2019-05-15T13:38:04-05:00 2018-06-30 390758449 WIPFLI LLP 4890 OWEN AYRES COURT SUITE 200 EAU CLAIRE WI 54701 990 2017-07-01 382908586 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC ASPI 9069322525 N10561 GRAND VIEW LANE IRONWOOD MI 49938 SIDNEY C SCZYGELSKI CFO/SENIOR VP OF FINANCE 9069322525 2019-05-10 1 PAUL M TRACZEK CPA P01368830 7158323407 2019-05-10 137.26.200.211 2019-05-10 15:00:45 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 E4255D669FE7A429B540D12C0E645A16D05D3497 2017 2019-02-21 02:37:17Z SIDNEY C SCZYGELSKI 2200 WESTWOOD DRIVE WAUSAU WI 54401 60169665 0 X WWW.ASPIRUS.ORG X 1989 MI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 11 6 419 71 0 26182 41760 77186 63185333 59023113 262727 387589 0 0 63489820 59487888 0 0 0 0 28335255 28795590 0 0 0 32037643 32886641 60372898 61682231 3116922 -2194343 75312267 74433017 24535586 26810846 50776681 47622171 X WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 1 0 47112455 59023113 ASPIRUS IRONWOOD HOSPITAL AND CLINICS IS A 25-BED CRITICAL ACCESS HOSPITAL WHICH PROVIDES HEALTH CARE SERVICES TO RESIDENTS OF IRONWOOD, MICHIGAN AND ITS SURROUNDING COMMUNITIES. SOME OF THE SERVICES PROVIDED BEYOND TRADITIONAL INPATIENT HOSPITALIZATIONS INCLUDE SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, THERAPIES, EYE CARE, ONCOLOGY, SLEEP LAB, AND CARDIOLOGY, AMONG VARIOUS OTHER HEALTH CARE SERVICES.ASPIRUS IRONWOOD HOSPITAL AND CLINICS PROVIDES HEALTH CARE SERVICES TO ALL PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. FOR THOSE INDIVIDUALS UNABLE TO PAY FOR THEIR HEALTH CARE NEEDS, ASPIRUS IRONWOOD HOSPITAL AND CLINICS OFFERS SERVICES FOR FREE OR AT A REDUCED PRICE THROUGH THE FINANCIAL AID DISCOUNT POLICY. PLEASE REFER TO SCHEDULE H OF THE FORM 990 FOR ADDITIONAL INFORMATION ON THE COST OF FINANCIAL AID DISCOUNTS PROVIDED TO PATIENTS DURING FISCAL YEAR 2018.ASPIRUS IRONWOOD HOSPITAL AND CLINICS ALSO PROVIDES HEALTH CARE SERVICES TO INDIVIDUALS COVERED UNDER GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID WHICH OFTEN REIMBURSE THE HOSPITAL AT AMOUNTS SUBSTANTIALLY LOWER THAN THE USUAL AND CUSTOMARY CHARGE. THOSE PEOPLE COVERED BY THESE TYPES OF PROGRAMS NEED ACCESS TO HEALTH CARE, BUT ARE OFTEN TIMES UNABLE TO TRAVEL LONG DISTANCES TO RECEIVE THIS CARE. ASPIRUS IRONWOOD HOSPITAL AND CLINICS PROVIDES THIS LOCAL, QUALITY HEALTH CARE TO MANY ELDERLY AND LOW INCOME INDIVIDUALS THAT ARE IN NEED OF HEALTH CARE. DURING FISCAL YEAR 2018, MORE THAN 72.2% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM BENEFICIARIES OF MEDICARE AND MEDICAID. 47112455 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 92 0 1 419 1 1 1 0 0 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JAMES LORENSON CHAIRPERSON 1.00 X X 0 0 0 JOHN GARSKE VICE CHAIRPERSON 1.00 X X 0 0 0 SARA LUSIGNAN TREASURER / VP OF FINANCE 1.00 40.00 X X 0 274914 46484 RICK NEVERS SECRETARY / SVP REG OPS SY 1.00 50.00 X X 0 422587 79085 JEFFREY NEHRING DDS FORMER CHAIRPERSON (TERM 9/30/17) 1.00 X X 0 0 0 MARIA GULAN DIRECTOR 1.00 40.00 X 0 209363 55268 CHARLES IKNAYAN MD DIRECTOR 1.00 X 0 0 0 JACOB KEMPEN DIRECTOR 1.00 40.00 X 0 229915 43182 KARI JACQUART DIRECTOR 1.00 X 0 0 0 PAUL ANDERSON DIRECTOR 1.00 X 0 0 0 CHRISTOPHER J PATRITTO DIRECTOR 1.00 X 0 0 0 MARCUS SANTINI DIRECTOR/PHYSICIAN 40.00 X 331451 0 41745 PAULA CHERMSIDE DIRECTOR / CEO 40.00 X 277365 0 30876 MATT HEYWOOD PRESIDENT & CEO ASPIRUS 1.00 50.00 X 0 1118732 163184 SIDNEY C SCZYGELSKI SVP OF FINANCE & CFO 1.00 50.00 X 0 644952 106596 CHUCK NELSON REGIONAL CEO - UP 1.00 40.00 X 0 389204 81847 SHANE JACQUES REGIONAL CFO 12.00 28.00 X 0 223027 38117 GRACE TOUSIGNANT REGIONAL CNO 12.00 28.00 X 0 195811 28752 JOHN HEISLER SVP & CHIEF HR OFFICER 1.00 50.00 X 0 369321 76970 DEAN DANNER SVP & ACI PRESIDENT 1.00 50.00 X 0 388969 44042 MICHAEL MCGRAIL MD SVP & SYSTEM CMO 1.00 50.00 X 0 486338 77636 CARI LOGEMANN SVP & GENERAL COUNSEL 1.00 50.00 X 0 421450 85137 RUTH RISLEY-GRAY SVP & CNO 1.00 50.00 X 0 377496 77201 ERIC ANDERSON SVP SERVICE LINE & PATIENT EXPERIENCE/INTERIM PRES 1.00 50.00 X 0 274165 64677 RENEE SMITH EXECUTIVE DIRECTOR ANI 1.00 50.00 X 0 431396 46277 TODD RICHARDSON SVP & CIO 1.00 50.00 X 0 392900 87961 NITIN NIGAM PHYSICIAN 40.00 X 659889 0 31305 ENRICO BRAUCHER PHYSICIAN 40.00 X 602189 0 44355 DANIEL LUKES PHYSICIAN 40.00 X 548013 0 16329 JAMES HUBBARD PHYSICIAN 40.00 X 566588 0 15500 STEVEN PHILLIPSON PHYSICIAN 40.00 X 474807 0 33855 3460302 6850540 1416381 44 0 1 0 ASPIRUS INC 2200 WESTWOOD DRIVE WAUSAU WI 54401 MANAGEMENT SERVICES 9496209 ASPIRUS WAUSAU HOSPITAL INC 425 PINE RIDGE BLVD WAUSAU WI 54401 LAB & MANAGEMENT SERVICES 4154022 MIRON CONSTRUCTION CO INC PO BOX 1372 GREEN BAY WI 543051372 CONSTRUCTION 2557207 ASPIRUS IRON RIVER HOSPITAL 1400 W ICE LAKE ROAD IRON RIVER MI 49935 PHYSICIAN SERVICES 2150414 MI EMERGENCY PHYSICIANS PO BOX 677979 DALLAS TX 752677979 ER PHYSICIAN COVERAGE 2064338 18 48319 28867 77186 NET PATIENT SERVICE REVENUE 621990 54663292 54663292 OTHER OPERATING REVENUE 900099 4254374 4254374 RELATED PARTY RENTAL 531120 87758 87758 NON RELATED PART RENTAL 900099 17349 17349 OTHER NON-OPERATING REVENUE 900099 340 340 59023113 404363 404363 665003 681777 -16774 -16774 -16774 59487888 59023113 0 387589 X 737024 350525 386499 22780301 19434640 3345661 1023221 1023221 2758152 1651413 1106739 1496892 1496892 8560341 4218157 4342184 42226 42226 19490 19490 6410890 5845709 565181 117491 117491 954231 703664 250567 634849 634849 159977 90392 69585 145285 145285 497269 497269 3001101 1068128 1932973 234248 234248 MEDICAL SUPPLIES 8701758 8562593 139165 QAAP EXPENSES 1474877 1474877 REPAIRS AND MAINTENANCE 93872 31538 62334 INCOME TAX EXPENSE 1689 547 1142 1837047 1014874 822173 61682231 47112455 14569776 0 2620 2270 15106237 16119486 8204825 8414257 1312001 1325930 233102 177055 69083941 37586919 33598858 31497022 13556178 14617526 236607 236607 3061839 2042864 75312267 74433017 4165272 4550049 853247 451227 2887217 14720525 10445832 6184018 7089045 24535586 26810846 X 49861594 46885765 915087 736406 50776681 47622171 75312267 74433017 X -2194343 234833 -1195000 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 8458 8458 0 PART II-B, LINE 1: ASPIRUS IRONWOOD HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND MHA HAVE NOTIFIED ASPIRUS IRONWOOD HOSPITAL & CLINICS THAT APPROXIMATELY $8,458 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 421754 421754 38861693 13238002 25623691 2225738 1221847 1003891 27515787 23127070 4388717 58969 58969 31497022 UNDER AGREEMENTS FOR PAYROLL LIABILITIES 26298 F DEFERRED COMPENSATION PLAN ASSETS 4524995 F INVESTMENTS IN UNCONSOLIDATED AFFILIATES 1033678 F INVESTMENTS - PROGRAM RELATED 9032555 F 14617526 DEFERRED COMPENSATION 4524995 LONG-TERM INSURANCE LIABILITY 1208653 DUE TO OTHER 369694 ACC INSURANCE DEDUCTIBLES 679867 MEDICAID, MEDICARE & BLUE CROSS PAYABLES 305836 7089045 X PART X, LINE 2: ALL SUBSIDIARIES, EXCEPT FOR ASPIRUS NETWORK, INC. (ANI), ARE TAX-EXEMPT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(2) OF THE CODE. THEY ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. ASPIRUS 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. INCOME TAXES FOR ANI, A NOT-FOR-PROFIT TAXABLE CORPORATION, WERE IMMATERIAL FOR THE YEARS ENDED JUNE 30, 2018 AND 2017. 1 1 X 1 X 1 X 1 1 1 0 1 1 950265 950265 0.01540 12837192 6156394 6680798 0.10830 13787457 6156394 7631063 0.12370 88250 88250 0.00140 1436669 1388128 48541 0.00080 24275 24275 0.00040 1549194 1388128 161066 0.00260 15336651 7544522 7792129 0.12630 2000 2000 0.00000 8500 8500 0.00010 3000 3000 0.00000 13500 13500 0.00010 1 1009831 17091497 16742152 349345 X 1 1 1 WESTERN UPPER MICHIGAN EYE CARE LLC EYE CLINIC 0.51000 0.00000 0.49000 1 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS N10561 GRAND VIEW LANE IRONWOOD MI 49938 WWW.ASPIRUS.ORG X X X X ASPIRUS IRONWOOD HOSPITAL & CLINICS INC 1 0 0 1 X X X X X X X X 15 1 1 0 1 X HTTP://WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES X 1 15 1 HTTP://WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.ASPIRUS.ORG/FINANCIALAID X WWW.ASPIRUS.ORG/FINANCIALAID X WWW.ASPIRUS.ORG/FINANCIALAID X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, ASPIRUS IRONWOOD HOSPITAL AND CLINICS APPOINTED A STEERING COMMITTEE WHICH IS MADE UP OF REPRESENTATIVES FROM MAJOR CROSS-SECTIONS OF COMMUNITY LEADERS AND EXPERTS THAT HAVE A STRONG UNDERSTANDING OF THE HEALTH NEEDS OF OUR REGION AND RURAL COMMUNITIES, FROM THE UNDERSERVED MINORITIES TO THE GENERAL POPULATION. THE STEERING COMMITTEE ISSUED A SURVEY WHICH WAS MAILED TO 8,000 HOUSEHOLDS ACROSS THE WESTERN UPPER PENINSULA. A RANDOM 2,000 HOUSEHOLDS OF GOGEBIC COUNTY WERE ALSO SENT A SURVEY. FIVE-HUNDRED SEVENTY-NINE RESPONSES WERE RETURNED, YIELDING A 32.5 PERCENT SURVEY RESPONSE. AS A WHOLE, THE SURVEY PRODUCES AN IMPRESSIVE 95 PERCENT CONFIDENCE LEVEL. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:- ASPIRUS ONTONAGON HOSPITAL, INC.- U.P. HEALTH SYSTEM - PORTAGE- BARAGA COUNTY MEMORIAL HOSPITAL- ASPIRUS KEWEENAW HOSPITAL ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: FIVE MAJOR PRIORITY AREAS WERE SELECTED BY THE STEERING COMMITTEE ON A REGIONAL SCALE WITH A GOAL OF THE MEMBER ORGANIZATIONS TO CONTINUE TO WORK TOGETHER, ADD MEMBERS, POOL RESOURCES, LEADERSHIP, AND EXPERTISE TO DEVELOP INITIATIVES WITH AN EVEN GREATER IMPACT ON A REGION BASIS THAN AN INDIVIDUAL ORGANIZATION MIGHT BE ABLE TO UNDERTAKE, ESPECIALLY WITH LIMITED RESOURCES. THESE FIVE STRATEGIES FOCUS ON THE OVERALL THEME OF PREVENTION AND DEVELOPING LONG-TERM HEALTH FOR THE POPULATIONS. THEY ARE: 1. FOCUS HUMAN RESOURCES AND LOCAL PUBLIC RESOURCES ON HEALTHY EATING AND NUTRITION COMMUNITY OUTREACH. ASPIRUS IRONWOOD HAS COLLABORATED WITH LOCAL SCHOOLS TO APPLY FOR FEDERAL FUNDING TO IMPROVE SCHOOL MEALS; IMPLEMENTED A JOINT PARTNERSHIP PROGRAM WITH A COMMUNITY FARMERS' MARKET TO SUPPORT HEALTHY EATING AND LOCAL GROWERS; PARTNERING WITH THE LOCAL COMMUNITY COLLEGE TO IMPLEMENT A FREE HEALTHY COOKING CLASS FOR TARGETED POPULATIONS; AND SUPPORTING THE LOCAL EXTENSION OFFICE WITH AN ANNUAL KNAPSACK PROGRAM TO PROVIDE FOOD FOR NEEDY FAMILIES. 2. DEVELOP FITNESS AND EXERCISE PROGRAMMING TO GOGEBIC AND IRON COUNTY RESIDENTS, REACHING AT LEAST 5% OF COUNTY RESIDENTS. ASPIRUS IRONWOOD HOSPITAL HAS PARTNERED WITH THE LOCAL EXTENSION OFFICES AND THERAPY DEPARTMENTS TO PROVIDE FREE OR REDUCED COST PROGRAMS SUCH AS CHAIR YOGA, BALANCING CLASS, YOGA AND COMMUNITY EVENTS.3. CONTINUE TO SUPPORT THE DIABETES EDUCATION PROGRAM THROUGH OFFERING A VARIETY OF AVENUES FOR EDUCATION TO THE COMMUNITY. GROW PATIENT ENCOUNTERS BY 5% ANNUALLY OVER 3 YEARS. ALSO IDENTIFY PATIENT POPULATION WITH DIABETES WHO ALSO USE TOBACCO PRODUCTS AND PROVIDE CESSATION EDUCATION TO 20% OF THE IDENTIFIED POPULATION. ASPIRUS IRONWOOD HOSPITAL IS IN THE PROCESS OF IMPLEMENTING A DIABETES SUPPORT GROUP; HOSTING GROUP DIABETES WELLNESS VISITS; SUPPORTING IN-SCHOOL SMOKING/VAPING CESSATION AND PREVENTION EDUCATION LOCALLY; AND OFFERING A COLLABORATIVE PROGRAM THAT SUPPORTS BOTH COUNSELING BY A REGISTERED DIETICIAN AND VISITS WITH A MID-LEVEL PRACTITIONER. 4. REACH 50% OF GOGEBIC AND IRON (WIS.) COUNTY POPULATION ANNUALLY WITH "HOW-TO" INFORMATION REGARDING POSITIVE DISEASE PREVENTION BEHAVIORS AND ACCESS TO SERVICES. ASPIRUS IRONWOOD HOSPITAL HAS PROVIDED AN ONLINE SCREEN PORTAL TO ALL RESIDENTS IN GOGEBIC AND IRON COUNTY; HELD INFORMATIONAL COMMUNITY PROGRAMS DIRECTLY RELATED TO WOMEN'S HEALTH ISSUES; HELD AN ANNUAL STROKE AWARENESS CAMPAIGN FOR RESIDENTS; AND REVISED THE LOCAL COMMUNITY HEALTH MAGAZINE TO FEATURE MORE INFORMATION ABOUT PREVENTION AND HEALTHY LIVING. 5. REACH 75% OF LOCAL GOVERNMENT AND BUSINESS LEADERS ANNUALLY IN AN EFFORT TO DIRECT POLICY AND ENVIRONMENTAL CHANGE REGARDING HEALTHY BEHAVIORS THROUGH EDUCATION AND LOBBYING. ASPIRUS IRONWOOD HOSPITAL HAS SERVED ON THE LEADERSHIP BOARD OF THE REGIONAL FARMERS' MARKETS AND PROVIDED A YEARLY PRESENTATION TO EACH MUNICIPALITY AND CHAMBER OF COMMERCE, OF ONGOING PROGRAMS AND COMMUNITY HEALTH NEEDS. 4 2 - ASPIRUS EYE CENTER E6112 BLUFF VIEW ROAD IRONWOOD MI 49938 EYE CLINIC 3 - ASPIRUS SURGICAL CENTER E6112 BLUFF VIEW ROAD IRONWOOD MI 49938 SURGEON OFFICES 4 - ASPIRUS IRONWOOD CLINIC N10565 GRAND VIEW LANE IRONWOOD MI 49938 PROVIDER BASED CLINIC 5 - ASPIRUS HURLEY CLINIC 501 GRANITE STREET HURLEY WI 54534 PROVIDER BASED CLINIC PART I, LINE 6A: ASPIRUS IRONWOOD HOSPITAL & CLINICS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE MICHIGAN HOSPITAL ASSOCIATION (MHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC THROUGH MHA'S DATABASE AND WEBSITE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FROM THE FORM 990. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT ASPIRUS IRONWOOD HOSPITAL & CLINICS INCLUDE THE OPERATION OF THE HOSPITAL'S INPATIENT MEDICAL/SURGICAL NURSING UNIT AS WELL AS THE INTENSIVE CARE UNIT. THE HOSPITAL INPATIENT AND INTENSIVE CARE UNITS OPERATE 24 HOURS PER DAY SEVEN DAYS PER WEEK AND ARE STAFFED BY A GROUP OF HIGHLY TRAINED NURSING STAFF INCLUDING REGISTERED NURSES, LICENSED PRACTICAL NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL INPATIENT AND INTENSIVE CARE UNITS COME FROM THE HOSPITAL'S EMERGENCY DEPARTMENT WHICH IS OPERATED TO PROVIDE EMERGENCY CARE TO PATIENTS OF THE COMMUNITY AND SURROUNDING AREAS. THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF ASPIRUS IRONWOOD HOSPITAL & CLINICS AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF ASPIRUS IRONWOOD HOSPITAL & CLINICS TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE INPATIENT UNIT REPORTED COMMUNITY BENEFIT COSTS OF $1,247,770 WITH DIRECT OFFSETTING REVENUE OF $1,205,443. THE INTENSIVE CARE UNIT REPORTED COMMUNITY BENEFIT COSTS OF $189,100 WITH DIRECT OFFSETTING REVENUE OF $182,685. PART II, COMMUNITY BUILDING ACTIVITIES: ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE THE HEALTH OF THE COMMUNITY BY ALLOCATING TIME AND FUNDING INTO DEVELOPING PROGRAMS THAT FOCUS ON HEALTHY LIFESTYLES FOR FAMILIES AND INDIVIDUALS. COALITION BUILDING IS A LARGE PART OF THIS. THROUGH COALITIONS SUCH AS INTEGRATED FAMILY SERVICES AND A SUBSTANCE ABUSE NETWORK, ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE HEALTHY BEHAVIORS AND REGULAR PHYSICAL ACTIVITY. ECONOMIC DEVELOPMENT IS PROMOTED THROUGH COLLABORATION WITH LOCAL CHAMBERS OF COMMERCE AND KIWANIS. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2018 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: ASPIRUS IRONWOOD HOSPITAL & CLINICS ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY EXAMINING THE NEEDS OF THE PATIENT. THIS IS DONE THROUGH ANALYSIS OF PATIENT VOLUMES IN DEPARTMENTS, SPECIALISTS, AND THE DIFFERENT CLINIC LOCATIONS WITHIN THE ORGANIZATION'S AREAS OF SERVICE. INFORMATION IS ALSO GATHERED DIRECTLY FROM THE PATIENTS TO SEE WHAT AREAS THEY WOULD LIKE TO SEE ADDITIONAL SUPPORT. INFORMATION REGARDING THE NEEDS OF THE GENERAL COMMUNITY IS OBTAINED FROM THE MICHIGAN HOSPITAL ASSOCIATION AND THE WISCONSIN HOSPITAL ASSOCIATION AND ANALYZED FOR POTENTIAL NEW SERVICE AREAS. ASPIRUS IRONWOOD HOSPITAL & CLINICS ALSO RECENTLY COLLABORATED WITH OTHER AREA HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IS AN IMPORTANT TOOL IN IDENTIFYING THE HEALTH NEEDS OF THE COMMUNITY AND RESULTS OF THE PROJECT ASSIST IN PRIORITIZING HEALTH NEEDS THAT LEAD TO THE ALLOCATION OF APPROPRIATE RESOURCES AND THE CREATION OF NEW PARTNERSHIPS TO IMPROVE THE HEALTH OF THE POPULATION. PART VI, LINE 3: A SUMMARY OF FINANCIAL ASSISTANCE CONTACT INFORMATION IS AVAILABLE IN THE FORM OF A BROCHURE IN THE WAITING AREAS THROUGHOUT ASPIRUS IRONWOOD HOSPITAL & CLINICS. PATIENT FINANCIAL SERVICES PERSONNEL ARE AVAILABLE TO DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROCEDURES AND PROGRAMS WITH PATIENTS. ASPIRUS IRONWOOD HOSPITAL & CLINICS ALSO HAS A SECTION ON ITS WEBSITE THAT PROVIDES CONTACT INFORMATION FOR FINANCIAL ASSISTANCE FOR THOSE HAVING DIFFICULTY MEETING THEIR FINANCIAL OBLIGATIONS. PART VI, LINE 4: THE COMMUNITIES THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS SERVE COVER AN APPROXIMATE 50-MILE RADIUS SURROUNDING THE IRONWOOD, MICHIGAN AREA. THIS AREA INCLUDES PORTIONS OF THE UPPER PENINSULA GOGEBIC COUNTY, UP TO THE ONTONAGON COUNTY REGION, INTO WISCONSIN COVERING IRON COUNTY, PARTS OF ASHLAND COUNTY, AND PARTS OF VILAS COUNTY. THE GEOGRAPHIC AREA THAT ASPIRUS IRONWOOD HOSPITAL & CLINICS SERVE INCLUDES AN ECONOMICALLY DEPRESSED AREA THAT IS BASED ON A MAJORITY OF FAMILIES THAT DO NOT HAVE HEALTH INSURANCE, OR THAT ARE UTILIZING MEDICAID. PART VI, LINE 5: ASPIRUS IRONWOOD HOSPITAL & CLINICS HAVE NUMEROUS CONTINUING EDUCATION EVENTS THAT ARE SET UP TO HELP IMPROVE THE MEDICAL CARE AND KNOWLEDGE OF THE LOCAL POPULATION. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. ASPIRUS IRONWOOD HOSPITAL & CLINICS CONTINUE TO REINVEST IN EQUIPMENT, TRAINING, AND RESEARCH AREAS IN ORDER TO IMPROVE PATIENT CARE IN THE COMMUNITIES THAT IT SERVES, AS WELL AS PROVIDING RESEARCH TO HELP THE LOCAL COMMUNITIES. PART VI, LINE 6: ASPIRUS IRONWOOD HOSPITAL & CLINICS IS AN AFFILIATED HEALTH SYSTEM WHICH SERVES THE COMMUNITY SURROUNDING IRONWOOD, MICHIGAN. AFFILIATES OF ASPIRUS IRONWOOD HOSPITAL & CLINICS PROMOTE THE HEALTH OF THE COMMUNITY BY FULFILLING THEIR INDIVIDUAL MISSIONS. ASPIRUS IRONWOOD HOSPITAL & CLINICS PROVIDES PHYSICIAN SERVICES IN AN OUTPATIENT CLINIC. ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. IS ALSO AN AFFILIATE OF ASPIRUS, INC. ASPIRUS IS AN INTERGRATED, COMMUNITY-GOVERNED HEALTH CARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES DEDICATED TO IMPROVING THE HEALTH OF ALL WE SERVE. WE WORK COLLABORATIVELY WITH OTHERS WHO SHARE OUR PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. PART VI, LINE 7, REPORTS FILED WITH STATES MI X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 SARA LUSIGNAN TREASURER / VP OF FINANCE 0 218284 0 31363 0 25267 0 5944 0 40540 0 321398 0 0 RICK NEVERS SECRETARY / SVP REG OPS SY 0 322120 0 61986 0 38481 0 19030 0 60055 0 501672 0 0 MARIA GULAN DIRECTOR 0 183723 0 21908 0 3732 0 11989 0 43279 0 264631 0 0 JACOB KEMPEN DIRECTOR 0 200250 0 25384 0 4281 0 13014 0 30168 0 273097 0 0 MARCUS SANTINI DIRECTOR/PHYSICIAN 304973 0 12752 0 13726 0 13500 0 28245 0 373196 0 0 0 PAULA CHERMSIDE DIRECTOR / CEO 213667 0 49423 0 14275 0 11931 0 18945 0 308241 0 0 0 MATT HEYWOOD PRESIDENT & CEO ASPIRUS 0 822805 0 293232 0 2695 0 19030 0 144154 0 1281916 0 0 SIDNEY C SCZYGELSKI SVP OF FINANCE & CFO 0 500272 0 97238 0 47442 0 19030 0 87566 0 751548 0 0 CHUCK NELSON REGIONAL CEO - UP 0 286094 0 58000 0 45110 0 18965 0 62882 0 471051 0 0 SHANE JACQUES REGIONAL CFO 0 192438 0 26521 0 4068 0 7697 0 30420 0 261144 0 0 GRACE TOUSIGNANT REGIONAL CNO 0 169578 0 23536 0 2697 0 6553 0 22199 0 224563 0 0 JOHN HEISLER SVP & CHIEF HR OFFICER 0 292124 0 63187 0 14010 0 18924 0 58046 0 446291 0 0 DEAN DANNER SVP & ACI PRESIDENT 0 291709 0 50695 0 46565 0 19030 0 25012 0 433011 0 0 MICHAEL MCGRAIL MD SVP & SYSTEM CMO 0 391427 0 82975 0 11936 0 12004 0 65632 0 563974 0 0 CARI LOGEMANN SVP & GENERAL COUNSEL 0 319704 0 64915 0 36831 0 19030 0 66107 0 506587 0 0 RUTH RISLEY-GRAY SVP & CNO 0 275808 0 58636 0 43052 0 19030 0 58171 0 454697 0 0 ERIC ANDERSON SVP SERVICE LINE & PATIENT EXPERIENC 0 233292 0 40147 0 726 0 4819 0 59858 0 338842 0 0 RENEE SMITH EXECUTIVE DIRECTOR ANI 0 344370 0 42139 0 44887 0 19030 0 27247 0 477673 0 0 TODD RICHARDSON SVP & CIO 0 292477 0 62933 0 37490 0 19030 0 68931 0 480861 0 0 NITIN NIGAM PHYSICIAN 611805 0 40555 0 7529 0 3000 0 28305 0 691194 0 0 0 ENRICO BRAUCHER PHYSICIAN 578416 0 15555 0 8218 0 13500 0 30855 0 646544 0 0 0 DANIEL LUKES PHYSICIAN 499795 0 40000 0 8218 0 3000 0 13329 0 564342 0 0 0 JAMES HUBBARD PHYSICIAN 513208 0 42675 0 10705 0 3000 0 12500 0 582088 0 0 0 STEVEN PHILLIPSON PHYSICIAN 472530 0 0 0 2277 0 3000 0 30855 0 508662 0 0 0 PART I, LINE 1A COMPANION TRAVEL, GROSS-UP PAYMENTS AND HOUSING ALLOWANCE, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. HOUSING ALLOWANCE - P. CHERMSIDE $4,556. PART I, LINE 1B ASPIRUS IRONWOOD HOSPITAL & CLINICS FOLLOWS THE COMPENSATION REVIEW PROCEDURES AND POLICIES OF ASPRIUS, INC. THE PHYSICIAN COMPENSATION OF ASPIRUS IRONWOOD HOSPITAL & CLINICS ALSO IS REVIEWED BY A COMMITTEE WHICH ALSO INCLUDES A REPRESENTATIVE FROM ASPIRUS, INC. TO PROVIDE ADDITIONAL ADMINISTRATIVE REVIEW AND SUPPORT TO THE COMPENSATION REVIEW PROCESS. PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. RELIED ON THE RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: R. NEVERS $32,268 S. LUSIGNAN $16,087 S. SCZYGELSKI $38,440 C. NELSON $35,012 D. DANNER $35,422 R. RISLEY-GRAY $38,590 T. RICHARDSON $35,685 C. LOGEMANN $34,955 R. SMITH $10,121 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 9% FOR VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL, AND 15% FOR THE CEO. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97710B7X4 2013-04-12 2998547 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 B WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97712DC53 2017-11-02 12000000 NEW CONSTRUCTION 0 0 0 A 2998547 2998547 2015 0 0 1 1 B 12000000 12000000 2016 0 0 1 1 A 0 0 1 0 0 0.00700 0.00700 0 0 1 B 0 0 1 0 0 0.00300 0.00300 0 0 1 A 0 0 1 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WI HEALTH & EDUCATION FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/19/2015 SCHEDULE K, PART VI THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2013 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (EIN 39-0964813); ASPIRUS GRAND VIEW (EIN 38-2908586); AND LANGLADE HOSPITAL HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429). INFORMATION REGARDING THE SERIES 2013 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2013 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2013 BONDS.] SCHEDULE K, PART VI THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2017 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS RIVERVIEW HOSPITAL & CLINICS, INC. (EIN 39-0868982); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND ASPIRUS ONTONAGON HOSPITAL, INC. (EIN 26-0806477). INFORMATION REGARDING THE SERIES 2017 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2017 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2017 BONDS.] PART III, LINES 3A AND 3B ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS IRONWOOD HOSPITAL & CLINICS, HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW MANAGEMENT AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. SCHEDULE K, PART III, LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. DIANA LORENSON SPOUSE OF JAMES LORENSON - AIW BOARD CHAIR 25138 EMPLOYMENT COMPENSATION 0 FORM 990, PART III, LINE 2 THE NEW PROGRAM, PET SERVICES, WAS ADDED IN FISCAL YEAR 2018. FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE WHICH CONSISTS OF THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, PAST CHAIRPERSON, AND CEO. THIS COMMITTEE HAS THE POWER TO ACT ON BEHALF OF THE ORGANIZATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR AUTHORIZATION GRANTED BY THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A SEE EXPLANATION FOR FORM 990, PART VI, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICER; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 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, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRONWOOD HOSPITAL & CLINICS 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 OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,845,709. MANAGEMENT AND GENERAL EXPENSES 565,181. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,410,890. FORM 990, PART XI, LINE 9: AI EQUITY TRANSFER -1,195,000. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION, ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS IN THE PAST YEAR. GRAND VIEW HOSPITAL AUXILIARY N10561 GRAND VIEW LANE IRONWOOD MI 49938 237178363 SUPPORTING ORGANIZATION OF THE HOSPITAL AND LIFELINE EMERGENCY SYSTEM MI 501(C)(3) LINE 10 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC 1 ASPIRUS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE SYSTEM MANAGEMENT WI 501(C)(3) LINE 12B, II N/A 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS EXTENDED SERVICES INC 425 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS CLINICS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTHCARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS VNA EXTENDED CARE INC 520 N 32ND AVENUE WAUSAU WI 54401 391597350 PERSONAL CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS VNA HOME HEALTH INC 1 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE RD IRON RIVER MI 49935 383236977 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LAURIUM MI 49913 381443361 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 WESTERN UPPER MICHIGAN EYE CARE LLC 131 W GENESEE STREET IRON RIVER MI 49935 272324957 EYE CARE SERVICES MI ASPIRUS IRONWOOD HOSPITAL & CLINICS INC RELATED -7413 98311 0 1 0.51000 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 1 ASPIRUS KEWEENAW ENTERPRISES 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 1 0 1 0 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 ASPIRUS WAUSAU HOSPITAL O 3516175 COST ASPIRUS WAUSAU HOSPITAL P 253239 COST ASPIRUS WAUSAU HOSPITAL Q 83621 COST ASPIRUS INC B 1195000 COST ASPIRUS INC M 8553014 COST ASPIRUS INC O 1251086 COST ASPIRUS INC P 299597 COST ASPIRUS INC Q 301252 COST ASPIRUS IRON RIVER HOSPITAL & CLINICS INC L 83751 COST ASPIRUS IRON RIVER HOSPITAL & CLINICS INC M 370000 COST ASPIRUS IRON RIVER HOSPITAL & CLINICS INC O 167398 COST ASPIRUS KEWEENAW HOSPITAL INC O 1037497 COST ASPIRUS KEWEENAW HOSPITAL INC P 100897 COST SCHEDULE R, PART V, LINE 1D ALL OUTSTANDING OBLIGATED GROUP DEBT IS GUARANTEED BY ALL MEMBERS OF THE OBLIGATED GROUP.