2026-05-14T07:55:04-05:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-07-01 383236977 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC ASPI 9062656121 1400 W ICE LAKE RD IRON RIVER MI 49935 LORI PECK INTERIM CFO 7158472118 2026-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-04-21 2024 2025-03-06 01:10:19Z MATTHEW HEYWOOD 1400 W ICE LAKE RD IRON RIVER MI 49935 45371576 0 X WWW.ASPIRUS.ORG X 1995 MI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 12 6 201 20 14641 11021 465337 79976 40468536 45100829 99402 51349 136464 137933 41169739 45370087 242 0 0 0 16468739 16792797 0 0 0 25314957 27226843 41783938 44019640 -614199 1350447 27103194 25259639 19698790 3987991 7404404 21271648 X WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 32442690 0 45086188 ASPIRUS IRON RIVER HOSPITAL (AIR) PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. AIR HAD 432 INPATIENT AND SWING BED DISCHARGES AND 1,825 INPATIENT DAYS ALONG WITH 7,999 EMERGENCY DEPARTMENT VISITS WITH AN EMERGENCY PROVIDER STAFFED 24/7. AIR HAS 2 PROVIDER CLINICS, ONE ON THE HOSPITAL CAMPUS AND ONE LOCATED 15 MILES AWAY IN CRYSTAL FALLS, MI., BOTH PROVIDED 19,465 PATIENT VISITS IN 2025. THE HOSPITAL HAS FULLY FUNCTIONING LAB AND RADIOLOGY DEPARTMENTS THAT ARE SUPPLEMENTED BY A MOBILE MRI UNIT THAT VISITS THE HOSPITAL CAMPUS TWO TIMES A WEEK. BOTH IP AND OP SURGERIES ARE PERFORMED WITH TOTAL OR CASES OF 647 IN 2025. BECAUSE OF REGIONAL AFFILIATION, AIR IS ALSO ABLE TO PROVIDE ORTHOPEDIC, CARDIOLOGY, BEHAVIORAL HEALTH, WOUND CARE, VASCULAR, PODIATRY AND ONCOLOGY SERVICES. 32442690 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 201 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X LORI PECK 7158472118 2200 WESTWOOD DRIVE WAUSAU WI 54401 JOHN D MATONICH CHAIR 1.00 2.00 X X 0 0 0 JENNIFER REDMAN-SCHELL VICE CHAIR/SVP & PRESIDENT-AMG 1.00 50.00 X X 0 727379 105151 KIRK SCHOTT TREASURER (THRU 12/24) 1.00 3.00 X X 0 0 0 KATIE CLARK SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 HANNAH GOODMAN BOARD MEMBER 1.00 2.00 X 0 0 0 RICHARD KOUBEK PHD BOARD MEMBER 1.00 2.00 X 0 0 0 CHARLY LOPER BOARD MEMBER 1.00 2.00 X 0 0 0 ROBIN MENEZUGGO BOARD MEMBER 1.00 2.00 X 0 0 0 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 1.00 40.00 X 0 962327 50605 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRES. REG. MKTS. 1.00 50.00 X 0 786524 125769 DANIEL LUKES DO BOARD MEMBER/PHYSICIAN 1.00 50.00 X 0 807264 41045 LORI PECK BOARD MEMBER/VP-FINANCE 1.00 50.00 X 0 539795 11487 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 1.00 50.00 X 0 471847 51071 PATRICK TINCHER JR BOARD MEMBER/VP-FIN REG OPS (THRU 01/24) 1.00 50.00 X 0 369291 50390 KRISTEN MESKE NP-C BOARD MEMBER/NP (THRU 09/24) 40.00 1.00 X 161684 0 4057 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 CHRISTINE HARFF (NV) PRESIDENT-UP REGION (THRU 11/24) 1.00 50.00 X 0 421827 34131 NATALIE SEABER (NV)PRES.-ASP. MI REG. (BEG MAY '25) 1.00 40.00 X 0 0 0 MICHAEL HOLZHUETER SVP-CHIEF HR OFFICER 2.00 50.00 X 0 879825 136340 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 763486 117666 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 745188 115516 WILL WEIDER SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 660670 105795 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 565843 99581 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 580755 35907 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 455617 41886 THOMAS POWELL VP-CHIEF MEDICAL INFO OFFICER 2.00 50.00 X 0 439263 18469 DONALD PATTON PHYSICIAN 40.00 X 225876 0 35877 KRISTINE FLOWERS PHYSICIAN 40.00 X 231431 0 48013 CARLOS CONDADO CRNA 40.00 X 268701 0 36894 AMY NIELSEN PHYSICIAN 40.00 X 350304 0 20151 MEDHAT FANOUS PHYSICIAN 40.00 X 636223 0 44876 SIDNEY SCZYGELSKI SVP OF FINANCE/CFO (FORMER) 2.00 50.00 X 0 1470041 37990 JESSE TISCHER SVP & PRESIDENT-AWH (FORMER) 0.00 0.00 X 0 732979 5855 1874219 16925895 1874356 34 1 1 0 INNOVA EMERGENCY SERVICES 700 N COLORADO BLVD SUITE 109 DENVER CO 80206 EMERGENCY DEPT PROVIDERS 2618145 TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 CONTRACTED RN STAFFING 458683 TELEHEALTH SOLUTIONS PLLC PO BOX 950505 ST LOUIS MO 63195 LOCUM DOCTOR 434150 ORTHOPEDIC SOLUTIONS N10565 GRANDVIEW LN IRONWOOD MI 49938 LOCUM DOCTOR 386149 UPPER PENINSULA HEALTH CARE SOLUTIONS 853 W WASHINGTON MARQUETTE MI 49855 MOBILE MRI SERVICES 299608 8 79976 79976 PATIENT SERVICE REVENUE 621110 43920591 43920591 PHARMACY REVENUE 456110 1117630 1117630 CONTRACT SERVICE REVENUE 621110 47967 47967 LAB REVENUE 621500 14641 14641 45100829 48558 48558 75649 0 75649 75649 75649 4280 0 1489 4280 -1489 2791 2791 CAFETERIA SALES 621990 62284 62284 62284 45370087 45086188 14641 189282 X 13674827 11544289 2130538 398701 313778 84923 1834382 1443659 390723 884887 696406 188481 17937 17937 4944 4944 1947 1947 6863953 4438232 2425721 13295 8597 4698 39112 37770 1342 6896 4459 2437 637485 66808 570677 72967 47180 25787 2594 1677 917 826635 826635 1751224 598218 1153006 199537 20911 178626 CORPORATE ALLOCATIONS 6382989 3347194 3035795 MEDICAL SUPPLIES 5740128 5543242 196886 HOSPITAL ASSESSMENT TAX 2207265 2207265 BAD DEBT EXPENSE 1282316 1282316 1175619 840689 334930 44019640 32442690 11576950 0 1647884 2449874 186982 205973 6479023 5132261 910664 915580 141671 157180 49529462 33609437 17219889 15920025 517081 478746 27103194 25259639 768597 1014164 15915000 0 3015193 2973827 19698790 3987991 X 7404404 21271648 7404404 21271648 27103194 25259639 X 1350447 12525 12504272 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4944 4944 0 PART II-B, LINE 1: MEMBERSHIP DUES ARE PAID TO THE MICHIGAN HOSPITAL ASSOCIATION (MHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA). A PORTION OF THOSE DUES ARE COMMITTED TO LOBBYING PURPOSES. MHA INVOICE STATES 9.87% OF $10,857 ($1,072) GOES FOR LOBBYING ON INVOICE COVERING THE PERIOD OF 7/1/24-6/30/25. SIMILARLY, AHA DUES COMMITTED TO LOBBYING WAS 39.00% OF $9,927 ($3,872). 210026 210026 35487836 21972085 13515751 13797873 11637352 2160521 33727 33727 15920025 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2760089 LONG TERM PENSION 125713 FINANCE LEASE LIABILITY 87763 DEFERRED POSTRETIREMENT BENEFITS 262 2973827 X 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 0 1 1 270870 270870 0.00630 8880979 5681367 3199612 0.07490 9151849 5681367 3470482 0.08120 40802 40802 0.00100 11305 11305 0.00030 6309817 6171279 138538 0.00320 11983 11983 0.00030 6373907 6171279 202628 0.00480 15525756 11852646 3673110 0.08600 1 443778 0 8565889 8648750 -82861 X 1 1 1 1 ASPIRUS IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 WWW.ASPIRUS.ORG 1060000150 X X X X ASPIRUS IRON RIVER HOSPITAL & CLINICS I 1 0 0 1 X X X X X X X X X 24 1 1 0 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 IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 5: THE FOLLOWING DESCRIPTION IS FOR THE CHNA COMPLETED IN FY25 (SPRING 2025). ASPIRUS INVITED OVER 50 KEY STAKEHOLDERS FROM THE UPPER PENINSULA AND NORTHERN WISCONSIN TO PARTICIPATE IN AT LEAST ONE OF TWO LISTENING SESSIONS HELD IN MARCH 2025. A CONCERTED EFFORT WAS MADE TO ENSURE THAT THE STAKEHOLDERS REPRESENTED THE NEEDS AND PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, HAVE LOW INCOME, OR ARE CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED. KEY INFORMANTS PROVIDING INPUT ON THE TOP ISSUES INCLUDED REPRESENTATIVES FROM MULTIPLE SECTORS AND GROUPS: GOVERNMENTAL PUBLIC HEALTH; SUBSTANCE USE; BASIC NEEDS (E.G., HOUSING, FOOD INSECURITY); LOCAL GOVERNMENT; EARLY CHILDHOOD; EDUCATION AND YOUTH DEVELOPMENT; LONG TERM CARE; AGING; EDUCATION; COMMUNITY AND ECONOMIC DEVELOPMENT; BEHAVIORAL HEALTH; HEALTHCARE; SOCIAL SERVICES. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 6A: FOR THE CHNA COMPLETED IN FY25 (SPRING 2025), THE HOSPITAL COLLABORATED WITH ASPIRUS KEWEENAW HOSPITAL AND ASPIRUS IRONWOOD HOSPITAL. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 11: IN FY25, ASPIRUS CONTINUED TO IMPLEMENT BOTH CROSS-ORGANIZATIONAL AS WELL AS LOCAL STRATEGIES. CROSS-ORGANIZATIONAL STRATEGIES ARE IMPLEMENTED (AS APPROPRIATE) LOCALLY BUT BENEFIT FROM THE EXPERTISE AND STRUCTURE AVAILABLE WITHIN THE SYSTEM. DESCRIPTIONS BELOW REFLECT BOTH CROSS-ORGANIZATIONAL AND LOCAL STRATEGIES. IN FY25, THE HOSPITAL'S SIGNIFICANT NEEDS WERE: MENTAL HEALTH; SUBSTANCE USE; CHRONIC DISEASES. TO ADDRESS THESE NEEDS, THE HOSPITAL AND/OR CLINIC: - CONDUCTED DEPRESSION SCREENING WITH PATIENTS. - PROVIDED ACCESS TO ADDICTION-RELATED TREATMENT, INCLUDING SUBOXONE. - FACILITATED REFERRALS TO LOCAL NON-PROFIT BEHAVIORAL HEALTH SERVICES ORGANIZATIONS FOR PATIENTS WITH SIGNIFICANT MENTAL HEALTH AND SUBSTANCE USE ISSUES. - FACILITATED A MONTHLY DIABETES SUPPORT GROUP. THE GROUP STARTED IN FEBRUARY 2023 AND AVERAGES ABOUT FIVE PEOPLE PER SESSION. - PROVIDED NUTRITION INFORMATION AT IRON COUNTY ON THE MOVE WELLNESS WEDNESDAY (A REGULAR INFORMATION SESSION SPONSORED BY THE IRON AREA HEALTH FOUNDATION). - PROVIDED FREE SPORTS PHYSICALS TO AREA STUDENTS. APPROXIMATELY 120 STUDENTS WERE SERVED. - PROVIDED FUNDING FOR PHOENIX HOUSE. PHOENIX HOUSE PROVIDES RESIDENTIAL AND OUTPATIENT SERVICES FOR INDIVIDUALS SEEKING RECOVERY FROM ADDICTION. THIS FUNDING HELPED LAY THE GROUNDWORK FOR A PEER RECOVERY PROGRAM IN THE UPPER PENINSULA OF MICHIGAN. - PROVIDED FUNDING TO THE IRON AREA HEALTH FOUNDATION, OUR PLACE COMMUNITY CENTER AND THE SUPERIOR HEALTH FOUNDATION. - PROVIDED TIME AND EXPERTISE TO THE IRON AREA HEALTH FOUNDATION, MICHIGAN TECH ADVISORY BOARD, AND THE NMU STUDENT LEADERSHIP FELLOWSHIP PROGRAM. - PROVIDES SEXUAL ASSAULT NURSE EXAMINER SERVICES.- INITIATED (THROUGH ASPIRUS AT THE SYSTEM LEVEL) A HEALTHY FOOD HOME-DELIVERY PROGRAM THAT HELPS PEOPLE MANAGE DIABETES THROUGH HEALTHY EATING. THE PROGRAM, NOURISHEDRX, IS BEING IMPLEMENTED THROUGH ASPIRUS AT HOME (HOME HEALTH). NOURISHEDRX UTILIZES THE CONCEPT OF "FOOD AS MEDICINE," RECOGNIZING THAT HEALTHY EATING CAN SIGNIFICANTLY IMPACT HEALTH OUTCOMES. IN FY25, 72 PATIENTS PARTICIPATED. - CONTINUED IMPLEMENTING A SOCIAL NEEDS SCREENING PROCESS THAT, OVER TIME, WILL PROVIDE INSIGHT INTO PATIENT NEEDS IN ADDITION TO THEIR IMMEDIATE CARE.- - - - - - - - - - - - - - - FOR THE 2022-2025 CHNA, FROM THE AUGUST 2021 COMMUNITY SURVEY, THE TOP-SELECTED ISSUES WERE: - HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES- DRUG ABUSE- LACK OF HEALTH INSURANCE- UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONSFROM THIS LIST, THE HOSPITAL IS ADDRESSING DRUG ABUSE (SUBSTANCE USE). THE OTHER THREE ISSUES WERE NOT SELECTED FOR THE FOLLOWING REASONS. - THE LACK OF AFFORDABLE HEALTH INSURANCE IS OF HIGH CONCERN FOR MANY PEOPLE IN THE UPPER PENINSULA. ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE THE AVAILABILITY AND THE AFFORDABILITY OF HEALTH INSURANCE, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. - UNEMPLOYMENT, WAGES AND ECONOMIC CONDITIONS ARE IMPORTANT ISSUES FOR ASPIRUS. ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE BENEFITS PACKAGES. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, HOWEVER, THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE. FOR THE 2025-2028 CHNA, THE HOSPITAL WILL FORMALLY ADDRESS THE FOLLOWING ISSUES THROUGH THEIR COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION STRATEGY: MENTAL HEALTH; ACCESS TO CARE.FOR THE 2025-2028 CHNA, THE HOSPITAL IS NOT ADDRESSING THE FOLLOWING NEEDS FOR THE FOLLOWING REASONS: - SUBSTANCE USE. SUBSTANCE USE WAS THE THIRD-HIGHEST RATED PRIORITY AREA IN THE COMMUNITY MEETING AND ASPIRUS HAS LIMITED CAPACITY TO LEAD COMMUNITY-LEVEL EFFORTS IN THIS AREA. THE HOSPITALS WILL CONTINUE TO ADDRESS SUBSTANCE USE THROUGH TREATMENT AND REFERRALS, AS WELL AS SYSTEM-LEVEL STRATEGIES (E.G., RECOVERY COACHES). - CHRONIC DISEASE. CHRONIC DISEASE WAS THE FOURTH-HIGHEST RATED PRIORITY AREA IN THE COMMUNITY MEETING AND ASPIRUS HAS LIMITED CAPACITY TO LEAD COMMUNITY-LEVEL EFFORTS IN THIS AREA. THE HOSPITALS WILL CONTINUE TO ADDRESS CHRONIC DISEASE THROUGH TREATMENT AND REFERRALS, AS WELL AS SYSTEM-LEVEL STRATEGIES (E.G., FRUIT AND VEGETABLE PRESCRIPTION PROGRAM). ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. PART V, SECTION B, LINE 13H: THE FINANCIAL ASSISTANCE POLICY ALSO ALLOWS FOR AN ADMINISTRATIVE REVIEW FOR CATASTROPHIC OR UNIQUE CIRCUMSTANCES. THIS ADDITIONAL PROVISION ALLOWS FOR ADMINISTRATION TO MAKE A DETERMINATION THAT MAY ASSIST A PATIENT IN A UNIQUE TIME OF FINANCIAL NEED. 2 1 - ASPIRUS IRON RIVER CLINIC 814 S ICE LAKE ROAD IRON RIVER MI 49935 PHYSICIAN PRACTICES, REHAB, LAB AND XRAY 2 - CRYSTAL FALLS CLINIC 1328 US HWY 2 CRYSTAL FALLS MI 49920 PHYSICIAN PRACTICES, LAB AND XRAY 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, LINE 7G: THE ABOVE COSTS OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE EMERGENCY DEPARTMENT. ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. THE EMERGENCY DEPARTMENT REPORTED COSTS OF $6,309,817 WITH OFFSETTING REVENUE OF $6,171,279. 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 $ 1,282,316. 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 NEEDS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL AND CLINICS:- SYSTEMATICALLY REVIEWS PATIENT EXPERIENCE DATA TO UNDERSTAND OPPORTUNITIES TO ADDRESS PATIENT CONCERNS. - MAINTAINS AN INVOLVED REGIONAL BOARD OF DIRECTORS, WITH LOCAL REPRESENTATION. HOSPITAL BOARD MEMBERS ARE FROM MULTIPLE SECTORS (E.G., ACADEMIA, INDUSTRY/BUSINESS, PHILANTHROPY, FINANCE, HEALTHCARE).- SUPPORTS ITS STAFF IN PARTICIPATING ON AND PRESENTING TO COMMUNITY BOARDS AND COMMITTEES THAT PROVIDE INSIGHT ON LOCAL CIRCUMSTANCES.- REVIEWS FUNDING REQUESTS TO THE HOSPITAL AS AN INDICATOR OF LOCAL NEEDS. - INITIATED A SOCIAL NEEDS SCREENING PROCESS THAT, OVER TIME, WILL PROVIDE INSIGHT INTO PATIENT NEEDS IN ADDITION TO THEIR IMMEDIATE CARE. 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: ASPIRUS IRON RIVER HOSPITAL IS ONE OF THREE ASPIRUS SYSTEM HOSPITALS IN A 5-COUNTY RURAL REGION OF THE UPPER PENINSULA OF MICHIGAN. THE 5-COUNTY REGION INCLUDES HOUGHTON, KEWEENAW, ONTONAGON, IRON AND GOGEBIC COUNTIES. ASPIRUS IRON RIVER HOSPITAL IS LOCATED IN IRON COUNTY. IRON COUNTY COVERS 1166 SQUARE MILES, WITH 10.0 PEOPLE PER SQUARE MILE AND AN OVERALL POPULATION OF 11,631 PEOPLE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER AGE 18: 17.4%PERSONS 65 YEARS AND OVER: 30.9%WHITE PERSONS: 94.0%AFRICAN AMERICAN PERSONS: <1%AMERICAN INDIAN PERSONS: <1%ASIAN PERSONS: <1%TWO OR MORE RACES: 4.2%HISPANIC OR LATINO: 1.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 2.0%ADULTS AGES 25 AND OVER WITH A HIGH SCHOOL DIPLOMA OR EQUIVALENT: 93.4% PERSONS IN POVERTY: 16.9%MEDIAN HOUSEHOLD INCOME: $53,614 PERCENT WITHOUT HEALTHCARE COVERAGE: 4.7%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS BENEFITS, ETC.): 55.2% NUMBER OF HOSPITALS IN THE COUNTY: 1 (ONLY ASPIRUS) THE COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, MENTAL HEALTH AND DENTAL HEALTH. THE COUNTY IS ALSO DESIGNATED AS MEDICALLY UNDERSERVED. PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH ITS COMMUNITY HEALTH AND COMMUNITY BENEFIT WORK. ADDITIONALLY, THE HOSPITAL: - MAINTAINS A REGIONAL BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY AND THE REGION. - BRINGS ITS EXPERTISE INTO THE COMMUNITY THROUGH PROGRAMS, SCREENINGS, AND COMMUNITY BOARD AND ADVISORY COMMITTEE MEMBERSHIP.- PROVIDES HIGH QUALITY SERVICES AND IMPLEMENTS ONGOING QUALITY IMPROVEMENT INITIATIVES. - BUDGETS FOR CUTTING EDGE TECHNOLOGIES AND EQUIPMENT THAT SUPPORT PATIENT HEALTH.- OFFERS RESOURCES AND/OR REFERRALS FOR TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - HOSTS ON-SITE BLOOD DRIVES.- PROVIDES OFFICE SPACE FOR COMMUNITY PARTNERS THAT MAY NOT BE ABLE TO AFFORD RENTING SPACE ON THEIR OWN.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 MI 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 JOHN PIETILA MD BOARD MEMBER/RADIOLOGIST 0 931556 0 0 0 30771 0 10350 0 40255 0 1012932 0 0 CONSTANCE BRADLEY BOARD MEMBER/SVP-PRES. REG. MKTS. 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 SVP-CHIEF STRATEGY OFFICER 0 486205 0 186599 0 72384 0 8565 0 106951 0 860704 0 58001 DANIEL LUKES DO BOARD MEMBER/PHYSICIAN 0 799942 0 0 0 7322 0 10350 0 30695 0 848309 0 0 JENNIFER REDMAN-SCHELL VICE CHAIR/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 MEDHAT FANOUS PHYSICIAN 629979 0 0 0 6244 0 4015 0 40861 0 681099 0 0 0 ERIC ANDERSON CHIEF COMPLIANCE OFFICER 0 454003 0 109647 0 2193 0 2636 0 96945 0 665424 0 0 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 459962 0 116101 0 4692 0 10350 0 25557 0 616662 0 0 LORI PECK BOARD MEMBER/VP-FINANCE 0 360993 0 151157 0 27645 0 9303 0 2184 0 551282 0 25874 JONATHAN BRUEGGEMAN BOARD MEMBER/MEDICAL DIRECTOR 0 435027 0 36010 0 810 0 10350 0 40721 0 522918 0 0 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 244957 0 149328 0 61332 0 10350 0 31536 0 497503 0 0 THOMAS POWELL VP-CHIEF MEDICAL INFO OFFICER 0 152526 0 0 0 286737 0 4252 0 14217 0 457732 0 0 CHRISTINE HARFF (NV) PRESIDENT-UP REGION (THRU 11/24 0 307485 0 95223 0 19119 0 7674 0 26457 0 455958 0 0 PATRICK TINCHER JR BOARD MEMBER/VP-FIN REG OPS (THRU 01 0 291270 0 68420 0 9601 0 9203 0 41187 0 419681 0 0 AMY NIELSEN PHYSICIAN 299918 0 45000 0 5386 0 7706 0 12445 0 370455 0 0 0 CARLOS CONDADO CRNA 262494 0 0 0 6207 0 5410 0 31484 0 305595 0 0 0 KRISTINE FLOWERS PHYSICIAN 224617 0 0 0 6814 0 7055 0 40958 0 279444 0 0 0 DONALD PATTON PHYSICIAN 218397 0 0 0 7479 0 5568 0 30309 0 261753 0 0 0 KRISTEN MESKE NP-C BOARD MEMBER/NP (THRU 09/24) 160013 0 0 0 1671 0 3200 0 857 0 165741 0 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRON RIVER HOSPITAL & CLINIC, 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 SCHEDULE J, PART I, LINE 4A - SEVERANCE PAYMENT: J. TISCHER $569,088 T. POWELL $237,748 W. CARROLL $41,555 SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $481,861 M. HEYWOOD $198,152 J. MATHESON $58,001 C. BRADLEY $52,586 L. PECK $25,874 M. WALTERS $56,910 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). DONALD PATTON MD DONALD PATTON AND KRISTEN MESKE (BOARD MEMBER) HAVE A FAMILY RELATIONSHIP 244250 PAYROLL 0 FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THERE SHALL BE A MINIMUM OF 9 VOTING DIRECTORS ALLOCATED AS FOLLOW. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN FOUR INDEPENDENT COMMUNITY CLASS DIRECTORS, THREE 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 DIRECTORS OF THE ORGANIZATION: 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 INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS THEN REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. AN INTERESTED PERSON IS A DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. AFTER DISCLOSURE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING MEMBERS SHALL DECIDE IF A CONFLICT EXISTS. THE MEMBER WILL ABSTAIN FROM VOTING ON THIS ISSUE IF A CONFLICT OF INTEREST IS DISCOVERED. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS IRON RIVER HOSPITAL & CLINICS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CHIEF ADMINISTRATIVE OFFICER, 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 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 IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 349,778. MANAGEMENT AND GENERAL EXPENSES 191,172. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 540,950. PHARMACY FEES: PROGRAM SERVICE EXPENSES 108,827. MANAGEMENT AND GENERAL EXPENSES 59,479. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 168,306. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,233,310. MANAGEMENT AND GENERAL EXPENSES 1,767,169. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,000,479. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 115,676. MANAGEMENT AND GENERAL EXPENSES 63,223. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 178,899. OTHER SERVICES: PROGRAM SERVICE EXPENSES 630,641. MANAGEMENT AND GENERAL EXPENSES 344,678. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 975,319. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 12,504,272. ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTHCARE WI 501(C)(3) LINE 12B, II N/A 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EXTENDED SERVICES INC 333 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS MEDICAL GROUP INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS AT HOME INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTH CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS INC 1 ASPIRUS VNA EXTENDED CARE INC 520 N 32ND AVENUE WAUSAU WI 54401 391597350 PERSONAL CARE SERVICES WI 501(C)(3) LINE 10 ASPIRUS AT HOME INC 1 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 1 ASPIRUS IRONWOOD HOSPITAL & CLINICS INC N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382908586 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LAURIUM MI 49913 381443361 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 DIVINE SAVIOR HEALTHCARE INC 2817 NEW PINERY ROAD PORTGAGE WI 53901 390806250 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MEDFORD HOSPITAL & CLINICS INC 135 S GIBSON STREET MEDFORD WI 54451 390964813 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL & CLINICS INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 390808443 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS STANLEY HOSPITAL & CLINICS INC 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS MERRILL HOSPITAL & CLINICS INC 601 S CENTER AVENUE MERRILL WI 54452 390808503 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391390638 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS EAGLE RIVER HOSPITAL & CLINICS INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 1 HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HEALTHCARE WI 501(C)(3) LINE 12B, II ASPIRUS INC 1 ASPIRUS MEDICAL GROUP - NORTHERN WISCONSIN INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391965593 MEDICAL SERVICES WI 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S HOSPITAL OF DULUTH 915 EAST 1ST STREET DULUTH MN 55805 410714079 HOSPITAL MN 501(C)(3) LINE 3 ASPIRUS INC 1 ST LUKE'S FOUNDATION 1000 EAST 1ST STREET NO 102 DULUTH MN 55805 411448118 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL INC 325 11TH AVENUE TWO HARBORS MN 55616 410786046 HOSPITAL MN 501(C)(3) LINE 3 ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL FOUNDATION OF NORTHEAST MINNESOTA 325 11TH AVENUE TWO HARBORS MN 55616 411700972 CHARITABLE FOUNDATION MN 501(C)(3) LINE 12A, I LAKE VIEW MEMORIAL HOSPITAL INC 1 WESTERN UPPER MICHIGAN EYE CARE LLC 131 W GENESEE STREET IRON RIVER MI 49935 272324957 EYE CARE SERVICES MI N/A 0 0 THE WESTWOOD CONFERENCE CENTER LLC 333 PINE RIDGE BLVD WAUSAU WI 54401 571184256 REAL ESTATE INVESTMENT WI N/A 0 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931678 HEALTH CARE SERVICES WI N/A C 1 ASPIRUS KEWEENAW ENTERPRISES INC 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 1 ASPIRUS HEALTH VENTURES 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 474925640 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF WI INC 300 WESTHILL DR SUITE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 1 ASPIRUS ARISE HEALTH PLAN OF MI INC 300 WESTHILL DR SUITE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 1 ASPIRUS CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC 2200 WESTWOOD DRIVE WAUSAU WI 54401 842513742 ASSOCIATION WI N/A C 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 ASPIRUS INC I 403162 COST ASPIRUS INC M 6398526 COST ASPIRUS INC O 15817881 COST ASPIRUS INC P 32142690 COST ASPIRUS INC S 4598007 COST ASPIRUS WAUSAU HOSPITAL INC Q 466033 COST ASPIRUS WAUSAU HOSPITAL INC R 495910 COST ASPIRUS MEDFORD HOSPITAL & CLINICS INC Q 72935 COST ASPIRUS MEDFORD HOSPITAL & CLINICS INC R 72935 COST ASPIRUS MEDICAL GROUP INC O 960861 COST ASPIRUS IRONWOOD HOSPITAL & CLINICS INC P 234344 COST