ASPIRUS KEWEENAW: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ASPIRUS KEWEENAW (EIN 38-1443361)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-02-08
- IRS object ID
- 201610399349301511
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-08T13:35:39-06:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 544028010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381443361 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASPI | BusinessNameControlTxt |
| Phone | 9063376500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA | AddressLine1Txt |
| City | LAURIUM | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49913 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANE JACQUES | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9063376500 | PhoneNum |
| Signature | 2016-01-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHLEEN J LABRAKE CPA | PreparerPersonNm |
| PTIN | P00164006 | PTIN |
| Phone | 7158453111 | PhoneNum |
| Preparation | 2016-01-23 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHANE JACQUES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1Txt |
| City | LAURIUM | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49913 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $51,298,175 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ASPIRUSKEWEENAW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1939 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | ASPIRUS KEWEENAW HOSPITAL PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL AND PHYSICIAN CLINIC SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 481 | TotalEmployeeCnt |
| Total Volunteers | 96 | TotalVolunteersCnt |
| Total Gross UBI | -$4,596 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$4,386 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $37,883 | PYContributionsGrantsAmt |
| CY Contributions Grants | $14,668 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $37,698,743 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $46,217,058 | CYProgramServiceRevenueAmt |
| PY Investment Income | $528,184 | PYInvestmentIncomeAmt |
| CY Investment Income | $447,475 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,575,013 | PYOtherRevenueAmt |
| CY Other Revenue | $2,027,675 | CYOtherRevenueAmt |
| PY Total Revenue | $40,839,823 | PYTotalRevenueAmt |
| CY Total Revenue | $48,706,876 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,282,960 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,657,467 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,862,376 | PYOtherExpensesAmt |
| CY Other Expenses | $20,300,031 | CYOtherExpensesAmt |
| PY Total Expenses | $40,145,336 | PYTotalExpensesAmt |
| CY Total Expenses | $45,957,498 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $694,487 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,749,378 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,573,455 | TotalAssetsBOYAmt |
| Total Assets EOY | $52,703,026 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,664,523 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,428,946 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,908,932 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,274,080 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, AND PHYSICIAN CLINIC SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,617,747 | ExpenseAmt |
| Revenue | $47,648,880 | RevenueAmt |
| Desc | ASPIRUS KEWEENAW HOSPITAL PROVIDES COMPREHENSIVE INPATIENT, OUTPATIENT, EMERGENCY, MEDICAL, AND PHYSICIAN CLINIC SERVICES. ASPIRUS KEWEENAW BEGAN EYE CLINIC SERVICES IN FY2015. THIS IS A NEW SERVICE FOR AKH. ASPIRUS KEWEENAW BUILT A NEW CLINIC IN HOUGHTON IN FY2015 PROVIDING BREAST CARE AND IMAGING, CANCER CARE, CHILDREN'S HEALTH, DIABETES CARE, FAMILY MEDICINE, HOME MEDICAL EQUIPMENT, IMAGING (RADIOLOGY), LABORATORY SERVICES, NUTRITION COUNSELING, ORTHOPEDICS, PEDIATRICS, SENIOR HEALTH, WALK-IN CARE, WEIGHT LOSS PROGRAM, AND WOMEN'S HEALTH. | Desc |
| Total Program Service Expenses | $38,617,747 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 101 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 481 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANE JACQUES | PersonNm |
| Phone | 9063376500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1Txt |
| City | LAURIUM | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49913 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| DANIEL DALQUIST | |||||||||
| CHAIRMAN | 0.50 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDWARD JENICH | |||||||||
| VICE CHAIRMAN | 0.50 | 1.00 | Yes (X) | Yes (X) | $16,800 | $0 | $0 | ||
| DAVID GILBERT MD | |||||||||
| SECRETARY | 0.50 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW HEYWOOD | |||||||||
| BOARD MEMBER / CEO OF AI | 1.00 | 51.00 | Yes (X) | $0 | $875,945 | $124,428 | |||
| CHARLES NELSON | |||||||||
| BOARD MEMBER / REGIONAL CEO UP | 24.00 | 17.00 | Yes (X) | Yes (X) | $0 | $318,458 | $74,308 | ||
| SANDRA HUUKI | |||||||||
| BOARD MEMBER | 0.50 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DARRELL LENTZ | |||||||||
| BOARD MEMBER / PRESIDENT AWH | 0.50 | 39.50 | Yes (X) | $0 | $315,572 | $68,176 | |||
| JERRY LUOMA MD | |||||||||
| BOARD MEMBER | 20.00 | 1.00 | Yes (X) | $58,037 | $0 | $11,393 | |||
| MARIANA PERINOT MD | |||||||||
| BOARD MEMBER & MEDICAL STAFF TERMED 1/1/2015 | 40.00 | Yes (X) | $219,787 | $0 | $7,327 | ||||
| DARRYL PIERCE | |||||||||
| BOARD MEMBER | 0.50 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DALE R TAHTINEN | |||||||||
| BOARD MEMBER | 0.50 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOEL TUORINIEMI | |||||||||
| BOARD MEMBER | 0.50 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH BENYI DO | |||||||||
| BOARD MEMBER & CHIEF OF STAFF | 40.00 | Yes (X) | $258,277 | $0 | $16,656 | ||||
| JOHN HEISLER | |||||||||
| BOARD MEMBER & SR VP/CHIEF HR OFFICER | 1.00 | 40.00 | Yes (X) | $0 | $287,789 | $44,598 | |||
| JOHN HORAN MD | |||||||||
| BOARD MEMBER & MEDICAL STAFF REP | 1.00 | 40.00 | Yes (X) | $419,894 | $0 | $10,275 | |||
| MICHAEL LUOMA MD | |||||||||
| BOARD MEMBER TERMED 1/1/2015 | 40.00 | Yes (X) | $216,621 | $0 | $27,995 | ||||
| RICK NEVERS | |||||||||
| BOARD MEMBER TERM ENDED 7/22/2014 | 1.00 | 40.00 | Yes (X) | $0 | $331,104 | $71,838 | |||
| SIDNEY C SCZYGELSKI | |||||||||
| CFO OF AI | 1.00 | 51.00 | Yes (X) | $0 | $445,401 | $99,296 | |||
| MICHAEL HAUSWIRTH | |||||||||
| COO | 40.00 | Yes (X) | $217,448 | $0 | $28,914 | ||||
| SHANE JACQUES | |||||||||
| CFO | 40.00 | Yes (X) | $180,771 | $0 | $22,933 | ||||
| GRACE TOUSIGNANT | |||||||||
| CNO | 40.00 | Yes (X) | $150,566 | $0 | $23,024 | ||||
| FREDERICK RAU | |||||||||
| ORTHOPEDIC SURGEON | 40.00 | $495,508 | $0 | $28,291 | Yes (X) | ||||
| SHAHAR MADJAR | |||||||||
| PHYSICIAN | 40.00 | $312,183 | $0 | $9,265 | Yes (X) | ||||
| BONNIE HAFEMAN | |||||||||
| PHYSICIAN | 40.00 | $340,095 | $0 | $22,521 | Yes (X) | ||||
| JOHN NOVOSAD | |||||||||
| ANESTHESIOLOGIST | 40.00 | $298,746 | $0 | $18,004 | Yes (X) | ||||
| JAMES BLACK | |||||||||
| ED PHYSICIAN | 40.00 | $320,272 | $0 | $32,491 | Yes (X) | ||||
| DUANE ERWIN | |||||||||
| FORMER CEO OF AI | 0.00 | 0.00 | $0 | $576,532 | $28,814 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,505,005 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,150,801 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $770,547 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COAST TO COAST HEALTH CARE | |||||
| PO BOX 56346 | ATLANTA | GA | 30343 | CONTRACTED PROVIDERS | $562,800 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | CONTRACTED PROVIDERS | $539,296 |
| CHG COMPANIES INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | CONTRACTED PROVIDERS | $287,741 |
| THOMAS K CARLSON | |||||
| 1 ASPEN LANE | GLADSTONE | MI | 49837 | CONTRACTED PROVIDERS | $274,400 |
| LOCUM TENENSCOM LLC | |||||
| 2655 NORTHWINDS PKWY | ALPHERETTA | GA | 30009 | CONTRACTED PROVIDERS | $238,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $12,016 | GovernmentGrantsAmt |
| All Other Contributions | $2,652 | AllOtherContributionsAmt |
| Total Contributions | $14,668 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621990 | $41,562,794 | $41,562,794 | |
| 340B REVENUE DRUG PROGRAM | 900099 | $4,523,046 | $4,523,046 | |
| CAFETERIA REVENUE | 624200 | $120,763 | $120,763 | |
| VENDING REVENUE | 624200 | $10,455 | $10,455 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $46,217,058 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,308 | TotalRevenueColumnAmt |
| Exclusion | $61,308 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $164,689 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $67,841 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $96,848 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,848 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$4,596 | UnrelatedBusinessRevenueAmt |
| Exclusion | $101,444 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,871,258 | SecuritiesAmt |
| Other | $38,367 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,430,435 | SecuritiesAmt |
| Other | $93,023 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $440,823 | SecuritiesAmt |
| Other | -$54,656 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $386,167 | TotalRevenueColumnAmt |
| Exclusion | $386,167 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| E.H.R INCENTIVE | 900099 | $1,563,040 | $1,563,040 | |
| OTHER REVENUE | 999999 | $367,787 | $367,787 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,930,827 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,706,876 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,648,880 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$4,596 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,047,924 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,175,013 | TotalAmt |
| Program Services | $802,101 | ProgramServicesAmt |
| Management And General | $372,912 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,647,666 | TotalAmt |
| Program Services | $17,663,862 | ProgramServicesAmt |
| Management And General | $1,983,804 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $557,549 | TotalAmt |
| Program Services | $501,277 | ProgramServicesAmt |
| Management And General | $56,272 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,955,937 | TotalAmt |
| Program Services | $2,657,604 | ProgramServicesAmt |
| Management And General | $298,333 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,321,302 | TotalAmt |
| Program Services | $1,172,415 | ProgramServicesAmt |
| Management And General | $148,887 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,505 | TotalAmt |
| Management And General | $31,505 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,450 | TotalAmt |
| Management And General | $62,450 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,877 | TotalAmt |
| Management And General | $12,877 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,118,470 | TotalAmt |
| Program Services | $2,889,390 | ProgramServicesAmt |
| Management And General | $1,229,080 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,904 | TotalAmt |
| Program Services | $8,354 | ProgramServicesAmt |
| Management And General | $195,550 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,597,653 | TotalAmt |
| Program Services | $7,512,426 | ProgramServicesAmt |
| Management And General | $85,227 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,120 | TotalAmt |
| Program Services | $106,936 | ProgramServicesAmt |
| Management And General | $77,184 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $494,352 | TotalAmt |
| Program Services | $481,533 | ProgramServicesAmt |
| Management And General | $12,819 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,665 | TotalAmt |
| Program Services | $160,902 | ProgramServicesAmt |
| Management And General | $55,763 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,154 | TotalAmt |
| Program Services | $86,154 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,702,916 | TotalAmt |
| Program Services | $1,606,377 | ProgramServicesAmt |
| Management And General | $96,539 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,951 | TotalAmt |
| Program Services | $86,585 | ProgramServicesAmt |
| Management And General | $101,366 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| EQUIPMENT RENTAL AND MA | $1,691,825 | $1,484,848 | $206,977 |
| CORPORATE ALLOCATIONS | $1,623,635 | $1,623,635 | |
| PROVISION FOR BAD DEBTS | $1,169,916 | $1,169,916 | |
| DUES AND SUBSCRIPTIONS/ | $719,371 | $81,769 | $637,602 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,267 | TotalAmt |
| Program Services | $145,298 | ProgramServicesAmt |
| Management And General | $50,969 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,957,498 | TotalAmt |
| Program Services | $38,617,747 | ProgramServicesAmt |
| Management And General | $7,339,751 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,165 | BOYAmt |
| EOY | $1,050,658 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,002,868 | BOYAmt |
| EOY | $9,273,561 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,285,153 | BOYAmt |
| EOY | $5,876,637 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,746 | BOYAmt |
| EOY | $600,250 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $926,915 | BOYAmt |
| EOY | $675,864 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $42,036,125 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,439,290 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,913,207 | BOYAmt |
| EOY | $24,596,835 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,317,190 | BOYAmt |
| EOY | $6,012,379 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,505,234 | BOYAmt |
| EOY | $1,490,088 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $56,567 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,011,977 | BOYAmt |
| EOY | $3,070,187 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,573,455 | BOYAmt |
| EOY | $52,703,026 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,955,498 | BOYAmt |
| EOY | $6,786,712 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,259,490 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,058,425 | BOYAmt |
| EOY | $18,669,750 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,279,229 | BOYAmt |
| EOY | $664,025 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,371 | BOYAmt |
| EOY | $2,048,969 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,664,523 | BOYAmt |
| EOY | $29,428,946 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,908,932 | BOYAmt |
| EOY | $23,274,080 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,908,932 | BOYAmt |
| EOY | $23,274,080 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,573,455 | BOYAmt |
| EOY | $52,703,026 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,749,378 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$384,230 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $10,463 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,463 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | ORGANIZATION HAS INDIRECT LOBBYING ACTIVITIES THROUGH THE PAYMENT OF HOSPITAL ASSOCIATION DUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $871,587 | OtherCostOrOtherBasisAmt |
| Book Value | $871,587 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,390,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,365,864 | DepreciationAmt |
| Book Value | $7,024,517 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,313,226 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,073,426 | DepreciationAmt |
| Book Value | $4,239,800 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,460,931 | OtherCostOrOtherBasisAmt |
| Book Value | $12,460,931 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,596,835 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM ASPIRUS KEWEENAW ENTERPRISES | $1,833,272 |
| DUE FROM ASPIRUS KEWEENAW FOUNDATION | $4,290 |
| NOTE RECEIVABLE | $892,500 |
| DUE FROM OTHER ENTITIES | $72,824 |
| THIRD PARTY RECEIVABLES | $267,301 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,070,187 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| LONG TERM INSURANCE PAYABLE | $225,630 |
| ASBESTOS LIABILITY | $61,471 |
| MEDICARE PAYABLE | $775,083 |
| BLUE CROSS PAYABLE | $921,922 |
| OTHER THIRD PARTY PAYABLE | $64,863 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,048,969 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL 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 HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE COMPANY IS A TAXABLE CORPORATION. ANY INCOME TAX PROVISION, IF REQUIRED, IS NOT CONSIDERED MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $151,218 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $151,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,665,230 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,323,045 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,342,185 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05230 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,816,448 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,323,045 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,493,403 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05570 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,917 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79,917 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,579,493 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,911,622 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $667,871 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,949 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,684,359 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,911,622 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $772,737 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01730 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,500,807 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,234,667 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,266,140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07300 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $688,708 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,798,373 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,693,957 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $104,416 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 OSCEOLA STREET | AddressLine1Txt |
| City | LAURIUM | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49913 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ASPIRUSKEWEENAW.ORG | WebsiteAddressTxt |
| State License | 1060000151 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PHYSICIAN CLINIC, HOME MEDICAL EQUIPMENT, & PHARMACY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASPIRUS KEWEENAW HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES.ASPX?SRCAUD=MAIN | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V - SUPPLEMENTAL INFORMATION FOR WEB ADDRESS | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.ASPIRUS.ORG/UPLOADS/PUBLIC/DOCUMENTS/FINANCIAL-AID-APPLICATION.P | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASPIRUS KEWEENAW HOSPITAL | PART V, SECTION B, LINE 5: SURVEY BY MAIL AND PARTICIPATION IN REGIONAL HEALTH ASSESSMENTS WITH OTHER HOSPITALS AND AGENCIES. |
| ASPIRUS KEWEENAW HOSPITAL | PART V, SECTION B, LINE 6A: ASPIRUS GRAND VIEW, ASPIRUS ONTONAGON, BARAGA COUNTY MEMORIAL HOSPITAL, PORTAGE HEALTH. |
| ASPIRUS KEWEENAW HOSPITAL | PART V, SECTION B, LINE 11: THE HOSPITAL HAS SUCCESSFULLY ADDRESS ALL ITEMS IDENTIFIED IN THE CHNA EXCEPT ONE. THIS IS MAINTAINING A ONE-ON-ONE HYPERTENSION CLINIC. THE NURSE PRACTITIONER SUPPORTING THE EFFORT IS NO LONGER WITH THE ORGANIZATION. THE CLINIC MANAGERS HAVE BEEN IN THE PROCESS OF WORKING WITH OTHER STAFF TO FILL GAPS AND ADDRESS THE NEEDS OF THE HYPERTENSION CLINIC. THE HOSPITAL EXPECTS SOLUTIONS AND SUPPORT OF THE CLINIC IN FALL OF 2015. |
| ASPIRUS KEWEENAW HOSPITAL | PART V, SECTION B, LINE 16I: BILLING INVOICES CONTAIN CONTACT INFORMATION FOR MORE INFORMATION ABOUT THE THE FINANCIAL ASSISTANCE POLICY. A POSTING OF HOW TO OBTAIN MORE INFORMATION ON THE FINANCIAL ASSISTANCE POLICY IS LOCATED IN THE EMERGENCY AND WAITING ROOMS. |
| ASPIRUS KEWEENAW HOSPITAL | PART V, SECTION B, LINE 22D: ASPIRUS KEWEENAW HOSPITAL USES THE LOOKBACK METHOD TO DETERMINE THE AMOUNTS CHARGED TO FAP ELIGIBLE INDIVIDUALS ARE BASED ON FPL LEVEL. THIS IS DISCOUNTED USING AVERAGE PAST AMOUNTS PAID BY COMMERCIALLY INSURED AND MEDICARE PATIENTS TO THE HOSPITAL. |
| PART V, SECTION B, LINE 5A | HOSPTIAL WEB ADDRESS TO LOCATE CHNA: HTTP://ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES.ASPX |
| PART V, SECTION B, LINE 10A | HOSPITALS MOST RECENT ADOPTED IMPLEMENTATION STRATEGY CAN BE FOLLOWED AT HTTP://WWW.ASPIRUS.ORG/MAIN/COMMUNITY-RESOURCES.ASPX |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | HTTP://WWW.ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 |
| ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | HTTP://WWW.ASPIRUS.ORG/UPLOADS/PUBLIC/DOCUMENTS/FINANCIAL-AID-APPLICATION.P |
| ASPIRUS KEWEENAW HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: | HTTP://WWW.ASPIRUS.ORG/MAIN/PAY-MY-BILL.ASPX?SRCAUD=MAIN#TAB2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| ASPIRUS HOUGHTON CLINIC | ||||
| 1000 CEDAR STREET | HOUGHTON | MI | 49931 | CLINIC & OUTPATIENT THERAPY |
| ASPIRUS KEWEENAW OUTPATIENT THERAPIES | ||||
| 342 HECLA STREET | LAURIUM | MI | 49913 | OUTPATIENT THERAPY |
| ASPIRUS KEWEENAW LAURIUM WELLNESS | ||||
| 300 HECLA STREET | LAURIUM | MI | 49913 | CLINIC |
| ASPIRUS EYE CLINIC | ||||
| 404 EAST SHARON AVENUE | HOUGHTON | MI | 49931 | CLINIC |
| ASPIRUS KEWEENAW LAKE LINDEN CLINIC | ||||
| 110 CALUMET STREET | LAKE LINDEN | MI | 49945 | CLINIC |
| ASPIRUS KEWEENAW FASTCARE | ||||
| 9900 MEMORIAL ROAD | HOUGHTON | MI | 49931 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST METHOD THAT IS USED ON THE FORM 990 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. THIS IS THEN DIVIDED BY GROSS PATIENT SERVICES REVENUE. |
| PART I, LINE 7G: | THE COST OF SUBSIDIZED HEATLH SERVICES ARE RELATED TO THE LAURIUM CLINIC. ASPIRUS KEWEENAW HOSPITAL UTILIZED AN INTERNAL DEPARTMENTAL FINANCIAL STATEMENT TO REPORT THE COST AND DIRECT OFFSETTING REVENUE THAT CALCULATES THE COMMUNITY BENEFIT EXPENSE. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24C, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $1,169,916. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFITS HOSPITAL'S COMMUNITY BENEFIT AND CHARITY CARE, THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. ASPIRUS KEWEENAW HOSPITAL, INC., IN ADDITION TO PROVIDING SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. ASPIRUS KEWEENAW HOSPITAL, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL WOULD NOT BE AVAILABLE LOCALLY. IN ADDITION TO INPATIENT HOSPITALIZATIONS, THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: EMERGENCY SERVICES, RESPIRATORY THERAPY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, FAMILY PRACTICE CLINICS, AND LABORATORY AND PATHOLOGY SERVICES. |
| PART III, LINE 4: | IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES RELATING TO SERVICES PROVIDED TO PATIENTS HAVING THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS 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), THE ORGANIZATION 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 OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | ALLOWABLE MEDICARE COSTS WERE OBTAINED FROM THE ORGANIZATION'S FILED MEDICARE COST REPORT. AS SUCH THEY ONLY INCLUDE THE AMOUNTS ALLOWED IN THE FORM 990 INSTRUCTIONS. THEREFORE, THEY ONLY INCLUDE A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND DO NOT CONSIDER ALL OF THE CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. THE MEDICARE REVENUES AMOUNTS LISTED DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS, AND A SIGNIFICANT PORTION OF LAB SERVICES PROVIDED TO AREA CLINIC PATIENTS. |
| PART III, LINE 9B: | UNDER THE ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, ASPIRUS KEWEENAW HOSPITAL MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE.ASPIRUS KEWEENAW HOSPITAL WILL PROVIDE MEDICALLY ACUTE SERVICES TO PATIENTS WHO MEET THE CRITERIA OF THE PATIENT FINANCIAL ASSISTANCE PROGRAM WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES FOR QUALIFYING PATIENTS. THIS PROGRAM IS PROVIDED FOR PATIENTS WHO ARE UNINSURED, UNDERINSURED, AND/OR MEDICALLY INDIGENT. PATIENTS AND THEIR FAMILIES HAVE A RESPONSIBILITY TO HELP THE HOSPITAL QUALIFY THEM FOR THE APPROPRIATE LEVEL OR TYPE OF FINANCIAL ASSISTANCE GIVEN THEIR CIRCUMSTANCES.DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM.RELATIONSHIP TO COLLECTION POLICIESASPIRUS MANAGMENT SHALL DEVELOP POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTION ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIED FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ASPIRUS, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH ASPIRUS. PATIENTS WHO DO NOT SATISFY THEIR FINANCIAL OBLIGATIONS WILL BE PROCESSED OUT TO THE ASPIRUS KEWEENAW CONTRACTED COLLECTION AGENCY. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, ASPIRUS MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS TO ELIGIBLE PATIENTS. EXTRAORDINARY COLLECTION ACTIONS1. ASPIRUS WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS, WILL NOT SEND UPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS FOR ANY PATIENT WITHOUT FIRST MAKING RESONABLE EFFORTS TO DETERMINE WHEATHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS SHALL INCLUDE:2. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL;3. DOCUMENTATION THAT ASPIRUS HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE PROGRAM PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH ASPIRUS APPLICATION REQUIREMENTS;4. DOCUMENTATION THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE ON A PRESUMPTIVE BASIS;5. DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN. |
| PART VI, LINE 2: | THE ORGANIZATION MEETS WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER TO CONSULT AND DETERMINE HOW TO MEET THE HEALTH CARE NEEDS IN THE ORGANIZATION'S GEOGRAPHICAL AREA. IN ADDITION, THE ORGANIZATION ITSELF EVALUATES ITS' OWN SERVICES OFFERED IN THEIR SERVICE AREA AND EVALUATES OTHER SERVICES THAT COULD BE PROVIDED TO BENEFIT THE COMMUNITY SERVED. |
| PART VI, LINE 3: | ASPIRUS KEWEENAW HOSPITAL WILL PROVIDE MEDICALLY ACUTE SERVICES TO PATIENTS WHO MEET THE CRITERIA OF THE PATIENT FINANCIAL ASSISTANCE PROGRAM (PFAP) WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES FOR QUALIFYING PATIENTS. THIS PROGRAM IS PROVIDED FOR PATIENTS WHO ARE UNINSURED, UNDERINSURED, AND/OR MEDICALLY INDIGENT. PATIENTS AND THEIR FAMILIES HAVE A RESPONSIBILITY TO HELP THE HOSPITAL QUALIFY THEM FOR THE APPROPRIATE LEVEL OR TYPE OF FINANCIAL ASSISTANCE GIVEN THEIR CIRCUMSTANCE.A PFAP BROCHURE IS GIVEN TO EACH INPATIENT. THE BROCHURE INFORMS PATIENTS OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM AND HOW TO APPLY. WE HAVE SIGNS POSTED IN ALL ASPIRUS KEWEENAW HOSPITAL AND CLINIC LOCATIONS THAT LET THE PATIENT KNOW ABOUT OUR PFAP PROGRAM. PFAP BROCHURES ARE DISPLAYED IN PATIENT AREAS OF OUR CLINICS AND HOSPITAL. SIGNS ARE POSTED THROUGHOUT AKH TO INFORM THE PATIENT THAT WE PARTICIPATE IN THE MEDICAID PROGRAM. A NOTICE REGARDING OUR SLIDING FEE SCALE AND HOW TO APPLY FOR IT, IS POSTED AT ALL PHYSICIAN RECEPTION AREAS. ALL BILLERS AND FRONT LINE STAFF DIRECT PATIENT INQUIRIES REGARDING PAYMENT, MEDICAID, AND FINANCIAL ASSISTANCE TO A FINANCIAL COUNSELOR. SELF PAY PATIENTS ARE INFORMED OF THE COST OF HIGH DOLLAR PROCEDURES AND OFFERED OPTIONS FOR PAYMENT AND ASSISTANCE PROGRAMS PRIOR TO SCHEDULING THE PROCEDURE. AN ASPIRUS KEWEENAW SOCIAL WORKER COUNSELS PATIENTS AND MAKES THEM AWARE OF ALL AVAILABLE COMMUNITY RESOURCES, INCLUDING MEDICAID AND OUR AKH PATIENT FINANCIAL ASSISTANCE PROGRAM. SHE ASSISTS THEM IN COMPLETING THE MEDICAID APPLICATION. A FINANCIAL COUNSELOR WILL VISIT THE PATIENT IF REQUESTED DURING THE SOCIAL WORKER INTERVIEW WITH THE PATIENT. FINANCIAL COUNSELORS SUGGEST OUR PFAP TO ELIGIBLE PATIENTS WHILE MAKING PAYMENT ARRANGEMENTS. |
| PART VI, LINE 4: | THE ORGANIZATION PROVIDES SERVICES PRIMARILY TO THE ELDERLY AND FRAIL OF NORTHERN HOUGHTON AND KEWEENAW COUNTIES. THE LARGEST CITIES IN THESE REGIONS INCLUDE HOUGHTON, HANCOCK, LAURIUM AND CALUMET. AS A PERCENTAGE OF TOTAL REVENUE, MEDICARE AND MEDICAID COMPRISE OF 47% AND 20%, RESPECTIVELY FOR THE ORGANIZATION. |
| PART VI, LINE 5: | THE BOARD OF DIRECTOR'S IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION PROVIDES, FREE OF CHARGE TO THE LOCAL SCHOOL, AN ATHLETIC TRAINER. |
| PART VI, LINE 6: | ASPIRUS KEWEENAW IS AN AFFILIATED HEALTH SYSTEM WHICH SERVES THE COMMUNITY SURROUNDING LAURIUM, MICHIGAN. AFFILIATES OF ASPIRUS KEWEENAW PROMOTE THE HEALTH OF THE COMMUNITY BY FULFILLING THEIR INDIVIDUAL MISSIONS. ASPIRUS KEWEENAW PROVIDES PHYSICIAN SERVICES IN OUTPATIENT CLINICS. ASPIRUS KEWEENAW IS ALSO AN AFFILIATE OF ASPIRUS, INC. ASPIRUS IS AN INTERGRATED, COMMUNITY-GOVERNED HEALTH CARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES DEDICATED TO IMPROVING THE HEALTH OF ALL WE SERVE. WE WORK COLLABORATIVELY WITH OTHERS WHO SHARE OUR PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW HEYWOOD | ||||||||||||||
| BOARD MEMBER / CEO OF AI | $0 | $572,243 | $0 | $233,564 | $0 | $70,138 | $0 | $10,300 | $0 | $114,128 | $0 | $1,000,373 | $0 | $0 |
| CHARLES NELSON | ||||||||||||||
| BOARD MEMBER / REGIONAL CEO UP | $0 | $237,702 | $0 | $74,736 | $0 | $6,020 | $0 | $13,996 | $0 | $60,312 | $0 | $392,766 | $0 | $0 |
| DARRELL LENTZ | ||||||||||||||
| BOARD MEMBER / PRESIDENT AWH | $0 | $246,521 | $0 | $64,793 | $0 | $4,258 | $0 | $8,993 | $0 | $59,183 | $0 | $383,748 | $0 | $0 |
| MARIANA PERINOT MD | ||||||||||||||
| BOARD MEMBER & MEDICAL STAFF TERMED | $219,623 | $0 | $0 | $0 | $164 | $0 | $0 | $0 | $7,327 | $0 | $227,114 | $0 | $0 | $0 |
| ELIZABETH BENYI DO | ||||||||||||||
| BOARD MEMBER & CHIEF OF STAFF | $257,254 | $0 | $0 | $0 | $1,023 | $0 | $10,340 | $0 | $6,316 | $0 | $274,933 | $0 | $0 | $0 |
| JOHN HEISLER | ||||||||||||||
| BOARD MEMBER & SR VP/CHIEF HR OFFICE | $0 | $239,916 | $0 | $36,511 | $0 | $11,362 | $0 | $0 | $0 | $44,598 | $0 | $332,387 | $0 | $0 |
| JOHN HORAN MD | ||||||||||||||
| BOARD MEMBER & MEDICAL STAFF REP | $369,614 | $0 | $50,000 | $0 | $280 | $0 | $0 | $0 | $10,275 | $0 | $430,169 | $0 | $0 | $0 |
| MICHAEL LUOMA MD | ||||||||||||||
| BOARD MEMBER TERMED 1/1/2015 | $211,380 | $0 | $0 | $0 | $5,241 | $0 | $6,346 | $0 | $21,649 | $0 | $244,616 | $0 | $0 | $0 |
| RICK NEVERS | ||||||||||||||
| BOARD MEMBER TERM ENDED 7/22/2014 | $0 | $236,472 | $0 | $74,420 | $0 | $20,212 | $0 | $14,127 | $0 | $57,711 | $0 | $402,942 | $0 | $0 |
| SIDNEY C SCZYGELSKI | ||||||||||||||
| CFO OF AI | $0 | $335,544 | $0 | $103,558 | $0 | $6,299 | $0 | $15,500 | $0 | $83,796 | $0 | $544,697 | $0 | $0 |
| MICHAEL HAUSWIRTH | ||||||||||||||
| COO | $182,688 | $0 | $30,107 | $0 | $4,653 | $0 | $7,520 | $0 | $21,394 | $0 | $246,362 | $0 | $0 | $0 |
| SHANE JACQUES | ||||||||||||||
| CFO | $163,126 | $0 | $17,544 | $0 | $101 | $0 | $6,694 | $0 | $16,239 | $0 | $203,704 | $0 | $0 | $0 |
| GRACE TOUSIGNANT | ||||||||||||||
| CNO | $134,338 | $0 | $15,322 | $0 | $906 | $0 | $5,558 | $0 | $17,466 | $0 | $173,590 | $0 | $0 | $0 |
| FREDERICK RAU | ||||||||||||||
| ORTHOPEDIC SURGEON | $490,936 | $0 | $0 | $0 | $4,572 | $0 | $6,028 | $0 | $22,263 | $0 | $523,799 | $0 | $0 | $0 |
| SHAHAR MADJAR | ||||||||||||||
| PHYSICIAN | $281,695 | $0 | $30,000 | $0 | $488 | $0 | $0 | $0 | $9,265 | $0 | $321,448 | $0 | $0 | $0 |
| BONNIE HAFEMAN | ||||||||||||||
| PHYSICIAN | $339,764 | $0 | $0 | $0 | $331 | $0 | $7,577 | $0 | $14,944 | $0 | $362,616 | $0 | $0 | $0 |
| JOHN NOVOSAD | ||||||||||||||
| ANESTHESIOLOGIST | $297,714 | $0 | $0 | $0 | $1,032 | $0 | $10,400 | $0 | $7,604 | $0 | $316,750 | $0 | $0 | $0 |
| JAMES BLACK | ||||||||||||||
| ED PHYSICIAN | $318,926 | $0 | $0 | $0 | $1,346 | $0 | $10,400 | $0 | $22,091 | $0 | $352,763 | $0 | $0 | $0 |
| DUANE ERWIN | ||||||||||||||
| FORMER CEO OF AI | $0 | $0 | $0 | $0 | $0 | $576,532 | $0 | $5,100 | $0 | $23,714 | $0 | $605,346 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | TRAVEL FOR COMPANIONS, TAX INDEMNIFICATION AND GROSS-UP PAYMENTS, AND HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR VALUE. TRAVEL FOR COMPANIONS: S. SCZYGELSKI $453; M. HEYWOOD $410; C. NELSON $385; J. HEISLER $410; D. LENTZ $390; R. NEVERS $510 - INCLUDED IN INCOME HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE - M. HEYWOOD $65,048; J. HEISLER $3,600 - INCLUDED IN INCOME. |
| PART I, LINE 3 | FOR THE PURPOSE OF DETERMINING COMPENSATION, ASPIRUS KEWEENAW HOSPITAL RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICIES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINES 4A-B | SCHEDULE J, PART I, LINE 4A - SEVERANCE PAYMENT: D. ERWIN $585,957 SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: R. NEVERS $17,763 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: 9% FOR VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL, AND 15% FOR THE CEO. 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; 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. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd | CUSIPCUSIPNum |
|---|---|---|---|---|---|---|---|---|
| VILLAGE OF LAURIUM FINANCE AUTHORITY | ||||||||
| A | 386007184 | 2004-03-05 | $3,546,723 | REFUNDING BOND SERIES 1997 | 0 | 0 | 0 | |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | ||||||||
| B | 391337855 | 2015-05-07 | $16,997,543 | NEW CONSTRUCTION | 0 | 0 | 0 | 97712DMG9 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $1,649,034 | $3,546,723 | $3,546,723 | 1998 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| B | $16,997,543 | $7,562,942 | 0 | 0 | 0 | Yes (1) | $230,937 | $3,422,222 | $6,012,379 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Private Bus Use By OthersPrivateBusUseByOthersPct |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.01000 | 0.01000 | Yes (1) | 0 | Yes (1) | |
| B | 0 | Yes (1) | 0 | 0 | 0.00500 | Yes (1) | 0 | Yes (1) | 0.00500 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 7 | FormAndLineReferenceDesc |
| Explanation | WE ARE ANALYZING AND EVALUATING POLICIES AND PROCEDURES RELATED TO OUR TAX-EXEMPT BONDS AND WILL UPDATE AS APPROPRIATE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JERRY LUOMA AND MICHAEL LUOMA HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | ASPIRUS, INC. AND KEWEENAW HEALTH FOUNDATION ARE VOTING MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS IS COMPRISED OF 3 MEMBERS FROM ASPIRUS, INC. AND 11 MEMBERS FROM KEWEENAW HEALTH FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | MAJOR OPERATING DECISION ITEMS UPON APPROVAL BY THE BOARD OF ASPIRUS KEWEENAW HOSPITAL REQUIRE APPROVAL BY THE ASPIRUS, INC. BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS HAS DELEGATED THE REVIEW PROCESS OF THE FORM 990 TO THE CFO. THE FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS ELECTRONICALLY PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, BOARD MEMBERS ARE REQUIRED TO DISCLOSE CONFLICTS TO THE BOARD. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. AN INTERESTED PERSON IS AN DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTE WITH BOARD DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. AFTER DISCLOSURE, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING MEMBERS SHALL DECIDE IF A CONFLICT EXISTS. THE MEMBER WILL ABSTAIN FROM VOTING ON THIS ISSUE IF A CONFLICT OF INTEREST IS DISCOVERED. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED BY USE OF STATE HOSPITAL ASSOCIATION SURVEY AND SYSTEM SURVEY. THE COMPENSATION OF THE CEO IS DETERMINED BY AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. WAGE DETERMINATION FOR OTHER EXECUTIVE POSITIONS, AN ANNUAL WAGE ANALYSIS IS COMPLETED. THE ORGANIZATION USES SALARY SURVEYS AND SALARY AGENCIES TO DETERMINE THE WAGE SCALE. CONSULTATION ON THE SETTING OF PAY IS PROVIDED TO THE ORGANIZATION BY ASPIRUS, INC. HUMAN RESOURCES. ALL EXECUTIVES ARE ELIGIBLE FOR THE INCENTIVE PLAN ESTABLISHED AND APPROVED BY ASPIRUS, INC. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION HAS DEEMED THAT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASPIRUS WAUSAU HOSPITAL INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391138241 | HOSPITAL | WI | 501(C)(3) | LINE 3 | ASPIRUS INC | Yes (1) | |
| ASPIRUS BUILDINGS INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391406537 | PROPERTY LEASING | WI | 501(C)(3) | LINE 9 | ASPIRUS INC | Yes (1) | |
| ASPIRUS SPECIALISTS INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391945080 | MEDICAL SPECIALIST SERVICES | WI | 501(C)(3) | LINE 9 | ASPIRUS INC | Yes (1) | |
| ASPIRUS EXTENDED SERVICES INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 390782130 | NURSING HOME SERVICES | WI | 501(C)(3) | LINE 9 | ASPIRUS INC | Yes (1) | |
| ASPIRUS CLINICS INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391670223 | MEDICAL SERVICES | WI | 501(C)(3) | LINE 9 | ASPIRUS INC | Yes (1) | |
| ASPIRUS ONTONAGON HOSPITAL INC | |||||||||||
| 601 SEVENTH STREET | ONTONAGON | MI | 49953 | 260806447 | HOSPITAL | MI | 501(C)(3) | LINE 3 | ASPIRUS INC | Yes (1) | |
| ASPIRUS VNA HOME HEALTH INC | |||||||||||
| 520 N 32ND AVENUE | WAUSAU | WI | 54401 | 390808511 | HOME HEALTHCARE SERVICES | WI | 501(C)(3) | LINE 9 | ASPIRUS INC | Yes (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 | Yes (1) | |
| ASPIRUS HEALTH FOUNDATION INC | |||||||||||
| 425 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391256656 | CHARITABLE FOUNDATION | WI | 501(C)(3) | LINE 7 | ASPIRUS INC | Yes (1) | |
| ASPIRUS GRAND VIEW | |||||||||||
| N 10561 GRAND VIEW LANE | IRONWOOD | MI | 49938 | 382908586 | HOSPITAL | MI | 501(C)(3) | LINE 3 | ASPIRUS INC | Yes (1) | |
| GRAND VIEW HOSPITAL AUXILIARY | |||||||||||
| N 10561 GRAND VIEW LANE | IRONWOOD | MI | 49938 | 237178363 | SUPPORTING ORGANIZATION TO HOSPITAL AND LIFELINE EMERGENCY CENTER | MI | 501(C)(3) | LINE 9 | ASPIRUS GRAND VIEW | Yes (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 | Yes (1) | |
| ASPIRUS INC | |||||||||||
| 333 PINE RIDGE BLVD | WAUSAU | WI | 54401 | 391328331 | HEALTH CARE MANAGEMENT SYSTEM | WI | 501(C)(3) | LINE 11B, II | 0 | N/A | |
| 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 | 0 | |
| ASPIRUS RIVERVIEW HOSPITAL & CLINICS | |||||||||||
| 410 DEWEY STREET | WISCONSIN RAPIDS | WI | 54494 | 390868982 | HOSPITAL | WI | 501(C)(3) | LINE 3 | ASPIRUS INC | Yes (1) | |
| 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 | Yes (1) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASPIRUS KEWEENAW ENTERPRISES | |||||||||||||
| 205 OSCOLA ST | LAURIUM | MI | 49913 | 383390273 | PHARMACY | MI | ASPIRUS KEWEENAW HOSPITAL | C | -$153,358 | $2,229,071 | 1.00000 | Yes (1) | |
| ASPIRUS NETWORK INC | |||||||||||||
| 3000 WESTHILL DRIVE 202 | WAUSAU | WI | 54401 | 391931678 | HEALTH CARE SERVICES | WI | C | Yes (1) | N/A | ||||
| ASPIRUS GRAND VIEW CARING CAREGIVERS | |||||||||||||
| N 10561 GRAND VIEW LANE | IRONWOOD | MI | 49938 | 382902754 | PERSONAL NEEDS SERVICES | MI | C | Yes (1) | N/A | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ASPIRUS KEWEENAW ENTERPRISES | ||
| A | $107,508 | ACTUAL |
| ASPIRUS INC | ||
| M | $2,397,000 | ACTUAL |
| ASPIRUS ONTONAGON HOSPITAL INC | ||
| L | $548,000 | ACTUAL |
| ASPIRUS GRANDVIEW | ||
| L | $175,000 | ACTUAL |
| ASPIRUS WAUSAU HOSPITAL INC | ||
| M | $113,000 | ACTUAL |
| KEWEENAW HEALTH FOUNDATION | ||
| P | $96,000 | ACTUAL |