ASPIRUS KEWEENAW: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS KEWEENAW (EIN 38-1443361)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201231369349300348
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T09:59:16-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 543072237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381443361 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ASPI | NameControl |
| Phone | 9063376090 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHANE JACQUES | Name |
| Title | CFO | Title |
| Phone | 9063376090 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERRI REXRODE CPA MST | Name |
| Phone | 9206620016 | Phone |
| Date Prepared | 2012-05-15 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SHANE JACQUES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 38046495 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ASPIRUSKEWEENAW.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1939 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | ASPIRUS KEWEENAW HOSPITAL PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 455 | TotalNbrEmployees |
| Total Nbr Volunteers | 35 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 163563 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 47254 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 33059001 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 34650606 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1378110 | InvestmentIncomePriorYear |
| Investment Income Current Year | 696312 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 58438 | OtherRevenuePriorYear |
| Other Revenue Current Year | 121767 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 34659112 | TotalRevenuePriorYear |
| Total Revenue Current Year | 35515939 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22137971 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20126634 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14034236 | OtherExpensePriorYear |
| Other Expenses Current Year | 14488131 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36172207 | TotalExpensesPriorYear |
| Total Expenses Current Year | 34614765 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1513095 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 901174 | RevenuesLessExpensesCY |
| Total Assets BOY | 25970158 | TotalAssetsBOY |
| Total Assets EOY | 26325831 | TotalAssetsEOY |
| Total Liabilities BOY | 10037501 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11209590 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15932657 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15116241 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, AND PHYSICIAN CLINIC SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 29845822 | Expense |
| Revenue | 34546311 | Revenue |
| Description | ASPIRUS KEWEENAW HOSPITAL PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, AND PHYSICIAN CLINIC SERVICES. | Description |
| Total Program Service Expense | 29845822 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 86 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 455 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SHANE JACQUES | NamePerson |
| Telephone Number | 9063376090 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BETTY J ANDERSON | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| GALE S ANDERSON | |||||||
| VICE CHAIRMAN | 0.50 | X | 0 | 0 | 0 | X | |
| DANIEL L DALQUIST | |||||||
| CHAIRMAN | 0.50 | X | 0 | 0 | 0 | X | |
| DUANE L ERWIN | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| ELIZABETH BENYI DO | |||||||
| BOARD MEMBER | 40.00 | X | 243163 | 0 | 12161 | ||
| DAVID H GILBERT MD | |||||||
| SECRETARY | 0.50 | X | 0 | 0 | 0 | X | |
| JERRY W LUOMA MD | |||||||
| BOARD MEMBER | 40.00 | X | 152798 | 0 | 22811 | ||
| GLENN KAUPPILA MD | |||||||
| BOARD MEMBER | 40.00 | X | 202294 | 0 | 21146 | ||
| MICHAEL MURPHY | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| RICK NEVERS | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| DARRYL PIERCE | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| JOEL TUORINIEMI | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| CHUCK NELSON | |||||||
| PRESIDENT/CEO ASPIRUS KEWEENAW HOSPITAL | 40.00 | X | 215120 | 0 | 28317 | X | |
| DALE TAHTINEN | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| MIKE HAUSWIRTH | |||||||
| COO | 40.00 | 138663 | 0 | 24155 | X | ||
| SHANE JACQUES | |||||||
| CFO | 40.00 | 75403 | 0 | 25892 | X | ||
| GRACE TOUSIGNANT | |||||||
| CNO | 40.00 | 120237 | 0 | 21288 | X | ||
| MICHAEL HAGWELL | |||||||
| CFO | 40.00 | 116648 | 0 | 21783 | X | ||
| JOHN NOVSAD MD | |||||||
| ANESTHESIOLOGIST | 40.00 | 275991 | 0 | 17721 | X | ||
| MARY LIMBACK MD | |||||||
| SURGEON | 40.00 | 325322 | 0 | 32480 | X | ||
| BRAD LAITINEN MD | |||||||
| ED PHYSICIAN | 40.00 | 288186 | 0 | 29014 | X | ||
| JAMES BLACK MD | |||||||
| ED PHYSICIAN | 40.00 | 291305 | 0 | 31034 | X | ||
| BRUCE HARVEY MD | |||||||
| ED DEPARTMENT DIRECTOR | 40.00 | 262097 | 0 | 26739 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2707227 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 314541 | TotalOtherCompensation |
| Number Individuals GT100 K | 24 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MCKESSON DRUG COMPANY | |||||
| 12748 COLLECTION CENTER DR | CHICAGO | IL | 60693 | DRUGS & SUPPLIES DISTRIBUTOR | 1509431 |
| MARK R SHEBUSKI MD PC | |||||
| 301 W LAKE AVENUE | HOUGHTON | MI | 49931 | PROVIDER SERVICES & BUILDING | 1113860 |
| MARQUETTE GENERAL HOSPITAL INC | |||||
| 580 W COLLEGE AVENUE | MARQUETTE | MI | 49855 | VARIOUS MEDICAL SERVICES | 854496 |
| NATIONAL GOVERNMENT SERVICES | |||||
| 17003 DME MAC NON-MSP | CHICAGO | IL | 60680 | MEDICARE PAYMENT TRUE-UP | 823180 |
| ASPIRUS INC | |||||
| PO BOX 1817 | WAUSAU | WI | 54402 | HOME OFFICE - VARIOUS | 624800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 32 | NumberOfContractorsGT100K |
| Government Grants | 37969 | GovernmentGrants |
| All Other Contributions | 9285 | AllOtherContributions |
| Total Contributions | 47254 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 621990 | 34546311 | 34546311 | |
| CAFETERIA REVENUE | 624200 | 95596 | $95,596 | |
| VENDING REVENUE | 624200 | 8699 | $8,699 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 34650606 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 672121 | TotalRevenueColumn |
| Exclusion | $672,121 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 124647 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2880 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 121767 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 121767 | TotalRevenueColumn |
| Exclusion | $121,767 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2526867 | Securities |
| Other | 25000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2493311 | Securities |
| Other | 34365 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 33556 | Securities |
| Other | -9365 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24191 | TotalRevenueColumn |
| Exclusion | $24,191 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35515939 | TotalRevenueColumn |
| Related Or Exempt Function Income | 34546311 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $922,374 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1334118 | Total |
| Program Services | 412253 | ProgramServices |
| Management And General | 921865 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14477054 | Total |
| Program Services | 13505440 | ProgramServices |
| Management And General | 971614 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 554575 | Total |
| Program Services | 488161 | ProgramServices |
| Management And General | 66414 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2510916 | Total |
| Program Services | 2210219 | ProgramServices |
| Management And General | 300697 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1249971 | Total |
| Program Services | 1100280 | ProgramServices |
| Management And General | 149691 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102002 | Total |
| Management And General | 102002 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106080 | Total |
| Management And General | 106080 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3469358 | Total |
| Program Services | 3151599 | ProgramServices |
| Management And General | 317759 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 210383 | Total |
| Program Services | 6261 | ProgramServices |
| Management And General | 204122 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5303037 | Total |
| Program Services | 5017166 | ProgramServices |
| Management And General | 285871 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 469456 | Total |
| Program Services | 422725 | ProgramServices |
| Management And General | 46731 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147794 | Total |
| Program Services | 109746 | ProgramServices |
| Management And General | 38048 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199 | Total |
| Management And General | 199 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 279716 | Total |
| Program Services | 251872 | ProgramServices |
| Management And General | 27844 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1086040 | Total |
| Program Services | 977933 | ProgramServices |
| Management And General | 108107 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 376318 | Total |
| Program Services | 109275 | ProgramServices |
| Management And General | 267043 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | 1921572 | 1921572 | |
| OTHER EXPENSES | 943446 | 161320 | 782126 |
| RECRUITMENT EXPENSE | 72730 | 72730 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34614765 | Total |
| Program Services | 29845822 | ProgramServices |
| Management And General | 4768943 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87114 | BOY |
| EOY | 26424 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1492475 | BOY |
| EOY | 4214093 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3542910 | BOY |
| EOY | 3892233 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 420237 | BOY |
| EOY | 425266 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1176727 | BOY |
| EOY | 1136957 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21543842 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14798073 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8014603 | BOY |
| EOY | 6745769 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6962309 | BOY |
| EOY | 4580689 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4273783 | BOY |
| EOY | 5304400 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25970158 | BOY |
| EOY | 26325831 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3217251 | BOY |
| EOY | 5080698 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6208292 | BOY |
| EOY | 5441150 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 611958 | BOY |
| EOY | 687742 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10037501 | BOY |
| EOY | 11209590 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14690183 | BOY |
| EOY | 14855922 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1242474 | BOY |
| EOY | 260319 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15932657 | BOY |
| EOY | 15116241 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25970158 | BOY |
| EOY | 26325831 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 901174 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1717590 | ReconcilationOtherChanges |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $4,410 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4410 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | ORGANIZATION HAS INDIRECT LOBBYING ACTIVITIES THROUGH THE PAYMENT OF HOSPITAL ASSOCIATION DUES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 746455 | OtherCostOrOtherBasis |
| Book Value | 746455 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13690349 | OtherCostOrOtherBasis |
| Depreciation | 9586550 | Depreciation |
| Book Value | 4103799 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6966967 | OtherCostOrOtherBasis |
| Depreciation | 5211523 | Depreciation |
| Book Value | 1755444 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 140071 | OtherCostOrOtherBasis |
| Book Value | 140071 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 6745769 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM KMMC ENTERPRISES | 1011476 |
| AMOUNT RECEIVABLE FROM THRID-PARTY REIMBURSEMENT | 2104645 |
| INVESTMENT IN UPPER PENINSULA HEALTH NETWORK, LLC | 1229880 |
| DUE FROM ASPIRUS, INC. | 3584 |
| DUE FROM ASPIRUS KEWEENAW FOUNDATION | 62315 |
| NOTE RECEIVABLE | 892500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5304400 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED COMPENSATION | Description |
| Amount | $687,742 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 687742 | TotalOfAmounts |
| Total Revenue | 35515939 | TotalRevenue |
| Total Expenses | 34614765 | TotalExpenses |
| Excess Or Deficit For Year | 901174 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 259504 | NetUnrealizedGLOnInvestments |
| Other | -$1,977,094 | OtherAmount |
| Total Adjustments | -1717590 | TotalAdjustments |
| Excess Or Deficit Per FS | -816416 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 35439993 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 35439993 | RevenueSubtotal |
| Other Revenues Not Included | 75946 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 75946 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 35515939 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 34538819 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 34538819 | ExpensesSubtotal |
| Other Expenses Not Included | 75946 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 75946 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 34614765 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS 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 THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL AND THE COMPANY RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. FEDERAL TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2007, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. |
| SCHEDULE D PART XII, LINE 4B; IS COMPRISED OF RENTAL EXPENSE AND EXPENSES PER THE 990 THAT ARE INCLUDED IN OTHER INCOME ON THE FINANCIAL STATEMENTS OF $75,946. SCHEDULE D, PART XIII, LINE 4B; IS COMPRISED OF RENTAL EXPENSE AND EXPENSES PER THE 990 THAT ARE INCLUDED IN OTHER INCOME ON THE FINANCIAL STATEMENTS $75,946. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 36512 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 36512 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3388962 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2291043 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1097919 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03360 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3425474 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2291043 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1134431 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03470 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 197290 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6370 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 190920 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 197290 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6370 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 190920 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3622764 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2297413 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1325351 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04050 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,044,403 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 11979960 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12098352 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -118392 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ASPIRUS KEWEENAW MEDICAL ARTS | ||||
| 301 LAKESHORE DR | HOUGHTON | MI | 49931 | CLINIC |
| ASPIRUS KEWEENAW OUTPATIENT THERAPIES | ||||
| 342 HECLA STREET | LAURIUM | MI | 49913 | OUTPATIENT THERAPY |
| ASPIRUS KEWEENAW OUTPATIENT THERAPIES | ||||
| 960 RAZORBACK DRIVE SUITE 3 | HOUGHTON | MI | 49931 | OUTPATIENT THERAPY |
| ASPIRUS KEWEENAW LAKE LINDEN CLINIC | ||||
| 110 CALUMET ST | LAKE LINDEN | MI | 49945 | CLINIC |
| ASPIRUS KEWEENAW FASTCARE | ||||
| 900 MEMORIAL RD | HOUGHTON | MI | 49931 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 7: THE COST METHOD THAT IS USED ON THE FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS. THIS IS THEN DIVIDED BY GROSS PATIENT SERVICES REVENUE. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1921572. |
| PART II: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFITS HOSPITAL'S COMMUNITY BENEFIT AND CHARITY CARE, THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. ASPIRUS KEWEENAW HOSPITAL, INC., IN ADDITION TO PROVIDING SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. ASPIRUS KEWEENAW HOSPITAL, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL WOULD NOT BE AVAILABLE LOCALLY. IN ADDITION TO INPATIENT HOSPITALIZATIONS, THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: EMERGENCY SERVICES, RESPIRATORY THERAPY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, FAMILY PRACTICE CLINICS, AND LABORATORY AND PATHOLOGY SERVICES. |
| PART III, LINE 8: ALLOWABLE MEDICARE COSTS WERE OBTAINED FROM THE ORGANIZATION'S FILED MEDICARE COST REPORT. AS SUCH THEY ONLY INCLUDE THE AMOUNTS ALLOWED IN THE FORM 990 INSTRUCTIONS. THEREFORE, THEY ONLY INCLUDE A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND DO NOT CONSIDER ALL OF THE CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. THE MEDICARE REVENUES AMOUNTS LISTED DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS, AND A SIGNIFICANT PORTION OF LAB SERVICES PROVIDED TO AREA CLINIC PATIENTS. |
| PART III, LINE 9B: UNDER THE ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, ASPIRUS KEWEENAW HOSPITAL MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE.ASPIRUS KEWEENAW HOSPITAL WILL PROVIDE MEDICALLY ACUTE SERVICES TO PATIENTS WHO MEET THE CRITERIA OF THE PATIENT FINANCIAL ASSISTANCE PROGRAM WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES FOR QUALIFYING PATIENTS. THIS PROGRAM IS PROVIDED FOR PATIENTS WHO ARE UNINSURED, UNDERINSURED, AND/OR MEDICALLY INDIGENT. PATIENTS AND THEIR FAMILIES HAVE A RESPONSIBILITY TO HELP THE HOSPITAL QUALIFY THEM FOR THE APPROPRIATE LEVEL OR TYPE OF FINANCIAL ASSISTANCE GIVEN THEIR CIRCUMSTANCES.DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM.AN ACCOUNT WILL BE CONSIDERED DELINQUENT IF ADEQUATE AND TIMELY PAYMENTS ARE NOT MADE AND/OR THERE IS A LACK OF COMMUNICATION FROM THE PATIENT/FAMILY:1.) 60 DAYS AFTER BALANCE BECOMES THE RESPONSIBILITY OF THE PATIENT/GUARANTOR. 2.) IF A PATIENT/GUARANTOR REFUSES TO PAY AN ACCOUNT WITHOUT VALID REASON. 3.) STATEMENTS ARE MAIL-RETURNED AND THE PATIENT/GUARANTOR CANNOT BE LOCATED. 4.) A PATIENT/GUARANTOR ACCOUNT HISTORY SHOWS THE DEBT IS UNLIKELY TO BE PAID. 5.) ACCOUNT PAYMENTS ARE INADEQUATE FOR THE BALANCE AND AGE OF ACCOUNT. 6.) THE PATIENT/GUARANTOR STOPS MAKING SCHEDULED PAYMENTS. |
| PART VI, LINE 2: THE ORGANIZATION MEETS WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO CONSULT AND DETERMINE HOW TO MEET THE HEALTH CARE NEEDS IN THE ORGANIZATION'S GEOGRAPHICAL AREA. IN ADDITION, THE ORGANIZATION ITSELF EVALUATES ITS' OWN SERVICES OFFERED IN THEIR SERVICE AREA AND EVALUATES OTHER SERVICES THAT COULD BE PROVIDED TO BENEFIT THE COMMUNITY SERVED. |
| PART VI, LINE 3: ASPIRUS KEWEENAW HOSPITAL WILL PROVIDE MEDICALLY ACUTE SERVICES TO PATIENTS WHO MEET THE CRITERIA OF THE PATIENT FINANCIAL ASSISTANCE PROGRAM (PFAP) WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES FOR QUALIFYING PATIENTS. THIS PROGRAM IS PROVIDED FOR PATIENTS WHO ARE UNINSURED, UNDERINSURED, AND/OR MEDICALLY INDIGENT. PATIENTS AND THEIR FAMILIES HAVE A RESPONSIBILITY TO HELP THE HOSPITAL QUALIFY THEM FOR THE APPROPRIATE LEVEL OR TYPE OF FINANCIAL ASSISTANCE GIVEN THEIR CIRCUMSTANCE.A PFAP BROCHURE IS GIVEN TO EACH INPATIENT. THE BROCHURE INFORMS PATIENTS OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM AND HOW TO APPLY. WE HAVE SIGNS POSTED IN ALL ASPIRUS KEWEENAW HOSPITAL AND CLINIC LOCATIONS THAT LET THE PATIENT KNOW ABOUT OUR PFAP PROGRAM. PFAP BROCHURES ARE DISPLAYED IN PATIENT AREAS OF OUR CLINICS AND HOSPITAL. SIGNS ARE POSTED THROUGHOUT AKH TO INFORM THE PATIENT THAT WE PARTICIPATE IN THE MEDICAID PROGRAM. A NOTICE REGARDING OUR SLIDING FEE SCALE AND HOW TO APPLY FOR IT, IS POSTED AT ALL PHYSICIAN RECEPTION AREAS. ALL BILLERS AND FRONT LINE STAFF DIRECT PATIENT INQUIRIES REGARDING PAYMENT, MEDICAID, AND FINANCIAL ASSISTANCE TO A FINANCIAL COUNSELOR. SELF PAY PATIENTS ARE INFORMED OF THE COST OF HIGH DOLLAR PROCEDURES AND OFFERED OPTIONS FOR PAYMENT AND ASSISTANCE PROGRAMS PRIOR TO SCHEDULING THE PROCEDURE. AN ASPIRUS KEWEENAW SOCIAL WORKER COUNSELS PATIENTS AND MAKES THEM AWARE OF ALL AVAILABLE COMMUNITY RESOURCES, INCLUDING MEDICAID AND OUR AKH PATIENT FINANCIAL ASSISTANCE PROGRAM. SHE ASSISTS THEM IN COMPLETING THE MEDICAID APPLICATION. A FINANCIAL COUNSELOR WILL VISIT THE PATIENT IF REQUESTED DURING THE SOCIAL WORKER INTERVIEW WITH THE PATIENT. FINANCIAL COUNSELORS SUGGEST OUR PFAP TO ELIGIBLE PATIENTS WHILE MAKING PAYMENT ARRANGEMENTS. |
| PART VI, LINE 4: THE ORGANIZATION PROVIDES SERVICES PRIMARILY TO THE ELDERLY AND FRAIL OF NORTHERN HOUGHTON AND KEWEENAW COUNTIES. THE LARGEST CITIES IN THESE REGIONS INCLUDE HOUGHTON, HANCOCK, LAURIUM AND CALUMET. AS A PERCENTAGE OF TOTAL REVENUE, MEDICARE AND MEDICAID COMPRISE OF 60% AND 11%, RESPECTIVELY FOR THE ORGANIZATION. |
| PART VI, LINE 6: THE BOARD OF DIRECTOR'S IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION PROVIDES, FREE OF CHARGE TO THE LOCAL SCHOOL, AN ATHLETIC TRAINER. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH BENYI DO | |||||||||||||
| 242429 | 0 | 0 | 0 | 734 | 0 | 0 | 0 | 12161 | 0 | 255324 | 0 | 0 | 0 |
| JERRY W LUOMA MD | |||||||||||||
| 102382 | 0 | 49595 | 0 | 821 | 0 | 0 | 0 | 22811 | 0 | 175609 | 0 | 0 | 0 |
| GLENN KAUPPILA MD | |||||||||||||
| 154313 | 0 | 47897 | 0 | 84 | 0 | 0 | 0 | 21146 | 0 | 223440 | 0 | 0 | 0 |
| CHUCK NELSON | |||||||||||||
| 208312 | 0 | 0 | 0 | 6808 | 0 | 0 | 0 | 28317 | 0 | 243437 | 0 | 0 | 0 |
| MIKE HAUSWIRTH | |||||||||||||
| 138203 | 0 | 0 | 0 | 460 | 0 | 0 | 0 | 24155 | 0 | 162818 | 0 | 0 | 0 |
| JOHN NOVSAD MD | |||||||||||||
| 275566 | 0 | 0 | 0 | 425 | 0 | 0 | 0 | 17721 | 0 | 293712 | 0 | 0 | 0 |
| MARY LIMBACK MD | |||||||||||||
| 233750 | 0 | 91179 | 0 | 393 | 0 | 0 | 0 | 32480 | 0 | 357802 | 0 | 0 | 0 |
| BRAD LAITINEN MD | |||||||||||||
| 288055 | 0 | 0 | 0 | 131 | 0 | 0 | 0 | 29014 | 0 | 317200 | 0 | 0 | 0 |
| JAMES BLACK MD | |||||||||||||
| 290841 | 0 | 0 | 0 | 464 | 0 | 0 | 0 | 31034 | 0 | 322339 | 0 | 0 | 0 |
| BRUCE HARVEY MD | |||||||||||||
| 261402 | 0 | 0 | 0 | 695 | 0 | 0 | 0 | 26739 | 0 | 288836 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VILLAGE OF LAURIUM FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 386007184 | IssuerEIN |
| Date Issued | 2004-03-05 | DateIssued |
| Issue Price | 3546723 | IssuePrice |
| Description Of Purpose | REFUNDING BOND SERIES 1997 | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 3546723 | TotalProceeds |
| Capital Expenditures | 3546723 | CapitalExpenditures |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 0 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BETTY ANDERSON AND GALE ANDERSON HAVE A FAMILY RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | ASPIRUS, INC. AND KEWEENAW HEALTH FOUNDATION ARE VOTING MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS IS COMPRISED OF 3 MEMBERS FROM ASPIRUS, INC. AND 11 MEMBERS FROM KEWEENAW HEALTH FOUNDATION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | MAJOR OPERATING DECISION ITEMS UPON APPROVAL BY THE BOARD OF ASPIRUS KEWEENAW HOSPITAL REQUIRE APPROVAL BY THE ASPIRUS, INC. BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS HAS DELEGATED THE REVIEW PROCESS OF THE FORM 990 TO THE CFO. | |
| ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. THIS PROCESS IS MONITORED THROUGH SELF DISCLOSURE. | FORM 990, PART VI, SECTION B, LINE 12C | |
| COMPENSATION IS DETERMINED BY USE OF STATE HOSPITAL ASSOCIATION SURVEY AND SYSTEM SURVEY. THE COMPENSATION OF THE CEO IS DETERMINED BY AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. WAGE DETERMINATION FOR OTHER EXECUTIVE POSITIONS, AN ANNUAL WAGE ANALYSIS IS COMPLETED. THE ORGANIZATION USES SALARY SURVEYS AND SALARY AGENCIES TO DETERMINE THE WAGE SCALE. CONSULTATION ON THE SETTING OF PAY IS PROVIDED TO THE ORGANIZATION BY ASPIRUS, INC. HUMAN RESOURCES. ANY INCREASES IN EXECUTIVE COMPENSATION IS APPROVED BY THE BOARD WITH THE ACTUAL AMOUNT OF SALARY INCREASE BASED OFF OF AN ANNUAL EMPLOYEE EVALUATION. FOR ALL EXECUTIVES, A BONUS POOL IS ESTABLISHED AND CRITERIA IS DEVELOPED AND DETERMINED AT THE BOARD OF DIRECTOR LEVEL. THE BOARD THEN REVIEWS ANNUALLY THE PLAN AND DETERMINES IF A PAYOUT WILL BE PROVIDED. ALL COMPENSATION DECISIONS ARE DOCUMENTED THROUGH A COMPENSATION SUB-COMITTEE OF THE BOARD OF DIRECTORS BY INDIVIDUALS WITHOUT CONFLICT. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION HAS DEEMED THAT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 259,504. EQUITY TRANSFER WITH FOUNDATION -2,000,000. TEMPORARILY RESTRICTED CONTRIBUTIONS AND INVESTMENT INCOME 22,906. TOTAL TO FORM 990, PART XI, LINE 5: -1,717,590. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEWEENAW HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352340440 | EIN |
| Primary Activities | DEVELOP RESOURCES TO IMPROVE THE HEALTH AND WELL BEING OF THE PEOPLE | PrimaryActivities |
| Legal Domicile State | MI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 7 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW ENTERPRISES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCOLA ST | AddressLine1 |
| City | LAURIUM | City |
| State | MI | State |
| ZIP Code | 49913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383390273 | EIN |
| Primary Activity | PHARMACY | PrimaryActivity |
| Legal Domicile State | MI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 208750 | ShareOfTotalIncome |
| Share Of EOY Assets | 1427289 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| ASPIRUS KEWEENAW ENTERPRISES | |
| A | 40536 |
| ASPIRUS KEWEENAW ENTERPRISES | |
| Q | 1214000 |