2020-06-04T10:35:33-05:00 2019-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2018-07-01 391138241 ASPIRUS WAUSAU HOSPITAL INC ASPI 7158472988 333 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 7158472988 2020-06-01 1 MICHAEL J PETERSON CPA P01833529 2187224705 2020-06-01 71.13.38.61 2020-06-01 09:55:05 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 2018 2020-11-06 18:47:13Z SIDNEY C SCZYGELSKI 333 PINE RIDGE BLVD WAUSAU WI 54401 573374194 0 X WWW.ASPIRUS.ORG X 1970 WI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 10 4 3113 476 502826 0 484342 3222621 503496031 552751382 9749747 12215362 2499657 2135938 516229777 570325303 118287 1103865 0 0 187277844 196096177 0 0 0 274192260 296867192 461588391 494067234 54641386 76258069 526389861 539380506 185176986 180663166 341212875 358717340 WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 368306387 1103865 554384494 ASPIRUS WAUSAU HOSPITAL, INC. PROVIDES HOSPITAL SERVICES FOR RESIDENTS OF WAUSAU AND THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 368306387 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 317 0 3113 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 4 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 DAVID M HECK CHAIR 1.00 2.00 X X 0 0 0 LISA S WESTPHAL VICE CHAIR 1.00 1.00 X X 0 0 0 CRAIG A HACKWORTH MD SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 CHAD H RADKE DO BOARD MEMBER 1.00 3.00 X 0 0 0 KATHY KELSEY FOLEY BOARD MEMBER 1.00 2.00 X 0 0 0 JAMES M CYGAN MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 852508 47066 KRISTEN R RAHN MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 337098 40210 LAWRENCE G LEIBERT MD BOARD MEMBER/ADC PHYSICIAN 1.00 40.00 X 0 500965 40446 MARY JO WENDLING MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 289309 15112 RANDY L BALK BOARD MEMBER 1.00 1.00 X 0 0 0 DARRELL LENTZ PRESIDENT AWH 46.00 4.00 X 456182 0 88958 MATTHEW F HEYWOOD PRESIDENT & CEO AI 1.00 50.00 X 0 1156743 195564 SIDNEY C SCZYGELSKI SVP & CFO AI 1.00 50.00 X 0 654883 117668 CARI LOGEMANN SVP & GENERAL COUNSEL 1.00 50.00 X 0 452398 81636 TONYA DARNER CHIEF OPERATING OFFICER 40.00 0.00 X 193441 0 20907 RICK L NEVERS SVP REG OPS SYSTEM INT OFF 1.00 50.00 X 0 456553 79281 JOHN HEISLER SVP AND CHIEF HR OFFICER 1.00 50.00 X 0 416068 40142 TODD RICHARDSON SVP AND CIO 1.00 50.00 X 0 395287 88380 JACOB KEMPEN TERMED 918 VP ANCILLARY & SUPPORT SERVICES 50.00 1.00 X 202663 0 39092 F DEAN DANNER JR TERM 62918 SVP AMBULATORY SVC & PRES ACI 1.00 50.00 X 0 386225 27706 ERIC ANDERSON SVP SERVICE LINE & PATIENT EXP 1.00 50.00 X 0 334002 80130 RUTH RISLEY-GRAY SVP NURSING SYSTEM CNO 40.00 10.00 X 0 392122 77261 JEANNINE NOSKO VP PATIENT CARE/CNO 50.00 0.00 X 275714 0 62066 STEPHEN BREWER VP HEART & VASCULAR 1.00 40.00 X 0 259236 64217 MICHAEL MCGRAIL MD SVP SYSTEM CMO 1.00 50.00 X 0 485524 80747 SARA LUSIGNAN TERMED 119 VP FINANCE 1.00 40.00 X 0 273228 57185 RENEE M SMITH MD EXECUTIVE DIRECTOR ANI 50.00 0.00 X 455560 0 45608 RYAN ANDREWS CHIEF MEDICAL OFFICER 1.00 49.00 X 374292 0 70191 ROBERT SMITH VP STEVENS POINT CAMPUS 1.00 49.00 X 219873 0 27076 MARIA GULAN VP AMBULATTORY SVC & PATIENT EXP 1.00 49.00 X 0 219710 50859 BRYANT HAMMIG DIRECTOR - PAYOR STRATEGY 40.00 0.00 X 214297 0 28874 JILL MICHAUD DIRECTOR - SYSTEM PHARMACY 40.00 0.00 X 210439 0 42277 BETTY VOGDS CLINICAL MEDICAL PHYSICIST 40.00 0.00 X 176199 0 20845 IVAN LUKOWSKI MANAGER - PHARMACY 40.00 0.00 X 175899 0 40695 KRISTIN RABENOLD ASSOCIATE CNO 40.00 0.00 X 177973 0 20767 3132532 7861859 1690966 107 0 1 0 MIRON PO BOX 1372 GREEN BAY WI 543051372 CONSTRUCTION 12496229 WI EMERGENCY MEDICAL SERVICE ASSOCIATION 333 PINE RIDGE BLVD WAUSAU WI 54401 EMERGENCY CONTRACTED PROVIDERS 8950245 FOCUSONE SOLUTIONS 13609 CALIFORNIA ST OMAHA NE 68154 CONTRACT LABOR 2658345 SURGICAL ASSOCIATIONS OF WAUSAU 2400 PINE RIDGE BLVD WAUSAU WI 54401 ON CALL SERVICES 1967063 ELLIS STONE CONSTRUCTION 3201 STANLEY STREET STEVENS POINT WI 54481 CONSTRUCTION SERVICES 1873769 218 3070925 151696 3222621 PATIENT SERVICE REVENUE 621400 506521085 506521085 LAB REVENUE 621400 31775743 31586513 189230 RENTAL REVENUE 532000 6969529 6969529 CONTRACT SERVICE REVENUE 621400 5547701 5547701 MOBILE UNIT REVENUE 621400 74740 74740 1862584 1862584 552751382 10663457 10663457 160130 160130 4440666 3048891 1391775 1391775 1391775 CAFETERIA AND VENDING 722210 1772027 1696862 75165 INVESTMENT IN WESTWOOD 523000 175909 175909 188002 125480 62522 2135938 570325303 554384494 502826 12215362 X 1103865 1103865 2677388 2677388 152139882 134840908 17298974 7193835 6258636 935199 23592653 17779121 5813532 10492419 10492419 695870 695870 160161 160161 33146 33146 110047360 49348015 60699345 310648 109872 200776 3978546 3606697 371849 160439 95437 65002 20965063 11991595 8973468 1501494 1333848 167646 347984 7757 340227 4031763 4031763 23922912 12699320 11223592 657118 34417 622701 MEDICAL SUPPLIES 111493461 108422031 3071430 BAD DEBT 11500872 11500872 HOSPITAL TAX 8561976 432750 8129226 RECRUITMENT 493304 87416 405888 -1994925 -2534459 539534 494067234 368306387 125760847 0 4270975 2764462 9711873 12452039 63875164 73690912 7215564 9125035 2211191 2351177 469942857 234289943 233241614 235652914 197304724 189328767 2565382 2867610 5993374 11147590 526389861 539380506 39524362 39421947 132002391 125869313 13650233 15371906 185176986 180663166 X 341212875 356119685 2597655 341212875 358717340 526389861 539380506 X 76258069 -2064230 -56689374 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27132 27132 0 PART II-B, LINE 1: A PORTION OF OUR ANNUAL WISCONSIN HOSPITAL ASSOCIATION (WHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) AND VARIOUS OTHER ASSOCIATION DUES ARE USED FOR LOBBYING ACTIVITIES. THE PERCENTAGES THAT ARE SPECIFIC TO LOBBYING PURPOSES ARE: WISCONSIN HOSPITAL ASSOCIATION 14.3%, AMERICAN HOSPITAL ASSOCIATION 22.73%, AMERICAN COLLEGE OF PHYSICIANS 90%, WISCONSIN MEDICAL SOCIETY 7%, ASSOCIATION OF AIR MEDICAL SERVICES 25%, AMERICAN OSTEOPATHIC ASSOC 3.33%, AMERICAN NURSES ASSOCIATION 5%, AND TRAUMA CENTER ASSOCIATION 29%. THE GRAND TOTAL DOLLAR AMOUNT GOING TOWARDS LOBBYING IS $27,132. 16948795 16948795 294547212 135947651 158599561 393535 272093 121442 142404421 98070199 44334222 15648894 15648894 235652914 AMOUNTS PAYABLE TO THRID-PARTY REIMBURSEMENT PROGRAMS 2003899 RETIREE HEALTHCARE BENEFITS 2843666 INTEREST RATE SWAP 3202600 DEFERRED COMPENSATION ACCRUAL 1387941 LONG-TERM INSURANCE LIABILITY 848685 ASBESTOS LIABILITY 5085115 15371906 1 1 X 1 X 1 X 1 1 1 0 1 1 3756706 3756706 0.00780 57956344 22629923 35326421 0.07320 10896710 4415794 6480916 0.01340 72609760 27045717 45564043 0.09440 7372974 5556374 1816600 0.00380 1542070 1542070 0.00320 11817872 7000392 4817480 0.01000 392732 155525 237207 0.00050 57517 57517 0.00010 21183165 12712291 8470874 0.01760 93792925 39758008 54034917 0.11200 291 291 0.00000 2267 2267 0.00000 2844 2844 0.00000 5402 5402 0.00000 1 3767505 99618878 116168675 -16549797 X 1 0 1 1 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 188 X X X ASPIRUS WAUSAU HOSPITAL INC 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES X 1 18 1 WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES 0 1 X 200.000000000000 300.000000000000 X 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 WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 5: A SIX-PAGE SURVEY WAS MAILED TO 2,100 HOUSEHOLDS IN MARATHON COUNTY. (THE SRC USED THE DILLMAN METHOD FOR THE 2,100 HOUSEHOLDS IN THE MAIL SURVEY. EACH PERSON IN THE SAMPLE WAS SENT A SURVEY INITIALLY. THOSE WHO HAD NOT RETURNED THEIR SURVEY WITHIN TWO WEEKS WERE SENT A POSTCARD REMINDING THEM TO COMPLETE THE SURVEY. TWO WEEKS AFTER THE POSTCARD, THOSE WHO HAD STILL NOT RESPONDED RECEIVED A SECOND POSTCARD.) OF THOSE 2,100 SURVEYS: -600 WERE SENT TO THREE SUBPOPULATIONS: UNDER AGE 35, HOUSEHOLD WITH INCOMES UNDER $25,000 AND MINORITIES OF VARYING ETHNICITY, TO ENSURE A REPRESENTATION FROM THESE CHALLENGING TO REACH GROUPS. -1,500 SURVEYS WERE RANDOMLY SENT THROUGHOUT MARATHON COUNTY. -AN ADDITIONAL 100 SURVEYS WERE DISTRIBUTED TO SELECTED MARATHON COUNTY NON-PROFIT PARTNERS BY UNITED WAY OF MARATHON COUNTY INCLUDING: SALVATION ARMY, THE NEIGHBOR'S PLACE AND BRIDGE CLINIC TO BETTER REACH MINORITIES AND UNDERSERVED POPULATIONS. THOSE WHO RECEIVED SURVEYS HAD THE OPTION TO COMPLETE THE SURVEY ONLINE. THE SRC RECEIVED THE FOLLOWING NUMBER OF RESPONSES FROM THESE THREE SOURCES: -443 PAPER SURVEYS FROM THOSE MAILED -33 PAPER SURVEYS FROM NON-PROFIT PARTNERS -21 ONLINE SURVEYS GIVEN AN ADULT POPULATION OF 103,194 IN MARATHON COUNTY, THIS DATA SHOULD PROVIDE ESTIMATES ACCURATE TO WITHIN PLUS OR MINUS 4.5% ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 6A: ASCENSION, MARSHFIELD CLINIC ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 6B: EO JOHNSON BUSINESS TECHNOLOGIES, U.S. WORKSTORIES, WAUSAU POLICE DEPARTMENT, MARATHON COUNTY BOARD, NORTH CENTRAL WISCONSIN WORKFORCE DEVELOPMENT BOARD, ASPIRUS ARISE, HOMME HEIGHTS, INC., MARATHON COUNTY CONSERVATION, PLANNING AND ZONING DEPARTMENT, MARATHON COUNTY PUBLIC LIBRARY, WAUSAU SCHOOL DISTRICT, MARATHON COUNTY SHERIFF'S DEPARTMENT, ASCENSION, UNITED WAY OF MARATHON COUNTY, MARATHON COUNTY HEALTH DEPARTMENT, MARATHON COUNTY DEVELOPMENT CORPORATION, NORTHCENTRAL TECHNICAL COLLEGE, AMONG OTHER AGENCIES AS PART OF THE SUBCOMMITTEES. ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 11: HEALTH NEEDS THAT ASPIRUS WAUSAU HOSPITAL PLANS TO ADDRESS:BEHAVIORAL HEALTH:VISION: PROMOTE WELL-BEING BY PREVENTING OR INTERVENING IN MENTAL ILLNESS SUCH AS DEPRESSION OR ANXIETY, ALONG WITH PREVENTING OR INTERVENING IN SUBSTANCE ABUSE OR OTHER ADDICTIONS.GOAL STATEMENTS:-INCREASE THE PUBLIC'S AWARENESS OF THE IMPORTANCE OF GOOD MENTAL WELL-BEING AND COMMUNITY SERVICES AVAILABLE TO SUPPORT THEIR MENTAL WELL-BEING.-IMPROVE ALCOHOL & OTHER DRUG ABUSE AND MENTAL HEALTH TREATMENT SERVICES-FURTHER INTEGRATE BEHAVIORAL HEALTH WITHIN THE DELIVERY OF HEALTH CAREALCOHOL & OTHER DRUG MISUSE AND ABUSE:VISION: CREATING A CULTURE IN COMMUNITIES WHERE ALCOHOL IS USED RESPONSIBLY AND OTHER DRUGS (TOBACCO, PRESCRIPTION, AND ILLICIT) ARE NOT MISUSED.GOAL STATEMENTS:-CHANGE SOCIAL NORMS, ATTITUDES, AND BEHAVIORS AROUND SUBSTANCE USE-STRENGTHEN COMMUNITY COLLABORATION AROUND SUBSTANCE ABUSE PREVENTION-INCREASE FUNDING FOR AODA PREVENTION, TREATMENT, AND ENFORCEMENTHEALTHY START FOR CHILDREN: VISION: PREVENTING OR REDUCING THE IMPACT OF POTENTIALLY TRAUMATIC EVENTS THAT CAN HAVE NEGATIVE, LASTING EFFECTS ON HEALTH AND WELL-BEING. THESE EXPERIENCES RANGE FROM PHYSICAL, EMOTIONAL, OR SEXUAL ABUSE TO PARENTAL DIVORCE OR THE INCARCERATION OF A PARENT OR GUARDIAN.HEALTHY WEIGHT:VISION: A WEIGHT THAT LOWERS YOUR RISK FOR HEALTH PROBLEMS, INCLUDING THOSE THAT LEAD TO CHRONIC CONDITIONS, SUCH AS DIABETES, HYPERTENSION, AND CHRONIC HEART FAILURE. ACHIEVEMENT OR MAINTENANCE OF A HEALTHY WEIGHT INCLUDES HEALTHY FOOD CHOICES AND PHYSICAL ACTIVITY.GOAL STATEMENTS:-CONTINUE THE COLLECTIVE EFFORTS OF THE HEALTHY EATING ACTIVE LIVING (HEAL) COALITION, STRIVING TO MOVE TO THE "COLLABORATION" STATUS-IDENTIFY ASPECTS OF HEALTHY WEIGHT THAT ARE IMPORTANT TO MARATHON COUNTY RESIDENTS-STRENGTHEN THE LINK BETWEEN HEALTHY WEIGHT AND ECONOMIC PROSPERITYBECAUSE AWH IS A HEALTH CARE PROVIDER, IT CANNOT MEANINGFULLY IMPACT ALL ISSUES IDENTIFIED BY THE CHNA. AWH WILL NOT BE DEVELOPING STRATEGIES TO ADDRESS HEALTH NEEDS OF AGING OR ORAL HEALTH AS ONE OF THE TOP HEALTH PRIORITIES. AWH DOES HAVE POPULATION HEALTH GOALS IN ALIGNMENT WITH THE COMMUNITY ACTIVITIES FOCUSED AROUND HEALTHY AGING, BEING END OF LIFE CARE. AWH WILL CONTINUE TO COLLABORATE WITH COMMUNITY PARTNERS IN ADDRESSING THIS ISSUE AS A NEED IN THE COMMUNITY. ORAL HEALTH IS ALSO PROMOTED ACROSS PROVIDERS, NOTING THAT ORAL HEALTH IS A COMPONENT OF GOOD OVERALL HEALTH. ASPIRUS MAINTAINS A GOOD RELATIONSHIP WITH DENTAL PROVIDERS IN THE COMMUNITY FOR REFERRALS AND OTHER SERVICES. ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 3 1 - NORTHWOODS SURGERY CENTER LLC 611 VETERANS PARKWAY WOODRUFF WI 54568 GENERAL MEDICAL & SURGICAL 2 - PINE RIDGE SURGERY CENTER 2500 PINE RIDGE BLVD WAUSAU WI 54401 GENERAL MEDICAL & SURGICAL 3 - STEVENS POINT SURGERY CENTER LLC 5409 VERN HOLMES DRIVE STEVENS POINT WI 54481 GENERAL MEDICAL & SURGICAL 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% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. - CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS AND IRREVOCABLE BURIAL TRUST FUNDS.- TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSE, LESS MEDICAID PROVIDER TAXES DIVIDED BY GROSS PATIENT SERVICE REVENUES. 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 THE ORGANIZATION. THE ORGANIZATION ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITABLE CARE POLICY. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS 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 OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE ORGANIZATION. PART I, LINE 7G: THE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE TRAUMA UNIT, PALLIATIVE (COMFORT CARE) UNIT, OUTPATIENT DIALYSIS, AND HOSPICE HOUSE. ASPIRUS WAUSAU HOSPITAL UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE TRAUMA UNIT REPORTED COSTS OF $3,329,709 WITH OFFSETTING REVENUE OF $1,881,452. THE PALLIATIVE CARE UNIT REPORTED COSTS OF $3,681,001 WITH OFFSETTING REVENUE OF $1,686,750. THE OUTPATIENT DIALYSIS UNIT REPORTED COSTS OF $3,625,556 WITH OFFSETTING REVENUE OF $2,920,926. THE HOSPICE HOUSE UNIT REPORTED COSTS OF $1,181,606 WITH OFFSETTING REVENUE OF $511,264. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24B, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $11,500,868. PART II, COMMUNITY BUILDING ACTIVITIES: AS ANY GOOD CORPORATE CITIZEN, ASPIRUS WAUSAU HOSPITAL IS INVOLVED IN A WIDE RANGE OF COMMUNITY BUILDING ACTIVITIES. AND WHILE SOME OF THESE ARE UNDERTAKEN SIMPLY BECAUSE THERE IS A COMMUNITY NEED AND ASPIRUS IS IN A POSITION TO HELP, OTHERS ARE UNDERTAKEN FOR MUCH MORE SPECIFIC REASONS. THE GOAL OF ASPIRUS WAUSAU HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES IS TO ADDRESS KEY COMMUNITY HEALTH ISSUES AS IDENTIFIED BY THE COMMUNITY NEEDS ASSESSMENT: THE MARATHON COUNTY LIFE REPORT SPEARHEADED BY THE UNITED WAY OF MARATHON COUNTY. THE FOLLOWING IS A LIST OF "COMMUNITY BUILDING" ACTIVITIES REPORTED IN PART II AND BRIEF DESCRIPTIONS OF THEM. ECONOMIC DEVELOPMENT (F2) CENTRAL WAUSAU PROGRESS: THIS IS ANOTHER COMMUNITY DEVELOPMENT PROGRAM THAT COMBINES THE VISION, RESOURCES, AND EFFORTS OF MANY PARTNERS THROUGHOUT THE WAUSAU AREA. MCDEVCO: MARATHON COUNTY ECONOMIC DEVELOPMENT CORPORATION, IN PRIVATE AND PUBLIC PARTNERSHIP WITH MARATHON COUNTY GOVERNMENT AND THE WAUSAU REGION CHAMBER OF COMMERCE, PROVIDES LEADERSHIP FOR REVIEWING AND RECOMMENDING ALL INITIATIVES RELATED TO EDUCATION AND ECONOMIC DEVELOPMENT. MCDEVCO IS COMMITTED TO BUSINESS GROWTH, AS WELL AS PROVIDING A HIGH QUALITY OF LIFE AND BUILDING STRONG COMMUNITIES IN THE MARATHON COUNTY REGION. WAUSAU REGION CHAMBER: THE LOCAL MEMBER OF THE US CHAMBER OF COMMERCE, THE WAUSAU REGION CHAMBER DEDICATES ITSELF TO IMPROVING THE LOCAL BUSINESS COMMUNITY AND ECONOMY THROUGH ADVOCACY, GROWTH/DEVELOPMENT, MARKETING AND PROFESSIONAL DEVELOPMENT. ASPIRUS WAUSAU HOSPITAL IS A LONGTIME CHAMBER MEMBER AND PROVIDES A LEADERSHIP ROLE IN MULTIPLE WAYS. COMMUNITY SUPPORT (F3) BOY SCOUTS OF AMERICA: BSA HAS A THRIVING COUNCIL, THE SAMOSET, LOCATED IN WAUSAU. THIS ORGANIZATION ENCOURAGES THE PHYSICAL, CIVIC, SOCIAL AND EDUCATIONAL DEVELOPMENT OF BOYS AND ASPIRUS WAUSAU HOSPITAL SUPPORTS ITS EFFORTS. BSA ACTIVITIES HELP ADDRESS THE FOLLOWING MARATHON COUNTY LIFE REPORT KEY CALLS TO ACTION: ALCOHOL AND DRUG MISUSE, AND OVERWEIGHT AND OBESITY. ROTARY: ROTARY IS A WORLDWIDE ORGANIZATION OF BUSINESS AND PROFESSIONAL LEADERS THAT PROVIDES HUMANITARIAN SERVICE, ENCOURAGES HIGH ETHICAL STANDARDS IN ALL VOCATIONS, AND HELPS BUILD GOODWILL AND PEACE IN THE WORLD. THE OBJECT OF ROTARY IS TO ENCOURAGE AND FOSTER THE IDEAL OF SERVICE AS A BASIS OF WORTHY ENTERPRISE. THE LOCAL CLUB HAS ABOUT 85 MEMBERS AND TRULY BENEFITS THE COMMUNITY. UNITED WAY: ASPIRUS WAUSAU HOSPITAL HAS DEEP AND LONGSTANDING INVOLVEMENT WITH THE LOCAL UNITED WAY. AS A PACESETTER ORGANIZATION, ASPIRUS DEMONSTRATES LEADERSHIP IN ITS INTERNAL SUPPORT CAMPAIGN TO BENEFIT THE UNITED WAY, WHICH HAS RESTRUCTURED TO FOLLOW A ROAD MAP TO COMMUNITY SUCCESS THAT DIRECTS ITS SUPPORT TO ORGANIZATIONS THAT IMPROVE EDUCATION, HEALTH AND INCOME IN THE COMMUNITY. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE: POLICY:I. ASPIRUS' FINANCIAL POLICY #6775518 REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. (ALSO REFER TO ASPIRUS POLICY #6762521)II. FAILURE TO MEET THESE REQUIREMENTS IN POLICY #6775518 WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET:A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF:1. MONTHLY STATEMENTS2. COLLECTION LETTERS3. COLLECTION PHONE CALLS III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS.IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE.V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE.PROCEDURE:I. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN POLICY/PROCEDURE ID# 6762521.A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS:1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS.2. ASPIRUS WAUSAU HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS.3. THE DEBT IS ACTUALLY NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE FIRST BILLING TO THE PATIENT).3. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE.II. BAD DEBT RECOVERIESA. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. B. PAYMENTS MADE DIRECTLY TO ASPIRUS, BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. C. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. PART III, LINE 4: THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. PART III, LINE 8: THE COSTING METHODOLOGY IS CMS2552 AS FILED COST REPORT. ASPIRUS WAUSAU HOSPITAL, INC. (ASPIRUS MANAGEMENT) HAS DETERMINED THAT THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. ASPIRUS IS THERE TO TREAT THE COMMUNITY AND THEY HAVE A LARGE PERCENTAGE OF MEDICARE BENEFIT PATIENTS. IF THOSE PATIENTS WERE TO BE REFUSED, THEN THEY WOULD NOT RECEIVE HEALTHCARE. PART III, LINE 9B: WE HAVE A PRACTICE IN PLACE (SEE BELOW) WHEN IS IT KNOWN THAT A PATIENT QUALIFIES THAT WE FOLLOW A DIFFERENT COLLECTION PROCEDURE BUT IT IS NOT DOCUMENTED IN THE POLICY. 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: IN 1996, THE UNITED WAY LED A COLLABORATIVE EFFORT TO PERFORM A COMMUNITY HEALTH ASSESSMENT THAT FOCUSED ON DATA RATHER THAN PERCEPTION. WITH SUPPORT FROM ASPIRUS AND OTHER COMMUNITY PARTNERS, THE UNITED WAY PERFORMED A COMMUNITY ASSESSMENT AND PUBLISHED IN JUNE 1997 THE FIRST ISSUE OF WHAT WAS CALLED THE MARATHON COUNTY LOCAL INDICATORS FOR EXCELLENCE (LIFE) REPORT.SINCE THAT TIME, ASPIRUS WAUSAU HOSPITAL HAS MAINTAINED STRONG INVOLVEMENT IN THE COMMUNITY ASSESSMENT PROCESS, FROM PLEDGING CASH SUPPORT AND IN KIND DONATIONS TO STEERING COMMITTEE CHAIRS AND MEMBERS. THE TENTH AND MOST RECENT VERSION OF THE MARATHON COUNTY LIFE REPORT 2015-2017 IS BY DEFINITION AN ASSESSMENT OF COMMUNITY STRENGTHS AND CHALLENGES. IT SEEKS TO IDENTIFY KEY ISSUES AND MONITOR TRENDS THAT AFFECT THE QUALITY OF LIFE IN MARATHON COUNTY. THE LIFE REPORT IDENTIFIED THE FOLLOWING ISSUES ESTABLISHED AS PRIORITIES:- MENTAL HEALTH- SUBSTANCE ABUSE- INCOME- A GREAT START FOR KIDS 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: ACCORDING THE U.S. CENSUS BUREAU, MARATHON COUNTY HAD A POPULATION OF 135,603 AS OF 2016. FOR THE PURPOSES OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT, WE WILL FOCUS ON MARATHON COUNTY AS THE "COMMUNITY" SERVED BY ASPIRUS WAUSAU HOSPITAL. WHILE THERE ARE DEMOGRAPHIC AND POPULATION DATA FOR SPECIFIC MARKETS (PRIMARY, SECONDARY, UPPER PENINSULA OF MICHIGAN, FOR EXAMPLE) MARATHON COUNTY BEARS SPECIAL ATTENTION, AS ASPIRUS WAUSAU HOSPITAL AND MANY OF THE SYSTEM'S CORPORATE FUNCTIONS RESIDE THERE. IN FACT, MARATHON COUNTY IN MANY RESPECTS IS THE "HOME" OF ASPIRUS AND IS THE SINGLE LARGEST SOURCE OF PATIENTS AMONG THE COUNTIES ASPIRUS SERVES. ASIDE FROM WAUSAU, THE COUNTY SEAT CLASSIFIED BY THE U.S. CENSUS BUREAU AS A "METROPOLITAN STATISTICAL AREA," MARATHON COUNTY IS LARGELY RURAL. WITH A TOTAL AREA OF 1,576 SQUARE MILES, IT IS THE LARGEST COUNTY IN WISCONSIN BY LAND AREA. HERE ARE SOME DETAILS ABOUT ITS POPULATION.ABOUT MARATHON COUNTY (2016):PERSONS PER SQUARE MILE 86.8%PERSONS UNDER 5 YEARS OLD 5.9%PERSONS UNDER 18 YEARS OLD 23.0%PERSONS 65 YEARS AND OVER 16.9%WHITE PERSONS 91.4%ASIAN PERSONS 5.8%PERSONS PER HOUSEHOLD 2.47PERSONS BELOW POVERTY LEVEL 10.4%MEDIAN HOUSEHOLD INCOME $54,227SOURCE: US CENSUS BUREAUTHE LARGEST EMPLOYERS IN MARATHON COUNTY:ASPIRUS WAUSAU HOSPITAL GREENHECK FAN CORP. KOLBE & KOLBE WAUSAU SCHOOL DISTRICT FOOTLOCKER.COM/EASTBAY WAUSAU PAPER/SCA MARATHON CHEESE MARATHON COUNTY NORTH CENTRAL HEALTH CARE NORTH CENTRAL TECHNICAL COLLEGE SOURCE: COMPREHENSIVE ANNUAL FINANCIAL REPORT MARATHON COUNTY, WISCONSIN FOR THE YEAR ENDED DECEMBER 31, 2018.MUCH OF ASPIRUS WAUSAU HOSPITAL'S BROADER SERVICE AREA (NORTH CENTRAL AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN) IS DEFINED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AS A HEALTH PROFESSIONAL SHORTAGE AREA AND MEDICALLY UNDERSERVED AREA. MARATHON COUNTY SPECIFICALLY IS DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION AS A HEALTH PROFESSIONAL SHORTAGE AREA, HEALTH PROFESSIONAL SHORTAGE AREA FOR MENTAL HEALTH, AND MEDICALLY UNDERSERVED AREA. PART VI, LINE 5: TODAY, THAT COMMUNITY LEADERSHIP AND VISION ENDURES. ASPIRUS WAUSAU HOSPITAL IS GUIDED BY A COMMUNITY BOARD OF DIRECTORS, WHICH THE ORGANIZATION'S BYLAWS STATE MUST CONSIST OF EIGHT OR NINE PHYSICIANS AND 11 TO 14 COMMUNITY MEMBERS. THIS BOARD HELPS ENSURE THAT STRATEGIC AND OPERATIONAL DECISIONS AT ASPIRUS WAUSAU HOSPITAL ARE MADE WITH THE COMMUNITY'S BEST INTEREST IN MIND. IN ADDITION, ASPIRUS WAUSAU HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, MEANING THAT IT EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. AS A NOT-FOR-PROFIT ORGANIZATION, ASPIRUS WAUSAU HOSPITAL REINVESTS SURPLUS FUNDS IN HEALTH SERVICES FOR THE COMMUNITY, SUCH AS NEW TECHNOLOGY THAT ADVANCES CARE AND IMPROVES ACCESS. ASPIRUS WAUSAU HOSPITAL ALSO WORKS COLLABORATIVELY WITH OTHER HEALTH CARE AND ACADEMIC ENTITIES TO OFFER PROFESSIONAL HEALTH EDUCATION OPPORTUNITIES THAT BENEFIT THE COMMUNITIES. FOR EXAMPLE, THE UNIVERSITY OF WISCONSIN WAUSAU FAMILY MEDICINE RESIDENCY PROGRAM IS BASED ON THE ASPIRUS WAUSAU HOSPITAL MEDICAL CAMPUS, AND PRODUCES SKILLED, DEDICATED FAMILY MEDICINE PHYSICIANS. THE VAST MAJORITY OF RESIDENCY GRADUATES END UP PRACTICING IN NORTH CENTRAL WISCONSIN, MAKING THE RESIDENCY PROGRAM INCREDIBLY VALUABLE TO THE ONGOING EASY ACCESS TO HIGH QUALITY PRIMARY HEALTH CARE. ASPIRUS WAUSAU HOSPITAL IS THE VEHICLE BY WHICH EXTENSIVE VOLUNTEER EFFORTS ARE ORGANIZED. THERE ARE MORE THAN 1,000 ASPIRUS VOLUNTEERS WHO SUPPORT THE PROVISION OF EXCELLENT MEDICAL CARE AT THE HOSPITAL AND IN OTHER VENUES. THESE VOLUNTEERS ALSO PROVIDE VALUABLE COMMUNITY OUTREACH THROUGH THE LIFELINE HOME HEALTH MONITORING PROGRAM, THE HANDS PROGRAM THAT TEACHES YOUNG CHILDREN THE IMPORTANCE OF HAND HYGIENE, AND MEALS ON WHEELS. ASPIRUS WAUSAU HOSPITAL ALSO SUPPORTS VALUABLE CLINICAL RESEARCH THROUGH ASPIRUS HEART & VASCULAR INSTITUTE (AHVI) RESEARCH & EDUCATION AND THROUGH THE ASPIRUS REGIONAL CANCER CENTER (ARCC). AHVI RESEARCH & EDUCATION HAS ABOUT 10 OPEN TRIALS AT ANY GIVEN TIME, AND SEEKS TO ADVANCE THE SAFE, EFFECTIVE AND COMPASSIONATE PRACTICE OF CARDIOVASCULAR MEDICINE IN NORTH CENTRAL WISCONSIN. THROUGH A RESEARCH AFFILIATION WITH THE UNIVERSITY OF WISCONSIN COMPREHENSIVE CANCER CENTER IN MADISON, ARCC IS PART OF A SATELLITE SYSTEM CALLED WISCONSIN ONCOLOGY NETWORK OFFERING CLINICAL TRIALS TO PATIENTS WITH ADVANCED DISEASE. ARCC IS ALSO ABLE TO OFFER FEDERALLY SPONSORED STUDIES AVAILABLE THROUGH THE EASTERN COOPERATIVE ONCOLOGY GROUP AND THE RADIOLOGIC THERAPY ONCOLOGY GROUP.ASPIRUS IS ALSO COMMITTED TO THE HEALTH OF THE COMMUNITY IT SERVES. BY PARTNERING WITH ORGANIZATIONS SUCH AS THE HEALTH DEPARTMENT, UNITED WAY, YWCA, UW-EXTENSION, AND OTHERS, ASPIRUS CAN INVEST IN PROGRAMS AND OFFER SERVICES TO POPULATIONS THAT WOULD NOT HAVE ACCESS OTHERWISE. PART VI, LINE 6: ASPIRUS WAUSAU HOSPITAL IS ONE OF EIGHT HOSPITALS UNDER THE ASPIRUS, INC. UMBRELLA. SIX OF THE HOSPITALS ARE SMALL, CRITICAL ACCESS FACILITY, WHILE ASPIRUS WAUSAU HOSPITAL AND ASPIRUS RIVERVIEW ARE REGIONAL TERTIARY CARE FACILITIES. THE ASPIRUS SYSTEM IS RELATIVELY YOUNG, ESPECIALLY IN THE UPPER PENINSULA OF MICHIGAN, WHERE FOUR OF THE CRITICAL ACCESS HOSPITALS ARE LOCATED. THESE FACILITIES ALL OPERATE AS LOCAL SOURCES OF CHARITY CARE AND STRONG CORPORATE CITIZENS. IN FACT, ASPIRUS KEWEENAW HOSPITAL RECEIVED IN JANUARY 2011 THE WINKS GUNDLACH AWARD FOR STRONG AND CONSISTENT SUPPORT OF THE KEWEENAW COMMUNITY FOUNDATION. THIS COMMITMENT TO LOCAL COMMUNITY IS REFLECTED THROUGHOUT THE ASPIRUS SERVICE AREA. IN WAUSAU, THE ASPIRUS HEALTH FOUNDATION RAISES MONEY FOR VARIOUS HEALTH RELATED INITIATIVES IN THE COMMUNITY AND WITHIN ASPIRUS. IN ADDITION TO RAISING MONEY AND RECEIVING COMMUNITY GIFTS, THE FOUNDATION ALSO DETERMINES THE BEST WAY TO UTILIZE ITS RESOURCES TO MAKE THE BIGGEST IMPACT ON THE COMMUNITY. THROUGHOUT THE ASPIRUS SERVICE AREA, AFFILIATED FOUNDATIONS SERVE THE NEEDS OF THEIR RESPECTIVE COMMUNITIES: THE COMMUNITY HEALTH FOUNDATION SERVES ANTIGO, WI AND SURROUNDING COMMUNITIES. ASPIRUS MEDFORD FOUNDATION SERVES MEDFORD, WI AND SURROUNDING COMMUNITIES. ASPIRUS ONTONAGON FOUNDATION SERVES ONTONAGON, MI AND SURROUNDING COMMUNITIES. GOGEBIC RANGE HEALTH FOUNDATION SERVES IRONWOOD, MI AND SURROUNDING COMMUNITIES.ASPIRUS RIVERVIEW FOUNDATION SERVICES WISCONSIN RAPIDS, WI AND SURROUNDING COMMUNITIES. WHILE ASPIRUS HAS GROWN AND EXPANDED ITS SERVICE AREA RAPIDLY IN THE PAST TEN YEARS, SYSTEM LEADERS ARE MAKING A CONCERTED EFFORT TO COLLABORATE INTERNALLY TO MAKE THE CONTINUUM OF CARE AS SEAMLESS AS POSSIBLE FOR CUSTOMERS. THIS MEANS PROVIDING HIGH QUALITY, EFFICIENT SERVICE FROM PRIMARY CARE TO SPECIALTY SERVICES AND POST-ACUTE CARE SUCH AS REHABILITATION AND HOME CARE. BY INTEGRATING SERVICES, AND COMMUNICATING EFFECTIVELY AMONG PROVIDERS, ASPIRUS IS BETTER ABLE TO MEET PATIENT NEEDS AND IMPROVE OUTCOMES. THIS COULD BE THE MOST IMPORTANT COMMUNITY BENEFIT OF ALL. PART VI, LINE 7 ASPIRUS HAS FOUR HOSPITALS IN WISCONSIN: ASPIRUS WAUSAU HOSPITAL IN WAUSAU, ASPIRUS LANGLADE HOSPITAL IN ANTIGO, ASPIRUS MEDFORD HOSPITAL IN MEDFORD, AND ASPIRUS RIVERVIEW HOSPITAL IN WISCONSIN RAPIDS. EACH OF THESE CENTERS FILES A SEPARATE COMMUNITY BENEFIT REPORT. ASPIRUS ALSO HAS FOUR HOSPITALS IN MICHIGAN'S UPPER PENINSULA: ASPIRUS KEWEENAW HOSPITAL IN LAURIUM, ASPIRUS IRONWOOD HOSPITAL IN IRONWOOD, ASPIRUS ONTONAGON HOSPITAL IN ONTONAGON AND ASPIRUS IRON RIVER HOSPITAL IN IRON RIVER. EACH OF THESE FACILITIES IS RESPONSIBLE FOR ITS OWN COMMUNITY BENEFITS REPORTING. 1 SUSAN G KOMEN OF WISCONSIN 2025 W OKLAHOMA AVENUE SUITE 116 MILWAUKEE WI 53215 752844639 501(C)(3) 25465 SPONSORSHIP WAUSAU AREA MOBILE MEALS 610 SCOTT STREET STE G WAUSAU WI 54403 391238060 501(C)(3) 11000 DONATION LEIGH YAWKEY WOODSON ART MUSEUM 700 N TWELFTH STREET WAUSAU WI 54403 237367344 501(C)(3) 10000 SPONSORHIP UNITED WAY OF MARATHON COUNTY 705 S 24TH AVENUE STE 400B WAUSAU WI 54401 390935496 501(C)(3) 49334 SPONSORSHIP FESTIVAL OF ARTS PO BOX 1763 WAUSAU WI 54402 391292264 501(C)(3) 6000 SPONSORSHIP WAUSAU DANCE THEATRE 124 N 3RD AVE WAUSAU WI 54401 237367344 501(C)(3) 5000 SPONSORSHIP COMMUNITY FOUNDATION OF NORTH CENTRAL WISCONSIN 500 FIRST STREET WAUSAU WI 54403 391577472 501(C)(3) 10000 SPONSORSHIP MARATHON COUNTY HEALTH DEPARTMENT 1000 LAKE VIEW DRIVE SUITE 100 WAUSAU WI 54403 396005716 GOV 25000 SPONSORSHIP MEDICAL COLLEGE OF WISCONSIN 1000 N 92ND STREET 1318 MILWAUKEE WI 53226 390806261 501(C)(3) 5000 SPONSORSHIP NORTH CENTRAL HEALTH CARE FACILITY (HUMAN SERVICES BOARD) 1100 LAKEVIEW DR PO BOX 1103 WWAUSAU WI 544031103 391267785 501(C)(3) 14600 SPONSORSHIP RISE UP CENTRAL WISCONSIN LLC 3104 RIB MOUNTAIN WAY WAUSAU WI 54401 822857210 501(C)(3) 23000 SPONSORSHIP WI EYE PUBLIC AFFAIRS NETWORK 122 WEST WASHINGTON AVENUE SUITE 200 MADISON WI 53703 391977300 501(C)(3) 5000 SPONSORSHIP WOODSON YMCA 707 N 3RD STREET WAUSAU WI 54403 390808463 501(C)(3) 10000 SPONSORSHIP 13 0 PART I, LINE 2: THE EXECUTIVE DIRECTOR OF ASPIRUS HEALTH FOUNDATION ADMINISTERS THE FUNDS IN THE ASPIRUS COMMUNITY PARTNER FUND (CPF). THE FUNDS FROM CPF ARE GIVEN TO COMMUNITY PROGRAMS TO INCREASE THE QUALITY OF LIFE IN THE REGION OR ARE RELATED TO HEALTH INITATIVES. THEY ARE NOT USED, IN GENERAL, FOR SPONSORSHIPS OR MARKETING-ALBEIT, WE WORK CLOSELY WITH MARKETING WHEN DISPERSING FUNDS FROM THE ACCOUNT. AN ANNUAL BUDGET IS SET FOR THE CPF AND THROUGHOUT THE YEAR WE MAINTAIN RECORDS TO TRACK WHO GETS THE FUNDS, AMOUNTS DISPERSED, AND WHY. X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 JAMES M CYGAN MD BOARD MEMBER/PHYSICIAN 0 847315 0 0 0 5193 0 16506 0 30560 0 899574 0 0 KRISTEN R RAHN MD BOARD MEMBER/PHYSICIAN 0 330622 0 0 0 6476 0 15265 0 24945 0 377308 0 0 LAWRENCE G LEIBERT MD BOARD MEMBER/ADC PHYSICIAN 0 495604 0 0 0 5361 0 16506 0 23940 0 541411 0 0 MARY JO WENDLING MD BOARD MEMBER/PHYSICIAN 0 284183 0 0 0 5126 0 13446 0 1666 0 304421 0 0 DARRELL LENTZ PRESIDENT AWH 335215 0 62615 0 58352 0 14356 0 74602 0 545140 0 50012 0 MATTHEW F HEYWOOD PRESIDENT & CEO AI 0 869672 0 267317 0 19754 0 16506 0 179058 0 1352307 0 0 SIDNEY C SCZYGELSKI SVP & CFO AI 0 514118 0 87791 0 52974 0 16506 0 101162 0 772551 0 49137 CARI LOGEMANN SVP & GENERAL COUNSEL 0 372200 0 58440 0 21758 0 16506 0 65130 0 534034 0 19856 TONYA DARNER CHIEF OPERATING OFFICER 174456 0 14093 0 4892 0 2887 0 18020 0 214348 0 0 0 RICK L NEVERS SVP REG OPS SYSTEM INT OFF 0 356162 0 55425 0 44966 0 16506 0 62775 0 535834 0 38383 JOHN HEISLER SVP AND CHIEF HR OFFICER 0 304853 0 56609 0 54606 0 16506 0 23636 0 456210 0 40214 TODD RICHARDSON SVP AND CIO 0 297875 0 56000 0 41412 0 16506 0 71874 0 483667 0 38563 JACOB KEMPEN TERMED 918 VP ANCILLARY & SUPPORT SERVICES 172351 0 25952 0 4360 0 10620 0 28472 0 241755 0 0 0 F DEAN DANNER JR TERM 62918 SVP AMBULATORY SVC & PRES ACI 0 161114 0 111152 0 113959 0 14413 0 13293 0 413931 0 66173 ERIC ANDERSON SVP SERVICE LINE & PATIENT EXP 0 274871 0 45840 0 13291 0 15344 0 64786 0 414132 0 11262 RUTH RISLEY-GRAY SVP NURSING SYSTEM CNO 0 286934 0 52327 0 52861 0 16506 0 60755 0 469383 0 45015 JEANNINE NOSKO VP PATIENT CARE/CNO 226367 0 28474 0 20873 0 10896 0 51170 0 337780 0 20013 0 STEPHEN BREWER VP HEART & VASCULAR 0 211912 0 26802 0 20522 0 12800 0 51417 0 323453 0 19003 MICHAEL MCGRAIL MD SVP SYSTEM CMO 0 400085 0 73833 0 11606 0 14262 0 66485 0 566271 0 0 SARA LUSIGNAN TERMED 119 VP FINANCE 0 221639 0 27914 0 23675 0 10593 0 46592 0 330413 0 22547 RENEE M SMITH MD EXECUTIVE DIRECTOR ANI 348984 0 64382 0 42194 0 16506 0 29102 0 501168 0 33431 0 RYAN ANDREWS CHIEF MEDICAL OFFICER 332090 0 34303 0 7899 0 8250 0 61941 0 444483 0 0 0 ROBERT SMITH VP STEVENS POINT CAMPUS 194750 0 23760 0 1363 0 8651 0 18425 0 246949 0 0 0 MARIA GULAN VP AMBULATTORY SVC & PATIENT EXP 0 193987 0 24127 0 1596 0 10407 0 40452 0 270569 0 0 BRYANT HAMMIG DIRECTOR - PAYOR STRATEGY 180274 0 18500 0 15523 0 5910 0 22964 0 243171 0 0 0 JILL MICHAUD DIRECTOR - SYSTEM PHARMACY 185119 0 19677 0 5643 0 10717 0 31560 0 252716 0 0 0 BETTY VOGDS CLINICAL MEDICAL PHYSICIST 176046 0 0 0 153 0 9225 0 11620 0 197044 0 0 0 IVAN LUKOWSKI MANAGER - PHARMACY 150434 0 15929 0 9536 0 8486 0 32209 0 216594 0 0 0 KRISTIN RABENOLD ASSOCIATE CNO 154451 0 15650 0 7872 0 8672 0 12095 0 198740 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS AND HOUSING ALLOWANCE, WHEN APPLICABLE, WAS ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. HOUSING ALLOWANCE - T. DARNER - $3,752 - INCLUDED IN INCOME TRAVEL FOR COMPANIONS - INCLUDED IN INCOME M. HEYWOOD - $177 S. SCZYGELSKI - $273 R. NEVERS - $273 J. HEISLER - $177 S. LUSIGNAN - $177 E. ANDERSON - $237 R. RISLEY-GRAY - $199 R. SMITH - $135 D. LENTZ - $100 PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: 457(F) RETIREMENT PLAN PROFILE: KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 9% FOR VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL, AND 15% FOR THE CEO. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. D. LENTZ - $50,012 S. SCZYGELSKI - $49,137 R. NEVERS - $38,383 T. RICHARDSON - $38,563 D. DANNER - $66,173 C. LOGEMANN - $19,856 R. RISLEY-GRAY - $45,015 S. LUSIGNAN - $22,547 S. BREWER - $19,003 R. SMITH - $33,431 J. HEISLER - $40,214 E. ANDERSON - $11,262 J. NOSKO - $20,013. A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 2012-02-29 32025000 REFUND BONDS SERIES 2012A 0 0 0 B WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97710BLW0 2009-10-07 27200000 REFUND BONDS ISSUED 3/18/2009 0 0 0 C WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97710BLV2 2009-10-07 20000000 SERIES 1998-VAR RATE DEMAND 0 0 0 D WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97710B7X4 2013-04-12 47001087 REVENUE BONDS SERIES 2013 0 0 0 A 23720 32025000 1 0 1 1 B 27200000 102000 1327347 26372644 2006 1 0 1 1 C 14000000 20000000 180978 159700 1999 1 0 1 1 D 55000 47001087 24037511 2014 1 0 1 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 1 1 0 1 0 0.00050 0.00050 0 0 1 D 0 1 1 0 1 0 0.00550 0.00550 0 0 1 A 0 0 1 0 0 0 0 0 1 B 1 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART III, LINE 9: SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. 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.] PART III, LINES 2, 3A AND 3B ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS WAUSAU HOSPITAL, INC., HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW LEASE AGREEMENTS, 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. 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 RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS WAUSAU HOSPITAL (EIN 39-1138241); AND ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC (EIN 38-2908586); 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. A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337856 97712DC53 2017-11-02 39002258 REVENUE BONDS SERIES 2017 0 0 0 A 39158357 39158357 0 0 1 1 A 0 0 1 0 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 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 OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBIT CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND 990-T ARE REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CORPORATE ALLOCATIONS: PROGRAM SERVICE EXPENSES 11,153,327. MANAGEMENT AND GENERAL EXPENSES 58,100,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,253,820. OTHER FEES: PROGRAM SERVICE EXPENSES 38,194,688. MANAGEMENT AND GENERAL EXPENSES 2,598,852. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,793,540. FORM 990, PART XI, LINE 9: EQUITY - BOND SWAP -20,245. POST RETIREMENT HEALTHCARE BENEFIT ADJUSTMENT -21,733. NET ASSET TRANSFER TO ASPIRUS, INC. -55,293,418. INTEREST RATE SWAP VALUATION ADJUSTMENT -902,355. INTEREST RATE SWAP -234,439. OTHER ADJUSTMENTS -217,184. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS WAUSAU HOSPITAL, INC., ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS IN THE PAST YEAR. 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