2026-05-14T10:17:08-05:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-07-01 390964813 ASPIRUS MEDFORD HOSPITAL & CLINICS INC ASPI 7157488100 135 SOUTH GIBSON STREET MEDFORD WI 54451 LORI PECK INTERIM CFO 7158472118 2026-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-04-25 2024 2025-03-06 01:10:19Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 114105948 0 X WWW.ASPIRUS.ORG X 1958 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 11 6 500 30 1508565 0 74936 165925 100237324 113528246 365 -92 397920 410313 100710545 114104392 136737 210298 0 0 40025375 41798838 0 0 0 46722588 50357366 86884700 92366502 13825845 21737890 72707885 73768596 14693432 13929976 58014453 59838620 X WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 51208623 210298 85434027 HOSPITAL SERVICES - ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMH) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN MEDFORD, WISCONSIN. DURING THE YEAR ENDED JUNE 30, 2025, THE HOSPITAL HAD 3,724 INPATIENT DAYS AND 82,240 OUTPATIENT VISITS. SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, CHEMOTHERAPY/INFUSION, DIALYSIS, AND THERAPIES ARE JUST SOME OF THE OTHER SERVICES THAT AMH PROVIDES WITHIN THE HOSPITAL. AS A CRITICAL ACCESS HOSPITAL, AMH PROVIDES ACCESS TO LOCAL HEALTH CARE FOR THE COMMUNITIES OF WHICH THEY SERVE.AMH ALSO PROMISES TO THE COMMUNITY TO PROVIDE HEALTH CARE SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY AS DEFINED IN AMH'S CHARITY AND COMMUNITY CARE POLICIES AND PROGRAMS. DURING FISCAL YEAR 2025, AMH'S CHARITY CARE PROGRAM AWARDED APPROXIMATELY $1,483,174 IN FINANCIAL ASSISTANCE THROUGH CHARGE REDUCTIONS TO PATIENTS WHO COULD NOT OTHERWISE AFFORD CARE. ADDITIONAL INFORMATION ON THE COST OF PROVIDING CHARITY CARE TO PATIENTS CAN BE FOUND IN SCHEDULE H OF THE FORM 990. IN ADDITION TO PROVIDING CHARITY CARE SERVICES, AMH ALSO PROVIDES A SIGNIFICANT NUMBER OF SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS. THESE SERVICES ARE CONSIDERED A LARGE NEED IN THE COMMUNITY AND AMH IS OFTEN REIMBURSED AT RATES BELOW THE COST OF PROVIDING THE CARE FOR THESE PATIENTS. 16810101 0 21125631 CLINIC SERVICES - AMH OPERATES FIVE OUTPATIENT CLINICS IN THE COMMUNITIES OF ATHENS, GILMAN, MEDFORD, PHILLIPS, AND PRENTICE (ALL LOCATED WITHIN THE STATE OF WISCONSIN). DURING THE YEAR ENDED JUNE 30, 2025, THE CLINICS HAD 57,312 VISITS. AMH PROVIDES ACCESS TO PRIMARY CARE PHYSICIANS IN THESE RURAL AND MEDICALLY UNDERSERVED AREAS.THE CLINICS ALSO SERVES A LARGE PORTION OF ELDERLY, DISABLED, AND LOW-INCOME PATIENTS WHO ARE COVERED UNDER THE MEDICARE AND WISCONSIN MEDICAID PROGRAMS. PATIENTS OF THE AMH CLINICS ARE ALSO ELIGIBLE FOR CHARITY CARE AS DEFINED BY AMH'S CHARITY CARE POLICY. CHARITY CARE AMOUNTS FOR THE CLINICS ARE INCLUDED IN THE TOTAL NOTED UNDER 4A ABOVE. 6117668 0 5402516 SENIOR CARE SERVICES - AMH OPERATES A 25-BED SKILLED NURSING FACILITY (SNF), 10 CBRF APARTMENTS, AND A 28-UNIT RCAC. DURING THE YEAR ENDED JUNE 30, 2025, THE SNF HAD A DAILY CENSUS OF 24.16 AND THE RCAC HAD A DAILY CENSUS OF 26.31. THROUGH THESE SENIOR CARE SERVICES, AMH PROVIDES CARE AND ASSISTANCE TO THE ELDERLY IN OUR COMMUNITY. MANY OF THE RESIDENTS RECEIVING SENIOR CARE SERVICES AT AMH RECEIVE CARE UNDER THE WISCONSIN MEDICAID OR FAMILY CARE PROGRAMS. AMH RECOGNIZES THAT THE COST OF CARING FOR THESE INDIVIDUALS OFTEN EXTENDS BEYOND THE AMOUNT THAT IS PAID TO AMH BY THE MEDICAID PROGRAM. ADDITIONAL INFORMATION ON THE COST OF PROVIDING SERVICES TO MEDICAID PROGRAM BENEFICIARIES CAN BE FOUND IN SCHEDULE H OF THE FORM 990. 74136392 1 1 0 1 0 0 0 0 0 1 1 0 0 1 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 0 0 0 0 0 0 1 1 1 0 0 1 0 0 500 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X LORI PECK 7158472118 2200 WESTWOOD DRIVE WAUSAU WI 54401 X JAMES MATHESON VICE CHAIR/SVP-CHIEF STRATEGY OFF. 1.00 40.00 X X 0 745188 115516 CONSTANCE BRADLEY B.M./SVP & PRES. REG. MRKTS 1.00 40.00 X 0 786524 125769 SUSAN SCHNEIDER B.M./VP-SYSTEM SR. PHYSICIAN EXEC. 1.00 40.00 X 0 580755 35907 DIANE ANDERSON BOARD MEMBER/NURSE PRACTITIONER 1.00 40.00 X 0 271745 39816 RACHEL DIXON BOARD MEMBER/PHYSICIAN ASSISTANT 1.00 40.00 X 0 97554 41346 RANDY JUEDES CHAIR 1.00 2.00 X X 0 0 0 JOHNATHON LANGE SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 BRENT ARNDT BOARD MEMBER 1.00 3.00 X 0 0 0 LEONARD HAMMAN BOARD MEMBER 1.00 3.00 X 0 0 0 JEFFREY KOENIG BOARD MEMBER 1.00 2.00 X 0 0 0 JASON STELIGA BOARD MEMBER 1.00 2.00 X 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 3868734 361440 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 677240 138394 JASON TROXELL (NV) PRESIDENT-ASPIRUS NW WI DIV. 1.00 40.00 X 0 236650 77821 DALE HUSTEDT (NV) PRES.-NW WI DIV. (THRU 10/24) 40.00 2.00 X 503937 0 35332 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 565843 99581 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 455617 41886 JENNIFER REDMAN-SCHELL SVP & PRESIDENT-AMG 2.00 50.00 X 0 727379 105151 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 763486 117666 MICHAEL HOLZHUETER SVP-CHIEF HR OFFICER 2.00 50.00 X 0 879825 136340 WILL WEIDER SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 660670 105795 DAVID BITTNER SVP-ENTERPRISE DEVELOPMENT 2.00 50.00 X 0 443682 120822 DAVID VANDERKIN RADIOLOGIST 40.00 X 952519 0 37269 CLINT SEMRAU PHYSICIAN 40.00 X 673441 0 51508 RICHARD MAYRER PHYSICIAN 40.00 X 484819 0 48605 RYAN CHECK PHYSICIAN 40.00 X 464462 0 47687 SHIRIN SULTANA PHYSICIAN 40.00 X 454745 0 43453 JESSE TISCHER SVP & PRESIDENT-AWH (FORMER) 0.00 0.00 X 0 732979 5855 SIDNEY SCZYGELSKI SVP OF FINANCE/CFO (FORMER) 2.00 50.00 X 0 1470041 37990 3533923 13963912 1970949 65 1 1 0 LOCUMSMART LLC 7259 BINGHAM JCT BLVD MIDVALE UT 84047 CONTRACTED LABOR SERVICES 1408841 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE SUITE 185 IRVINE CA 92614 CONTRACTED SERVICES 618190 AMERICAN RADIOLOGY SC PO BOX 972633 DALLAS TX 753972633 CONTRACTED LABOR SERVICES 570499 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 CONTRACTED LABOR SERVICES 569815 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACTED LABOR SERVICES 512008 16 165925 165925 PATIENT SERVICE REVENUE 621110 106392451 106390089 2362 PHARMACY REVENUE 456110 6983896 5477693 1506203 CONTRACT SERVICE REVENUE 621110 38113 38113 113786 94392 19394 113528246 194221 0 194221 194221 194221 92 -92 -92 -92 63633 1464 62169 62169 CAFETERIA REVENUE 722514 153923 153923 153923 114104392 111962174 1508565 467728 209298 209298 1000 1000 313258 313258 33542120 29833375 3708745 989380 836105 153275 4756959 3998471 758488 2197121 1845946 351175 13131 13131 7075578 6222974 852604 9563 5379 4184 124786 121280 3506 145827 82028 63799 1209150 48829 1160321 125828 70778 55050 192953 108536 84417 469985 120996 348989 4004706 2927784 1076922 160589 6485 154104 MEDICAL SUPPLIES 18722779 16221948 2500831 CORPORATE ALLOCATIONS 12781186 7189417 5591769 BAD DEBT EXPENSE 2735802 2735802 REPAIRS AND MAINTENANCE 1623235 913070 710165 962268 636891 325377 92366502 74136392 18230110 0 2610 5055 13581577 13302680 1488788 1534096 4588 23447 58150292 10702277 50089366 47448015 7540956 11455303 72707885 73768596 1860820 1952331 188800 188800 11328016 10494323 1315796 1294522 14693432 13929976 X 58014453 59838620 58014453 59838620 72707885 73768596 X 21737890 -19913723 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13131 13131 0 PART II-B, LINE 1: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMH) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE AHA AND WHA HAVE NOTIFIED AMH THAT A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE PERCENTAGES OF DUES ATTRIBUTED TO LOBBYING ARE 39.0% FOR THE AHA AND 15.83% FOR WHA FOR DOLLAR AMOUNTS OF $9,226 AND $3,079, RESPECTIVELY. AMH IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). THE RWHC PROVIDES SUPPORT SERVICES FOR SEVERAL ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE AIDING ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES ANALYSIS ON CURRENT HEALTH CARE ISSUES TO PROMOTE AND IMPROVE HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS INCLUDES SOME LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. $826 OR 12.6% OF THESE DUES WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 97909 14562 112471 99056 -1147 97909 97316 1740 99056 145315 -36638 11361 97316 143901 27506 26092 145315 0.00000 1.00000 0.00000 0 1 1 470299 470299 45843567 5903398 39940169 11830451 4798879 7031572 5975 5975 47448015 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 11260859 RELATED PARTY RECEIVABLE 1564 OPERATING LEASE 68196 FINANCE LEASE 124684 11455303 FINANCE LEASE OBLIGATION 129748 OPERATING LEASE OBLIGATION 68196 ASBESTOS LIABILITY 1096578 1294522 X PART V, LINE 4: ENDOWMENT FUNDS HELD BY ASPIRUS HEALTH FOUNDATION, INC.; ANY AMOUNT ABOVE $120,000 MAY BE USED TO PURCHASE ITEMS FOR THE COUNTRY GRAND ASSISTED LIVING FACILITY AT ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. PART X, LINE 2: ASPIRUS HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND CONCLUDED THAT NO MATERIAL LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT JUNE 30, 2025. 1 1 X 1 X 1 X 1 1 1 0 1 1 504054 504054 0.00560 11319300 15944796 0 0.00000 11823354 15944796 504054 0.00560 191797 191797 0.00210 89940 89940 0.00100 209298 209298 0.00230 491035 491035 0.00540 12314389 15944796 995089 0.01100 1 551 551 0.00000 2 556 556 0.00000 1 551 551 0.00000 4 1658 1658 0.00000 1 929758 0 11893764 12355993 -462229 X 1 1 1 1 ASPIRUS MEDFORD HOSPITAL 135 SOUTH GIBSON STREET MEDFORD WI 54451 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 1024 X X X X ASPIRUS MEDFORD HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS X 1 24 1 WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 X X X X X X X 1 1 X X X X 1 X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS MEDFORD HOSPITAL PART V, SECTION B, LINE 5: FOR THE CHNA COMPLETED IN SPRING 2025 (EFFECTIVE JULY 1, 2025), APPROXIMATELY 250 TAYLOR COUNTY RESIDENTS SHARED THEIR PERSPECTIVES ON KEY COMMUNITY HEALTH NEEDS THROUGH AN ANONYMOUS SURVEY, WITH ADDITIONAL INSIGHTS GATHERED FROM LOCAL STAKEHOLDERS. INTENTIONAL OUTREACH EFFORTS ENSURED THAT THE VOICES REPRESENTED IN THIS PROCESS INCLUDED:- INDIVIDUALS AND ORGANIZATIONS ENGAGED IN PUBLIC HEALTH PRACTICE;- MEDICALLY UNDERSERVED POPULATIONS, THOSE WITH LOW INCOME, AND MINORITY GROUPS WITHIN THE HOSPITAL'S SERVICE AREA; AND- REPRESENTATIVES OF THE BROADER COMMUNITY WHO REFLECT THE DIVERSE INTERESTS AND NEEDS OF TAYLOR COUNTY RESIDENTS.THE SURVEY WAS DISTRIBUTED THROUGH MULTIPLE CHANNELS TO MAXIMIZE REACH AND ACCESSIBILITY. IT WAS MADE AVAILABLE BOTH ELECTRONICALLY AND IN PAPER FORM AND WAS PUBLISHED IN THE SHOPPER, A FREE LOCAL PUBLICATION DELIVERED TO EVERY HOUSEHOLD IN TAYLOR COUNTY. IN ADDITION, NUMEROUS PARTNER ORGANIZATIONS INCLUDING PUBLIC LIBRARIES, CHAMBERS OF COMMERCE, THE TAYLOR COUNTY HEALTH DEPARTMENT, AGING AND DISABILITY RESOURCE CENTER (ADRC), SCHOOL DISTRICTS, AND LOCAL COMMUNITY COALITIONS SUPPORTED DISTRIBUTION TO HELP ENSURE BROAD COMMUNITY AWARENESS AND PARTICIPATION.ADDITIONALLY, COMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND AN IN-PERSON PRIORITIZATION MEETING HELD FEBRUARY 5, 2025. COMMUNITY STAKEHOLDERS REPRESENTED A WIDE VARIETY OF SECTORS. STAKEHOLDERS INCLUDED: ADRC OF TAYLOR COUNTY, ASPIRUS MEDFORD HOSPITAL AND CLINICS, CITY OF MEDFORD, FULCRUM FOUNDATION, GILMAN SCHOOL DISTRICT, HEALTHFIRST WIC, KLINNER INSURANCE, MEDFORD AREA PUBLIC SCHOOL DISTRICT, PREVENT SUICIDE TAYLOR COUNTY, RIB LAKE SCHOOL DISTRICT, SALVATION ARMY, SANDBOX CHILDCARE CENTER, TAYLOR COUNTY BOARD, TAYLOR COUNTY DRUG OPPOSITION PARTNERS, TAYLOR COUNTY EMERGENCY MANAGEMENT, TAYLOR COUNTY HEALTH DEPARTMENT, TAYLOR COUNTY HOUSING AUTHORITY, TAYLOR COUNTY HUMAN SERVICES, TAYLOR COUNTY HYBRID TREATMENT COURT, TAYLOR COUNTY SHERIFF'S DEPARTMENT, THE R.E.C. CENTER, UNITED WAY OF TAYLOR COUNTY, VILLAGE OF GILMAN AND THE WOMEN, INFANTS AND CHILDREN PROGRAM. ASPIRUS MEDFORD HOSPITAL PART V, SECTION B, LINE 6B: ASPIRUS MEDFORD HOSPITAL COLLABORATED WITH THE TAYLOR COUNTY HEALTH DEPARTMENT. ASPIRUS MEDFORD HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS MEDFORD HOSPITAL. ASPIRUS MEDFORD HOSPITAL PART V, SECTION B, LINE 11: ASPIRUS MEDFORD HOSPITAL & CLINICS (AMHC) IDENTIFIED FOUR SIGNIFICANT HEALTH PRIORITIES THROUGH ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE PRIORITIES REFLECT THE MOST PRESSING HEALTH CHALLENGES FACING THE COMMUNITY. AMHC ADDRESSES THESE NEEDS THROUGH A COMBINATION OF DIRECT SERVICES, PARTNERSHIPS, COMMUNITY EDUCATION, AND SYSTEM-LEVEL STRATEGIES, AS DESCRIBED BELOW. 1. MENTAL HEALTH MENTAL HEALTH REMAINS A CRITICAL COMMUNITY NEED. AMHC ADDRESSES THIS PRIORITY THROUGH A MULTIFACETED APPROACH FOCUSED ON PREVENTION, ACCESS, AND COMMUNITY COLLABORATION, INCLUDING: - EXPANDING AND PROVIDING ONGOING SUPPORT FOR THE CARES MODEL WITHIN LOCAL SCHOOLS AND INITIATIVES EXTENDING ITS REACH TO COMMUNITY-BASED SETTINGS. - ENHANCING ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH TELEMEDICINE AND STRATEGIC COMMUNITY PARTNERSHIPS. - HOSTING COMMUNITY-WIDE ENGAGEMENT EVENTS SUCH AS THE ASPIRUS-SUPPORTED BE KIND TO YOUR MIND EVENT, WHICH PROVIDES FAMILIES WITH MENTAL HEALTH EDUCATION, RESOURCES, AND POSITIVE COMMUNITY CONNECTION. - PARTNERING WITH THE MEDFORD SCHOOL DISTRICT TO PROVIDE CONTINUING EDUCATION OPPORTUNITIES FOR PROFESSIONALS AND CAREGIVERS ON A VARIETY OF MENTAL AND BEHAVIORAL HEALTH TOPICS. - COLLABORATING WITH THE PREVENT SUICIDE TAYLOR COUNTY COALITION TO INCREASE AWARENESS, EDUCATION, AND PREVENTION EFFORTS RELATED TO SUICIDE AND MENTAL HEALTH. 2. SUBSTANCE MISUSE (ALCOHOL, TOBACCO, VAPING, AND OTHER DRUGS) SUBSTANCE MISUSE, INCLUDING ALCOHOL, VAPING, TOBACCO, AND OPIOID USE, CONTINUES TO IMPACT COMMUNITY HEALTH. AMHC ADDRESSES THIS NEED THROUGH PREVENTION, EDUCATION, AND HARM REDUCTION EFFORTS, INCLUDING: - PARTNERING WITH THE TAYLOR COUNTY DRUG OPPOSITION PARTNERS TO SUPPORT YOUTH-FOCUSED AND COMMUNITY-WIDE EDUCATION CAMPAIGNS AIMED AT PREVENTION AND AWARENESS. - SUPPORTING INITIATIVES DESIGNED TO DECREASE ACCESS TO OPIOIDS AND REDUCE YOUTH USE OF TOBACCO, VAPING PRODUCTS, AND ALCOHOL. - SUPPORTING STUDENT LEADERSHIP EVENTS ACROSS COUNTY SCHOOL DISTRICTS, WHERE STUDENTS DEVELOP LEADERSHIP SKILLS AND LEARN ABOUT THE RISKS ASSOCIATED WITH SUBSTANCE MISUSE, ENABLING THEM TO SHARE PREVENTION MESSAGING WITH THEIR PEERS. - MAINTAINING A MEDICATION DISPOSAL DROP BOX AT THE ASPIRUS MEDFORD PHARMACY TO PROMOTE SAFE DISPOSAL OF UNUSED AND EXPIRED MEDICATIONS. - SUPPORTING COMMUNITY AWARENESS CAMPAIGNS SUCH AS OVERDOSE AWARENESS INITIATIVES AND "ONE PILL CAN KILL" SAFETY MESSAGING TO REDUCE MISUSE AND PREVENT OVERDOSE. 3. HEALTHCARE QUALITY AND ACCESS IMPROVING ACCESS TO HIGH-QUALITY HEALTHCARE SERVICES REMAINS A PRIORITY, PARTICULARLY IN A RURAL SETTING. AMHC ADDRESSES THIS NEED BY: - EXPANDING PRIMARY CARE SERVICES AND OPENING AN URGENT CARE FACILITY TO INCREASE ACCESS TO SAME-DAY AND AFTER-HOURS CARE. - EXPANDING E-VISIT OFFERINGS TO INCLUDE CONDITIONS SUCH AS COLD, FLU, COVID-19 SYMPTOMS, SORE THROAT, INSOMNIA, AND OTHER COMMON HEALTH CONCERNS, ALLOWING PATIENTS TO RECEIVE CARE FROM HOME THROUGH THE MYASPIRUS APP OR WEBSITE. - MAINTAINING SAME-DAY APPOINTMENT AVAILABILITY FOR CLINIC SERVICES WHEN CLINICALLY APPROPRIATE. - CONTINUING TO RECRUIT AND ADD PRIMARY CARE CLINICIANS TO IMPROVE ACCESS TO FAMILY MEDICINE SERVICES IN THE COMMUNITY. - PROMOTING PREVENTIVE CARE AND HEALTH LITERACY THROUGH COMMUNITY EDUCATION AND EVENTS, INCLUDING THE ANNUAL "BOO TO THE FLU" HALLOWEEN-THEMED FLU VACCINATION CLINIC, WHICH ENCOURAGES IMMUNIZATION IN A FAMILY-FRIENDLY AND LESS INTIMIDATING ENVIRONMENT FOR CHILDREN AND ADULTS. 4. COMMUNITY ENGAGEMENT AMHC RECOGNIZES THAT STRONG COMMUNITY CONNECTIONS CONTRIBUTE TO OVERALL HEALTH AND WELL-BEING. TO SUPPORT THIS PRIORITY, THE HOSPITAL: - ENCOURAGES AND SUPPORTS EMPLOYEE VOLUNTEERISM AND CIVIC ENGAGEMENT THROUGHOUT THE COMMUNITY. - PARTNERS WITH LOCAL SCHOOL DISTRICTS TO PROVIDE VOLUNTEER AND SERVICE-LEARNING OPPORTUNITIES FOR STUDENTS. ***********************************NEEDS NOT CURRENTLY ADDRESSED FOR THE CHNA COMPLETED IN FY22 (AND EFFECTIVE IN FY23), ASPIRUS MEDFORD'S TOP PRIORITIES ARE MENTAL HEALTH; SUBSTANCE MISUSE; HEALTHCARE QUALITY AND ACCESS; COMMUNITY ENGAGEMENT. ADDITIONAL ISSUES WERE BROUGHT TO COMMUNITY STAKEHOLDERS FOR REVIEW AND INPUT. THESE WILL NOT BE FORMALLY ADDRESSED THROUGH THE IMPLEMENTATION STRATEGY; HOWEVER, ASPIRUS IS COMMITTED TO CONTRIBUTE TO OPPORTUNITIES TO ADDRESS THESE PRIORITIES AS THEY PRESENT THROUGH COMMUNITY INVESTMENT. THESE ISSUES INCLUDE: - EDUCATION ACCESS & QUALITY SPECIFICALLY, CHILDCARE ACCESS, QUALITY, AND AFFORDABILITY - NEIGHBORHOOD & BUILT ENVIRONMENT INCLUDING OPPORTUNITIES FOR PHYSICAL ACTIVITY AND RECREATION, INTERNET ACCESS AND INFRASTRUCTURE AND TRANSPORTATION - SOCIAL & COMMUNITY CONTEXT - AWARENESS OF COMMUNITY RESOURCES HOSPITAL LEADERS, IN REVIEWING THE TOP NOTED THAT SOCIAL & COMMUNITY CONTEXT AWARENESS OF COMMUNITY RESOURCES WILL BE ADDRESSED AS A PART OF THE STRATEGY TO IMPROVE COMMUNITY ENGAGEMENT. IN ADDITION, AFTER THE SPRING 2022 COMMUNITY STAKEHOLDER INPUT SESSIONS, THE NEED FOR GREATER ACCESS TO QUALITY EDUCATION SPECIFICALLY CHILDCARE ACCESS BECAME A SUBSTANTIAL ISSUE. HOWEVER, HOSPITAL CAPACITY WAS LIMITED, AND HOSPITAL LEADERS SUGGESTED THAT IT WILL SUPPORT COMMUNITY EFFORTS TO IMPROVE CHILDCARE ACCESS, HOWEVER, IT WILL NOT BE ADDRESSED AS A PART OF THE IMPLEMENTATION STRATEGY. FOR THE CHNA AND IS THAT WERE EFFECTIVE JULY 1, 2025 (FOR FY26 AND THE SUBSEQUENT YEARS), ASPIRUS MEDFORD PRIORITIZED MENTAL HEALTH AND SUICIDE PREVENTION; ALCOHOL AND OTHER DRUG USE AND RECOVERY AND SUPPORT; ACCESS AND AFFORDABILITY OF CARE; HEALTHY RELATIONSHIPS, CONNECTEDNESS AND ENGAGEMENT. NEEDS THAT WERE NOT PRIORITIZED (AND THE REASONS FOR NOT BEING PRIORITIZED) ARE BELOW: - TRANSPORTATION - RESOURCE STEWARDSHIP TRANSPORTATION TRANSPORTATION CONSISTENTLY EMERGED AS A SIGNIFICANT BARRIER, PARTICULARLY IN RURAL AREAS WHERE ACCESS TO HEALTHCARE, EMPLOYMENT, AND SOCIAL SERVICES IS OFTEN DEPENDENT ON RELIABLE TRANSIT. COMMUNITY MEMBERS FREQUENTLY CITED TRANSPORTATION CHALLENGES AS A KEY OBSTACLE TO RECEIVING TIMELY AND EQUITABLE CARE. ALTHOUGH TRANSPORTATION FALLS OUTSIDE THE SCOPE OF OUR DIRECT HEALTHCARE DELIVERY MISSION, ASPIRUS MEDFORD RECOGNIZES ITS CRITICAL ROLE IN OVERALL HEALTH OUTCOMES. WE WILL CONTINUE TO SUPPORT AND COLLABORATE WITH LOCAL GOVERNMENT AGENCIES, NONPROFIT ORGANIZATIONS, AND OTHER COMMUNITY STAKEHOLDERS TO EXPLORE CREATIVE, SUSTAINABLE SOLUTIONS. OUR ROLE WILL FOCUS ON CONVENING CONVERSATIONS, ADVOCATING FOR RESOURCES, AND PARTICIPATING IN INITIATIVES THAT SEEK TO IMPROVE TRANSPORTATION ACCESS ACROSS THE REGION. RESOURCE STEWARDSHIP THE THEME OF RESOURCE STEWARDSHIP ENSURING THE EFFICIENT AND EQUITABLE USE AND ACCESS TO LOCAL RESOURCES, SERVICES, AND PROGRAMS WAS ALSO HIGHLIGHTED DURING THE ASSESSMENT. WHILE NOT SELECTED AS A STAND-ALONE PRIORITY, THIS ISSUE WILL BE INTEGRATED INTO OUR BROADER STRATEGY UNDER THE THEME OF ACCESS & AFFORDABILITY OF CARE. SPECIFICALLY, ASPIRUS MEDFORD WILL LOOK FOR OPPORTUNITIES TO ENHANCE COORDINATION AMONG COMMUNITY PARTNERS, REDUCE DUPLICATION OF SERVICES, AND STRENGTHEN OVERALL SYSTEM EFFICIENCY. ASPIRUS MEDFORD REMAILS COMMITTED TO SUPPORTING EFFORTS THAT ALIGN WITH THESE NEEDS THROUGH COMMUNITY INVESTMENTS, PARTNERSHIPS AND ADVOCACY. ASPIRUS MEDFORD HOSPITAL PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. ASPIRUS MEDFORD HOSPITAL PART V, SECTION B, LINE 13H: THE FINANCIAL ASSISTANCE POLICY ALSO ALLOWS FOR AN ADMINSTRATIVE REVIEW FOR CATASTROPHIC OR UNIQUE CIRCUMSTANCES. THIS ADDITIONAL PROVISION ALLOWS FOR ADMINSTRATION TO MAKE A DETERMINATION THAT MAY ASSIST A PATIENT IN A UNIQUE TIME OF FINANCIAL NEED. 11 1 - ASPIRUS MEDFORD CLINIC 143 SOUTH GIBSON STREET MEDFORD WI 54451 OUTPATIENT CLINIC 2 - ASPIRUS THERAPY & FITNESS - MEDFORD 103 SOUTH GIBSON STREET MEDFORD WI 54451 THERAPY FITNESS CENTER 3 - ASPIRUS PHARMACY - MEDFORD 139 SOUTH GIBSON STREET MEDFORD WI 54451 RETAIL PHARMACY 4 - ASPIRUS CARE & REHAB 135 SOUTH GIBSON STREET MEDFORD WI 54451 SKILLED NURSING FACILITY 5 - ASPIRUS KIDNEY CARE - MEDFORD 111 SOUTH GIBSON STREET MEDFORD WI 54451 DIALYSIS CENTER 6 - ASPIRUS PRENTICE CLINIC 1511 RAILROAD AVENUE PRENTICE WI 54456 OUTPATIENT CLINIC 7 - ASPIRUS THERAPY - PRENTICE 619 BRIDGE STEET PRENTICE WI 54456 THERAPY FITNESS CENTER 8 - ASPIRUS COUNTRY GARDENS 635 WEST CEDAR STREET MEDFORD WI 54451 ASSISTED LIVING CENTER 9 - ASPIRUS ATHENS CLINIC 729 PINE STREET ATHENS WI 54411 OUTPATIENT CLINIC 10 - ASPIRUS PHILLIPS CLINIC 625 PETERSON AVENUE PHILLIPS WI 54555 OUTPATIENT CLINIC 11 - ASPIRUS GILMAN CLINIC 320 EAST MAIN STREET GILMAN WI 54433 OUTPATIENT CLINIC PART I, LINE 3C: THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY). SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS WHERE RETIREMENT WITHDRAWALS HAVE NOT BEGUN AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990, SCHEDULE H 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 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 FOR FORM 990. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24E, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $2,735,802. PART II, COMMUNITY BUILDING ACTIVITIES: ASPIRUS MEDFORD SUPPORTED A DOWN SYNDROME AWARENESS EVENT AND ALSO PARTICIPATED IN A COMMUNITY COLLABORATION MEETING. BOTH OF THOSE WORK TO ENHANCE COMMUNITY SUPPORT FOR LOCAL NETWORKS AND POSITIVE COMMUNITY ENGAGEMENT. SOCIAL NETWORKS AND COMMUNITY ENGAGEMENT ARE POSITIVE PROTECTIVE FACTORS. ASPIRUS MEDFORD HOSPITAL SUPPORTED THE NATIONAL NIGHT OUT. NATIONAL NIGHT OUT PROMOTES POLICE-COMMUNITY PARTNERSHIPS AND NEIGHBORHOOD CAMARADERIE. HAVING A SAFE COMMUNITY REDUCES STRESS AND ENCOURAGES HEALTHY OUTDOOR ACTIVITIES. 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 RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. 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 3: THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. 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 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 RECEIVABLES 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 REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY 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 STATEMENTS 2. COLLECTION LETTERS INCLUDING PLAIN LANGUAGE SUMMARY (PLS) 3. COLLECTION PHONE CALLS 4. VERIFICATION THAT CHARITY CARE WAS OFFERED WITHIN THE PAST 12-MONTHS AS RECORDED IN THE ELECTRONIC HEALTH RECORD (EMR) WITH STAFF HAVING THE DISCRETION TO OFFER AGAIN WITHIN THE 12-MONTHS. III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. 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 THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE LAST PATIENT PAYMENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. B. BAD DEBT RECOVERIES 1. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. 2. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. 3. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED TWO TIMES MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE SUBMITTED TO ACCOUNTS PAYABLE AND APPROVED BY THE DIRECTOR FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. 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 THE HOSPITAL 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, 2025, 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).MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: PATIENT FINANCIAL SERVICES (PFS) PROACTIVELY IDENTIFIES UNINSURED PATIENTS AND UNDER-INSURED PATIENTS AND SCREENS THEM FOR FINANCIAL ASSISTANCE AND COUNSELING WITHOUT REGARD TO RACE, ETHNICITY, GENDER, RELIGION, OR NATIONAL ORIGIN. THESE SERVICES ARE PROVIDED AT NO CHARGE. PFS COUNSELORS WORK WITH UNINSURED AND UNDER-INSURED PATIENTS TO HELP THEM UNDERSTAND THE SYSTEM'S FINANCIAL ASSISTANCE/DISCOUNTING POLICIES AND HOW THEY CAN QUALIFY FOR ASSISTANCE AND/OR DISCOUNTS INCLUDING A REFERRAL TO PUBLIC AND PRIVATE PROGRAMS TO DETERMINE ELIGIBILITY. PART VI, LINE 2: IN ADDITION TO ASSESSING COMMUNITY NEEDS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL TAKES A MULTIFACETED APPROACH TO IDENTIFYING AND ADDRESSING PATIENT AND COMMUNITY PRIORITIES. KEY ACTIONS INCLUDE:PATIENT-CENTERED INSIGHTS: SYSTEMATICALLY REVIEWING PATIENT EXPERIENCE DATA TO IDENTIFY OPPORTUNITIES FOR ADDRESSING CONCERNS AND ENHANCING CARE DELIVERY.ENGAGED GOVERNANCE: MAINTAINING AN ACTIVE LOCAL BOARD OF DIRECTORS THAT MEETS QUARTERLY. MEMBERS REPRESENT DIVERSE SECTORS, INCLUDING BANKING, LOCAL BUSINESSES, AND COMMUNITY SERVICE ORGANIZATIONS, ENSURING VARIED PERSPECTIVES INFORM HOSPITAL DECISION-MAKING.COMMUNITY INTEGRATION: ENCOURAGING AND SUPPORTING STAFF PARTICIPATION ON COMMUNITY BOARDS, COALITIONS, AND COMMITTEES, ENABLING THE HOSPITAL TO STAY ATTUNED TO LOCAL CHALLENGES AND OPPORTUNITIES.FUNDING AS A NEEDS INDICATOR: REGULARLY REVIEWING FUNDING REQUESTS SUBMITTED TO THE HOSPITAL OR HOSPITAL FOUNDATION TO GAIN ADDITIONAL INSIGHTS INTO UNMET COMMUNITY NEEDS.SOCIAL NEEDS SCREENING: LAUNCHING A SOCIAL NEEDS SCREENING PROCESS TO BETTER UNDERSTAND PATIENT CHALLENGES BEYOND IMMEDIATE MEDICAL CARE, FOSTERING A MORE HOLISTIC APPROACH TO HEALTH AND WELL-BEING OVER TIME.THESE STRATEGIES DEMONSTRATE THE HOSPITAL'S COMMITMENT TO BEING A PROACTIVE AND RESPONSIVE PARTNER IN ADVANCING COMMUNITY HEALTH. PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS HOW TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS SENT FROM THE FINANCIAL CLEARANCE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS WHEN REQUESTED OR DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO ASSIST ALL UNINSURED PATIENTS WITH SCREENING AND APPLYING FOR MEDICAL ASSISTANCE. PART VI, LINE 4: THE PRIMARY SERVICE AREA OF THE HOSPITAL IS TAYLOR COUNTY, ALTHOUGH IT DOES SERVE NEIGHBORING COUNTIES INCLUDING PRICE. TAYLOR COUNTY IS A RURAL COUNTY IN CENTRAL WISCONSIN. IT COVERS 975 SQUARE MILES, WITH 20.4 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 19,913 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER 18 YEARS OLD: 23.3%PERSONS 65 YEARS AND OVER: 20.7%WHITE PERSONS: 94.8%AFRICAN AMERICAN PERSONS: <1%AMERICAN INDIAN PERSONS: >1%ASIAN PERSONS: <1%TWO OR MORE RACES: 3.0%HISPANIC OR LATINO: 2.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 4.9%HIGH SCHOOL GRADUATE OR HIGHER: 90.2%PERSONS BELOW POVERTY LEVEL: 9.3%MEDIAN HOUSEHOLD INCOME: $63,142PERCENT UNINSURED: 7.3%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS' BENEFITS, ETC.): 37.1%NUMBER OF HOSPITALS IN THE COUNTY: 1 (INCLUDING ASPIRUS MEDFORD HOSPITAL)TAYLOR COUNTY IS A DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR MENTAL HEALTH AND PRIMARY CARE.TAYLOR COUNTY INCLUDES A POPULATION OF INDIVIDUALS FROM THE AMISH, MENNONITE, GERMAN BAPTIST, AND OLD GERMAN BAPTIST RELIGIONS (OFTEN REFERRED TO COLLECTIVELY AS THE PLAIN COMMUNITY OR PLAIN PEOPLE). THE PLAIN PEOPLE ALSO REQUIRE SPECIAL CONSIDERATION BY ASPIRUS MEDFORD AND THE HEALTH DEPARTMENTS BECAUSE OF THEIR NON-MAINSTREAM LIFESTYLE. DEPENDING ON THE FAITH, BELIEFS MAY INFLUENCE THE USE OF PREVENTIVE HEALTH CARE, TREATMENT FOR ILLNESSES AND INJURIES, USE OF INSURANCE, USE OF ELECTRICITY, TRANSPORTATION, AND VARIOUS OTHER FACETS OF DAILY LIFE. PART VI, LINE 5: COMMITMENT TO EXCELLENCE: THE HOSPITAL PROVIDES HIGH-QUALITY SERVICES AND IS DEDICATED TO CONTINUOUS IMPROVEMENT THROUGH ONGOING QUALITY INITIATIVES, ENSURING PATIENTS RECEIVE THE BEST POSSIBLE CARE.INVESTMENT IN TECHNOLOGY: IT PRIORITIZES BUDGETING FOR STATE-OF-THE-ART TECHNOLOGIES AND EQUIPMENT, ENSURING THAT PATIENTS BENEFIT FROM THE LATEST ADVANCEMENTS IN MEDICAL CARE.SUPPORTIVE SERVICES: RECOGNIZING BARRIERS TO CARE, THE HOSPITAL OFFERS TRANSPORTATION ASSISTANCE TO PATIENTS WHEN NEEDED, HELPING ENSURE ACCESS TO ESSENTIAL SERVICES.ADVANCING THE HEALTHCARE WORKFORCE: BY SERVING AS PRECEPTORS FOR STUDENTS IN HEALTH PROFESSIONS, THE HOSPITAL PLAYS A CRITICAL ROLE IN TRAINING THE NEXT GENERATION OF HEALTHCARE PROVIDERS, CONTRIBUTING TO A STRONGER, MORE PREPARED WORKFORCE.COMMUNITY COLLABORATION: THE EMERGENCY DEPARTMENT MEETS REGULARLY WITH LAW ENFORCEMENT AND HUMAN SERVICES AND OTHER SUPPORT AGENCIES TO BEST SERVE PATIENTS (PARTICULARLY PATIENTS WITH MENTAL ILLNESS) AND THE COMMUNITY. THESE INITIATIVES HIGHLIGHT THE HOSPITAL'S UNWAVERING COMMITMENT TO BEING A CORNERSTONE OF HEALTH AND SUPPORT WITHIN THE COMMUNITY, STRIVING TO ADDRESS BOTH IMMEDIATE AND LONG-TERM NEEDS.AS PART OF A LARGER NETWORK OF ASPIRUS HEALTHCARE FACILITIES, THE HOSPITAL HAS ACCESS TO: - LOW-COST TEMPORARY LODGING AT ASPIRUS' FLAGSHIP TERTIARY CARE HOSPITAL PARTNER (IN WAUSAU, WI) SO THAT PATIENTS AND/OR THEIR FAMILY NEEDING EXTENDED SPECIALTY CARE HAVE ACCOMMODATIONS. - PROFESSIONAL DEVELOPMENT FOR STAFF, ASSURING THE CARE PROVIDED INCORPORATES THE MOST UP-TO-DATE BEST PRACTICES. - CROSS-TRAINING OPPORTUNITIES. FOR INSTANCE, A WAUSAU-BASED BEREAVEMENT COORDINATOR TRAINS STAFF ACROSS THE SYSTEM ON NORMAL GRIEF RESPONSE, RESILIENCE AND HOSPICE CARE AND SUPPORT. THE COORDINATOR TRAINS THROUGH THE NURSE RESIDENCY PROGRAM AS WELL AS IN UNIT/DEPARTMENT MEETINGS. UNIT/DEPARTMENT LEADERS CAN REQUEST BEREAVEMENT INFORMATION AND SUPPORT FOR THEIR TEAM. SIMILARLY, HOSPITALS HAVE ACCESS TO INJURY PREVENTION EXPERTISE AND RESOURCES THROUGH THE LEVEL 2 TRAUMA CENTER IN WAUSAU. - A MARKETING/COMMUNICATIONS TEAM THAT SUPPORTS THE ONLINE ASPIRUS MEDIA CENTER FEATURING MEDICAL EXPERTS. THE TEAM DEVELOPS AND PROMOTES HEALTH EDUCATION INFORMATION (E.G., ON DIABETES, TICK BITES, SNOWMOBILE SAFETY) FOR PATIENTS AND THE GENERAL PUBLIC. PART VI, LINE 6: ASPIRUS HEALTH IS A NONPROFIT, COMMUNITY-DIRECTED HEALTH SYSTEM BASED IN WAUSAU, WISCONSIN, SERVING NORTHEASTERN MINNESOTA, NORTHERN AND CENTRAL WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. THE HEALTH SYSTEM OPERATES 17 HOSPITALS AND 130 OUTPATIENT LOCATIONS WITH NEARLY 14,000 TEAM MEMBERS, INCLUDING 1,300 EMPLOYED PHYSICIANS AND ADVANCED PRACTICE CLINICIANS. ASPIRUS SERVES COMMUNITIES THROUGH HOME HEALTH AND HOSPICE CARE, PHARMACIES, CRITICAL CARE AND AIR-MEDICAL TRANSPORT, MEDICAL GOODS, AND ADULT LIVING AND CARE FACILITIES. THE COMBINED EFFORTS PROVIDE RURAL COMMUNITIES WITH THE ACCESS TO CARE THAT THEY MAY NOT OTHERWISE BE ABLE TO HAVE. FOR MORE INFORMATION, VISIT ASPIRUS.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 MEDFORD AREA PUBLIC SCHOOL DISTRICT 124 W STATE STREET MEDFORD WI 54451 390992246 GOVERNMENT 70774 0 TO SUPPORT THE MEDFORD AREA PUBLIC SCHOOL DISTRICT CARES PROGRAM WHICH ADDRESSES SOCIAL, EMOTIONAL, BEHAVIORAL AND MENTAL HEALTH IN ADDITION TO FITNESS CENTER IMPROVEMENTS AND OTHER MENTAL HEALTH INITIATIVES. THE REC CENTER 422 LEILA STREET MEDFORD WI 54451 993602422 501(C)(3) 30000 0 TO SUPPORT THE ADDITION OF A COMMUNITY LEARNING SPACE AND PROGRAMMING AT THE REC CENTER. RIB LAKE SCHOOL DISTRICT 1236 KENNEDY STREET RIB LAKE WI 54470 396004128 GOVERNMENT 25000 0 TO SUPPORT THE RIB LAKE SCHOOL DISTRICT CARES PROGRAM WHICH ADDRESSES SOCIAL, EMOTIONAL, BEHAVIORAL AND MENTAL HEALTH. PHILLIPS SCHOOL DISTRICT 990 FLAMBEAU AVENUE PO BOX 70 PHILLILPS WI 54555 396008030 GOVERNMENT 25000 0 TO SUPPORT THE PHILLIPS SCHOOL DISTRICT CARES PROGRAM WHICH ADDRESSES SOCIAL, EMOTIONAL, BEHAVIORAL AND MENTAL HEALTH GILMAN SCHOOL DISTRICT 325 N 5TH AVENUE GILMAN WI 54433 396002230 GOVERNMENT 25000 0 TO SUPPORT THE GILMAN SCHOOL DISTRICT CARES PROGRAM WHICH ADDRESSES SOCIAL, EMOTIONAL, BEHAVIORAL AND MENTAL HEALTH. 5 0 PART I, LINE 2: GRANTS ARE PROVIDED TO SUPPORT COMMUNITY PARTNERS AND NON-PROFITS THAT THE HOSPITAL AND ASPIRUS, INC. DETERMINES. GRANTS PROVIDED ARE GENERAL SUPPORT SO THERE IS NOT A FORMAL PROCESS FOR MONITORING USE OF GRANT FUNDS. HOWEVER, PRIOR TO PROVIDING ANY GRANT, THE HOSPITAL IS AWARE OF WHAT THE INTENDED USE WILL BE. 1 1 0 0 0 0 0 1 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1523574 0 2122736 0 222424 0 10350 0 351090 0 4230174 0 198152 SIDNEY SCZYGELSKI SVP OF FINANCE/CFO (FORMER) 0 418918 0 474490 0 576633 0 9284 0 28706 0 1508031 0 481861 MICHAEL HOLZHUETER SVP-CHIEF HR OFFICER 0 632337 0 239983 0 7505 0 10350 0 125990 0 1016165 0 0 DAVID VANDERKIN RADIOLOGIST 943955 0 0 0 8564 0 10350 0 26919 0 989788 0 0 0 CONSTANCE BRADLEY B.M./SVP & PRES. REG. MRKTS 0 557181 0 172222 0 57121 0 10350 0 115419 0 912293 0 52586 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 508507 0 193167 0 61812 0 10350 0 107316 0 881152 0 56910 JAMES MATHESON VICE CHAIR/SVP-CHIEF STRATEGY OFF. 0 486205 0 186599 0 72384 0 8565 0 106951 0 860704 0 58001 JENNIFER REDMAN-SCHELL SVP & PRESIDENT-AMG 0 524479 0 198502 0 4398 0 10350 0 94801 0 832530 0 0 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 0 616776 0 25000 0 35464 0 10350 0 128044 0 815634 0 0 WILL WEIDER SVP-CHIEF INFORMATION OFFICER 0 472935 0 180578 0 7157 0 2778 0 103017 0 766465 0 0 JESSE TISCHER SVP & PRESIDENT-AWH (FORMER) 0 29283 0 73104 0 630592 0 2566 0 3289 0 738834 0 0 CLINT SEMRAU PHYSICIAN 667641 0 0 0 5800 0 10350 0 41158 0 724949 0 0 0 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 0 454003 0 109647 0 2193 0 2636 0 96945 0 665424 0 0 SUSAN SCHNEIDER B.M./VP-SYSTEM SR. PHYSICIAN EXEC. 0 459962 0 116101 0 4692 0 10350 0 25557 0 616662 0 0 DAVID BITTNER SVP-ENTERPRISE DEVELOPMENT 0 402065 0 25000 0 16617 0 10350 0 110472 0 564504 0 0 DALE HUSTEDT (NV) PRES.-NW WI DIV. (THRU 10/24) 239682 0 146833 0 117422 0 10315 0 25017 0 539269 0 85366 0 RICHARD MAYRER PHYSICIAN 478331 0 0 0 6488 0 10350 0 38255 0 533424 0 0 0 RYAN CHECK PHYSICIAN 419058 0 0 0 45404 0 9730 0 37957 0 512149 0 0 0 SHIRIN SULTANA PHYSICIAN 408935 0 0 0 45810 0 4639 0 38814 0 498198 0 0 0 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 244957 0 149328 0 61332 0 10350 0 31536 0 497503 0 0 JASON TROXELL (NV) PRESIDENT-ASPIRUS NW WI DIV. 0 199058 0 36949 0 643 0 7312 0 70509 0 314471 0 0 DIANE ANDERSON BOARD MEMBER/NURSE PRACTITIONER 0 265296 0 0 0 6449 0 8204 0 31612 0 311561 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B AMHC SPONSORS A NONQUALIFIED TAX EQUALIZED ANNUITY PLAN COVERING EMPLOYED PHYSICIANS. PHYSICIANS ARE ELIGIBLE TO PARTICIPATE IN THE PLAN AFTER ONE YEAR OF SERVICE. PARTICIPANTS IN THE PLAN ARE IMMEDIATELY 100% VESTED. SCHEDULE J, PART I, LINE 4A - SEVERANCE PAYMENT: J. TISCHER $569,088 W. CARROLL $41,555 SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $481,861 M. HEYWOOD $198,152 D. HUSTEDT $85,366 J. MATHESON $58,001 M. WALTERS $56,910 C. BRADLEY $52,586 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: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. 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; 24 MONTHS FROM 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. PART I, LINE 7 SHORT-TERM AND LONG-TERM INCENTIVE BONUSES ARE CALCULATED USING AN OBJECTIVE FORMULA THAT INCLUDES FISCAL YEAR MEASURES APPROVED BY THE BOARD IN AREAS OF CLINICAL QUALITY AND SERVICE, EMPLOYEE SATISFACTION, AND FINANCIAL PERFORMANCE. IN ADDITION, TARGETED RETENTION BONUSES MAY BE IMPLEMENTED TO ENSURE KEY TALENT REMAINS IN PLACE TO MEET STRATEGIC DEMANDS. ALL INCENTIVE PAYMENTS ARE EXAMINED FOR REASONABLENESS AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD FOR DISQUALIFIED PERSONS OR THROUGH EXECUTIVE MANAGEMENT AND ASPIRUS' HUMAN RESOURCE FUNCTION (FOR NON-DISQUALIFIED PERSONS). A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97710B7X4 2013-04-12 16902595 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 A 5615000 16902595 198812 16703783 2016 1 0 1 1 A 0 1 1 0 0 0.00890 0.00100 0.00990 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2013 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (EIN 39-0964813); ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC. (EIN 38-2908586); AND LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429). A PORTION OF THE ASPIRUS WAUSAU HOSPITAL, INC. SERIES 2013 BONDS REFINANCED ALL SERIES 2000 BONDS AND THE ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. PORTION OF THESE BONDS ARE REFINANCING SERIES 2009 (REFINANCING A PORTION OF SERIES 2004 AND SERIES 1998 BONDS). INFORMATION REGARDING THE SERIES 2013 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION, RESPECTIVELY. FOR EACH ENTITY THAT BORROWED FUNDS, THE INFORMATION REPORTED IN PART I, PART II AND PART III OF SCHEDULE K RELATES ONLY TO THE PORTION OF THE SERIES 2013 BONDS LOANED TO THE ORGANIZATION, RESPECTIVELY. FOR EACH ENTITY THAT BORROWED FUNDS, THE INFORMATION REPORTED IN PART IV OF SCHEDULE K RELATES TO THE ENTIRE ISSUE OF THE SERIES 2013 BONDS. SCHEDULE K, PART III, LINES 3A AND 3B: ASPIRUS, INC., A MEMBER OF ASPIRUS MEDFORD HOSPITAL & CLINICS, INC., HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW MANAGEMENT AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCE PROPERTY. ON A CONTRACT-BY-CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. PART III, LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. 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 7A THERE SHALL BE A MINIMUM OF 10 VOTING DIRECTORS ALLOCATED AS FOLLOWS. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS, TWO ASPIRUS CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., TWO PROVIDER CLASS DIRECTOR NOMINATED BY THE CORPORATION'S BOARD AND ELECTED BY ASPIRUS, INC. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBIT CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 990-T ARE REVIEWED 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 PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. RELIES ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, EXPLANATION OF HOURS WORKED: SOME OFFICERS AND DIRECTORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS -19,913,723. 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