2020-11-11T13:56:15-06:00 2019-12-31 ERNST & YOUNG US LLP 155 N Wacker Drive Chicago IL 60606 990 2019-01-01 391028657 GUNDERSEN CLINIC LTD % GERALD OETZEL GUND 6087827300 1836 SOUTH AVENUE LA CROSSE WI 54601 GERALD OETZEL CFO 6087827300 2020-11-10 true JESS WAGENER P01622613 3128792000 99.59.251.89 36964520203165000015 2020-11-11 P E25FB6EA45473F7CCDD5332CA215900F76A46F16 E25FB6EA45473F7CCDD5332CA215900F76A46F16 2019 2021-01-29 14:40:06Z SCOTT RATHGABER MD 1836 SOUTH AVENUE LA CROSSE WI 54601 164268310 false X WWW.GUNDERSENHEALTH.ORG X 1963 WI SEE SCHEDULE O 10 0 0 0 4903213 0 256106 115778 158542145 163065419 207436 638306 346001 351722 159351688 164171225 2056290 2172657 0 0 0 0 0 0 0 241147690 250748855 243203980 252921512 -83852292 -88750287 195462356 222201328 539070683 654389913 -343608327 -432188585 X TO PROVIDE MEDICAL AND SURGICAL SERVICES, ENGAGE IN MEDICAL EDUCATION AND RESEARCH, AND PROMOTE COMMUNITY HEALTH TO DELIVER THE HIGHEST QUALITY COMPREHENSIVE HEALTH CARE TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. false false 196856732 2172657 163065419 SEE SCHEDULE O 196856732 true true false true false false false false false false true false false false true true false true false false false false false false false false false true true true false false false false false false false false false false false false false true false false false true X 0 0 0 true true false false false false false false false false false false false X 10 0 false true false false true true true true true false false true true true true true true true true false WI X GERALD OETZEL 6087757914 1900 SOUTH AVENUE NCA1-01 LA CROSSE WI 54601 X Jeffrey Lawrence MD Medical Doctor 0.0 40.0 X 0 1198447 59548 Edward Riley II MD Medical Doctor 0.0 40.0 X 0 1160992 41992 Jerry Davis MD Medical Doctor 0.0 40.0 X 0 1120188 48348 Douglas Hughes MD Medical Doctor 0.0 40.0 X 0 1072188 48348 Mark Topolski MD Medical Doctor 0.0 40.0 X 0 964684 41992 Scott Rathgaber MD Chief Executive Officer, Medic 2.0 46.0 X X 0 922188 60548 Michael Dolan MD Exec VP, Medical Chief Operati 2.0 46.0 X 0 597116 61048 Marilu Bintz MD Chief Population Health Office 2.0 46.5 X 0 597100 47956 Julio Bird MD Medical Governors - 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Member 2.0 46.0 X 0 274192 38882 Daniel P Breazeale Vice President Finance 0.0 40.0 X 0 265076 43460 Kraig Schuster Administrative Vice President 0.0 41.0 X 0 233207 54030 Garith Steiner Vice President 2.0 42.0 X 0 251213 32276 Lisa Wied Administrative Vice President 0.0 41.0 X 0 224372 52884 Pamela Maas Vice President Business Develo 0.0 40.0 X 0 242545 34619 Michael McKee Administrative Vice President 0.0 42.3 X 0 220996 54290 Kari Adank Vice President Compliance 0.0 40.0 X 0 210246 49942 Michael O'Neill Vice President Strategy Execut 0.0 41.0 X 0 183236 45680 Ellen Pedretti-Fendt Vice President Application Ser 0.0 40.0 X 0 185930 40588 Janine Luz Vice President Learning 0.0 40.0 X 0 181961 40978 Jennifer Kleven MD Medical Governors - Member 2.0 42.0 X 0 156500 22693 Mark Teresi Interim CFO Thru 03/19 0.0 40.0 X 151990 0 0 0 14885402 1259984 1 true true true GUNDERSEN LUTHERAN ADMIN SERVICES 1910 SOUTH AVENUE LA CROSSE WI 54601 SERVICES/SUPPLIES 187128456 1 X 72645 8985 34148 115778 MEDICAL SERVICE PROVIDED 621498 158350440 158162206 188234 0 ONLINE SALES - DERM AND PLASTICS 446199 34269 0 34269 0 VISION 446130 196936 0 196936 0 PHARMACY 446110 1794792 0 1794792 0 DIAGNOSTIC TESTING INCOME 621511 2688982 0 2688982 0 163065419 204201 204201 0 0 448807 97085 351722 0 351722 351722 434105 434105 434105 434105 0 0 0 0 0 0 0 0 0 0 164171225 158162206 4903213 990028 1371724 1371724 800933 800933 0 0 0 0 0 0 0 0 61351569 28112255 33239314 0 0 22912 22912 0 0 11422791 10949355 473436 43481 41766 1715 1942560 1727608 214952 474530 347114 127416 0 8737255 4189644 4547611 674184 659995 14189 0 0 0 0 8761731 4281973 4479758 1004763 482545 522218 LEASED EMPLOYEES 125776887 114025946 11750941 0 SUPPLIES/BAD DEBTS 26009147 25429913 579234 0 RECRUITING DEVELOPMENT 3567342 3494000 73342 0 MISCELLANEOUS 959703 919049 40654 0 252921512 196856732 56064780 0 127240 141227 0 0 0 0 16562016 17150472 0 0 0 0 0 0 3711126 4771133 222958 224761 365169133 185679696 159762347 179489437 11125480 11342386 20000 0 0 0 1881725 2063567 2049464 7018345 195462356 222201328 5922836 5901191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533147847 648488722 539070683 654389913 X -343608327 -432188585 0 0 -343608327 -432188585 195462356 222201328 X -88750287 190029 -20000 X X false true X true true true X SUPPLEMENTAL INFORMATION THE CLINIC HAS OBTAINED TAX-EXEMPT STATUS AS AN ORGANIZATION WHOSE MAIN PURPOSE IS TO PROVIDE MEDICAL CARE. HOWEVER, THE CLINIC IS NOT REQUIRED TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE OF WISCONSIN AS A HOSPITAL AND IS NOT REQUIRED TO FILE SCHEDULE H. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 22912 242328 22912 242328 252898600 2142825123 252921512 2143067451 1000000 1000000 250000 781949 1000000 1000000 1000000 1000000 4000000 6000000 219895 243711 231180 242328 937114 250000 250000 250000 250000 1000000 1500000 9296257 9296257 250546893 110706558 139840335 105325983 74973138 30352845 0 0 0 179489437 0 INTERCOMPANY PAYABLE 633574832 MALPRACTICE CLAIM RESERVE 8113682 ASSET RETIREMENT OBLIGATIONS 1110586 OPERATING LEASE OBLIGATIONS 5662779 LEASE CONTRACT PAYABLE 26843 648488722 X FORM 990, SCH D, PART X LINE 2 INCOME TAX MATTERS (DOLLARS IN THOUSANDS) THE SYSTEM QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), WITH THE EXCEPTION OF DEGEN BERGLUND, INC. AND GUNDERSEN LUTHERAN ENVISION, LLC, WHICH ARE FOR-PROFIT ENTITIES. AT DECEMBER 31, 2019 AND 2018, NET DEFERRED TAX ASSETS OF $6,900 AND $7,574, RESPECTIVELY, WHICH PRIMARILY ARE RELATED TO NET OPERATING LOSS CARRYFORWARDS, HAVE VALUATION ALLOWANCES OF $6,900 AND $6,300, RESPECTIVELY, RECORDED AGAINST THEM DUE TO THE UNCERTAINTY OF REALIZING THOSE BENEFITS IN THE FUTURE. AT DECEMBER 31, 2019, THE SYSTEM'S FEDERAL NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $28,700, AND THE STATE NET OPERATING LOSS CARRYFORWARDS WERE APPROXIMATELY $25,400, WHICH WILL EXPIRE BETWEEN 2028 AND 2037. THE SYSTEM HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS. THE SYSTEM'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR 2014 AND PRIOR YEARS. THE TAX CUTS AND JOBS ACT (ACT) WAS ENACTED ON DECEMBER 22, 2017. THE ACT REDUCES THE U.S. FEDERAL CORPORATE TAX RATE FROM 35% TO 21%, REQUIRES COMPANIES TO PAY A ONE-TIME TRANSITION TAX ON EARNINGS OF CERTAIN FOREIGN SUBSIDIARIES THAT WAS PREVIOUSLY TAX DEFERRED, AND CREATES NEW TAXES ON CERTAIN FOREIGN SOURCED EARNINGS. FOR TAX-EXEMPT ENTITIES, THE ACT ALSO REQUIRES ORGANIZATIONS TO CATEGORIZE CERTAIN FRINGE BENEFIT EXPENSES AS A SOURCE OF UNRELATED BUSINESS INCOME, PAY AN EXCISE TAX ON REMUNERATION ABOVE CERTAIN THRESHOLDS THAT IS PAID TO EXECUTIVES BY THE ORGANIZATION, AND REPORT INCOME OR LOSS FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS, AMONG OTHER PROVISIONS. AT DECEMBER 31, 2019, THE SYSTEM HAS MADE A REASONABLE ESTIMATE OF THE TAX EFFECTS OF THE ENACTMENT OF THE ACT. CERTAIN REGULATORY GUIDANCE PROVIDES FOR A MEASUREMENT PERIOD OF UP TO ONE YEAR DURING WHICH THE ACCOUNTING FOR THE TAX EFFECTS OF THE ACT MAY BE COMPLETED. THE SYSTEM MAY RECORD FURTHER ADJUSTMENTS IN FUTURE PERIODS UPON OBTAINING, PREPARING, OR ANALYZING ADDITIONAL INFORMATION ABOUT FACTS AND CIRCUMSTANCES THAT EXISTED AS OF THE DATE OF ENACTMENT THAT WOULD HAVE AFFECTED THE INCOME TAX EFFECTS INITIALLY REPORTED. THE SYSTEM WILL CONTINUE TO REVISE AND REFINE THE CALCULATIONS AS ADDITIONAL INTERNAL REVENUE SERVICE GUIDANCE IS ISSUED. ADJUSTMENTS IN FUTURE PERIODS UPON OBTAINING, PREPARING, OR ANALYZING ADDITIONAL INFORMATION ABOUT FACTS AND CIRCUMSTANCES THAT EXISTED AS OF THE DATE OF ENACTMENT THAT WOULD HAVE AFFECTED THE INCOME TAX EFFECTS INITIALLY REPORTED. THE SYSTEM WILL CONTINUE TO REVISE AND REFINE THE CALCULATIONS AS ADDITIONAL INTERNAL REVENUE SERVICE GUIDANCE IS ISSUED. true GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391249705 501(C)(3) 1305876 OPERATIONS ST JOSEPH'S HEALTH SERVICES INC 400 WATER AVENUE HILLSBORO WI 54634 390929538 501(C)(3) 35400 COST PROPERTY TRANSFER PROPERTY TRANSFER 2 CHARITY CARE 4544 800933 BOOK CHARITY CARE FORM 990, SCHEDULE I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS ASSISTANCE WAS TO RELATED ORGANIZATIONS, FUNDS ARE MONITORED BY MANAGEMENT AND THE BOARD OF GOVERNORS. true false false false false false false BENJAMIN JARMAN MD MEDICAL GOVERNORS - MEMBER 0 464042 0 0 0 5192 0 40600 0 1446 0 511280 0 0 Brian Sieck MD FORMER OFFICER 0 410492 0 0 0 43923 0 40600 0 1446 0 496461 0 0 Bryan Erdmann Administrative Vice President 0 265097 0 0 0 2884 0 39331 0 25394 0 332706 0 0 Dana Benden MD Medical Governors - Member 0 470792 0 2500 0 500 0 40600 0 6216 0 520608 0 0 Douglas Hughes MD Medical Doctor 0 1067496 0 0 0 4692 0 29400 0 19002 0 1120590 0 0 Edward Riley II MD Medical Doctor 0 1160992 0 0 0 0 0 40600 0 6646 0 1208238 0 0 Elizabeth Smith-Houskamp PhD RN Administrative Chief Operating 0 432500 0 0 0 4692 0 40600 0 54 0 477846 0 0 Ellen Pedretti-Fendt Vice President Application Ser 0 179980 0 5450 0 500 0 27136 0 15161 0 228227 0 0 Garith Steiner Vice President 0 251033 0 0 0 180 0 32276 0 3585 0 287074 0 0 Gerald Oetzel Chief Financial Officer 0 454234 0 0 0 40653 0 40600 0 12668 0 548155 0 0 Gregory Thompson MD Medical Governors - Member, Ch 0 464246 0 0 0 5192 0 40600 0 20002 0 530040 0 0 Janine Luz Vice President Learning 0 175994 0 3000 0 2967 0 26354 0 14678 0 222993 0 0 Jeffrey Lawrence MD Medical Doctor 0 1193255 0 0 0 5192 0 40600 0 19002 0 1258049 0 0 Jeffrey Thompson MD FORMER CEO 0 251396 0 0 0 28813 0 40600 0 21584 0 342393 0 0 Jennifer Kleven MD Medical Governors - Member 0 154000 0 2500 0 0 0 22693 0 2179 0 181372 0 0 Jerry Davis MD Medical Doctor 0 1115496 0 0 0 4692 0 29400 0 19002 0 1168590 0 0 Jonathan Zlabek MD Medical Governors - Member 0 336996 0 6500 0 4928 0 40600 0 21502 0 410526 0 0 Julio Bird MD Medical Governors - Member 0 511496 0 0 0 4692 0 40600 0 18984 0 575772 0 0 Kari Adank Vice President Compliance 0 210246 0 0 0 0 0 30994 0 21952 0 263192 0 0 Kelley Bahr MD Medical Governors - Member 0 352500 0 2500 0 5192 0 40600 0 54 0 400846 0 0 Kraig Schuster Administrative Vice President 0 232096 0 0 0 1111 0 32682 0 24686 0 290575 0 0 Lisa Wied Administrative Vice President 0 220996 0 0 0 3376 0 31936 0 21002 0 277310 0 0 Marilu Bintz MD Chief Population Health Office 0 591908 0 0 0 5192 0 40600 0 7410 0 645110 0 0 Mark Topolski MD Medical Doctor 0 957492 0 2500 0 4692 0 40600 0 1446 0 1006730 0 0 Mary Ellen McCartney Chief Human Resources Officer 0 339186 0 0 0 500 0 40600 0 13598 0 393884 0 0 Mary Kuffel MD Medical Vice President 0 505912 0 2500 0 4692 0 40600 0 1446 0 555150 0 0 Michael Dolan MD Exec VP, Medical Chief Operati 0 593116 0 4000 0 0 0 40600 0 25334 0 663050 0 0 Michael McKee Administrative Vice President 0 220496 0 0 0 500 0 32842 0 24628 0 278466 0 0 Michael O'Neill Vice President Strategy Execut 0 180943 0 0 0 2293 0 26732 0 19002 0 228970 0 0 P Michael Jacobs DPM Medical Vice President 0 381496 0 0 0 4692 0 40600 0 21496 0 448284 0 0 Pamela Maas Vice President Business Develo 0 238750 0 0 0 3795 0 34619 0 54 0 277218 0 0 Daniel P Breazeale Vice President Finance 0 229946 0 0 0 35130 0 24512 0 19002 0 308590 0 0 Robyn Borge MD Medical Governors - Member 0 267500 0 2500 0 4192 0 38882 0 54 0 313128 0 0 Rose Ann-Laureto Chief Information Officer 0 342186 0 0 0 72083 0 40600 0 11170 0 466039 0 0 Scott Rathgaber MD Chief Executive Officer, Medic 0 916996 0 0 0 5192 0 40600 0 20002 0 982790 0 0 Sigurd Gundersen III MD Medical Governors - Member 0 459496 0 0 0 500 0 40600 0 23742 0 524338 0 0 Stephanie Carroll MD Medical Vice President 0 321496 0 7500 0 0 0 37914 0 23487 0 390397 0 0 Todd Kowalski MD Medical Vice President 0 372996 0 2500 0 0 0 40600 0 24712 0 440808 0 0 William Farrell Chief Business & Strategy Offi 0 391500 0 0 0 19502 0 29400 0 54 0 440456 0 0 Mark Teresi Interim CFO Thru 03/19 151990 0 0 0 0 0 0 0 0 0 151990 0 0 0 FORM 990, SCH J, PART I LINES 2 &3 ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FORM 990, SCH J, PART I LINE 4A 2019 SEVERANCE PAYMENTS: ROSE ANN-LAURETO $70,583 FORM 990, SCH J, PART II GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. PROVIDES LEASED EMPLOYEES AND MANAGEMENT SERVICES TO GUNDERSEN CLINIC. THEREFORE THE AMOUNTS REPORTED ON SCHEDULE J REPRESENT REIMBURSEMENTS TO GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. PAID AN INDEPENDENT EMPLOYMENT AGENCY $151,990 FOR MARK TERESI'S SERVICES AS INTERIM CFO. FORM 990, PART I LINE 1 TO PROVIDE MEDICAL AND SURGICAL SERVICES, ENGAGE IN MEDICAL EDUCATION AND RESEARCH, AND PROMOTE COMMUNITY HEALTH TO DELIVER THE HIGHEST QUALITY COMPREHENSIVE HEALTH CARE TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. FORM 990, PART III LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: GUNDERSEN CLINIC, LTD. (THE CLINIC) HAS 561 PHYSICIANS REPRESENTING NEARLY EVERY SPECIALTY SERVING A 21 COUNTY REGION IN WESTERN WISCONSIN, NORTHEASTERN IOWA AND SOUTHEASTERN MINNESOTA. THE CLINIC PROVIDES MEDICAL CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CHARITY CARE AND/OR FINANCIAL ASSISTANCE IS DETERMINED BASED ON FINANCIAL INFORMATION PROVIDED BY THE PATIENT AND ANALYSIS OF OTHER RELEVANT INFORMATION. THERE WERE APPROXIMATELY 1,054,162 PATIENT ENCOUNTERS FOR 2019. THE CLINIC PROVIDED UNCOMPENSATED CARE RELATED TO CHARITY, $800,993; MEDICARE, $25,238,751; AND MEDICAID, $10,884,177 FOR THE TOTAL AMOUNT OF $36,690,512 AT COST BASED ON POLICIES AND CONTRACTS ARRANGED TO HELP SUPPORT THE COMMUNITY'S NEEDS. THE $36,690,512 IS THE SUM OF UNREIMBURSED MEDICARE & MEDICAID COST PLUS CHARITY AT COST. ALL OF THESE ARE CALCULATED USING THE SAME METHOD UTILIZED FOR THE HOSPITAL CALCULATION OF CHARITY COST AND UNREIMBURSED MEDICARE AND MEDICAID COSTS. THE COST OF CHARITY IS CALCULATED BY ALLOCATING THE COST TO PROVIDE SERVICES TO A PATIENT BETWEEN ANY PAYMENTS, BAD DEBT, AND CHARITY WRITE-OFFS WHERE TOTAL PAYMENTS ARE LESS THAN THE COST OF SERVICES PROVIDED. THE UNREIMBURSED MEDICARE AND MEDICAID COSTS ARE CALCULATED BY COMPARING THE COST OF SERVICES TO MEDICARE AND MEDICAID PATIENTS TO THE NET REVENUE FOR THOSE SAME PATIENTS. THE UNREIMBURSED COST IS THE AMOUNT THE COST EXCEEDS THE NET REVENUE FOR THOSE SAME PATIENTS. MEDICARE AND MEDICAID PATIENTS TO THE NET REVENUE FOR THOSE SAME PATIENTS. THE UNREIMBURSED COST IS THE AMOUNT THE COST EXCEEDS THE NET REVENUE FOR THOSE SAME PATIENTS. FORM 990, PART IV LINE 24A TAX EXEMPT BONDS GUNDERSEN CLINIC, LTD. IS PART OF THE OBLIGATED GROUP (GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC., GUNDERSEN LUTHERAN MEDICAL CENTER, INC., GUNDERSEN CLINIC, LTD., AND GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.) AND TAX-EXEMPT DEBT RESIDES ON THE BALANCE SHEET OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FEIN 39-1606449. FORM 990, PART V LINES 1 & 2 ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. AND ALL PAYMENTS TO VENDORS ARE MADE BY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. HENCE LINES 1 & 2 INDICATE ZERO (0) FILINGS. FORM 990, PART VI LINE 3 ALL MANAGEMENT AND PERSONNEL SERVICES FOR GUNDERSEN LUTHERAN MEDICAL CENTER ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICE, INC. FORM 990, PART VI LINE 6 GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI LINE 7A GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990 PART VI LINE 7B THE CORPORATION'S SOLE SHAREHOLDER IS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. THE BYLAWS MAY BE AMENDED BY THE BOARD WITH APPROVAL OF THE PARENT CORPORATION, OR BY THE VOTE OF THE SOLE SHAREHOLDER. ALSO, THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED UNDER THE DIRECTION OF THE CORPORATION'S BOARD OF GOVERNORS, SUBJECT TO CERTAIN APPROVAL POWERS OF THE BOARD OF GOVERNORS AND BOARD OF TRUSTEES OF THE PARENT CORPORATION. FORM 990, PART VI LINE 11B THE FORM 990 WILL BE AVAILABLE FOR ALL BOARD MEMBERS AT A BOARD MEETING AND THE GUNDERSEN LUTHERAN HEALTH SYSTEM FINANCE COMMITTEE RECEIVES A COPY OF THE 990 BEFORE FILING. UPON FURTHER REVIEW FROM THE CFO AND/OR THE EXECUTIVE DIRECTOR FINANCE, THE 990S ARE APPROVED AND FILED. FORM 990, PART VI LINE 12C GUNDERSEN CLINIC, LTD. MONITORS CONFLICTS ON AN ANNUAL BASIS BY REVIEWING DISCLOSURES ON COMPLETED CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI LINE 15 ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. THE COMPENSATION OF THE CEO IS DETERMINED ANNUALLY BY A COMMITTEE MADE UP OF THE COMMUNITY MEMBERS OF THE BOARD OF TRUSTEES. THEIR DETERMINATION IS MADE AFTER A REVIEW OF MARKET DATA OBTAINED FROM SEVERAL ORGANIZATIONS AND CEO PERFORMANCE. MEETING MINUTES ARE TAKEN AND KEPT AT THE MEETINGS WHERE SUCH DISCUSSIONS TAKE PLACE. RECOMMENDATIONS FOR COMPENSATION FOR THE ORGANIZATIONS' KEY MANAGEMENT EMPLOYEES ARE DEVELOPED ANNUALLY BY THE CEO, AFTER A REVIEW OF PERFORMANCE AND COMPARABLE MARKET DATA. THE PROPOSED SALARIES ARE INDEPENDENTLY REVIEWED BY AN OUTSIDE AUDITING FIRM. THE COMPENSATION RECOMMENDATIONS, AUDIT REPORTS, ALONG WITH THE MARKET DATA, ARE PRESENTED TO A COMMITTEE MADE UP OF THE COMMUNITY MEMBERS OF THE BOARD OF TRUSTEES. THE COMPENSATION AMOUNTS ARE NOT EFFECTIVE UNTIL THE BOARD COMMITTEE APPROVES THEM. MEETING MINUTES ARE TAKEN AND KEPT AT THE MEETINGS WHERE THE BOARD REVIEWS AND APPROVES THE COMPENSATION OF THE KEY EMPLOYEES. FORM 990, PART VI LINE 19 REQUESTS FOR ALL DOCUMENTS ARE MADE THROUGH THE LEGAL DEPARTMENT AND THE APPROPRIATE DOCUMENTS ARE MADE AVAILABLE FOR INSPECTION IN THE LEGAL DEPARTMENT. FORM 990, PART VII, SECTION A, LINE 1 & PART VI SECTION A LINE 3 GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. PROVIDES LEASED EMPLOYEES AND MANAGEMENT SERVICES TO GUNDERSEN CLINIC. THEREFORE, THE AMOUNTS REPORTED ON PART VII REPRESENT REIMBURSEMENTS TO GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FORM 990, PART VIII LINE 2A THE PROVISION OF MEDICAL SERVICES IN A MANNER BENEFICIAL TO THE COMMUNITY FURTHERS GUNDERSEN CLINIC, LTD.'S CHARITABLE PURPOSE OF PROMOTION OF HEALTH. FORM 990, PART XI LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: WRITE OFF OF INVESTMENT FORM 990, PART XII LINE 3A THE INFORMATION IN THE SCHEDULE IS PRESENTED IN ACCORDANCE WITH THE REQUIREMENTS OF TITLE 2 U.S. CODE OF FEDERAL REGULATIONS PART 200, UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS. GUNDERSEN LUTHERAN HEALTH SYSTEMS INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391866425 SUPTNG ORG. WI 501(C)(3) LINE 12B II NA false GUNDERSEN LUTHERAN MEDICAL CENTER INC 1910 SOUTH AVENUE LA CROSSE WI 54601 390813416 HEALTHCARE WI 501(C)(3) Line 3 GLHS false GUNDERSEN LUTHERAN ADMINISTRATIVE SVC 1910 SOUTH AVENUE LA CROSSE WI 54061 391606449 SUPTNG ORG. WI 501(C)(3) Line 12B II GLHS false GUNDERSEN LUTHERAN MEDICAL FOUNDATION I 1836 SOUTH AVENUE LA CROSSE WI 54061 391249705 FOUNDATION WI 501(C)(3) Line 7 GLHS false GUNDERSEN LUTHERAN CREDENTIALING SVC IN 1910 SOUTH AVENUE LA CROSSE WI 54061 391856898 CREDENTIALING WI 501(C)(3) Line 12C II GLHS false TRI-COUNTY MEMORIAL HOSPITAL 18601 LINCOLN STREET WHITEHALL WI 54773 390704510 HEALTHCARE WI 501(C)(3) Line 3 GLHS false HARMONY COMMUNITY HEALTHCARE INC 815 MAIN AVENUE SOUTH HARMONY MN 55939 410711606 HEALTHCARE MN 501(C)(3) Line 10 GLHS false TWEETEN LUTHERAN HEALTHCARE CENTER INC 125 FIFTH AVENUE SE SPRING GROVE MN 55974 411565003 HEALTHCARE MN 501(C)(3) Line 10 GLHS false TRI-STATE AMBULANCE INC 235 CAUSEWAY BOULEVARD LA CROSSE WI 54601 391965415 MDCL TRANSPO WI 501(C)(3) Line 3 GLHS false TRI-STATE REGIONAL AMBULANCE INC 235 CAUSEWAY BOULEVARD LA CROSSE WI 54601 391962965 MDCL TRANSPO WI 501(C)(3) Line 10 GLHS false LUTHERAN REAL ESTATE HOLDING CORP 1910 SOUTH AVENUE LA CROSSE WI 54601 391480826 HOUSING WI 501(C)(3) Line 12C II GLHS false COMMUNITY HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391586700 INDP LIVING WI 501(C)(3) Line 10 LRHC false LUTHERAN HOUSING OF LA CROSSE 1900 SOUTH AVENUE LA CROSSE WI 54601 391751934 INDP LIVING WI 501(C)(3) Line 10 LRHC false ST JOSEPH'S HEALTH SERVICES INC 400 WATER AVENUE HILLSBORO WI 54634 390929538 HEALTHCARE WI 501(C)(3) Line 3 GLHS false ST JOSEPH'S MEMORIAL FOUNDATION INC 400 WATER AVENUE HILLSBORO WI 54634 391455787 FOUNDATION WI 501(C)(3) Line 12A I SJHS false TRI-COUNTY MEMORIAL FOUNDATION INC 18601 LINCOLN STREET WHITEHALL WI 54773 300093022 FOUNDATION WI 501(C)(3) Line 12A I TCMH false MEMORIAL HOSPITAL OF BOSCOBEL 205 PARKER STREET BOSCOBEL WI 53805 390845590 HEALTHCARE WI 501(C)(3) Line 3 GLHS false MEMORIAL HOSPITAL OF BOSCOBEL FOUNDATION 205 PARKER STREET BOSCOBEL WI 53805 391688793 FUNDRAISING WI 501(C)(3) Line 7 MHB false BOSCOBEL AREA HEALTHCARE PARTNERS 205 PARKER STREET BOSCOBEL WI 53805 450498844 FUNDRAISING WI 501(C)(3) Line 7 MHB false PALMER LUTHERAN HEALTH CENTER INC 112 JEFFERSON STREET WEST UNION IA 52175 421320763 HEALTHCARE IA 501(C)(3) Line 3 GLHS false PALMER MEMORIAL FOUNDAITON 112 JEFFERSON STREET WEST UNION IA 52175 421032878 FOUNDATION IA 501(C)(3) Line 7 PLHC false MOUNDVIEW MEMORIAL HOSPITALS AND CLINICS 402 WEST LAKE STREET FRIENDSHIP WI 53934 390944012 HEALTHCARE WI 501(C)(3) Line 3 GLHS false MEMORIAL HEALTHCARE FOUNDATION OF ADAMS 402 WEST LAKE STREET FRIENDSHIP WI 53934 391775074 FOUNDATION WI 501(C)(3) Line 12A I MMHC false DEGN BERGLUND INC 1709 LOSEY BLVD S LA CROSSE WI 54601 390971110 RTL PHARMACY WI GLHS C CORP 0 0 true GUNDERSEN LUTHERAN ENVISION LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 264706546 RENEWABLE ENERGY WI GLHS C CORP 0 0 true false true true false false false false false false true true true true false false true true false false GUNDERSEN CLINIC LTD 1836 SOUTH AVENUE LA CROSSE WI 54601 391028657 0 22912 22912 252898600 252921512 1000000 250000 0 0 0 GUNDERSEN LUTHERAN ADMIN SE 1910 SOUTH AVENUE LA CROSSE WI 54601 391606449 0 219416 219416 830211483 830430899 1000000 250000 0 0 0 GUNDERSEN LUTHERAN MEDICAL C 1910 SOUTH AVENUE LA CROSSE WI 54601 390813416 0 0 0 1059029736 1059029736 1000000 250000 0 0 0 GUNDERSEN LUTHERAN HEALTH SY 1836 SOUTH AVENUE LA CROSSE WI 54601 391866425 0 0 0 685304 685304 127796 31949 0 0 0