SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public Inspection
Name of the organization
Aspirus Ontonagon Hospital Inc
 
Employer identification number

26-0806477
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    108,051   108,051 0.700 %
b Medicaid (from Worksheet 3, column a) . . . . .     3,938,587 3,209,163 729,424 4.730 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     4,046,638 3,209,163 837,475 5.430 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     3,433   3,433 0.020 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     2,528,763 2,178,235 350,528 2.270 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     6,607   6,607 0.040 %
j Total. Other Benefits . .     2,538,803 2,178,235 360,568 2.330 %
k Total. Add lines 7d and 7j .     6,585,441 5,387,398 1,198,043 7.760 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     24,960   24,960 0.160 %
9 Other            
10 Total     24,960   24,960 0.160 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
126,389
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
4,058,958
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,045,283
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
13,675
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

 

No
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ASPIRUS ONTONAGON HOSPITAL INC
601 S SEVENTH STREET
ONTONAGON,MI49953 		X X     X   X   PHYSICIAN CLINIC, SKILLED NURSING FACILITY  
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ASPIRUS ONTONAGON HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://aspirus.org/Uploads/Public/Documents/Comm-Benefit-Report-AOH.pdf
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ASPIRUS ONTONAGON HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://aspirus.org/Main/Pay-My-Bill.aspx?srcaud=Main#tab2
b
http://aspirus.org/Main/Pay-My-Bill.aspx?srcaud=Main#tab2
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
ASPIRUS ONTONAGON HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ASPIRUS ONTONAGON HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
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 1700 random households in Gogebic County. 360 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 Grand View Hospital- Aspirus Keweenaw Hospital- Aspiurs Iron River Hopsital- Portage Health- Baraga County Memorial Hospital
ASPIRUS ONTONAGON HOSPITAL, INC. Part V, Section B, Line 6b: Western Upper Peninsula Health Department, Copper Country Mental Health Services, Gogebic County Community Mental Health Authority, Upper Great Lakes Family Health Center, Iron County Health Department
ASPIRUS ONTONAGON HOSPITAL, INC. Part V, Section B, Line 11: The four major priority areas for Ontonagon County were identified as Impact of Aging Population, Importance of Prevention related to obesity, diabetes, and smoking, Correlation Between Socio-Economic Status and Poor Health, and Expanded Access to Care Via the Evolving Affordable Care Act. To address the impact of an aging population, we aim to increase support for services to manage chronic disease and care for those in need. To address the importance of prevention, we provide nutrition and exercise counseling to reduce prevalance of obesity, diabetes and pre-diabetes screenings, education, and personal counseling, and we offer smoking cessation programs. To address the correlation between lower socio-econimc status and poor health, we aim to increase education and counseling to high risk patients in those categories. To address the issue expanded access to the ACA, we plan to increase programs to make access easy for new patients. The three biggest needs identified for Ontonagon County were Hypertension, Obesity, and Diabetes. We hold Blood pressure screenings regularly at local health fairs and community events. Community members are given results and recommended to follow-up with a provider if the BP readings are higher than normal. We conduct diabetic clinics monthly at both of our clinics, one attached to the hospital, and one located in the southern end of the county. The clinics focus highest priority on our patients who demonstrate the triad of diabetes, obesity, and hypertension, since they are at greatest risk of complications. We hold diabetic support groups monthly here in Ontonagon, and also in the southern end of the county in Ewen. We have also held lunch n learn programs focused on nutrition.
PART V, SECTION B, LINE 16(i) THE FAP PLAIN LANGUAGE SUMMARY AND FAP APPLICATION ARE TRANSLATED INTO THE PRIMARY LANGUAGES SPOKEN BY LEP POPULATIONS. ASPIRUS IS CURRENTLY WORKING TO FINALIZE THE TRANSLATION OF THE FAP POLICY INTO THE PRIMARY LANGUAGES SPOKEN BY LEP POPULATIONS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2016
Page 9
Schedule H (Form 990) 2016
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 1 - ASPIRUS ONTONAGON HOSPITAL NURSING HOME
601 SOUTH SEVENTH STREET
ONTONAGON,MI49953 		SKILLED NURSING FACILITY
2 2 - AOH Family Practice Clinic
601 South Seventh Street
OnTOnAGOn,MI49953 		ClINIC
3 3 - ASPIRUS UP CLINIC - Bruce Crossing
13833 US Hwy 45
BRUCE CROSSING,MI49912 		CLINIC
4 4 - FITNESS CENTER
400 RIVER STREET
ONTONAGON,MI49953 		OUTPATIENT PHYSICAL THERAPY AND FITNESS CENTER
5
6
7
8
9
10
Schedule H (Form 990) 2016
Page 10
Schedule H (Form 990) 2016
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
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 organization did not include any physician clinics in calculating subsidized health service costs. The subsidized health services included the emergency department with costs of $728,294 and direct offsetting revenue of $647,367, the Inpatient Unit with costs of $352,665 and direct offsetting revenue of $311,045, the Nursing Home with costs of $827,283 and direct offsetting revenue of $612,651 and the RHC with costs of 620,521 and direct offsetting revenue of $607,172. The subsidized heatlh services costs were estimated using an overall cost to charge ratio.
Part II, Community Building Activities: WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. 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 THREE 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 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 health care 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 receivable are written off after all collection efforts have been followed in accordance with Aspirus' policies.
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 ORGANIZAITON 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 HOSPTIAL 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, 2017 AND DOES NOT CONSIDER MEDCIARE 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).
Part III, Line 9b: Upon a patients approval for financial assistance, this is loaded as an insurance coverage to the patients account with an effective and termination date to assure capturing all charges for the patient for adjustment in a workqueue 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 2017, 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 3: All patient statements provide information regarding the Aspirus Finacial 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 ED to assist with Medical Assistance applications.
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. AOH also has employees that represent Aspirus Ontonagon Hospital and are active in other groups to help in building community effots to improve healthcare in our service area.
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 otherwise without the efforts of a combined partnership may not have access to this care locally.
Part VI, Line 7, Reports Filed With States MI
Schedule H (Form 990) 2016
Additional Data


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