2013-11-13T11:22:39-06:00 2013-06-30 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2012-07-01 390782130 ASPIRUS EXTENDED SERVICES INC ASPI 7158472250 425 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI 7158472250 2013-11-12 1 KATHLEEN J LABRAKE CPA P00164006 7158453111 2013-11-12 2012 2016-02-25 16:41:14Z MATTHEW HEYWOOD 333 PINE RIDGE BLVD WAUSAU WI 54401 6793427 0 X WWW.ASPIRUS.ORG X 1999 WI TO PROVIDE HEALTH CARE AND EDUCATION SERVICES TO PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. 8 5 168 3 0 0 4965 1381725 5086971 5376978 27511 17511 16678 17213 5136125 6793427 135457 350 0 0 3530122 3477811 0 0 0 1872835 1997585 5538414 5475746 -402289 1317681 4829054 6204789 482719 550862 4346335 5653927 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 3989451 350 5376978 ASPIRUS EXTENDED SERVICES, INC. (AES) A WHOLLY OWNED SUBSIDIARY OF ASPIRUS, INC. (ASPIRUS), OPERATES A 66-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. 3989451 1 1 0 0 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 1 0 0 0 0 1 0 0 0 1 22 0 1 168 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X SIDNEY C SCZYGELSKI 7158472250 333 PINE RIDGE BLVD WAUSAU WI 54401 X N JEAN BURGENER 1.00 40.00 X X 0 180489 37589 GREGG OLSON 1.00 X X 0 0 0 JOHN REARDON 1.00 X X 0 0 0 MICHAEL RIGGLE DMV 1.00 X X 0 0 0 ALAN BARKSTROM 1.00 X 0 0 0 DEBBIE L VOLD 1.00 X 0 0 0 DARRELL LENTZ 1.00 41.00 X X 0 227171 50337 TODD RICHARDSON 1.00 40.00 X 0 234425 6765 SIDNEY C SCZYGELSKI 1.00 51.00 X 0 390057 79956 DUANE L ERWIN 1.00 51.00 X 0 807484 134626 0 1839626 309273 0 0 1 0 ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 INSURANCE, PAYROLL, OTHER 858394 ASPIRUS INC PO BOX 90 WAUSAU WI 54401 MANAGEMENT FEES AND SHARED SERVICES 216440 PROBUILD COMPANY LLC 801 S 24TH AVE WAUSAU WI 54401 CONSTRUCTION 105428 3 830000 551725 1381725 NET PATIENT REVENUE 623000 5360445 5360445 OTHER OPERATING REVENU 623000 16533 16533 5376978 14980 14980 17213 0 17213 17213 17213 2531 0 2531 2531 2531 6793427 5376978 0 34724 350 350 2894416 2181172 713244 35869 27030 8839 356443 213151 143292 191083 143996 47087 214457 214457 10750 10750 265219 121975 143244 8085 841 7244 20523 6614 13909 30750 30750 223820 109073 114747 36628 17398 19230 20705 12702 8003 573155 562196 10959 13027 12761 266 DIETARY/MEDICAL SUPPLIE 449236 449236 WMAP ASSESSMENT 130956 130956 PENALTIES 274 274 5475746 3989451 1486295 0 2173123 3772354 201948 226506 342706 478363 21608 17272 15946 16738 4558673 3002484 1911530 1556189 121528 111583 40665 25784 4829054 6204789 373562 356266 109157 194596 482719 550862 X 4346335 5653927 4346335 5653927 4829054 6204789 1317681 -10089 0 X X 0 1 X 1 0 X 13295 11851 24795 4965 1381725 1436631 9568726 9322943 6584186 5054584 5376978 35907417 9582021 9334794 6608981 5059549 6758703 37344048 250000 250000 512091 512091 762091 762091 36581957 83504 64061 38863 35722 32193 254343 83504 64061 38863 35722 32193 254343 9665525 9398855 6647844 5095271 6790896 37598391 0.97300 0.99180 0.00680 0.00820 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 326736 326736 3695804 2683066 1012738 177681 89136 88545 358452 230282 128170 1556189 ASBESTOS LIABILITY 75000 DUE TO AFFILIATES 107874 LONG TERM INSURANCE LIABILITY 11722 194596 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ALL SUBSIDIARIES, EXCEPT FOR ASPIRUS NETWORK, INC., 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 TAX. ASPIRUS PAYS TAXES ON CERTAIN ACTIVITIES CONSIDERED TAXABLE IN ACCORDANCE WITH THE CODE. TAXES FOR ASPIRUS NETWORK, INC., A FOR-PROFIT TAXABLE CORPORATION, WERE IMMATERIAL FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. 0 1 0 0 0 0 0 0 0 N JEAN BURGENER 0 148059 0 27990 0 4440 0 7597 0 29992 0 218078 0 0 DARRELL LENTZ 0 188846 0 36086 0 2239 0 5717 0 44620 0 277508 0 0 TODD RICHARDSON 0 67707 0 160000 0 6718 0 923 0 5842 0 241190 0 0 SIDNEY C SCZYGELSKI 0 302883 0 85154 0 2020 0 13716 0 66240 0 470013 0 0 DUANE L ERWIN 0 575926 0 216804 0 14754 0 11512 0 123114 0 942110 0 0 PART I, LINE 4B KEY EMPLOYEES OF THE COMPANY OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN IS JANUARY 1 TO DECEMBER 31ST. THE CONTRIBUTIONS MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIES 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. NO PARTICIPANTS LISTED ON SCHEDULE J RECEIVED DISTRIBUTIONS DURING THE YEAR. SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: FOR THE PURPOSES OF DETERMINING COMPENSATION, THE FILING ORGANIZATION, ASPIRUS EXTENDED SERVICES, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. X 1 42500 FAIR MARKET VALUE 1 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): PLEASEANT VIEW MEMORIAL FOUNDATION MADE A ONE TIME DONATION OF A NEW LIFT VAN TO ASPIRUS EXTENDED SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS: THE PARENT ORGANIZATION, ASPIRUS, INC. (80%), AND MEMORIAL MEMBER ASSOCIATION, INC. (20%). 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 ORGANIZATION: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; 4) CHANGE THE FORMULA OR METHODOLOGY FOR DETERMINING PHYSICIAN COMPENSATION; 5) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, STRATEGIC AND LONG RANGE PLANS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY THE ORGANIZATION'S MANAGEMENT. THE FORM 990 IS PROVIDED TO BOARD MEMBERS FOR REVIEW AND APPROVAL PRIOR TO FILING. 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 C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. EXPLANATION FOR HOURS WORKED FORM 990, PART VII, LINE 1A DUANE L. ERWIN, SIDNEY C. SCZYGELSKI, AND DARRELL LENTZ ARE EMPLOYED BY ASPIRUS, INC., A RELATED ORGANIZATION. ASPIRUS, INC'S PURPOSE IS TO SERVE AS A SUPPORTING ORGANIZATION TO MULTIPLE SUBSIDIARY ORGANIZATIONS. DUANE L. ERWIN, SIDNEY C. SCZYGELSKI, AND DARRELL LENTZ DEVOTE THEIR TIME PROVIDING MANAGEMENT SERVICES TO THE RELATED TAX-EXEMPT ENTITIES. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. IN ADDITION, SOME OFFICERS AND DIRECTORS ALSO PROVIDE SERVICES TO OTHER RELATED ORGANIZATIONS OTHER THAN ASPIRUS EXTENDED SERVICES, INC. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS OF ASPIRUS, INC., THE PARENT ORGANIZATION OF ASPIRUS EXTENDED SERVICES, INC., ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT OF THE FINANCIAL STATEMENT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE TO THIS PROCESS IN THE CURRENT YEAR. ASPIRUS INC 425 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 0 ASPIRUS BUILDINGS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391406537 PROPERTY LEASING WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS SPECIALISTS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391945080 MEDICAL SPECIALIST SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS ONTONAGON HOSPITAL INC 601 SEVENTH STREET ONTONAGON MI 49953 260806477 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 0 ASPIRUS VNA HOME HEALTH INC 520 N 32ND AVENUE WAUSAU WI 54401 390808511 HOME HEALTHCARE SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 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 0 ASPIRUS DOCTOR'S CLINIC INC 420 DEWEY STREET WISCONSIN RAPIDS WI 54495 391972671 MEDICAL SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 ASPIRUS INC 0 ASPIRUS CLINICS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 MEDICAL SERVICES WI 501(C)(3) LINE 9 ASPIRUS INC 0 ASPIRUS GRAND VIEW N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382908586 HOSPITAL MI 501(C)(3) LINE 3 ASPIRUS INC 0 GRAND VIEW HOSPITAL AUXILIARY N 10561 GRAND VIEW LANE IRONWOOD MI 49938 237178363 LIFELINE EMERGENCY SYSTEM MI 501(C)(3) LINE 9 ASPIRUS GRAND VIEW 0 ASPIRUS GRAND VIEW SERVICE CORP N 10561 GRAND VIEW LANE IRONWOOD MI 49938 383005582 PHYSICIAN SERVICES MI 501(C)(3) LINE 3 ASPRISU GRAND VIEW 0 ASPIRUS NETWORK INC 3000 WESTHILL DRIVE 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI N/A C 0 ASPIRUS GRAND VIEW CARING CAREGIVERS INC N 10561 GRAND VIEW LANE IRONWOOD MI 49938 382902754 PERSONAL NEEDS SERVICES MI N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0