2023-05-12T10:51:24-05:00 2022-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2021-07-01 390808443 ASPIRUS STEVENS POINT HOSPITAL & CLINICS ASPI 7153465000 900 ILLINOIS AVENUE STEVENS POINT WI 54481 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 7158472250 2023-05-12 1 SIDNEY SCZYGELSKI 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2023-05-12 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 157168031 0 X WWW.ASPIRUS.ORG X 1955 WI WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 8 7 774 37 5073 3150 335237 4730980 175601340 151906752 -85795 6770 893653 523529 176744435 157168031 22359 0 0 0 75399727 66622469 0 0 0 122785228 97710524 198207314 164332993 -21462879 -7164962 114066007 100703599 49406182 63899419 64659825 36804180 WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES. 0 0 123884447 0 151699584 ASPIRUS STEVENS POINT HOSPITAL IS A 50-BED HOSPITAL CAMPUS PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2022, ASCENSION ST. MICHAEL'S HOSPITAL, INC. TREATED APROXIMATELY 2,517 ADULTS AND CHILDREN FOR A TOTAL OF APPROXIMATELY 10,805 PATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES FOR APPROXIMATELY 110,003 OUTPATIENT VISITS, WHICH INCLUDED APPROXIMATELY 4,733 OUTPATIENT SURGERIES AND APPROXIMATELY 25,535 EMERGENCY ROOM VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 123884447 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 99 0 1 774 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X SIDNEY C SCZYGELSKI 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 JESSE G TISCHER VICE CHAIR/SVP REGIONAL MARKETS 2.00 50.00 X X 0 644385 101649 JAMIE SCHAEFER CHAIR 1.00 4.00 X X 0 0 0 DAN BURNS SECRETARY/TREASURER 2.00 4.00 X X 0 0 0 BILL ARCISZEWSKI BOARD MEMBER 1.00 4.00 X 0 0 0 ANGELA BAILEY BOARD MEMBER 1.00 4.00 X 0 0 0 TRINA DANIELS MD BOARD MEMBER 1.00 4.00 X 0 0 0 JOSEPH KINSELLA BOARD MEMBER 1.00 4.00 X 0 0 0 JAMES NASH DO BOARD MEMBER 1.00 4.00 X 0 0 0 ROBERT SMITH PRESIDENT-ASPIRUS SOUTHEAST DIVISION 2.00 50.00 X 48661 262093 14200 JENNIFER REDMAN-SCHELL SVP & PRESIDENT-ASPIRUS MEDICAL GROUP 2.00 50.00 X 0 572454 92664 MATTHEW HEYWOOD PRESIDENT & CEO-ASPIRUS 2.00 50.00 X 0 2684221 266094 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 2.00 50.00 X 0 915379 141626 DALE A HUSTEDT INTERIM PRESIDENT STANLEY & PRES. AMH 2.00 50.00 X 0 329623 82452 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 2.00 50.00 X 0 306056 43153 BENJAMIN BARSOTTI CHIEF MEDICAL INFORMATION OFFICER 2.00 50.00 X 0 462446 50766 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 2.00 50.00 X 0 394127 62857 ERIC ANDERSON SVP-SERVICE LINE & PATIENT EXP. 2.00 50.00 X 0 495034 104300 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 452729 89948 JOHN HEISLER SVP & CHIEF HUMAN RESOURCES OFFICER 2.00 50.00 X 0 751984 56650 JON HARDESTY VP-CORPORATE HUMAN RESOURCES 2.00 50.00 X 0 325937 43270 LISA ROWE-PEPLINSKI VP-CARE QUALITY & PATIENT SAFETY 2.00 50.00 X 0 367202 18878 MATTHEW BREWER VP-OPERATIONS 2.00 50.00 X 0 313780 42259 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 2.00 50.00 X 0 449756 89333 PAUL VAN DEN HEUVEL VP-NETWORKS STRATEGY 2.00 50.00 X 0 340811 45098 RENEE SMITH EXECUTIVE DIRECTOR-ANI 2.00 50.00 X 0 460002 93775 RUTH RISLEY-GRAY SVP & SYSTEM CNO 2.00 50.00 X 0 329902 52673 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 2.00 50.00 X 0 516494 97286 WENDY ANGELO VP-CMO - POPULATION HEALTH 2.00 50.00 X 0 363857 42762 EDWARD RYAN DIRECTOR-EMS CENTRAL 40.00 X 83195 131983 38702 HONG ZHOU CLINICAL MEDICAL PHYSICIST-RADIATION 40.00 X 84640 125001 15321 CHRISTOPHER THOMPSON SUPERVISOR PHARMACY 40.00 X 62106 107994 36670 STEVEN KING DIRECTOR-SURGICAL SERVICES 40.00 X 62803 103888 13048 JOHN FAULKS PHARMACIST 40.00 X 58774 84333 37054 400179 12291471 1772488 0 0 1 0 HAYES LOCUMS LLC 6700 N ANDREWS AVE STE 600 FORT LAUDERDALE FL 33309 STAFFING SERVICES 3363410 TOTAL MSP LLC (STAFFENCY LLC) 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 STAFFING SERVICES 2168035 MEDICAL STAFFING SOLUTIONS INC PO BOX 101 RICE LAKE WI 54868 STAFFING SERVICES 1033547 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 STAFFING SERVICES 799168 REGIONAL MEDICAL LABORATORY 4142 S MINGO TULSA OK 74146 LAB SERVICE 403702 15 4730980 4730980 PATIENT SERVICE REVENUE 621990 142803166 142803166 LAB REVENUE 541380 5462168 5457095 5073 CONTRACT SERVICE REVENUE 900099 3230766 3230766 PHARMACY REVENUE 900099 16869 16869 393783 191688 202095 151906752 6770 6770 13969 0 13969 13969 13969 836 0 836 836 CAFETERIA/VENDING REVENUE 722514 508724 508724 508724 157168031 151699584 5073 732394 53858438 51057245 2801193 1432550 1383262 49288 9395454 9331735 63719 1936027 1835060 100967 24459 24459 16019196 9871610 6147586 196 196 184658 150839 33819 77661 2418 75243 3317686 93614 3224072 194134 144983 49151 1119334 2 1119332 8538771 3585782 4952989 286688 25430 261258 MEDICAL SUPPLIES 31755637 31234628 521009 CORPORATE ALLOCATIONS 24688920 6091005 18597915 REPAIRS & MAINTENANCE 2669953 2047736 622217 BAD DEBT EXPENSE 2464094 2464094 6369137 4564808 1804329 164332993 123884447 40448546 0 6450 9680 92779 504613 21737415 22567168 3146670 2936976 0 377718 80086564 7231927 76634822 72854637 749301 0 11698570 1452807 114066007 100703599 10864893 8914006 13224 12163 0 53696902 38528065 1276348 49406182 63899419 X 64659825 36804180 0 0 64659825 36804180 114066007 100703599 X -7164962 -20690683 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24459 24459 0 PART II-B, LINE 1: ASPIRUS STEVENS POINT HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE PERCENTAGES THAT ARE SPECIFIC FOR LOBBYING PURPOSES ARE AS FOLLOWS: 26.5% OF THE AMERICAN HOSPITAL ASSOCIATION TOTALING $18,222, 15.3% OF THE WISCONSIN HOSPITAL ASSOCIATION TOTALING $6,237 MAKING THE GRAND TOTAL OF DUES DIRECTED TOWARDS LOBBYING $24,459. 6880000 6880000 58210515 3630500 54580015 14919075 3601427 11317648 76974 76974 72854637 LONG TERM INSURANCE LIABILITY 38400 DEFERRED COMPENSATION LIABILITY 53209 OPERATING LEASE LIABILITY 1045514 ASSET RETIREMENT OBLIGATION LIABILITY 139225 1276348 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, 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 1174912 122106 1052806 0.00650 26377026 13096139 13280887 0.08200 27551938 13218245 14333693 0.08850 22531 22531 0.00010 63294 63294 0.00040 3772694 3061794 710900 0.00440 36663 36663 0.00020 101971 101971 0.00060 3997153 3061794 935359 0.00570 31549091 16280039 15269052 0.09420 1 1018788 0 20349767 23612394 -3262627 X 1 1 1 1 ASPIRUS STEVENS POINT HOSPITAL & CLINICS 900 ILLINOIS AVENUE STEVENS POINT WI 54481 WWW.ASPIRUS.ORG/FIND-A-LOCATION/ASPIRU 146 X X X ASPIRUS STEVENS POINT HOSPITAL & CLINICS 1 0 1 0 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X HTTPS://WWW.ASPIRUS.ORG/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 2: A HOSPITAL ORGANIZATION THAT ACQUIRES A HOSPITAL FACILITY (THROUGH MERGER OR ACQUISITION) MUST MEET THE REQUIREMENTS OF SECTION 501(R)(3) WITH RESPECT TO THE ACQUIRED HOSPITAL FACILITY BY THE LAST DAY OF THE ORGANIZATION'S SECOND TAXABLE YEAR BEGINNING AFTER THE DATE ON WHICH THE HOSPITAL FACILITY WAS ACQUIRED. THE FILING HOSPITAL WAS ACQUIRED BY A NEW PARENT (ASPIRUS INC - 45-3358926) ON 08/01/2021 (TAX YEAR 2021). THE CHNA WILL BE DUE THE LAST DAY OF THE SECOND TAXABLE YEAR WHICH WILL BE 06/30/2024.TAX YEAR 2021 HEALTH NEEDS COMMENTARY: THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT EFFORTS IN FY22 WERE SIGNIFICANTLY IMPACTED BY A NUMBER OF FACTORS, INCLUDING: THE TRANSITION OF THE HOSPITAL FROM ASCENSION HEALTH TO ASPIRUS HEALTH IN AUGUST 2021; THE SUBSEQUENT CHANGES IN PROCESSES, TEAM STRUCTURE AND RELATED IMPACTS; COVID-19 AND ITS RIPPLE EFFECT ON COMMUNITY OUTREACH AND PUBLIC EVENTS / PROGRAMS.HEALTHY WEIGHT - ASPIRUS STEVENS POINT HOSPITAL CONTINUED TO FINANCIALLY SUPPORT THE HEALTHY HABITS PROGRAM AT THE BOYS AND GIRLS CLUB. DURING THE SUMMER OF 2022, HEALTHY HABITS CONSISTED OF TWO PROGRAMS: COOKING CLUB AND GREEN THUMB (GARDENING). THESE PROGRAMS WERE RUN AT THE BERARD CENTER (STEVENS POINT) AND PLOVER CENTER AT LEAST TWO TIMES PER WEEK WITH YOUTH AGES 6-12 (1ST - 6TH GRADE). DURING THESE PROGRAMS, YOUTH LEARNED ABOUT THE IMPORTANCE OF EATING A HEALTHY, BALANCED DIET CONSISTING OF FRESH, WHOLE FOODS. THEY ALSO LEARNED ABOUT THE BENEFITS OF GROWING YOUR OWN FOOD. ALONG THE WAY, THEY MADE MANY RECIPES AND TRIED NEW FOODS WITH THE GOAL OF IMPROVING THEIR EATING HABITS AND OPINIONS ABOUT HEALTHY FOODS. THROUGHOUT THE SUMMER, THERE WERE 238 UNDUPLICATED YOUTH WHO PARTICIPATED IN COOKING CLUB AND 92 YOUTH WHO PARTICIPATED IN GREEN THUMB. OF THESE YOUTH, APPROXIMATELY 50% QUALIFY FOR THE FREE OR REDUCED-PRICE SCHOOL LUNCH PROGRAM. THE BIRTHING CENTER AT ASPIRUS STEVENS POINT HOSPITAL HAS A STRONG EMPHASIS ON BREASTFEEDING. BREASTFEEDING REDUCES THE RISK OF CHILDHOOD OBESITY. FOR FY22 (JULY 1, 2021-JUNE 30, 2022), THE BIRTHING CENTER'S GOAL WAS TO MAINTAIN THE FY21 LEVEL FOR BREASTFEEDING INITIATION RATES (85-90 PERCENT). THE FY22 BREASTFEEDING INITIATION RATE AT ASPIRUS STEVENS POINT HOSPITAL WAS 86 PERCENT. IN ADDITION TO WORKING WITHIN THE HOSPITAL TO PROMOTE BREASTFEEDING, THE LACTATION STAFF ARE ACTIVE WITH THE PORTAGE COUNTY BREASTFEEDING COALITION. THE COALITION ENCOURAGES BREASTFEEDING-FRIENDLY WORKSITES. FOR FY22, THE COALITION, LED BY A MEMBER OF THE STEVENS POINT HOSPITAL BIRTHING CENTER TEAM, PLANNED TO MAINTAIN THE SAME NUMBER OF BREASTFEEDING-FRIENDLY WORKSITES (COMPARED TO FY21). THE NUMBER OF BREASTFEEDING-FRIENDLY WORKSITES REMAINED CONSISTENT AT 16 FROM FY21 TO FY22. WITH BUSINESSES OPENING BACK UP, IT IS HOPED THAT THE NUMBER WILL INCREASE MOVING FORWARD.THE ASPIRUS STEVENS POINT HOSPITAL CONTINUED TO EXPLORE THE POLICY/SYSTEM AND ENVIRONMENTAL CHANGE EFFORTS IN FY22. THE PRIMARY VEHICLE FOR THIS WORK IS THROUGH THE NEWLY NAMED HEAL (HEALTHY EATING ACTIVE LIVING) PORTAGE COUNTY GROUP. IN FY22, HEAL SOUGHT A PARTNERSHIP WITH MIDSTATE TECHNICAL COLLEGE AND RECEIVED FUNDING TO INSTALL THE COMMUNITY'S FIRST HEALTHY PARKING SPOT SIGN. THE PLAN IS TO FIND ADDITIONAL RESOURCES AND OPPORTUNITIES IN FY23 TO CONTINUE INSTALLING THESE SPOTS/SIGNAGE. ADDITIONALLY, THE GROUP CONTINUES WORK ON REINSTATING ELECTRONIC BENEFIT TRANSFER (EBT) AT THE FARMERS MARKET IN STEVENS POINT. ASPIRUS HEALTH, PRIMARILY THROUGH CARE MANAGEMENT, IMPLEMENTS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM ACROSS THE SYSTEM. PATIENTS WITH CHRONIC DISEASE ARE SCREENED FOR FOOD INSECURITY AND 'PRESCRIBED' FRUITS AND VEGETABLES. THE FVRX CAN BE USED LIKE CASH AT THE LOCAL FARMERS MARKET. MENTAL HEALTH - IN FY22, ASPIRUS STEVENS POINT HOSPITAL PROVIDED FINANCIAL SUPPORT FOR THE PEACE OF MINDS MENTAL WELLNESS WEBSITE AND THE SUICIDE PREVENTION AND MENTAL HEALTH COALITION.AODA -THE LOCAL AODA COALITION DID NOT MEET IN FY22. ASPIRUS HEALTH CONTRACTS WITH AN OUTSIDE AGENCY TO PROVIDE RECOVERY COACHING SERVICES THROUGHOUT THE SYSTEM'S WISCONSIN FOOTPRINT. ASPIRUS IS WORKING TO BUILD RELATIONSHIPS AND STRUCTURES IN ALL WISCONSIN HOSPITALS TO SUPPORT HAVING A RECOVERY COACH AVAILABLE WITHIN AN HOUR OR TWO TO THOSE PATIENTS INTERESTED IN WORKING WITH A COACH. THE FOLLOWING HEALTH ISSUES WERE NOT SELECTED FOR THE REASONS DESCRIBED BELOW. ORAL HEALTH THIS WAS A PRIORITY IN THE TWO PREVIOUS CHNA CYCLES. PRIOR TO AND THROUGHOUT THAT TIME, ASCENSION ST. MICHAEL'S AND ITS COMMUNITY PARTNERS SUPPORTED THE ASCENSION DENTAL CENTER, WHICH SERVES INDIVIDUALS WHO RECEIVE MEDICAID. TO EXPAND SERVICES, THE ASCENSION DENTAL CENTER BECAME PART OF A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER IN EARLY 2019. WITH THAT TRANSFER, ASCENSION ST. MICHAEL'S PRIMARY RESOURCE FOR ADDRESSING ORAL HEALTH WAS NO LONGER IN PLACE. FINANCIAL STABILITY THIS WAS IDENTIFIED AS ONE OF THE FOUR CALLS TO ACTION THROUGH THE LIFE PROCESS. THIS ISSUE WAS NOT SELECTED BY THE HOSPITAL BECAUSE IT IS NOT WITHIN THE HOSPITAL'S AREA OF EXPERTISE. AGING ALTHOUGH 'IMPACT OF AN AGING POPULATION ON OUR COMMUNITY' WAS IDENTIFIED IN THE LIFE REPORT AS AN 'ISSUE TO WATCH,' IT WAS NOT RAISED TO THE LEVEL OF A CALL TO ACTION. THE ISSUE WAS RAISED IN THE ASCENSION ST. MICHAEL'S PRIORITIZATION MEETING, WITH THE DISCUSSION CONCLUDING THAT MANY SERVICES FOR INDIVIDUALS WHO ARE AGING ARE CURRENTLY IN PLACE IN THE COUNTY. 7 1 - ASPIRUS BEHAVIORAL CLINIC-WILSHIRE 122 WILSHIRE BOULEVARD STEVENS POINT WI 54481 PSYCHIATRIC SERVICES 2 - ASPIRUS BEHAVIORAL CLINIC - MARIA DR 3398 E MARIA DRIVE STEVENS POINT WI 54481 PSYCHIATRIC SERVICES 3 - ASPIRUS WAUPACA CLINIC 190 GRAND SEASONS DRIVE WAUPACA WI 54981 OUTPATIENT PHYSICIAN CLINIC 4 - ASPIRUS BEHAVIORAL CLINIC - PRENTICE 209 PRENTICE STREET N STEVENS POINT WI 54481 OUTPATIENT ALCOHOL AND CHEMICAL DEPENDENCY TREATMENT CENTER 5 - ASPIRUS OUTPATIENT THERAPIES HOOVER RD 3500 HOOVER ROAD STEVENS POINT WI 54481 PHYSICAL AND OCCUPATIONAL THERAPY 6 - ASPIRUS BEHAVIORAL HEALTH RESIDENTIAL 201 PRENTICE STREET N STEVENS POINT WI 54481 RESIDENTIAL ALCOHOL AND CHEMICAL DEPENDENCY TREATMENT CENTER 7 - ASPIRUS OUTPATIENT THERAPIES PLOVER RD 2401 PLOVER ROAD PLOVER WI 54467 PHYSICAL AND OCCUPATIONAL THERAPY 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. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS 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 HOSPITAL IS REPORTING THEIR MEDVAC/AMBULANCE SERVICE WITH COSTS OF $3,772,693 AND OFFSETTING REVENUE OF $3,061,794 AS A SUBSIDIZED SERVICE. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $2,464,094. SCHEDULE H - GENERAL EXPLANATION IN AUGUST 2021, THE ORGANIZATION'S PARENT BECAME ASPIRUS INC, WHO IS THE SOLE PARENT MEMBER OF THE ORGANIZATIONS REPORTED ON SCHEDULE R ATTACHED. THE FIRST MONTH OF THE FISCAL YEAR (JULY) THE ORGANIZATION WAS A PART OF A RELATED PARTY STRUCTURE WITH THE OVERARCHING PARENT BEING ASCENSION HEALTH ALLIANCE (45-3358926). FURTHER DETAIL OF THIS IS PROVIDED IN SCHEDULE O AND SCHEDULE R OF THIS ACCOMPANYING 990. AT THE TIME OF THIS CHANGE, THERE WERE MANY CHANGES IMPLEMENTED THAT IMPACTED THE RESPONSES ON SCHEDULE H. FOR 11 OF THE 12 MONTHS, THE RESPONSES AS RECORDED ON SCHEDULE H WERE ACCURATE. FOR CONTEXT OF WHAT THE FIRST MONTH (JULY 2021) WAS, THE 2020 990 CAN PROVIDE MORE DETAIL, BUT SOME HIGHLIGHTS ARE BELOW OF WHAT RESPONSES WOULD BE DURING THAT ONE MONTH:SCHEDULE H, PART I, LINE 3A: 250%SCHEDULE H, PART I, LINE 3B: 400%SCHEDULE H, PART I, LINE 3C: SUBJECT TO THE OTHER PROVISIONS OF THIS FINANCIAL ASSISTANCE POLICY, A PATIENT WITH INCOME GREATER THAN 400% OF THE FPL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER A "MEANS TEST" FOR SOME DISCOUNT OF PATIENT'S CHARGES FOR SERVICES FROM THE ORGANIZATION BASED ON A PATIENT'S TOTAL MEDICAL DEBT. A PATIENT ELIGIBLE FOR THIS CATEGORY OF FINANCIAL ASSISTANCE WILL NOT BE CHARGED MORE THAN THE CALCULATED AGB CHARGES.THE HOSPITAL ALSO USES INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY AS FACTORS IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARESCHEDULE H, PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM: PRIOR TO AUGUST 2021, THE HOSPITAL WAS AFFILIATED WITH MINISTRY HEALTH AND ASCENSION HEALTH. 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 3. COLLECTION PHONE CALLS 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 FIRST BILLING TO THE PATIENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. II. BAD DEBT RECOVERIES A. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. B. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. C. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULES AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND SURGICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ASPIRUS STEVENS POINT HOSPITAL & CLINICS 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, 2022 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: UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENT'S ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT. PART V, LINE 7A HTTPS://WWW.ASPIRUS.ORG/COMMUNITY-RESOURCES PART VI, LINE 2: IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, ASPIRUS STEVENS POINT HOSPITAL & CLINIC, INC. USES BOTH HOSPITAL DATA AND RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. ASPIRUS STEVENS POINT HOSPITAL & CLINIC INC. UTILIZES THIS INFORMATION TO DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS. 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 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 FROM CENTRAL BILLING OFFICE 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 DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AS WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: ASPIRUS STEVENS POINT HOSPITAL PRIMARILY SERVES THE RESIDENTS OF PORTAGE COUNTY AND THE SURROUNDING COUNTIES IN A RURAL AREA OF CENTRAL WISCONSIN. THE POPULATION OF PORTAGE COUNTY IS APPROXIMATELY 70,000, WITH 13% OF RESIDENTS LIVING AT OR BELOW THE FEDERAL POVERTY THRESHOLD. THE MEDIAN HOUSEHOLD INCOME IS $56,000. APPROXIMATELY 5% OF THE INDIVIDUALS LIVING IN THE COUNTY ARE UNINSURED AND 17% RECEIVE MEDICAID. THERE ARE 3 HOSPITALS IN PORTAGE COUNTY. ASPIRUS STEVENS POINT IS A DISPROPORTIONATE SHARE HOSPITAL. (DISPROPORTIONATE SHARE HOSPITALS SERVE A SIGNIFICANTLY DISPROPORTIONATE NUMBER OF LOW-INCOME PATIENTS AND RECEIVE PAYMENTS FROM THE CENTERS FOR MEDICAID AND MEDICARE SERVICES TO COVER THE COSTS OF PROVIDING CARE TO UNINSURED PATIENTS.) PORTAGE COUNTY INCLUDES DESIGNATED PRIMARY CARE, MENTAL HEALTH CARE AND DENTAL HEALTH CARE SHORTAGE AREAS. PART VI, LINE 5: THE ORGANIZATION STRIVES TO FURTHER ITS EXEMPT PURPOSES BY THE FOLLOWING:(1) AS MENTIONED, THE ORGANIZATION PROVIDES SEVERAL SERVICES WHICH ARE NOT OTHERWISE AVAILABLE BEING IN A RURAL SETTING.(2) BASED ON THE ORGANIZATION'S MISSION, EMERGENCY ROOMS ARE MADE AVAILABLE TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY.(3) THE ORGANIZATION ALSO PARTICIPATES IN THE EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH INTERNSHIP PROGRAMS. CERTAIN SPECIALIZED SERVICES AVAILABLE INCLUDE: DENTAL SERVICES TO PRIMARILY THE INDIGENT, FERTILITY CLINIC SERVICES AND WIC HOMEVISITS TO NEW MOTHERS AND INFANTS.- THE HOSPITAL PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID).- CHARITY CARE IS AVAILABLE TO ALL IN THE COMMUNITY BASED ON NEED AND SUPPORT IS PROVIDED ON SLIDING SCALE DISCOUNTS. PART VI, LINE 6: STEVENS POINT HOSPITAL & CLINICS PART OF THE ASPIRUS HEALTH SYSTEM. ASPIRUS, INC. IT IS A MULTI-SPECIALTY HEALTH SYSTEM WITH A BASE LOCATION IN WAUSAU, WISCONSIN. STEVENS POINT HOSPITAL & CLINICS WORKS WITH ASPIRUS TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES THEY SERVE. AS NOTED PREVIOUSLY IN THE FORM 990, A NUMBER OF REPRESENTATIVES FROM ASPIRUS HAVE ROLES ON THE BOARD OF DIRECTORS OF STEVENS POINT HOSPITAL & CLINICS AND TOGETHER PROMOTE THE MISSION OF ASPIRUS. ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES TO IMPROVING THE HEALTH OF ALL IT SERVES. ASPIRUS WORKS COLLABORATIVELY WITH OTHERS WHO SHARE ITS PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. ASPIRUS AND STEVENS POINT HOSPITAL & CLINICS WORK COLLABORATIVELY TO STREAMLINE PROCESSES TO CONTINUE TO PROVIDE HIGH QUALITY CARE TO MEMBERS OF COMMUNITIES WHICH OTHERWISE WITHOUT THE EFFORTS OF A COMBINED PARTNERSHIP MAY NOT HAVE ACCESS TO THIS CARE LOCALLY. PART VI, LINE 7, REPORTS FILED WITH STATES WI X 1 1 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO-ASPIRUS 0 1051076 0 1629342 0 3803 0 17346 0 248748 0 2950315 0 0 SIDNEY C SCZYGELSKI SENIOR VP OF FINANCE & CFO 0 610115 0 177495 0 127769 0 20196 0 121430 0 1057005 0 112143 JOHN HEISLER SVP & CHIEF HUMAN RESOURCES OFFICER 0 289961 0 426149 0 35874 0 13626 0 43024 0 808634 0 25179 JESSE G TISCHER VICE CHAIR/SVP REGIONAL MARKETS 0 501025 0 142821 0 539 0 11714 0 89935 0 746034 0 0 JENNIFER REDMAN-SCHELL SVP & PRESIDENT-ASPIRUS MEDICAL GROU 0 405520 0 113119 0 53815 0 17346 0 75318 0 665118 0 51368 TODD RICHARDSON SVP & CHIEF INFORMATION OFFICER 0 357568 0 105424 0 53502 0 17346 0 79940 0 613780 0 50634 ERIC ANDERSON SVP-SERVICE LINE & PATIENT EXP. 0 382299 0 111001 0 1734 0 17346 0 86954 0 599334 0 0 RENEE SMITH EXECUTIVE DIRECTOR-ANI 0 315463 0 89914 0 54625 0 17346 0 76429 0 553777 0 53547 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 322706 0 94649 0 35374 0 16347 0 73601 0 542677 0 26065 MICHAEL HOLZHUETER SVP-GENERAL COUNSEL 0 399152 0 25600 0 25004 0 8700 0 80633 0 539089 0 0 BENJAMIN BARSOTTI CHIEF MEDICAL INFORMATION OFFICER 0 367202 0 65298 0 29946 0 17346 0 33420 0 513212 0 23406 BRETT DAVIS PRESIDENT-ASPIRUS HEALTH PLAN 0 260587 0 127333 0 6207 0 16557 0 46300 0 456984 0 0 DALE A HUSTEDT INTERIM PRESIDENT STANLEY & PRES. AM 0 254714 0 71383 0 3526 0 17346 0 65106 0 412075 0 0 WENDY ANGELO VP-CMO - POPULATION HEALTH 0 316829 0 44644 0 2384 0 7418 0 35344 0 406619 0 0 LISA ROWE-PEPLINSKI VP-CARE QUALITY & PATIENT SAFETY 0 287310 0 55655 0 24237 0 17283 0 1595 0 386080 0 22695 PAUL VAN DEN HEUVEL VP-NETWORKS STRATEGY 0 302649 0 31790 0 6372 0 11252 0 33846 0 385909 0 0 RUTH RISLEY-GRAY SVP & SYSTEM CNO 0 213913 0 91534 0 24455 0 17417 0 35256 0 382575 0 19718 JON HARDESTY VP-CORPORATE HUMAN RESOURCES 0 249182 0 49445 0 27310 0 10120 0 33150 0 369207 0 21288 MATTHEW BREWER VP-OPERATIONS 0 241222 0 47427 0 25131 0 9318 0 32941 0 356039 0 24855 WILLIAM CARROLL VP-INFORMATION TECHNOLOGY 0 235726 0 45609 0 24721 0 10403 0 32750 0 349209 0 23743 ROBERT SMITH PRESIDENT-ASPIRUS SOUTHEAST DIVISION 48434 192109 0 43647 227 26337 0 13601 89 510 48750 276204 0 21302 EDWARD RYAN DIRECTOR-EMS CENTRAL 79398 110907 0 17990 3797 3086 1804 7443 13568 15887 98567 155313 0 0 HONG ZHOU CLINICAL MEDICAL PHYSICIST-RADIATION 84522 124821 0 0 118 180 1301 2530 5504 5986 91445 133517 0 0 CHRISTOPHER THOMPSON SUPERVISOR PHARMACY 62005 87381 0 0 101 20613 1960 5504 13976 15230 78042 128728 0 0 JOHN FAULKS PHARMACIST 58183 83233 0 200 591 900 1852 5831 14267 15104 74893 105268 0 0 STEVEN KING DIRECTOR-SURGICAL SERVICES 62278 88026 0 15062 525 800 979 6729 1771 3569 65553 114186 0 0 PART I, LINE 1A PAUL VAN DEN HEUVEL ($4,050) HAD A TAXABLE HOUSING ALLOWANCE. PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS STEVENS POINT 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, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: J. REDMAN-SCHELL $51,368 S. SCZYGESLSKI $112,143 RO. SMITH $21,302 B. BARSOTTI $23,406 J. MATHESON $26,065 M. BREWER $24,855 J. HEISLER $25,179 J. HARDESTY $21,288 L. ROWE-PEPLINSKI $22,695 RE. SMITH $53,547 R. RISLEY-GRAY $19,718 T. RICHARDSON $50,634 W. CARROL $23,743 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. A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTH 391337855 97712JDN0 2021-11-10 54274720 REVENUE BONDS SERIES 2021 0 0 0 A 54274720 386648 53888072 2018 0 0 1 1 A 0 0 1 0 0 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 2021 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL & CLINICS, INC. (EIN 39-1138241); ASPIRUS BUILDINGS, INC. (EIN 39-1406537); ASPIRUS STEVENS POINT HOSPITAL & CLINICS, INC. (EIN 39-0808443); ASPIRUS STANLEY HOSPITAL & CLINICS, INC. (EIN 39-0807065); ASPIRUS MERRILL HOSPITAL & CLINICS, INC. (EIN 39-0808503); ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL & CLINICS, INC. (EIN 39-1390638); ASPIRUS EAGLE RIVER HOSPITAL & CLINICS, INC. (EIN 39-0985690); AND THE HOWARD YOUNG MEDICAL CENTER, INC. (EIN 39-0873606). INFORMATION REGARDING THE SERIES 2021 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2021 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2021 BONDS.] PART III, LINES 3A AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF APIRUS STEVENS POINT HOSPITAL & CLINICS INC., HAS POLICIES AND PROCEDURES IN PLACE TO REVIEW LEASE AGREEMENTS, MANAGEMENT, AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. SCHEDULE K, 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 4 IN AUGUST 2021, THE ORGANIZATION'S PARENT BECAME ASPIRUS INC, WHO IS THE SOLE PARENT MEMBER OF THE ORGANIZATIONS REPORTED ON SCHEDULE R ATTACHED. THE FIRST MONTH OF THE FISCAL YEAR (JULY) THE ORGANIZATION WAS A PART OF A RELATED PARTY STRUCTURE WITH THE OVERARCHING PARENT BEING ASCENSION HEALTH ALLIANCE (45-3358926). THE DIRECT PARENT BEING MINISTRY HEALTH CARE INC. (39-1490371) WHO IS OWNED BY ASCENSION HEALTH (31-1662309) WHICH IS OWNED BY ASCENSION HEALTH ALLIANCE (45-3358926). THE BYLAWS AND ARTICLES WERE AMENDED TO REFLECT THIS CHANGE. FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE AUGUST 1, 2021, THE PARENT ORGANIZATION, ASPIRUS, INC., IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. PRIOR TO THAT, MINISTRY HEALTH CARE INC WAS THE CORPORATE MEMBER. FURTHER DETAILS ARE PROVIDED THROUGHOUT THE FORM. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS COMPRISED OF TEN DIRECTORS. THERE SHALL BE THREE CLASSES OF VOTING DIRECTORS: THE ASPIRUS MEMBER CLASS, COMMUNITY CLASS, AND THE PROVIDER CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS, CONSISTING OF THREE NOMINATED BY THE NOMINATING COMMITTEE AND THREE NOMINATED BY ASPIRUS, INC. WITH CONSIDERATION TO INPUT FROM THE CORPORATION'S BOARD, AND ELECTED BY ASPIRUS, INC., TWO ASPIRUS MEMBER CLASS DIRECTORS NOMINATED AND ELECTED BY ASPIRUS, INC., TWO PROVIDER CLASS DIRECTOR FROM EACH HOSPITAL, CONSISTING OF PHYSICIANS IN THE ACTIVE CATEGORY OF THE MEDICAL STAFF AT THE HOSPITAL, 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 INFORMATION INCLUDING THE UBIT CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND 990-T ARE REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSET ADJUSTMENT FROM ACQUISITION OF NEW PARENT -20,690,683. FORM 990, PART XII, LINE 2C: THE HOSPITAL RELIED ON THEIR NEW PARENT MEMBER, ASPIRUS INC, IN THE SELECTION OF THE INDEPENDENT AUDITORS. THEY WERE INCLUDED IN THEIR CONSOLIDATED AUDIT. 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 BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501 (C) 3 LINE 10 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 MEDICAL GROUP INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501 (C) 3 LINE 10 ASPIRUS INC 1 ASPIRUS ONTONAGON INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501 (C) 3 LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH 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 VNA HOME HEALTH 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 IRON RIVER HOSPITAL & CLINICS INC 1400 W ICE LAKE ROAD IRON RIVER MI 49935 383236977 HOSPITAL MI 501 (C) 3 LINE 3 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 MEDFORD FOUNDATION INC 135 S GIBSON STREET MEDFORD WI 54451 391777081 CHARITABLE FOUNDATION WI 501 (C) 3 LINE 7 ASPIRUS INC 1 ASPIRUS STEVENS POINT HOSPITAL FOUNDATION INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 391657410 CHARITABLE FOUNDATION WI 501 (C) 3 LINE 12A, I 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 MERRILL HOSPITAL FOUNDATION INC 601 S CENTER AVENUE MERRILL WI 54452 391627755 CHARITABLE FOUNDATION WI 501 (C) 3 LINE 12A, I 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 2200 WESTWOOD DRIVE WAUSAU WI 54401 391965593 HOSPITAL WI 501 (C) 3 LINE 3 ASPIRUS INC 1 MINISTRY HEALTH CARE INC C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 391490371 PARENT (FORMER) MO 501 (C) 3 LINE 12A, I ASCENSION HEALTH 1 ASCENSION HEALTH C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 311662309 NATIONAL HEALTH SYSTEM MO 501 (C) 3 LINE 12A, I ASCENSION HEALTH ALLIANCE 1 ASCENSION HEALTH ALLIANCE C/O TAX DEPARTMENT PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501 (C) 3 LINE 12A, I N/A 0 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 0 ASPIRUS KEWEENAW ENTERPRISES INC 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 0 ASPIRUS HEALTH VENTURES 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 474925640 HEALTH INSURANCE PLAN WI N/A C 0 ASPIRUS ARISE HEALTH PLAN OF WI INC 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 364832569 HEALTH INSURANCE PLAN WI N/A C 0 ASPIRUS ARISE HEALTH PLAN OF MI INC 3000 WESTHILL DR SUITE 303 WAUSAU WI 54401 475448266 HEALTH INSURANCE PLAN MI N/A C 0 ASPIRUS CAMPUS PROPERTY 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 0 0 1 1 0 1 1 1 1 0 ASPIRUS MEDICAL GROUP INC Q 85011 COST ASPIRUS MEDICAL GROUP INC P 378089 COST ASPIRUS MEDICAL GROUP INC O 1214232 COST ASPIRUS MERRILL HOSPITAL M 55635 COST ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL Q 1905619 COST ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL O 1902152 COST ASPIRUS RHINELANDER & TOMAHAWK HOSPITAL L 359793 COST ASPIRUS RIVERVIEW HOSPITAL Q 64607 COST ASPIRUS RIVERVIEW HOSPITAL L 99793 COST ASPIRUS HOSPITAL L 68074 COST ASPIRUS WAUSAU HOSPITAL INC I 122489 COST ASPIRUS WAUSAU HOSPITAL INC O 669200 COST ASPIRUS WAUSAU HOSPITAL INC P 218336 COST ASPIRUS WAUSAU HOSPITAL INC Q 155019 COST ASPIRUS INC Q 526263 COST ASPIRUS INC P 17397564 COST ASPIRUS INC M 24794690 COST ASPIRUS INC O 59025469 COST HOWARD YOUNG MEDICAL CENTER I 157802 COST HOWARD YOUNG MEDICAL CENTER Q 76971 COST HOWARD YOUNG MEDICAL CENTER O 51795 COST SCHEDULE R, PART II, PART III AND PART IV: IN AUGUST 2021, THE ORGANIZATION'S PARENT BECAME ASPIRUS INC, WHO IS THE SOLE PARENT MEMBER OF THE ORGANIZATIONS REPORTED ON SCHEDULE R ATTACHED. THE FIRST MONTH OF THE FISCAL YEAR (JULY) THE ORGANIZATION WAS A PART OF A RELATED PARTY STRUCTURE WITH THE OVERARCHING PARENT BEING ASCENSION HEALTH ALLIANCE (45-3358926). THE DIRECT PARENT BEING MINISTRY HEALTH CARE INC. (39-1490371) WHO IS OWNED BY ASCENSION HEALTH (31-1662309) WHICH IS OWNED BY ASCENSION HEALTH ALLIANCE (45-3358926). THE RELATED PARTY STRUCTURE OF ASCENSION HEALTH ALLIANCE/ASCENSION HEALTH/MINISTRY HEALTH CARE CAN BE PROVIDED UPON REQUEST. ALL COMPENSATION FROM BOTH RELATED PARTY STRUCTURES HAS BEEN REPORTED ON THE FORM 990. TRANSACTIONS AS REPORTED ON SCHEDULE R, PART V, LINE 2 TRANSACTIONS ARE NOT INCLUDING TRANSACTIONS WITH ASCENSION HEALTH ENTITIES FOR THE ONE MONTH OF RELATIONSHIP.