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Aspirus Ontonagon Hospital Inc

Aspirus Ontonagon Hospital
601 South Seventh Street
Ontonagon, MI 49953
Bed count25Medicare provider number231309Member of the Council of Teaching HospitalsNOChildren's hospitalNO
EIN: 260806477
Display data for year:
Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
8.62%
Spending by Community Benefit Category- 2021
(as % of total functional expenses)
* = CBI denoted preventative categories
Community Benefit Spending Compared to Functional Expenses, 2010-2021
Additional data

Community Benefit Expenditures: 2021

  • All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.

    • Operating expenses$ 14,117,212
      Total amount spent on community benefits
      as % of operating expenses
      $ 1,216,540
      8.62 %
  • Amount spent in the following IRS community benefit categories:
      • Financial Assistance at cost
        as % of operating expenses
        $ 85,634
        0.61 %
        Medicaid
        as % of operating expenses
        $ 788,494
        5.59 %
        Costs of other means-tested government programs
        as % of operating expenses
        $ 0
        0 %
        Health professions education
        as % of operating expenses
        $ 0
        0 %
        Subsidized health services
        as % of operating expenses
        $ 331,001
        2.34 %
        Research
        as % of operating expenses
        $ 0
        0 %
        Community health improvement services and community benefit operations*
        as % of operating expenses
        Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.
        $ 9,831
        0.07 %
        Cash and in-kind contributions for community benefit*
        as % of operating expenses
        $ 1,580
        0.01 %
        Community building*
        as % of operating expenses
        $ 0
        0 %
    • * = CBI denoted preventative categories
    • Community building activities details:
        • Did tax-exempt hospital report community building activities?Not available
          Number of activities or programs (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Persons served (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Community building expense
          as % of operating expenses
          $ 0
          0 %
          Physical improvements and housing
          as % of community building expenses
          $ 0
          Economic development
          as % of community building expenses
          $ 0
          Community support
          as % of community building expenses
          $ 0
          Environmental improvements
          as % of community building expenses
          $ 0
          Leadership development and training for community members
          as % of community building expenses
          $ 0
          Coalition building
          as % of community building expenses
          $ 0
          Community health improvement advocacy
          as % of community building expenses
          $ 0
          Workforce development
          as % of community building expenses
          $ 0
          Other
          as % of community building expenses
          $ 0
          Direct offsetting revenue$ 0
          Physical improvements and housing$ 0
          Economic development$ 0
          Community support$ 0
          Environmental improvements$ 0
          Leadership development and training for community members$ 0
          Coalition building$ 0
          Community health improvement advocacy$ 0
          Workforce development$ 0
          Other$ 0

    Other Useful Tax-exempt Hospital Information: 2021

    • In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

      • Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
        as % of operating expenses
        $ 61,473
        0.44 %
        Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?NO
    • Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy

      The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

      • Does the organization have a written financial assistance (charity care) policy?YES
        Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?YES
        Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
        as % of operating expenses
        $ 0
        0 %
    • Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
      • Reported to credit agencyNot available
    • Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.

      • After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid?YES
    • The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.

      • If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines?Not available
    • In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

      • Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute?NO

    Community Health Needs Assessment Activities: 2021

    • The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

      • Did the tax-exempt hospital report that they had conducted a CHNA?YES
        Did the CHNA define the community served by the tax-exempt hospital?YES
        Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?YES
        Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?YES
        Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?YES

    Supplemental Information: 2021

    This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
    • Statement of Program Service Accomplishments
      Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
    • 4A (Expenses $ 9728804 including grants of $ 1000) (Revenue $ 12118138)
      ASPIRUS ONTONAGON HOSPITAL, INC. (AOH) OPERATES SEVERAL HEALTHCARE SERVICE LINES INCLUDING AN 18-BED CRITICAL ACCESS HOSPITAL AND A PHYSICIAN CLINIC. AOH STRIVES TO OFFER THE BEST CARE POSSIBLE TO THE RESIDENTS OF ONTONAGON COUNTY AND THE SURROUNDING AREA. AOH IS COMMITTED TO KEEPING HEALTHCARE DECISIONS LOCAL TO PROVIDE A SUCCESSFUL COMMUNITY HOSPITAL FOR GENERATIONS TO COME. FOR THE YEAR ENDED JUNE 30, 2022, AOH SERVICED THE COMMUNITY THROUGH 383 INPATIENT DAYS, 549 SWING BED INPATIENT DAYS, 2,372 SKILLED NURSING FACILITY DAYS OF CARE, AND 12,957 OUTPATIENT VISITS. IN ADDITION, THE FAMILY PRACTICE CLINIC HAD 5,881 VISITS AND THE ONCOLOGY CLINIC HAD 178 VISITS.AOH PROVIDES A SIGNIFICANT AMOUNT OF SERVICES TO PATIENTS UNDER ITS CHARITY CARE POLICY OR TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS. THESE PROGRAMS OFTEN REIMBURSE AOH AT RATES WELL BELOW THE COST OF CARING FOR THESE INDIVIDUALS. ADDITIONAL INFORMATION ON THE COST OF PROVIDING THIS CARE CAN BE FOUND IN SCHEDULE H TO THE FORM 990.
      Facility Information
      Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, ASPIRUS ONTONAGON HOSPITAL APPOINTED A STEERING COMMITTEE WHICH IS MADE UP OF REPRESENTATIVES FROM MAJOR CROSS-SECTIONS OF COMMUNITY LEADERS AND EXPERTS THAT HAVE A STRONG UNDERSTANDING OF THE HEALTH NEEDS OF THE REGION AND RURAL COMMUNITIES, FROM THE UNDERSERVED MINORITIES TO THE GENERAL POPULATION. SURVEYS WERE SENT TO ABOUT 23,800 HOUSEHOLDS ACROSS THE WESTERN UPPER PENINSULA; OVER 3,500 WERE RETURNED.
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:- ASPIRUS IRON RIVER- ASPIRUS IRONWOOD- ASPIRUS KEWEENAW
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 6B: WESTERN UPPER PENINSULA HEALTH DEPARTMENT
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 7D: SCHEDULE H, SECTION B, LINES 7A & 10A:HTTPS://WWW.ASPIRUS.ORG/UPLOADS/PUBLIC/DOCUMENTS/REPORTS/2022%20CHNA%20REPORTS/2022_ONTONAGON_ASSESSMENT.PDF
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 11: ASPIRUS ONTONAGON HOSPITAL PLANS TO ADDRESS MENTAL HEALTH, SUBSTANCE USE, AND CHRONIC DISEASES.MENTAL HEALTH GOAL STATEMENTS:-INCREASE THE PUBLIC'S AWARENESS OF THE IMPORTANCE OF GOOD MENTAL WELL-BEING AND COMMUNITY SERVICES AVAILABLE TO SUPPORT THEIR MENTAL WELL-BEING.-IMPROVE ALCOHOL & OTHER DRUG ABUSE AND MENTAL HEALTH TREATMENT SERVICES-FURTHER INTEGRATE BEHAVIORAL HEALTH WITHIN THE DELIVERY OF HEALTH CAREALCOHOL & OTHER DRUG MISUSE AND ABUSE GOAL STATEMENTS:-CHANGE SOCIAL NORMS, ATTITUDES, AND BEHAVIORS AROUND SUBSTANCE USE -STRENGTHEN COMMUNITY COLLABORATION AROUND SUBSTANCE ABUSE PREVENTION-INCREASE FUNDING FOR AODA PREVENTION, TREATMENT, AND ENFORCEMENTCHRONIC DISEASES GOAL STATEMENTS: -EDUCATE PATIENTS REGARDING PREVENTION OF CHRONIC DISEASES -PROVIDE EFFECTIVE MANAGEMENT STRATEGIES INCLUDING DIETARY AND EXERCISE RESOURCES AND ELIMINATING SUBSTANCE ABUSE THE FOLLOWING ISSUES WILL NOT BE ADDRESSED: - HEALTH INSURANCE IS EXPENSIVE OR HAS HIGH COSTS FOR CO-PAYS AND DEDUCTIBLES ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE.- LACK OF HEALTH INSURANCE ASPIRUS PROVIDES FINANCIAL ASSISTANCE FOR PATIENTS WHO STRUGGLE TO AFFORD CARE.- UNEMPLOYMENT, WAGES, AND ECONOMIC CONDITIONS ASPIRUS WORKS TO PAY FAIR WAGES AND PROVIDE REASONABLE COMPENSATION PACKAGES. ASPIRUS HOSPITALS MAY CONTRIBUTE TO EFFORTS THAT IMPROVE ECONOMIC CONDITIONS, BUT THEIR PRIMARY FOCUS IS TO DELIVER HIGH QUALITY MEDICAL CARE.
      ASPIRUS ONTONAGON HOSPITAL, INC.
      PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY.
      Supplemental Information
      Schedule H (Form 990) Part VI
      PART I, LINE 3C:
      THE PATIENT/GUARANTOR, HUSBAND OR WIFE, AND DEPENDENTS MAY NOT HAVE PROPERTY IN EXCESS OF THE FOLLOWING (EXCEPT FOR BALANCES INCURRED AT HOSPITALS THAT PARTICIPATE IN THE NATIONAL HEALTH SERVICE CORPS PROGRAM (NHSC) AND/OR MICHIGAN STATE LOAN REPAYMENT PROGRAM (MSLRP) WHERE THIS CRITERIA DOES NOT APPLY): PRIMARY RESIDENCE IS EXEMPT FOR PATIENTS UNDER 200% FEDERAL POVERTY GUIDELINES. FOR THOSE OVER 200% EQUITY ALLOWANCE IS $75,000 (FINANCIAL STATEMENTS AND TAX BILLS ARE REQUIRED). INCOME PRODUCING LAND (E.G., DAIRY FARM) IS EVALUATED INDIVIDUALLY ON A CASE-BY-CASE BASIS. CASH ASSETS IN EXCESS OF $4,000 AT THE TIME OF APPLICATION. SPECIFICALLY EXCLUDED FROM CONSIDERATION ARE IRA AND PENSION PLANS AND IRREVOCABLE BURIAL TRUST FUNDS. TOTAL NET ASSETS CANNOT EXCEED 800% OF FEDERAL POVERTY GUIDELINES. THIS INCLUDES ALL ASSETS INCLUDING CASH ASSETS ABOVE.
      PART I, LINE 7:
      THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES DIVIDED BY GROSS PATIENT SERVICES REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THIS ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FROM THE FORM 990.
      PART I, LINE 7G:
      THE SUBSIDIZED HEALTH SERVICES INCLUDED THE EMERGENCY DEPARTMENT WITH COSTS OF $967,610 AND DIRECT OFFSETTING REVENUE OF $867,189; THE INPATIENT UNIT WITH COSTS OF $689,856 AND DIRECT OFFSETTING REVENUE OF $595,944; A RURAL HEALTH CLINIC WITH COSTS OF $725,157 AND DIRECT OFFSETTING REVENUE OF $619,091; AND THE NURSING HOME WITH COSTS OF $30,603 AND DIRECT OFFSETTING REVENUE OF $0. THE SUBSIDIZED HEALTH SERVICES COSTS WERE ESTIMATED USING AN OVERALL COST TO CHARGE RATIO.
      PART I, LN 7 COL(F):
      THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $104,465.
      PART II, COMMUNITY BUILDING ACTIVITIES:
      AOH PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. AOH, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL WOULD NOT BE AVAILABLE LOCALLY. THE BOARD ALSO CONTAINS EIGHT COMMUNITY REPRESENTATIVES. THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: DIAGNOSTICS, EMERGENCY SERVICES, INFUSION SERVICES, NURSING HOME SERVICES, SWING BED SERVICES, CLINICAL SERVICES, LABORATORY SERVICES, REHABILITATION SERVICES, ONCOLOGY, AND WOMEN'S SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED.
      PART III, LINE 2:
      THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES. THE COSTING METHODOLOGY USED WAS THE PATIENT CARE COST TO CHARGE RATIO WHICH WAS DERIVED FROM THE CALCULATION ON IRS WORKSHEET 2.
      PART III, LINE 3:
      THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS.
      PART III, LINE 8:
      THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ASPIRUS ONTONAGON HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD ABOVE FOR THE IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2022 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICES REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS.
      PART III, LINE 9B:
      UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENT'S ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT.
      PART VI, LINE 2:
      ASPIRUS ONTONAGON HOSPITAL UTILIZES SEVERAL METHODS IN ASSESSING COMMUNITY HEALTH CARE NEEDS WHICH INCLUDE: WORKING CLOSELY WITH THE LOCAL HEALTH DEPARTMENT, SCHOOL DISTRICT, COUNTY AGING DEPARTMENT, AND OTHER ORGANIZATIONS IN THE COMMUNITY; DEMOGRAPHIC DATA FROM SURROUNDING COMMUNITIES; AND EXTERNAL REPORTS, PARTICULARLY THOSE PUBLISHED BY THE LOCAL DEPARTMENT OF HEALTH. ASPIRUS ONTONAGON HOSPITAL, AT THE END OF FISCAL YEAR 2021, COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND WILL USE THE DATA AND FINDINGS OF THIS REPORT TO GUIDE THE ORGANIZATION IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS.
      PART VI, LINE 4:
      ASPIRUS ONTONAGON HOSPITAL'S COMMUNITY CARE PROGRAM DOES NOT HAVE ANY BOUNDARIES. THE MAJORITY OF AOH'S PATIENTS DO RESIDE IN ONTONAGON COUNTY AND ARE EITHER MEDICARE OR MEDICAID PROGRAM BENEFICIARIES. ONTONAGON COUNTY IS REMOTE AND AOH IS THE ONLY HOSPITAL IN THE COUNTY. THE MAIN INDUSTRIES IN THE COUNTY HAVE CLOSED, CAUSING MANY ECONOMIC HARDSHIPS OVER THE PAST FEW YEARS AND A POPULATION DECLINE.
      PART VI, LINE 5:
      ASPIRUS ONTONAGON HOSPITAL, INC. IS IN A PHYSICIAN SHORTAGE AREA AND WORKS HARD TO RECRUIT PROVIDERS TO OUR AREA AND FILL THE NEEDS OF OUR COMMUNITY. PROVIDERS FROM AFFILIATED HOSPITALS ARE OCCASIONALLY SENT TO AOH TO COVER FOR UNFILLED POSITIONS. AOH ALSO HAS EMPLOYEES THAT REPRESENT ASPIRUS ONTONAGON HOSPITAL AND ARE ACTIVE IN OTHER GROUPS TO HELP IN BUILDING COMMUNITY EFFORTS TO IMPROVE HEALTHCARE IN OUR SERVICE AREA.
      PART VI, LINE 7, REPORTS FILED WITH STATES
      MI
      PART III, LINE 4:
      THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THESE TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ACCOUNTS RECEIVABLES ARE WRITTEN OFF AFTER ALL COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH ASPIRUS' POLICIES.BAD DEBT POLICY AND PROCEDURE:POLICY: I. ASPIRUS' FINANCIAL POLICY REQUIRES SETTLEMENT OF A PATIENT SELF-PAY BILL OR ACCOUNT WILL BE REFERRED FOR OUTSIDE COLLECTION. II. FAILURE TO MEET THESE REQUIREMENTS IN ASPIRUS POLICY WILL RESULT IN THE ACCOUNT BEING CONSIDERED FOR BAD DEBT ONCE ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THE ACCOUNT WILL BE REMOVED FROM ACCOUNTS RECEIVABLE AND TURNED OVER TO AN OUTSIDE AGENCY OR LAW FIRM FOR COLLECTION. PRIOR TO THIS HAPPENING, THE FOLLOWING CRITERIA MUST BE MET: A. PATIENT FINANCIAL SERVICES STAFF WILL MAKE REASONABLE COLLECTION EFFORTS BY WAY OF: 1. MONTHLY STATEMENTS 2. COLLECTION LETTERS 3. COLLECTION PHONE CALLS III. ALL COLLECTION ACTIVITY AND PATIENT CONTACTS WILL BE DOCUMENTED ON THE INDIVIDUAL ACCOUNTS. IV. ALL COLLECTION ACCOUNTS ARE TO BE TREATED THE SAME REGARDLESS OF PAYOR TYPE: SELF-PAY, GENERAL INSURANCE, MEDICARE, OR MEDICAL ASSISTANCE. V. PATIENT FINANCIAL SERVICES STAFF WILL USE SOUND BUSINESS JUDGMENT WHEN WORKING WITH THE ACCOUNT. AT THE DISCRETION OF THE FINANCIAL COUNSELOR, CREDIT REPORTS WILL BE REQUESTED FROM THE CREDIT BUREAU AND PROPERTY VERIFICATION OBTAINED THROUGH THE COUNTY TREASURER'S OFFICE. PROCEDURE: VI. THE FINAL STEP IS TO SUBMIT THE ACCOUNT TO A COLLECTION AGENCY OR LAW FIRM. EACH ACCOUNT IS REVIEWED TO DETERMINE IF THE ACCOUNT HAS MET THE BAD DEBT CRITERIA. ONCE IT HAS BEEN DETERMINED THAT ALL REQUIREMENTS HAVE BEEN MET, THE ACCOUNT IS TRANSFERRED FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY THE FINANCIAL COUNSELOR. SPECIFIC PROCEDURES PERTAINING TO THE DETAILED PROCEDURAL STEPS FOR TRANSFERRING TO THE AGENCY CAN BE FOUND IN THE INTERNAL POLICY. A. ADDITIONAL INFORMATION REGARDING MEDICARE BAD DEBTS: 1. THE DEBT MUST BE RELATED TO COVERED SERVICES AND DERIVED FROM DEDUCTIBLE AND COINSURANCE AMOUNTS. 2. THE HOSPITAL MUST PROVIDE REASONABLE COLLECTION EFFORTS. 3. THE DEBT IS NOT COLLECTABLE (AT LEAST 120 DAYS OUTSTANDING FROM THE DATE OF THE FIRST BILLING TO THE PATIENT.) 4. SOUND BUSINESS JUDGMENT ESTABLISHES THAT THERE WAS NO LIKELIHOOD OF RECOVERY AT ANY TIME IN THE FUTURE. II. BAD DEBT RECOVERIES A. PAYMENTS ON MONTHLY REMITTANCE ADVICES FROM OUTSIDE COLLECTION AGENCIES WILL BE POSTED TO EACH INDIVIDUAL ACCOUNT. B. PAYMENTS MADE DIRECTLY TO ASPIRUS BUT INTENDED FOR COLLECTION ACCOUNTS WILL BE POSTED TO THE APPROPRIATE ACCOUNT AND REPORTED DAILY/WEEKLY TO COLLECTION AGENCIES FOR RECONCILIATION OF THEIR RECORDS. C. INVOICES FOR COMMISSIONS DUE TO COLLECTION AGENCIES WILL BE PROCESSED MONTHLY. INVOICE AND REMITTANCE ADVICE WILL BE REVIEWED BY THE FINANCIAL COUNSELOR TEAM LEAD AND APPROVED BY THE MANAGER/DIRECTOR, THEN SUBMITTED TO FISCAL SERVICES FOR CHECK PROCESSING AND PAYMENT TO AGENCIES FOR COMMISSIONS DUE.
      PART VI, LINE 3:
      ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE EMERGENCY DEPARTMENT TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS.
      PART VI, LINE 6:
      ASPIRUS ONTONAGON HOSPITAL IS PART OF THE ASPIRUS HEALTH SYSTEM. ASPIRUS, INC. IS A MULTI-SPECIALTY HEALTH SYSTEM WITH A BASE LOCATION IN WAUSAU, WISCONSIN. ASPIRUS ONTONAGON HOSPITAL WORKS WITH ASPIRUS TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES THEY SERVE. AS NOTED PREVIOUSLY IN THE FORM 990, A NUMBER OF REPRESENTATIVES FROM ASPIRUS HAVE ROLES ON THE BOARD OF DIRECTORS OF ASPIRUS ONTONAGON HOSPITAL AND TOGETHER PROMOTE THE MISSION OF ASPIRUS. ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTHCARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES TO IMPROVING THE HEALTH OF ALL IT SERVES. ASPIRUS WORKS COLLABORATIVELY WITH OTHERS WHO SHARE ITS PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. ASPIRUS AND ASPIRUS ONTONAGON HOSPITAL WORK COLLABORATIVELY TO STREAMLINE PROCESSES TO CONTINUE PROVIDE HIGH QUALITY CARE TO MEMBERS OF COMMUNITIES WHICH, WITHOUT THE EFFORTS OF A COMBINED PARTNERSHIP, MAY NOT HAVE ACCESS TO THIS CARE LOCALLY.