2016-08-04T15:25:09-07:00 2015-12-31 990 2015-01-01 390808509 THE MONROE CLINIC INC MONR 6083242775 515 22ND AVENUE MONROE WI 53566 James Nemeth CFO 6083242775 2016-08-04 2015 2016-12-15 16:53:06Z James Nemeth 515 22nd Avenue Monroe WI 53566 204209878 0 X WWW.MONROECLINIC.ORG X 1963 WI THE MONROE CLINIC, INC. PROVIDES HEALTHCARE SERVICES TO THE COMMUNITIES IN AND SURROUNDING GREEN COUNTY, WI AND STEPHENSON COUNTY, IL. MEDICAL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. 15 9 1373 207 1278450 0 152146 97617 172789829 176431839 3657774 1289047 0 0 176599749 177818503 0 0 0 0 100789497 101109335 0 0 0 64736227 67232396 165525724 168341731 11074025 9476772 263951300 271535083 103750337 102143118 160200963 169391965 X WORKING TOGETHER TO ACHIEVE THE HIGHEST STANDARDS IN HEALTHCARE, WE CREATE HEALTHY COMMUNITIES THROUGH GOD'S HEALING SPIRIT. VISION: EXCEPTIONAL HEALTH CARE. AN EXCEPTIONAL EXPERIENCE. 0 0 132552975 0 176431839 MONROE CLINIC IS A NOT-FOR-PROFIT HEALTH SYSTEM FEATURING A MULTI-SPECIALTY CLINIC AND HOSPITAL DEDICATED TO BRINGING THE BEST CARE TO THE COMMUNITIES WE SERVE. WORKING TOGETHER TO ACHIEVE THE HIGHEST STANDARDS OF HEALTHCARE, WE CREATE HEALTHY COMMUNITIES THROUGH GOD'S HEALING SPIRIT. SPONSORED BY THE CONGREGATION OF SISTERS OF ST. AGNES (CSA), MONROE CLINIC OFFERS COMPREHENSIVE HEALTH CARE WITH OVER 120 PROVIDERS, A 24-HOUR EMERGENCY DEPARTMENT, HOME CARE AND HOSPICE SERVICES, AS WELL AS MULTIPLE CLINIC LOCATIONS IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. IN ALL THAT WE DO, WE ARE DEDICATED TO HELPING OUR PATIENTS GET BETTER FASTER AND STAY HEALTHIER LONGER. AS A STATE-OF-THE-ART HEALTH SYSTEM, WE OFFER ADVANCED MEDICAL EQUIPMENT AND TECHNOLOGY COMBINED WITH CARE AND SENSITIVITY. PHYSICIANS AND STAFF ARE COMMITTED TO PROVIDING PERSONALIZED HEALTH CARE, EDUCATION AND PEACE OF MIND. OUR PATIENTS BENEFIT FROM EXCEPTIONAL PREVENTIVE AND REHABILITATION SERVICES AND MORE THAN 25 MEDICAL SPECIALTIES. WITH GOD'S BLESSING, MONROE CLINIC IS ABLE TO MEET THE NEEDS OF THOSE WE ARE PRIVILEGED TO SERVE. 0 0 0 132552975 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1676 0 1 1373 1 1 1 0 0 0 0 0 X 15 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL WI X JAMES NEMETH 6083242775 515 22ND AVENUE MONROE WI 53566 CHRISTINE WELLINGTON CHAIRPERSON 3 0 X X 0 0 0 MIKE GREENFIELD VICE CHAIRPERSON 3 0 X X 0 0 0 SISTER MARY NOEL BROWN DIRECTOR 3 2 X 0 0 0 JOHN FREY PHYSICIAN/SECRETARY 50 0 X X 319770 0 27900 MICHELLE BRUKWICKI TREASURER 3 0 X X 0 0 0 JAMES BERBERET DIRECTOR 3 0 X 0 0 0 CHARLES DEARTH DIRECTOR 3 0 X 0 0 0 PATRICIA JAMES DIRECTOR 3 0 X 0 0 0 PATRICIA LEITZEN FYE DIRECTOR 3 0 X 0 0 0 SISTER SUSAN STUCKI DIRECTOR 3 0 X 0 0 0 MICHAEL SANDERS PRESIDENT/CEO 50 0 X X X 817718 0 178982 PAUL BEKX CHIEF OF STAFF/DIRECTOR 50 0 X 236217 0 20906 JONATHAN SWINDLE PHYSICIAN/ORTHOPEDIC SURGEON 50 0 X 649888 0 56651 MARK THOMPSON CHIEF MEDICAL OFFICER 50 0 X X 466211 0 106579 DARREN PIPP PHYSICIAN 50 0 X 363698 0 36310 CARRIE BLUM CHIEF INFORMATION OFFICER 50 0 X 210461 0 59851 JULIE WILKE VP CLINICAL OPERATIONS 50 0 X 350199 0 88557 JANE MONAHAN VP MINISTRY/HR 50 0 X 194297 0 57732 PAULA RAIBLEY-ELMER VP/CHIEF NURSING OFFICER 50 0 X 255260 0 82251 JAMES NEMETH CHIEF FINANCIAL OFFICER 50 0 X 259549 0 75481 LUCINDA WERKHEISER VP/SERVICE EXCELLENCE 50 0 X 186065 0 69112 DAVID BUCHANAN PHYSICIAN/INTERVENTIONAL CARDIOLOGIST 50 0 X 690868 0 48163 NICHOLAS MAXWELL PHYSICIAN/GENERAL SURGEON 50 0 X 996225 0 60024 WISSAM MATTAR PHYSICIAN 50.00 0 X 771132 0 50278 ANDREW RIKKERS PHYSICIAN/GENERAL SURGEON 50 0 X 970954 0 65761 LANCE SATHOFF PHYSICIAN 50 0 X 1021682 0 66130 8760194 0 1150668 130 0 1 0 AMERISOURCE BERGEN DRUG CORP 27550 NETWORK PLACE CHICAGO IL 60671 PHARMACEUTICALS 12647865 STATE OF WISCONSIN DEPT OF HEALTH SERVICES 1 W WILSON ST MADISON WI 53701 HOSPITAL ASSESSMENT 2746397 OWENS & MINOR 12199 COLLECTION CENTER DR CHICAGO IL 60693 SURGICAL SUPPLIES 2537001 EPIC SYSTEMS CORP 5301 TOKAY BLVD MADISON WI 53711 EHR MANAGEMENT 1910823 STRYKER ORTHOPAEDICS Box 93213 Chicago IL 60673 SURGICAL SUPPLIES 1040730 97 0 0 0 11139 86392 86 0 97617 NET PATIENT REVENUE 900099 168436247 168436247 0 0 OTHER OPERATING REVENUE 561499 6717142 6717142 0 0 990-T SERVICES TO NON-PATIENTS 621990 1155208 0 1155208 0 ALL OTHER REVENUE - OUTPATIENT 900099 123242 0 123242 0 0 0 0 0 176431839 1428552 1428552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26251870 0 26391375 0 -139505 0 -139505 -139505 0 0 0 0 177818503 176442436 1278450 0 5169645 4497591 672054 0 71909929 61842539 10067390 4102414 3018068 1084346 15088238 12793862 2294376 4839109 3560041 1279068 97898 97898 55550 55550 113907 113907 8171709 5186033 2985676 27633811 24653269 2980542 2511519 408165 2103354 1125011 961375 163636 3530689 3530689 12273807 7107327 5166480 REPAIRS AND MAINTENANCE 4939496 2221732 2717764 DUES AND SUBSCRIPTIONS 1072950 805591 267359 MISCELLANEOUS 5706049 1852786 3853263 168341731 132552975 35788756 0 121461 110690 23009831 30212261 0 0 23868900 26841073 0 0 0 0 0 0 3626318 3748655 2298175 2377593 235198843 131361640 109368207 103837203 94231253 96243269 0 0 0 0 32786 0 7394369 8164339 263951300 271535083 17556537 17393931 0 0 0 0 76511402 73686667 0 0 0 0 0 0 0 0 9682398 11062520 103750337 102143118 X 160103736 169294738 97227 97227 0 0 160200963 169391965 263951300 271535083 X 9476772 -1119673 0 0 0 833903 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 0 0 1 4967 4967 0 Schedule C, Part II-B, Line 1 A PORTION OF WISCONSIN HOSPITAL ASSOCIATION AND CATHOLIC HOSPITAL ASSOCIATION DUES ARE ALLOCATED TO LOBBYING. 3300227 37367 -23600 0 0 0 3313994 3125858 59712 203657 0 89000 0 3300227 2654654 142898 408306 0 80000 0 3125858 2377224 24079 253351 0 0 0 2654654 2348831 0 28393 0 0 0 2377224 0 0.698 0.302 0 1 1 0 1570352 1570352 0 146730785 131361640 15369145 0 0 0 0 0 80607846 0 80607846 0 6289860 0 6289860 103837203 Deferred Compensation 9212520 Asset Retirement Obligation 1850000 11062520 X 177418826 -1119673 0 0 1061670 -58003 177476829 113907 227767 341674 177818503 168227824 0 0 0 0 0 168227824 113907 0 113907 168341731 Schedule D, Part V, Line 4 THE OPERATING ENDOWMENT HAS BEEN ESTABLISHED TO SUPPORT THE OPERATING COSTS OF THE MONROE CLINIC AND HOSPITAL FOUNDATION. THE FUTURE OF HEALTHCARE ENDOWMENT HAS BEEN ESTABLISHED TO PROVIDE FUNDING FOR GRANTS AND PROGRAMS THAT SUPPORT THE MONROE CLINIC AND HOSPITAL FOUNDATION MISSION. Schedule D, Part X, Line 2 THE MONROE CLINIC IS A TAX EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CLINIC IS ALSO EXEMPT FROM STATE INCOME TAX. IN ORDER TO ACCOUNT FOR UNCERTAIN TAX POSITIONS, THE CLINIC DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CLINIC HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2015 OR 2014. THE CLINIC'S FEDERAL TAX RETURNS FOR TAX YEARS 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. Schedule D, Part XI, Line 2d INCREASE IN EQUITY IN UNCONSOLIDATED AFFILIATE 635,058 AND CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 479,809 TOTAL 1,061,670 Schedule D, Part XI, Line 4b OTHER 227,767 IN CONTRIBUTIONS TO THE MONROE CLINIC HOSPITAL FOUNDATION 1 1 1 X 1.20 1 X 1 1 0 1 1 1310796 1310796 0.0078 12529585 12529585 0.0745 173152 173152 0.001 0 0 14013533 0 14013533 0.0833 562071 562071 0.0033 235439 235439 0.0014 2819558 2819558 0.0168 94146 94146 0.0006 0 0 3711214 0 3711214 0.0221 0 0 17724747 0 17724747 0.1054 1 4464312 0 13878833 20039134 -6160301 X 1 1 1 1 MONROE CLINIC 515 22ND AVENUE MONROE WI 53566 X X X MONROE CLINIC 1 0 0 1 X X X X X X X X X X 13 1 0 1 1 X https://www.monroeclinic.org 1 15 1 https://www.monroeclinic.org 0 0 1 X 120 120 X X X X X X 1 1 X X X 1 X https://www.monroeclinic.org X https://www.monroeclinic.org X https://www.monroeclinic.org X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 3-MONROE CLINIC MONROE CLINIC IS AN ACTIVE PARTICIPANT IN THE GREEN COUNTY HEALTHY COMMUNITIES COALITION. THE COALITION IS CO-CHAIRED BY REPRESENTATIVES FROM MONROE CLINIC, GREEN COUNTY HEALTH DEPARTMENT, AND THE UNIVERSITY OF WISCONSIN EXTENSION. THE ASSESSMENT INCORPORATED COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUSED ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA. IT INCLUDED COLLECTION AND ANALYSIS OF INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH. BASED ON THE RESULTS OF THE PRIMARY AND SECONDARY DATA COLLECTION, HEALTH NEEDS WERE IDENTIFIED. Schedule H, Part V, Section B, Line 5-MONROE CLINIC AS AN ACTIVE PARTICIPANT IN THE GREEN COUNTY HEALTHY COMMUNITIES COALITION (GCHCC), MONROE CLINIC COLLABORATED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PRIORITIZATION OF HEALTH NEEDS. THE MISSION OF THE GCHCC IS: FOSTERING COLLABORATIVE EFFORTS TO ASSESS NEEDS, DEFINE RESOURCES, AND RECOGNIZE OPPORTUNITIES TO BUILD HEALTHIER COMMUNITIES THAT SUPPORT HEALTHY LIFESTYLES. THE COALITION IS CO-CHAIRED BY REPRESENTATIVES FROM MONROE CLINIC, GREEN COUNTY HEALTH DEPARTMENT, AND THE UNIVERSITY OF WISCONSIN-EXTENSION. THE PROCESS FOR THE IDENTIFICATION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS WAS UNDERTAKEN BY GCHCC. AS THE FRAMEWORK FOR IDENTIFYING HEALTH NEEDS, THE COALITION ADOPTED THE STATE PUBLIC HEALTH AGENDA: HEALTHIEST WISCONSIN 2020. THE HEALTH NEEDS WERE DERIVED FROM AN EXAMINATION OF DATA ON HEALTH BEHAVIORS AND THE SOCIAL, ECONOMIC AND EDUCATIONAL FACTORS THAT ARE DETERMINANTS OF HEALTH. THE HEALTH NEEDS WERE PRIORITIZED THROUGH A STRUCTURED PROCESS USING DEFINED CRITERIA. Schedule H, Part V, Section B, Line 6b-MONROE CLINIC MONROE CLINIC - AS AN ACTIVE PARTICIPANT IN THE GREEN COUNTY HEALTHY COMMUNITIES COALITION (GCHCC), MONROE CLINIC COLLABORATED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PRIORITIZATION OF HEALTH NEEDS. COALITION IS CO-CHAIRED BY REPRESENTATIVES FROM MONROE CLINIC, GREEN COUNTY HEALTH DEPARTMENT, AND THE UNIVERSITY OF WISCONSIN-EXTENSION. OTHER ORGANIZATIONS REPRESENTED INCLUDE: BEHRING SENIOR CENTER, BLACKHAWK TECHNICAL COLLEGE, CITY OF MONROE, COLONY BRANDS, FIRST NATIONAL BANK, FOWLER MEMORIAL FREE DENTAL CLINIC, GREEN COUNTY, GREEN COUNTY BOARD, GREEN COUNTY DEVELOPMENT CORPORATION, GREEN COUNTY FAMILY ADVOCATES, GREEN COUNTY HUMAN SERVICES, GREEN COUNTY SHERIFF'S DEPARTMENT, GREEN COUNTY UW-EXTENSION, GREEN COUNTY YMCA, MONROE BOARD OF EDUCATION, MONROE CHAMBER OF COMMERCE, LITERACY COUNCIL, MONROE TRUCK EQUIPMENT, MONROE UNIFIED SCHOOL DISTRICT, SCHOOL DISTRICT OF MONTICELLO, SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, STATE OF WISCONSIN, ST. VINCENT DE PAUL, UNITED METHODIST CHURCH OF MONROE, UNITED WAY, UW-EXTENSION GREEN COUNTY JUSTICE CENTER, UW-SCHOOL OF NURSING, VILLAGE OF NEW GLARUS. Schedule H, Part V, Section B, Line 11-MONROE CLINIC MONROE CLINIC PLANS TO MEET THE IDENTIFIED PRIORITY HEALTH NEEDS THROUGH A COMMITMENT OF RESOURCES FOR 1) ACCESS TO HIGH-QUALITY HEALTH SERVICES, 2) ADEQUATE, APPROPRIATE AND SAFE FOOD AND NUTRITION AND 3) MENTAL HEALTH CARE. ACCESS TO HIGH-QUALITY HEALTH SERVICES WILL BE ACHIEVED BY REDUCING USE OF THE EMERGENCY DEPARTMENT AND INCREASING ACCESS TO NEEDED PRIMARY HEALTH CARE AND PREVENTIVE SERVICES. PROMOTE HEALTH INSURANCE COVERAGE FOR ALL BY ASSISTING WITH HEALTH CARE PROGRAM ENROLLMENT AND IMPLEMENTING A SHARE+CARE PROGRAM. PROVIDE COMMUNITY EDUCATION ON THE APPROPRIATE USE OF HEALTH CARE SERVICES AT HEALTH FAIRS/SCREENINGS. PROMOTE THE USE OF PREVENTIVE CARE SERVICES BY HOLDING FLU CLINICS AND SENDING AUTOMATED REMINDERS FOR PREVENTIVE SERVICES. ADEQUATE, APPROPRIATE AND SAFE FOOD AND NUTRITION WILL BE ACHIEVED BY CREATING AN ENVIRONMENT IN GREEN COUNTY THAT PROMOTES AND SUPPORTS HEALTHY EATING AND LIFESTYLE HABITS AND PROMOTES AND SUPPORTS BEING PHYSICALLY ACTIVE. PROVIDED WEIGHT ASSESSMENT AND COUNSELING FOR NUTRITION/PHYSICAL ACTIVITY FOR CHILDREN AT HEALTHY KIDS DAY AND PARTNERING WITH THE AMERICAN HEART ASSOCIATION AND AREA SCHOOLS JUMP ROPE FOR HEART. EMPLOYER WELLNESS PROGRAMS ESTABLISHED AT 4 LOCAL EMPLOYERS. BUILD COMMUNITY AWARENESS OF MENTAL HEALTH ISSUES, AND REDUCE SOCIAL STIGMA. PROVIDE EDUCATION TO COMMUNITY MEMBERS AND COMMUNITY PROFESSIONALS ABOUT MENTAL HEALTH ISSUES. BUILD COMMUNITY CAPACITY TO PROVIDE MENTAL HEALTH SERVICES AND MAKE THESE SERVICES MORE ACCESSIBLE. PROVIDE RESOURCES AND EDUCATION WHICH ARE DIRECTED AT EARLY PREVENTION OF MENTAL HEALTH PROBLEMS IN CHILDREN, YOUTH AND ADULTS. ESTABLISHED A MEDICATION DROP BOX SITE THAT COLLECTS 15 POUNDS A WEEK OF UNUSED MEDICATIONS. TRAINED 50 COMMUNITY MEMBERS IN MENTAL HEALTH FIRST AID. MONROE CLINIC HAS CHOSEN NOT TO FOCUS ON THE FOLLOWING AREAS BECAUSE WE BELIEVE WE CAN HAVE A GREATER IMPACT ON THE PRIORITY HEALTH NEEDS: : ALCOHOL AND OTHER DRUG USE, CHRONIC DISEASE PREVENTION AND MANAGEMENT, ENVIRONMENTAL AND OCCUPATIONAL HEALTH, INJURY AND VIOLENCE, ORAL HEALTH, REPRODUCTIVE AND SEXUAL HEALTH, TOBACCO USE AND EXPOSURE. TAKING EXISTING COMMUNITY RESOURCES INTO CONSIDERATION, WE HAVE SELECTED TO CONCENTRATE ON THOSE HEALTH NEEDS THAT WE CAN MOST EFFECTIVELY ADDRESS GIVEN OUR AREAS OF FOCUS AND EXPERTISE. THEREFORE, THE HOSPITAL'S CHARITABLE RESOURCES WILL BE PLACED ON THE SELECTED PRIORITY HEALTH NEEDS. THE IMPLEMENTATION STRATEGY ADOPTED BY MONROE CLINIC ACTIVELY ADDRESSES THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA AS "PRIORITY HEALTH NEEDS." 10 MONROE CLINIC - HIGHLAND WOMEN'S CARE 3103 W KUNKLE BLVD FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - FREEPORT 1301 S KIWANIS DRIVE FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - FREEPORT EYE CARE 1110 S PARK BLVD FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - BRODHEAD 1904 FIRST CENTER AVENUE BRODHEAD WI 53520 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - LENA 214 SCHUYLER LENA IL 61048 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - NEW GLARUS 1800 SECOND STREET NEW GLARUS WI 53574 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - ALBANY 700 CAROLAN DRIVE ALBANY WI 53502 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC- DURAND 400 S CENTER STREET DURAND IL 61024 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC FASTCARE 405 W 8TH ST MONROE WI 53566 COMMUNITY-BASED OUTPATIENT CLINIC MONROE CLINIC - BLANCHARDVILLE 309 S MAIN STREET BLANCHARDVILLE WI 53516 COMMUNITY-BASED OUTPATIENT CLINIC Schedule H, Part I, Line 7 A COST TO CHARGE RATIO WAS USED TO COMPUTE THE COST OF COMMUNITY BENEFIT SERVICES. Schedule H, Part I, Line 7g SUBSIDIZED HEALTH SERVICES INCLUDE BEHAVIORAL HEALTH/OUTPATIENT MENTAL HEALTH, PALLIATIVE CARE, SELF-HELP/SPORTS INJURY PREVENTION, AND CONTINUING CARE/HOME CARE SERVICES. Schedule H, Part III, Section A, Line 4 ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. THESE OBLIGATIONS ARE PRIMARILY FROM RESIDENTS OF SOUTHERN WISCONSIN AND NORTHERN ILLINOIS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE CLINIC BILLS THIRD PARTY PAYORS ON EACH PATIENT'S BEHALF OR IF A PATIENT IS UNINSURED THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYOR, SECONDARY INSURANCE IS BILLED AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. THE CLINIC DOES NOT CHARGE INTEREST ON PAST DUE ACCOUNTS. ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND AN ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH REFLECTS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS PRIMARILY FOR UNINSURED PATIENTS AND AMOUNTS FOR WHICH PATIENTS ARE PERSONALLY RESPONSIBLE THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CLINIC ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CLINIC ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CLINIC RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Section B, Line 8 MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. TO ARRIVE AT COST OF MEDICARE SERVICES THE TOTAL EXPENSES LESS OTHER OPERATING REVENUE IS MULTIPLIED BY THE RATIO OF MEDICARE REVENUE TO TOTAL REVENUE. Schedule H, Part III, Section C, Line 9b MONROE CLINIC RECOGNIZES THE INHERENT VALUE OF ALL INDIVIDUALS. ALL INDIVIDUALS HAVE THE RIGHT TO BE TREATED WITH RESPECT AND DIGNITY. THOSE INDIVIDUALS INDICATING LACK OF FINANCIAL RESOURCES TO PAY FOR SERVICES WILL BE DIRECTED TO MONROE CLINIC'S COMMUNITY CARE PROGRAM TO ENSURE ALL INDIVIDUALS QUALIFYING FOR ASSISTANCE ARE INDEED GIVEN ASSISTANCE. INDIVIDUALS WITH THE FINANCIAL RESOURCES TO PAY FOR SERVICES ARE EXPECTED TO DO SO IN A TIMELY MANNER TO ENSURE MONROE CLINIC'S FINANCIAL HEALTH AND ABILITY TO MAINTAIN OPERATIONS AND CONTINUED COMMUNITY CARE. PATIENTS WITH FINANCIAL RESOURCES ARE ASKED TO PAY CO-PAYMENTS AT THE TIME OF SERVICE AND TO PAY BALANCES REMAINING DUE AFTER INSURANCE HAS PAID WITHIN 30 DAYS OR MAKE MUTUALLY AGREEABLE PAYMENT ARRANGEMENTS WITH PATIENT ACCOUNTING. COLLECTION AGENCIES USED BY MONROE CLINIC GUARANTEE COMPLIANCE WITH THE FAIR DEBT COLLECTION PRACTICES ACT AND THE ACA INTERNATIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY. Schedule H, Part VI, Line 2 MONROE CLINIC, IN COLLABORATION WITH THE GREEN COUNTY HEALTH DEPARTMENT, THE GREEN COUNTY HEALTHY COMMUNITIES COALITION ASSESSED THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES USING THE STATE PUBLIC HEALTH AGENDA, HEALTHIEST WISCONSIN 2020, AS THE FRAMEWORK. THE GOALS OF THE HEALTHIEST WISCONSIN 2020 ARE TO IMPROVE HEALTH ACROSS THE LIFE SPAN AND ELIMINATE HEALTH DISPARITIES AND ACHIEVE HEALTH EQUALITY. THE HEALTH NEEDS WERE DERIVED FROM AN EXAMINATION OF DATA ON HEALTH BEHAVIORS AND THE SOCIAL, ECONOMIC AND EDUCATIONAL FACTORS THAT ARE DETERMINANTS OF HEALTH. Schedule H, Part VI, Line 3 MONROE CLINIC PROVIDES FINANCIAL COUNSELORS WHO ACT AS PATIENT ADVOCATES AND HELP THOSE IN NEED APPLY FOR MONROE CLINIC'S COMMUNITY CARE PROGRAMS OR OTHER STATE, COUNTY OR FEDERAL PROGRAMS (I.E. WISCONSIN BADGERCARE, WISCONSIN AND ILLINOIS WELL WOMAN PROGRAMS, MEDICARE, MEDICAID, ETC.). PATIENTS CAN FIND OUT ABOUT THESE SERVICES THROUGH MONROECLINIC.ORG'S INFORMATION PAGES, MONROE CLINIC'S ANNUAL MISSION REPORT POSTED ON OUR WEBSITE AND MAILED TO HOUSEHOLDS IN OUR SERVICE AREA, AND THROUGH COMMUNITY OUTREACH THAT OFFERS ASSISTANCE EXPLAINING NEW FEDERAL/STATE PROGRAMS OR CHANGES TO THOSE PROGRAMS. ADDITIONALLY, MONROE COUNSELORS HELP PATIENTS UNDERSTAND WHAT PROGRAMS THEY COULD BE ELIGIBLE FOR, HELP THEM THROUGH APPLICATION PROCEDURES AND ALSO PROVIDE APPROVAL/DENIAL NOTIFICATION TO THE PATIENTS IN A TIMELY MANNER. Schedule H, Part VI, Line 4 MONROE CLINIC GIVES SPECIAL CONSIDERATION TO PERSONS IN NEED OF FINANCIAL ASSISTANCE THROUGH OUR COMMUNITY CARE PROGRAM. MONROE CLINIC DOES NOT DISCRIMINATE AGAINST A PATIENT BECAUSE OF RACE, CREED, COLOR, NATIONAL ORIGIN, OR BECAUSE A PATIENT IS COVERED BY A PROGRAM SUCH AS MEDICAID OR MEDICARE. FOR PATIENTS WHO HAVE NO HEALTH INSURANCE LIMITED HEALTH INSURANCE OR WHO EXPECT TO HAVE DIFFICULTY PAYING THEIR BILL THE COMMUNITY CARE PROGRAM PROVIDES HEALTHCARE AT REDUCED COST OR AT NO COST. THE PROGRAM PROVIDES HEALTHCARE WITH A PAYMENT SCHEDULE THAT RECOGNIZES AN INDIVIDUAL'S FINANCIAL CONDITION. COMMUNITY CARE APPLICATIONS ARE ACCEPTED FROM PATIENTS WHO RESIDE IN OUR PRIMARY AND SECONDARY SERVICE AREAS WHICH INCLUDE THE FOLLOWING COUNTIES IN WISCONSIN: GREEN, LAFAYETTE, AND SECTIONS OF DANE, ROCK, AND IOWA COUNTIES. IN ILLINOIS, STEPHENSON AND SECTIONS OF WINNEBAGO AND JODAVIESS COUNTIES. INDIVIDUALS MUST BE A RESIDENT OF ONE OF THESE AREAS FOR A MINIMUM OF THREE MONTHS PRIOR TO BE ELIGIBLE FOR THE COMMUNITY CARE PROGRAM. Schedule H, Part VI, Line 5 A MAJORITY OF THE MONROE CLINIC BOARD OF DIRECTORS IS COMPRISED OF PEOPLE THAT RESIDE IN THE GEOGRAPHIC AREAS WE SERVE. MONROE CLINIC REINVESTS BACK INTO THE COMMUNITY THROUGH ITS COMMUNITY BENEFIT PROGRAMS AND THROUGH MEDICAL EQUIPMENT AND PROGRAMS NEEDED IN THE COMMUNITY. EXAMPLES OF THIS INCLUDE PALLIATIVE CARE, PARISH NURSING PROGRAM, YOUTH APPRENTICESHIP AND JOB SHADOWING PROGRAMS, SCREENING OUTREACH AND MANY OTHER PROGRAMS. FURTHER, MONROE CLINIC HAS INVESTED IN THE ELECTRONIC HEALTH RECORD. OUR PATIENTS ARE GEOGRAPHICALLY DIVERSE AND MONROE CLINIC HAS TEN BRANCH PHYSICIAN CLINICS IN OUTLYING AREAS. THE INVESTMENT IN ELECTRONIC HEALTH RECORDS MEANS THAT OUR PATIENTS CAN BE SEEN ANYWHERE AND HAVE THEIR MEDICAL HISTORY IMMEDIATELY AVAILABLE. THIS PROMOTES BETTER HEALTH FOR OUR PATIENTS AND INCREASED SAFETY AS WE CAN TRACK MEDICAL EVENTS AND ONGOING MEDICATION NEEDS. Schedule H, Part VI, Line 7 LIST OF STATES RECEIVING COMMUNITY BENEFITS REPORTS: WISCONSIN AND ILLINOIS X 1 1 0 0 0 0 0 1 0 0 0 PAUL BEKX CHIEF OF STAFF/DIRECTOR 235723 0 404 0 90 0 19682 0 1224 0 257123 0 404 0 CARRIE BLUM CHIEF INFORMATION OFFICER 174760 0 35500 0 202 0 58242 0 1609 0 270313 0 35500 0 DAVID BUCHANAN PHYSICIAN/INTERVENTIONAL CARDIOLOGIST 678831 0 11641 0 396 0 30826 0 17337 0 739031 0 11641 0 PAULA RAIBLEY-ELMER VP/CHIEF NURSING OFFICER 208336 0 45784 0 1140 0 67481 0 14770 0 337511 0 45784 0 JOHN FREY PHYSICIAN/SECRETARY 318899 0 475 0 396 0 26169 0 1730 0 347669 0 475 0 WISSAM MATTAR PHYSICIAN 770603 0 475 0 54 0 43179 0 7099 0 821410 0 475 0 NICHOLAS MAXWELL PHYSICIAN/GENERAL SURGEON 995492 0 475 0 258 0 47674 0 12350 0 1056249 0 475 0 JANE MONAHAN VP MINISTRY/HR 158637 0 35144 0 516 0 56206 0 1527 0 252030 0 35144 0 JAMES NEMETH CHIEF FINANCIAL OFFICER 214675 0 44723 0 151 0 73680 0 1800 0 335029 0 44723 0 DARREN PIPP PHYSICIAN 363133 0 475 0 90 0 28705 0 7605 0 400008 0 475 0 ANDREW RIKKERS PHYSICIAN/GENERAL SURGEON 970419 0 475 0 60 0 48424 0 17337 0 1036715 0 475 0 MICHAEL SANDERS PRESIDENT/CEO 677102 0 137052 0 3564 0 176136 0 2846 0 996700 0 137052 0 LANCE SATHOFF PHYSICIAN 1021117 0 475 0 90 0 48793 0 17337 0 1087812 0 475 0 JONATHAN SWINDLE PHYSICIAN/ORTHOPEDIC SURGEON 649353 0 475 0 60 0 39314 0 17337 0 706539 0 475 0 MARK THOMPSON CHIEF MEDICAL OFFICER 390715 0 75226 0 270 0 104165 0 2414 0 572790 0 75226 0 LUCINDA WERKHEISER VP/SERVICE EXCELLENCE 150776 0 35018 0 270 0 51986 0 17125 0 255175 0 35018 0 JULIE WILKE VP CLINICAL OPERATIONS 288346 0 61079 0 774 0 86370 0 2187 0 438756 0 61079 0 Schedule J, Part I, Line 1a PROVIDED MEMBERSHIP FOR THE PRESIDENT/CEO TO THE LOCAL KIWANIS ORGANIZATION: TOTAL VALUE: $115. Schedule J, Part I, Line 3 THE ORGANIZATION'S CEO AND SENIOR LEADERSHIP TEAM'S COMPENSATION PLAN IS REVIEWED AND APPROVED AT FORMAL MEETINGS OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT/NON-EMPLOYEE MEMBERS WHO HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENT TO BE REVIEWED AND RECOMMENDED BY THE COMPENSATION COMMITTEE. THE COMMITTEE REVIEW COMPARABLE WISCONSIN AND NATIONAL COMPENSATION DATA AND ESTABLISHES BASE COMPENSATION AT THE COMPARABLE MARKET MEDIAN BY POSITION AS OUTLINED IN THE COMPENSATION COMMITTEE CHARTER, ADDITIONALLY THE COMMITTEE HAS AUTHORITY TO RETAIN A COMPENSATION CONSULTANT TO ASSIST THE COMMITTEE IN EVALUATING SENIOR MANAGEMENT COMPENSATION. Schedule J, Part I, Line 6 THE ORGANIZATION USES NET EARNINGS AS 20% OF THE CALCULATION FOR THE GAIN SHARE PROGRAM. A REDEVELOPMENT AUTHORITY OF THE CITY OF MONROE 271322385 611420AP5 2009-11-24 64459717 CONSTRUCTION OF HOSPITAL 1 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITIES 391337855 2012-04-19 16415700 REFUNDING OF 1999 BOND ISSUE 0 0 0 C WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-04-19 21750843 PARTIAL ADVANCED REFUNDING OF 2009 ISSUE 0 0 0 A 0 20855000 64442747 4653664 6327046 0 1036820 0 0 57522008 0 0 2012 0 0 1 1 B 0 0 16415700 0 0 0 130700 0 0 0 16285000 0 2000 1 0 1 1 C 0 0 21750843 0 0 21459636 291207 0 0 0 0 0 2012 0 1 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 1 0 0 0 0 1 B 1 0 0 0 0 1 C 1 0 0 0 0 1 A 1 B 1 C 1 Schedule K, Part I, Column a-11/24/2009 64,459,717 REDEVELOPMENT AUTHORITY OF THE CITY OF MONROE TOTAL PROCEEDS OF ISSUE VARIANCE BETWEEN ISSUE PRICE AND TOTAL PROCEEDS (16,970) IS THE LOSS ON THE INVESTMENT. Schedule K, Part I, Column c-04/19/2012 16,415,700 WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHO WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITIES SARAH ENDICOTT MICHAEL SANDERS' DAUGHTER 43920 EMPLOYMENT 1 Form 990, Part I, Line 1 SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY, AND OUTPATIENT HEALTHCARE IN SUPPORT OF THE CORPORATION'S HEALTH CARE MISSION. THE MONROE CLINIC, BECAUSE OF ITS MISSION STATEMENT, OFFERS A CHARITY CARE PROGRAM TO ELIGIBLE BENEFICIARIES. Form 990, Part III, Line 4a IN 2015 OUR PHYSICIANS AND STAFF PROVIDED SERVICES TO PATIENTS ACCESSING OUR SYSTEM WITH OVER 250,000 VISITS. IN 1939, CSA ESTABLISHED ST. CLARE HOSPITAL AT THE REQUEST OF A SMALL GROUP OF PHYSICIANS WHO OPENED MONROE CLINIC IN THE SAME YEAR. IN 1992 ST. CLARE HOSPITAL AND MONROE CLINIC CONSOLIDATED UNDER CONTINUED SPONSORSHIP OF CSA AS A CATHOLIC NOT FOR PROFIT INTEGRATED HEALTHCARE FACILITY. MONROE CLINIC HAS A SPECIAL COMMITMENT TO PROVIDE HEALTHCARE SERVICES TO ALL PATIENTS WITHOUT ANY FORM OF DISCRIMINATION INCLUDING THE ABILITY TO PAY. THE PASSION AND DETERMINATION OF BOTH THE FOUNDING PHYSICIAN AND CSA HAS DEVELOPED AN EXCEPTIONAL HEALTHCARE ORGANIZATION THAT FOCUSES ON QUALITY AND OUTCOME MEASURES THAT EXCEED NATIONAL BENCHMARKS. IN 2010 MONROE CLINIC COMMITTED TO PUBLISHING OUR QUALITY SCORES IN LOCAL NEWSPAPERS AND ON OUR WEBSITE. TO DATE WE HAVE BEEN AMONG THE HIGHEST PERFORMING HOSPITALS IN THE AREA. PATIENT SATISFACTION SCORES ARE SIGNIFICANTLY ABOVE THE AVERAGE OF OTHER HEALTHCARE FACILITIES. OUR HIGHLY TRAINED PHYSICIANS AND STAFF ARE READY TO PROVIDE BOTH EXCEPTIONAL HEALTHCARE AND AN EXCEPTIONAL EXPERIENCE TO THE PATIENTS AND COMMUNITIES WE SERVE. IN CALENDAR YEAR 2015 MONROE CLINIC PROVIDED MORE THAN $14.0 MILLION IN COMMUNITY BENEFIT TO MORE THAN 37,500 INDIVIDUALS. THIS $14.0 MILLION REPRESENTS APPROXIMATELY 8.3 PERCENT OF MONROE CLINIC'S TOTAL NET PATIENT REVENUE. THE COMMUNITY BENEFIT AT COST IS COMPRISED OF $1.3 MILLION OF CHARITY CARE, $12.5 MILLION IN UNREIMBURSED COSTS FOR MEDICAID PATIENTS, $173 THOUSAND IN SUBSIDIZED HEALTHCARE SERVICES (SERVICES PROVIDED TO PATIENTS AT LESS THAN WHAT IT COST US TO PROVIDE THESE SERVICES). EACH YEAR MONROE CLINIC USES SURPLUS FUNDS TO ENHANCE PATIENT AND SCREENING PROGRAMS. THROUGH OUR SPENDING AND THAT OF OUR EMPLOYEES MONROE CLINIC CONTRIBUTES SIGNIFICANTLY TO THE LOCAL COMMUNITY. Form 990, Part VI, Section A, Line 6 THE CORPORATION HAS TWO CLASSES OF MEMBERS. THE CLASS A MEMBERS ARE THE GENERAL SUPERIOR OF CSA AND THOSE PERSONS WHO ARE MEMBERS OF THE GENERAL COUNCIL OF CSA. THE CLASS B MEMBERS ARE INDIVIDUALS APPOINTED BY THE CLASS A MEMBERS AND CONSIST OF NOT LESS THAN NINE MEMBERS AND NOT MORE THAN 13 MEMBERS. Form 990, Part VI, Section A, Line 7a THERE IS A GOVERNING BODY THAT HAS FINAL APPROVAL FOR ANY NEW BOARD MEMBERS. Form 990, Part VI, Section A, Line 7b VARIOUS DECISIONS SUCH AS INDEBTEDNESS OF A CERTAIN SCOPE, MISSION OF THE ORGANIZATION, AND FINAL APPROVAL OF BOARD MEMBERS MUST BE BY CLASS A MEMBERS OF CONGREGATION OF SISTERS OF ST. AGNES SPONSORSHIP MINISTRY BOARD. Form 990, Part VI, Section B, Line 11b ANNUALLY, THE BOARD OF DIRECTORS IS PROVIDED AN OVERVIEW OF THE FORM 990 AND HAS AN OPPORTUNITY TO ASK QUESTIONS AND PROVIDE INPUT. Form 990, Part VI, Section B, Line 12c ANNUALLY, CONFLICT OF INTEREST STATEMENTS AND POLICY ARE DISTRIBUTED TO MEMBERS OF THE BOARD AND ANY EMPLOYEE WHO HAS AUTHORITY TO ENTER INTO CONTRACTS AND OTHER TRANSACTIONS ON BEHALF OF MONROE CLINIC. THE COMPLETED FORMS ARE REVIEWED BY ADMINISTRATION. Form 990, Part VI, Section B, Line 15 THE ORGANIZATION'S CEO AND SENIOR LEADERSHIP TEAM'S COMPENSATION PLAN IS REVIEWED AND APPROVED AT FORMAL MEETINGS OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT NON-EMPLOYEE MEMBERS WHO HAVE NO PERSONAL INTEREST IN THE COMPENSATION AGREEMENT TO BE REVIEWED AND RECOMMENDED BY THE COMPENSATION COMMITTEE. THIS COMMITTEE REVIEWS COMPARABLE WISCONSIN AND NATIONAL COMPENSATION DATA AND ESTABLISHES BASE COMPENSATION AT THE COMPARABLE MARKET MEDIAN BY THE POSITION AS OUTLINED IN THE COMPENSATION COMMITTEE CHARTER. ADDITIONALLY THE COMMITTEE HAS AUTHORITY TO RETAIN A COMPENSATION CONSULTANT TO ASSIST THE COMMITTEE IN EVALUATING SENIOR MANAGEMENT COMPENSATION. Form 990, Part VI, Section C, Line 19 A PAPER COPY OF THE DOCUMENTS/STATEMENTS IS PROVIDED UPON REQUEST. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES EQUITY IN EARNINGS OF UNCONSOLIDATED AFFILIATES 198,845 AND CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 635,058, TOTAL 833,903. MONROE CLINIC AND HOSPITAL FOUNDATION INC 515 22ND AVENUE MONROE WI 53566 205769038 SUPPORT THE MISSION OF THE MONROE CLINIC WI 501(C) (3) LINE 7 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 THE MONROE CLINIC APPLIED FOR AND WAS GRANTED THE AUTOMATIC 3 MONTH EXTENSION.