2018-04-04T17:37:28-05:00 2017-06-30 390758449 WIPFLI LLP 11 SCOTT ST WAUSAU WI 54401 990 2016-07-01 391256656 Aspirus Health Foundation Inc ASPI 7158472250 425 Pine Ridge Blvd Wausau WI 54401 Sidney C Sczygelski CFO/SENIOR VP OF FINANCE 7158472250 2018-03-10 1 Kathleen J LaBrake CPA P00164006 7158453111 2018-03-10 50.50.56.238 2018-03-10 11:29:49 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 FEDE6E2ED2B59B1C13DC36E78E84E5663127854C 2016 2021-01-29 14:40:06Z Matthew Heywood 333 PINE RIDGE BLVD WAUSAU WI 54401 5136238 0 X WWW.ASPIRUS.ORG X 1976 WI We heal people, promote health and strengthen communities. 13 10 0 500 0 0 6273261 1651052 0 0 310662 741667 116374 136997 6700297 2529716 730137 903147 0 0 286445 282494 0 0 91619 191134 238425 1207716 1424066 5492581 1105650 24215379 28402818 5046581 6068829 19168798 22333989 We heal people, promote health and strengthen communities. 0 0 624240 624240 DONOR DESIGNATED CONTRIBUTIONS ACTIVITY:THROUGH ITS PHILANTHROPIC ACTIVITIES THE FOUNDATION ADVANCESEXTRAORDINARY HEALTH CARE BY PROVIDING FUNDS FOR RESEARCH, EDUCATION,INFORMATION, CLINICAL PROGRAMS AND CARE DELIVERY, HEALTH SERVICES, AND SCREENING. DONOR DESIGNATED CONTRIBUTIONS PROVIDE SUPPORT FOR THE DESIGNATED FUNDS OF ASPIRUS WAUSAU HOSPITAL. 504577 278907 72142 UNRESTRICTED CONTRIBUTIONS ACTIVITY:THROUGH ITS PHILANTHROPIC ACTIVITIES THE FOUNDATION ADVANCESEXTRAORDINARY HEALTH CARE BY PROVIDING FUNDS FOR RESEARCH, EDUCATION,INFORMATION, PROGRAMS, SERVICES AND SCREENINGS, COMMUNITY HEALTH INITIATIVES, AND WORKFORCE DEVELOPMENT SCHOLARSHIPS. 1128817 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 19 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X SIDNEY C SCZYGELSKI 7158472250 2200 Westwood Drive WAUSAU WI 54401 X JOHN TUBBS Chair 1.00 X X 0 0 0 Paul M LaPree Vice Chair 1.00 X X 0 0 0 Deborah Kane Secretary/Treasurer 1.00 X X 0 0 0 Kay Gruling MD Director 1.00 X 0 0 0 Chad Radke DO Director 1.00 3.00 X 0 0 0 BILL BECKER DIRECTOR 1.00 X 0 0 0 BRAD PECK DIRECTOR 1.00 X 0 0 0 BEN REIF DIRECTOR 1.00 X 0 0 0 STEVEN WEILAND MD DIRECTOR 1.00 40.00 X 0 0 0 Lyn Krohn DireCTOR 1.00 X 0 0 0 Charles Peth DireCTOR 1.00 X 0 0 0 Noel Sonnek MD DIRECTOR / PHYSICIAN 1.00 40.00 X 0 343295 29443 Steward Etten director 1.00 X 0 0 0 Paul Dobbratz Director 1.00 X 0 0 0 Mary Thao Director 1.00 X 0 0 0 MATTHEW HEYWOOD CEO AI 1.00 50.00 X 0 994138 146997 KALYNN PEMPEK EXECUTIVE DIRECTOR 40.00 X 0 144790 29320 SIDNEY C SCZYGELSKI CFO AI/ASST TREAS 1.00 50.00 X 0 562384 93647 Cari Logemann SVP & General Counsel/Asst 1.00 50.00 X 0 359569 76513 JOHN HEISLER SVP CHIEF HR OFFICER 1.00 49.00 X 0 331227 67055 DEAN DANNER SVP AMBULATORY SERVICES 1.00 48.00 X 0 367581 72374 MICHAEL MCGRAIL MD SVP SYSTEM CMO 1.00 50.00 X 0 485324 82591 RUTH RISLEY-GraY SVP NURSING, CNO 1.00 49.00 X 0 347049 74562 TODD RICHARDSON SVP AND CIO 1.00 50.00 X 0 393488 80991 RICK NEVERS SVP Reg Ops System Int Off 1.00 50.00 X 0 381217 70836 KATHRYNE MCGOWAN SVP POPULATION HEALTH, ANI 1.00 50.00 X 0 309566 70073 0 5019628 894402 0 0 1 0 0 202601 313700 1134751 62617 1651052 595442 595442 2677017 2530792 146225 146225 146225 113707 202601 63772 49935 49935 26878 11958 14920 14920 ADMINISTRATIVE FEE 561000 72142 72142 72142 2529716 72142 0 806522 903147 903147 95866 57520 19173 19173 122017 51976 24879 45162 64611 32470 13063 19078 122049 122049 8751 8751 2224 2224 24808 21335 65 3408 26644 16809 6783 3052 1465 939 199 327 6444 6444 Miscellaneous other 27336 27336 Bad Debt 13027 13027 ANNUAL EDUCATION FORUM 5677 4258 1419 1424066 1128817 203630 91619 420422 877333 459963 134374 25695 79931 21867 21867 0 0 23301869 27311180 7430 0 24215379 28402818 55574 106342 4991007 5962487 5046581 6068829 X 13513913 15483200 312326 1027761 5342559 5823028 19168798 22333989 24215379 28402818 X 1105650 1806731 252810 X X 0 1 X 1 0 X 1113558 1071644 982421 6273261 1651052 11091936 1113558 1071644 982421 6273261 1651052 11091936 5058400 6033536 84992 154785 246436 251655 595442 1333310 599 599 49767 55573 60092 59812 72142 297386 12723231 563411 0.47420 0.55170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13335036 802177 1722766 -100000 -17978 15742001 282419 13052232 385 13335036 265006 10706 6707 282419 214273 12537 38196 265006 174306 15000 24967 214273 0.57950 0.36990 0.05060 0 0 21867 21867 0 0 DONOR IMPOSED LIABILITIES 5962487 5962487 X 3712207 1806731 1806731 1905476 624240 624240 2529716 799826 0 799826 624240 624240 1424066 Part V, Line 4: THE ENDOWMENTS ARE MAINTAINED TO SUPPORT QUALITY OF LIFE PROGRAMS FOR HOSPICE AND PALLIATIVE CARE PATIENTS AND FAMILIES, CANCER PATIENTS, HEART PATIENTS, AND THE SCHOLARSHIP PROGRAM. Part X, Line 2: The Foundation IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE FOUNDATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. Part XI, Line 4b - Other Adjustments: DESIGNATED CONTRIBUTIONS RAISED FOR OTHERS 624,240. Part XII, Line 4b - Other Adjustments: DESIGNATED CONTRIBUTIONS RAISED FOR OTHERS 624,240. FESTIVAL OF TREES 196879 119613 77266 328 12559 300 16160 WOMEN'S HEALTH GOLF 90562 67979 22583 5417 10876 8990 500 1218 1 28867 15009 13858 1945 4427 1052 316308 202601 113707 7362 15631 21549 800 18430 63772 49935 26878 709 475 602 10172 1 1.00000 26878 709 475 602 10172 11958 14920 WI 1 0 1 0 1.00000 Kristin Phillips 425 PINE RIDGE BLVD WAUSAU WI 54401 0 KALYNN PEMPEK 2430 RESP. FOR SPECIAL EVENT FUNDRAISERS AND ANNUAL GIVING PROGRAMS INCLUDING COORDINATING RAFFLES AS AN INTEGRAL COMPONENT OF EVENTS AND CHARITABLE GIVING PROGRAMS. X 0 1 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 501(C)(3) 259963 N/A N/A Cancer program, Cardiac program, Women's health fund including NICU, breast Northcentral Technical College Foundation Inc 1000 W Campus Drive Wausau WI 54401 391266481 501(C)(3) 5000 N/A N/A To fund health care workforce scholarships Marathon County alcohol & other drug partnership council po box 2145 WaUSAU WI 54402 391699560 501(C)(3) 7500 N/A N/A to fund assessment on prevalence and perceptions of medical abuse Community Foundation of North Central Wisconsin Inc 500 First Street Suite 2600 Wausau WI 54403 391577472 501(C)(3) 10000 N/A N/A To Fund JoJo's Jungle Adaptive Park Rhinelander Area Food Pantry 627 Coon Street Rhinelander WI 54501 331141966 501(C)(3) 6000 N/A N/A To fund Weekend food for kids Good News Project Inc 1106 N 5th Street waUSAU WI 54403 391916194 501(C)(3) 5000 n/A n/A To help fund Bariatric equipment University of Wisconsin Systems 780 Regent Street Madison WI 53706 391805963 N/A 45903 n/A n/A Scholarships for Health Care Professionals The Medical College of Wisconsin Inc 8701 Watertown Plank Road Milwaukee WI 53226 390806261 501(C)(3) 75000 n/A n/A Scholarships for health care professionals 7 1 Part I, Line 2: ALL PAYMENTS ARE MONITORED BY THE GRANT ADMINISTRATOR TO ENSURE ADHERENCE TO THE STATED GRANT PURPOSE. ANY UNUSED OR UNSPENT FUNDS ARE RETURNED TO THE GRANTOR. X X 1 0 0 1 0 0 0 0 0 0 0 Noel Sonnek MD DIRECTOR / PHYSICIAN 0 334474 0 0 0 8821 0 18830 0 10613 0 372738 0 0 MATTHEW HEYWOOD CEO AI 0 734056 0 257815 0 2267 0 18830 0 128167 0 1141135 0 0 KALYNN PEMPEK EXECUTIVE DIRECTOR 0 129893 0 10430 0 4467 0 12138 0 17182 0 174110 0 0 SIDNEY C SCZYGELSKI CFO AI/ASST TREAS 0 441313 0 93183 0 27888 0 18830 0 74817 0 656031 0 0 Cari Logemann SVP & General Counsel/Asst 0 295196 0 63114 0 1259 0 18556 0 57957 0 436082 0 0 JOHN HEISLER SVP CHIEF HR OFFICER 0 265586 0 56537 0 9104 0 13026 0 54029 0 398282 0 0 DEAN DANNER SVP AMBULATORY SERVICES 0 281530 0 50514 0 35537 0 17796 0 54578 0 439955 0 0 MICHAEL MCGRAIL MD SVP SYSTEM CMO 0 382842 0 81065 0 21417 0 11948 0 70643 0 567915 0 0 RUTH RISLEY-GraY SVP NURSING, CNO 0 263353 0 56735 0 26961 0 17865 0 56697 0 421611 0 0 TODD RICHARDSON SVP AND CIO 0 284010 0 61187 0 48291 0 18830 0 62161 0 474479 0 0 RICK NEVERS SVP Reg Ops System Int Off 0 287340 0 59975 0 33902 0 18830 0 52006 0 452053 0 0 KATHRYNE MCGOWAN SVP POPULATION HEALTH, ANI 0 253530 0 54574 0 1462 0 12888 0 57185 0 379639 0 0 Part I, Line 1a TRAVEL FOR COMPANIONS AND TAX INDEMNIFICATION AND GROSS-UP PAYMENTS, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. TRAVEL FOR COMPANIONS - S. SCZYGELSKI $188, M. HEYWOOD $188, J. HEISLER $181, D. DANNER $184, R. RISLEY-GRaY $152, R. NEVERS $206, K. MCGOWAN $199. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - N. SONNEK $438 - Included in income. Part I, Line 3 FOR THE PURPOSES OF DETERMINING COMPENSATIOn FOR THE FILING ORGANIZATION, ASPIRUS HEALTH FOUNDATION, INC. RELIED ON 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 - SUPPLEMENTAL NONQUALIFIED RETIRMENT 457 (F) DISTRIBUTION: S. SCZYGELSKI $20,721, D. DANNER $30,171, R. RISLEY-GRaY $24,196, T. RICHARDSON $47,095, R. NEVERS $31,318. 457(F) RETIREMENT PLAN PROFILE: KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1ST 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: 9% FOR VICE PRESIDENT; 13% FOR SENIOR LEADERSHIP COUNCIL; AND 15% FOR THE CEO. IF THE 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 MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT, TO 12. 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; 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. X Holiday Decorations 103 34512 FMV X Gift Baskets 131 26750 FMV X Paid Time Off (Hours) 16 1355 FMV 0 0 1 0 Part I, Line 32b: Part I, Types of Property - Donated items have been grouped into broad categories which can be supported by a detailed description of items contributed. Part 1 Column (b) reflects the number of contributions. Aspirus Health Foundation policy maintains that the fair market value of an item equates to the cash value received for those specified goods. Form 990, Part VI, Section A, line 6 THE PARENT ORGANIZATION, ASPIRUS, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Section A, line 7a See explanation for Form 990, Part VI, Line 7B. 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, and 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 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, Officers, 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 DOCUMENTED IN THE MEETING MINUTES. Form 990, Part VI, Section B, line 15 For purposes of determining compensation, Aspirus Health Foundation, 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 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, EXPLANATION FOR HOURS WORKED: Some officers and directors also provided service to other related organizations other than Aspirus Health Foundation, Inc. These hours are reflected in Line 2 of Column B. Form 990, Part XI, line 9: Equity Transfers from Aspirus Affilates 252,810. FORM 990, PART XII, LINE 2C: The audit committee of the Board of Directors of Aspirus, Inc., the parent organization of Aspirus Health Foundation, Inc., assumes the responsibility for the oversight of the consolidated audit of the financial statements and selection of the independent accountant. There was no change in this process in the past year. Grand View Hospital auxiliary N 10561 GRAND VIEW LANE IRONWOOD MI 49938 237173363 SUPPORTING ORG TO HOSPITAL'S LIFELINE EMERGENCY SYSTEM MI 501(c)(3) Line 10 ASPIRUS Ironwood Hospital & Clinics Inc 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET laurium MI 49913 381443361 hosPITAL MI 501(c)(3) Line 3 asprius inc 1 ASPIRUS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE SYSTEM MANAGEMENT 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 VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTHCARE 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 RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(c)(3) Line 3 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 IRON RIVER HOSPTIAL & 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 EXTENDED SERVICES INC 425 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(c)(3) Line 10 ASPIRUS INC 1 ASPIRUS CLINICS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL 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 Western Upper Michigan Eye Care LLC 131 W Genesee Street Iron River MI 49935 272324957 Eye Care Services MI N/A ASPIRUS NETWORK INC 3000 WESTHILL DR 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 1 Aspirus Keweenaw Enterprise 205 osceola street laurium MI 49913 383390273 Pharmacy MI N/A C 1 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 Aspirus Wausau Hospital Inc C 313700 Aspirus Wausau Hospital Inc B 259963 Aspirus Wausau Hospital Inc O 286979 Aspirus Inc M 122049 aspirus inc C 252810 Schedule R, Part V, Line 1D All outstanding obligated group debt is guaranteed by all members of the obligated group.