2016-02-10T11:21:41-06:00 2015-06-30 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2014-07-01 391138241 ASPIRUS WAUSAU HOSPITAL INC ASPI 7158472988 333 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE/CFO 7158472988 2016-01-23 1 KATHLEEN J LABRAKE CPA P00164006 7158453111 2016-01-23 2014 2016-08-17 19:52:53Z SIDNEY C SCZYGELSKI 333 PINE RIDGE BLVD WAUSAU WI 54401 530888965 0 X WWW.ASPIRUS.ORG X 1970 WI ASPIRUS WAUSAU HOSPITAL, INC. IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM WHICH LEADS BY ADVANCING INITATIVES DEDICATED TO IMPROVING THE HEALTH OF ALL WE SERVE. 10 4 2622 607 2356621 10117 510208 466629 360984667 411231800 5502692 24386604 2879823 4132079 369877390 440217112 120113 133788 0 0 146111110 166603921 0 0 0 181604331 207152731 327835554 373890440 42041836 66326672 468411849 407545667 151380953 151236234 317030896 256309433 ASPIRUS WAUSAU HOSPITAL, INC. IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE 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. 0 0 266437545 133788 413007258 ASPIRUS WAUSAU HOSPITAL, INC. PROVIDES HOSPITAL SERVICES FOR RESIDENTS OF WAUSAU AND THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 266437545 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 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 1 0 0 0 0 1 1 1 1 0 0 1 320 0 1 2622 1 1 1 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 333 PINE RIDGE BLVD WAUSAU WI 54401 X LISA S WESTPHAL BOARD MEMBER 1.00 1.00 X 0 0 0 HILARY P SCULLY MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 351068 38255 SUSAN M SCHNEIDER MD BOARD MEMBER/PHYSICIAN 1.00 36.00 X 0 317411 28574 CHAD H RADKE DO BOARD MEMBER 1.00 1.00 X 0 0 0 KATHY J STRASSER BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES S MARTING DO BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 527224 38274 RENEEE M SMITH MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 301945 37591 KATHY KELSEY FOLEY CHAIR 1.00 2.00 X X 0 0 0 CRAIG A HACKWORTH MD SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 DAVID M HECK VICE CHAIR 1.00 1.00 X X 0 0 0 THOMAS RENGEL BOARD MEMBER (THRU 9/2014) 40.00 1.00 X 451582 0 17511 DARRELL LENTZ PRESIDENT AWH 40.00 1.00 X 315572 0 68176 SIDNEY C SCZYGELSKI CFO AI 1.00 51.00 X 0 445401 99296 MATTHEW F HEYWOOD CEO AI 1.00 51.00 X 0 875945 124428 JOHN HEISLER SVP AND CHIEF HR OFFICER 1.00 40.00 X 0 287789 44598 RICK L NEVERS SVP REG OPS SYSTEM INT OFF 1.00 40.00 X 0 331104 71838 TODD RICHARDSON SVP AND CIO 1.00 40.00 X 0 312876 83234 KATHRYN J DRENGLER VP PATIENT CARE/CNO 40.00 X 240319 0 38290 JACOB KEMPEN VP CLINICAL SERVICES 40.00 X 209506 0 36544 RUTH RISLEY GREY SVP NURSING SYSTEM CNO 1.00 40.00 X 0 218430 57813 DEAN DANNER SVP COO OF ASPIRUS CLINICS 1.00 40.00 X 0 346764 33801 MARITA HATTEM SVP ORG AND SERVICE LINE D 40.00 X 0 315520 73529 MARIA GULAN VP OPERATIONS & SERVICE DVMT 1.00 40.00 X 0 192903 30876 WILLIAM WESSELS AWH/ACI CHIEF MEDICAL OFFICER 40.00 1.00 X 302326 0 51767 JEFFREY MASTEN CHIEF MEDICAL PHYSICIST 40.00 X 237151 0 17263 RAYMOND WERY MEDICAL PHYSICIST CONSULTA 40.00 X 177707 0 37296 BRUCE HASSELQUIST MEDICAL PHYSICIST CONSULTA 40.00 X 178060 0 30204 RAMSES MASIS RESIDENT PHYSICIAN 40.00 X 205640 0 26499 WILLIAM NOBLE PHYSICIAN 40.00 X 170960 0 26552 DUANE L ERWIN FORMER CEO AI 1.00 50.00 X 0 576532 28814 NORMA JEAN BURGENER FORMER VP OF POST ACUTE CARE 40.00 X 126950 0 17606 2615773 5400912 1158629 68 1 1 0 ASPIRUS CLINICS INC 425 PINE RIDGE WAUSAU WI 54401 MEDICAL DIRECTORS, PAYROLL 55748798 ASPIRUS INC 333 PINE RIDGE WAUSAU WI 54401 MANAGEMENT FEES, PAYROLL 34771212 PRISM HEALTHCARE PARTNERS LTD 190 SOUTH LA SALLE ST STE 2900 CHICAGO IL 60603 CONSULTANTS 7546450 WISCONSIN EMERGENCY MEDICAL 333 PINE RIDGE WAUSAU WI 54401 ER PHYSICIANS 6410753 GE MEDICAL SYSTEM 8200 W TOWER AVENUE MILWAUKEE WI 53223 EQUIPMENT MAINTENANCE 2443167 211 466629 466629 PATIENT SERVICE REVENUE 621400 340993050 340993050 LAB REVENUE 621400 54786789 54501358 285431 CONTRACT SERVICE REVENUE 621400 5552061 5552061 RENTAL REVENUE 532000 4247389 4247389 MOBILE UNIT REVENUE 621400 524818 524818 5127693 5127693 411231800 10659888 10659888 104398569 90671853 13726716 13726716 13726716 CAFETERIA AND VENDING 722210 1684322 1515544 168778 IDEAL PROTEIN 561439 1273922 1273922 INVESTMENT IN WESTWOOD 523000 277350 277350 896485 545345 351140 4132079 440217112 413007258 2356621 24386604 X 133788 133788 1233453 1233453 131203513 113032553 18170960 6494999 6495091 -92 18863634 13273629 5590005 8808322 8808336 -14 6591652 6591652 164638 164638 128463 538 127925 48767 48767 76408319 27688684 48719635 2654650 126692 2527958 4666612 3129292 1537320 450863 71513 379350 18545226 10621052 7924174 1342467 1116138 226329 338626 3935 334691 2728072 2728072 15048301 7492338 7555963 701640 328274 373366 MEDICAL SUPPLIES 71494476 68816311 2678165 HOSPITAL TAX 8823166 432902 8390264 COLLECTION EXPENSE 395216 1416 393800 FOOD SERVICE 334088 191860 142228 -3712511 -1918449 -1794062 373890440 266437545 107452895 0 22789685 15986994 8187468 18511068 51501985 55186190 5212418 6317511 2641003 1748132 334424864 175239063 151699288 159185801 214067168 133777897 3127629 3216865 9185205 13615209 468411849 407545667 27033771 32446555 115309500 109625812 9037682 9163867 151380953 151236234 X 317030896 256309433 317030896 256309433 468411849 407545667 X 66326672 -21856343 -105191792 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 29005 29005 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: AHA 22.8%, WHA 12.0%, AMA 50%, ACP 90%, OF ACP SERVICES, ACOOFP 7.5%, AANP 7.5%, WMS 10%. THE GRAND TOTAL DOLLAR AMOUNT GOING TOWARDS LOBBYING IS $29,005. 9620011 9620011 199722964 98851847 100871117 322297 162673 159624 101340534 69524422 31816112 23419058 6700121 16718937 159185801 AMOUNTS PAYABLE TO THRID-PARTY REIMBURSEMENT PROGRAM 1327102 RETIREE HEALTHCARE BENEFITS 3136350 INTEREST RATE SWAP 2824000 DEFERRED COMPENSATION ACCRUAL 1291259 LONG-TERM INSURANCE LIABILITY 585156 9163867 X PART X, LINE 2: ALL SUBISIDIARIES, EXCEPT FOR 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 FOR ANI, A NOT-FOR-PROFIT TAXABLE CORPORATION, WERE IMMATERIAL FOR THE YEAR ENDED JUNE 30, 2015 AND 2014. 1 1 1 X 1 X 1 1 0 1 1 12417232 12417232 0.03320 40592694 19907735 20684959 0.05540 3817791 2249914 1567877 0.00420 56827717 22157649 34670068 0.09280 20 57521 4155035 2872249 1282786 0.00340 25 94 1777197 400 1776797 0.00480 4 2395 7606834 3772744 3834090 0.01030 1 242213 36499 205714 0.00060 6 57839 57839 0.00020 56 60010 13839118 6681892 7157226 0.01930 56 60010 70666835 28839541 41827294 0.11210 3 1693 1693 0.00000 1 65 65 0.00000 4 1758 1758 1 -1077260 79726673 97490275 -17763602 X 1 1 1 1 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 WWW.ASPIRUS.ORG/ASPIRUSWAUSAUHOSPITAL 188 X X X ASPIRUS WAUSAU HOSPITAL INC 0 0 1 X X X X X X X X 13 1 1 1 1 X HTTP://WWW.ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES.ASPX?SRCAUD=MAIN X HTTP://WWW.UNITEDWAYMC.ORG/LIFEREPORT.HTM 1 14 1 HTTP://WWW.ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES.ASP?SRCAUD=MAIN 1 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 X HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 X HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 X X X X X 1 1 X X X X 1 X X 0 0 ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 5: SEE THE ATTACHED COMMUNITY HEALTH NEEDS ASSESSMENT ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 6A: MINISTRY ST. CLARE'S HOSPITAL3400 MINISTRY PKWY.WESTON, WI 54476 ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 11: PRIORITIZED DESCRIPTION OF COMMUNITY HEALTH NEEDS IDENTIFIED - THE MARATHON COUNTY LIFE REPORT 2013-2015 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 A LONG-TERM CALL TO ACTION, TWO IMMEDIATE CONCERNS AND FOUR ISSUES TO WATCH.A GREAT START FOR KIDS: A LONG-TERM ACTION:- EDUCTIONAL INVESTMENTS- THE IMPACT OF CHILDHOOD TRAUMAIMMEDIATE CONCERNS:- A CHALLENGED ECONOMY- ALCOHOL AND DRUG USE, MISUSE, AND ABUSEISSUES TO WATCH, NOT IN ORDER OF IMPORTANCE:- UNMET BASIC NEEDS- OBESITY- HEALTHY AGING- INTIMATE PARTNER VIOLENCE ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 22D: THE LOOK BACK METHOD USING TRADITIONAL MEDICARE RATES UNDER REG. 501(R) IS UTILIZED TO CALCULATE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIBIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 ASPIRUS WAUSAU HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: HTTP://ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 3 NORTHWOODS SURGERY CENTER LLC 611 VETERANS PARKWAY WOODRUFF WI 54568 GENERAL MEDICAL & SURGICAL PINE RIDGE SURGERY CENTER 2500 PINE RIDGE BLVD WAUSAU WI 54401 GENERAL MEDICAL & SURGICAL STEVENS POINT SURGERY CENTER LLC 5409 VERN HOLMES DRIVE STEVENS POINT WI 54481 GENERAL MEDICAL & SURGICAL PART I, LINE 7: THE COSTING METHODOLOGY IS CMS2552 AS FILED COST REPORT. PART I, LINE 7G: THE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE CCHS PALLIATIVE UNIT, OUTPATIENT DIALYSIS, CCHS HOSPICE HOUSE AND AMBULANCE SERVICE. ASPIRUS WAUSAU HOSPITAL UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE CCHS PALIATIVE UNIT REPORTED COSTS OF $2,404,294 WITH OFFSETTING REVENUES OF $1,351,727. THE OUTPATIENT DIALYSIS REPORTED COSTS OF $2,443,292 WITH OFFSETTING REVENUES OF $2,131,364. THE CCHS HOSPICE HOUSE REPORTED COSTS $646,027 WITH OFFSETTING REVENUES OF $356,374. THE AMBULANCE SERVICE REPORTED COSTS OF $12,429,178 WITH OFFSETTING REVEUNES OF $10,315,957. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24C, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $395,214. PART II, COMMUNITY BUILDING ACTIVITIES: AS ANY GOOD CORPORATE CITIZEN, ASPIRUS WAUSAU HOSPITAL, INC. 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, INC.'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, INC. IS A LONGTIME CHAMBER MEMBER AND PROVIDES A LEADERSHIP ROLE IN MULTIPLE WAYS. COMMUNITY SUPPORT (F3)- BOY SCOUTS OF AMERICA (BSA): 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, INC. 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, INC. 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 5360 REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. (ALSO REFER TO ASPIRUS POLICY #7370 & 7155)II. FAILURE TO MEET THESE REQUIREMENTS IN POLICY 5360 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 CALLSIII. 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# 7155 DATED 2/7/14.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.THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2. 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) FEELS 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: ASPIRUS WAUSAU HOSPITAL, INC. MAKES REASONABLE EFFORTS TO DETERMINE IF FINANCIAL ASSISTANCE SHOULD BE OFFERED BEFORE ASSIGNING A CASE TO A COLLECTION AGENCY. ASPIRUS INFORMS PATIENTS AND OFFERS THEM FINANCIAL ASSISTANCE APPLICATION FORMS AT THE TIME OF REGISTRATION, IN EMERGENCY ROOMS, FINANCIAL SERVICE OFFICES, THE BILLING OFFICE, AND ON STATEMENTS AND LETTERS. ASPIRUS CAN ONLY PURSUE THE APPLICANT WHO HAS COMPLETED THE FINANCIAL ASSISTANCE APPLICATION FORMS IN THEIR ENTIRETY. PART VI, LINE 2: ASPIRUS WAUSAU HOSPITAL, INC. IS A LEADER IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY. IT HAS DEVELOPED STRONG PARTNERSHIPS WITH KEY COMMUNITY AGENCIES AND HELPED SPEARHEAD INITIATIVES TO ASSESS THE COMMUNITY'S HEALTH NEEDS AND FACTORS SUPPORTING A HIGH QUALITY OF LIFE AND VIBRANT COMMUNITY.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, INC. HAS MAINTAINED STRONG INVOLVEMENT IN THE COMMUNITY ASSESSMENT PROCESS, FROM PLEDGING CASH SUPPORT AND IN KIND DONATIONS TO STEERING COMMITTEE CHAIRS AND MEMBERS. THE NINTH AND MOST RECENT VERSION OF THE MARATHON COUNTY LIFE REPORT 2013 2015 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 A LONG-TERM CALL TO ACTION, TWO IMMEDIATE CONCERNS, AND FOUR ISSUES TO WATCH. A GREAT START FOR KIDS: A LONG-TERM CALL TO ACTION:- EDUCATIONAL INVESTMENTS- THE IMPACT OF CHILDHOOD TRAUMAIMMEDIATE CONCERNS:- A CHALLENGED ECONOMY- ALCOHOL AND DRUG USE, MISUSE, AND ABUSEISSUES TO WATCH, NOT IN ORDER OF IMPORTANCE:- UNMET BASIC NEEDS- OBESITY- HEALTHY AGING- INTIMATE PARTNER VIOLENCE PART VI, LINE 3: ASPIRUS WAUSAU HOSPITAL, INC. MAKES LISTS OF AVAILABLE GOVERNMENT ASSISTANCE PROGRAMS AVAILABLE TO PATIENTS AND FAMILIES IN THE CASHIER'S OFFICE, WHICH IS LOCATED OFF THE MAIN LOBBY. IN ADDITION, ALL PATIENTS ARE MADE AWARE OF ASPIRUS WAUSAU HOSPITAL'S FINANCIAL AID PROGRAMS THROUGH STATEMENTS AND FOLLOW UP LETTERS. FINANCIAL COUNSELORS SEEK TO MEET ONE ON ONE WITH ANY PATIENTS WHO DO NOT HAVE INSURANCE, SO COUNSELORS CAN EXPLAIN ALL OPTIONS AVAILABLE. PART VI, LINE 4: ACCORDING TO THE U.S. CENSUS BUREAU, MARATHON COUNTY HAD A POPULATION OF 135,416 AS OF 2013. FOR THE PURPOSES OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT, WE WILL FOCUS ON MARATHON COUNTY AS THE "COMMUNITY" SERVED BY ASPIRUS WAUSAU HOSPITAL, INC. 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, INC. 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 (2013):PERSONS PER SQUARE MILE 86.8PERSONS UNDER 5 YEARS OLD 6.2%PERSONS UNDER 18 YEARS OLD 23.7%PERSONS 65 YEARS AND OVER 15.4%WHITE PERSONS 91.8%ASIAN PERSONS 5.6%PERSONS PER HOUSEHOLD 2.50PERSONS BELOW POVERTY LEVEL 10.4%MEDIAN HOUSEHOLD INCOME $53,762SOURCE: US CENSUS BUREAUTHE LARGEST EMPLOYERS IN MARATHON COUNTY: ASPIRUS WAUSAU HOSPITAL 3,000GREENHECK FAN CORP. 1,500WAUSAU SCHOOL DISTRICT 1,476FOOTLOCKER.COM/EASTBAY 1,300KOLBE AND KOLBE MILLWORKS 1,122WAUSAU PAPERS 984PRIME HEALTHCARE (UMR/WAUSAU BENEFITS) 800MARATHON CHEESE 800MARATHON COUNTY 740NORTH CENTRAL HEALTH CARE 685SOURCE: COMPREHENSIVE ANNUAL FINANCIAL REPORT MARATHON COUNTY, WISCONSIN FOR THE YEAR ENDED DECEMBER 31, 2012.MUCH OF ASPIRUS WAUSAU HOSPITAL, INC.'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: ASPIRUS WAUSAU HOSPITAL, INC. IS A TRUE COMMUNITY ORGANIZATION. IT WAS CREATED IN THE 1970S WHEN COMMUNITY LEADERS DECIDED THE TWO LOCAL HOSPITALS OPERATING AT THAT TIME COULD BE MORE EFFECTIVE AND MORE EFFICIENT IF THEY MERGED.TODAY, THAT COMMUNITY LEADERSHIP AND VISION ENDURES. ASPIRUS WAUSAU HOSPITAL, INC. 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, INC. ARE MADE WITH THE COMMUNITY'S BEST INTEREST IN MIND. IN ADDITION, ASPIRUS WAUSAU HOSPITAL, INC. 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, INC. REINVESTS SURPLUS FUNDS IN HEALTH SERVICES FOR THE COMMUNITY, SUCH AS NEW TECHNOLOGY THAT ADVANCES CARE AND IMPROVES ACCESS. ASPIRUS WAUSAU HOSPITAL, INC. ALSO WORKS COLLABORATIVELY WITH OTHER HEALTHCARE 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 HEALTHCARE. ASPIRUS WAUSAU HOSPITAL, INC. 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, INC. 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, 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, INC. IS ONE OF EIGHT HOSPITALS UNDER THE ASPIRUS, INC. UMBRELLA. EACH OF THE OTHER SIX HOSPITALS IS A SMALL, AND ALMOST ALL ARE CRITICAL ACCESS FACILITIES, WHILE ASPIRUS WAUSAU HOSPITAL, INC. IS A REGIONAL TERTIARY CARE FACILITY. 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.- MEMORIAL HEALTH CENTER FOUNDATION SERVES MEDFORD, WI, AND SURROUNDING COMMUNITIES.- ASPIRUS ONTONAGON FOUNDATION SERVES ONTONAGON, MI, AND SURROUNDING COMMUNITIES.- ASPIRUS GRAND VIEW FOUNDATION SERVES IRONWOOD, MI, AND SURROUNDING COMMUNITIES.WHILE ASPIRUS HAS GROWN AND EXPANDED ITS SERVICE AREA RAPIDLY IN THE PAST SIX 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, INC. HAS FOUR HOSPITALS IN WISCONSIN. ASPIRUS WAUSAU HOSPITAL IN WAUSAU, LANGLADE HOSPITAL IN ANTIGO, ASPIRUS MEDFORD HOSPITAL AND CLINICS IN MEDFORD AND ASPIRUS RIVERVIEW HOSPITAL AND CLINICS IS IN WISCONSIN RAPIDS. EACH OF THESE CENTERS FILES A COMMUNITY BENEFIT REPORT. ASPIRUS, INC. ALSO HAS FOUR HOSPITALS IN MICHIGAN'S UPPER PENINSULA: ASPIRUS KEWEENAW HOSPITAL IN LARIUM, ASPIRUS GRAND VIEW IN IRONWOOD AND ASPIRUS ONTONAGON IN ONTONAGON AND ASPIRUS IRON RIVER HOSPITAL AND CLINICS, IN IRON RIVER. EACH OF THESE FACILITIES IS RESPONSIBLE FOR ITS OWN COMMUNITY BENEFITS REPORTING. 1 NTC FOUNDATION 1000 WEST CAMPUS DRIVE WAUSAU WI 54401 391266481 501(C)(3) 11000 DONATION 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 SPONSORSHIP WAUSAU DANCE THEATRE PO BOX 18015 MERRIFIELD VA 22118 237281913 501(C)(3) 7500 SPONSORSHIP WIFC-DISCO CURES CANCER PO BOX 2048 WAUSAU WI 54402 390942767 N/A 7500 SPONSORSHIP MARATHON CO HEALTH DEPR 1000 LAKEVIEW DR STE 100 WAUSAU WI 54403 237240695 501(C)(3) 15000 SPONSORSHIP 5 1 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 X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 HILARY P SCULLY MD BOARD MEMBER/PHYSICIAN 0 331812 0 10710 0 8546 0 10400 0 27855 0 389323 0 0 SUSAN M SCHNEIDER MD BOARD MEMBER/PHYSICIAN 0 308807 0 0 0 8604 0 10400 0 18174 0 345985 0 0 CHARLES S MARTING DO BOARD MEMBER/PHYSICIAN 0 518620 0 0 0 8604 0 10400 0 27874 0 565498 0 0 RENEEE M SMITH MD BOARD MEMBER/PHYSICIAN 0 293511 0 0 0 8434 0 10400 0 27191 0 339536 0 0 THOMAS RENGEL BOARD MEMBER (THRU 9/2014) 390292 0 44710 0 16580 0 5100 0 12411 0 469093 0 0 0 DARRELL LENTZ PRESIDENT AWH 246521 0 64793 0 4258 0 8993 0 59183 0 383748 0 0 0 SIDNEY C SCZYGELSKI CFO AI 0 335544 0 103558 0 6299 0 15500 0 83796 0 544697 0 0 MATTHEW F HEYWOOD CEO AI 0 572243 0 233564 0 70138 0 10300 0 114128 0 1000373 0 0 JOHN HEISLER SVP AND CHIEF HR OFFICER 0 239916 0 36511 0 11362 0 0 0 44598 0 332387 0 0 RICK L NEVERS SVP REG OPS SYSTEM INT OFF 0 236472 0 74420 0 20212 0 14127 0 57711 0 402942 0 0 TODD RICHARDSON SVP AND CIO 0 237555 0 74180 0 1141 0 14676 0 68558 0 396110 0 0 KATHRYN J DRENGLER VP PATIENT CARE/CNO 109275 0 38367 0 92677 0 8377 0 29913 0 278609 0 0 0 JACOB KEMPEN VP CLINICAL SERVICES 170870 0 34867 0 3769 0 10343 0 26201 0 246050 0 0 0 RUTH RISLEY GREY SVP NURSING SYSTEM CNO 0 179951 0 35892 0 2587 0 7577 0 50236 0 276243 0 0 DEAN DANNER SVP COO OF ASPIRUS CLINICS 0 235736 0 71084 0 39944 0 9801 0 24000 0 380565 0 0 MARITA HATTEM SVP ORG AND SERVICE LINE D 0 222478 0 69864 0 23178 0 10279 0 63250 0 389049 0 0 MARIA GULAN VP OPERATIONS & SERVICE DVMT 0 146283 0 29842 0 16778 0 6180 0 24696 0 223779 0 0 WILLIAM WESSELS AWH/ACI CHIEF MEDICAL OFFICER 272979 0 25313 0 4034 0 5200 0 46567 0 354093 0 0 0 JEFFREY MASTEN CHIEF MEDICAL PHYSICIST 202730 0 19527 0 14894 0 12314 0 4949 0 254414 0 0 0 RAYMOND WERY MEDICAL PHYSICIST CONSULTA 175331 0 0 0 2376 0 11107 0 26189 0 215003 0 0 0 BRUCE HASSELQUIST MEDICAL PHYSICIST CONSULTA 173158 0 0 0 4902 0 3223 0 26981 0 208264 0 0 0 RAMSES MASIS RESIDENT PHYSICIAN 144277 0 60000 0 1363 0 3223 0 23276 0 232139 0 0 0 WILLIAM NOBLE PHYSICIAN 140687 0 30223 0 50 0 4603 0 21949 0 197512 0 0 0 DUANE L ERWIN FORMER CEO AI 0 0 0 0 0 576532 0 5100 0 23714 0 605346 0 0 NORMA JEAN BURGENER FORMER VP OF POST ACUTE CARE 76256 0 27514 0 23180 0 6343 0 11263 0 144556 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: M. HEYWOOD $410; J. HEISLER $410; R. RISLEY GREY $365; W. WESSELS $385; S. SCZYGELSKI $435; R. NEVERS $510; M. HATTEM $365; D. LENTZ $390 - INCLUDED IN INCOME. GROSS-UP PAYMENTS: C. MARTING $463; S. SCHNEIDER $463; H. SCULLY $463; S. SCZYGELSKI $3,394; R. SMITH $345; S. HACKWORTH $678 - INCLUDED IN INCOME. HOUSING ALLOWANCE: M. HEYWOOD $65,048; J. HEISLER $3,600 - INCLUDED IN INCOME. PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A - SEVERANCE PAYMENT: K. DRENGLER - $91,090 D. ERWIN - $585,957 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 PRESEIDENT, 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. M. GULAN - $16,087 R. NEVERS - $17,763 N. BURGENER - $21,759 D. DANNER - $34,225 M. HATTEM - $19,226 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 27833241 REFUND BONDS ISSUED 3/18/2009 0 0 0 C WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97710BLV2 2009-10-07 20841864 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 9135000 32025000 1 0 1 1 B 27833241 1429347 26403894 2006 1 0 1 1 C 6655000 20841864 340678 20501186 1999 1 0 1 1 D 10000 47001087 22999596 24001113 2014 1 0 1 1 A 0 1 0 0 0.01920 0.01920 0.03840 0 0 1 B 0 0 0 0 0.01200 0.01200 0.02400 0 0 1 C 0 1 0 0 0.01420 0.01420 0.02840 0 0 1 D 0 1 0 0 0.00450 0.00450 0.00900 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH. DATE THE REBATE COMPUTATION WAS PERFORMED: 02/22/2013 ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH. DATE THE REBATE COMPUTATION WAS PERFORMED: 12/14/2007 ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH. DATE THE REBATE COMPUTATION WAS PERFORMED: 04/28/2000 SCHEDULE K, PART III, LINE 9: SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. RADIOLOGY ASSOCIATES OF WAUSAU SC RELATED PARTY TO BOARD MEMBER CRAIG HACKWORTH, MD 344644 RADIOLOGY SERVICES/MEDICAL CONTRACTS 0 WI EMERGENCY MEDICAL SERVICES ASSOCIATION RELATED PARTY TO BOARD MEMBER CHAD RADKE, DO 6704431 EMERGENCY SERVICES/MEDICAL CONTRACTS 0 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 11 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. EXPLANATION OF HOURS WORKED SOME OFFICERS AND DIRETORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART IX, LINE 11G CORPORATE ALLOCATIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 39,142,011. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,142,011. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 5,310,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,310,699. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 22,377,985. MANAGEMENT AND GENERAL EXPENSES 9,281,680. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,659,665. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 295,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 295,944. FORM 990, PART XI, LINE 9: INTEREST RATE SWAP -412,303. INTEREST RATE SWAP VALUATION ADJUSTMENT -420,755. POST RETIREMENT HEALTHCARE BENEFIT ADJUSTMENT -338,489. NET ASSET TRANSFER TO ASPIRUS, INC. -104,000,000. EQUITY - BOND SWAP -20,245. 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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