFORD HOSPITALPART V, SECTION B, LINE 13H: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY.
FieldValueIRS element (for citing)
Facility13FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - ASPIRUS MEDFORD CLINIC
143 SOUTH GIBSON STREETMEDFORDWI54451OUTPATIENT CLINIC
2 - ASPIRUS CARE & REHAB
135 SOUTH GIBSON STREETMEDFORDWI54451SKILLED NURSING FACILITY
3 - ASPIRUS PHARMACY - MEDFORD
139 SOUTH GIBSON STREETMEDFORDWI54451RETAIL PHARMACY
4 - ASPIRUS THERAPY & FITNESS - MEDFORD
103 SOUTH GIBSON STREETMEDFORDWI54451THERAPY FITNESS CENTER
5 - ASPIRUS COUNTRY GARDENS
635 WEST CEDAR STREETMEDFORDWI54451ASSISTED LIVING FACILITY
6 - ASPIRUS KIDNEY CARE - MEDFORD
111 SOUTH GIBSON STREETMEDFORDWI54451DIALYSIS CENTER
7 - ASPIRUS PRENTICE CLINIC
1511 RAILROAD AVENUEPRENTICEWI54456OUTPATIENT CLINIC
8 - ASPIRUS PHILLIPS CLINIC
625 PETERSON AVENUEPHILLIPSWI54555OUTPATIENT CLINIC
9 - ASPIRUS THERAPY - PRENTICE
619 BRIDGE STREETPRENTICEWI54456THERAPY FITNESS CENTER
10 - ASPIRUS RIB LAKE CLINIC
1121 HIGHWAY 102RIB LAKE WIWI54451OUTPATIENT CLINIC
11 - ASPIRUS GILMAN CLINIC
320 EAST MAIN STREETMEDFORDWI54433OUTPATIENT CLINIC
12 - ASPIRUS FASTCARE CLINIC - ABBOTSFORD
1011 EAST SPRUCE ST SUITE 6ABBOTSFORDWI54405OUTPATIENT CLINIC
13 - ASPIRUS ATHENS CLINIC
729 PINE STREETATHENSWI54411OUTPATIENT CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF: PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% OF FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200%, THE 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 THE 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 ON FORM 990, SCHEDULE H IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR FORM 990.
PART I, LINE 7G:DIALYSIS HAD COSTS OF $1,027,248 WITH DIRECT OFFSETTING REVENUE OF $770,496.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,962,712.
PART II, COMMUNITY BUILDING ACTIVITIES:ONE OF THE LARGER COMMUNITY BUILDING ACTIVITIES ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS INVOLVED IN IS GETTING PHYSICIANS AND HEALTH CARE WORKERS TO THE AREA TO IMPROVE THE ACCESS TO HEALTH CARE NEEDS IN THE SERVICE AREA. AMHC ALSO PROMOTES HEALTH CARE RELATED JOBS AND EDUCATION TO THE STUDENTS IN THE COMMUNITY.
PART III, LINE 2:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON AMHC'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO AMHC. AMHC ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO AMHC.
PART III, LINE 3:MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS FOR WHICH PATIENTS ARE PERSONALLY RESPONSIBLE, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, AMHC ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OR REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, AMHC 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 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), AMHC RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS 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 AMHC 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, RADIOLOGY, AMBULANCE, AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT AMHC PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED 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 SERVICES REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).
PART III, LINE 9B:UPON A PATIENTS APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENTS 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 MEDFORD HOSPITAL & CLINICS, INC. (AMHC) UTILIZES SEVERAL METHODS IN ASSESSING COMMUNITY HEALTH CARE NEEDS. SOME OF THEM ARE AS FOLLOWS: WORKING CLOSELY WITH THE LOCAL HEALTH DEPARTMENT, SCHOOL DISTRICT, COUNTY AGING DEPARTMENT, AND OTHER ORGANIZATIONS IN THE COMMUNITY; DEMOGRAPHIC DATA FROM SURROUNDING COMMUNITIES; AND EXTERNAL REPORTS, PARTICULARLY THOSE PUBLISHED BY THE LOCAL DEPARTMENT OF HEALTH. AMHC, AT THE END OF FISCAL YEAR 2016, COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND WILL USE THE DATA AND FINDINGS OF THIS REPORT TO GUIDE AMHC IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS.
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:ALTHOUGH ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS LOCATED IN MEDFORD, WISCONSIN, WE HAVE HISTORICALLY DEFINED OUR "COMMUNITY" AS A MUCH BROADER AREA, INCLUDING ALL OF TAYLOR COUNTY, THE SOUTHERN AREA OF PRICE COUNTY, THE NORTHEAST PORTION OF CLARK COUNTY, AND THE NORTHWEST CORNER OF MARATHON COUNTY. WITHIN THIS AREA OUR PRIMARY SERVICE AREA CONSISTS OF A 5 TO 20 MILE RADIUS AROUND MEDFORD. APPROXIMATELY 80% OF OUR PATIENT VOLUME COMES FROM OUR PRIMARY AREA. TAYLOR AND PRICE COUNTIES ARE LARGELY CAUCASIAN AND ARE ALMOST EXCLUSIVELY RURAL WITH 14% OF ADULTS BEING UNINSURED AND 24% OF CHILDREN IN THE MEDFORD SCHOOL DISTRICT ARE ELIGIBLE FOR FREE OR REDUCED SCHOOL LUNCHES. FROM AN EDUCATIONAL STAND POINT, 59% OF OUR SERVICE AREA ONLY HAS A HIGH SCHOOL DIPLOMA OR LESS. THE MEDIAN HOUSEHOLD INCOME IS BELOW THE STATE AVERAGE, WHILE THE STATE AVERAGE IS ALSO BELOW THE NATIONAL AVERAGE. THE MAJOR OCCUPATIONS IN THE COMMUNITY ARE MANUFACTURING, AGRICULTURE, HEALTHCARE, AND SALES/OFFICE POSITIONS.
PART VI, LINE 5:ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS IN A PHYSICIAN SHORTAGE AREA AND WORKS HARD TO RECRUIT PROVIDERS TO OUR AREA TO FILL THE NEEDS OF OUR COMMUNITY. WE ALSO HAVE EMPLOYEES THAT ARE REPRESENTING AMHC AND ARE ACTIVE IN OTHER GROUPS TO HELP IN BUILDING COMMUNITY EFFORTS TO IMPROVE HEALTHCARE IN OUR SERVICE AREA. AMHC ALSO GIVES CASH DONATIONS TO PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS IN THE COMMUNITY.ONE-THIRD OF AMHC'S GOVERNING BODY IS COMPRISED OF RESIDENTS THAT ARE IN AMHC'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE FAMILY MEMBERS THEREOF. AMHC ALSO EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY TO INSURE THAT OUR SERVICE AREA HAS THE HEALTHCARE NEEDED.
PART VI, LINE 6:ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS A PARTNER WITH ASPIRUS, INC. A MULTI-SPECIALTY HEALTH SYSTEM WITH A BASE LOCATION IN WAUSAU, WISCONSIN. AMHC WORKS WITH ASPIRUS TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES THEY SERVE. AS NOTED PREVIOUSLY IN THE FORM 990, A NUMBER OF REPRESENTATIVES FROM ASPIRUS HAVE ROLES ON THE BOARD OF DIRECTORS OF AMHC AND TOGETHER PROMOTE THE MISSION OF ASPIRUS. ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES TO IMPROVING THE HEALTH OF ALL IT SERVES. ASPIRUS WORKS COLLABORATIVELY WITH OTHERS WHO SHARE ITS PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. ASPIRUS AND AMHC WORK COLLABORATIVELY TO STREAMLINE PROCESSES TO CONTINUE TO PROVIDE HIGH QUALITY CARE TO MEMBERS OF COMMUNITIES WHICH OTHERWISE WITHOUT THE EFFORTS OF A COMBINED PARTNERSHIP MAY NOT HAVE ACCESS TO THIS CARE LOCALLY.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ASPIRUS HEALTH FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 PINE RIDGE BLVDAddressLine1Txt
CityWAUSAUCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54401ZIPCd
FieldValueIRS element (for citing)
Recipient EIN391256656RecipientEIN
Cash Grant$150,000CashGrantAmt
Valuation Method UsedCOSTValuationMethodUsedDesc
Purpose Of GrantFOR THE ASPIRUS FAMILY HOUSING PROJECTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAS A MAJOR EMPLOYER AND COMMUNITY SUPPORTER, ASPIRUS MEDFORD HOSPITALS & CLINICS, INC. (AMHC) RECEIVES MANY REQUESTS FOR DONATIONS OF BOTH MONEY AND MATERIAL GOODS BY VARIOUS LOCAL AGENCIES AND INDIVIDUALS. AS A NONPROFIT, AMHC MUST CONTINUOUSLY JUSTIFY ITS TAX-EXEMPT STATUS TO THE IRS. AMHC NEEDS TO UTILIZE ITS RESOURCES AND ENDORSE THOSE ACTIVITIES THAT SUPPORT ITS TAX-EXEMPT PURPOSE, WHICH IS TO PROVIDE HEALTH CARE SERVICES AND PROMOTE HEALTH AND WELLNESS TO THE COMMUNITIES IT SERVES. REQUESTS ARE CHANNELED IN A WAY THAT MAXIMIZES BENEFIT TO THE COMMUNITY AND ASSURES COMPLIANCE WITH CORPORATE NOT-FOR-PROFIT RULES. AMHC'S WRITTEN DONATIONS POLICY OUTLINES ACCEPTABLE RECIPIENTS AND APPROPRIATE OBJECTIVES PRIOR TO AWARDING ANY ASSISTANCE. DUE TO THE CHARITABLE NATURE OF THE GRANTS AND ALLOCATIONS AWARDED, NO FORMAL MONITORING IS REQUIRED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RUTH RISLEY-GRAY
VICE CHAIRPERSON / SVP NURSING SYSTE$0$286,934$0$52,327$0$52,861$0$16,506$0$60,755$0$469,383$0$45,015
MATTHEW HEYWOOD
BOARD MEMBER$0$869,672$0$267,317$0$19,754$0$16,506$0$179,058$0$1,352,307$0$0
SUSAN FRAZIER
PHYSICIAN / BOARD MEMBER$286,098$0$0$0$2,397$0$7,938$0$14,405$0$310,838$0$0$0
MATT BREWER
BOARD MEMBER / VP OF OPERATIONS AI$0$213,660$0$26,807$0$1,058$0$6,269$0$49,714$0$297,508$0$0
RICK NEVERS TERM 718
INTERIM CEO/BOARD MEMBER$0$356,162$0$55,425$0$44,966$0$16,506$0$62,775$0$535,834$0$38,383
GREG SHAW
CFO$155,952$0$19,872$0$1,063$0$4,919$0$30,784$0$212,590$0$0$0
SID SCZYGELSKI
SVP OF FINANCE AND CFO OF$0$514,118$0$87,791$0$52,974$0$16,506$0$101,162$0$772,551$0$49,137
CARI LOGAMAN
SVP & GENERAL COUNSEL$0$372,200$0$58,440$0$21,758$0$16,506$0$65,130$0$534,034$0$19,856
ERIC ANDERSON
SVP SERVICE LINE & PATIENT EXPERIENC$0$274,871$0$45,840$0$13,291$0$15,344$0$64,786$0$414,132$0$11,262
RENEE SMITH
EXECUTIVE DIRECTOR ANI$0$348,984$0$64,382$0$42,194$0$16,506$0$29,102$0$501,168$0$33,431
TODD RICHARDSON
SVP & CIO OF AI$0$297,875$0$56,000$0$41,413$0$16,506$0$71,874$0$483,668$0$38,563
MICHAEL MCGRAIL
SVP SYSTEM CMO OF AI$0$400,085$0$73,833$0$11,606$0$14,262$0$66,485$0$566,271$0$0
JOHN HEISLER
SVP & CHIEF HR OFFICER OF$0$304,853$0$56,609$0$54,606$0$16,506$0$23,636$0$456,210$0$40,214
F DEAN DANNER JR
SVP AMBULATORY SERVICES, PRES ACI (T$0$161,114$0$111,152$0$113,959$0$14,413$0$13,293$0$413,931$0$66,173
ERICK T BRANSTETTER
PHYSICIAN$340,387$0$32,400$0$15,256$0$5,127$0$15,066$0$408,236$0$0$0
SUJATHA ROBERTS
PHYSICIAN$690,367$0$0$0$7,322$0$8,250$0$28,426$0$734,365$0$0$0
TROY SENNHOLZ
PHYSICIAN$437,873$0$0$0$5,552$0$6,440$0$32,854$0$482,719$0$0$0
CARY TAUCHMAN
PHYSICIAN$368,221$0$0$0$8,765$0$7,718$0$26,294$0$410,998$0$0$0
DAVID VANDERKIN
PHYSICIAN$451,896$0$0$0$7,239$0$8,250$0$20,813$0$488,198$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATAX INDEMNIFICATION AND GROSS-UP PAYMENTS WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - E. BRANSTETTER $14,851- INCLUDED IN INCOME. TRAVEL FOR COMPANIONS, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. TRAVEL FOR COMPANIONS- M. HEYWOOD- $177; S. SCZYGELSKI- $273; E. ANDERSON- $237; R. NEVERS- $273; R. RISLEY-GRAY- $199; J. HEISLER- $177; R. SMITH $135; D. HUSTEDT $237; M. BREWER $237
PART I, LINE 4BAMHC SPONSORS A NONQUALIFIED TAX EQUALIZED ANNUITY PLAN COVERING EMPLOYED PHYSICIANS. PHYSICIANS ARE ELIGIBLE TO PARTICIPATE IN THE PLAN AFTER ONE YEAR OF SERVICE. PARTICIPANTS IN THE PLAN ARE IMMEDIATELY 100% VESTED. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $ 49,137 D. DANNER $ 66,173 R. NEVERS $ 38,383 T. RICHARDSON $ 38,563 R. RISLEY-GRAY $ 45,015 R. SMITH $ 33,431 C. LOGEMANN $ 19,856 E. ANDERSON $ 11,262 J. HEISLER $ 40,214

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WI HEALTH & EDUCATION FACILITIES AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391337855BondIssuerEIN
CUSIP97710B7X4CUSIPNum
Bond Issued2013-04-12BondIssuedDt
Issue Price$16,902,595IssuePriceAmt
PurposeCONSTRUCT, RENOVATE, AND EQUIP FACILITIESPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,730,000RetiredAmt
Total Proceeds$16,902,595TotalProceedsAmt
Substantial Completion2006SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts0EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00890PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00100PrivateBusConcerningUBIPct
Total Private Business Use0.00990TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMEDISSUER NAME: WI HEALTH & EDUCATION FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/05/2018
PART VITHE 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.]
PART III, LINES 3A AND 3BASPIRUS, INC., A MEMBER OF ASPIRUS MEDFORD 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-FINANCE PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2RICK NEVERS, MATTHEW HEYWOOD, RUTH RISLEY-GREY AND F. DEAN DANNER, JR. HAVE A BUSINESS RELATIONSHIP. THESE BOARD MEMBERS ARE EMPLOYED BY ASPIRUS, INC. AND IT'S AFFILIATES. (SEE INFORMATION RELATED TO ASPIRUS, INC. DESCRIBED IN FORM 990, PART VI, SECTION A, LINES 6 AND 7.)
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS TWO CORPORATE MEMBERS: MEMORIAL MEMBER ASSOCIATION, INC. (50%) AND ASPIRUS, INC. (50%), BOTH WISCONSIN NONSTOCK CORPORATIONS.
FORM 990, PART VI, SECTION A, LINE 7AAMHC'S BOARD OF DIRECTORS IS ELECTED AS FOLLOWS: (A) FOUR DIRECTORS ARE APPOINTED BY MEMORIAL MEMBER ASSOCIATION. (B) FOUR DIRECTORS ARE APPOINTED BY ASPIRUS, INC. (C) TWO DIRECTORS REPRESENT PROVIDERS ASSOCIATED WITH THE CORPORATION AS FOLLOWS: TWO PROVIDER CLASS DIRECTORS, CONSISTING OF LICENSED HEALTH PROFESSIONALS IN THE ACTIVE MEDICAL OR ALLIED HEALTH CATEGORIES OF THE MEDICAL STAFF OF THE HOSPITAL, WITH CONSIDERATION TO INPUT FROM THE CORPORATION'S BOARD, AND ELECTED JOINTLY BY MMA & ASPIRUS INC.
FORM 990, PART VI, SECTION A, LINE 7BPOWERS RESERVED TO THE CORPORATE MEMBERS: IN ADDITION TO DOING ALL THINGS REQUIRED BY LAW AND EXCEPT AS OTHERWISE PROVIDED, THE CORPORATE MEMBERS HAVE THE FOLLOWING SPECIFIC RIGHTS AND RESPONSIBILITIES: (A) INITIATE AND APPROVE ANY CHANGE IN THE PHILOSOPHY, CHARACTER, OR MISSION OF THE CORPORATION AND ITS STRATEGIC PLANS. (B) APPROVE ANY CHANGES TO THE USE OF THE HOSPITAL'S NAME AND BRANDING OF THE HOSPITAL. (C) INITIATE AND APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION. (D) AMEND THE BYLAWS OF THE CORPORATION AND ALL SUBSIDIARIES. (E) TAKE ANY ACTION ABLE TO BE TAKEN BY THE JOINT MEMBERS COUNCIL. (F) INITIATE AND APPROVE THE ADDITION OF NEW MEMBERS OF THE CORPORATION. (G) INITIATE AND APPROVE BORROWING OF MONEY AND OTHER FORMS OF INDEBTEDNESS. (H) INITIATE AND APPROVE THE PURCHASE, SALE, LEASE, DISPOSITION, ENCUMBRANCE OR ALIENATION OF PROPERTY WITH A VALUE IN EXCESS OF $1,000,000. (I) APPROVE THE ESTABLISHMENT, TRANSFER OF OWNERSHIP AND/OR DISSOLUTION OF ANY SUBSIDIARY CORPORATIONS. (J) INITIATE AND APPROVE ANY PLAN OF DISSOLUTION OR MERGER, CONSOLIDATION. (K) APPROVES STRATEGIC ALLIANCES AND AFFILIATIONS OF CORPORATION WITH OTHER HOSPITALS AND HEALTH SYSTEMS. (L) SELECTION AND RETENTION OF THE PRESIDENT/CEO. (M) FINAL APPROVAL OF OPERATING AND CAPITAL BUDGETS.
FORM 990, PART VI, SECTION B, LINE 11BTHE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 990-T ARE REVIEWED 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 12CEACH BOARD MEMBER AND EMPLOYEE SHALL DISCLOSE TO THE APPROPRIATE LEVEL OF MANAGEMENT ANY CIRCUMSTANCE UNDER WHICH THE BOARD MEMBER, EMPLOYEE, OR AN IMMEDIATE FAMILY MEMBER, BY VIRTUE OF A FINANCIAL INTEREST, MAY BE INFLUENCED, OR MAY APPEAR TO BE INFLUENCED, EITHER IN WHOLE OR IN PART, BY ANY PURPOSE OR MOTIVE OTHER THAN THE SUCCESS AND WELL BEING OF AMHC AND ITS SUBSIDIARIES AND THE ACHIEVEMENT OF ITS PUBLIC CHARITABLE PURPOSES. PRIOR TO ENTERING INTO ANY ARRANGEMENT WITH AN OUTSIDE ORGANIZATION, INDIVIDUALS MUST DISCLOSE POTENTIAL CONFLICTS OF INTEREST TO THEIR RESPECTIVE SUPERVISOR; BOARD MEMBERS TO THE BOARD PRESIDENT. EACH CIRCUMSTANCE OF A POTENTIAL CONFLICT OF INTEREST WILL BE REVIEWED ON AN INDIVIDUAL BASIS. THE MANAGER WILL RESPOND IN WRITING (WITH A COPY TO THE PERSONNEL FILE) AFTER CONSULTATION WITH THE APPROPRIATE VICE PRESIDENT AS TO WHETHER THE ARRANGEMENT IS OR IS NOT ACCEPTABLE.
FORM 990, PART VI, SECTION B, LINE 15FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19AMHC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION A, EXPLANATION OF HOURS WORKED:SOME OFFICERS AND DIRECTORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B.
FORM 990, PART XII, LINE 2C:THE AUDIT COMMITTEE OF THE ASPIRUS, INC. BOARD PROVIDES OVERSIGHT OF THE AUDIT PROCESS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ASPIRUS MEDFORD FOUNDATION INC
135 SOUTH GIBSON STREETMEDFORDWI54451391777081CHARITABLE FOUNDATIONWI501(C)(3)LINE 7MEMORIAL MEMBER ASSOCIATION INCYes (1)
CEDAR COURT APARTMENTS INC
135 SOUTH GIBSON STREETMEDFORDWI54451391412339LOW INCOME HOUSINGWI501(C)(3)LINE 7MEMORIAL MEMBER ASSOCIATION INCYes (1)
ASPIRUS CLINICS INC
425 PINE RIDGE BLVDWAUSAUWI54401391670223MEDICAL SERVICESWI501(C)(3)LINE 10ASPIRUS INC0
ASPIRUS ONTONAGON HOSPITAL INC
601 SEVENTH STONTONAGONMI49953260806477HOSPITALMI501(C)(3)LINE 3ASPIRUS INCYes (1)
ASPIRUS VNA HOME HEALTH INC
520 N 32ND AVENUEWAUSAUWI54401390808511HOME HEALTHCARE CENTERWI501(C)(3)LINE 10ASPIRUS INCYes (1)
ASPIRUS VNA EXTENDED CARE INC
520 N 32ND AVENUEWAUSAUWI54401391597350PERSONAL CARE SERVICESWI501(C)(3)LINE 10ASPIRUS VNA HOME HEALTH INCYes (1)
ASPIRUS HEALTH FOUNDATION INC
425 PINE RIDGE BLVDWAUSAUWI54401391256656CHARITABLE FOUNDATIONWI501(C)(3)LINE 7ASPIRUS INCYes (1)
ASPIRUS IRONWOOD HOSPITAL & CLINICS INC
N 10561 GRAND VIEW LANEIRONWOODMI49938382908586HOSPITALMI501(C)(3)LINE 3ASPIRUS INCYes (1)
GRAND VIEW HOSPITAL AUXILIARY
N 10561 GRAND VIEW LANEIRONWOODMI49938237178363SUPPORTING ORGANIZATION TO HOSPITAL AND LIFELINE EMERGENCY SYSTEMMI501(C)(3)LINE 10ASPIRUS IRONWOOD HOSPITAL & CLINICS INCYes (1)
ASPIRUS IRON RIVER HOSPITAL & CLINICS INC
1400 W ICE LAKE ROADIRON RIVERMI49935383236977HOSPITALMI501(C)(3)LINE 3ASPIRUS INCYes (1)
ASPIRUS RIVERVIEW HOSPITAL & CLINICS
410 DEWEY STREETWISCONSIN RAPIDSWI54494390868982HOSPITALWI501(C)(3)LINE 3ASPIRUS INCYes (1)
ASPIRUS INC
333 PINE RIDGE BLVDWAUSAUWI54401391328331HOSPITALWI501(C)(3)LINE 12B, II0N/A
ASPIRUS WAUSAU HOSPITAL INC
333 PINE RIDGE BLVDWAUSAUWI54401391138241HOSPITALWI501(C)(3)LINE 3ASPIRUS INCYes (1)
ASPIRUS BUILDINGS INC
333 PINE RIDGE BLVDWAUSAUWI54401391406537PROPERTY LEASINGWI501(C)(3)LINE 10ASPIRUS INCYes (1)
ASPIRUS EXTENDED SERVICES INC
425 PINE RIDGE BLVDWAUSAUWI54401390782130NURSING HOME SERVICESWI501(C)(3)LINE 10ASPIRUS INCYes (1)
ASPIRUS KEWEENAW HOSPITAL
205 OSCEOLALAURIUMMI49913381443361HOSPITALMI501(C)(3)LINE 3ASPIRUS INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1WESTERN UPPER MICHIGAN EYE CARE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1131 W GENESEE STREETAddressLine1Txt
CityIRON RIVERCityNm
State AbbreviationMIStateAbbreviationCd
ZIP49935ZIPCd
FieldValueIRS element (for citing)
EIN272324957EIN
Primary ActivitiesEYE CARE SERVICESPrimaryActivitiesTxt
Legal Domicile StateMILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
ASPIRUS NETWORK INC
3000 WESTHILL DRIVE 202WAUSAUWI54401391931678HEALTH CARE SERVICESWIN/ACYes (1)
ASPIRUS KEWEENAW ENTERPRISES INC
205 OSCEOLA STREETLAURIUMMI49913383390273PHARMACYMIN/ACYes (1)
ASPIRUS HEALTH VENTURES INC
3000 WESTHILL DRIVE 303WAUSAUWI54401474925640OTHER INS RELATED - INS HOLDING COMPANYWIN/ACYes (1)
ASPIRUS ARISE HEALTH PLAN OF WI INC
3000 WESTHILL DRIVE 303WAUSAUWI54401364832569HEALTH INSURANCE PLANSWIN/ACYes (1)
ASPIRUS ARISE HEALTH PLAN OF MI INC
3000 WESTHILL DRIVE 303WAUSAUWI54401475448266HEALTH INSURANCE PLANSMIN/ACYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ASPIRUS WAUSAU HOSPITAL
L$57,028COST
ASPIRUS WAUSAU HOSPITAL
M$636,982COST
ASPIRUS WAUSAU HOSPITAL
O$6,844,217COST
ASPIRUS WAUSAU HOSPITAL
P$764,889COST
ASPIRUS WAUSAU HOSPITAL
Q$97,145COST
ASPIRUS INC
M$10,181,955COST
ASPIRUS INC
O$14,848,916COST
ASPIRUS INC
P$407,357COST
ASPIRUS INC
Q$57,155COST
ASPIRUS CLINICS INC
J$50,674COST
ASPIRUS CLINICS INC
O$313,610COST
ASPIRUS EXTENDED SERVICES
O$141,235COST
ASPIRUS HEALTH FOUNDATION INC
B$150,000COST

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART V, LINE 1DFormAndLineReferenceDesc
ExplanationALL OUTSTANDING OBLIGATED GROUP DEBT IS GUARANTEED BY ALL MEMBERS OF THE OBLIGATED GROUP.ExplanationTxt