GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC (EIN 39-1606449)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-11
IRS object ID
201333169349300638
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-11T16:55:55-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11212 North 96th Street Suite 300AddressLine1
CityOmahaCity
StateNEState
ZIP Code68114ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391606449EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GUNDERSEN LUTHERAN ADMINISTRATIVEBusinessNameLine1
Business Name Line2SERVICES INCBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% DARA BARTELSInCareOfName
Name ControlGUNDNameControl
Phone6087827300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11910 SOUTH AVEAddressLine1
Address Line2SuiteAddressLine2
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKATHLEEN KLOCKName
TitleSENIOR VICE PRESIDENTTitle
Phone6087756600Phone
Date Signed2013-11-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLORRAINE A EGGERName
Phone4023481450Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJEFFREY THOMPSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11910 SOUTH AVEAddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts627807546GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GUNDERSENHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTO SUPPORT GUNDERSEN LUTHERAN'S HEALTH CARE AND OTHER ORGANIZATIONS MISSIONS THROUGHOUT OUR SERVICE AREA MANAGING THE LARGER PORTION OF BUSINESS SERVICES, EDUCATION, AND INVESTING.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees7069TotalNbrEmployees
Total Nbr Volunteers847TotalNbrVolunteers
Total Gross UBI516630TotalGrossUBI
Contributions Grants Prior Year1103430ContributionsGrantsPriorYear
Contributions Grants Current Year741474ContributionsGrantsCurrentYear
Program Service Revenue Prior Year590212520ProgramServiceRevenuePriorYear
Program Service Revenue CY605423434ProgramServiceRevenueCY
Investment Income Prior Year1776471InvestmentIncomePriorYear
Investment Income Current Year691358InvestmentIncomeCurrentYear
Other Revenue Prior Year-51978OtherRevenuePriorYear
Other Revenue Current Year265221OtherRevenueCurrentYear
Total Revenue Prior Year593040443TotalRevenuePriorYear
Total Revenue Current Year607121487TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY10996205GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year518676407SalariesEtcPriorYear
Salaries Etc Current Year528708316SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year76079968OtherExpensePriorYear
Other Expenses Current Year79983501OtherExpensesCurrentYear
Total Expenses Prior Year594756375TotalExpensesPriorYear
Total Expenses Current Year619688022TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1715932RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-12566535RevenuesLessExpensesCY
Total Assets BOY996513087TotalAssetsBOY
Total Assets EOY1059183225TotalAssetsEOY
Total Liabilities BOY992116884TotalLiabilitiesBOY
Total Liabilities EOY1067433042TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4396203NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8249817NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense607261942Expense
Grants10994070Grants
Revenue605423434Revenue
DescriptionGENERAL SERVICES PROVIDED TO GUNDERSEN CLINIC, LTD., GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC., GUNDERSEN LUTHERAN MEDICAL CENTER, INC.AND OTHER AFFILIATES: ADMINISTRATIVE, INFORMATION SYSTEMS, BILLING AND CODING, LAUNDRY, MEDICAL RECORDS, HUMAN RESOURCES, FINANCE, FACILITY OPERATIONS, CENTRAL SERVICES AND OTHER MISCELLANEOUS SERVICES.Description
Total Program Service Expense607261942TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationstrueMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096424NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees7069NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDARA BARTELSNamePerson
Telephone Number6087759487TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11900 SOUTH AVENUE NCA1-01AddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (37 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JEFFREY THOMPSON MD
CHIEF EXECUTIVE OFFICER40.06.0XX711992061084
GREG PRAIRIE
BOARD OF TRUSTEES - VP2.04.0XX00
DONALD FRANK
BOARD OF TRUSTEES - SECRETARY2.06.0XX000
STEVEN BURGESS
BOARD OF TRUSTEES - TREASURER2.04.0XX000
WILLIAM AGGER MD
BOARD OF GOVERNORS40.06.0X243914058444
BRIAN RUDE
BOARD OF TRUSTEES - MEMBER2.04.0X000
MARK PLATT
BOARD OF TRUSTEES - MEMBER2.04.0X000
BRIAN MULRENNAN MD
BOARD OF TRUSTEES/GOVERNORS40.06.0X277381062584
JONATHAN ZLABEK MD
BOARD OF TRUSTEES/GOVERNORS40.06.0X258654060084
JULIO BIRD MD
BOARD OF GOVERNORS - EXEC VP40.06.0XX664632058584
WENDY LOMMEN
BOARD OF TRUSTEES - TREASURER2.04.0XX000
FRANK ABERGER MD
BOARD OF GOVERNORS40.06.0X486314062584
MARY KUFFEL MD
BOARD OF GOVERNORS - CMO40.06.0XX435510038940
STEPHEN SHAPIRO MD
BOARD OF TRUSTEES/GOVERNORS40.08.0X432458061084
BRIAN SIECK MD
BD OF GOV. - SEC/TREAS/TRUSTEE40.06.0XX359638060496
GREG THOMPSON MD
Board of Governors - Member40.08.0X343492063584
BRAD STURM
BOARD OF TRUSTEES - MEMBER2.04.0X000
GORDON EDWARDS
CHIEF FINANCIAL OFFICER40.00.0X340689059084
SCOTT RATHGABER MD
MEDICAL VICE PRESIDENT40.00.0501122060084X
SIGURD GUNDERSEN III MD
MEDICAL VICE PRESIDENT40.02.8442760058584X
MICHAEL J DOLAN MD
MEDICAL VICE PRESIDENT40.02.0432568058804X
MARILU BINTZ MD
MEDICAL VICE PRESIDENT40.02.0511944046740X
MARY JO KLOS
VICE PRESIDENT40.00.25161086020762X
JANICE DEHAAN
VICE PRESIDENT40.01.5266624057004X
DEBRA RISLOW
VICE PRESIDENT40.01.0287545051648X
KATHLEEN KLOCK
SENIOR VICE PRESIDENT40.00.0395360037500X
GERALD ARNDT
SENIOR VICE PRESIDENT40.01.0384412038940X
MARY LU GERKE
VICE PRESIDENT40.00.0199124039240X
ROBERT TRINE
SENIOR VICE PRESIDENT40.00.0365023057537X
KELLY BARTON
Vice President40.01.5172998026448X
BRYAN ERDMANN
Vice President40.02.8166557047551X
PATRICK CONWAY MD
MEDICAL DOCTOR40.00.0597698058584X
MICHAEL REDMAN MD
MEDICAL DOCTOR40.00.0333984058584X
DAN LILLY JD
GENERAL COUNSEL40.01.0286639062403X
TODD KOWALSKI MD
MEDICAL DOCTOR40.00.0250716054864X
JEFFREY HILLESLAND MD
Medical Doctor40.00.0279044059844X
DARYL APPLEBURY
CHIEF OF CORPORATE VENTURES40.03.3215893053817X
FieldValueIRS element (for citing)
Total Reportable Comp From Org10805771TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1595490TotalOtherCompensation
Number Individuals GT100 K643NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Gundersen Lutheran Medical Center
1910 South AvenueLA CROSSEWI54601Purchased Services673501175
Gundersen Clinic LTD
1836 South AvenueLA CROSSEWI54601Purchased Services583649928
Kraus Anderson Construction Co
PO Box 158CIRCLE PINESMN55014Building Contractor75540428
EPIC System Corporation
Box 88314MILWAUKEEWI532880314MEDICAL RCD SW SUPL5113857
Forsythe Solutions Group
PO Box 809024CHICAGOIL60680Consultants3099536
FieldValueIRS element (for citing)
Number Of Contractors GT100 K117NumberOfContractorsGT100K
Related Organizations355285RelatedOrganizations
Government Grants386189GovernmentGrants
Total Contributions741474TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSERVICE PROVIDED TO GUNDERSENDescription
Business Code561000BusinessCode
Total Revenue Column605423434TotalRevenueColumn
Related Or Exempt Function Income605423434RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue605423434TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column715426TotalRevenueColumn
Unrelated Business Revenue516630UnrelatedBusinessRevenue
Exclusion$198,796ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real788829Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real523608Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real265221Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column265221TotalRevenueColumn
Exclusion$265,221ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other20138383Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other20162451Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-24068Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-24068TotalRevenueColumn
Exclusion-$24,068ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column607121487TotalRevenueColumn
Related Or Exempt Function Income605423434RelatedOrExemptFunctionIncome
Unrelated Business Revenue516630UnrelatedBusinessRevenue
Exclusion$439,949ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total10981380Total
Program Services10981380ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total14825Total
Program Services14825ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4393293Total
Program Services1266720ProgramServices
Management And General3126573ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total390755855Total
Program Services387317878ProgramServices
Management And General3437977ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total47326853Total
Program Services46622523ProgramServices
Management And General704330ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total62542497Total
Program Services59721360ProgramServices
Management And General2821137ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total23689818Total
Program Services23559008ProgramServices
Management And General130810ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1704523Total
Program Services359623ProgramServices
Management And General1344900ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total502845Total
Program Services502845ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total222647Total
Program Services222647ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total715426Total
Program Services715426ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4315508Total
Program Services4222898ProgramServices
Management And General92610ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total860281Total
Program Services860281ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total15869894Total
Program Services15810301ProgramServices
Management And General59593ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12826920Total
Program Services12826920ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8513680Total
Program Services8486101ProgramServices
Management And General27579ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total545427Total
Program Services480468ProgramServices
Management And General64959ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1718378Total
Program Services1676120ProgramServices
Management And General42258ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total9152447Total
Program Services9152447ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18555678Total
Program Services18541228ProgramServices
Management And General14450ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total79418Total
Program Services79418ProgramServices
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS/COLLECTIONS26403642640364
MISCELLANEOUS837098577203259895
DUES, MEMBERSHIPS, LICENSES466319168747297572
RECRUITING4566484552111437

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total619688022Total
Program Services607261942ProgramServices
Management And General12426080ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY20867BOY
EOY22213EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY58666734BOY
EOY76237794EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY34009BOY
EOY26641EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY21886823BOY
EOY17521477EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5105095BOY
EOY4692562EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5806756BOY
EOY6384044EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis188850443LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec107022386LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY81153217BOY
EOY81828057EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY460666927BOY
EOY509951819EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY363172659BOY
EOY362518618EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY996513087BOY
EOY1059183225EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY114446581BOY
EOY98561918EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY342545000BOY
EOY406680000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY535125303BOY
EOY562191124EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY992116884BOY
EOY1067433042EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4396203BOY
EOY-8249817EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4396203BOY
EOY-8249817EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY996513087BOY
EOY1059183225EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-12566535ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-77486ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment-1999ReconcilationPriorAdjustment
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
GUNDERSEN CLINIC LTD
39102865703truetruetrue$0
GUNDERSEN LUTHERAN MEDICAL CENTER INC
39081341603truetruetrue$0
GUNDERSEN LUTHERAN HEALTH SYSTEM
39186642507truetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts
General ExplanationGundersen Lutheran Administrative Services is an integral part of the Gundersen Lutheran Health System and provides support to each of the organizations listed; however, such services cannot easily be quantified in dollar-based terms.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Org Belongs To Affiliated GroupXOrgBelongsToAffiliatedGroup
Total Grassroots LobbyingTotalGrassrootsLobbying

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals222647FilingOrganizationsTotals
Affiliated Group Totals232875AffiliatedGroupTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals222647FilingOrganizationsTotals
Affiliated Group Totals232875AffiliatedGroupTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals619465375FilingOrganizationsTotals
Affiliated Group Totals1570265863AffiliatedGroupTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals619688022FilingOrganizationsTotals
Affiliated Group Totals1570498738AffiliatedGroupTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals
Affiliated Group Totals1000000AffiliatedGroupTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals
Affiliated Group Totals250000AffiliatedGroupTotals
FieldValueIRS element (for citing)
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus3201660CurrentYearMinus3
Current Year Minus2258826CurrentYearMinus2
Current Year Minus1216456CurrentYearMinus1
Current Year232875CurrentYear
Total909817Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART II-A LINE 1A-D:Identifier
ExplanationGUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC., 1910 S. AVE, LA CROSSE, WI 54601, 39-1606449 LOBBYING EXPENSE - $222,647 OTHER EXEMPT PURPOSE EXPENSE - $619,465,375 GUNDERSEN CLINIC, LTD. 1836 S. AVE, LA CROSSE, WI 54601, 39-1028657 LOBBYING EXPENSE - $10,228 OTHER EXEMPT PURPOSE EXPENSE - $543,636,068 GUNDERSEN LUTHERAN MEDICAL CENTER, INC., 1910 S.AVE, LA CROSSE, WI 54601, 39-0813416 LOBBYING EXPENSE - $0 OTHER EXEMPT PURPOSE EXPENSE - $407,164,420 GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. 1836 SOUTH AVE., LA CROSSE, WI 54601, 39-1866425 LOBBYING EXPENSE - $0 OTHER EXEMPT PURPOSE EXPENSE - $0Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1242123OtherCostOrOtherBasis
Book Value1242123BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis28258746OtherCostOrOtherBasis
Depreciation5408561Depreciation
Book Value22850185BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1668294OtherCostOrOtherBasis
Depreciation391016Depreciation
Book Value1277278BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis157681280OtherCostOrOtherBasis
Depreciation101222809Depreciation
Book Value56458471BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings81828057TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY RECEIVABLE349975695
UNAMORTIZED BOND ISSUE COSTS3693035
ACCRUED INTEREST RECEIVABLE1656152
OTHER RECEIVABLES6859700
UPPER MIDWEST CONSOLIDATED SER200000
RECEIVABLE FROM ENVISION134036
FieldValueIRS element (for citing)
Total Book Value Other Assets362518618TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
INTERCOMPANY PAYABLE$518,118,504
LOSS ON SWAP CONTRACTS$41,489,815
DEFERRED COMPENSATION$809,232
LONG-TERM TEB PREM (DISC)$1,773,573
FieldValueIRS element (for citing)
Total Of Amounts562191124TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPART X, LINE 2:Identifier
ExplanationTHE OBLIGATED GROUP (GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC., GUNDERSEN LUTHERAN MEDICAL CENTER, INC., GUNDERSEN CLINIC, LTD., AND GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.) ADOPTED THE PROVISIONS RELATING TO UNCERTAIN TAX POSITIONS OF THE FASB ACCOUNTING STANDARDS CODIFICATION ON JANUARY 1, 2007. THE CODIFICATION CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE OBLIGATED GROUP HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST AS OF DECEMBER 31, 2012 AND 2011. THE OBLIGATED GROUP'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR THE FISCAL YEARS ENDED DECEMBER 31, 2006, AND PRIOR.Explanation

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedtrueGrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable (4 entries)

RegionRegionNumber Of OfficesNumberOfOfficesNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedSpecific Services ProvidedSpecificServicesProvidedTotal ExpendituresTotalExpenditures
Central America and the Caribbean00GrantmakingN/A14825
Sub-Saharan Africa00Program ServicesMEDICAL SERVICES11104
South America00Program ServicesMEDICAL SERVICES14566
Central America and the Caribbean00Program ServicesMEDICAL SERVICES42162
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent82657SubtotalAmountSpent
Total Amount Spent82657TotalAmountSpent

Grants To Orgs Outside US GrantsToOrgsOutsideUS

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Purpose Of GrantGeneral SupportPurposeOfGrant
Amount Of Cash Grant12690AmountOfCashGrant
Manner Of Cash DisbursementCHECKMannerOfCashDisbursement
Amount Of Non Cash Assistance2135AmountOfNonCashAssistance
Description Of Non Cash AssistanceSEE STMTDescriptionOfNonCashAssistance
Method Of ValuationFMVMethodOfValuation
FieldValueIRS element (for citing)
Total Number Of501c3 Orgs1TotalNumberOf501c3Orgs
Total Number Of Other Orgs0TotalNumberOfOtherOrgs
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV (3 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 2:GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES PROVIDED A GRANT INDIRECTLY THROUGH AN EXEMPT ORGANIZATION RECOGNIZED BY THE IRS TO PROVIDE SERVICES TO FOREIGN ORGANIZATIONS.
PART I, LINE 3, COLUMN (E):REGION: SUB-SAHARAN AFRICA (E) SPECIFIC TYPES OF SERVICES IN REGION: MEDICAL SERVICES (SURGICAL) AND COMMUNITY HEALTH NEEDS ASSESSMENT. REGION: SOUTH AMERICA (E) SPECIFIC TYPES OF SERVICES IN REGION: MEDICAL SERVICES (SURGICAL)AND COMMUNITY HEALTH NEEDS ASSESSMENT. REGION: CENTRAL AMERICA AND THE CARIBBEAN (E) SPECIFIC TYPES OF SERVICES IN REGION: MEDICAL SERVICES (SURGICAL) AND COMMUNITY HEALTH NEEDS ASSESSMENT.
PART II, COLUMN (H):(H) DESCRIPTION OF NON-CASH ASSISTANCE: EDUCATION WORKSHOPS and LITERACY ASSESSMENTS.REGION: CENTRAL AMERICA AND THE CARIBBEAN

Schedule I IRS990ScheduleI

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Tri-State Regional Ambulance
235 Causeway BlvdLa CrosseWI54603391962965501(C)(3)1059988GENERAL SUPPORT
GUNDERSEN LUTHERAN HEALTH SYSTEM INC
1836 SOUTH AVENUELA CROSSSEWI54601391866425501(C)(3)8900000GENERAL SUPPORT
GUNDERSEN LUTHERAN CREDENTIALING
1836 SOUTH AVENUELA CROSSEWI54601391866898501(C)(3)1021392GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPART 1, LINE 2Identifier
ExplanationThe funds are monitored by management, board of governors and the board of trustees.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (30 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JEFFREY THOMPSON MD
CHIEF EXECUTIVE OFFICER70817200038200375000236380773130000
WILLIAM AGGER MD
BOARD OF GOVERNORS2395100400004040370500238840304848000
BRIAN MULRENNAN MD
BOARD OF TRUSTEES/GOVERNORS27317201000032090375000251380340019000
JONATHAN ZLABEK MD
BOARD OF TRUSTEES/GOVERNORS25317202500029820375000226380318792000
JULIO BIRD MD
BOARD OF GOVERNORS - EXEC VP65367207500034600375000211380723270000
SCOTT RATHGABER MD
MEDICAL VICE PRESIDENT49717200039500375000226380561260000
FRANK ABERGER MD
BOARD OF GOVERNORS438672000476420375000251380548952000
MARY KUFFEL MD
BOARD OF GOVERNORS - CMO4319120003598037500014940474504000
STEPHEN SHAPIRO MD
BOARD OF TRUSTEES/GOVERNORS4280720400003860375000270720497030000
BRIAN SIECK MD
BD OF GOV. - SEC/TREAS/TRUSTEE3591980004400375000264840423622000
SIGURD GUNDERSEN III MD
MEDICAL VICE PRESIDENT43892200038380375000211380501398000
MICHAEL J DOLAN MD
MEDICAL VICE PRESIDENT4321820003860362200260720494860000
MARILU BINTZ MD
MEDICAL VICE PRESIDENT5081240003820037500092940558738000
MARY JO KLOS
VICE PRESIDENT6110200099984092820121610182529000
JANICE DEHAAN
VICE PRESIDENT2656720009520329200268750326419000
DEBRA RISLOW
VICE PRESIDENT2871850003600375000171690342214000
KATHLEEN KLOCK
SENIOR VICE PRESIDENT3850000100000360037500034880436348000
GERALD ARNDT
SENIOR VICE PRESIDENT37441201000000037500049280426840000
MARY LU GERKE
VICE PRESIDENT19912400000300000113140240438000
ROBERT TRINE
SENIOR VICE PRESIDENT36158900034340344530231380422614000
GORDON EDWARDS
CHIEF FINANCIAL OFFICER3175890100000131000375000216380399827000
PATRICK CONWAY MD
MEDICAL DOCTOR597672000260375000245720659770000
MICHAEL REDMAN MD
MEDICAL DOCTOR33017200038120375000211380392622000
DAN LILLY JD
GENERAL COUNSEL28663900000363190291070352065000
TODD KOWALSKI MD
MEDICAL DOCTOR246672040000440337800236530308149000
DARYL APPLEBURY
CHIEF OF CORPORATE VENTURES21589300000327330233850272011000
KELLY BARTON
Vice President15818600014812025008014940199500000
JEFFREY HILLESLAND MD
Medical Doctor27587300031710375000223980338942000
BRYAN ERDMANN
Vice President16277500037820249870227010214245000
GREG THOMPSON MD
Board of Governors - Member33967200038200375000261380407130000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPART I, LINE 4AIdentifier
Return ReferenceSEVERANCE PAYMENTReturnReference
ExplanationMARY JO KLOS - $98,500Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WHEFA SERIES 2011A ISSUANCE
A39133785597710BJ782011-09-29162468632SEE PART VIfalsefalsefalse
WHEFA SERIES 2011B ISSUANCE
B39133785597710BK502011-09-2940000000SEE PART VIfalsefalsefalse
WHEFA SERIES 2009 ISSUANCE
C39133785597710BE652011-03-1778715000SEE PART VIfalsefalsefalse
WHEFA SERIES 2008B ISSUANCE
D39133785597710BBG62010-09-0161400000SEE PART VIfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
A5865000016256346200904738031938652007014024500truefalsefalsetrue
B0040010713000304885003970576400falsefalsefalsetrue
C00787150000078715000000000truefalsetruetrue2005
D00614000000061400000000000truefalsetruetrue2008

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsTotal Private Business UseTotalPrivateBusinessUse
Afalsefalsefalsefalse0falsefalsefalsetrue
Bfalsefalsefalsefalse0falsefalsefalsetrue
Cfalsetruefalsefalse0.01600falsefalsefalsetrue0.01600
Dfalsefalsefalsefalse0falsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledException To RebateExceptionToRebateVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
0
Afalsetruefalsefalsefalse0falsetrue
0
Bfalsetruetruefalsefalse0falsetrue
PIPERMERRILL
Cfalsetruetruetruefalse0falsetrue29.5falsefalse
MERRILL
Dfalsetruetruetruefalse0falsetrue27.falsefalse

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue
Dtrue

Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part I Bond Issues: Line A0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2011A (f) Description of Purpose: Refunded the 2000 Series A and B issued 10/10/2000, Series 2008A issued 5/29/2008 Part II Line 3 Amounts reported include investment income
Part I Bond Issues: Line B0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2011B (f) Description of Purpose: New Money for Construction and Equipping of Hospital Part II Line 3 Amounts reported include investment income
Part I Bond Issues: Line C0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2009 (c) Cusip ID: 97710BE65/9910BE73 (f) Description of Purpose: Conversion and Reissuace of 2009 Bonds, origionally issued 5/22/2009
Part I Bond Issues: Line D0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2008B (f) Description of Purpose: Conversion and Reissuace of 2008 Bonds, originally issued 5/29/2008

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WHEFA SERIES 2012 ISSUANCE
A39133785597710B4B52012-09-2771789897SEE PART VIfalsefalsefalse
WHEFA SERIES 2003A ISSUANCE
B39133785597710VLT32003-07-23114412216SEE PART VItruefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
A00718965380009610540028645159042247081falsefalsefalsetrue
B103555000907000011441221600356290811151179321864907441330700truefalsetruetrue2005

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsTotal Private Business UseTotalPrivateBusinessUse
Afalsefalsefalsefalse0falsefalsefalsetrue
Bfalsetruefalsefalse0.01600falsefalsefalsetrue0.01600

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledException To RebateExceptionToRebateVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsNo Rebate DueNoRebateDueTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
0
Afalsetruefalsefalsefalse0falsetrue
PIPERMERRIL
Bfalsetruetruefalse0falsetruetrue29.5falsefalse

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part I Bond Issues: LIne A0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2012 (f) Description of Purpose: New Money for Construction and Equipping of Hospital Part II Line 3: Amounts reported include investment income.
Part I Bond Issues: Line B0(a) Issuer Name: Wisconsin Health and Educational Facilities Authority Series 2003A (f) Description of Purpose: Refunded the 1993 Series A and B
Part IV Arbitrage0Column B, Line (c): Rebate Computations were performed on 3/28/2006; 10/31/2008; 9/21/2011; 9/27/2011

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonGORDON EDWARDSNamePerson
Relationship With OrganizationCFORelationshipWithOrganization
Purpose Of LoanRELOCATIONPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$40,000OriginalPrincipalAmount
Balance Due26641BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due26641TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (11 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
SEAN AGGER
SEE SUPPLEMENTAL INFO151604EMPLOYMENTfalse
INGRI GUNDERSEN LOMBARDI
SEE SUPPLEMENTAL INFO36172EMPLOYMENTfalse
JAMES KLOCK
SEE SUPPLEMENTAL INFO108938EMPLOYMENTfalse
BELINDA KLOCK
SEE SUPPLEMENTAL INFO69492EMPLOYMENTfalse
JAMES KLOCK
SEE SUPPLEMENTAL INFO95334EMPLOYMENTfalse
BRENDA WHITE
SEE SUPPLMENETAL INFO19976EMPLOYMENTfalse
SAMUEL THOMPSON
SEE SUPPLEMENTAL INFO11703EMPLOYMENTfalse
JONATHAN KLOCK
SEE SUPPLEMENTAL INFO30030EMPLOYMENTfalse
TOM THOMPSON
SEE SUPPLEMENTAL INFO47574EMPLOYMENTfalse
Lynn Sturm
SEE SUPPLEMENTAL INFO81385EMPLOYMENTfalse
Amy Strupp
SEE SUPPLEMENTAL INFO19050EMPLOYMENTfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSCHEDULE L, PART II, LOANS TO AND FROM INTERESTED PERSONS:Identifier
Explanation(A) NAME OF PERSON: GORDON EDWARDS (A) PURPOSE OF LOAN: RELOCATION EXPENSES - FORGIVEN OVER 5 YEARS SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: SEAN AGGER (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF WILLIAM AGGER,M.D., DIRECTOR (A) NAME OF PERSON: INGRI GUNDERSEN LOMBARDI (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF SIGURD GUNDERSEN III, M.D., KEY EMPLOYEE (A) NAME OF PERSON: JAMES KLOCK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KATHLEEN KLOCK, KEY EMPLOYEE (A) NAME OF PERSON: BELINDA KLOCK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KATHLEEN KLOCK, KEY EMPLOYEE (A) NAME OF PERSON: JAMES KLOCK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KATHLEEN KLOCK, KEY EMPLOYEE (A) NAME OF PERSON: JONATHAN KLOCK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KATHLEEN KLOCK, KEY EMPLOYEE (A) NAME OF PERSON: BRENDA WHITE (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF GERALD ARNDT, KEY EMPLOYEE (A) NAME OF PERSON: SAMUEL THOMPSON (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF JEFF THOMPSON, M.D., DIRECTOR (A) NAME OF PERSON: TOM THOMPSON (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF JEFF THOMPSON, M.D., DIRECTOR (A) NAME OF PERSON: LYNN STURM (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF BRAD STURM, DIRECTOR (A) NAME OF PERSON: AMY STRUPP (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF KELLY BARTON, KEY EMPLOYEEExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:TO SUPPORT GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S PROGRAMS OF HEALTH CARE, MEDICAL EDUCATION, MEDICAL RESEARCH AND COMMUNITY HEALTH PROMOTION ACTIVITIES WITHIN THE MEANING OF SECTION 509(A)(3) OF THE IRC; BORROWING AND LENDING OF FUNDS AND PROPERTY, ENGAGING IN FINANCIAL TRANSACTIONS WITH AND/OR ON BEHALF OF THE GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., ALONG WITH GENERAL SERVICES PROVIDED TO GUNDERSEN CLINIC, LTD. AND GUNDERSEN LUTHERAN MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 6:GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A:GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7B:GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., THE PARENT CORPORATION AND SOLE MEMBER OF THE CORPORATION, SHALL HAVE THE POWER, TO RECOMMEND AND REVIEW, AS APPROPRIATE, AND APPROVE CERTAIN MATTERS . ARTICLES OF INCORPORATION MAY BE AMENDED BY VOTE OF THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11:THE GUNDERSEN LUTHERAN HEALTH SYSTEM FINANCE COMMITTEE RECEIVES A COPY OF THE 990 BEFORE FILING AND UPON FURTHER REVIEW FROM THE CONTROLLER THE 990S ARE APPROVED AND FILED.
FORM 990., PART VI, SECTION B, LINE 12C:GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. MONITORS CONFLICTS ON AN ANNUAL BASIS BY REVIEWING DISCLOSURES ON COMPLETED CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15: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 COMPENSATION RECOMMENDATIONS, 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 XI, LINE 2CTHE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (20 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
GUNDERSEN LUTHERAN HEALTH SYSTEM INC
1836 SOUTH AVENUELA CROSSEWI54601391866425SUPTNG. ORGWI501(C)(3)LINE 11b,IINAfalse
GUNDERSEN LUTHERAN MEDICAL CENTER INC
1910 SOUTH AVENUELA CROSSEWI54601390813416HEALTH CAREWI501(C)(3)LINE 3GLHSfalse
GUNDERSEN CLINIC LTD
1910 SOUTH AVENUELA CROSSEWI54601391028657SUPTNG. ORGWI501(C)(3)LINE 3GLHSfalse
GUNDERSEN LUTHERAN MEDICAL FNDTN INC
1836 SOUTH AVENUELA CROSSEWI54601391249705FOUNDATIONWI501(C)(3)LINE 7GLHSfalse
GUNDERSEN LUTHERAN HEALTH PLAN INC
1836 SOUTH AVENUELA CROSSEWI54601391807071HEALTH INS.WI501(C)(4)GLHSfalse
GUNDERSEN LUTHERAN CREDENTIALING SVS INC
1910 SOUTH AVENUELA CROSSEWI54601391856898CREDENTIALINGWI501(C)(3)LINE 11A, IGLHSfalse
TRI-COUNTY MEMORIAL HOSPITAL INC
18601 LINCOLN STREETWHITEHALLWI54773390704510HEALTH CAREWI501(C)(3)LINE 3GLHSfalse
HARMONY COMMUNITY HEALTHCARE INC
815 MAIN AVENUE SHARMONYMN55939410711606HEALTH CAREMN501(C)(3)LINE 9GLHSfalse
TWEETEN LUTHERAN HEALTHCARE CENTER INC
125 FIFTH AVENUE SESPRING GROVEMN55974411565003HEALTH CAREMN501(C)(3)LINE 9GLHSfalse
TRI-STATE AMBULANCE INC
235 CAUSEWAY BLVDLA CROSSEWI54601391965415MDCL TRANSPO.WI501(C)(3)LINE 3GLHSfalse
LUTHERAN REAL ESTATE HOLDING CORPORATION
1910 SOUTH AVENUELA CROSSEWI54601391480826HOUSINGWI501(C)(3)LINE 9GLHSfalse
LUTHERAN HOUSING OF LA CROSSE INC
1900 SOUTH AVENUELA CROSSEWI54601391751934INDP LIVINGWI501(C)(3)LINE 9LRHCfalse
COMMUNITY HOUSING OF LA CROSSE INC
1900 SOUTH AVENUELA CROSSEWI54601391586700INDP LIVINGWI501(C)(3)LINE 7LRHCfalse
OPTIONS IN REPRODUCTIVE CARE INC
1201 CALEDONIA STREETLA CROSSEWI54603391166634HEALTH CAREWI501(C)(3)LINE 3GLHSfalse
TRI-STATE REGIONAL AMBULANCE INC
235 CAUSEWAY BLVDLA CROSSEWI54603391962965MDCL TRANSPO.WI501(C)(3)LINE 9GLHSfalse
STJOSEPH'S HEALTH SERVICES INC
400 WATER AVENUEHILLSBOROWI54634390929538HEALTH CAREWI501(C)(3)LINE 3GLHSfalse
ST JOSEPH MEMORIAL FOUNDATION INC
400 WATER STREETHILLSBOROWI54634391455787FOUNDATIONWI501(c)(3)LINE 11A, IS JOSEPH HSfalse
TRI-COUNTY MEMORIAL FOUNDATION INC
18601 LINCOLN STREETWHITEHALLWI54773300093022FOUNDATIONWI501(c)(3)LINE 3TRI-COUNTYfalse
GUNDERSEN LUTHERAN EXPRESS CARE INC
1836 SOUTH AVELA CROSSEWI54601900102388HEALTHCAREWI501(c)(3)LINE 11GLHSfalse
GUNDERSEN LUTHERAN HEALTH PLAN MN INC
1900 SOUTH AVELA CROSSEWI54601452633920health insMN501(c)(4)SEE STMTglhpfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
DEGEN BERGLUND INC
1709 LOSEY BLVD SLA CROSSEWI54601390971110RETAIL PHARMACYWIGLHSC CORP000.00000true
GUNDERSEN LUTHERAN ENVISION LLC
1836 SOUTH AVENUELA CROSSEWI54601264706546RENEWABLE ENRGYWIGLHSC CORP000.00000true
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GUNDERSEN LUTHERAN HEALTH PLAN INC
M75783669FAIR VALUE
GUNDERSEN LUTHERAN HEALTH PLAN INC
Q11395107FAIR VALUE
GUNDERSEN LUTHERAN ENVISION LLC
A459438FAIR VALUE
DEGEN BERGLUND INC
A57192FAIR VALUE

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPART II, PAGE 3, LINE 6Identifier
ExplanationTHE APPLICATION FOR 501(C)(4) IS PENDING.Explanation

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