2012-11-14T14:27:59-06:00 2012-06-30 390758449 WIPFLI LLP 11 SCOTT ST WAUSAU WI 54401 990 2011-07-01 391256656 ASPIRUS HEALTH FOUNDATION INC ASPI 7158472250 425 PINE RIDGE BLVD WAUSAU WI 54401 SIDNEY C SCZYGELSKI 7158472250 2012-11-14 1 KATHLEEN J LABRAKE CPA P00164006 7158453111 2012-11-14 2011 2016-02-24 21:20:13Z DUANE L ERWIN 333 PINE RIDGE BLVD WAUSAU WI 54401 1664235 0 X WWW.ASPIRUS.ORG X 1976 WI TO DEVELOP RESOURCES TO ADVANCE THE HEALTH OF OUR COMMUNITIES AND INCREASE REGIONAL HEALTH SERVICES. 13 9 5 500 -402 -402 1176389 1369963 0 0 83396 79271 67523 75269 1327308 1524503 821237 771224 0 0 332572 289085 0 0 116294 146381 140853 1300190 1201162 27118 323341 8667626 8905553 4345663 4276666 4321963 4628887 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 610032 610032 0 DONOR DESIGNATED CONTRIBUTIONS ACTIVITY:THROUGH ITS PHILANTHROPIC ACTIVITIES THE FOUNDATION ADVANCESEXTRAORDINARY HEALTH CARE BY PROVIDING FUNDS FOR RESEARCH, EDUCATION,INFORMATION, CLINICAL PROGRAMS AND CARE DELIVERY, HEALTH SERVICES, AND SCREENING. DONOR DESIGNATED CONTRIBUTIONS PROVIDE SUPPORT FOR THE DESIGNATED FUNDS OF ASPIRUS WAUSAU HOSPITAL. 284087 161192 43983 UNRESTRICTED CONTRIBUTIONS ACTIVITY:THROUGH ITS PHILANTHROPIC ACTIVITIES THE FOUNDATION ADVANCESEXTRAORDINARY HEALTH CARE BY PROVIDING FUNDS FOR RESEARCH, EDUCATION,INFORMATION, PROGRAMS, SERVICES AND SCREENINGS, COMMUNITY HEALTH INITIATIVES, AND WORKFORCE DEVELOPMENT SCHOLARSHIPS. 40411 0 0 KOHL'S CARES FOR KIDS COMMUNITY ACTIVITY:THE KOHL'S CARES FOR KIDS PARTNERSHIP PROVIDES ANNUAL SUPPORT TOSPECIAL INITIATIVES THAT PROTECT AND ADVANCE THE HEALTH OF CHILDREN. IN2011, THIS GIFT WAS DIRECTED TO CREATING AN INTERACTIVE ONLINE OBESITY AWARENESS AND EDUCATION PROGRAM. THE FOUNDATION RECEIVED A TOTAL OF $66,854 FROM THE KOHL'S CARES FOR KIDS PARTNERSHIP IN 2011 TO SUPPORT THESE PURPOSES. 934530 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 11 0 1 5 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X SIDNEY C SCZYGELSKI 7158472250 333 PINE RIDGE BLVD WAUSAU WI 54401 X DUANE L ERWIN 2.00 X X 0 750625 126366 G LANE WARE 1.00 X 0 0 0 A BRENDA DAVIS 1.00 X 0 0 0 BILL BECKER 1.00 X 0 0 0 JEN NIEUWENHUIS GUSTAFSON 1.00 X 0 0 0 JOHN A JOHNKOSKI MD 1.00 X 0 0 0 BARBARA JUEDES 1.00 X 0 0 0 PAUL M LAPREE 1.00 X 0 0 0 CINDY HERMEL 1.00 X 0 0 0 BRAD PECK 1.00 X 0 0 0 BEN REIF 1.00 X 0 0 0 JOHN TUBBS 1.00 X 0 0 0 STEVEN WEILAND MD 1.00 X 0 0 0 ROGER V LUCAS 2.00 X 0 263314 47800 SIDNEY C SCZYGELSKI 2.00 X 0 377724 76760 KALYNN PEMPEK 40.00 X 96952 0 19828 96952 1391663 270754 0 0 1 0 0 151673 390775 827515 1369963 97681 97681 18144 36554 -18410 -18410 -18410 103823 151673 72135 31688 31688 30641 31043 -402 -402 ADMINISTRATIVE FEE 561000 43983 43983 43983 1524503 43983 -402 110959 771224 771224 67258 40355 13452 13451 152870 62618 24065 66187 68957 32257 11753 24947 71859 71859 7000 7000 12523 12523 2557 25 2532 8360 5269 70 3021 26085 14319 6634 5132 2428 775 101 1552 1677 1677 349 349 ANNUAL EDUCATION FORUM 8015 6011 2004 1201162 934530 150338 116294 284348 390488 10899 2736 187607 67214 33415 37455 21867 18429 5116 3438 7932494 8320078 213747 84144 8667626 8905553 66122 62646 3468 4279541 4210552 4345663 4276666 X 4018877 4257553 170819 224067 132267 147267 4321963 4628887 8667626 8905553 X 323341 -16417 X X 0 1 1 X 0 X 655755 1724956 1131251 1176389 1369963 6058314 655755 1724956 1131251 1176389 1369963 6058314 283974 5774340 165606 100607 83758 83396 97681 531048 45455 39951 37742 38977 43983 206108 6795470 502086 0.84970 0.85150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 149304 15000 10002 174306 120376 16148 12780 149304 103053 10070 7253 120376 60049 46000 2004 108053 0.84490 0.15510 0 0 21867 18429 3438 3438 DONOR IMPOSED LIABILITIES 4210552 4210552 1524503 1201162 323341 -16417 -16417 306924 898054 -16417 -16417 914471 610032 610032 1524503 591130 0 591130 610032 610032 1201162 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT IS MAINTAINED TO SUPPORT QUALITY OF LIFE PROGRAMS FOR HOSPICE AND PALLIATIVE CARE PATIENTS AND FAMILIES, CANCER PATIENTS, AND HEART PATIENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: PART X, LINE 2B: ASPIRUS HEALTH FOUNDATION, INC IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE FOUNDATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE FOUNDATION ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES THAT THE INTERNAL REVENUE SERVICE CONSIDERS UNRELATED TO ITS EXEMPT PURPOSE AND, THEREFORE, TAXABLE. THESE ACTIVITIES, HOWEVER, ANNUALLY RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES. THE FOUNDATION DOES NOT PRESENTLY ANTICIPATE THAT A TAX BENEFIT FROM THESE NET OPERATING LOSSES WILL BE REALIZED IN THE FUTURE. ACCORDINGLY, ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. NO DEFERRED TAX ASSET AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL TAX BASES OF REPORTING THE FOUNDATION'S ASSETS AND LIABILITIES. THE FOUNDATION'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. AS OF AND FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THERE WAS NO INCOME TAX EXPENSE, TAX PENALTIES, OR INTEREST RELATED TO TAX PENALITIES RECORDED BY THE FOUNDATION IN THE FINANCIAL STATEMENTS. ASPIRUS HEALTH FOUNDATION, INC RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS IN 2012 OR 2011. FEDERAL RETURNS FOR THE YEARS ENDED JUNE 30, 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE IRS. PART XII, LINE 4B - OTHER ADJUSTMENTS: DESIGNATED CONTRIBUTIONS RAISED FOR OTHERS: 610,032. PART XIII, LINE 4B - OTHER ADJUSTMENTS: DESIGNATED CONTRIBUTIONS RAISED FOR OTHERS: 610,032. FESTIVAL OF TREES 120293 57116 63177 372 11800 1875 17056 WOMEN'S HEALTH GOLF 89665 63956 25709 10990 9154 10118 3 45538 30601 14937 1341 3898 1180 4351 255496 151673 103823 12703 24852 3055 31525 72135 31688 30641 4979 2474 23590 1 0.90000 30641 4979 2474 23590 31043 -402 WI 1 0 1 0 1.00000 DORIS BEISNER 425 PINE RIDGE BLVD WAUSAU WI 54401 0 KALYNN PEMPEK 1684 RESP. FOR SPECIAL EVENT FUNDRAISERS AND ANNUAL GIVING PROGRAMS INCLUDING COORDINATING RAFFLES AS AN INTEGRAL COMPONENT OF EVENTS AND CHARITABLE GIVING PROGRAMS. X 0 1 ASPIRUS CLINICS INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391670223 501(C)(3) 32500 N/A N/A SUPPORT OF OPERATIONS PREVIOUSLY PROVIDED BY CARE FOUNDATION, INC. GENERAL OPERATING SUPPORT CARE FOUNDATION INC 500 WIND RIDGE DRIVE 100 WAUSAU WI 54401 391858393 501(C)(3) 32500 N/A N/A GENERAL OPERATING SUPPORT ASPIRUS WAUSAU HOSPITAL INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391138241 501(C)(3) 305336 N/A N/A WOMEN'S HEALTH FUND, CANCER PROGRAM, WOMEN'S HEALTH SPECIAL EVENT: GOLF OUTING, RESTRICTED FOR WOMEN'S HEALTH FUND FOR BREAST CANCER SCREENING, WAUSAU HOSPITAL DEPT FUND, FOT SPECIAL EVENT, DIABETES PROGRAM, HEART PROGRAM, ARTS ALIVE 2011 EVENT, VOLUNTEER SCHOLARSHIP FUND, CANCER PROGRAM FROM KOMEN GRANT, WOMEN'S HEALTH NICU FUND, HOSPICE RESPITE GARDEN, HOSPICE MUSIC THERAPY PROGRAM, INJURY PREVENTION FUND, RAINBOW'S END, KOHL'S CARES FOR KIDS. FOREST COUNTY POTAWATOMI COMMUNITY PO BOX 340 CRANDON WI 54520 391225059 N/A 9000 N/A N/A KIDS AND COMMUNITY ON THE MOVE PROGRAM MEMORIAL HEALTH CENTER INC 135 SOUTH GIBSON MEDFORD WI 54451 390964813 501(C)(3) 9000 N/A N/A MOVE TO IMPROVE FAMILIES PROGRAM FOR THERAPY AND FITNESS CENTER. 5 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL PAYMENTS ARE MONITORED BY GRANT ADMINISTRATOR TO ENSURE ADHERENCE TO STATED GRANT PURPOSE. ANY UNUSED OR UNSPENT FUNDS ARE RETURNED TO THE GRANTOR. X X 0 1 0 0 0 0 0 0 0 DUANE L ERWIN 0 544700 0 191221 0 14704 0 10193 0 116174 0 876992 0 0 ROGER V LUCAS 0 185158 0 56372 0 21784 0 4817 0 42984 0 311115 0 0 SIDNEY C SCZYGELSKI 0 292917 0 79742 0 5065 0 13428 0 63332 0 454484 0 0 PART I, LINE 4B ROGER V. LUCAS RECEIVED A DISTRIBUTION FROM 457B DEFERRED COMPENSATION PLAN IN 2011: $16,647 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: FOR THE PURPOSES OF DETERMINING COMPENSATION FOR THE FILING ORGANIZATION, ASPIRUS HEALTH FOUNDATION, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART II: TRAVEL AND HEALTH INSURANCE GROSS UPS, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUALS'S COMPENSATION AT FAIR MARKET VALUE. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT ORGANIZATION, ASPIRUS, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A SEE FORM 990, PART VI, SECTION A, LINE 7B EXPLANATION FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ASPIRUS, INC.: 1) CHANGE OR AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) CHANGE THE MISSION, PURPOSE, OR SCOPE OF THE CORPORATION; 3) RATIFICATION OR REMOVAL OF DIRECTORS OR OFFICERS; AND 4) APPROVAL OF ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS, AND 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. ASPIRUS HEALTH FOUNDATION, INC.'S BOARD OF DIRECTORS RECEIVED A COPY OF THE FINAL RETURN PRIOR TO FILING WITH THE IRS, AND REVIEWED THE RETURN AT ITS BOARD MEETING IN OCTOBER 2012. 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 15A THE ORGANIZATION HAD AN INDEPENDENT AUDIT FOR EXECUTIVE COMPENSATION WHICH INCLUDED BASE SALARY, INCENTIVE PLANS, AND BENEFITS FOR ALL OFFICER AND EXECUTIVE POSITIONS. THE REVIEW WAS COMMISSIONED BY THE COMPENSATION COMMITTEE OF THE BOARD AND WAS CONDUCTED BY AN INDEPENDENT CONSULTING FIRM. THE MARKET ANALYSIS WAS COMPLETED IN JUNE AND JULY OF 2009 AND PRESENTED TO THE COMPENSATION COMMITTEE OF THE BOARD IN AUGUST FOR FINAL COMPENSATION DETERMINATION. 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 DUANE L. ERWIN AND SIDNEY C. SCZYGELSKI 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 AND SIDNEY C. SCZYGELSKI WORK IN AVERAGE ON EXCESS OF 40 HOURS PER WEEK PROVIDING SERVICES TO ASPIRUS AND ITS AFFILIATES. ROGER V. LUCAS IS ALSO AN EMPLOYEE OF ASPIRUS, INC. AND WORKS ON AVERAGE IN EXCESS OF 40 HOURS PER WEEK PROVIDING SERVICES TO ASPIRUS AND ITS AFFILIATES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -16,417. FORM 990, PART XII, LINE 2C ASPIRUS HEALTH FOUNDATION IS PROVIDED OVERSIGHT OF ITS AUDIT PROCESS AND SELECTION OF THE INDEPENDENT ACCOUNTANT THROUGH THE AUDIT COMMITTEE OF ITS PARENT ORGANIZATION ASPIRUS, INC. THERE WAS NO CHANGE IN THIS PROCESS DURING THE YEAR JUNE 30, 2012. 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 EXTENDED SERVICES INC 425 PINE RIDGE BLVD WAUSAU WI 54401 390782130 NURSING HOME SERVICES WI 501(C)(3) LINE 9 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 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 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 237173363 SUPPORTING ORG TO HOSPITAL'S 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 ASPIRUS GRAND VIEW 0 ASPIRUS NETWORK INC 3000 WESTHILL DR 202 WAUSAU WI 54401 391931679 HEALTH CARE NETWORK WI ASPIRUS INC C 1.00000 ASPIRUS GRAND VIEW CARING CAREGIVERS INC N 10561 GRANDVIEW LANE IRONWOOD MI 49938 382902754 PERSONAL NEEDS SERVICES MI ASPIRUS GRAND VIEW C 1.00000 0 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0