2014-05-14T09:23:51-05:00 2013-06-30 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2012-07-01 382908586 ASPIRUS GRAND VIEW ASPI 9069322525 N10561 GRAND VIEW LANE IRONWOOD MI 49938 CHARMAINE CHIANTELLO 9069322525 2014-05-13 1 KATHLEEN J LABRAKE CPA P00164006 7158453111 2014-05-13 2012 2015-11-30 17:44:51Z PAULA CHERMSIDE N10561 GRAND VIEW LANE IRONWOOD MI 49938 37308785 0 X WWW.ASPIRUSGRANDVIEW.ORG X 1989 MI PROVISION OF HEALTH CARE SERVICES 11 4 402 54 39332 30740 10596 8685 32260452 37042722 335897 257378 0 0 32606945 37308785 0 0 0 0 13361315 14908651 0 0 0 15250648 16102451 28611963 31011102 3994982 6297683 35951026 43871013 9804353 14806370 26146673 29064643 X TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES, TODAY AND TOMORROW, THAT ARE CUSTOMER-FOCUSED AND FISCALLY RESPONSIBLE IN PARTNERSHIP WITH OUR COMMUNITIES. 0 0 24823686 36129535 ASPIRUS GRAND VIEW 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 GRAND VIEW 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 GRAND VIEW 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 2013.ASPIRUS GRAND VIEW 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 GRAND VIEW PROVIDES THIS LOCAL, QUALITY HEALTH CARE TO MANY ELDERLY AND LOW INCOME INDIVIDUALS THAT ARE IN NEED OF HEALTH CARE. DURING FISCAL YEAR 2013, MORE THAN 65% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM BENEFICIARIES OF MEDICARE AND MEDICAID. 867162 873855 ASPIRUS GRAND VIEW HOME HEALTH IS A MEDICARE-CERTIFIED HOME HEALTH AGENCY WHICH PROVIDES A WIDE RANGE OF HOME HEALTH CARE SERVICES INCLUDING DISEASE MANAGEMENT; EDUCATION; SURGICAL DRESSING CHANGES; INTRAVENOUS ANTIBIOTICS; INJECTIONS; PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY; AND MEDICATION MANAGEMENT. EXPERIENCED REGISTERED NURSES, HOME CARE AIDES, AND THERAPISTS MAKE UP THE TEAM THAT DESIGNS A PLAN OF CARE TO SUIT EACH INDIVIDUAL PATIENT'S NEEDS WHILE IN THE COMFORT OF THEIR OWN HOME. 25690848 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 72 0 402 1 1 1 0 0 0 0 0 0 0 0 0 X 11 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X CHARMAINE CHIANTELLO 9069322525 N10561 GRAND VIEW LANE IRONWOOD MI 49938 X RICHARD ARMSTRONG 1.00 X 0 0 0 CARRIE MILJEVICH 1.00 X 0 0 0 MARIA GULAN 1.00 40.00 X 0 160804 34214 CHARLES IKNAYAN MD 1.00 X 0 0 0 JAMES LORENSON 1.00 X 0 0 0 CHRISTOPHER POGLIANO MD 1.00 40.00 X 0 248055 28323 JOEL RUEBER 1.00 40.00 X 0 220594 31114 JACOB KEMPEN 1.00 40.00 X 0 185340 18135 JEFFREY NEHRING DDS 1.00 X X 0 0 0 JOHN GARSKE 1.00 X X 0 0 0 SIDNEY C SCZYGELSKI 1.00 51.00 X X 0 390057 79956 RICK NEVERS 1.00 40.00 X X 0 245545 61758 CAROL GOFFNETT 26.00 14.00 X 242336 0 30712 CHARMAINE CHIANTELLO 28.00 12.00 X 159824 0 9187 PAULA CHERMSIDE 40.00 X X 0 0 0 HARRY SKYE MD 40.00 X 488202 0 5244 JOHN JAROCKI 40.00 X 216123 0 23677 DONNA CATALDO MD 40.00 X 198135 0 0 CARL GREEN 40.00 X 179993 0 21512 CHRISTA KLYDER 40.00 X 170634 0 14999 1655247 1450395 358831 10 0 1 0 MI EMERGENCY PHYSICIANS PO BOX 793 TRAVERSE CITY MI 496850793 ER PHYSICIAN COVERAGE 1608927 UPPER PENINSULA MANAGED CARE 228 W WASHINGTON ST MARQUETTE MI 49855 PHYSICIAN CREDENTIALS 352347 NORTHERN LOWER PENINSULA LABS E6381 GHELLER DR BESSEMER MI 49911 PATHOLOGIST 285138 DONNA M CATALDO PC N11175 HI BRITTEN WY BESSEMER MI 49911 RADIOLOGIST 214646 VIRTUAL RADIOLOGIC PROFESSIONALS 25983 NETWORK PLACE CHICAGO IL 60673 RADIOLOGIST 195445 8 8685 8685 NET PATIENT SERVICE REVENUE 621990 33648951 33609619 39332 OTHER OPERATING REVENUE 900099 2923583 2923583 RELATED PARTY RENTAL 531120 470188 470188 37042722 257378 257378 37308785 37003390 39332 257378 X 442059 442059 11722144 9732665 1989479 520067 447936 72131 1257959 918506 339453 966422 802401 164021 76633 76633 47373 47373 4818664 4060181 758483 149129 149129 771418 397451 373967 350735 350735 576681 576681 115497 65792 49705 37147 37147 61825 61825 1429964 1429964 125973 125973 MEDICAL SUPPLIES 4940130 4940130 REPAIRS AND MAINTENANCE 852419 733673 118746 QAAP EXPENSES 839069 839069 MISCELLANEOUS 373752 307775 65977 536042 250826 285216 31011102 25690848 5320254 0 849 978 5999783 9842111 5010729 7320893 893969 915604 827148 793152 36866533 25699688 9836454 11166845 5411999 6155470 3870612 6605895 4099483 1070065 35951026 43871013 4152754 6082193 1824347 2998547 776951 1495283 3050301 4230347 9804353 14806370 X 25169440 28049122 977233 1015521 26146673 29064643 35951026 43871013 X 6297683 392168 -3771881 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 6399 6399 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: ASPIRUS GRAND VIEW PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND MICHIGAN HOSPITAL ASSOCIATION (MHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA AND MHA HAVE NOTIFIED ASPIRUS GRAND VIEW THAT APPROXIMATELY $6,399 OF THE ANNUAL DUES WERE USED IN CONJUCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 33912 33912 18421943 10988826 7433117 54736 38686 16050 17469075 14671868 2797207 886867 308 886559 11166845 UNDER BOND INDENTURE AGREEMENT 3000748 F UNDER AGREEMENTS FOR PAYROLL LIABILITIES 29137 F DEFERRED COMPENSATION PLAN ASSETS 2476152 F FUNDED DEPRECIATION INVESTMENTS 92334 F INVESTMENTS IN UNCONSOLIDATED AFFILIATES 1007524 F 6605895 DEFERRED COMPENSATION 2470990 DUE TO AFFILIATES 1072547 LONG TERM INSURANCE LIABILITY 686810 4230347 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ASPIRUS GRAND VIEW AND ASPIRUS GRAND VIEW SERVICE CORPORATION ARE NONPROFIT 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 501(A) OF THE CODE. THEY ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE OTHER SUBSIDIARIES OF ASPIRUS GRAND VIEW ARE TAXABLE CORPORATIONS AND INCLUDE ASPIRUS GRAND VIEW CARING CAREGIVERS, INC. AND WESTERN UPPER MICHIGAN EYE CARE, LLC. THE ORGANIZATION ANNUALLY EVALUATES THE ACTIVITY IN THESE TAXABLE SUBSIDIARIES TO DETERMINE ANY NEED FOR AN ESTIMATED PROVISION OR CREDIT FOR INCOME TAXES OR RELATED DEFERRED TAX ASSETS OR LIABILITIES. IF ANY TAX PROVISIONS OR CREDITS ARE DETERMINED TO BE NECESSARY, THE ORGANIZATION RECORDS THESE AMOUNTS IN THE CONSOLIDATED FINANCIAL STATEMENTS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ASPIRUS GRAND VIEW IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES THAT THE INTERNAL REVENUE SERVICE (IRS) CONSIDERS UNRELATED TO ITS EXEMPT PURPOSE AND, THEREFORE, TAXABLE. IF THESE ACTIVITIES RESULT IN NET OPERATING INCOME FOR INCOME TAX PURPOSES, ASPIRUS GRAND VIEW RECOGNIZES THE ANTICIPATED TAX LIABILITY AND EXPENSE. IF THESE ACTIVITIES RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES, ASPIRUS GRAND VIEW DOES NOT RECOGNIZE THE TAX BENEFIT FROM THE NET OPERATING LOSSES THAT WOULD BE REALIZED IN THE FUTURE UNLESS IT CAN BE DETERMINED THAT IT IS REASONABLE THAT SUCH AN ESTIMATED BENEFIT WILL BE REALIZED IN THE FUTURE. CURRENTLY, ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. NO DEFERRED TAX ASSETS AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL TAX BASES OF REPORTING ASPIRUS GRAND VIEW'S ASSETS AND LIABILITIES. THE ORGANIZATION'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. FOR 2013 AND 2012, THERE WERE NO MATERIAL TAX PENALTIES, OR INTEREST RELATED TAX PENALTIES, RECORDED BY THE ORGANIZATION IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED BENEFITS IN 2013 AND 2012. FEDERAL RETURNS FOR THE YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE IRS. 1 1 1 X 1 X 1 1 1 0 1 1 923180 923180 0.02980 4956815 2671095 2285720 0.07370 5879995 2671095 3208900 0.10350 95322 95322 0.00310 10000 10000 0.00030 3360805 1666512 1694293 0.05460 9291 9291 0.00030 3475418 1666512 1808906 0.05830 9355413 4337607 5017806 0.16180 3600 3600 0.00010 1980 1980 0.00010 5580 5580 0.00020 0 1258630 629315 12262663 12136086 126577 X 1 1 1 WESTERN UPPER MICHIGAN EYE CARE LLC EYE CLINIC 0.51000 0.00000 0.49000 1 1 ASPIRUS GRAND VIEW

N10561 GRAND VIEW LANE IRONWOOD MI 49938

X X X X HOME HEALTH SERVICES ASPIRUS GRAND VIEW 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 150.000000000000 1 300.000000000000 1 X X X 1 1 X X X X 1 X 1 X X X 1 X 0 0 4 GRAND VIEW EYE CENTER

E6112 BLUFF VIEW ROAD IRONWOOD MI 49938

EYE CLINIC GRAND VIEW SURGICAL CENTER

E6112 BLUFF VIEW ROAD IRONWOOD MI 49938

SURGEON OFFICES ASPIRUS GRAND VIEW IRONWOOD CLINIC

N10565 GRAND VIEW LANE IRONWOOD MI 49938

PROVIDER BASED CLINIC ASPIRUS GRAND VIEW HURLEY CLINIC

501 GRANITE STREET HURLEY WI 54534

PROVIDER BASED CLINIC PART I, LINE 3C: COUNSELORS QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE AND DISCOUNTING ELIGIBILITY BY REVIEWING PERSONAL FINANCIAL DATA AND TAX DOCUMENTS. COUNSELORS UTILIZE AN INCOME VALUE CALCULATION WORKSHEET TO PERFORM AN INCOME/ASSET ANALYSIS. CONSIDERATION IS GIVEN TO THE LIQUIDATION OF ASSETS. CURRENT FEDERAL POVERTY LEVEL GUIDELINES ARE USED IN THE CALCULATIONS. INCOMES IN EXCESS OF 300% OF THE FEDERAL POVERTY LEVEL ARE STILL CONSIDERED ELIGIBLE AND COULD STILL BE APPROVED BY MANAGEMENT FOR ADMINISTRATIVE WRITE OFF OF THE ENTIRE OR A PARTIAL AMOUNT OF THEIR BALANCES BASED ON INDIVIDUAL CASES OR CIRCUMSTANCES OF A PATIENT OR THEIR FAMILY. PART I, LINE 6A: ASPIRUS GRAND VIEW 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 GRAND VIEW 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 GRAND VIEW 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 GRAND VIEW TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES IS BASED ON THE COSTING METHODS USED ON THE HOSPITAL'S MEDICARE COST REPORT. THIS METHODOLOGY PROVIDES FOR A DIRECT ALLOCATION OF EXPENSES AS WELL AS PROVIDING THE SAME DATA TO THE MEDICARE PROGRAM AND THE IRS FOR FORM 990 PURPOSES. PART I, L7 COL(F): THE COSTING METHOD AND CALCULATIONS USED ON FORM 990 ARE BASED ON TOTAL OPERATING EXPENSES EXCLUDING BAD DEBT EXPENSE. THE COMMUNITY BENEFIT EXPENSE PERCENTAGES ARE CALCULATED BY DIVIDING THE COMMUNITY BENEFIT EXPENSE FOR EACH CATEGORY OF COMMUNITY SERVICES PROVIDED BY ASPIRUS GRAND VIEW REPORTED IN THE TABLE ON LINE 7 PART I OF THE SCHEDULE H BY THE TOTAL OPERATING EXPENSES OF THE HOSPITAL LESS THE PROVISION FOR BAD DEBTS OF $3,348,549. PART II: ASPIRUS GRAND VIEW PROMOTES 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 PROJECT ZERO, GREAT LAKES CENTER FOR YOUTH DEVELOPMENT, AND INTEGRATED FAMILY SERVICES, ASPIRUS GRAND VIEW PROMOTES HEALTHY BEHAVIORS AND REGULAR PHYSICAL ACTIVITY AS WELL AS PREVENTION OF SUBSTANCE ABUSE AND UNDERAGE DRINKING. ECONOMIC DEVELOPMENT IS PROMOTED THROUGH COLLABORATION WITH LOCAL CHAMBERS OF COMMERCE AND KIWANIS. SUPPORT IS ALSO GIVEN TO LOCAL ORGANIZATIONS SUCH AS BESSEMER ATHLETICS/BAND, GOGEBIC COMMUNITY COLLEGE, HURLEY SCHOOL DISTRICT/LITTLE LEAGUE/LIONS, IRON COUNTY UW EXTENSION, IRONWOOD AREA SCHOOLS, IRONWOOD CHAMBER, PAAVO NURMI MARATHON, RANGE SHRINERS CLUB, AND BIG BROTHERS BIG SISTERS. PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS FOR WHICH PATIENTS ARE PERSONALLY RESPONSIBLE, THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.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 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 RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE OF FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE ORGANIZATION. 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 GRAND VIEW 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, 2013 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).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING THE SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. 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.IF AN ACCOUNT REMAINS UNPAID AFTER TWO STATEMENT CYCLES, PFS GENERATES A PATIENT LETTER WITH OPTIONS TO PAY IN FULL, NEGOTIATE A PAYMENT PLAN, OR FILE FOR UNCOMPENSATED CARE. BY PHONE, OR IN PERSON, PFS ATTEMPTS TO MAKE A FOLLOW UP CONTACT TO DISCUSS THE PAYMENT OPTIONS. IF ACCEPTABLE PAYMENT TERMS CANNOT BE REACHED, OR IF A PATIENT DEFAULTS ON THE PRESCRIBED PAYMENT PLAN, THE ACCOUNT MAY ENTER THE COLLECTION PROCESS AFTER REASONABLE ATTEMPTS HAVE BEEN MADE TO CONTACT THE PATIENT. ASPIRUS GRAND VIEW PART V, SECTION B, LINE 3: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, ASPIRUS GRAND VIEW 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. IN ADDITION TO THE MAILED SURVEY, RESULTS FROM A TELEPHONE SURVEY, COORDINATED BY THE WISCONSIN DIVISION OF PUBLIC HEALTH, AND INFORMATION FROM THE CDC'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM WERE ALSO TAKEN INTO ACCOUNT SINCE ASPIRUS GRAND VIEW'S PRIMARY SERVICE AREA ALSO INCLDUES IRON COUNTY, WISCONSIN.QUANTITATIVE DATA INCLUDING STATISTICS AND DEMOGRAPHIC INFORMATION WERE OBTAINED FROM A WIDE ARRAY OF PUBLISHED SOURCES AND FROM HEALTH CARE PROVIDERS, INCLUDING THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH AND OTHER GOVERNMENT AND PRIVATE AGENCIES. ASPIRUS GRAND VIEW PART V, SECTION B, LINE 4: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:- ASPIRUS ONTONAGON HOSPITAL, INC.- PORTAGE HEALTH- BARAGA COUNTY MEMORIAL HOSPITAL- ASPIRUS KEWEENAW HOSPITAL ASPIRUS GRAND VIEW PART V, SECTION B, LINE 5C: THE CHNA CAN BE FOUND ON THE HOSPITAL FACILITY'S WEBSITE: WWW.ASPIRUSGRANDVIEW.ORG. ASPIRUS GRAND VIEW PART V, SECTION B, LINE 7: THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY ASPIRUS GRAND VIEW; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA. ASPIRUS GRAND VIEW ALSO CONSIDERED STAFFING RESOURCES IN ADDITION TO FINANCIAL CONSIDERATIONS TO ENSURE THAT THERE ARE ENOUGH PERSONNEL RESOURCES AVAILABLE FOR ANY PROGRAMS THAT MAY NOT CURRENTLY BE OFFERED BY THE HOSPITAL. DUE TO THE FINANCIAL AND STAFFING CONSTRAINTS, THE HOSPITAL HAS DETERMINED THE TOP THREE PRIORITES THAT THEY WILL FOCUS THEIR ATTENTION ON, AS THESE ISSUES WERE THE MOST CRITICAL AND SIGNIFICANT WORK NEEDS TO BE DONE IN THESE AREAS. OVER THE NEXT THREE YEARS AS THE IMPLEMENTATION STRATEGY IS IMPLEMENTED, THE HOSPITAL PLANS TO CONTINUALLY EVALUATE THE BENEFITS PROVIDED TO COMMUNITY MEMBERS TO ENSURE THAT HEALTH NEEDS ARE MET WHENEVER POSSIBLE. ASPIRUS GRAND VIEW PART V, SECTION B, LINE 14G: FINANCIAL ASSISTANCE IS LISTED AS AN OPTION ON COLLECTION LETTERS. ASPIRUS GRAND VIEW PART V, SECTION B, LINE 20D: ALL FAP-ELIGIBLE PATIENTS ARE CHARGED ACCORDING TO THE HOSPITAL'S NORMAL CHARGEMASTER AND THEN DISCOUNTS ARE PROVIDED FROM THE STANDARD CHARGE BASED ON THE PATIENT'S DETERMINATION ACCORDING TO THE FINANCIAL AID DISCOUNT POLICY. PART VI, LINE 2: ASPIRUS GRAND VIEW 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 HOSPITAL'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 GRAND VIEW 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 GRAND VIEW. PATIENT FINANCIAL SERVICES PERSONNEL ARE AVAILABLE TO DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROCEDURES AND PROGRAMS WITH PATIENTS. ASPIRUS GRAND VIEW 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 GRAND VIEW SERVES 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 GRAND VIEW SERVES 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 GRAND VIEW HAS 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 GRAND VIEW CONTINUES 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 GRAND VIEW IS AN AFFILIATED HEALTH SYSTEM WHICH SERVES THE COMMUNITY SURROUNDING IRONWOOD, MICHIGAN. AFFILIATES OF ASPIRUS GRAND VIEW PROMOTE THE HEALTH OF THE COMMUNITY BY FULFILLING THEIR INDIVIDUAL MISSIONS. ASPIRUS GRAND VIEW SERVICE CORPORATION PROVIDES PHYSICIAN SERVICES IN AN OUTPATIENT CLINIC. ASPIRUS GRAND VIEW CARING CAREGIVERS, INC. PROVIDES PRIVATE PERSONAL NEEDS SERVICES. ASPIRUS GRAND VIEW 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. REPORTS FILED WITH STATES PART VI, LINE 7 MI X X X 1 1 X X X 0 1 0 0 0 0 0 0 0 MARIA GULAN 0 130535 0 28018 0 2251 0 10108 0 24106 0 195018 0 0 CHRISTOPHER POGLIANO MD 0 230657 0 4230 0 13168 0 3000 0 25323 0 276378 0 0 JOEL RUEBER 0 177098 0 26529 0 16967 0 7278 0 23836 0 251708 0 0 JACOB KEMPEN 0 156725 0 25616 0 2999 0 7624 0 10511 0 203475 0 0 SIDNEY C SCZYGELSKI 0 302883 0 85154 0 2020 0 13716 0 66240 0 470013 0 0 RICK NEVERS 0 179118 0 53326 0 13101 0 11107 0 50651 0 307303 0 0 CAROL GOFFNETT 226959 0 0 0 15377 0 11846 0 18866 0 273048 0 0 0 CHARMAINE CHIANTELLO 150172 0 0 0 9652 0 7587 0 1600 0 169011 0 0 0 HARRY SKYE MD 480002 0 0 0 8200 0 3000 0 2244 0 493446 0 0 0 JOHN JAROCKI 203080 0 0 0 13043 0 3000 0 20677 0 239800 0 0 0 DONNA CATALDO MD 198135 0 0 0 0 0 0 0 0 0 198135 0 0 0 CARL GREEN 165461 0 10000 0 4532 0 0 0 21512 0 201505 0 0 0 CHRISTA KLYDER 151102 0 15000 0 4532 0 0 0 14999 0 185633 0 0 0 PART I, LINE 1A GROSS-UP PAYMENTS, TRAVEL FOR COMPANIONS, AND HOUSING ALLOWANCE, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. GROSS-UP PAYMENTS - C. GOFFNETT $4,953, H. SKYE $1,200, J. JAROCKI $6,043, C. GREEN $4,532, C. KLYDER $4,532 - INCLUDED IN TAXABLE COMPENSATION. TRAVEL FOR COMPANIONS - C. GOFFNETT $375 - INCLUDED IN TAXABLE COMPENSATION. HOUSING ALLOWANCE - C. GOFFNETT $2,286 - INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 1B ASPIRUS GRAND VIEW FOLLOWS THE COMPENSATION REVIEW PROCEDURES AND POLICIES OF ASPRIUS, INC. THE PHYSICIAN COMPENSATION OF ASPIRUS GRAND VIEW 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 4B THE FOLLOWING INDIVIDUALS RECEIVED A 457F DISTRIBUTION IN THE CURRENT YEAR FROM A RELATED ORGANIZATION (INCLUDED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J): R. NEVERS $9,913, J. RUEBER $14,430 A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 2013-04-12 2998547 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 A 3000579 3000579 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 1 SCHEDULE K, PART II: PROCEEDS OF ISSUE ARE IN EXCESS OF ISSUE PRICE OF BONDS IN PART I DUE TO THE INVESTMENT EARNINGS DURING THE PROJECT PERIOD. DIANA LORENSON SPOUSE OF JAMES LORENSON, BOARD DIRECTOR 18018 EMPLOYMENT COMPENSATION 0 NORTHERN LOWER PENINSULA LABS CORPORATION WHOLLY OWNED BY CHARLES IKNAYAN, MD, BOARD DIRECTOR 285138 PAYMENT FOR CONTRACTED PATHOLOGY 0 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 2 SIDNEY SCZYGELSKI, MARIA GULAN, JOEL RUEBER, JACOB KEMPEN, AND RICK NEVERS ARE EMPLOYED BY ONE OF ASPIRUS GRAND VIEW'S MEMBERS, ASPIRUS, INC. AND ITS SUBSIDIARIES. FORM 990, PART VI, SECTION A, LINE 6 ASPIRUS GRAND VIEW'S MEMBERS ARE ASPIRUS, INC., A WISCONSIN NONPROFIT CORPORATION AND GOGEBIC RANGE HEALTH FOUNDATION, A MICHIGAN NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A FOUR MEMBERS OF THE BOARD OF DIRECTORS ARE ELECTED BY ASPIRUS, INC. AND FOUR MEMBERS OF THE BOARD ARE ELECTED BY GOGEBIC RANGE HEALTH FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B ASPIRUS, INC. AND GOGEBIC RANGE HEALTH FOUNDATION HAVE THE FOLLOWING RIGHTS AND RESPONSIBILITIES: (A) INITIATE AND APPROVE ANY CHANGE IN PHILOSOPHY, CHARACTER, OR MISSION OF THE CORPORATION. (B) INITIATE AND APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION. (C) AMEND THE BYLAWS OF THE CORPORATION AND ALL SUBSIDIARIES WITH SUPERSEDING AUTHORITY OVER AMENDMENTS ADOPTED BY THE BOARD AS PROVIDED IN THE ARTICLES OF INCORPORATION AND/OR THE BYLAWS. (D) INITIATE AND APPROVE THE ADDITION OF ANY NEW MEMBERS OF THE CORPORATION. (E) APPROVE THE ESTABLISHMENT, TRANSFER OF OWNERSHIP, AND/OR DISSOLUTION OF ANY SUBSIDIARY CORPORATIONS. (F) INITIATE AND APPROVE BORROWING OF MONEY AND OTHER FORMS OF INDEBTEDNESS IN EXCESS OF $5,000,000. (G) APPROVE THE PURCHASE, SALE, LEASE, DISPOSITION, ENCUMBRANCE, OR ALIENATION OF PROPERTY WITH A VALUE IN EXCESS OF $5,000,000. (H) INITIATE AND APPROVE ANY PLAN OF DISSOLUTION, MERGER, OR CONSOLIDATION. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS REVIEWED BY THE ORGANIZATION'S CONTROLLER, AND THEN BY THE CFO. WHEN A FINAL DRAFT OF THE RETURN IS COMPLETE, COPIES OF THE RETURN ARE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST FORM. THE FORM IS REVIEWED INITIALLY BY THE COO, THEN BY THE BOARD OF DIRECTORS TO REVIEW ANY POTENTIAL CONFLICTS. EACH PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15 EFFECTIVE IN FISCAL YEAR 2013, A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS HAS BEEN ESTABLISHED TO PROVIDE A MORE FORMAL REVIEW PROCESS OVER EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS SALARY RECOMMENDATIONS (MADE BY THE COO) FOR THE COO AND CFO AND MAKE THEIR APPROVAL BASED ON PERFORMANCE EVALUATIONS AND MARKET COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. EXPLANATION OF HOURS WORKED: FORM 990, PART VII, SECTION A, COLUMN B CAROL GOFFNETT, CHARMAINE CHIANTELLO, AND PAULA CHERMSIDE ARE EMPLOYED BY ASPIRUS GRAND VIEW. ASPIRUS GRAND VIEW'S PURPOSE IS TO PROVIDE HEALTH CARE SERVICES TO AREA RESIDENTS AND THOSE IN NEED OF CARE THROUGH THE OPERATION OF ITS HOSPITAL AND ITS SUBSIDIARY ORGANIZATIONS. CAROL GOFFNET, CHARMAINE CHIANTELLO, AND PAULA CHERMSIDE DEVOTE THEIR TIME PROVIDING MANAGEMENT SERVICES TO ASPIRUS GRAND VIEW AND RELATED ORGANIZATIONS. SIDNEY C. SCZYGELSKI, MARIA GULAN, JOEL RUEBER, JACOB KEMPEN, AND RICK NEVERS ARE EMPLOYED BY ASPIRUS, INC. AND ITS AFFILIATED ORGANIZATIONS. ASPIRUS, INC'S PURPOSE IS TO SERVE AS A SUPPORTING ORGANIZATION TO MULTIPLE SUBSIDIARY ORGANIZATIONS AS LISTED IN SCHEDULE R, AS WELL AS THE PARTNER HOSPITALS WHICH ASPIRUS, INC. HOLDS A MEMBERSHIP INTEREST IN THE OPERATIONS OF THOSE ADDITIONAL HOSPITALS. THE EMPLOYEES OF ASPIRUS, INC. DEVOTE THEIR TIME PROVIDING MANAGEMENT SERVICES TO THE RELATED ORGANIZATIONS AND AFFILIATED PARTNER HOSPITALS. THESE EMPLOYEES OFTEN WORK HOURS IN EXCESS OF AN AVERAGE OF 40 HOURS EACH WEEK IN ORDER TO FULFILL THIS MISSION. CHRISTOPHER POGLIANO, M.D. IS AN EMPLOYED PHYSICIAN OF ASPIRUS GRAND VIEW SERVICE CORPORATION, A NONPROFIT SUBSIDIARY OF ASPIRUS GRAND VIEW, AND PROVIDES AN AVERAGE OF 40 HOURS PER WEEK OF PHYSICIAN AND MANAGEMENT SERVICES WHILE WORKING FOR ASPIRUS GRAND VIEW SERVICE CORPORATION IN ADDITION TO HIS DUTIES ON THE BOARD OF DIRECTORS FOR ASPIRUS GRAND VIEW. HOURS WORKED AT RELATED ORGANIZATIONS ARE REFLECTED IN LINE 2 OF COLUMN B. OTHER FEES FORM 990, PART IX, LINE 11G PHYSICIAN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,870,256. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,870,256. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,189,925. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,189,925. ADMINISTRATIVE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 758,483. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 758,483. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: OPERATING EQUITY TRANSFERS TO ASPIRUS GRAND VIEW SERVICE CORPORATION -3,836,836. INCREASE IN INTEREST IN NET ASSETS OF SUPPORTING ORGANIZATIONS 29,603. GAIN FROM CONTROLLED SUBSIDIARY 35,352. FORM 990, PART XII, LINE 2C ASPIRUS GRAND VIEW'S BOARD OF DIRECTORS PROVIDES OVERSIGHT OF THE INDEPENDENT ACCOUNTANTS AND THE MEMBERS OF THE BOARD MEET WITH THE ACCOUNTANT DURING THE AUDIT PROCESS TO DISCUSS THE AUDIT AND OTHER MATTERS. ASPIRUS GRAND VIEW ALSO IS PROVIDED ADDITIONAL OVERSIGHT OF THE AUDIT PROCESS AND SELECTION OF THE INDEPENDENT ACCOUNTANT THROUGH THE AUDIT COMMITTEE OF ASPIRUS, INC. THERE WAS NO CHANGE TO THIS PROCESS IN THE PAST YEAR. ASPIRUS GRAND VIEW SERVICE CORPORATION N10565 GRAND VIEW LANE IRONWOOD MI 49938 383005582 PHYSICIAN SERVICES MI 501(C)(3) LINE 3 ASPIRUS GRAND VIEW 1 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 9 ASPIRUS GRAND VIEW 1 ASPIRUS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE SYSTEM MANAGEMENT WI 501(C)(3) LINE 11B, 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 0 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS SPECIALISTS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391945080 MEDICAL SPECIALIST SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS EXTENDED SERVICES INC 425 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS CLINICS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 0 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTHCARE SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS VNA EXTENDED CARE INC 520 N 32ND AVENUE WAUSAU WI 54401 391597350 PERSONAL CARE SERVICES WI 501(C)(3) LINE 9 ASPIRUS VNA HOME HEALTH INC 0 ASPIRUS DOCTOR'S CLINIC INC 2031 PEACH STREET WISCONSIN RAPIDS WI 54495 391982671 MEDICAL SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 0 WESTERN UPPER MICHIGAN EYE CARE LLC 131 W GENESEE STREET IRON RIVER MI 49935 272324957 EYE CARE SERVICES MI ASPIRUS GRAND VIEW RELATED -15030 66387 1 1 0.51000 ASPIRUS GRAND VIEW CARING CAREGIVERS INC N10561 GRAND VIEW LANE IRONWOOD MI 49938 382902754 PERSONAL NEEDS SERVICES MI ASPIRUS GRAND VIEW C 96052 630739 1.00000 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 0 1 1 1 0 1 0 0 0 0 1 0 1 1 1 1 1 1 1 0 ASPIRUS GRAND VIEW SERVICE CORPORATION J 442548 FAIR MARKET VALUE ASPIRUS GRAND VIEW SERVICE CORPORATION R 3836836 COST