2017-02-08T10:52:45-06:00 2016-06-30 390758449 Wipfli LLP PO Box 8010 Wausau WI 544028010 990 2015-07-01 390964813 Aspirus Medford Hospital & Clinics Inc ASPI 7157488100 135 South Gibson Medford WI 54451 GREG SHAW CFO 7157488100 2017-01-19 1 Kathleen J LaBrake CPA P00164006 7158453111 2017-01-19 2015 2021-01-29 14:40:06Z BRUCE CZECH 135 SOUTH GIBSON STREET MEDFORD WI 54451 86531260 0 X www.aspirus.org/AspirusMedfordHospital X 1958 WI ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS A CRITICAL ACCESS, LEVEL III, TRAUMA CARE HOSPITAL. AMHC OFFERS COMPREHENSIVE PRIMARY CARE THROUGH OUR CLINICS IN GILMAN, MEDFORD, PHILLIPS, PRENTICE, ABBOTSFORD, AND RIB LAKE. AMHC HAS THERAPY CENTERS IN PRENTICE AND MEDFORD, AN ACUTE CARE SWING BED PROGRAM, A KIDNEY CARE CENTER (DIALYSIS CENTER), A PUBLIC FITNESS CENTER, A RETAIL PHARMACY IN MEDFORD, PLUS A CONTINUUM OF SENIOR CARE SERVICES FROM ASSISTED LIVING TO RESTORATIVE NURSING SERVICES. 12 2 728 111 4693821 -386630 993800 108125 74816593 75967486 1773755 355197 114997 128976 77699145 76559784 44642 2054385 0 0 37980797 38046820 0 0 0 27429271 31116414 65454710 71217619 12244435 5342165 106014742 111066092 26189238 25123980 79825504 85942112 X ASPIRUS MEDFORD HOSPITAL AND CLINICS, INC. IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM WHICH LEADS BY ADVANCING INITITATIVES DEDICATED TO IMPROVING THE HEALTH OF ALL WE SERVE. WE WORK COLLABORATIVELY WITH OTHERS WHO SHARE OUR PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. 0 0 39539528 2054385 50975090 HOSPITAL SERVICES - ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN MEDFORD, WISCONSIN. DURING THE YEAR ENDED JUNE 30, 2016, THE HOSPITAL HAD 2,070 INPATIENT DAYS AND 70,766 OUTPATIENT VISITS. SURGERY, EMERGENCY CARE, RADIOLOGY, LABORATORY, CHEMOTHERAPY/INFUSION, DIALYSIS, AND THERAPIES ARE JUST SOME OF THE OTHER SERVICES THAT AMHC PROVIDES WITHIN THE HOSPITAL. AS A CRITICAL ACCESS HOSPITAL, AMHC PROVIDES ACCESS TO LOCAL HEALTH CARE FOR THE COMMUNITIES IN WHICH THEY SERVE.AMHC ALSO PROMISES TO THE COMMUNITY TO PROVIDE HEALTH CARE SERVICES TO THOSE IN NEED REGARDLESS OF THEIR ABILITY TO PAY AS DEFINED IN AMHC'S CHARITY AND COMMUNITY CARE POLICIES AND PROGRAMS. DURING FISCAL YEAR 2015, AMHC'S CHARITY CARE PROGRAM AWARDED APPROXIMATLEY $2,470,514 IN FINANCIAL ASSISTANCE THROUGH CHARGE REDUCTIONS TO PATIENTS WHO COULD NOT OTHERWISE AFFORD CARE. ADDITIONAL INFORMATION ON THE COST OF PROVIDING CHARITY CARE TO PATIENTS CAN BE FOUND IN SCHEDULE H OF THE FORM 990. IN ADDITION TO PROVIDING CHARITY CARE SERVICES, AMHC ALSO PROVIDES A SIGNIFICANT AMOUNT OF SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS. DURING FISCAL YEAR 2016, APPROXIMATELY 54 PERCENT OF THE PATIENT SERVICES PROVIDED BY AMHC WERE PROVIDED TO MEDICARE AND MEDICAID PROGRAM BENEFICIARIES. THESE SERVICES ARE CONSIDERED A LARGE NEED IN THE COMMUNITY AND AMHC IS OFTEN REIMBURSED AT RATES BELOW THE COST OF PROVIDING THE CARE FOR THESE PATIENTS. 9710988 12519585 CLINIC SERVICES - AMHC OPERATES SIX OUTPATIENT CLINICS IN THE COMMUNITIES OF ABBOTSFORD, GILMAN, MEDFORD, PHILLIPS, PRENTICE AND RIB LAKE (ALL LOCATED WITHIN THE STATE OF WISCONSIN). DURING THE YEAR ENDED JUNE 30, 2016, THE CLINICS HAD 61,793 VISITS. AMHC PROVIDES ACCESS TO PRIMARY CARE PHYSICIANS IN THESE RURAL AND MEDICALLY UNDERSERVED AREAS.THE CLINICS ALSO SERVES A LARGE PORTION OF ELDERLY, DISABLED, AND LOW INCOME PATIENTS WHO ARE COVERED UNDER THE MEDICARE AND WISCONSIN MEDICAID PROGRAMS. PATIENTS OF THE AMHC CLINICS ARE ALSO ELIGIBLE FOR CHARITY CARE AS DEFINED BY AMHC's CHARITY CARE POLICY. CHARITY CARE AMOUNTS FOR THE CLINICS ARE INCLUDED IN THE TOTAL NOTED UNDER 4A ABOVE. 3394257 4375938 SENIOR CARE SERVICES - AMHC OPERATES A 99-BED SKILLED NURSING FACILITY (SNF), 10 CBRF APARTMENTS, AND A 28-UNIT RCAC. DURING THE YEAR ENDED JUNE 30, 2016, THE SNF HAD A DAILY CENSUS OF 72.2 AND THE RCAC HAD A DAILY CENSUS OF 27.2. THROUGH THESE SENIOR CARE SERVICES, AMHC PROVIDES CARE AND ASSISTANCE TO THE ELDERLY IN OUR COMMUNITY. A MAJORITY OF THE RESIDENTS RECEIVING SENIOR CARE SERVICES AT AMHC RECEIVE CARE UNDER THE WISCONSIN MEDICAID OR FAMILY CARE PROGRAMS. AMHC RECOGNIZES THAT THE COST OF CARING FOR THESE INDIVIDUALS OFTEN EXTENDS BEYOND THE AMOUNT THAT IS PAID TO AMHC BY THE MEDICAID PROGRAM. ADDITIONAL INFORMATION ON THE COST OF PROVIDING SERVICES TO MEDICAID PROGRAM BENEFICIARIES CAN BE FOUND IN SCHEDULE H OF THE FORM 990. 3794324 2034016 3794324 2034016 56439097 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 116 0 1 728 1 1 1 0 0 0 0 0 0 0 0 0 X 12 2 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X GREG SHAW CFO 7157488100 135 SOUTH GIBSON STREET MEDFORD WI 54451 X Bruce Czech Chair 1.00 1.00 X X 0 0 0 F Dean Danner Jr Vice Chair 1.00 48.00 X X 0 333863 69073 Debbie Woods Treasurer 1.00 0.00 X X 0 0 0 Susan Frazier Physician / Secretary 40.00 X X 202330 0 20492 Matthew Heywood Board Member/Asst. Secretary 1.00 50.00 X 0 884848 132937 Graham Courtney Board Member 40.00 1.00 X 0 0 0 Michael Riggle Board Member 1.00 1.00 X 0 0 0 Rick Nevers Board Member 1.00 50.00 X 0 391429 71338 Ruth Risley-Gray Board Member 1.00 49.00 X 0 307360 65088 Troy D Sennholz Chief of Staff / Board Member 40.00 X 353548 0 35942 Cathy Reuter Physician / Board Member 40.00 X 148855 0 5529 Patrick Belson Physician / Board Member 40.00 X 370283 0 33358 Erick T Branstetter Physician / Secretary (Termed 10/15) 40.00 X X 533986 0 35606 Gregory A Olson President / CEO 40.00 2.00 X 377054 0 31236 Greg Shaw CFO 40.00 X 104292 0 11696 Sidney Sczygelski SVP of Finance and CFO 1.00 50.00 X 0 580594 89459 Jodi Johnson VP Patient Care Services 40.00 1.00 X 163013 0 13086 Angela Hupf VP Human Resources 40.00 X 182443 0 28160 Kathryne McGowan SVP Population Health, Executive Director ANI 1.00 50.00 X 0 288000 61581 Cari Logemann SVP & General Counsel 1.00 50.00 X 0 324135 70669 Todd Richardson SVP & CIO 1.00 50.00 X 0 334322 77297 Michael McGrail SVP System CMO 1.00 50.00 X 0 439142 69729 John Heisler SVP & Chief HR Officer 1.00 49.00 X 0 336213 63612 Sujatha Roberts Physician 40.00 X 358698 0 35858 Amy A Falkenberg Physician 40.00 X 348248 0 40858 Mohammas Taha Physician 40.00 X 311056 0 37071 Larry Brunzkick Physician 40.00 X 297410 0 35606 Ryan Diegel Physician 40.00 X 285376 0 34812 Marita Hattem Board Member (Termed - 01/2015) 1.00 X 52061 0 9546 4088653 4219906 1179639 45 1 1 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 Echo, sleep lab, physician, and other 8014942 Aspirus Inc 333 PINE RIDGE BLVD WAUSAU WI 54401 Corporate Services 5268014 Miron Construction Co Inc PO Box 1372 GREEN BAY WI 54305 Contracted Construction Co 701260 Shared Medical Services Inc 209 Limestone Pass Cottage Grove WI 53527 Contracted Imaging Services 494600 American Radiology SC 372 E 16th PL Lombard IL 60148 Contracted Employment 366956 33 59620 48505 108125 PATIENT SERVICE REVENUE 621110 65948487 65947647 840 PHARMACY REVENUE 446110 8649963 3956982 4692981 OTHER OPERATING REVENUE 621110 688346 688346 CONTRACT SERVICE REVENUE 621110 458050 458050 CAFETERIA 621990 222640 222640 75967486 1377125 1377125 144544 15568 128976 128976 128976 8864454 69526 9879112 76796 -1014658 -7270 -1021928 -1021928 76559784 69904629 4693821 1853209 X 2054385 2054385 2544538 1826386 718152 25711273 22957249 2754024 1484345 1319567 164778 6462572 5444921 1017651 1844092 1607728 236364 43502 43502 42096 42096 11743049 4224911 7518138 278563 278563 127232 122731 4501 184397 184397 1983179 1302999 680180 125267 89087 36180 300593 271669 28924 3615018 3170856 444162 237038 80977 156061 MEDICAL SUPPLIES 11086453 10941433 145020 LICENSES AND FEES 526605 313252 213353 EQUIPMENT RENTAL/MAINTE 417060 304584 112476 BAD DEBT EXPENSE 406362 406362 71217619 56439097 14778522 0 10893109 17668485 8962003 8491332 1049615 1112166 556167 443593 62921199 31674804 32477959 31246395 43595595 44955564 2077008 2088976 6403286 5059581 106014742 111066092 7735176 7053336 16011253 15667559 2442809 2403085 26189238 25123980 X 78134807 84400495 1570697 1421617 120000 120000 79825504 85942112 106014742 111066092 X 5342165 821444 -47001 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12168 12168 0 PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE AHA AND WHA HAVE NOTIFIED AMHC THAT A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. The percentages of dues attributed to lobbying are 22.12% for the AHA and 15.5% for WHA for dollar amounts of $3,604 and $2,439, respectively. AMHC IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND IMPROVE HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS INCLUDES SOME LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. $6,125 OR 19.4% OF THESE DUES WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 131113 -9209 121904 129531 1582 131113 127340 2191 129531 127536 -196 127340 126900 636 127536 0.00000 0.98440 0.01560 0 1 1 227478 227478 41559394 17881356 23678038 17910768 12300886 5609882 3223559 1492562 1730997 31246395 Deferred Compensation 2209674 Long-Term Insurance Liability 193411 2403085 X 76938084 821444 15568 837012 76101072 458712 458712 76559784 68834095 22838 22838 68811257 2406362 2406362 71217619 Part V, Line 4: TERM-ENDOWMENT FUNDS HELD BY ASPIRUS MEDFORD FOUNDATION, INC.; ANY AMOUNT ABOVE $120,000 MAY BE USED TO PURCHASE ITEMS FOR THE COUNTRY GARDENS ASSISTED LIVING FACILITY AT ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. Part X, Line 2: AMHC 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. AMHC IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT. Part XI, Line 2d - Other Adjustments: Rental Expenses 15,568. Part XI, Line 4b - Other Adjustments: Change in interest in Net Assets of AMHC Foundation, Inc. 59,620. Provision for bad debts 406,362. Loss on Sale of Fixed Assets -7,270. Part XII, Line 2d - Other Adjustments: Loss on Sale of Fixed Assets 7,270. Rent Expense 15,568. Part XII, Line 4b - Other Adjustments: PROVISION FOR BAD DEBTS 406,362. Contribution Expense 2,000,000. 1 1 X 1 X 1 X 1 1 1 0 1 1 1266556 1266556 0.01790 12506738 10850960 1655778 0.02340 577648 428264 149384 0.00210 14350942 11279224 3071718 0.04340 265255 265255 0.00370 6047 6047 0.00010 1258253 1120649 137604 0.00190 51495 51495 0.00070 1581050 1120649 460401 0.00640 15931992 12399873 3532119 0.04980 8943 8943 0.00010 73252 73252 0.00100 82195 82195 0.00110 1 208331 0 10384075 10340517 43558 X 1 0 1 1 Aspirus Medford Hospital 135 SOUTH GIBSON STREET MEDFORD WI 54451 1027 X X X X Aspirus Medford Hospital 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X http://www.aspirus.org/Uploads/Public/Documents/CHIPReport2016-18%20(Update X 1 15 1 http://aspirus.org/Uploads/Public/Documents/Comm-Benefit-Report-AMH.pdf 1 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X 1 X www.aspirus.org/financialaid X www.aspirus.org/financialaid X www.aspirus.org/financialaid X X X X X 1 X 0 X X X X 1 X 0 0 Aspirus Medford Hospital Part V, Section B, Line 5: Aspirus Medford Hospital & Clinics gathered qualitative information and perspectives on community health needs through two rounds of one-on-one and small group interviews with key community stakeholders. The primary goal of these interviews were to ascertain a range of perspectives on the community's health needs. AMHC gathered information from the following specified groups within the community: people with special knowledge or expertise in public health - federal, tribal, regional, state or local health or other departments or agencies, with current data or other information relevant to the health needs of the community served by the hospital facility - leaders, representatives of medically underserved populations, low-income populations, minority populations, and populations with chronic disease needs. Aspirus Medford Hospital Part V, Section B, Line 6b: Taylor County Health DepartmentPrice County Health Department Aspirus Medford Hospital Part V, Section B, Line 11: There were items identified in the CHNA which were not addressed by AMHC; however, all items were considered if a need was brought to the attention of the group during the information gathering phase of the CHNA process. Currently our hospital has a program that funds efforts in our communities that are addressing the identified needs. There is an application process that organizations can apply for funding with and funding is awarded based upon how the identified needs are met. In addition, there are procedural efforts underway in various departments to improve access to care, as well as other needs that have been identified through the assessment process. Aspirus Medford Hospital Part V, Section B, Line 22d: Aspirus hospitals use the look-back method for determining Amount Generally Billed (AGB) percentages. Aspirus hospitals calculate one average AGB percentage for all emergency and medically necessary care provided by the hospital facility. Using allowed traditional Medicare claims for service dates July 1, 2015 to June 30, 2016. Patients approved for Aspirus Financial Assistance will not be charged more than this percentage of gross charges for emergent and medically necessary care. 12 1 - Aspirus Medford Clinic 143 SOUTH GIBSON STREET MEDFORD WI 54451 OUTPATIENT CLINIC 2 - Aspirus Care & Rehab 135 SOUTH GIBSON STREET MEDFORD WI 54451 SKILLED NURSING FACILITY 3 - Aspirus Pharmacy - Medford 139 SOUTH GIBSON STREET MEDFORD WI 54451 RETAIL PHARMACY 4 - Aspirus Therapy & Fitness - Medford 103 SOUTH GIBSON STREET MEDFORD WI 54451 THERAPY FITNESS CENTER 5 - Aspirus Country Gardens 635 WEST CEDAR STREET MEDFORD WI 54451 ASSISTED LIVING FACILITY 6 - Aspirus Kidney Care - Medford 111 SOUTH GIBSON STREET MEDFORD WI 54451 DIALYSIS CENTER 7 - Aspirus Prentice Clinic 1511 RAILROAD AVENUE PRENTICE WI 54456 OUTPATIENT CLINIC 8 - Aspirus Phillips Clinic 625 PETERSON AVENUE PHILLIPS WI 54555 OUTPATIENT CLINIC 9 - Aspirus Therapy - Prentice 619 BRIDGE STREET PRENTICE WI 54456 THERAPY FITNESS CENTER 10 - Aspirus Rib Lake Clinic 1121 HIGHWAY 102 RIB LAKE WI WI 54451 OUTPATIENT CLINIC 11 - Aspirus Gilman Clinic 320 EAST MAIN STREET MEDFORD WI 54433 OUTPATIENT CLINIC 12 - Aspirus FastCare Clinic - Abbotsford 1011 East Spruce St Suite 6 Abbotsford WI 54405 OUTPATIENT CLINIC Part I, Line 3c: The patient/guarantor, husband or wife, and dependents may not have property in excess of: primary residence is exempt for patients under 200% of Federal Poverty Guidelines. For those over 200%, the 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 the 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 excced 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: DIALYSIS HAD COSTS OF $1,258,253 WITH DIRECT OFFSETTING REVENUE OF $1,120,649. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 406,362. Part II, Community Building Activities: ONE OF THE LARGER COMMUNITY BUILDING ACTIVITIES ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS INVOLVED IN IS GETTING PHYSICIANS AND HEALTH CARE WORKERS TO the AREA TO IMPROVE THE ACCESS TO HEALTH CARE NEEDS IN the SERVICE AREA. AMHC ALSO PROMOTES HEALTH CARE RELATED JOBS AND EDUCATION TO THE STUDENTS IN THE COMMUNITY. Part III, Line 2: The costing methodology used on Form 990 is based on a cost to charge ratio which is developed based on AMHC's total operating expenses, excluding the provision for bad debts divided by gross patient service revenue. This cost to charge ratio is applied against the total charges that are written off during the fiscal year to estimate the cost of the care of patients that have accounts that are deemed to be bad debts to AMHC. AMHC also recognizes that it also provides a discount to self-pay or uninsured patients. These amounts are included in the contractual adjustments on the financial statements and are not included in the ratio as described above and approved by the IRS for use on form 990. If considered, these additional write-off amounts to uninsured accounts would also increase the estimated bad debt expense amount associated with these uncollectible accounts to AMHC. Part III, Line 3: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS FOR WHICH PATIENTS ARE PERSONALLY RESPONSIBLE, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. Part III, Line 4: Patient Accounts Receivable and Credit Policy: In evaluating the collectability of patient accounts receivable, AMHC analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources or revenue in evaluating the sufficiency of the allowance for uncollectible accounts. Specifically, for receivables associated with services provided to patients who have third-party coverage, AMHC analyzes contractually due amounts and provides an allowance for uncollectible amounts on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), AMHC records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for uncollectible accounts. The audited financial statements do not include a separate footnote regarding bad debt expense. 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 AMHC 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, RADIOLOGY, AMBULANCE, AND REHABILITATION SERVICES PROViDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANESTHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT AMHC PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2014 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICES REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). Part III, Line 9b: Upon a patients approval for financial assistance, this is loaded as an insurance coverage to the patients account with an effective and termination date to assure capturing all charges for the patient for adjustment in a workqueue prior to any remaining balance being moved to patient liability and therefore preventing undiscounted services from being billed to a patient. Part VI, Line 2: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) UTILIZES SEVERAL METHODS IN ASSESSING COMMUNITY HEALTH CARE NEEDS. SOME OF THEM ARE AS FOLLOWS: WORKING CLOSELY WITH THE LOCAL HEALTH DEPARTMENT, SCHOOL DISTRICT, COUNTY AGING DEPARTMENT, AND OTHER ORGANIZATIONS IN THE COMMUNITY; DEMOGRAPHIC DATA FROM SURROUNDING COMMUNITIES; AND EXTERNAL REPORTS, PARTICULARLY THOSE PUBLISHED BY THE LOCAL DEPARTMENT OF HEALTH. AMHC, AT THE END OF FISCAL YEAR 2016, COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND WILL USE THE DATA AND FINDINGS OF THIS REPORT TO GUIDE AMHC IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS. Part VI, Line 3: All patient statements provide information regarding the Aspirus Finacial 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 at 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: Although Aspirus Medford Hospital & Clinics, Inc. (AMHC) is located in Medford, Wisconsin, we have historically defined our "community" as a much broader area, including all of Taylor County, the southern area of Price County, the northeast portion of Clark County, and the northwest corner of Marathon County. Within this area our primary service area consists of a 5 to 20 mile radius around Medford. Approximately 80% of our patient volume comes from our primary area. Taylor and Price Counties are largely Caucasian and are almost exclusively rural with 10% of adults being uninsured and 39% of children in the Medford School district are eligible for free or reduced school lunches. From an educational stand point, 59% of our service area only has a high school diploma or less. The median household income is below the state average, while the state average is also below the national average. The major occupations in the community are manufacturing, agriculture, healthcare, and sales/office positions. Part VI, Line 5: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS IN A PHYSICIAN SHORTAGE AREA AND WORKS HARD TO RECRUIT PROVIDERS TO OUR AREA TO FILL THE NEEDS OF OUR COMMUNITY. WE ALSO HAVE EMPLOYEES THAT ARE REPRESENTING AMHC AND ARE ACTIVE IN OTHER GROUPS TO HELP IN BUILDING COMMUNITY EFFORTS TO IMPROVE HEALTHCARE IN OUR SERVICE AREA. AMHC ALSO GIVES CASH DONATIONS TO PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS IN THE COMMUNITY.ONE-THIRD OF AMHC'S GOVERNING BODY IS COMPRISED OF RESIDENTS THAT ARE IN AMHC'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE FAMILY MEMBERS THEREOF. AMHC ALSO EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY TO INSURE THAT OUR SERVICE AREA HAS THE HEALTHCARE NEEDED. Part VI, Line 6: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (AMHC) IS A PARTNER WITH ASPIRUS, INC. A MULTI-SPECIALTY HEALTH SYSTEM WITH A BASE LOCATION IN WAUSAU, WISCONSIN. AMHC 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 AMHC 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 AMHC 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 1 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 2000000 COST ESTABLISHMENT OF ASPIRUS SCHOLARS ENDOWMENT 1 0 Part I, Line 2: AS A MAJOR EMPLOYER AND COMMUNITY SUPPORTER, ASPIRUS MEDFORD HOSPITALS & CLINICS, INC. (AMHC) RECEIVES MANY REQUESTS FOR DONATIONS OF BOTH MONEY AND MATERIAL GOODS BY VARIOUS LOCAL AGENCIES AND INDIVIDUALS. AS A NONPROFIT, AMHC MUST CONTINUOUSLY JUSTIFY ITS TAX-EXEMPT STATUS TO THE IRS. AMHC NEEDS TO UTILIZE ITS RESOURCES AND ENDORSE THOSE ACTIVITIES THAT SUPPORT ITS TAX-EXEMPT PURPOSE, WHICH IS TO PROVIDE HEALTH CARE SERVICES AND PROMOTE HEALTH AND WELLNESS TO THE COMMUNITIES IT SERVES. REQUESTS ARE CHANNELED IN A WAY THAT MAXIMIZES BENEFIT TO THE COMMUNITY AND ASSURES COMPLIANCE WITH CORPORATE NOT-FOR-PROFIT RULES. AMHC'S WRITTEN DONATIONS POLICY OUTLINES ACCEPTABLE RECIPIENTS AND APPROPRIATE OBJECTIVES PRIOR TO AWARDING ANY ASSISTANCE. DUE TO THE CHARITABLE NATURE OF THE GRANTS AND ALLOCATIONS AWARDED, NO FORMAL MONITORING IS REQUIRED. X X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 F Dean Danner Jr Vice Chair 0 232445 0 63986 0 37432 0 17028 0 52045 0 402936 0 0 Susan Frazier Physician / Secretary 186202 0 0 0 16128 0 8519 0 11973 0 222822 0 0 0 Matthew Heywood Board Member/Asst. Secretary 0 649912 0 232922 0 2014 0 13360 0 119577 0 1017785 0 0 Rick Nevers Board Member 0 291780 0 68268 0 31381 0 18145 0 53193 0 462767 0 0 Ruth Risley-Gray Board Member 0 237122 0 67504 0 2734 0 14872 0 50216 0 372448 0 0 Troy D Sennholz Chief of Staff / Board Member 331236 0 5616 0 16696 0 13056 0 22886 0 389490 0 0 0 Cathy Reuter Physician / Board Member 140590 0 6866 0 1399 0 5329 0 200 0 154384 0 0 0 Patrick Belson Physician / Board Member 353494 0 0 0 16789 0 13056 0 20302 0 403641 0 0 0 Erick T Branstetter Physician / Secretary (Termed 10/15) 458392 0 74252 0 1342 0 13056 0 22550 0 569592 0 0 0 Gregory A Olson President / CEO 260084 0 78281 0 38689 0 13056 0 18180 0 408290 0 0 0 Sidney Sczygelski SVP of Finance and CFO 0 376534 0 157197 0 46863 0 18660 0 70799 0 670053 0 0 Jodi Johnson VP Patient Care Services 144656 0 16733 0 1624 0 462 0 12624 0 176099 0 0 0 Angela Hupf VP Human Resources 134521 0 27452 0 20470 0 6138 0 22022 0 210603 0 0 0 Kathryne McGowan SVP Population Health, Executive Dir 0 245256 0 41541 0 1203 0 4662 0 56919 0 349581 0 0 Cari Logemann SVP & General Counsel 0 253718 0 69397 0 1020 0 15593 0 55076 0 394804 0 0 Todd Richardson SVP & CIO 0 261084 0 71992 0 1246 0 18113 0 59184 0 411619 0 0 Michael McGrail SVP System CMO 0 370677 0 58414 0 10051 0 3750 0 65979 0 508871 0 0 John Heisler SVP & Chief HR Officer 0 256725 0 70436 0 9052 0 12179 0 51433 0 399825 0 0 Sujatha Roberts Physician 334050 0 5750 0 18898 0 13056 0 22802 0 394556 0 0 0 Amy A Falkenberg Physician 331582 0 0 0 16666 0 13056 0 27802 0 389106 0 0 0 Mohammas Taha Physician 278836 0 1000 0 31220 0 13056 0 24015 0 348127 0 0 0 Larry Brunzkick Physician 273737 0 3964 0 19709 0 13056 0 22550 0 333016 0 0 0 Ryan Diegel Physician 255561 0 13179 0 16636 0 12778 0 22034 0 320188 0 0 0 Marita Hattem Board Member (Termed - 01/2015) 29887 0 0 0 22174 0 8237 0 1309 0 61607 0 0 0 Part I, Line 1a TRAVEL for companions, tax indemnification and gross-up payments, AND housing allowance or residence for personal use, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. TRAVEL FOR COMPANIONS - M. HEYWOOD $253; D. DANNER $105; R. NEVERS $202; R. RISLEY-GRAY $175; G. OLSON $170; S. SCZYGELSKI $166; J. JOHNSON $32; K MCGOWAN $120; T. RICHARDSON $105; J. HEISLER $184 - INCLUDED IN INCOME. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - E. BRANSTETTER $892; S. FRAZIER $1,363; T. SENNHOLZ $1,500; P. Belson $1,587; C. REUTER $1,040: G. Olson $1,480; G. SHAW $430; J. JOHNSON $725; A. Hupf $1,054; - INCLUDED IN INCOME. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE - M. MCGRAIL $1,200 - INCLUDED IN INCOME. Part I, Line 4b AMHC SPONSORS A NONQUALIFIED TAX EQUALIZED ANNUITY PLAN COVERING EMPLOYED PHYSICIANS. PHYSICIANS ARE ELIGIBLE TO PARTICIPATE IN THE PLAN AFTER ONE YEAR OF SERVICE. PARTICIPANTS IN THE PLAN ARE IMMEDIATELY 100% VESTED. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $ 40,323 D. DANNER $ 31,730 R. NEVERS $ 29,240 M. HATTEM $ 22,105 A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 97710B7X4 2013-04-12 16902595 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 A 880000 16902595 2006 1 0 1 1 A 0 0 1 0 0 0.01690 0.01690 0 0 1 A 0 0 1 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: WI HEALTH & EDUCATION FACILITIES AUTHORITY Date the Rebate Computation was Performed: 06/19/2015 PART VI The proceeds of the Wisconsin Health and Educational Facilities Authority Revenue Bonds, Series 2013 (Aspirus, Inc. Obligated Group) were borrowed by the following organizations: Aspirus Wausau Hospital, Inc. (EIN 39-1138241); Aspirus Medford Hospital & Clinics, Inc. (EIN 39-0964813); Aspirus Grand View (EIN 38-2908586); and Langlade Hospital Hotel Dieu of St. Joseph of Antigo Wisconsin (EIN 39-0806429). Information regarding the Series 2013 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 2013 Bonds loaned to the Organization. The information reported in Part IV relates to the entire issue of the Series 2013 Bonds.] PART III, LINES 3A AND 3B Aspiurs, Inc., a member of Aspirus Medford Hospital & Clinics, Inc., has policies and procedures in place to review management and service contracts to identify agreements that may result in private business use of bond-finance property. On a contract by contract basis, Aspirus, Inc. will seek help from Bond Counsel as management deems necessary. SUSAN COURTNEY FAMILY MEMBER OF G. COURTNEY, BOARD MEMBER 104960 EMPLOYMENT COMPENSATION 0 UMR INC (Subsidiary of United Health Group Inc) BRUCE CZECH IS the BOARD chair AND CFO OF UMR, INC. 568698 AMHC CONTRACTS WITH UMR TO ADMINISTER THE SELF-INSURED HEALTH PLAN. 0 Amanda Lange FAMILY MEMBER OF G. COURTNEY, BOARD Member 75799 EMPLOYMENT COMPENSATION 0 MEGAN LAHER FAMILY MEMBER OF G. COURTNEY, BOARD Member 35246 EMPLOYMENT COMPENSATION 0 MARK REUTER FAMILY MEMBER OF C. REUTER, BOARD MEMBER 281966 EMPLOYMENT COMPENSATION 0 Form 990, Part VI, Section A, line 2 MARITA A. HATTEM, JEANNE D. SCINTO, Rick Nevers, Matthew Heywood, AND F. DEAN DANNER, JR. have a bUSINESS RELATIONSHIP. THESE BOARD MEMBERS ARE EMPLOYED BY ASPIRUS, INC. AND IT'S AFFILIATES. (SEE INFORMATION RELATED TO ASPIRUS, INC. DESCRIBED IN FORM 990, PART VI, SECTION A, LINES 6 AND 7.) Form 990, Part VI, Section A, line 6 The organization has two corporate members: MEMORIAL MEMBER ASSOCIATION, INC. (50%) AND ASPIRUS, INC. (50%), BOTH WISCONSIN NONSTOCK CORPORATIONS. Form 990, Part VI, Section A, line 7a AMHC's BOARD OF DIRECTORS IS ELECTED AS FOLLOWS: (A) FOUR DIRECTORS ARE APPOINTED BY MEMORIAL MEMBER ASSOCIATION. (B) FOUR DIRECTORS ARE APPOINTED BY ASPIRUS, INC. (C) FOUR DIRECTORS ARE APPOINTED BY OR REPRESENT PHYSICIANS ASSOCIATED WITH THE CORPORATION AS FOLLOWS: (1) TWO PHYSICIAN DIRECTORS ARE PHYSICIANS EMPLOYED BY AMHC WHO ARE ELECTED BY THE PHYSICIANS EMPLOYED BY AMHC. (2) ONE PHYSICIAN DIRECTOR IS A MEMBER OF THE ACTIVE MEDICAL STAFF AND IS ELECTED BY THE MEMBERS OF THE MEDICAL STAFF OF AMHC. (3) ONE PHYSICIAN DIRECTOR IS THE CHIEF OF STAFF. THE CHIEF OF STAFF IS ELECTED BY THE MEDICAL STAFF ON AN ANNUAL BASIS AND IS SEATED ON THE AMHC BOARD FOR HIS/HER TERM AS CHIEF OF STAFF. Form 990, Part VI, Section A, line 7b POWERS RESERVED TO THE CORPORATE MEMBERS: IN ADDITION TO DOING ALL THINGS REQUIRED BY LAW AND EXCEPT AS OTHERWISE PROVIDED, THE CORPORATE MEMBERS HAVE THE FOLLOWING SPECIFIC RIGHTS AND RESPONSIBILITIES: (A) INITIATE AND APPROVE ANY CHANGE IN THE PHILOSOPHY, CHARACTER, OR MISSION OF THE CORPORATION AND APPROVE THE LONG-RANGE GOALS, STRATEGIC PLANS, AND OVERALL PURPOSES. (B) INITIATE AND APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION AND ALL SUBSIDIARIES. (C) INITIATE AND APPROVE THE ADDITION OF NEW MEMBERS OF THE CORPORATION. (D) INITIATE AND APPROVE THE ESTABLISHMENT, TRANSFER AND/OR DISSOLUTION OF ANY SUBSIDIARY CORPORATIONS. (E) INITIATE AND APPROVE BORROWING OF MONEY AND OTHER FORMS OF INDEBTEDNESS IN EXCESS OF $1,000,000. (F) INITIATE AND APPROVE THE PURCHASE, SALE, LEASE, DISPOSITION, ENCUMBRANCE OR ALIENATION OF PROPERTY WITH A VALUE IN EXCESS OF $1,000,000. (G) INITIATE AND APPROVE ANY PLAN OF DISSOLUTION OR MERGER, CONSOLIDATION, ACQUISITION OR DISPOSITION OF REAL PROPERTY, OR RELOCATION OF THE FACILITIES. (H) INITIATE AND APPROVE STRATEGIC ALLIANCES AND AFFILIATIONS OF THE CORPORATION. (I) INITIATE AND APPROVE THE DISTRIBUTION OF THE NET PROCEEDS AND ASSETS OF THE CORPORATION IN THE EVENT OF DISSOLUTION. (J) APPROVE THE SELECTION OF THE CEO OF THIS CORPORATION. Form 990, Part VI, Section B, line 11 THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 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 EACH BOARD MEMBER AND EMPLOYEE SHALL DISCLOSE TO THE APPROPRIATE LEVEL OF MANAGEMENT ANY CIRCUMSTANCE UNDER WHICH THE BOARD MEMBER, EMPLOYEE, OR AN IMMEDIATE FAMILY MEMBER, BY VIRTUE OF A FINANCIAL INTEREST, MAY BE INFLUENCED, OR MAY APPEAR TO BE INFLUENCED, EITHER IN WHOLE OR IN PART, BY ANY PURPOSE OR MOTIVE OTHER THAN THE SUCCESS AND WELL BEING OF AMHC AND ITS SUBSIDIARIES AND THE ACHIEVEMENT OF ITS PUBLIC CHARITABLE PURPOSES. PRIOR TO ENTERING INTO ANY ARRANGEMENT WITH AN OUTSIDE ORGANIZATION, INDIVIDUALS MUST DISCLOSE POTENTIAL CONFLICTS OF INTEREST TO THEIR RESPECTIVE SUPERVISOR; BOARD MEMBERS TO THE BOARD PRESIDENT. EACH CIRCUMSTANCE OF A POTENTIAL CONFLICT OF INTEREST WILL BE REVIEWED ON AN INDIVIDUAL BASIS. THE MANAGER WILL RESPOND IN WRITING (WITH A COPY TO THE PERSONNEL FILE) AFTER CONSULTATION WITH THE APPROPRIATE VICE PRESIDENT AS TO WHETHER THE ARRANGEMENT IS OR IS NOT ACCEPTABLE. Form 990, Part VI, Section B, line 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MEDFORD HOSPITAL & CLINICS, 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 ESTABISHING 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 AMHC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, EXPLANATION OF HOURS WORKED: SOME OFFICERS AND DIRECTORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. Form 990, Part IX, line 11g Contracted/Purchased Services: Program service expenses 1,970,939. Management and general expenses 418,066. Fundraising expenses 0. Total expenses 2,389,005. Medical Fees: Program service expenses 1,392,387. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,392,387. Lab Purchased Services: Program service expenses 576,679. Management and general expenses 0. Fundraising expenses 0. Total expenses 576,679. Pharmacy Purchased Services: Program service expenses 284,906. Management and general expenses 0. Fundraising expenses 0. Total expenses 284,906. Allocations: Program service expenses 0. Management and general expenses 6,625,107. Fundraising expenses 0. Total expenses 6,625,107. Consulting Fees: Program service expenses 0. Management and general expenses 351,095. Fundraising expenses 0. Total expenses 351,095. Recruitment: Program service expenses 0. Management and general expenses 120,764. Fundraising expenses 0. Total expenses 120,764. Customer Relations: Program service expenses 0. Management and general expenses 15,172. Fundraising expenses 0. Total expenses 15,172. Laundry Purchased Services: Program service expenses 0. Management and general expenses 2,472. Fundraising expenses 0. Total expenses 2,472. Collection Expense: Program service expenses 0. Management and general expenses -14,538. Fundraising expenses 0. Total expenses -14,538. Form 990, Part XI, line 9: LOSS FROM UNCONSOLIDATED AFFILIATES -47,001. FORM 990, PART XII, LINE 2C: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.'s BOARD OF DIRECTORS PROVIDEs OVERSIGHT OF THE INDEPENDENT ACCOUNTANTS AND THE MEMBERS OF THE BOARD MEET WITH THE ACCOUNTANT BOTH PRIOR TO YEAR-END AND AFTER YEAR-END TO DISCUSS THE AUDIT AND OTHER MATTERS. ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. ALSO IS PROVIDED ADDITIONAL OVERSIGHT OF ITS AUDIT PROCESS AND SELECTION OF THE INDEPENDENT ACCOUNTANT THROUGH THE AUDIT COMMITTEE OF ASPIRUS, INC. THERE WERE NO CHANGES TO THIS PROCESS DURING THE YEAR ENDED JUNE 30, 2016. Greater Iron County EMS Inc 1400 W Ice Lake Road Iron RIver MI 49935 383491283 Emergency medical care and transportation MI 501(c)(3) Line 11a, I Aspirus Iron River Hospital & Clinics Inc 1 Grand View Hospital Auxiliary N 10561 Grand View Lane Ironwood MI 49938 237178363 Supporting organization to hospital and lifeline emergency system MI 501(c)(3) Line 9 Aspirus Grand View 1 CEDAR COURT APARTMENTS INC 135 SOUTH GIBSON STREET MEDFORD WI 54451 391412339 LOW INCOME HOUSING WI 501(c)(3) Line 7 MEMORIAL MEMBER ASSOCIATION INC 1 Aspirus Inc 333 Pine Ridge Blvd Wausau WI 54401 391328331 Hospital WI 501(c)(3) Line 11b, 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 center WI 501(c)(3) Line 9 Aspirus Inc 1 Aspirus VNA Extended Care Inc 520 N 32nd Avenue Wausau WI 54401 391597350 Personal Care Services WI 501(c)(3) Line 9 Aspirus VNA Home Health Inc 1 Aspirus Riverview Hospital & Clinics 410 Dewey Street WIsconsin Rapids WI 54494 390868982 Hospital WI 501(c)(3) Line 3 Aspirus Inc 1 Aspirus Ontonagon Hospital Inc 601 Seventh St Ontonagon MI 49953 260806477 Hospital MI 501(c)(3) Line 3 Aspirus Inc 1 ASPIRUS MEDFORD FOUNDATION INC 135 SOUTH GIBSON STREET MEDFORD WI 54451 391777081 CHARITABLE FOUNDATION WI 501(c)(3) Line 7 MEMORIAL MEMBER ASSOCIATION INC 1 ASPIRUS KEWEENAW HOSPITAL 205 OSCEOLA STREET LARIUM MI 49913 381443361 HOSPITAL MI 501(c)(3) Line 3 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 Health FOundation Inc 425 Pine Ridge Blvd Wausau WI 54401 391256656 ChariTABLE FOUNDATION WI 501(c)(3) Line 7 Aspirus Inc 1 Aspirus Grand View Service Corporation N 10561 Grand View Lane Ironwood MI 49938 383005582 Physician services MI 501(c)(3) Line 3 Aspirus Grand View 1 Aspirus Grand View 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 9 Aspirus Inc 1 Aspirus Clinics Inc 425 Pine Ridge Blvd Wausau WI 54401 391670223 Medical services WI 501(c)(3) Line 9 Aspirus Inc 1 Aspirus Buildings Inc 333 Pine Ridge Blvd Wausau WI 54401 391406537 Property Leasing WI 501(c)(3) Line 9 Aspirus Inc 1 Aspirus Network Inc 3000 Westhill Drive 202 Wausau WI 54401 391931678 Health Care Services WI N/A C 1 Aspirus Grand View Caring Caregivers Inc N10561 Grand View Lane Ironwood MI 49938 382902754 Personal needs services MI N/A C 1 ASPIRUS KEWEENAW ENTERPRISES INC 205 OSCEOLA STREET LAURIUM MI 49913 383390273 PHARMACY MI N/A C 1 0 1 0 1 1 0 0 1 0 0 0 1 1 1 1 1 1 0 0 Aspirus Wausau Hospital L 193893 Cost Aspirus Wausau Hospital M 71266 Cost Aspirus Wausau Hospital O 80128 Cost Aspirus Wausau Hospital P 7982028 Cost Aspirus Inc H 69133 Cost Aspirus Inc M 6625107 Cost Aspirus Inc L 220163 Cost Aspirus Inc O 96443 Cost Aspirus Inc P 189481 Cost Aspirus Clinics Inc O 150911 Cost Aspirus Clinics Inc P 69406 Cost SCHEDULE R, PART V, LINE 1D All outstanding obligated group debt is guaranteed by all members of the obligated group.