2025-05-15T09:58:05-05:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 390806250 DIVINE SAVIOR HEALTHCARE INC DIVI 6087424131 PO BOX 387 2817 NEW PINERY ROAD PORTAGE WI 53901 JERRY M YANG SVP - CHIEF FINANCIAL OFFICER 7158472250 2025-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-04-29 2023 2025-03-06 01:10:19Z ASPIRUS DIVINE SAVIOR HOSPITAL & CLINICS INC MATTHEW HEYWOOD 2200 WESTWOOD DRIVE WAUSAU WI 54401 83635443 0 X WWW.ASPIRUS.ORG X 1917 WI WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 13 7 458 14 0 0 906324 738245 78891194 80068422 854881 1655079 84410 101373 80736809 82563119 35253 36500 0 0 37746747 35560113 0 0 0 54794474 48423193 92576474 84019806 -11839665 -1456687 86627338 81210216 36629079 30951055 49998259 50259161 WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 58030914 36500 79067370 ASPIRUS DIVINE SAVIOR HOSPITAL & CLINICS, INC. IS A 22 STAFFED-BED HOSPITAL CAMPUS, LOCATED IN PORTAGE, WI, PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2024, ASPIRUS DIVINE SAVIOR HOSPITAL & CLINICS, INC. TREATED APPROXIMATELY 1,162 ADULTS AND CHILDREN FOR A TOTAL OF APPROXIMATELY 3,962 PATIENT DAYS OF SERVICE. THE HOSPITAL AND ASSOCIATED CLINICS ALSO PROVIDED SERVICES FOR APPROXIMATELY 138,562 OUTPATIENT VISITS, WHICH INCLUDED APPROXIMATELY 2,791 OUTPATIENT SURGERIES, 11,768 EMERGENCY ROOM VISITS AND 54,978 CLINIC VISITS DURING FISCAL YEAR 2024. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 2188275 0 1001052 ADS OWNS AND OPERATES A 40-BED ASSISTED LIVING FACILITY. THE ASSISTED LIVING FACILITY OFFERS INTERMEDIATE CARE NURSING FOR RESIDENTS WHO REQUIRE LONG-TERM CARE. THE FACILITY ALSO OFFERS 24/7 NURSING CARE, MEDICATION MANAGEMENT, NUTRITION SERVICES AND RECREATIONAL THERAPY, AS WELL AS ACCESS TO OTHER HEALTHCARE AND HOSPITAL SERVICES OFFERED BY ADS'S HOSPITAL PROGRAMS. IN 2024, 6,103 ASSISTED LIVING DAYS WERE PROVIDED BY THE EXTENDED CARE FACILITY. 60219189 1 1 0 1 0 0 0 0 0 0 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 0 458 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JERRY M YANG 7158472250 2200 WESTWOOD DRIVE WAUSAU WI 54401 MARY D IRONSIDE CHAIR 1.00 2.00 X X 0 0 0 DANIEL J BURNS VICE CHAIR 1.00 2.00 X X 0 0 0 JESSE TISCHER VICE CHAIR (THRU JAN '24)/SVP & PRES.-AWH 1.00 50.00 X X 0 764397 116000 LYNN M VOGT TREASURER 1.00 2.00 X X 0 0 0 CONSTANCE BRADLEY SECRETARY/SVP-PRES REG MKTS 1.00 50.00 X X 0 489478 90167 MICHAEL J BOVEE BOARD MEMBER 1.00 2.00 X 0 0 0 TRINA DANIELS MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 543092 39371 JUSTIN HUEBNER BOARD MEMBER 1.00 2.00 X 0 0 0 BONITA KOLRUD MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 358304 40188 SUSAN KRECKMAN MD BOARD MEMBER/PHYSICIAN 1.00 40.00 X 0 342439 38090 SHELLY MONDEIK EDD BOARD MEMBER 1.00 2.00 X 0 0 0 JOSHUA POGORELEC DO BOARD MEMBER/REGIONAL MED. DIRECTOR 1.00 40.00 X 0 704638 45626 JENNIFER REDMAN-SCHELL BOARD MEMBER/SVP & PRES. -AMG 1.00 40.00 X 0 607634 94564 REBECCA SOMMER PHD BOARD MEMBER 1.00 2.00 X 0 0 0 JERRY M YANG SVP-CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 0 0 ROBERT SMITH (NV) PRESIDENT-ASPIRUS SE 1.00 40.00 X 0 394255 54865 BRIAN KIEF (NV) PRESIDENT-ADS & ARH 1.00 40.00 X 0 373274 44481 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 2.00 50.00 X 0 1618117 304186 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 2.00 50.00 X 0 1294746 134273 MICHAEL HOLZHUETER ASSIST. SEC. /SVP-GENERAL COUNSEL 1.00 50.00 X 0 688935 115911 JEFFREY JONES SVP-CFO (THRU 04/23) 2.00 50.00 X 0 222942 12956 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 2.00 50.00 X 0 669631 49745 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 2.00 50.00 X 0 522951 102957 ERIC ANDERSON CHAIR(THRU SEP '23)/CHIEF COMPLIANCE OFFICER 2.00 50.00 X 0 498735 99668 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 2.00 50.00 X 0 510162 34165 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 2.00 50.00 X 0 350449 76560 JOESPH MUELLER PHYSICIAN 40.00 X 995462 0 46101 WALTER KAO PHYSICIAN 40.00 X 498439 0 11326 BRAD ROGOWSKI PHYSICIAN 40.00 X 480192 0 26499 TERRA THIMM PHYSICIAN 40.00 X 438739 0 48185 CRAIG DESTREE MEDICAL DIRECTOR 40.00 X 412302 0 33635 2825134 10954179 1659519 53 0 1 0 TOTAL MSP LLC 221 WEST COLLEGE AVE APPLETON WI 54944 STAFFING SERVICE 4195683 NOVUS WISCONSIN SERVICE CORP PO BOX 12766 PENSACOLA FL 32591 STAFFING SERVICE 2774378 MEDICAL STAFFING SOLUTIONS INC PO BOX 101 RICE LAKE WI 54868 STAFFING SERVICE 1549107 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE STE 185 IRVINE CA 92614 MAINTENANCE SERVICE 1010409 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 STAFFING SERVICE 764191 28 737609 636 738245 PATIENT SERVICE REVENUE 621990 77701616 77701616 CLINIC REVENUE 623000 1001052 1001052 1365754 1365754 80068422 290 290 17435 0 17435 17435 17435 2727113 1072324 1654789 1654789 1654789 CAFETERIA REVENUE 722514 83938 83938 83938 82563119 80068422 0 1756452 X 35500 35500 1000 1000 29231151 25041578 4189573 823772 664965 158807 3688964 2977804 711160 1816226 1466093 350133 10273 10273 13036 13036 12682353 7889099 4793254 2463 1532 931 94509 87647 6862 137761 85695 52066 1986861 55916 1930945 98926 61537 37389 42585 26490 16095 591760 591760 5474647 3550152 1924495 184929 5204 179725 CORPORATE ALLOCATIONS 11804115 7342789 4461326 MEDICAL SUPPLIES 8925462 8277426 648036 BAD DEBT EXPENSE 2814911 2814911 REPAIRS AND MAINTENANCE 2232719 1388870 843849 1325883 1259892 65991 84019806 60219189 23800617 0 1361679 1646408 10578985 10196159 1283612 1357212 355858 38669 147054011 84392484 66446566 62661527 525258 525492 6075380 4784749 86627338 81210216 3209130 831207 54615 7892 32434039 29881583 931295 230373 36629079 30951055 X 49913627 50174529 84632 84632 49998259 50259161 86627338 81210216 X -1456687 1717589 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 13036 13036 0 PART II-B, LINE 1: ASPIRUS DIVINE SAVIOR HOSPITAL & CLINICS PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA), THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. AHA HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $7,505 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. WHA HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $4,029 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. RWHC HAS NOTIFIED THE HOSPITAL THAT APPROXIMATELY $1,502 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES. IN TOTALITY, $13,036 OF THE ANNUAL DUES THE HOSPITAL PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 3891227 3891227 98295700 50831436 47464264 44336156 33561048 10775108 530928 530928 62661527 DEFERRED COMPENSATION 39081 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 4558547 FINANCE LEASE - ROU ASSET 187121 4784749 DEFERRED COMPENSATION 39081 FINANCE LEASE LIABILITY 191292 230373 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, 2024. 1 1 X 1 X 1 X 1 1 1 0 1 1 587073 587073 0.00720 13457647 5868721 7588926 0.09350 14044720 5868721 8175999 0.10070 77262 77262 0.00100 52050 52050 0.00060 43068 43068 0.00050 172380 172380 0.00210 14217100 5868721 8348379 0.10280 1 50 740 740 0.00000 1 69 113 113 0.00000 2 119 853 853 0.00000 1 1002647 0 10881470 14535624 -3654154 X 1 1 1 1 DIVINE SAVIOR HEALTHCARE INC 2817 NEW PINERY ROAD PORTAGE WI 53901 WWW.ASPIRUS.ORG 80 X X X DIVINE SAVIOR HEALTHCARE INC 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X SEE PART V, SECTION C, LINE 7D X 1 21 1 HTTPS://WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS 0 1 X 200.000000000000 300.000000000000 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 DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 5: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), COLUMBIA COUNTY COMMUNITY MEMBERS PROVIDED FEEDBACK ON COMMUNITY HEALTH NEEDS THROUGH A COMMUNITY SURVEY AND KEY INFORMANT INTERVIEWS. APPROXIMATELY 650 PEOPLE RESPONDED TO THE COMMUNITY SURVEY AND TWENTY-SEVEN KEY INFORMANT INTERVIEWS WERE CONDUCTED. AN INTENTIONAL EFFORT WAS MADE TO ENSURE THAT THE INDIVIDUALS AND ORGANIZATIONS REPRESENTED THE NEEDS AND PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, 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. THE COMMUNITY SURVEY, DEVELOPED AND DISTRIBUTED BY ASPIRUS DIVINE SAVIOR AND COLUMBIA COUNTY HEALTH DEPARTMENT, WAS CONDUCTED IN FALL 2021. THE SURVEY WAS AVAILABLE IN SPANISH AND WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. NUMEROUS ORGANIZATIONS INCLUDING LIBRARIES, CHAMBERS OF COMMERCE, COLUMBIA COUNTY HEALTH DEPARTMENT, AGING AND DISABILITY RESOURCE CENTER, FOOD PANTRIES, COALITIONS AND MORE DISTRIBUTED THE SURVEY. KEY INFORMANTS PROVIDING INPUT ON THE TOP ISSUES INCLUDED REPRESENTATIVES FROM MULTIPLE SECTORS AND GROUPS: EDUCATION; AGING; SUBSTANCE USE AND RECOVERY; FAITH; RECREATION; HEALTH CARE; YOUTH SERVICES; MEDIA; ELECTED PUBLIC OFFICE; OTHER. DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 6B: FOR THE CHNA COMPLETED IN FY22 (SPRING 2022), ASPIRUS DIVINE SAVIOR COLLABORATED WITH THE COLUMBIA COUNTY HEALTH DEPARTMENT TO COMPLETE THIS WORK. COLUMBIA COUNTY HEALTH DEPARTMENT CONTRACTED WITH UNIVERSITY OF WISCONSIN-OSHKOSH FOR DATA ANALYSIS AND WISCONSIN COMMUNITY HEALTH ALLIANCE FOR PROCESS FACILITATION. ASPIRUS DIVINE SAVIOR HOSPITAL'S CHNA WAS AUTHORED BY ASPIRUS DIVINE SAVIOR HOSPITAL. DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTPS://WWW.ASPIRUS.ORG/COMMUNITY-REPORTS-NEEDS DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 11: IN FY24, ASPIRUS STRENGTHENED ITS COMMUNITY HEALTH EFFORTS BY IMPLEMENTING CROSS-ORGANIZATIONAL STRATEGIES ALONG WITH 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 FY24, ASPIRUS DIVINE SAVIOR HOSPITAL'S SIGNIFICANT NEEDS WERE MENTAL HEALTH AND SUBSTANCE USE. THE HOSPITAL ADDRESSED THOSE AND OTHER NEEDS IN THE FOLLOWING WAYS. MENTAL HEALTHIN FY24 THE HOSPITAL PROVIDED FUNDING TO THE BOYS & GIRLS CLUB. THE BOYS & GIRLS CLUB IS A SAFE PLACE FOR KIDS TO GO AFTER SCHOOL, AND OFFERS PROGRAMING TO ADDRESS YOUTH ACADEMICS, SOCIAL DEVELOPMENT AND PHYSICAL HEALTH. 110 KIDS WERE SERVED. ASPIRUS DIVINE SAVIOR PROVIDED FUNDING FOR A MENTAL HEALTH FIRST AID COURSE. TEN PEOPLE ATTENDED THE TRAINING. ASPIRUS DIVINE SAVIOR HELPED FUND THE HOPE HOUSE OF SOUTH CENTRAL WISCONSIN TO PROVIDE SUPPORT TO VICTIMS OF DOMESTIC AND SEXUAL VIOLENCE.THE HOSPITAL IS PART OF THE PREVENT SUICIDE COALITION AND THE PREVENTION AND RESPONSE COALITION. COALITION EFFORTS INCLUDED: - PROVIDING FUNDING TO SCHOOLS TO IMPLEMENT SOURCES OF STRENGTH.- BEGINNING TO PLAN A MENTAL HEALTH ANTI-STIGMA CAMPAIGN.- CREATION AND DISTRIBUTION OF A MENTAL HEALTH RESOURCES BROCHURE. FIVE HUNDRED WERE PRINTED AND HAVE BEEN DISTRIBUTED SO FAR. ASPIRUS STAFF DISTRIBUTED BROCHURES INTERNALLY (E.G., TO CLINICS, THE EMERGENCY DEPARTMENT AND CARE COORDINATION) AND EXTERNALLY.- PLANNING AND IMPLEMENTING THE FALL 2024 WALK FOR HOPE. ASPIRUS STAFF ASSISTED ON THE PLANNING COMMITTEE AND THE HOSPITAL CONTRIBUTED FINANCIALLY.SUBSTANCE USEASPIRUS DIVINE SAVIOR HAS A MEDICATION DROP BOX IN THE FRONT ENTRANCE. THIS ASSURES UNUSED PRESCRIPTION DRUGS ARE DISPOSED OF IN THE APPROPRIATE MANNER. PHARMACY STAFF SPEND ABOUT 1 HOUR PER WEEK DISPOSING OF THE MEDICATIONS. THEY COLLECTED 792 POUNDS FOR THE YEAR.ASPIRUS WORKS WITH THREE BRIDGES RECOVERY TO PROVIDE RECOVERY COACHES FOR PATIENTS STRUGGLING WITH SUBSTANCE USE. ASPIRUS HEALTH FOUNDATION AND THE HOSPITAL PROVIDED FUNDING TO INCLUDE RECOVERY COACHING SERVICES THAT ARE NOT COVERED UNDER THE ED2 RECOVERY GRANT.THE HOSPITAL PROVIDED FUNDING TO SUPPORT HARBOR RECOVERY CENTER. HARBOR RECOVERY CENTER PROVIDES SERVICES AND SUPPORT TO INDIVIDUALS AND THEIR FAMILIES WHO ARE STRUGGLING WITH SUBSTANCE USE AND/OR MENTAL HEALTH. THEY ALSO PROVIDE EDUCATIONAL OPPORTUNITIES AND EVENTS TO BUILD A RECOVERY CULTURE. IN 2023 THEY SERVED 220 IN PRIMARY SERVICES AND 1400 IN SECONDARY SERVICES. SECONDARY SERVICES WOULD INCLUDE ANYTHING THAT IS NOT A ONE-ON-ONE SESSION. EXAMPLES OF SECONDARY SERVICES ARE FAMILY MEALS, EVENTS AND SUPPORT GROUPS. ASPIRUS DIVINE SAVIOR STAFF SERVED ON THE PREVENTION AND RESPONSE COLUMBIA COUNTY COALITION. THIS COALITION COLLABORATES WITH COLUMBIA COUNTY COMMUNITIES TO IDENTIFY, GUIDE, SUPPORT, LEAD AND ADVOCATE FOR PREVENTION AND RECOVERY STRATEGIES TO DECREASE THE OCCURRENCE OF SUBSTANCE ABUSE IN COLUMBIA COUNTY. A STAFF MEMBER ALSO ATTENDED THE OVERDOSE FATALITY REVIEW MEETINGS WHICH IS A PROCESS FOR UNDERSTANDING THE RISK FACTORS AND CIRCUMSTANCES LEADING TO FATAL OVERDOSES AND IDENTIFYING OPPORTUNITIES TO PREVENT FUTURE OVERDOSES.OTHERASPIRUS OFFERS A FRUIT AND VEGETABLE PRESCRIPTION (FVRX) PROGRAM. A HEALTH CARE PROVIDER WRITES THE PRESCRIPTION FOR HEALTH, WHICH IS A $20 VOUCHER FOR PATIENTS TO PURCHASE FRUITS AND VEGETABLES FROM LOCAL FARMERS. THE PROGRAM ALSO PROVIDES NUTRITION INFORMATION AND ACCESS TO RECIPES. THE COMBINATION OF PROVIDER GUIDANCE, A VOUCHER FOR PRODUCE AND KNOWLEDGE CAN HAVE A POWERFUL IMPACT ON FRUIT AND VEGETABLE CONSUMPTION AND ULTIMATELY HEALTH OUTCOMES. ASPIRUS PRIMARILY SUPPORTS THE PROGRAM FINANCIALLY, THOUGH SOME TECHNICAL ASSISTANCE AND RESOURCE-LINKING IS ALSO PROVIDED. IN SUMMER 2024, 110 VOUCHERS WERE GIVEN TO THE PORTAGE BOYS & GIRLS CLUB PARTICIPANTS, AND DOZENS WERE GIVEN TO ASPIRUS DIVINE SAVIOR PATIENTS. DURING THE 2024 SEASON,19 VOUCHERS WERE REDEEMED AT THE LOCAL FARMER'S MARKET. ASPIRUS DIVINE SAVIOR ADDED RESOURCES TO THE FINDHELP SOCIAL NEEDS PLATFORM. THE PLATFORM IS INTEGRATED INTO ASPIRUS' ELECTRONIC HEALTH RECORD AND SUPPORTS PROVIDERS IN IDENTIFYING RESOURCES TO MEET PATIENTS' SOCIAL NEEDS (E.G., TRANSPORTATION, HOUSING, FOOD). POSTCARDS WITH FINDHELP INFORMATION WERE ALSO PRINTED AND DISTRIBUTED THROUGHOUT THE COMMUNITY. THE HOSPITAL CONTINUES TO SUPPORT THE COMMUNITY WITH ITS MEDICALLY INTEGRATED WELLNESS CENTER, LA VITA. COMMUNITY MEMBERS CAN ACCESS THE SERVICES. LAVITA FITNESS CENTER COORDINATES A FOOD DRIVE ANNUALLY AND COLLECTED 500LBS OF FOOD IN 2023. ASPIRUS DIVINE SAVIOR IS REPRESENTED ON THE PORTAGE AREA UNITED WAY BOARD. THE HOSPITAL ALSO PROVIDED FINANCIAL SUPPORT. THE PORTAGE AREA UNITED WAY IS AN ORGANIZATION THAT PROVIDES FUNDING TO PORTAGE AREA AGENCIES WHO PROVIDE MUCH NEEDED SERVICES TO THOSE IN OUR COMMUNITY THAT NEED IT MOST.ASPIRUS DIVINE SAVIOR PROVIDED MULTIPLE PROGRAMS FOR THE COMMUNITY, INCLUDING A HEALTH PRESENTATION AT A LOCAL DAYCARE, A MINI COURSE DAY AT PORTAGE HIGH SCHOOL, PARTICIPATION IN THE TOUCHED TWICE HEALTH FAIR AND NATIONAL NIGHT OUT, AS WELL AS SUPPORT GROUPS FOR INDIVIDUALS WITH DIABETES AND INDIVIDUALS WITH A BRAIN INJURY OR STROKE.ASPIRUS DIVINE SAVIOR HOSTS BLOOD DRIVES EVERY OTHER MONTH TO KEEP THE BLOOD SUPPLY UP FOR LOCAL PATIENTS. THE THREE NEEDS THAT WERE PRIORITIZED IN THE COMMUNITY STAKEHOLDER MEETING AND WILL NOT BE FORMALLY PURSUED BY THE HOSPITAL IN ITS IMPLEMENTATION STRATEGY ARE: - LACK OF COMMUNICATION BETWEEN PARTNERS- LACK OF HEALTH CARE PROVIDERS- TRANSPORTATION THE HOSPITAL VIEWS COMMUNICATION, HEALTH CARE PROVIDERS AND TRANSPORTATION AS CONTRIBUTORS TO THE ISSUES OF MENTAL HEALTH AND SUBSTANCE USE. WHILE THESE ARE NOT THE HOSPITAL'S FORMAL PRIORITIES, THEY MAY BE PART OF THE STRATEGY TO ADDRESS THE PRIORITY NEEDS AROUND MENTAL HEALTH AND SUBSTANCE USE. DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. DIVINE SAVIOR HEALTHCARE, INC. PART V, SECTION B, LINE 13H: THE CHARITABLE CARE POLICY OF DIVINE SAVIOR HEALTHCARE, INC. ALSO ALLOWS FOR AN ADMINISTRATIVE DETERMINATION FOR A PATIENT THAT MAY UNDERGO A CATASTROPHIC EVENT OR UNIQUE CIRCUMSTANCE. THIS ADDITIONAL PROVISION ALLOWS FOR ADMINISTRATION TO MAKE A DETERMINATION THAT MAY ASSIST A PATIENT IN A UNIQUE TIME OF FINANCIAL NEED. 4 1 - ASPIRUS PORTAGE CLINIC 2817 NEW PINERY ROAD PORTAGE WI 53901 PHYSICIAN CLINIC 2 - ASPIRUS DIVINE SAVIOR WELLNESS CENTER 2815 NEW PINERY ROAD PORTAGE WI 53901 WELLNESS CENTER 3 - ASPIRUS TIVOLI COMMUNITY 2805 HUNTERS TRAIL PORTAGE WI 53901 SKILLED NURSING FACILITY, ASSISTED LIVING FACILITY, AND HOME HEALTH PROGRAM 4 - ASPIRUS OXFORD CLINIC N4390 CROSSROADS CLINIC ROAD OXFORD WI 53952 PHYSICIAN 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 6A: DIVINE SAVIOR HEALTHCARE, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S WEBSITE. 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 $2,814,911. PART II, COMMUNITY BUILDING ACTIVITIES: ONE OF THE PRIMARY FACTORS IMPACTING A PERSON'S HEALTH IS THEIR INCOME. IN GENERAL, INDIVIDUALS WITH LOW INCOME HAVE SHORTER LIFESPANS AND LOWER QUALITY OF LIFE (FROM A PHYSICAL HEALTH PERSPECTIVE). ASPIRUS' INVOLVEMENT IN WORKFORCE AND/OR ECONOMIC DEVELOPMENT BOARDS HELPS THE COMMUNITY GAIN STRENGTH IN TERMS OF A DIVERSE ECONOMY, WELL-PAYING JOBS (TO SUPPORT A HIGHER INCOME) AND THE INFRASTRUCTURE (E.G., CHILDCARE) NEEDED FOR A ROBUST ECONOMY. EVERY COMMUNITY DESERVES STRONG HEALTH CARE SERVICES. IN ORDER TO HAVE A STRONG HEALTH CARE SYSTEM, A STRONG HEALTH CARE WORKFORCE IS NEEDED. ONE WAY TO EXPAND THE PIPELINE OF HEALTH CARE WORKERS IS TO OFFER OPPORTUNITIES ABOUT HEALTH CARE CAREERS TO YOUTH STILL IN SCHOOL. HEALTH CAREERS INFORMATION CAN INCREASE YOUNG PEOPLE'S INTEREST IN HEALTH CAREERS AND INCREASE THE NUMBER OF NEW HEALTH CARE WORKERS IN THE FIELD. 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/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. 3. 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 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, 2024 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:- 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, INCLUDING ACADEMIA, INDUSTRY/BUSINESS, PHILANTHROPY, FINANCE, AND 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 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. IF ASPIRUS FINANCIAL COUNSELORS NOTICE THE PATIENT HAS NOT BEEN OFFERED AN APPLICATION WITHIN THE PAST YEAR, THEY WILL ALSO ASK IF THE PATIENT WOULD LIKE ONE MAILED OR IF THE PATIENT SHOWS FINANCIAL DISTRESS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS, WHEN APPLICABLE. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. ELEVATE PFS (CONTRACTED ENTITY) IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: THE PRIMARY SERVICE AREA OF THE HOSPITAL IS COLUMBIA COUNTY, ALTHOUGH IT DOES SERVE NEIGHBORING COUNTIES INCLUDING MARQUETTE AND ADAMS. THE HOSPITAL IS LOCATED IN COLUMBIA COUNTY, POPULATION 58,488. COLUMBIA COUNTY IS CLASSIFIED AS URBAN (ALTHOUGH IT ALSO HAS RURAL AREAS) AND IT COVERS 765 SQUARE MILES AND HAS 76.4 PEOPLE PER SQUARE MILE. HERE ARE SOME DETAILS ABOUT ITS POPULATION: PERSONS UNDER 18 YEARS OLD: 21%PERSONS 65 YEARS AND OVER: 18.4%WHITE PERSONS: 95.3%AFRICAN AMERICAN PERSONS: 1.7%HISPANIC OR LATINO: 3.7%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 5.1%HIGH SCHOOL GRADUATE OR HIGHER: 93.3%PERSONS BELOW POVERTY LEVEL: 6.9%MEDIAN HOUSEHOLD INCOME: $69,262PERCENT WITHOUT HEALTHCARE COVERAGE: 5.1%PERCENT USING PUBLIC INSURANCE (MEDICAID, MEDICARE, VETERANS' BENEFITS, ETC.): 32.5%NUMBER OF HOSPITALS IN THE COUNTY: 2 (INCLUDING ASPIRUS DIVINE SAVIOR HOSPITAL)COLUMBIA COUNTY IS NOT A DESIGNATED HEALTH PROFESSIONS SHORTAGE AREA (HPSA) FOR MENTAL HEALTH, DENTAL CARE OR PRIMARY CARE. THE CITY OF PORTAGE (IN COLUMBIA COUNTY) IS A POPULATION-DESIGNATED HPSA FOR MENTAL HEALTH. NEIGHBORING MARQUETTE AND ADAMS COUNTIES ARE SHORTAGE AREAS FOR MENTAL HEALTH, DENTAL CARE AND PRIMARY CARE. 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 BOARD OF DIRECTORS THAT REFLECTS THE COMMUNITY. - 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 TRANSPORTATION ASSISTANCE FOR PATIENTS AS APPROPRIATE. - PROVIDES PRECEPTORS FOR HEALTH PROFESSIONS STUDENTS-IN-TRAINING, WHICH ADVANCES THE HEALTH CARE WORKFORCE. - PROMOTES AND HOSTS BLOOD DRIVES. 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 18 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 HARBOR RECOVERY CENTER PO BOX 803 PORTAGE WI 53901 873034870 501(C)(3) 15000 0 SUBSTANCE ABUSE/ADDICTION RECOVERY PROGRAM SUPPORT THREE BRIDGES RECOVERY WISCONSIN INC 441 GARFIELD STREET WISCONSIN RAPIDS WI 54494 825015616 501(C)(3) 10000 0 SUBSTANCE ABUSE/ADDICTION RECOVERY PROGRAM SUPPORT PORTAGE AREA UNITED WAY PO BOX 354 PORTAGE WI 53901 237166773 501(C)(3) 5500 0 PORTAGE COMMUNITY PROGRAM SUPPORT 3 0 PART I, LINE 2: WHEN COMMUNITY BENEFIT FUNDS ARE DONATED TO LOCAL AGENCIES TO COMPLETE COMMUNITY HEALTH IMPROVEMENT EFFORTS, ASPIRUS REQUESTS A FORMAL REPORT AT THE CONCLUSION OF THE FISCAL YEAR. 0 1 0 0 0 0 0 0 0 MATTHEW HEYWOOD PRESIDENT & CEO ASPIRUS 0 1252366 0 353673 0 12078 0 9900 0 294286 0 1922303 0 0 SIDNEY SCZYGELSKI SENIOR VP OF FINANCE/CFO 0 659271 0 285397 0 350078 0 9900 0 124373 0 1429019 0 337358 JOESPH MUELLER PHYSICIAN 950136 0 0 0 45326 0 9900 0 36201 0 1041563 0 0 0 JESSE TISCHER VICE CHAIR (THRU JAN '24)/SVP & PRES 0 593684 0 118969 0 51744 0 4185 0 111815 0 880397 0 50242 MICHAEL HOLZHUETER ASSIST. SEC. /SVP-GENERAL COUNSEL 0 545744 0 83740 0 59451 0 9440 0 106471 0 804846 0 55822 JOSHUA POGORELEC DO BOARD MEMBER/REGIONAL MED. DIRECTOR 0 678838 0 0 0 25800 0 9900 0 35726 0 750264 0 0 MICHAEL WALTERS SVP-SYSTEM CHIEF MEDICAL OFFICER 0 553897 0 56638 0 59096 0 9900 0 39845 0 719376 0 56806 JENNIFER REDMAN-SCHELL BOARD MEMBER/SVP & PRES. -AMG 0 509155 0 94839 0 3640 0 9900 0 84664 0 702198 0 0 JAMES MATHESON SVP-CHIEF STRATEGY OFFICER 0 405912 0 73047 0 43992 0 8193 0 94764 0 625908 0 32339 ERIC ANDERSON CHAIR(THRU SEP '23)/CHIEF COMPLIANCE 0 423444 0 72853 0 2438 0 9358 0 90310 0 598403 0 0 TRINA DANIELS MD BOARD MEMBER/PHYSICIAN 0 537474 0 0 0 5618 0 9900 0 29471 0 582463 0 0 CONSTANCE BRADLEY SECRETARY/SVP-PRES REG MKTS 0 391495 0 70030 0 27953 0 9900 0 80267 0 579645 0 24444 SUSAN SCHNEIDER VP-SYSTEM SR. PHYSICIAN EXEC. 0 450107 0 55813 0 4242 0 9900 0 24265 0 544327 0 0 WALTER KAO PHYSICIAN 487900 0 0 0 10539 0 9758 0 1568 0 509765 0 0 0 BRAD ROGOWSKI PHYSICIAN 473950 0 0 0 6242 0 9900 0 16599 0 506691 0 0 0 TERRA THIMM PHYSICIAN 396307 0 5000 0 37432 0 9157 0 39028 0 486924 0 0 0 ROBERT SMITH (NV) PRESIDENT-ASPIRUS SE 0 316346 0 68932 0 8977 0 5475 0 49390 0 449120 0 5807 CRAIG DESTREE MEDICAL DIRECTOR 396841 0 0 0 15461 0 9900 0 23735 0 445937 0 0 0 TODD RICHARDSON SVP-CHIEF INFORMATION OFFICER 0 216988 0 69318 0 64143 0 6050 0 70510 0 427009 0 39964 BRIAN KIEF (NV) PRESIDENT-ADS & ARH 0 314196 0 56117 0 2961 0 9900 0 34581 0 417755 0 0 BONITA KOLRUD MD BOARD MEMBER/PHYSICIAN 0 349740 0 0 0 8564 0 8183 0 32005 0 398492 0 0 SUSAN KRECKMAN MD BOARD MEMBER/PHYSICIAN 0 335158 0 0 0 7281 0 8678 0 29412 0 380529 0 0 JEFFREY JONES SVP-CFO (THRU 04/23) 0 220906 0 0 0 2036 0 3492 0 9464 0 235898 0 0 PART I, LINE 3 FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION RELIED ON THE RELATED ORGANIZATIONS TO ESTABLISH 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. PART I, LINE 4B SCHEDULE J, PART I, LINE 4B RELATED PARTY INFORMATION - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $337,358 J. TISCHER $50,242 J. MATHESON $32,339 M. HOLZHUETER $55,822 T. RICHARDSON $39,964 M. WALTERS $56,806 C. BRADLEY $24,444 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 AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2020-06-29 39808745 REFUND 2008 ISSUE 0 0 0 A 9827275 39808745 139675 39669070 2020 0 1 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART VI: THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY REVENUE BONDS, SERIES 2020 BONDS (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY DIVINE SAVIOR HEALTHCARE, INC. (EIN 39-0806250). THE PROCEEDS OF THE SERIES 2020 BONDS WERE USED TO REFINANCE THE DIVINE SAVIOR HEALTHCARE, INC., SERIES 2016 BONDS (REFINANCING OF SERIES 2006 BONDS) AND SERIES 2019 BONDS (REFINANCING OF SERIES 2009, 2012, 2014 BONDS). INFORMATION REGARDING THE SERIES 2020 BONDS IS REPORTED IN SCHEDULE K FOR THAT ORGANIZATION. FOR THE 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 2020 BONDS LOANED TO THE ORGANIZATION. FOR THE ENTITY THAT BORROWED FUNDS, THE INFORMATION REPORTED IN PART IV OF SCHEDULE K RELATES TO THE ENTIRE ISSUE OF THE SERIES 2020 BONDS. PART III, LINES 2, 3A, AND 3B: ASPIRUS, INC., THE PARENT ORGANIZATION OF DIVINE SAVIOR HEALTHCARE, 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. PART III, LINE 9: SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES 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 11 VOTING DIRECTORS ALLOCATED AS FOLLOW. THERE SHALL BE FOUR CLASSES OF VOTING DIRECTORS: THE COMMUNITY CLASS, ASPIRUS CLASS, PROVIDER CLASS, AND SISTERS OF DIVINE SAVIOR (SDS) CLASS. NO LESS THAN SIX INDEPENDENT COMMUNITY CLASS DIRECTORS (APPROVED BY MEMBER), 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. AND ONE SDS CLASS DIRECTOR NOMINATED AND ELECTED BY SDS. 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 OFFICER; 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. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND IS 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, DIVINE SAVIOR HEALTHCARE, 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 AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 290,416. MANAGEMENT AND GENERAL EXPENSES 176,438. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 466,854. CONTRACT NURSING AND OTHER LABOR FEES: PROGRAM SERVICE EXPENSES 6,838,172. MANAGEMENT AND GENERAL EXPENSES 4,154,420. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,992,592. OTHER FEES: PROGRAM SERVICE EXPENSES 644,726. MANAGEMENT AND GENERAL EXPENSES 392,053. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,036,779. HOUSEKEEPING FEES: PROGRAM SERVICE EXPENSES 115,785. MANAGEMENT AND GENERAL EXPENSES 70,343. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 186,128. FORM 990, PART XI, LINE 9: INTERCOMPANY TRANSFERS 1,717,589. 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