2025-11-04T13:12:07-06:00 2024-12-31 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2024-01-01 461495343 MARSHFIELD CLINIC HEALTH SYSTEM INC MARS 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 NICHOLAS OLSON EVP, CFO 6053331000 2025-11-04 1 0 JESS WAGENER P01622613 3128792000 2024 2025-03-06 01:10:19Z BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 415964284 0 X WWW.MARSHFIELDCLINIC.ORG/HEALTH-SYSTEM X 2012 WI WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 24 12 10202 0 327883 57692 73868 80629 336611226 320398342 19892897 33969058 0 65280 356577991 354513309 667534 69614 0 0 160407874 142996201 0 0 0 177840089 177916090 338915497 320981905 17662494 33531404 687467973 711318473 296758503 136324663 390709470 574993810 WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 0 0 288890676 69614 320398342 MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) WAS INCORPORATED IN OCTOBER 2012 AS PART OF A PROSPECTIVE REORGANIZATION OF MARSHFIELD CLINIC AND ITS AFFILIATED ENTITIES INTO AN INTEGRATED HEALTHCARE SYSTEM. THE REORGANIZATION WAS IMPLEMENTED UPON RECEIPT OF AN INTERNAL REVENUE SERVICE (IRS) DETERMINATION LETTER RECOGNIZING MCHS AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3) IN 2014. MCHS AS A STANDALONE ENTITY HOUSES CERTAIN ADMINISTRATIVE FUNCTIONS THAT SUPPORT THE SYSTEM AS A WHOLE. 288890676 1 1 0 1 0 0 0 0 0 0 1 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 1241 0 1 10202 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 24 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X NICHOLAS OLSON EVP CFO 6053331000 2301 EAST 60TH STREET SIOUX FALLS SD 57104 GEORGE BROWN MD CHAIR 9.00 0.00 X X 27000 0 0 MARK BRADLEY VICE CHAIR (THRU MAR 2024) 4.00 3.00 X X 5500 0 0 RICHARD LEINENKUGEL VICE CHAIR 4.00 0.00 X X 5500 0 0 ALPA SHAH MD SECRETARY (THRU MAR 2024) 4.00 39.00 X X 0 283360 9460 DAVID JUNKER MD SECRETARY 3.00 52.00 X X 0 929786 51612 TOM WENZEL TREASURER 4.00 1.00 X X 8000 0 0 BARBARA BOYER MD BOARD MEMBER 2.00 52.00 X 0 429508 43301 KENT RAY DO BOARD MEMBER 3.00 53.00 X 0 405006 48974 JULIE BRUSSOW BOARD MEMBER (THRU JAN 2024) 2.00 0.00 X 1000 0 0 COLLEEN HOERNEMAN BOARD MEMBER 9.00 2.00 X 5500 0 0 JAYANTH VEDRE MD BOARD MEMBER 2.00 52.00 X 0 711891 36310 CHRISTOPHER ADLER MD BOARD MEMBER 2.00 52.00 X 0 367109 23561 PATRICK WOLF DO BOARD MEMBER (THRU MAR 2024) 2.00 53.00 X 0 65500 4352 JESSICA WERNBERG MD BOARD MEMBER 3.00 53.00 X 0 459068 40681 ELVIS PETER MD BOARD MEMBER 3.00 54.00 X 0 812372 48068 MICHAEL LUEBKE BOARD MEMBER (THRU MAR 2024) 4.00 1.00 X 11000 0 0 TOM EVERT BOARD MEMBER 4.00 1.00 X 10500 0 0 BERNIE PATTERSON BOARD MEMBER (THRU MAR 2024) 2.00 0.00 X 3500 0 0 JANET LINDEMANN MD BOARD MEMBER 2.00 0.00 X 6500 0 0 SANJAY KUMAR MD BOARD MEMBER 2.00 52.00 X 0 1072801 42168 WILLIAM SENNHOLZ BOARD MEMBER 2.00 0.00 X 1500 0 0 TERRY FRANKLAND BOARD MEMBER 4.00 1.00 X 19000 0 0 TYLER DAHL MD BOARD MEMBER (THRU MAR 2024) 2.00 52.00 X 0 1169680 39311 MAUREEN MCCAUSLAND BOARD MEMBER 2.00 0.00 X 6500 0 0 TOM STILL BOARD MEMBER 2.00 0.00 X 3000 0 0 MATTHEW THOMAS MD BOARD MEMBER 3.00 52.00 X 0 877617 41999 MATTHEW OELSTROM MD BOARD MEMBER 2.00 54.00 X 0 499726 37964 BART ISAACSON MD BOARD MEMBER (THRU MAR 2024) 2.00 52.00 X 0 322040 38947 RICHARD WICKA BOARD MEMBER 2.00 0.00 X 1500 0 0 KATHERINE WINIARCZYK DO BOARD MEMBER 2.00 52.00 X 0 332455 37544 ANDREW DANIELS BOARD MEMBER 2.00 0.00 X 0 0 0 EVERETTE NEWCOMB MD BOARD MEMBER 2.00 0.00 X 0 0 0 BRIAN HOERNEMAN MD INTERIM MCHS CEO 50.00 5.00 X 1584168 0 39013 JEANETTE WOJTALEWICZ INTERIM MCHS CFO 50.00 5.00 X 972510 0 0 KRISTA HOGLUND MCHS HEALTH PLAN CEO 50.00 5.00 X 679971 0 39714 JERARD JENSEN MCHS GENERAL COUNSEL (THRU JAN 2024) 50.00 5.00 X 889281 0 11274 LISA BOERO MCHS GENERAL COUNSEL 50.00 5.00 X 415495 0 10811 SAMANTHA KLEBE DO CHIEF MEDICAL OFFICER 50.00 5.00 X 703503 0 36357 TERRI NEWMIER MCHS CHIEF HR OFFICER 50.00 5.00 X 580192 0 27751 KATHY BRESSLER MCHS COO 50.00 5.00 X 985571 0 37461 SUSAN TURNEY MD FORMER MCHS CEO 0.00 0.00 X 2241715 0 0 CATHY BUKOWSKI FORMER MCHS CFO 0.00 0.00 X 631969 0 0 WILLIAM MELMS MD FORMER CHIEF MEDICAL OFFICER 0.00 0.00 X 199385 0 0 9999260 8737919 746633 1425 1 1 0 CERNER CORPORATION PO BOX 203448 DALLAS TX 75320 IT SERVICES 19553140 KAUFMAN HALL & ASSOCIATES LLC 8610 SOLUTION CENTER CHICAGO IL 60677 PROFESSIONAL SERVICES 8789404 AE BUSINESS SOLUTIONS 2323 CROSSROADS DR STE 300 MADISON WI 53718 IT SERVICES 5234396 MICROSOFT CORP 1950 N STEMMONS FWY STE 5010 DALLAS TX 75207 IT SERVICES 4983195 XTEND HEALTHCARE LLC PO BOX 654073 DALLAS TX 75265 PROFESSIONAL SERVICES 4875368 223 80629 80629 INTERCOMPANY REVENUE 561000 315494592 315494592 CONTRACT REVENUE 561000 4903750 4903750 320398342 16589578 327883 16261695 -467022 -467022 65280 0 65280 65280 65280 79278894 18583 61438676 12299 17840218 6284 17846502 17846502 354513309 320398342 327883 33706455 X 6000 6000 63614 63614 7128572 7128572 3254555 181486 3073069 99912159 99084271 827888 2511241 2260117 251124 22455391 20209852 2245539 7734283 6960855 773428 2445292 2200763 244529 883160 794844 88316 916470 824823 91647 431369 388232 43137 56022945 50420650 5602295 1685289 1516760 168529 2333037 2099733 233304 58603171 52742854 5860317 4025482 3622934 402548 946313 851682 94631 12545 11291 1254 8734239 7860815 873424 23246790 20922111 2324679 6762212 6085991 676221 EQUIP REPAIRS & MAINT 9594710 8635239 959471 DUES, SUBS, LICENSES 690217 621195 69022 EXCISE TAX 368989 332090 36899 RECRUITMENT EXPENSES 213860 192474 21386 320981905 288890676 32091229 0 14422818 0 123049219 194952845 0 33497543 32689991 53274225 29574225 1879 720 20663866 22468297 224314044 174389262 68348767 49924782 107569023 106916150 100137726 112597046 165869693 161764780 633214 429637 687467973 711318473 126958292 133946991 2125000 169362853 0 437358 252672 296758503 136324663 X 390709470 574993810 390709470 574993810 687467973 711318473 X 33531404 -7418252 158171188 X 0 1 X 1 1 1 X X 8 MARSHFIELD CLINIC INC 390452970 3 1 65290958 0 LAKEVIEW MEDICAL CENTER INC OF RICE LAKE 390837206 3 1 15430273 0 FLAMBEAU HOSPITAL INC 390973724 3 1 3358979 0 MCHS HOSPITALS INC 810977948 3 0 170720648 0 BEAVER DAM COMMUNITY HOSPITALS INC 391157876 3 0 12295476 0 DICKINSON COUNTY HEALTHCARE SYSTEM 382780429 3 0 17080408 0 MEMORIAL HOSPITAL INC 390806828 3 0 3924301 0 MCHS FOUNDATION INC 812822823 7 0 789633 0 8 288890676 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 FORM 990, SCHEDULE A, PART IV, SECTION A, LINE 6: THE COMMUNITY ENGAGEMENT DEPARTMENT PROVIDES SUPPORT TO VARIOUS LOCAL NONPROFIT ORGANIZATIONS. FORM 990, SCHEDULE A, PART IV, SECTION D, LINE 3: SUPPORTING ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN THE ORGANIZATION'S INVESTMENT POLICIES AND USE OF ITS INCOME OR ASSETS BY VIRTUE OF THE OVERLAP OF BOARD AND EXECUTIVE OVERSIGHT. FORM 990, SCHEDULE A, PART IV, SECTION E, LINE 3A: MCHS HAS THE RIGHT TO APPOINT, ELECT OR APPROVE/DISAPPROVE MEMBERS OF MOST OF THE SUPPORTED ORGANIZATIONS' BOARDS. IN THE CASE OF MARSHFIELD CLINIC, INC., MCHS DOES NOT ELECT OR APPOINT, BUT THE 11 MEMBERS OF THE MARSHFIELD CLINIC BOARD ARE ALSO MEMBERS OF THE MCHS BOARD. FORM 990, SCHEDULE A, PART IV, SECTION E, LINE 3B: THERE IS EITHER BOARD OVERLAP OR EXECUTIVE OVERLAP IN EACH OF THE AFFILIATED ORGANIZATIONS. EXECUTIVE LEADERS FROM EACH SUPPORTED ORGANIZATION REPORT TO MCHS EXECUTIVES. FORM 990, SCHEDULE A, PART IV, SECTION A, LINE 1: SINCE THE MERGER WITH SANFORD IN 2025, THE ORGANIZATION'S BYLAWS WERE UPDATED TO LIST ALL SUPPORTED ORGANIZATIONS BY NAME. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 753770 0 1 162700 916470 0 FORM 990, PART II-B: WHERE ITS EXPERIENCE MAY BE HELPFUL, MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) MAY OFFER RECOMMENDATIONS CONCERNING LEGISLATION OR REGULATIONS BEING CONSIDERED. IN ADDITION, IT MAY ANALYZE AND TAKE POSITIONS ON ISSUES THAT HAVE A RELATIONSHIP TO THE ORGANIZATION'S OPERATIONS. OCCASIONALLY STAFF MEMBERS WILL SEND MAIL TO MEMBERS OF CONGRESS AND THEIR STAFF. MCHS IS ALSO A MEMBER OF VARIOUS HEALTHCARE ASSOCIATIONS (I.E. WISCONSIN HOSPITAL ASSOCIATION) THAT MAY PERFORM SOME LOBBYING ACTIVITY. TOTAL DUES PAID BY MCHS ARE REPORTED ON LINE 1-I. 170828 40733 130095 336271 236371 99900 223806945 174112158 49694787 49924782 LTD PTNSHP COMM INV 112597046 F 112597046 INVESTMENT IN HHJV 15578 F INVESTMENT IN SHP 161749202 F 161764780 0 OPERATING LEASE PAYABLE LT 252672 252672 X PART X, LINE 2: THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. THE SYSTEM HAS DETERMINED THAT IT DOESN'T HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024 OR DECEMBER 31, 2023. 1 PATIENT COSTS CHARITABLE BENEFIT 150 63614 0 N/A N/A PART I, LINE 2: MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) PROVIDES ASSISTANCE (PRIMARILY CONTRIBUTIONS) TO A VARIETY OF ORGANIZATIONS, ALL OF WHICH ARE 501(C)(3). MCHS MAKES DETERMINATIONS ON GRANTS AND OTHER ASSISTANCE BASED ON THE RECIPIENT ORGANIZATION'S MISSION, REPUTATION AND THE ORGANIZATION'S INTENDED USE OF FUNDS. 1 X X X X X 1 1 0 0 0 0 0 1 0 SUSAN TURNEY MD FORMER MCHS CEO 0 0 0 0 2241715 0 0 0 0 0 2241715 0 0 0 BRIAN HOERNEMAN MD INTERIM MCHS CEO 1043925 0 516277 0 23966 0 8625 0 30388 0 1623181 0 0 0 TYLER DAHL MD BOARD MEMBER (THRU MAR 2024) 0 1065184 0 78910 0 25586 0 8625 0 30686 0 1208991 0 0 SANJAY KUMAR MD BOARD MEMBER 0 1046669 0 0 0 26132 0 8625 0 33543 0 1114969 0 0 KATHY BRESSLER MCHS COO 711231 0 241650 0 32690 0 8625 0 28836 0 1023032 0 0 0 DAVID JUNKER MD SECRETARY 0 903654 0 0 0 26132 0 8625 0 42987 0 981398 0 0 JEANETTE WOJTALEWICZ INTERIM MCHS CFO 0 0 0 0 972510 0 0 0 0 0 972510 0 0 0 MATTHEW THOMAS MD BOARD MEMBER 0 796625 0 54860 0 26132 0 8625 0 33374 0 919616 0 0 JERARD JENSEN MCHS GENERAL COUNSEL (THRU JAN 2024) 54195 0 0 0 835086 0 0 0 11274 0 900555 0 0 0 ELVIS PETER MD BOARD MEMBER 0 793788 0 0 0 18584 0 8625 0 39443 0 860440 0 0 JAYANTH VEDRE MD BOARD MEMBER 0 467329 0 218976 0 25586 0 8625 0 27685 0 748201 0 0 SAMANTHA KLEBE DO CHIEF MEDICAL OFFICER 476625 0 201334 0 25544 0 8625 0 27732 0 739860 0 0 0 KRISTA HOGLUND MCHS HEALTH PLAN CEO 434735 0 209280 0 35956 0 8625 0 31089 0 719685 0 0 0 CATHY BUKOWSKI FORMER MCHS CFO 0 0 0 0 631969 0 0 0 0 0 631969 0 0 0 TERRI NEWMIER MCHS CHIEF HR OFFICER 396875 0 173800 0 9517 0 8625 0 19126 0 607943 0 0 0 MATTHEW OELSTROM MD BOARD MEMBER 0 377912 0 121394 0 420 0 8625 0 29339 0 537690 0 0 JESSICA WERNBERG MD BOARD MEMBER 0 455936 0 0 0 3132 0 8625 0 32056 0 499749 0 0 BARBARA BOYER MD BOARD MEMBER 0 425536 0 0 0 3972 0 7614 0 35687 0 472809 0 0 KENT RAY DO BOARD MEMBER 0 401874 0 0 0 3132 0 8625 0 40349 0 453980 0 0 LISA BOERO MCHS GENERAL COUNSEL 411868 0 0 0 3627 0 8625 0 2186 0 426306 0 0 0 CHRISTOPHER ADLER MD BOARD MEMBER 0 364498 0 161 0 2450 0 8625 0 14936 0 390670 0 0 KATHERINE WINIARCZYK DO BOARD MEMBER 0 332093 0 0 0 362 0 7463 0 30081 0 369999 0 0 BART ISAACSON MD BOARD MEMBER (THRU MAR 2024) 0 320234 0 0 0 1806 0 8625 0 30322 0 360987 0 0 ALPA SHAH MD SECRETARY (THRU MAR 2024) 0 279695 0 0 0 3665 0 7562 0 1898 0 292820 0 0 WILLIAM MELMS MD FORMER CHIEF MEDICAL OFFICER 0 0 0 0 199385 0 0 0 0 0 199385 0 0 0 PART I, LINE 1A THE ORGANIZATION MAY OCCASIONALLY REIMBURSE OR PROVIDE A HOUSING ALLOWANCE FOR KEY EXECUTIVES IN ORDER TO ASSIST WITH RELOCATING TO THE AREA. THE ORGANIZATION MAY ALSO CONTRIBUTE TO OR REIMBURSE FOR HEALTH AND SOCIAL CLUB DUES AS DEEMED NECESSARY IN ORDER TO SUPPORT A BUSINESS NEED. PART I, LINE 3 THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS. PART I, LINES 4A-B LINE 4A: IN 2024, SUSAN TURNEY, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $1,879,544, WILLIAM MELMS, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $199,385, CATHY BUKOWSKI RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $631,969 AND JERARD JENSEN RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $753,004. LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION FROM OR HAD AMOUNTS VEST IN THE PLAN: SUSAN TURNEY, MD - $362,171 PART I, LINE 7 SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. A WISCONSIN HEALTH AND ED FACILITIES AUTHORITY 391337855 97712DUG9 2016-10-05 316977541 SEE PART VI 0 0 0 B WISCONSIN HEALTH AND ED FACILITIES AUTHORITY 391337855 97712DA71 2017-09-13 328044486 SEE PART VI 0 0 0 C WISCONSIN HEALTH AND ED FACILITIES AUTHORITY 391337855 97712DQ25 2018-09-26 100000000 SEE PART VI 0 0 0 D WI HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712D6Y7 2020-06-30 318530787 SEE PART VI 0 0 0 A 110290000 316990839 2672884 102907260 211404657 2017 1 0 1 1 B 12460000 328044486 3044486 325000000 1 0 1 1 C 50000000 100000000 737000 99263000 2018 0 0 1 1 D 67445000 318531498 1186942 1726605 100011535 215606416 2020 1 0 1 1 A 0 1 1 1 1 1 0.00020 0.00000 0.00020 0 1 0.00510 1 1 B 0 1 1 1 1 1 0.00990 0.00000 0.00990 0 1 0.00490 1 1 C 0 0 1 1 1 1 0 1 0.00020 1 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 1 0.00010 1 1 A 0 0 1 1 1 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 PART I, COLUMN A, ALL BONDS: THE ISSUER'S FULL NAME IS WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. NOTES RELATED TO COLUMN A, SERIES 2016 & 2012 REISSUANCE: PART I, COLUMN F: THE BONDS WERE ISSUES TO REIMBURSE THE BORROWER FOR COSTS ASSOCIATED WITH ITS NEW MONEY PROJECT AS WELL AS TO REISSUE THE SERIES 2012 BONDS (ISSUED ON 4/13/2012), REFUND SERIES 2006B BONDS (ISSUED ON 1/31/2006), LINE OF CREDIT (ISSUED ON 4/1/2012), REFUND VARIOUS USDA LOANS AND PAY THE CHIPPEWA LEASE. THE 2012 BONDS WERE REFUNDED DURING THE FISCAL YEAR AND ONLY THE 2016 PORTION OF THE ISSUE REMAINS OUTSTANDING. PART II, LINE 3: THE TOTAL PROCEEDS EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. PART III, LINE 8B: ON DECEMBER 14, 2023, THE SYSTEM ENTERED INTO A SALE OF BOND FINANCED PROPERTY, PURSUANT TO SECTION 1.141-12(E) THE SYSTEM ELECTED TO USE PROCEEDS FROM THE SALE FOR AN ALTERNATIVE QUALIFYING PURPOSE. PART IV, LINE 2B: THE CURRENT REFUNDING PORTION OF THE ISSUE MET THE SIX MONTH SPENDING EXCEPTION. PART IV, LINE 2C: A REBATE CALCULATION WAS COMPLETED ON OCTOBER 1, 2021 WITH NO REBATE LIABILITY BEING DUE. NOTES RELATED TO COLUMN B, SERIES 2017BC: PART I, COLUMN F: THE BONDS WERE ISSUED TO CURRENTLY REFUND THE 2017A TAXABLE SERIES ORIGINALLY ISSUED ON 6/30/2017. PART IV, LINE 2B: THE PROCEEDS OF THE ISSUE WERE EXPENDED WITHIN SIX MONTHS OF THE ISSUE DATE AND HAVE THUS MET THE REQUIREMENTS OF THE SIX MONTH SPENDING EXCEPTION. NOTES RELATED TO COLUMN C, SERIES 2018: PART I, COLUMN F: THE BONDS WERE ISSUED TO FINANCE OR REIMBURSE THE BORROWER FOR COSTS ASSOCIATED WITH THE ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF THE PROJECTS AS WELL AS TO PAY ISSUANCE COSTS. PART IV, LINE 2B: THE PROCEEDS OF THE ISSUE WERE EXPENDED WITHIN SIX MONTHS OF THE ISSUE DATE AND HAVE THUS MET THE REQUIREMENTS OF THE SIX MONTH SPENDING EXCEPTION. NOTES RELATED TO COLUMN D, SERIES 2020ABC: PART I, COLUMN F: THE BONDS WERE ISSUED TO PAY ALL OR A PORTION OF THE COSTS OF THE PROJECT, TO PAY THE COSTS OF THE CURRENT REFUNDING OF THE AUTHORITY'S (I) ADJUSTABLE RATE REVENUE BONDS, SERIES 2017D (MARSHFIELD CLINIC HEALTH SYSTEM, INC) ISSUED ON DECEMBER 28, 2017, (II) ADJUSTABLE RATE REVENUE BONDS, SERIES 2018B (MARSHFIELD CLINIC HEALTH SYSTEM, INC) ISSUED ON SEPTEMBER 26, 2018, (III) ADJUSTABLE RATE REVENUE BONDS, SERIES 2018C (MARSHFIELD CLINIC HEALTH SYSTEM, INC) ISSUED ON NOVEMBER 8, 2018, AND TO PAY CERTAIN COSTS ASSOCIATED WITH THE ISSUE OF THE BONDS INCLUDING THE PREMIUM ON THE BOND INSURANCE POLICY. PART II, LINE 3: THE DIFFERENCE IN THE TOTAL PROCEEDS AND THE ISSUE PRICE IS DUE TO INVESTMENT EARNINGS. PART IV, LINE 2B: THE CURRENT REFUNDING PORTION OF THE ISSUE MET THE SPENDING EXCEPTION. NOTES RELATED TO COLUMN A, SERIES 2012B REISSUANCE: PART I, COLUMN F: THE BONDS WERE ORIGINALLY ISSUED ON JUNE 13, 2012 IN THE AMOUNT OF 104,090,000. ON FEBRUARY 15, 2022 THE BONDS WERE PARTIALLY REDEEMED AND MARSHFIELD ENTERED INTO A SWAP AGREEMENT WITH BANK OF AMERICA. BOND COUNSEL WAS UNSURE IF THIS CONSTITUTED A REISSUANCE AND FILED A FORM 8038. NOTES RELATED TO COLUMN B, SERIES 2024A: PART I, COLUMN F: THE BONDS WERE ISSUED TO FINANCE AND REIMBURSE THE SYSTEM FOR COSTS ASSOCIATED WITH THE ACQUISITION, CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING AND EQUIPPING OF CERTAIN HEALTH FACILITIES AS WELL AS REFINANCE SERIES 2012A (REISSUED ON 10/5/2016), SERIES 2019A (ISSUED ON 9/30/2019), SERIES 2020B (ISSUED ON 6/30/2020), SERIES 2022A (ISSUED ON 2/10/2022) AND SERIES 2022B (ISSUED ON 2/15/2022). PART III, LINE 3: THE TOTAL PROCEEDS EXCEEDS THE ISSUE PRICE DUE TO INVESTMENT EARNINGS ON THE PROJECT FUND. A WI HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BZ54 2022-02-15 54800000 SEE PART VI 0 0 0 B WI HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712JKN2 2024-07-02 391760984 SEE PART VI 0 0 0 A 54800000 54800000 1 0 1 1 B 393011434 3391511 2627253 106264398 280728272 2024 1 0 1 1 A 0 1 1 1 1 1 0.00020 0.00000 0.00020 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 JUSTIN KOPLITZ FAMILY RELATIONSHIP WITH TERRY FRANKLAND 145396 EMPLOYMENT 0 PETER TURNEY FAMILY RELATIONSHIP WITH SUSAN TURNEY, MD 36090 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS RICHARD LEINENKUGEL AND MARK BRADLEY HAVE A FAMILY RELATIONSHIP. BOARD MEMBER COLLEEN HOERNEMAN AND OFFICER BRIAN HOERNEMAN, MD HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE EXECUTIVE MANAGEMENT TEAM. AN EXTERNAL ACCOUNTING FIRM REVIEWS AND SIGNS THE RETURN. BEFORE THE RETURN IS FILED, A COMPLETE COPY IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISITING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTEND OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. FORM 990, PART VI, SECTION B, LINE 15 THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO ENSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO THE COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 30,081,396. MANAGEMENT AND GENERAL EXPENSES 3,342,378. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,423,774. CONSULTING: PROGRAM SERVICE EXPENSES 20,339,254. MANAGEMENT AND GENERAL EXPENSES 2,259,917. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,599,171. FORM 990, PART XI, LINE 9: EQUITY INCOME (LOSS) FROM SECURITY HEALTH PLAN -4,462,449. NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS 162,633,637. SECURITY HEALTH PLAN OF WISCONSIN INC 1515 N ST JOSEPH AVE MARSHFIELD WI 54449 391572880 HMO WI 501(C)(4) N/A MCHS 1 FLAMBEAU HOSPITAL INC 98 SHERRRY AVE PARK FALLS WI 54552 390973724 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 LAKEVIEW MEDICAL CENTER INC 1700 W STOUT ST RICE LAKE WI 54868 390837206 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 MARSHFIELD CLINIC INC 1000 N OAK AVE MARSHFIELD WI 54449 390452970 MEDICAL SVCS WI 501(C)(3) LINE 3 MCHS 1 FAMILY HEALTH CENTER OF MARSHFIELD INC 1000 N OAK AVE MARSHFIELD WI 54449 391681547 COM HLTH CTR WI 501(C)(3) LINE 7 N/A 0 MCHS HOSPITALS INC 1000 N OAK AVE MARSHFIELD WI 54449 810977948 HOSPITAL WI 501(C)(3) LINE 3 MCHS 1 MCHS FOUNDATION INC 1000 N OAK AVE MARSHFIELD WI 54449 812822823 PHILANTHROPY WI 501(C)(3) LINE 7 MCHS 1 BEAVER DAM COMMUNITY HOSPITALS INC 707 S UNIVERSITY AVE BEAVER DAM WI 53916 391157876 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 MEMORIAL HOSPITAL INC N3708 RIVER AVE NEILLSVILLE WI 54456 390806828 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 DICKINSON COUNTY HEALTHCARE SYSTEM 1721 S STEPHENSON AVE IRON MOUNTAIN MI 49801 382780429 HOSPITAL MI 501(C)(3) LINE 3 MCHS HOSP 0 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 DICKINSON COUNTY HEALTHCARE SYSTEM A 829303 COST MCHS FOUNDATION INC C 80629 COST SECURITY HEALTH PLAN OF WISCONSIN INC M 4579528 COST BEAVER DAM COMMUNITY HOSPITALS INC P 75849239 COST DICKINSON COUNTY HEALTHCARE SYSTEM P 32738534 COST FLAMBEAU HOSPITAL INC P 30740644 COST LAKEVIEW MEDICAL CENTER INC OF RICE LAKE P 98321655 COST MARSHFIELD CLINIC INC P 145540487 COST MCHS HOSPITALS INC P 1132510139 COST MEMORIAL HOSPITAL INC P 26835490 COST DICKINSON COUNTY HEALTHCARE SYSTEM R 14000000 COST BEAVER DAM COMMUNITY HOSPITALS INC S 66858910 COST FLAMBEAU HOSPITAL INC S 37555560 COST LAKEVIEW MEDICAL CENTER INC OF RICE LAKE S 99025194 COST MARSHFIELD CLINIC INC S 239115336 COST MCHS HOSPITALS INC S 1247456690 COST MEMORIAL HOSPITAL INC S 29158136 COST FORM 990, PART V, LINE 1: MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A 501(C)3 ORGANIZATION), IS THE PARENT ORGANIZATION OF THE FOLLOWING ORGANIZATIONS: MARSHFIELD CLINIC, INC. SECURITY HEALTH PLAN OF WISCONSIN, INC. MCHS HOSPITALS, INC. MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC.