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AVE, LA CROSSE,WI 54601, 39-1606449 LOBBYING EXPENSE - $256,582 OTHER EXEMPT PURPOSE EXPENSE - $682,487,186 GUNDERSEN CLINIC, LTD. 1836 S. AVE, LA CROSSE, WI 54601, 39-1028657 LOBBYING EXPENSE - $24,980 OTHER EXEMPT PURPOSE EXPENSE - $220,116,857 GUNDERSEN LUTHERAN MEDICAL CENTER. INC.,1910 S. AVE, LA CROSSE, WI 54601, 39-0813416 LOBBYING EXPENSE - $0 OTHER EXEMPT PURPOSE EXPENSE - $799,372,884 GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. 1836 SOUTH AVE., LA CROSSE, WI 54601, 39-1866425 LOBBYING EXPENSE - $0 OTHER EXEMPT PURPOSE EXPENSE - $0 false 9465411 9465411 192427826 78153344 114274482 1766044 1146481 619563 84184208 64232408 19951800 144311256 0 ASSET RETIREMENT OBLIG-FIN47 1645927 INTERCOMPANY PAYABLE 409494944 RESERVE MALPRACTICE CLAIMS 3397896 LONG-TERM MALPRAC CLAIM RSV 5103939 419642706 X Income Tax Matters Part X, Line 2 THE OBLIGATED GROUP HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2014 AND 2013. THE OBLIGATED GROUP'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR 2008, AND PRIOR. true Gundersen Lutheran Medical Foundation Inc 1836 South Avenue La Crosse WI 54601 391249705 501(C)(3) 871536 GLMF Support LUTHERAN MEDICAL FOUNDATION, INC. 1 Charity Care 1050 2855075 BOOK CHARITY CARE SUPPLEMENTAL INFORMATION ASSISTANCE WAS TO RELATED ORGANIZATIONS, FUNDS ARE MONITORED BY MANAGEMENT AND THE BOARD OF GOVERNORS. true false false false false false false false false Jeffrey Thompson MD Chief Executive Officer 0 768860 0 0 80621 0 39000 0 21316 0 909797 0 0 Stephen Shapiro MD Board of Governors - Member 0 435260 0 4000 0 360 0 39000 0 24750 0 503370 0 0 Brian Sieck MD Board of Governors- SEC/Treas 0 382480 0 0 25206 0 39000 0 22250 0 468936 0 0 Greg Thompson MD Board of Governors-Member,CMO 0 406928 0 10000 0 3794 0 39000 0 19566 0 479288 0 0 Jonathan Zlabek MD Board of Governors - Member 0 277860 0 6500 0 3218 0 39000 0 21316 0 347894 0 0 Julio Bird MD Board of Governors - Exec VP 0 665360 0 0 3434 0 39000 0 18816 0 726610 0 0 Sigurd Gundersen III MD Board of Governors - Member 0 362360 0 2500 0 3794 0 39000 0 18816 0 426470 0 0 P Michael Jacobs DPM Board of Governors - Member 0 276324 0 0 2828 0 39000 0 21316 0 339468 0 0 Kelley Bahr MD Board of Governors - Member 0 295500 0 0 2985 0 34510 0 54 0 333049 0 0 Brian Mulrennan MD Board of Governors - Member 0 296860 0 2500 0 3407 0 37279 0 21316 0 361362 0 0 Mary Kuffel MD Medical Vice President 0 444412 0 0 3434 0 39000 0 1524 0 488370 0 0 Michael Dolan MD Medical Vice President 0 471775 0 2500 0 0 38173 0 24000 0 536448 0 0 Marilu Bintz MD Medical Vice President 0 522004 0 0 3794 0 39000 0 9096 0 573894 0 0 Scott Rathgaber MD Medical Vice President 0 496860 0 0 3794 0 39000 0 20316 0 559970 0 0 Mary Lu Gerke Vice President 0 204004 0 0 0 30750 0 11116 0 245870 0 0 Janice DeHaan Vice President 0 46258 0 0 91980 0 6143 0 9217 0 153598 0 0 Kraig Schuster Vice President 0 137383 0 0 0 36833 0 26611 0 19496 0 220323 0 0 Beth Smith-Houskamp Vice President 0 249761 0 3400 0 49822 0 38124 0 1054 0 342161 0 0 Bryan Erdmann Vice President 0 198255 0 0 3194 0 30371 0 22466 0 254286 0 0 Kelly Barton Vice President 0 198660 0 0 2405 0 30375 0 20016 0 251456 0 0 Kathleen Klock Senior Vice President 0 401500 0 0 0 39000 0 2554 0 443054 0 0 Gerald Arndt Senior Vice President 0 393412 0 0 0 39000 0 4940 0 437352 0 0 Robert Trine Senior Vice President 0 124453 0 0 27313 0 2381 0 6272 0 160419 0 0 Mark Platt Senior Vice President 0 347360 0 0 3434 0 39000 0 18816 0 408610 0 0 Debra Rislow Senior Vice President 0 331056 0 0 360 0 39000 0 14196 0 384612 0 0 Michael Allen Chief Financial Officer 0 352152 0 0 5929 0 39000 0 24750 0 421831 0 0 Jeffrey Lawrence MD Medical Doctor 0 1201860 0 0 3434 0 39000 0 18816 0 1263110 0 0 Edward Riley II MD Medical Doctor 0 1124360 0 0 450 0 39000 0 24750 0 1188560 0 0 Jerry Davis MD Medical Doctor 0 1146360 0 0 3434 0 28600 0 18816 0 1197210 0 0 Mark Topolski MD Medical Doctor 0 877860 0 0 41442 0 39000 0 18816 0 977118 0 0 Ronald Schneider DDS Dentist 0 853860 0 0 150 0 39000 0 22250 0 915260 0 0 Frank Aberger MD Former Board of Gov Member 444360 47117 0 39000 0 21316 0 551793 0 0 William Agger MD Former Board of Gov Member 0 221353 0 0 0 360 0 33823 0 19423 0 274959 0 0 PART I, Line 1A, 2 and 3 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. Part I, Line 4A SEVERANCE PAYMENT Janice Dehaan -$90,333 Form 990, Part I, Line 1 Description of Organization Mission 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 3 SIGNIFICANT CHANGES TO PROGRAM SERVICES: IN 2013, THE CLINIC CONVERTED CLINIC BASED DEPARTMENTS TO HOSPITAL PROVIDER BASED DEPARTMENTS. 2014 WAS THE FIRST FULL YEAR REPORTING THE CONVERTED CLINIC BASED DEPARTMENTS AS HOSPITAL PROVIDER BASED DEPARTMENTS. Form 990, Part III, Line 4a Program Service Accomplishments: GUNDERSEN CLINIC, LTD. (THE CLINIC) HAS 510 PHYSICIANS REPRESENTING NEARLY EVERY SPECIALTY SERVING A 19 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 996,000 PATIENT ENCOUNTERS FOR 2014. THE CLINIC PROVIDED UNCOMPENSATED CARE RELATED TO CHARITY, $2,299,188; MEDICARE, $41,075,053; AND MEDICAID, $12,306,872 FOR THE TOTAL AMOUNT OF $55,681,114 AT A COST BASED ON POLICIES AND CONTRACTS ARRANGED TO HELP SUPPORT THE COMMUNITY'S NEEDS. THE $55,681,114 IS THE SUM OF UNREIMBURSED MEDICARE AND 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. UNREIMBURSED COST IS THE AMOUNT THE COST EXCEEDS THE NET REVENUE. 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 VI, Section A, Line 6 GUNDERSEN LUTHERAN HEALTH SYSTEM,INC. IS THE SOLE MEMBER OF THIS ORGANIZATION. FORM 990, Part VI, Line 7a GUNDERSEN LUTHERAN HEALTH SYSTEMS, INC. FORM 990, Part VI, Section A, 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, Section B, Line 11 THE FORM 990 WILL BE AVAILABLE FOR ALL BOARD MEMBERS THROUGH THE DIRECTOR'S DESK WEBSITE and THE GUNDERSEN LUTHERAN HEALTH SYSTEM FINANCE COMMITTEE RECEIVES A COPY OF THE 990 BEFORE FILING AND UPON FURTHER REVIEW FROM THE INTERIM CFO THE 990S ARE APPROVED AND FILED. FORM 990, Part VI, Section B, Line 12c GUNDERSEN CLINIC, LTD. MONITORS CONFLICTS ON AN ANNUAL BASIS BY REVIEWING DISCLOSURES ON COMPLETED CONFLICT OF INTEREST STATEMENTS. FORM 990, Part VI, Section B, 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, SECTION C, 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 ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FORM 990, PART VII, SECTION B, Line 1 ALL PAYMENTS TO VENDORS ARE MADE BY 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 XII, LINE 2C THE PROCESS ALLOWS THE AUDIT COMMITTEE OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. TO INDEPENDENTLY COMMUNICATE WITH THE EXTERNAL AUDIT FIRM THROUGHOUT THE YEAR, BUT FORMAL COMMUNICATION OCCURS BEFORE THE ENGAGEMENT AND UPON CONCLUSION. THE AUDIT COMMITTEE MEETS WITH THE AUDIT FIRM FOR PRESENTATION OF THE STATEMENTS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, Part XII, Line 3A GUNDERSEN CLINIC, LTD. OPERATES IN CONJUNCTION WITH A GROUP OF OTHER AFFILIATED CORPORATIONS GOVERNED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. AS SUCH, ANY FEDERAL AWARDS TO GUNDERSEN CLINIC, LTD. UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. SINGLE AUDIT ACT AND OMB CIRCULAR A-133. 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