2014-08-13T14:20:10-05:00 2013-09-30 KPMG LLP 191 W NATIONWIDE BLVD SUITE 500 COLUMBUS OH 432152568 990 2012-10-01 390452970 MARSHFIELD CLINIC % NARAYANA MURALI MD CORP SEC MARS 7153875511 1000 North Oak Avenue Suite Marshfield WI 54449 Alan Marshall 7153875511 2014-08-08 true 6142492300 2012 2015-11-30 17:44:51Z Brian Ewert MD President 1000 North Oak Avenue Marshfield WI 54449 1465040455 false X www.marshfieldclinic.org X 1916 WI The mission of Marshfield Clinic is to serve patients through accessible high quality health care, research and education. 11 0 8980 400 21522999 -2141538 13180930 13738812 1148561271 1145721419 14003815 10584540 1434310 1017890 1177180326 1171062661 16174737 16202937 0 0 779876055 783810355 0 0 1914502 361657322 352850567 1157708114 1152863859 19472212 18198802 1028178070 1040642079 530554476 523772494 497623594 516869585 X SEE SCHEDULE O false false 899345353 16202937 1014489372 Patient Medical Care SEE SCHEDULE O 52938201 14049299 MEDICAL RESEARCH AND EDUCATION SEE SCHEDULE O 43805006 95659749 LABORATORY MEDICINE SEE SCHEDULE O 996088560 true true false true false false false true false true true false false true true true false true false true true false false false true true false true false true true false true false false false false false false false false true true false false true true true true true false true 1009 0 true 8980 true true true true CA false false false true true false false false false X 11 0 false false false false true true true true true false false true true true true true true true true true true OH WI X NARAYANA MURALI MD CORP SEC 7153875511 1000 N OAK AVE Marshfield WI 54449 Ivan B Schaller MD 55.0 1.0 X 209010 0 51839 Dan Erickson MD 55.0 2.0 X 216249 48483 Matthew Thomas MD 55.0 1.0 X 411580 46645 Ron Martin MD 55.0 X 435267 39175 John Przybylinski MD 55.0 X 178995 34019 Seth Fagbemi MD 55.0 X 475926 59981 Jane Stark MD 55.0 X 188686 50710 Brian Ewert MD 55.0 X X 580597 53947 C Todd Stewart 55.0 X X 441482 48638 Mark LePage MD 55.0 1.0 X X 442203 54031 Narayana Murali MD 55.0 2.0 X X 280939 51879 Douglas J Reding MD 55.0 X X 578775 52947 Peter Meyer MD 55.0 X X 169658 45192 Caesar Gonzaga MD 55.0 X 311153 53161 David J Simenstad MD 55.0 X 1103538 53947 Gary Jankowski 55.0 1.0 X 430763 51704 Jim Coleman 55.0 X 445981 53826 Ken Letkeman 55.0 X 314656 22813 David Keefe 55.0 X 281764 38402 Steve Christianson 55.0 X 225253 50552 Tom Satkus 55.0 X 252415 54634 Laura Nelson MD 55.0 X 370802 51147 Fred Bollow MD 55.0 X 355941 49412 William Yanke MD 55.0 X 327747 51273 Richard Mercier MD 55.0 X 534820 54826 Timothy Swan MD 55.0 X 500156 48638 Rod Sorenson DO 55.0 X 435248 48638 Greg Burnett MD 55.0 X 292561 53826 David Cook MD 55.0 X 277591 53161 Roderick Koehler MD 55.0 X 297838 53826 Gene Shaw MD 55.0 X 366778 53831 Eric Penniman MD 55.0 X 252300 48568 Bradley Bekkum MD 55.0 X 320779 48632 Theodore Praxel MD 55.0 X 339970 55451 Scott Paulman MD 55.0 X 1268211 33402 Sanjay Rao MD 55.0 X 1150964 50138 Vivekananda Gonugunta MD 55.0 X 1048169 33818 Adedayo Onitilo MD 55.0 X 965648 55942 John Neal MD 55.0 X 849955 53632 17930368 0 1914686 1259 false true false AE BUSINESS SOLUTIONS 2310 CROSSROADS DR STE 2800 MADISON WI 53718 SERVICE/CAP. EQUIP 5348946 KNUTSON CONSTRUCTION 7715 WAYZATA BLVD MINNEAPOLIS MN 55426 REMODELING 7170841 BOLDT COMPANY LOCK BOX 285 MILWAUKEE WI 532880285 REMODELING 5780072 BOLDT PROCUREMENT LLC PO BOX 419 APPLETON WI 549120419 REMODELING 3641769 OLYMPUS AMERICA INC PO BOX 120600 DALLAS TX 753120600 MAINTENANCE & REPAIR 3218734 172 689118 181902 8626281 4241511 251925 13738812 PATIENT MEDICAL CARE 621500 1014519506 1014489372 30134 LABORATORY MEDICINE 621500 116901438 95659749 21241689 MEDICAL RESEARCH & EDUCATION 621500 14300475 14049299 251176 1145721419 8417949 8417949 -679121 -679121 483807 483807 270996 192717 78279 0 78279 78279 233141482 9857904 230154383 9999291 2987099 -141387 2845712 2845712 343262 689118 288638 54624 54624 48779 48779 48779 53148624 53342765 -194141 -194141 CAFETERIA SALES 900099 546542 546542 546542 1171062661 1124198420 21522999 11602430 16202937 16202937 0 0 0 13395463 4952563 8442900 0 0 590102100 518123472 70949517 1029111 55179695 47598677 7480818 100200 89841533 73091477 16574178 175878 35291564 30026701 5191964 72899 0 692232 56533 635699 208559 208559 226522 226522 0 0 35120925 22499074 12583764 38087 7814072 32702 7778470 2900 6171733 3795800 2351641 24291 35213857 22363003 12539470 311384 131139 131139 21095106 18277752 2782189 35165 8542731 7562836 944877 35019 0 409827 409670 157 7426028 3917809 3508219 0 30905242 29140574 1755649 9019 4145322 4117544 27778 OPERATING SUPPLIES 174081357 173831337 177653 72367 MAINTENANCE AND REPAIRS 7422236 7111597 307820 2819 OPERATING EXPENSES 11998857 11831804 161690 5363 OTHER EXPENSES 1244822 1013559 231263 1152863859 996088560 154860797 1914502 35612751 55973383 65595655 7102207 2777073 2213286 161012770 165120911 0 0 0 0 29710569 28681521 16001805 17884696 9247956 10410627 713331334 337866824 339577954 375464510 166671940 207669691 0 0 9080903 11299537 4758783 4673435 188129911 154148275 1028178070 1040642079 110688303 121476686 0 0 1145000 1694004 343433355 330463189 0 0 0 0 12029179 936824 0 0 63258639 69201791 530554476 523772494 X 473547447 490170476 23860064 26483026 216083 216083 497623594 516869585 1028178070 1040642079 X 18198802 -4403402 5450591 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false true 100 false false true 853213 false false 853313 false Description of the organization's lobbying activity: Where its experience may be helpful, Marshfield Clinic 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. PART II-B LINE 1 (D) OCCASIONALLY SEND MAIL TO MEMBERS OF CONGRESS, AND THEIR STAFF. 1045957 X true 43172004 1567033 5577482 1244246 49072273 35848004 1375000 6620000 671000 43172004 34049063 3310280 -266824 1244515 35848004 29443159 2333428 2927520 655044 34049063 27221448 2413872 614273 806434 29443159 0.67500 0.32500 false false 20958547 20958547 345381596 141559545 203822051 7872881 2509056 5363825 271577304 187550082 84027222 1978641 65562364 6248141 61292864 375464509 CASH FOR CURRENT BOND FUNDS 12930437 TRUSTED FUND - REVENUE BONDS 43902329 DEFERRED FINA COST AND OTHER 1909751 LM OR RSTR BY DON FOR SPEC PUR 24530735 LIMT OR RESTR FOR RETIRE PLAN 36471105 RESTRICTED FOR SELF INSURANCE 17776401 RESTRTD FOR UNEMPLOYMENT COMP 4410635 RESTRICTED FUNDS - OTHER 12216882 154148275 0 HEALTH PLAN PREPAYMENT 17035398 UNPAID PROFESSIONAL LIABILITY 9490636 457 PLAN PAYABLE 36471105 MISCELLANEOUS 6204652 69201791 X PART III, LINE 4 THE MISSION OF MARSHFIELD CLINIC IS TO SERVE PATIENTS THROUGH ACCESSIBLE, HIGH QUALITY HEALTH CARE, RESEARCH AND EDUCATION. AS PART OF SERVING PATIENTS, THE CLINIC STRIVES TO PROVIDE AN INVITING ATMOSPHERE TO TREAT PATIENTS AND ASSIST IN THE HEALING PROCESS. PLEASANT FACILITIES AND GROUNDS, PLUS APPROPRIATE WORKS OF ART ALL ASSIST IN THIS HEALING PROCESS, AS WELL AS SERVE TO ENHANCE THE WORK ENVIRONMENT FOR PHYSICIANS AND STAFF. QUALITY WORKS OF ART ALSO ENHANCE THE CLINIC'S EDUCATIONAL MISSION BY DISPLAYING ART WORK FOR SCHOOL CHILDREN AS WELL AS PATIENTS AND VISITORS. PART V, LINE 4 MARSHFIELD CLINIC MAINTAINS ENDOWMENT FUNDS IN THE FOLLOWING CATEGORIES: GENERAL ENDOWMENT TO FUND OPERATIONS, ENDOWED PROGRAMS TO FUND VARIOUS PATIENT CARE, RESEARCH AND EDUCATION PROGRAMS SUCH AS ONCOLOGY RESEARCH, SUMMER STUDENT INTERN PROGRAMS, AND THE ANGEL FUND; AND ENDOWED CHAIRS AND ENDOWED DISTINGUISHED PHYSICIAN/SCIENTIST AWARDS TO FUND THE RESEARCH, EDUCATION OR ADMINISTRATIVE ACTIVITES OF THE NAMED CHAIR OR AWARD RECIPIENT. PART X, LINE 2 THE CLINIC 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. BASED ON AN ANALYSIS PREPARED BY THE CLINIC, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE CLINIC AT SEPTEMBER 30, 2013 OR 2012. North America 1 23 Program Services FOOD SAFETY TESTS 2757643 1 23 1 23 2757643 2757643 false false false false false false Part I, Line 3(1) Marshfield Food Safety, LLC (MFS), a wholly owned subsidiary of Marshfield Clinic (MC) provides food safety testing services on-site at or nearby various food producers for the benefit of the public. MFS Canada Food Safety is a 100% owned subsidiary of MFS and maintains its operations in Canada. It commenced its operations in 2011 and included the same types of activities as MFS. For tax reporting purposes, MFS is a disregarded entity. The Canadian operational information is being disclosed on the Schedule F to assure compliance with 990 requirements. The listed employees are employees of MFS and not of Marshfield Clinic. The expenditures listed represent 100% (MC's share of MFS as of September 30, 2013) of operational expenses incurred by MFS Canada. Auction 269252 196309 72943 500 10068 28763 3828 300 20260 Fore a Cure 178550 121656 56894 2200 28101 10617 20 584579 371154 213425 4900 8153 34762 24790 11625 99771 1032381 689119 343262 5400 20421 91626 28618 11925 130648 288638 54624 48779 false 48779 48779 WI true false true false 0.28000 0.72000 Joseph Baierl 1000 N Oak Ave Marshfield WI 54449 false Joseph Baierl 6339 Coord. & management of Clinic gaming activities X false true FAMILY HEALTH CENTER 1515 ST JOSEPH AVE MARSHFIELD WI 54449 391681547 501(C)(3) 15788592 GENERAL SUPPORT MFLD AREA UNITED WAY PO BOX 771 MARSHFIELD WI 54449 391035073 501(C)(3) 72000 GENERAL SUPPORT COMMUNITY FOUNDATION 500 3RD ST SUITE 310 WAUSAU WI 54403 391577472 501(C)(3) 31000 GENERAL SUPPORT NEW VISIONS GALLERY RENT 1000 N OAK AVE MARSHFIELD WI 54449 510190879 501(C)(3) 26625 fmv rent GENERAL SUPPORT CITY OF EAU CLAIRE AMBULANCE SERVICE PO BOX 1087 EAU CLAIRE WI 54702 396005436 501(C)(3) 27250 GENERAL SUPPORT FRIENDS OF ST JOSEPH'S 2661 COUNTY HWY I CHIPPEWA FALLS WI 54729 390810545 501(C)(3) 17500 GENERAL SUPPORT COMPETITIVE WISCONSIN 22 N CARROLL STREET STE 200 MADISON WI 53703 391398399 501(C)(3) 10000 GENERAL SUPPORT WI WOMENS HEALTH FOUNDATION 2503 TODD DR MADISON WI 53713 391900678 501(C)(3) 10000 GENERAL SUPPORT WMC FOUNDATION INC PO BOX 352 MADISON WI 53701 391394068 501(C)(3) 10000 GENERAL SUPPORT UNITED WAY OF MARATHON 137 RIVER DRIVE WAUSAU WI 54403 390935496 501(C)(3) 32202 GENERAL SUPPORT UNITED WAY OF MERRILL 813 E 1ST ST PO BOX 813 MERRILL WI 54452 391286800 501(C)(3) 5614 GENERAL SUPPORT WHA WISCONSIN HOSPITAL ASSOC PO BOX 259038 MADISON WI 53725 390969552 501(C)(3) 10000 GENERAL SUPPORT HERITAGE FOUNDATION 1000 N OAK AVE MARSHFIELD WI 54449 391865942 501(C)(3) 14538 GENERAL SUPPORT MARSHFIELD AREA COMMUNITY FOUNDATION PO Box 1087 Marshfield WI 544490456 396578767 501(C)(3) 22000 General Support UNITED WAY OF CHIPPEWA 3603 N Hastings Way Ste 200 Eau Claire WI 547020232 391077901 501(C)(3) 20000 General Support COMMUNITY FOUNDATION OF CENTRAL WI 1501 Clark St PO Box 968 Stevens Point WI 544810968 390827885 501(C)(3) 12500 General Support CENTERGY INC 500 1st St STE 15 Wausau WI 54403 391643470 501(C)(3) 10000 General Support MARSHFIELD AREA YMCA 410 W McMillian St Marshfield WI 54449 391557086 501(C)(3) 7500 General Support FOUNDATION OF ST JOSEPH HOSPITAL 611 St Josheph Ave Marshfield WI 54449 391684957 501(C)(3) 6000 General Support 19 Schedule I, Part I, Line 2 Marshfield Clinic (the Clinic) provides assistance (primarily contributions) to a variety of organizations, most of which are 501 (C)(3) and some of which are affiliates for financial reporting purposes (i.e., Family Health Center and Heritage Foundation). The Clinic makes determinations on grant assistance and other assistance (i.e., contributions) based on the recipient organization's mission, reputation, and the organization's intended use of funds. The largest contribution is to Family Health Center (FHC), which is a member of the Clinic's obligated group and included in the Clinic's consolidated financial statements. FHC's mission and use of funds are aligned with the Clinic's mission as a 501(C)(3) organization, and monitored closely. X X X X false false false false false false false false false Brian Ewert MD 207204 0 0 0 1806 0 30540 0 21299 0 260849 0 0 0 Dan Erickson MD 214443 1806 30540 17943 264732 Matthew Thomas MD 411160 420 30540 16105 458225 Ron Martin MD 417301 17966 30540 8635 474442 John Przybylinski MD 176540 2455 23652 10367 213014 Seth Fagbemi MD 457960 17966 30540 29441 535907 Jane Stark MD 187294 1392 27939 22771 239396 Brian Ewert MD 562631 17966 30540 23407 634544 C Todd Stewart 440852 630 30540 18098 490120 Mark LePage MD 428343 13860 30540 23491 496234 Narayana Murali MD 262810 18129 30540 21339 332818 Douglas J Reding MD 569219 7750 1806 30540 22406 631721 David J Simenstad MD 1085572 17966 30540 23407 1157485 Gary Jankowski 403361 27402 30540 21164 482467 Jim Coleman 435138 375 10468 30540 23286 499807 Ken Letkeman 314026 630 2080 20733 337469 David Keefe 263798 17966 30540 7862 320166 Steve Christianson 218414 6839 30409 20143 275805 Tom Satkus 228852 23563 30540 24094 307049 Laura Nelson MD 353172 17630 30540 20607 421949 Fred Bollow MD 336635 19306 30540 18872 405353 William Yanke MD 325941 1806 30540 20733 379020 Richard Mercier MD 533014 1806 30540 24286 589646 Timothy Swan MD 481350 18806 30540 18098 548794 Rod Sorenson DO 432406 70 2772 30540 18098 483886 Greg Burnett MD 288095 3000 1466 30540 23286 346387 David Cook MD 274608 2983 30540 22621 330752 Roderick Koehler MD 296872 966 30540 23286 351664 Gene Shaw MD 347972 18806 30540 23291 420609 Scott Paulman MD 1250406 175 17630 30540 2862 1301613 Sanjay Rao MD 1150334 630 30540 19598 1201102 Vivekananda Gonugunta MD 1030539 17630 30540 3278 1081987 Adedayo Onitilo MD 898696 14000 52952 30540 25402 1021590 Peter Meyer MD 168032 1626 25594 19598 214850 Caesar Gonzaga MD 307445 3708 30540 22621 364314 Eric Penniman MD 251670 630 30540 18028 300868 Bradley Bekkum MD 312727 7632 420 30540 18092 369411 Theodore Praxel MD 338164 1806 30540 24911 395421 John Neal MD 831149 18806 30540 23092 903587 A WI Health & Education Facility Authority 391337855 97710vzy7 2006-01-31 71634384 Building & Equipment false false false B WI Health & Education Facility Authority 391337855 97710vzy7 2006-01-31 65000000 Building & Equipment false false false C WI Health & Education Facility Authority 391337855 2012-04-03 130115000 Refunding Rev Bonds false false false D WI Health & Education Facility Authority 391337855 97710bz54 2012-06-13 104090000 Building & Equipment false false false A 1745000 0 71634384 6595566 0 0 699591 0 0 68522365 0 0 2008 false false true true B 1770000 0 65000000 0 0 0 829612 0 0 68178577 0 0 2008 false false true true C 8985000 0 130115000 1037199 0 0 298298 0 0 129816702 0 0 2012 true false true true D 295000 0 104090000 0 0 0 424385 0 0 67592764 0 36497236 2013 false false false true A false true false false 0.00560 0.00560 true true 0.00020 true true B false false false false 0 true true 0.00020 true true C false false false false 0 true true 0.00020 true true D false false false false 0 true false false true A false false false true false false 0 false 0 false true B true true false 0 false 0 false true C false true false false false false 0 false 0 false true D false true false false false false 0 false 0 false true A true B true C true D true PART IV: 0 2/23/13 X 15 3885 fmv/sales price X 2005 fmv/sales price X 9 17389 fmv/sales price X 23 11590 fmv/sales price X FOOD & BEVERAGE 24 5760 fmv/sales price X JEWELRY 17 8761 fmv/sales price X LIVESTOCK 46 41215 fmv/sales price X Miscellaneous 195 75485 fmv/sales price X Sporting Goods 5 4225 FMV/SALE PRICE X Tickets 28 14926 FMV/SALES PRICE X Travel/Experience 47 66684 FMV/SALE PRICE false true false Part III, Organization`s Mission, Ln 1 THE MISSION OF MARSHFIELD CLINIC IS TO SERVE PATIENTS THROUGH ACCESSIBLE, HIGH QUALITY HEALTH CARE, RESEARCH AND EDUCATION. THROUGH RESEARCH, EDUCATION AND STANDARDIZATION OF QUALITY, OUR VISION IS TO REDUCE THE BURDEN OF DISEASE, DISABILITY AND COST FOR OUR PATIENTS AND COMMUNITIES. Part III Statement of Program Service Accomplishments- Ln 4a Medical Care: The Marshfield Clinic system provides patient care, research and education throughout northern, central and western Wisconsin, with locations in 37 communities. Marshfield Clinic (the Clinic) has 746 physicians in 86 medical specialties and subspecialties. For 97 years, the Clinic has provided medical care to all patients regardless of their ability to pay. Charity care determinations are based on financial information provided by the patient and analysis of other relevant information. Because the Clinic anticipates either no or nominal payment for these services, the amounts are excluded from revenues. There were approximately 3,900,000 patient encounters for fiscal year 2013. The Clinic provided Charity Care of $7,883,000 in fiscal year 2013 based on the cost of providing care to patients who cannot afford to pay in accordance with its Charity Care Policy. The Clinic also provides substantial community support through the provision of services to individuals supported by public programs such as general relief, Medicare and Medicaid. The Clinic's cost of providing services under these programs in excess of reimbursement received by the Clinic, and the estimated unreimbursed cost of providing care to low income underinsured and uninsured patients through the Clinics partnership with Family Health Center, a federally funded community health center was $203,015,000 in fiscal year 2013. Medical Research and Education, Ln 4b Through its research division, Marshfield Clinic Research Foundation (MCRF), the Clinic is engaged in medical and scientific research on national and international levels. The MCRF mission is to discover and communicate scientific knowledge that substantially improves human health and well-being. Since MCRFs establishment in 1959, research discoveries by MCRF scientists and Clinic physicians have expanded knowledge in multiple fields of human health and reduced the burden of disease and disability. Areas of focus include clinical research, rural and agricultural health and safety, human genetics, epidemiology, and biomedical informatics. The Marshfield Clinic Education Division also has a history of strong commitment to education and public service. Full residency programs for recent medical school graduates include internal medicine, pediatrics, medicine and pediatrics, dermatology, and general surgery. All programs are fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) of the American Medical Association. The Clinic has exemplary accreditation status with the Accreditation Council on Continuing Medical Education [ACCME] as a longstanding provider of Continuing Medical Education to area physicians and allied health providers. Additionally, we serve as an academic clinical campus of the University of Wisconsin School of Medicine and Public Health. We have over 80 national post-secondary academic affiliations and over 30 State post-secondary academic affiliations for student, resident, and fellowship training. Marshfield Clinic is recognized as a Training Center for the American Heart Association and also sponsors educational events and training for the public including diabetes education mental health programs. Laboratory Medicine, Ln 4c Marshfield Labs provides comprehensive anatomical and high-complexity diagnostic testing services to patients of Marshfield Clinic and other area medical facilities. In addition to the primary laboratory located in Marshfield, Marshfield Labs is serving the needs of surrounding communities with smaller labs at many Marshfield Clinic centers throughout central and northern Wisconsin. Proximity to our laboratories provides convenience and expeditious service to Marshfield Clinic patients. Marshfield Labs has become a center for the latest technologies and most advanced testing methods utilized today. Some of the advanced tests and emerging technologies offered by Marshfield Labs would not otherwise be available to patients in rural areas. Part VI, Governance, Management, and Disclosure, Ln 6 As of September 30, 2013 the Marshfield Clinic has 634 physicians who are referred to as "shareholders." As disclosed in the organization`s original 1023, all shareholders sign an agreement that provides that the assets of the organization are held in trust for charitable, educational and scientific purpose. "Shareholders" do not build up equity in the organization and, in the event of dissolution of Marshfield Clinic, all of the assets of the organization would be distributed to another charitable organization. Part VI, Governance, Management, and Disclosure, Ln 7a The shareholders have the right to elect the organization's officers and directors. Part VI, Governance, Management, and Disclosure, Ln 7b The shareholders have the right to approve any changes to the organization's Articles of Incorporation and Bylaws by a vote of two-thirds of the shareholders present at each of two consecutive shareholder meetings at which a quorum is present. The shareholders have the right to terminate the employment of a physician-shareholder by a vote of four-fifths of the outstanding shares entitled to vote. The shareholders have the right to approve any dissolution or liquidation of the organization by a vote of four-fifths of the shareholders. In the event of liquidation or dissolution of the organization, after payment of liabilities, the shareholders by majority vote of the shareholders shall select the educational, scientific or charitable organizations to which the organization's assets shall be transferred. Part VI, Governance, Management, and Disclosure, Ln 11a Describe the process the Organization uses to review the Form 990. (Excerpts from Marshfield Clinics 990/990-T Review Policy) The Chief Financial Officer and Controller shall review the completed Form 990 and Form 990-T in-depth. After their review and prior to filing Form 990 and Form 990-T with the IRS, the CFO or his/her designee will provide to each member of the Board of Directors a copy in electronic or paper form of the completed Form 990 (and all required schedules) and the completed Form 990-T (and all required schedules). Thereafter, at the next Board meeting (or at a special meeting called for this purpose), the CFO and/or his/her designee shall review the forms and schedules with the board members and answer any questions. In addition, the FY13 form 990 was reviewed by KPMG prior to filing. Part VI, Governance, Management, and Disclosure, Ln 12c Describe how the Organization regularly and consistently monitors and enforces compliance with its Conflict of Interest Policy. (Excerpts from Marshfield Clinics Conflict of Interest Policy) "Each disclosing individual shall complete and submit the disclosure form to the Secretary of the Board of Directors on or before January 1st of each year, or, if earlier, within one month after the individual qualifies as a disclosing individual. Each disclosing individual shall update his/her disclosure form during the year as necessary. The secretary shall maintain the completed disclosure forms in a confidential manner. The Secretary shall make the completed disclosure forms available to the executive committee and/or Board of Directors as necessary to make conflict of interest determinations and decisions concerning the fairness and reasonableness of transactions to Marshfield Clinic. In addition, the Secretary shall disclose the completed forms as necessary to those Clinic employees responsible for completion of the Clinic's IRS Form 990." Part VI, Governance, Management, and Disclosure, Lines 15a, and 15b (Excerpts from Compensation Policy) "The Clinic's Independent Compensation Committee (Compensation Committee) shall have final authority for approving compensation of Directors and other "disqualified persons" as that term is defined in 26 CFR sec. 53.4958-3. It shall be the responsibility of the Compensation Committee to insure that the Clinic 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 26 CFR sec. 53.4958-6 with respect to each disqualified person. In determining reasonableness of compensation, the Compensation Committee shall evaluate appropriate information as to comparability of compensation, including but not limited to: their own independent knowledge and expertise; compensation levels paid by similarly situated organizations for comparable positions; the availability of similar services in the Clinic's geographic area; current compensation surveys compiled by independent firms; and actual written job offers from similar institutions. The Compensation Committee shall timely document its determination of reasonableness of compensation." Part VI, Governance, Management, and Disclosure, Ln 19 Marshfield Clinic does not make its current governing documents, Conflict of Interest Policy or financial statements available to the public. Federal tax law does not require that such documents be made publicly available unless they were included on a form that is publicly available. Marshfield Clinic does make available its Form 1023, as required. Part XI, Line 5 - Reconciliation of Net Assets Net Asset Transfers: Transfer of asset from Family Health Center $34 Transfer of startup cash to Marshfield Clinic Health System ($750,000) Transfer of earnings from Lakeview Medical Center $6,219,000 TOTAL NET ASSET TRANSFERS $5,469,034 Reduction in shareholder equity ($11,000) Miscellaneous adjustments ($7,443) TOTAL OTHER CHANGES IN NET ASSETS $ 5,450,591 Schedule A, Part I Per IRS instructions for the Form 990, "the definition of hospitals for Schedule A (Form 990 or 990-EZ), Part I, is different from the definition for Schedule H (Form 990), hospitals. Accordingly, an Organization that checks this box may or may not be required to complete Schedule H (Form 990)". Marshfield Clinic is not recognized by any State as a hospital. Therefore, we are not required to complete Schedule H. Marshfield Clinic Health System, Inc. Marshfield Clinic Health System, Inc. (the "Organization") is a Wisconsin non-stock, not-for-profit corporation. The Organization was incorporated on October 12, 2012, as part of the reorganization of certain activities historically conducted by the Marshfield Clinic (the "Clinic") and its affiliates. On February 19, 2014, the Organization received a decision from the US Tax Court, which declared, adjudged and decided that the Organization was qualified as an organization described in IRC section 501(c)(3) and IRC section 509(a)(3), and was exempt from taxation under IRC section 501(a), effective October 12, 2012. The IRS subsequently sent a determination letter on March 7th, 2014 providing that the organization was exempt from federal income tax under 501(c)(3) of the Internal Revenue Code, with an effective date of October 12, 2012. Effective February 28, 2014, the Organization became the sole corporate member of the Clinic and Lakeview Medical Center, Inc. of Rice Lake ("Lakeview") (replacing the Clinic) and one of two corporate members (replacing the Clinic) of Flambeau Hospital, Inc. ("Flambeau"). The Organization is a supporting organization and the supported organizations are the Clinic, Lakeview, and Flambeau (collectively, the "Supported Organizations"). On May 6th, 2014, the Organization also became the sole corporate member of Security Health Plan (the "Plan"). Over a period of four years, the Clinic's leadership and physician shareholders (now Class A Members) engaged in numerous discussions and planning meetings in developing a plan of reorganization for the purpose of creating a comprehensive healthcare system under the strategic direction and control of a common parent entity. The Organization was formed to serve as that parent entity, with its board of directors (the "Board") serving as an overarching governing body exercising fiduciary responsibilities on behalf of the System as a whole. In this regard, the Organization's Board, which is comprised of representatives from each of the Supported Organizations and the Plan, including all eleven of the members of the Clinic's board of directors, as well as thirteen community board members, is tasked with promoting the efficient and effective operation of the System. Up until the time the Organization received confirmation from the IRS recognizing it as an exempt organization described in Section 501(c)(3) of the Code, its activities were conducted largely by its Board and through the lease of certain employees of the Supported Organizations. Since February 28, 2014, the Organization has been in a period of transition, carrying out steps to consolidate certain administrative functions (currently carried on by each Supported Organization and the Plan) at the System level, with the intent of transitioning appropriate personnel and other resources to the Organization accordingly. Such administrative functions will include Fiscal Affairs, Human Resources, Marketing, Corporate Communications, Facilities and Properties, Legal Services, Government Relations, Development and Materials Management. In addition, certain other actions will be taken to more fully integrate the Organization, the Supported Organizations and the Plan within the System. Specifically, as of June 1, 2014, the Organization became a member of the obligated group associated with tax-exempt bonds that have been issued on behalf of the Clinic and Lakeview. Marshfield Food Safety LLC 1000 N OAK AVE MARSHFIELD WI 54449 201056380 Food Testing WI 22727027 11619701 MC Security Health Plan Of Wisconsin Inc 1515 N St Josephs Ave Marshfield WI 54449 391572880 HMO WI 501(c)(4) N/A NA false Lakeview Medical Center Auxiliary Inc 1100 N Main Street Rice Lake WI 54868 391329084 Support Org WI 501(c)(3) 11,III-O NA false Flambeau Hospital Inc 98 Sherry Ave Park Falls WI 54552 390973724 hospital WI 501(c)(3) 3 NA false Lakeview Medical Center of Rice Lake 1700 West Stout St Rice Lake WI 54868 390837206 Hospital WI 501(c)(3) 3 na false Marshfield Clinic Heritage Fndtn Inc 1000 N OAK AVE MARSHFIELD WI 54449 391865942 Honor indvdls WI 501(c)(3) 11-Type I NA false Dgnstc Treatmnt Ctr 3401 Cranberry Blvd Weston WI 54476 200691634 medical svcs WI NA Related 6782086 6710898 false false 0.50000 true true true true false false false false false true true true true false false true true true true SECURITY HEALTH PLAN OF WISCONSIN INC 1A 27027 COST SECURITY HEALTH PLAN OF WISCONSIN INC 1C 180000 COST SECURITY HEALTH PLAN OF WISCONSIN INC 1D 4298797 COST SECURITY HEALTH PLAN OF WISCONSIN INC 1K 52656 COST SECURITY HEALTH PLAN OF WISCONSIN INC IL 225365811 COST SECURITY HEALTH PLAN OF WISCONSIN INC 1M 78116634 COST SECURITY HEALTH PLAN OF WISCONSIN INC 1Q 41969206 COST