2016-02-10T11:21:41-06:00 2015-06-30 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2014-07-01 390782130 ASPIRUS EXTENDED SERVICES INC ASPI 7158472250 425 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI CFO/SENIOR VP OF FINANCE 7158472250 2016-01-23 1 KATHLEEN J LABRAKE CPA P00164006 7158453111 2016-01-23 2014 2016-04-25 22:37:26Z MATTHEW HEYWOOD 333 PINE RIDGE BLVD WAUSAU WI 54401 4842306 0 X WWW.ASPIRUS.ORG X 1999 WI TO PROVIDE HEALTH CARE AND EDUCATION SERVICES TO PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. 7 4 157 3 0 0 22302 3200 4955554 4808281 10219 14393 19202 16432 5007277 4842306 568 292 0 0 3552566 3514359 0 0 0 1830342 2133982 5383476 5648633 -376199 -806327 6967389 6186943 1685666 1719190 5281723 4467753 ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM, WHICHLEADS BY ADVANCING INITIATIVES DEDICATED TO IMPROVING THE HEALTH OFALL WE SERVE. WE WORK COLLABORATIVELY WITH OTHERS WHO SHARE OURPASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. 0 0 4688343 292 4808281 ASPIRUS EXTENDED SERVICES, INC. (AES), A WHOLLY OWNED SUBSIDIARY OF ASPIRUS, INC. (ASPIRUS), OPERATES A 50-BED SKILLED NURSING FACILITY (PLEASANT VIEW), A SENIOR APARTMENT COMPLEX, A 16-UNIT CBRF (COMMUNITY BASED RESIDENTIAL CARE FACILITY), TWO ADULT FAMILY HOMES, AND AN ADULT DAY CARE IN PHILLIPS, WISCONSIN. 4688343 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 26 0 1 157 1 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X SIDNEY C SCZYGELSKI 7158472250 333 PINE RIDGE BLVD WAUSAU WI 54401 X TODD RICHARDSON BOARD MEMBER/CIO AWH 1.00 40.00 X 0 312876 83234 JOHN REARDON BOARD MEMBER 1.00 X 0 0 0 GREGG OLSON CHAIR 1.00 X X 0 0 0 MICHAEL RIGGLE DMV VICE CHAIR 1.00 X X 0 0 0 ALAN BARKSTROM SECRETARY 1.00 X X 0 0 0 DARRELL LENTZ TREASURER/PRESIDENT AWH 1.00 40.00 X X 0 315572 68176 MARGARET DONNELLY BOARD PRESIDENT / VP OF PAC (EFFECTIVE 9/14) 1.00 X X 0 62800 3630 SIDNEY C SCZYGELSKI CFO AI 1.00 51.00 X 0 445401 99296 MATTHEW HEYWOOD CEO AI 1.00 51.00 X 0 875945 124428 DUANE L ERWIN FORMER CEO AI 0.00 0.00 X 0 576532 28814 N JEAN BURGENER FORMER VP PAC/FORMER BOARD PRESIDENT (THRU 5/5/14) 1.00 X 0 126950 17606 0 2716076 425184 0 1 1 0 MIRON CONSTRUCTION CO INC PO BOX 1372 GREEN BAY WI 54305 CONTRACTOR 2131127 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 INSURANCE, PAYROLL, OTHER 901496 ASPIRUS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 MANAGEMENT FEES/SHARED SERVICES 280636 3 3200 3200 NET PATIENT REVENUE 623000 4793999 4793999 OTHER OPERATING REVENU 623000 14282 14282 4808281 14393 14393 16432 0 16432 16432 16432 4842306 4808281 0 30825 X 292 292 2822240 2642647 179593 88754 80989 7765 419429 404330 15099 183936 169729 14207 3820 3820 562202 165458 396744 4916 1835 3081 30771 5625 25146 33825 33825 217753 206250 11503 17193 13529 3664 16532 15534 998 14364 14364 707360 462344 245016 14381 14381 DIETARY/MEDICAL SUPPLIE 396102 396102 WMAP ASSESSMENT 102000 102000 BAD DEBT 7298 7298 RECRUITMENT 5400 5400 65 65 5648633 4688343 960290 0 3573935 1007328 225423 239981 370932 433538 17021 15885 17196 16576 8645389 4301662 2623819 4343727 115669 108106 23394 21802 6967389 6186943 417170 491327 1103533 1083726 164963 144137 1685666 1719190 X 5281723 4467753 5281723 4467753 6967389 6186943 -806327 -7643 0 X X 0 1 X 1 0 X 24795 4965 1381725 22302 3200 1436987 6584186 5054584 5376978 4955554 4808281 26779583 6608981 5059549 6758703 4977856 4811481 28216570 250000 250000 512091 512091 762091 762091 27454479 38863 35722 32193 10219 14393 131390 38863 35722 32193 10219 14393 131390 6647844 5095271 6790896 4988075 4825874 28347960 0.96850 0.97140 0.00460 0.00550 X 0 0 0 0 0 0 0 0 1 505 505 0 PART II-B, LINE 1: ASPIRUS EXTENDED SERVICES, INC. PAYS ANNUAL ASSOCIATION DUES TO LEADINGAGE WISCONSIN. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATION MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL INDUSTRY ENVIRONMENT. 326736 326736 5905078 3750067 2155011 223530 137825 85705 2190045 413770 1776275 4343727 DUE TO AFFILIATES 132415 LONG TERM INSURANCE LIABILITY 11722 144137 X PART X, LINE 2: ALL SUBSIDIARIES, EXCEPT FOR ASPIRUS NETWORK, INC. (ANI), ARE TAX-EXEMPT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. ASPIRUS 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. INCOME TAXES FOR ANI, A NOT-FOR-PROFIT TAXABLE CORPORATION, WERE IMMATERIAL FOR THE YEARS ENDED JUNE 30, 2015 AND 2014. 1 1 0 0 0 0 0 0 0 TODD RICHARDSON BOARD MEMBER/CIO AWH 0 237555 0 74180 0 1141 0 14676 0 68558 0 396110 0 0 DARRELL LENTZ TREASURER/PRESIDENT AWH 0 246521 0 64793 0 4258 0 8993 0 59183 0 383748 0 0 SIDNEY C SCZYGELSKI CFO AI 0 335544 0 103558 0 6299 0 15500 0 83796 0 544697 0 0 MATTHEW HEYWOOD CEO AI 0 572243 0 233564 0 70138 0 10300 0 114128 0 1000373 0 0 DUANE L ERWIN FORMER CEO AI 0 0 0 0 0 576532 0 5100 0 23714 0 605346 0 0 N JEAN BURGENER FORMER VP PAC/FORMER BOARD PRESIDENT 0 76256 0 27514 0 23180 0 6343 0 11263 0 144556 0 0 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: N. JEAN BURGENER $21,759 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN 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 THE VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL; AND 15% FOR THE CEO. IF THE PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. 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. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS: THE PARENT ORGANIZATION, ASPIRUS, INC. (72.68%), AND MEMORIAL MEMBER ASSOCIATION, INC. (27.23%). FORM 990, PART VI, SECTION A, LINE 7A SEE COMMENTS FOR FORM 990, PART VI, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE MEMBERS OF THE ORGANIZATION0: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICER; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG-RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11 THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE ORGANIZATION'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS EXTENDED SERVICES, 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, WRIITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, LINE 1A, EXPLANATION FOR HOURS WORKED: SOME OFFICERS AND DIRECTORS ALSO PROVIDED SERVICE TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS EXTENDED SERVICES, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART IX, LINE 24E PENALTIES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 65. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION, ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACDCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS IN THE PAST YEAR. ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE SYSTEM MANAGEMENT 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 BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 9 ASPIRUS INC 1 ASPIRUS SPECIALISTS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391945080 MEDICAL SPECIALIST SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 1 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 1 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTHCARE SERVICES 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 HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 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 GRAND VIEW N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382908586 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS 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 ASPIRUS GRAND VIEW SERVICE CORP N 10561 GRAND VIEW LANE IRONWOOD MI 49938 383005582 PHYSICIAN SERVICES MI 501(C)(3) LINE 3 ASPRIUS GRAND VIEW 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 RIVERVIEW HOSPITAL & CLINICS INC 410 DEWEY STREET WISCONSIN RAPIDS WI 54494 390868982 HOSPITAL WI 501(C)(3) LINE 3 ASPIRUS INC 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 1 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 1 ASPIRUS GRAND VIEW CARING CAREGIVERS INC N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382902754 PERSONAL NEEDS SERVICES MI N/A C 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 1 1 0 0 ASPIRUS WAUSAU HOSPITAL INC O 762988 COST ASPIRUS WAUSAU HOSPITAL INC P 111987 COST ASPIRUS INC M 321619 COST ASPIRUS INC P 67793 COST