efile Public Visual Render
ObjectId: 201720419349301362 - Submission: 2017-02-10
TIN: 26-0806477
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
15
Open to Public Inspection
Name of the organization
Aspirus Ontonagon Hospital Inc
Employer identification number
26-0806477
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
ASPIRUS INC
333 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-1328331
HEALTH CARE SYSTEM MANAGEMENT
WI
501(c)(3)
Line 11b, II
N/A
No
(2)
ASPIRUS WAUSAU HOSPITAL INC
333 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-1138241
HOSPITAL
WI
501(c)(3)
Line 3
ASPIRUS INC
Yes
(3)
ASPIRUS BUILDINGS INC
333 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-1406537
PROPERTY LEASING
WI
501(c)(3)
Line 9
ASPIRUS INC
Yes
(4)
ASPIRUS EXTENDED SERVICES INC
425 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-0782130
NURSING HOME SERVICES
WI
501(c)(3)
Line 9
ASPIRUS INC
Yes
(5)
ASPIRUS CLINICS INC
425 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-1670223
MEDICAL SERVICES
WI
501(c)(3)
Line 9
ASPIRUS INC
Yes
(6)
ASPIRUS VNA HOME HEALTH INC
520 N 32ND AVENUE
WAUSAU
,
WI
54401
39-0808511
HOME HEALTHCARE SERVICES
WI
501(c)(3)
Line 9
ASPIRUS INC
Yes
(7)
ASPIRUS VNA EXTENDED CARE INC
520 N 32ND AVENUE
WAUSAU
,
WI
54401
39-1597350
PERSONAL CARE SERVICES
WI
501(c)(3)
Line 9
ASPIRUS VNA HOME HEALTH INC
Yes
(8)
ASPIRUS HEALTH FOUNDATION INC
425 PINE RIDGE BLVD
WAUSAU
,
WI
54401
39-1256656
CHARITABLE FOUNDATION
WI
501(c)(3)
Line 7
ASPIRUS INC
Yes
(9)
ASPIRUS GRAND VIEW
N10561 GRAND VIEW LANE
IRONWOOD
,
MI
49938
38-2908586
HOSPITAL
MI
501(c)(3)
Line 3
ASPIRUS INC
Yes
(10)
GRAND VIEW HOSPITAL AUXILLIARY
N10561 GRAND VIEW LANE
IRONWOOD
,
MI
49938
23-7178363
Supporting organization to hospital and lifeline emergency system
MI
501(c)(3)
Line 9
ASPIRUS GRAND VIEW
Yes
(11)
ASPIRUS GRAND VIEW SERVICE CORP
N10561 GRAND VIEW LANE
IRONWOOD
,
MI
49938
38-3005582
PHYSICIAN SERVICES
MI
501(c)(3)
Line 3
ASPIRUS GRAND VIEW
Yes
(12)
ASPIRUS IRON RIVER HOSPITAL & CLINICS INC
1400 W ICE LAKE ROAD
IRON RIVER
,
MI
49935
38-3236977
HOSPITAL
MI
501(c)(3)
Line 3
ASPIRUS INC
Yes
(13)
ASPIRUS RIVERVIEW HOSPITAL & CLINICS
410 DEWEY STREET
WISCONSIN RAPIDS
,
WI
54494
39-0868982
HOSPITAL
WI
501(c)(3)
Line 3
ASPIRUS INC
Yes
(14)
Greater Iron County EMS Inc
1400 W ICE LAKE ROAD
iron RIVER
,
MI
49935
38-3491283
Emergency medical care and transportation
MI
501(c)(3)
Line 11a, I
Aspirus Iron RIver Hospital & Clinics Inc
Yes
(15)
aspirus keweenaw hosptial
205 OSCEOLA STREET
laurium
,
MI
49913
38-1443361
hosPITAL
MI
501(c)(3)
Line 3
aspirus iNC
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Page 2
Schedule R (Form 990) 2015
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
Western Upper Michigan Eye Care LLC
131 W Genesee Street
Iron River
,
MI
49935
27-2324957
Eye Care Services
MI
N/A
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
ASPIRUS NETWORK INC
3000 WESTHILL DRIVE 202
WAUSAU
,
WI
54401
39-1931679
HEALTH CARE NETWORK
WI
N/A
C
Yes
(2)
ASPIRUS GRAND VIEW CARING CAREGIVERS
N 10561 GRAND VIEW LANE
IRONWOOD
,
MI
49938
38-2902754
PERSONAL NEEDS SERVICES
MI
N/A
C
Yes
(3)
ASPIRUS KEWEENAW ENTERPRISES INC
205 OSCEOLA STREET
LAURIUM
,
MI
49913
38-3390273
PHARMACY
MI
N/A
C
Yes
Schedule R (Form 990) 2015
Page 3
Schedule R (Form 990) 2015
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
asPIRUS WAUSAU HOSPITAL INC
L
50,318
cOST
(2)
asPIRUS WAUSAU HOSPITAL INC
P
78,112
COST
(3)
ASPIRUS WAUSAU HOSPITAL INC
O
1,342,588
COST
(4)
ASPIRUS INC
B
200,000
COST
(5)
ASPIRUS INC
E
2,805,618
COST
(6)
ASPIRUS INC
M
1,469,504
COST
(7)
ASPIRUS INC
O
159,877
COST
(8)
ASPIRUS INC
P
115,587
COST
(9)
ASPIRUS INC
Q
60,240
COST
(10)
Aspirus Keweenaw Hospital
M
66,424
COST
(11)
Aspirus Keweenaw Hospital
O
622,029
COST
(12)
Aspirus Keweenaw Hospital
P
377,572
COST
Schedule R (Form 990) 2015
Page 4
Schedule R (Form 990) 2015
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2015
Page 5
Schedule R (Form 990) 2015
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2015
Additional Data
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