GUNDERSEN CLINIC LTD: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
GUNDERSEN CLINIC LTD (EIN 39-1028657)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201123189349303212
Schema version
2010v3.4
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)
Timestamp2011-11-14T11:07:14-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12 COPELAND AVENUE SUITE 301AddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54603ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391028657EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GUNDERSEN CLINIC LTDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGUNDNameControl
Phone6087827300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11836 SOUTH AVENUEAddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGORDON T EDWARDSName
TitleCHIEF FINANCIAL OFFICERTitle
Phone6087827300Phone
Date Signed2011-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARY JO WERNER CPAName
Phone6087847300Phone
Date Prepared2011-11-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
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 Line11836 SOUTH AVENUEAddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts503763678GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GUNDLUTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1963YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MEDICAL AND SURGICAL SERVICES, ENGAGE IN MEDICAL EDUCATION AND RESEARCH AND PROMOTE COMMUNITY HEALTH TO DELIVER THE HIGHEST QUALITY COMPREHENSIVE HEALTH CARE TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI1028TotalGrossUBI
Net Unrelated Business Txbl Income-391NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year245864ContributionsGrantsPriorYear
Contributions Grants Current Year345239ContributionsGrantsCurrentYear
Program Service Revenue Prior Year433921793ProgramServiceRevenuePriorYear
Program Service Revenue CY500160057ProgramServiceRevenueCY
Investment Income Prior Year787315InvestmentIncomePriorYear
Investment Income Current Year3206571InvestmentIncomeCurrentYear
Other Revenue Prior Year25601OtherRevenuePriorYear
Other Revenue Current Year20859OtherRevenueCurrentYear
Total Revenue Prior Year434980573TotalRevenuePriorYear
Total Revenue Current Year503732726TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1217123GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1290195GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year269380307SalariesEtcPriorYear
Salaries Etc Current Year278168413SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year157266874OtherExpensePriorYear
Other Expenses Current Year238792547OtherExpensesCurrentYear
Total Expenses Prior Year427864304TotalExpensesPriorYear
Total Expenses Current Year518251155TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7116269RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-14518429RevenuesLessExpensesCY
Total Assets BOY375122074TotalAssetsBOY
Total Assets EOY378967775TotalAssetsEOY
Total Liabilities BOY316930197TotalLiabilitiesBOY
Total Liabilities EOY345915921TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY58191877NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY33051854NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE MEDICAL AND SURGICAL SERVICES, ENGAGE IN MEDICAL EDUCATION AND RESEARCH AND PROMOTE COMMUNITY HEALTH TO DELIVER THE HIGHEST QUALITY COMPREHENSIVE HEALTH CARE TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense435698469Expense
Grants1290195Grants
Revenue500159029Revenue
DescriptionMEDICAL SERVICES PROVIDED: OUTPATIENT AND INPATIENT MEDICAL SERVICES WERE PROVIDED WITHOUT REGARD TO ABILITY TO PAY AND WITHOUT DISCRIMINATION AGAINST MEDICARE AND MEDICAID PATIENTS. GUNDERSEN CLINIC, LTD. (THE CLINIC) HAD 1,450,171 OUTPATIENT VISITS DURING THE YEAR, AS WELL AS PROVIDING SERVICES TO 14,756 PATIENTS DURING HOSPITAL STAYS AT GUNDERSEN LUTHERAN MEDICAL CENTER, INC. CHARITY CARE: THE CLINIC PROVIDED UNCOMPENSATED CARE RELATED TO CHARITY, MEDICARE, AND MEDICAID SERVICES IN THE AMOUNT OF APPROXIMATELY $121,783,419 BASED ON POLICIES AND CONTRACTS ARRANGED TO HELP SUPPORT THE COMMUNITY'S NEEDS.Description
Total Program Service Expense435698469TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DARA BARTELSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6087759487TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11900 SOUTH AVENUE NCA1-01AddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerKey EmployeeKeyEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JULIO BIRD MD
EXECUTIVE VICE-PRESIDENT - BOARD OF GOVERNORS2.00XXX065829953187
FRANK ABERGER MD
BOARD OF GOVERNORS - SECRETARY / TREASURER2.00XX044684458187
BRIAN SIECK MD
BOARD OF GOVERNORS - MEMBER2.00X035470459417
STEPHEN SHAPIRO MD
BOARD OF GOVERNORS - MEMBER2.00X041757458917
BRIAN MULRENNAN MD
BOARD OF GOVERNORS - MEMBER2.00X026169258187
JONATHAN ZLABEK MD
BOARD OF GOVERNORS - MEMBER2.00X025258354937
SCOTT RATHGABER MD
BOARD OF GOVERNORS - MEMBER2.00X053815453887
GARY LENTH MD
BOARD OF GOVERNORS - MEMBER2.00X041161658625
WILLIAM AGGER MD
BOARD OF GOVERNORS - MEMBER2.00X024187838293
JEFFREY THOMPSON MD
CHIEF EXECUTIVE OFFICER0.00X067791554687
SIGURD GUNDERSEN III MD
MEDICAL VICE-PRESIDENT0.00X049225453187
MICHAEL J DOLAN MD
MEDICAL VICE-PRESIDENT0.00X043965657617
MARILU BINTZ MD
MEDICAL VICE-PRESIDENT0.00X048853743407
MARY JO KLOS
VICE PRESIDENT0.00X019030747210
DEBRA RISLOW
VICE PRESIDENT0.00X025632449982
KATHLEEN KLOCK
SENIOR VICE PRESIDENT0.00X036242340457
GERALD ARNDT
SENIOR VICE PRESIDENT0.00X035876539557
JANICE DEHAAN
VICE PRESIDENT0.00X024633759326
JAN HOLTROP
REGIONAL EXECUTIVE DIRECTOR0.00X013792642616
DANIEL LANGE MD
MEDICAL DOCTOR0.00077620455687X
JEFFREY LAWRENCE MD
MEDICAL DOCTOR0.000101984453187X
EDWARD RILEY MD
MEDICAL DOCTOR0.00086346461417X
KURT MUELLER MD
MEDICAL DOCTOR0.00081039254399X
RONALD SCHNEIDER DDS
MEDICAL DOCTOR0.00084960650729X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs11415372TotalReportableCompFrmRltdOrgs
Total Other Compensation1214486TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
GUNDERSEN LUTHERAN ADMINISTRATIVE SERVIC
1910 SOUTH AVENUELA CROSSEWI54601PURCHASED SERVICES/SUPPLIES389059476
GUNDERSEN LUTHERAN MEDICAL CENTER INC
1910 SOUTH AVENUELA CROSSEWI54601PURCHASED SERVICES/SUPPLIES86706548
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations248718RelatedOrganizations
Government Grants24617GovernmentGrants
All Other Contributions71904AllOtherContributions
Total Contributions345239TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEDICAL SERV. PROVIDED6241004827588254827577971028
PHARMACY6241001360117113601171
MEDICAL EDUCATION AND62410033460583346058
MEDICAL/ADMINISTRATIVE624100454003454003
FieldValueIRS element (for citing)
Total Program Service Revenue500160057TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3206571TotalRevenueColumn
Exclusion$3,206,571ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real51811Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real30952Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real20859Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column20859TotalRevenueColumn
Exclusion$20,859ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column503732726TotalRevenueColumn
Related Or Exempt Function Income500159029RelatedOrExemptFunctionIncome
Unrelated Business Revenue1028UnrelatedBusinessRevenue
Exclusion$3,227,430ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1290195Total
Program Services1290195ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4483307Total
Program Services4483307ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total207341000Total
Program Services206095455ProgramServices
Management And General1245545ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total23503845Total
Program Services23276994ProgramServices
Management And General226851ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total31718674Total
Program Services30808818ProgramServices
Management And General909856ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11121587Total
Program Services11024703ProgramServices
Management And General96884ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total176Total
Program Services176ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total63232Total
Program Services63232ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total47277447Total
Program Services46015979ProgramServices
Management And General1261468ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total350546Total
Program Services350052ProgramServices
Management And General494ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total50208262Total
Program Services49559921ProgramServices
Management And General648341ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1044648Total
Program Services1042301ProgramServices
Management And General2347ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7792054Total
Program Services4168343ProgramServices
Management And General3623711ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1551890Total
Program Services1530918ProgramServices
Management And General20972ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total790743Total
Program Services787892ProgramServices
Management And General2851ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total22386Total
Management And General22386ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total96956392Total
Program Services28384437ProgramServices
Management And General68571955ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13648864Total
Program Services8514056ProgramServices
Management And General5134808ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1794749Total
Program Services1370081ProgramServices
Management And General424668ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT/COLLECTIONS1510214815102148
RECRUITING874855874011844
DUES/MEMBERSHIPS/LICENS7794727779571515
MISCELLANEOUS534683177493357190

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total518251155Total
Program Services435698469ProgramServices
Management And General82552686ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3519691BOY
EOY6100008EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY56422480BOY
EOY57492493EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1241860BOY
EOY51091EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1780470BOY
EOY1991115EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY865755BOY
EOY770671EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis302507381LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec134653575LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY167633229BOY
EOY167853806EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9230222BOY
EOY10057636EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY60000BOY
EOY60000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY134368367BOY
EOY134590955EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY375122074BOY
EOY378967775EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20444896BOY
EOY22832657EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY296485301BOY
EOY323083264EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY316930197BOY
EOY345915921EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY58191877BOY
EOY33051854EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58191877BOY
EOY33051854EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY375122074BOY
EOY378967775EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-14518429ReconcilationRevenueExpenses
Reconcilation Other Changes-10621594ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: THE CLINIC HAS OBTAINED TAX-EXEMPT STATUS AS AN ORGANIZATION WHOSE MAIN PURPOSE IS TO PROVIDE MEDICAL CARE. HOWEVER, THE CLINIC IS NOT REQUIRED TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE OF WISCONSIN AS A HOSPITAL AND IS NOT REQUIRED TO FILE SCHEDULE H.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 Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals10435FilingOrganizationsTotals
Affiliated Group Totals258826AffiliatedGroupTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals10435FilingOrganizationsTotals
Affiliated Group Totals258826AffiliatedGroupTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals435688034FilingOrganizationsTotals
Affiliated Group Totals993318813AffiliatedGroupTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals435698469FilingOrganizationsTotals
Affiliated Group Totals993577639AffiliatedGroupTotals

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

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals
Affiliated Group Totals0AffiliatedGroupTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals
Affiliated Group Totals0AffiliatedGroupTotals

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 Minus3160921CurrentYearMinus3
Current Year Minus2222185CurrentYearMinus2
Current Year Minus1201660CurrentYearMinus1
Current Year258826CurrentYear
Total843592Total

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 IV, SUPPLEMENTAL INFORMATION:Identifier
ExplanationPART II-A LINE 1A-D: GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC., 1910 S. AVE, LA CROSSE, WI 54601, 39-1606449, LOBBYING EXPENSE - $248,391 OTHER EXEMPT PURPOSE EXPENSE - $159,753,466, GUNDERSEN CLINIC, LTD. 1836 S. AVE, LA CROSSE, WI 54601, 39-1028657 - LOBBYING EXPENSE - $10,435, OTHER EXEMPT PURPOSE EXPENSE - $435,688,034, GUNDERSEN LUTHERAN MEDICAL CENTER, INC., 1910 S. AVE, LA CROSSE, WI 54601 - 39-0813416 - LOBBYING EXPENSE - $0, OTHER EXEMPT PURPOSE EXPENSE - $397,877,313.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8827834OtherCostOrOtherBasis
Book Value8827834BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis188669213OtherCostOrOtherBasis
Depreciation53785712Depreciation
Book Value134883501BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2596880OtherCostOrOtherBasis
Depreciation1520399Depreciation
Book Value1076481BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis102413454OtherCostOrOtherBasis
Depreciation79347464Depreciation
Book Value23065990BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings167853806TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
GUNDERSEN LUTHERAN MEDICAL CENTER/GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES133258898
NONCOMPETE/MEDICAL RECORDS/GOODWILL42577
OTHER RECEIVABLES1060489
GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.228443
GUNDERSEN LUTHERAN HEALTH PLAN, INC.548
FieldValueIRS element (for citing)
Total Book Value Other Assets134590955TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE RESERVE$5,401,486
NOTES PAYABLE - ACQUISITIONS$245,801
GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.$7,017
GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC$315,994,630
ASSET RETIREMENT OBLIGATION$1,434,330
FieldValueIRS element (for citing)
Total Of Amounts323083264TotalOfAmounts
Total Revenue503732726TotalRevenue
Total Expenses518251155TotalExpenses
Excess Or Deficit For Year-14518429ExcessOrDeficitForYear
Net Unrealized GL On Investments-10621594NetUnrealizedGLOnInvestments
Total Adjustments-10621594TotalAdjustments
Excess Or Deficit Per FS-25140023ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt482165053TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-10621594NetUnrealizedGainsInvestments
Other Revenues-63232OtherRevenues
Revenue Not Rptd F990-10684826RevenueNotRptdF990
Revenue Subtotal492849879RevenueSubtotal
Other Revenues Not Included10882847OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt10882847RevenueNotRptdOnFinStmt
Total Revenue Per Form990503732726TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt507305076TotExpensesEtcAuditedFinclStmt
Other Expenses Included-155022OtherExpensesIncluded
Expenses Not Rptd F990-155022ExpensesNotRptdF990
Expenses Subtotal507460098ExpensesSubtotal
Other Expenses Not Included10791057OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt10791057ExpensesNotRptdOnFinStmt
Total Expenses Per Form990518251155TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE 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, 2010 AND 2009. THE OBLIGATED GROUP'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR THE FISCAL YEARS ENDED DECEMBER 31, 2006, AND PRIOR.
PART XII, LINE 2D - OTHER ADJUSTMENTS:INVESTMENT EXPENSES -63,232.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC. GRANTS 185,974. RENTAL EXPENSES -30,952. GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. INVESTMENT ALLOCATION 10,727,825.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 30,952. GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC. GRANTS -185,974.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:INVESTMENT EXPENSES 63,232. GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. INVESTMENT ALLOCATION 10,727,825.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1GUNDERSEN LUTHERAN MEDICAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11836 SOUTH AVENUEAddressLine1
CityLA CROSSECity
StateWIState
ZIP Code54601ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient391249705EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant1269568AmountOfCashGrant
Purpose Of GrantSUPPORT OF THE GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: ASSISTANCE WAS TO A RELATED ORGANIZATION, THUS THE FUNDS ARE MONITORED BY MANAGEMENT AND THE BOARD OF GOVENORS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

Base 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
JULIO BIRD MD
06550510003248035741017446071148600
FRANK ABERGER MD
04430960003748035741022446050503100
BRIAN SIECK MD
03455960545003658035741023676041412100
STEPHEN SHAPIRO MD
0416096011000378035741023176047649100
BRIAN MULRENNAN MD
023459605250021846035741022446031987900
JONATHAN ZLABEK MD
02478460197502762035741019196030752000
SCOTT RATHGABER MD
05343960003758035741018146059204100
GARY LENTH MD
0411388000228035741022884047024100
WILLIAM AGGER MD
023437502500725303531902974028017100
JEFFREY THOMPSON MD
06743070003608035741018946073260200
SIGURD GUNDERSEN III MD
047859601005003608035741017446054544100
MICHAEL J DOLAN MD
0405396010000024260035741021876049727300
MARILU BINTZ MD
04749290100000360803574107666053194400
MARY JO KLOS
01903070000027908019302023751700
DEBRA RISLOW
0255964000360035741014241030630600
KATHLEEN KLOCK
03524230100000003574104716040288000
GERALD ARNDT
03487650100000003574103816039832200
JANICE DEHAAN
02447750001562035741023585030566300
DANIEL LANGE MD
07720960004108035741019946083189100
JEFFREY LAWRENCE MD
0101659600032480357410174460107303100
EDWARD RILEY MD
08630960350018035741025676092488100
KURT MUELLER MD
0806384040003608035741018658086479100
RONALD SCHNEIDER DDS
076625200083354035741014988090033500

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationPART I, LINE 1A, 2, AND 3. ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. AND ALL PAYMENTS TO VENDORS ARE MADE BY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TAX EXEMPT BONDSFORM 990, PART IV, LINE 24AGUNDERSEN LUTHERAN CLINIC, INC. IS PART OF THE OBLIGATED GROUP (GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC., GUNDERSEN LUTHERAN MEDICAL CENTER, INC., GUNDERSEN CLINIC, LTD., AND GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC.) AND TAX-EXEMPT DEBT RESIDES ON THE GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FEIN 39-1606449.
FORM 990, PART VI, SECTION A, LINE 6GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11THE GUNDERSEN LUTHERAN HEALTH SYSTEM FINANCE COMMITTEE RECEIVES A COPY OF THE 990 BEFORE FILING AND UPON FURTHER REVIEW FROM THE ACCOUNTING MANAGER, CONTROLLER AND CFO THE 990 IS APPROVED AND FILED.
FORM 990, PART VI, SECTION B, LINE 12CGUNDERSEN CLINIC, LTD. MONITORS CONFLICTS ON AN ANNUAL BASIS BY REVIEWING DISCLOSURES ON COMPLETED CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15ALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. THE COMPENSATION OF THE CEO IS DETERMINED ANNUALLY BY A COMMITTEE MADE UP OF THE COMMUNITY MEMBERS OF THE BOARD OF TRUSTEES. THEIR DETERMINATION IS MADE AFTER A REVIEW OF MARKET DATA OBTAINED FROM SEVERAL ORGANIZATIONS AND CEO PERFORMANCE. MEETING MINUTES ARE TAKEN AND KEPT AT THE MEETINGS WHERE SUCH DISCUSSIONS TAKE PLACE. RECOMMENDATIONS FOR COMPENSATION FOR THE ORGANIZATIONS' KEY MANAGEMENT EMPLOYEES ARE DEVELOPED ANNUALLY BY THE CEO, AFTER A REVIEW OF PERFORMANCE AND COMPARABLE MARKET DATA. THE COMPENSATION RECOMMENDATIONS, ALONG WITH THE MARKET DATA, ARE PRESENTED TO A COMMITTEE MAKE 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 19REQUESTS FOR ALL DOCUMENTS ARE MADE THROUGH THE LEGAL DEPARTMENT AND THE APPROPRIATE DOCUMENTS ARE MADE AVAILABLE FOR INSPECTION IN THE LEGAL DEPARTMENT.
FORM 990, PART VII, SECTION AALL PERSONNEL SERVICES FOR GUNDERSEN CLINIC, LTD. ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC.
FORM 990, PART VII, SECTION BALL PAYMENTS TO VENDORS ARE MADE BY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC.
FORM 990, PART VII, SECTION AHOURS WORKED BY OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES BY ENTITY: JEFFREY THOMPSON - WORKS 40 HOURS FOR RELATED ORGANIZATIONS JULIO BIRD - WORKS 40 HOURS FOR RELATED ORGANIZATIONS MARILU BINTZ - WORKS 40 HOURS FOR RELATED ORGANIZATIONS MICHAEL DOLAN - WORKS 40 HOURS FOR RELATED ORGANIZATIONS SIGURD GUNDERSEN III - WORKS 40 HOURS FOR RELATED ORGANIZATIONS GARY LENTH - WORKS 40 HOURS FOR RELATED ORGANIZATIONS JOHN ZLABEK - WORKS 40 HOURS FOR RELATED ORGANIZATIONS MARY JO KLOS - WORKS 40 HOURS FOR RELATED ORGANIZATIONS DEBRA RISLOW - WORKS 40 HOURS FOR RELATED ORGANIZATIONS KATHLEEN KLOCK - WORKS 40 HOURS FOR RELATED ORGANIZATIONS GERALD ARNDT - WORKS 40 HOURS FOR RELATED ORGANIZATIONS JANICE DEHAAN - WORKS 40 HOURS FOR RELATED ORGANIZATIONS
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -10,621,594.
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.
FORM 990, PART VIII, LINE 2ATHE PROVISION OF MEDICAL SERVICES IN A MANNER BENEFICIAL TO THE COMMUNITY FURTHERS GUNDERSEN CLINIC, LTD.'S CHARITABLE PURPOSE OF PROMOTION OF HEALTH.
PART VIII, LINE 2CTHE PROVISION OF MEDICAL EDUCATION AND RESEARCH FURTHERS THE GUNDERSEN CLINIC, LTD.'S CHARITABLE PURPOSE OF ADVANCEMENT OF EDUCATION AND RESEARCH DEVELOPMENT.
FORM 990, PART VIII, LINE 2DPROVISION OF MEDICAL/ADMINISTRATIVE SERVICES TO GUNDERSEN LUTHERAN HEALTH PLAN, INC. IMPROVES THE COMMUNITY'S ACCESS TO HEALTH CARE, FURTHERING THE CHARITABLE PURPOSE OF PROMOTION OF HEALTH.
FORM 990, PART VIII, LINE 2BTHE PHARMACIES ARE LOCATED IN MAIN GUNDERSEN CLINIC, LTD.'S BUILDINGS FOR THE CONVENIENCE OF GUNDERSEN CLINIC, LTD. PATIENTS AND, THEREFORE, FURTHERS THE CHARITABLE PURPOSE OF PROMOTION OF HEALTH.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GL BIOGAS I LLC
1836 SOUTH AVENUELA CROSSEWI54601273726088RENEWABLE ENERGYWI-5768484400GUNDERSEN LUTHERAN ENVISION LLC
GL BIOGAS II LLC
1836 SOUTH AVENUELA CROSSEWI54601273726267RENEWABLE ENERGYWI-5500GUNDERSEN LUTHERAN ENVISION LLC

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GUNDERSEN LUTHERAN HEALTH SYSTEM INC
1836 SOUTH AVENUELA CROSSEWI54601391866425SUPPORTING ORGWI501(C)(3)LINE 7N/A0
GUNDERSEN LUTHERAN MEDICAL CENTER INC
1910 SOUTH AVENUELA CROSSEWI54601390813416HEALTH CAREWI501(C)(3)LINE 3N/A0
GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC
1836 SOUTH AVENUELA CROSSEWI54601391249705FOUNDATIONWI501(C)(3)LINE 7N/A0
GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC
1910 SOUTH AVENUELA CROSSEWI54601391606449SUPPORTING ORGWI501(C)(3)LINE 11B, IIN/A0
GUNDERSEN LUTHERAN HEALTH PLAN INC
1836 SOUTH AVENUELA CROSSEWI54601391807071HEALTH INSURANCEWI501(C)(4)N/A0
GUNDERSEN LUTHERAN CREDENTIALING SERVICES INC
1910 SOUTH AVENUELA CROSSEWI54601391856898CREDENTIALING SERVICESWI501(C)(3)LINE 11A, IN/A0
TRI-COUNTY MEMORIAL HOSPITAL INC
18601 LINCOLN STREETWHITEHALLWI54773390704510HEALTH CAREWI501(C)(3)LINE 3N/A0
HARMONY COMMUNITY HEALTHCARE INC
815 MAIN AVENUE SHARMONYMN55939410711606HEALTH CAREMN501(C)(3)LINE 3N/A0
TWEETEN LUTHERAN HEALTHCARE CENTER INC
125 FIFTH AVENUE SESPRING GROVEMN55974411565003HEALTH CAREMN501(C)(3)LINE 3N/A0
TRI-STATE AMBULANCE INC
221 BUCHNER PLACELA CROSSEWI54601391965415MEDICAL TRANSPORATIONWI501(C)(3)LINE 3N/A0
GUNDERSEN LUTHERAN COULEE TRAILS INC
126 1/2 W JEFFERSONVIROQUAWI54665391962965MEDICAL TRANSPORATIONWI501(C)(3)LINE 9N/A0
LUTHERAN REAL ESTATE HOLDING CORPORATION
1910 SOUTH AVENUELA CROSSEWI54601391480826HOUSINGWI501(C)(3)LINE 9N/A0
LUTHERAN HOUSING OF LA CROSSE INC
1900 SOUTH AVENUELA CROSSEWI54601391751934INDEPENDENT LIVINGWI501(C)(3)LINE 90LUTHERAN REAL ESTATE HOLDING CORPORATION
COMMUNITY HOUSING OF LA CROSSE INC
1900 SOUTH AVENUELA CROSSEWI54601391586700INDEPENDENT LIVINGWI501(C)(3)LINE 70LUTHERAN REAL ESTATE HOLDING CORPORATION
OPTIONS IN REPRODUCTIVE CARE INC
1201 CALEDONIA STREETLA CROSSEWI54603391166634HEALTH CAREWI501(C)(3)LINE 3N/A0

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 OwnershipPercentageOwnership
DEGEN BERGLUND INC
1709 LOSEY BLVD SLA CROSSEWI54601390971110RETAIL PHARMACYWIGUNDERSEN LUTHERAN HEALTH SYSTEM INCC-22880144735601.00000
GUNDERSEN LUTHERAN ENVISION LLC
1836 SOUTH AVENUELA CROSSEWI54601264706546RENEWABLE ENERGYWIGUNDERSEN LUTHERAN HEALTH SYSTEM INCC-32631516671081.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GUNDERSEN LUTHERAN HEALTH PLAN INC
Q75432274FAIR VALUE
GUNDERSEN LUTHERAN HEALTH PLAN INC
O147559FAIR VALUE
GUNDERSEN LUTHERAN HEALTH PLAN INC
E500000FAIR VALUE
GUNDERSEN LUTHERAN HEALTH PLAN INC
D55552FAIR VALUE

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