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0 0 BELLIN COLLEGE INC 391620530 2 true 0 0 THE BELLIN HEALTH FOUNDATION INC 391809171 7 true 0 0 20 0 0 false false false false false true false false false false false false false false false false SCHEDULE A, PART I, LINE 12G INFORMATION ON SUPPORTED ORGANIZATIONS GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. 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. SCHEDULE A, PART I, LINE 12G ORGANIZATIONS NOT LISTED IN GOVERNING DOCUMENT GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. SUPPORTS THE FOLLOWING ORGANIZATIONS THAT ARE 501(C)(3) PUBLIC CHARITIES AFFILIATED WITH THE SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION A, LINE 1 SUPPORTED ORGS LISTED BY NAME THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501 (C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE AS AMENDED (HEREINAFTER THE "INTERNAL REVENUE CODE"). THE CORPORATION'S ACTIVITIES SHALL BE CARRIED OUT EXCLUSIVELY TO SUPPORT, OPERATE FOR THE BENEFIT OF, PERFORM THE FUNCTIONS OF, AND CARRY OUT SOME OR ALL OF THE CHARITABLE PURPOSES OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC, GUNDERSEN CLINIC, LTD., GUNDERSEN LUTHERAN MEDICAL CENTER, INC., AND THEIR NONPROFIT AFFILIATES (HEREINAFTER REFERRED TO AS THE "HEALTH SYSTEM") SO LONG AS THOSE ORGANIZATIONS ARE DESCRIBED IN EITHER SECTION 509 (A)(1) OR 509 (A)(2) OF THE INTERNAL REVENUE CODE (OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW). SCHEDULE A, PART IV, SECTION A, LINE 6 SUPPORT TO OTHER SUPPORTED ORGS GENERAL SERVICES PROVIDED TO GUNDERSEN LUTHERAN MEDICAL FOUNDATION, INC. AND OTHER AFFILIATES: ADMINISTRATIVE, INFORMATION SYSTEMS, BILLING AND CODING, LAUNDRY, MEDICAL RECORDS, HUMAN RESOURCES, FINANCE, FACILITY OPERATIONS, CENTRAL SERVICES AND OTHER MISCELLANEOUS SERVICES. GLAS ALSO GIVES GRANTS TO QUALIFIED 501(C)(3) PUBLIC CHARITIES AND GOVERNMENTAL ENTITIES THAT SUPPORT THE MISSION OF GLAS AND THE ORGANIZATIONS THEY SUPPORT. SCHEDULE A, PART IV, SECTION C, LINE 1 MAJORITY DIRECTOR DETAIL PURSUANT TO THE BYLAWS OF THE SUPPORTED ORGANIZATIONS, THE CORPORATION EITHER HAS A MAJORITY OF THE SAME DIRECTORS AS THE SUPPORTED ORGANIZATION OR HAS THE POWER TO APPOINT A MAJORITY OF THE DIRECTORS OR TRUSTEES OF THE SUPPORTED ORGANIZATION. IN ADDITION, THE CHIEF EXECUTIVE OFFICER, AND PRESIDENT OF ONE OR MORE OF THE SUPPORTED ORGANIZATIONS ARE THE SAME PERSONS WHO ARE THEN SERVING AS THE CHIEF EXECUTIVE OFFICER AND PRESIDENT OF THE CORPORATION AS A RESULT, THE OFFICERS AND DIRECTORS OF THE CORPORATION AND THE OFFICERS AND DIRECTORS OF EACH OF THE SUPPORTED ORGANIZATIONS OVERLAP CONSIDERABLY. ACCORDINGLY, THE OFFICERS AND DIRECTORS OF THE CORPORATION AND THE OFFICERS AND DIRECTORS OF EACH SUPPORTED ORGANIZATION MAINTAIN A CLOSE AND CONTINUOUS WORKING RELATIONSHIP. IN THIS WAY, THE SUPPORTED ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN THE CORPORATION'S OPERATIONS, INCLUDING THE DEVELOPMENT OF ITS POLICIES, PROGRAMS, AND ACTIVITIES, INCLUDING ITS INVESTMENT POLICIES, AND OTHERWISE DIRECTING THE USE OF THE CORPORATION'S INCOME AND ASSETS OF THE CORPORATION. IN SUMMARY, THE CORPORATION EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF THE SUPPORTED ORGANIZATION AND A MAJORITY OF THE OFFICERS, DIRECTORS, OR TRUSTEES OF THE SUPPORTED ORGANIZATION IS APPOINTED OR ELECTED, DIRECTLY OR INDIRECTLY, BY THE GOVERNING BODY, MEMBERS OF THE GOVERNING BODY, OR OFFICERS (ACTING IN THEIR OFFICIAL CAPACITY) OF THE CORPORATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 437650 470625 437650 470625 1205516671 3192999412 1205954321 3193470037 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 242027 276873 429679 470625 1419204 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 SCHEDULE C, PART II-A, LINE 2C, COLUMN (E) THE 4-YEAR AVERAGE PERIOD INCLUDES THE CURRENT AND 4 PRIOR TAX PERIODS, WHICH EXCLUDES A SHORT YEAR PERIOD FROM JANUARY 1, 2023, THROUGH SEPTEMBER 30, 2023. THE 4 PERIODS INCLUDED IN THE AVERAGE ARE 2022, SHORT YEAR 2023, FISCAL YEAR 2023, AND FISCAL YEAR 2024. 10255062 10255062 147511542 56721360 90790182 141304197 114598181 26706016 86065439 59503163 26562276 154313536 FEDERAL INCOME TAXES INTERCOMPANY PAYABLE 503890984 LOSS ON SWAP CONTRACTS 4575419 OPERATING LEASE OBLIGATIONS 3518429 LT CIMP LIABILIATY/OTHER LIABILITIES 9992496 TEB PRE/(DISC) CURRENT AND LT 12985481 SECURITY DEPOSIT PAYABLE 77997 DEFERRED REVENUE SALES TAX PAYABLE LT DEBT NET OF CURRENT MATURITIES 535040806 X 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART X, LINE 2 THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, AND HAVE BEEN FULLY RESERVED. true VARC INC 1133 NELSON PARKWAY VIROQUA WI 54665 391211167 501 (C) 3 165000 OPERATIONS SUPPORT LA CROSSE AREA FAMILY YMCA 1140 MAIN STREET LA CROSSE WI 54601 390806172 501 (C) 3 77500 OPERATIONS SUPPORT SAINT CLARE HEALTH MISSION 916 FERRY STREET LA CROSSE WI 54601 823903651 501 (C) 3 75000 OPERATIONS SUPPORT LA CROSSE MEDICAL HEALTH SCIENCE CONSORTIUM 1725 STATE STREET LA CROSSE WI 54601 391804725 501 (C) 3 68304 OPERATIONS SUPPORT GREAT RIVERS UNITED WAY 1855 EAST MAIN ST ONALASKA WI 54650 390848188 501 (C) 3 55750 OPERATIONS SUPPORT MINNESOTA STATE COLLEGE 1250 HOMER ROAD WINONA MN 55987 411540247 501 (C) 3 50000 OPERATIONS SUPPORT LA CROSSE AREA CHAMBER OF COMMERCE 601 7TH ST N LA CROSSE WI 54601 390414500 501 (C) 6 35050 OPERATIONS SUPPORT KARUNA INC 315 3RD ST SOUTH UNIT 620 LA CROSSE WI 54601 872587965 501 (C) 3 35000 OPERATIONS SUPPORT NEW HORIZONS SHELTER AND OUTREACH CENTERS PO BOX 2031 LA CROSSE WI 54601 391737699 501 (C) 3 35000 OPERATIONS SUPPORT FAMILY AND CHILDRENS CENTER 1707 MAIN ST LA CROSSE WI 54601 390821863 501 (C) 3 30000 OPERATIONS SUPPORT LA CROSSE COUNTY TREASURER 212 6TH ST N LA CROSSE WI 54601 396005709 GOVERNMENT ENTITY 30000 OPERATIONS SUPPORT SUNFLOWER CHILD DEVLOPMENT CENTER 300 IOWA HIGHWAY 9 DECORAH IA 52101 421036817 501 (C) 3 25000 OPERATIONS SUPPORT CIA SIAB INC 1825 SUNSET LANE LA CROSSE WI 54601 813606765 501 (C) 3 20000 OPERATIONS SUPPORT LA CROSSE SYMPHONY ORCHESTRA 201 MAIN ST SUITE 230 LA CROSSE WI 54601 391024330 501 (C) 3 20000 OPERATIONS SUPPORT ADULT & TEEN CHALLENGE OF WESTERN WISCONSIN INC 2507 WESTON ST LA CROSSE WI 546016851 822144057 501 (C) 3 20000 OPERATIONS SUPPORT BOYS AND GIRLS CLUBS OF GREATER LA CROSSE PO BOX 91 LA CROSSE WI 54602 396084791 501 (C) 3 20000 OPERATIONS SUPPORT NORTHEAST IOWA MENTAL HEALTH CENTER PO BOX 349 DECORAH IA 52101 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443536 0 0 CHRISTINE WOLESKE PRESIDENT, (END 7.1.25) 0 947182 0 728601 0 212756 0 185351 0 15782 0 2089672 0 201125 LEANNE ANDERSEN CHIEF PEOPLE OFFICER 558734 0 116418 0 5270 0 43827 0 27987 0 752236 0 0 0 PRAVEEN CHOPRA CHIEF DIGITAL AND INFORMATION OFFICER 602977 0 106400 0 8424 0 48300 0 29546 0 795647 0 0 0 WILLIAM FARRELL CHIEF STRATEGY & INNOVATION OFFICER 487426 0 103225 0 4775 0 48300 0 339 0 644065 0 0 0 JERRY DAVIS PHYSICIAN 1118021 0 0 0 5255 0 34500 0 23667 0 1181443 0 0 0 DOUGLAS HUGHES PHYSICIAN 1222337 0 0 0 4607 0 43613 0 23667 0 1294224 0 0 0 JEFFREY LAWRENCE PHYSICIAN 1063004 0 0 0 5807 0 48300 0 23667 0 1140778 0 0 0 MARK TOPOLSKI PHYSICIAN 1305468 0 0 0 4775 0 48300 0 23875 0 1382418 0 0 0 STEVEN WHITFORD PHYSICIAN 1170639 0 2000 0 4782 0 48300 0 26867 0 1252588 0 0 0 KARI ADANK VICE PRESIDENT, COMPLIANCE 268610 0 0 0 1032 0 37844 0 22296 0 329782 0 0 0 MARILU BINTZ MD FORMER MEDICAL VP, COMMUNITY AND CMO-CRITICAL ACCESS HOSPITALS, MD 109201 0 100000 0 51959 0 36295 0 2332 0 299787 0 0 0 STEPHANIE CARROLL MD MEDICAL VICE PRESIDENT, MD 305920 0 15667 0 688 0 39470 0 27699 0 389444 0 0 0 ERIC DEHN VICE PRESIDENT, DIGITAL SOLUTIONS AND ENTERPRISE ARCHITECTURE 312797 0 0 0 609 0 44118 0 21590 0 379114 0 0 0 JANINE LUZ-JENSEN VICE PRESIDENT, TALENT ACQUISITION, TALENT DEVELOPMENT, & LEARNING 241385 0 0 0 4678 0 34216 0 18547 0 298826 0 0 0 KRISTER MATTSON VICE PRESIDENT, ENTERPRISE ANALYTICS AND DATA SCIENCE 305177 0 0 0 428 0 38458 0 17745 0 361808 0 0 0 SHANNON MULLIGAN VICE PRESIDENT, HR & TOTAL REWARDS 232590 0 0 0 55988 0 9464 0 10406 0 308448 0 0 0 ELLEN PEDRETTI-FENDT VICE PRESIDENT, BUSINESS PARTNERING AND SERVICE DELIVERY 226752 0 0 0 1912 0 32340 0 26788 0 287792 0 0 0 STEPHEN SHAPIRO MD CHIEF MEDICAL FOUNDATION OFFICER, MD 547371 0 0 0 1109 0 48300 0 15670 0 612450 0 0 0 JONI OLSON FORMER ADMINISTRATOR 165292 0 0 0 4098 0 23561 0 17662 0 210613 0 0 0 SCHEDULE J, PART I, LINE 1A FIRST-CLASS OR CHARTER TRAVEL CHARTER AIRFARE WAS UTILIZED BY 18 DIRECTORS AND OFFICERS FOR BUSINESS PURPOSES AND THEREFORE NOT REPORTABLE AS COMPENSATION SCHEDULE J, PART I, LINE 1A HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE A HOUSING ALLOWANCE FOR SCOTT RATHGABER WAS INCLUDED IN TAXABLE COMPENSATION. SCHEDULE J, PART I, LINE 4A SEVERANCE OR CHANGE-OF-CONTROL PAYMENT SHANNON MULLIGAN RECEIVED SEVERANCE PAYMENTS DURING THE CALENDAR YEAR PURSUANT TO A CONFIDENTIAL SEVERANCE AGREEMENT. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D AND SCHEDULE J, PART II, COLUMN B(III). SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN FOR CALENDAR YEAR 2024: CHRISTINE WOLESKE PETER VANDENHOUTEN JOHN CEELEN LISA HARTON ANDREA WERNER CINDY LASECKI, MD BELLIN MEMORIAL HOSPITAL, A RELATED PARTY, HAS A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. CHRISTINE WOLESKE AND PETER VANDENHOUTEN PARTICIPATED IN THE 457(F) PLAN. THE FOLLOWING INDIVIDUAL, LISTED ON PART VII OF FORM 990, HAD THE FOLLOWING AMOUNTS DISTRIBUTED DURING CALENDAR YEAR 2024: CHRISTINE WOLESKE $201,125 PETER VANDENHOUTEN $39,255 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES PROVIDES QUARTERLY BONUSES FOR EMPLOYEES WHO TAKE ON INTERIM LEADERSHIP DUTIES. SCHEDULE J, PART I, LINE 3 ALL PERSONNEL SERVICES ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2021A ISSUANCE 391337855 97712JBU6 2021-08-12 117893194 SEE PART VI false false false B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2016 ISSUANCE 391337855 2016-02-12 40000000 SEE PART VI false false false C WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2009A AND 2009 B ISSUANCE 391337855 2012-10-01 78715000 SEE PART VI false false false D WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2008B ISSUANCE 391337855 97710BBG6 2012-10-01 61400000 SEE PART VI false false false A 0 0 117893194 0 0 0 1202288 0 0 0 116690906 0 2021 true false true true B 0 0 40000000 0 0 0 0 0 0 0 40000000 0 2016 true false true true C 31815000 0 78715000 0 0 0 0 0 0 0 78715000 0 2005 true false true true D 23675000 0 61400000 0 0 0 0 0 0 0 61400000 0 2008 true false true true A false true false false false false 0.0027 0.0 0.0027 false false 0 false true B false false false false false false 0.0 0.0 0.0 false false 0 false true C false true false false false false 0.0008 0.0 0.0008 false true 0.0051 true true D false false false false false false 0.0 0.0 0.0 false true 0.0 true true A false false true false false false 0 false false false 0 false false true B false false true false true false 0 false false false 0 false false true C false false true false true true MORGANMERRILL 29.5 true false false 0 false false true D false false true false true true MERRILL 27.0 true false false 0 false false true A true B true C true D true SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND A: PROCEEDS OF THE SERIES 2021A BONDS WERE USED TO CURRENTLY REFUND THE 2011A SERIES ORIGINALLY ISSUED 9/29/2011 AND PAY COSTS OF ISSUANCE. THE SERIES 2011A BOND PROCEEDS WERE USED TO CURRENTLY REFUND IN THEIR ENTIRETY THE SERIES 2000A AND 2000B ORIGINALLY ISSUED 10/10/2000. SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND B: PROCEEDS OF THE SERIES 2016 BONDS WERE USED TO CURRENTLY REFUND, IN THEIR ENTIRETY, THE WISCONSIN HEALTH AND EDUCATIONAL FACILITY VARIABLE RATE REVENUE BONDS, SERIES 2011B (GUNDERSEN LUTHERAN). SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND C: PROCEEDS OF THE SERIES 2009A AND 2009B BONDS WERE USED TO FINANCE CONSTRUCTION AND EQUIPPING OF HOSPITAL FACILITIES AND CURRENTLY REFUND THE SERIES 2003B AND 2003C BONDS. SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND D: PROCEEDS OF THE SERIES 2008B BONDS WERE USED TO FINANCE THE REPAYMENT OF A LINE OF CREDIT USED TO REFUND THE SERIES 2006 BONDS, WHICH FINANCED THE CONSTRUCTION AND EQUIPPING OF HEALTH CARE FACILITIES, AND PAID COSTS OF ISSUANCE. SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND E: PROCEEDS OF THE SERIES 2022 BONDS WERE USED TO CURRENTLY REFUND IN THEIR ENTIRETY THE 2012 SERIES ORIGINALLY ISSUED 9/27/2012 AND TO PAY COSTS OF ISSUANCE. THE SERIES 2012 BONDS WERE USED TO CONSTRUCT AND EQUIP A CLINIC. SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND F: THE SERIES 2015 BONDS FINANCED THE CONSTRUCTION AND EQUIPPING OF A CLINIC. INVESTMENT EARNINGS IS THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS OF THE ISSUE. SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE BOND G: SERIES 2020A BONDS FINANCED THE CONSTRUCTION AND EQUIPPING OF A CLINIC. INVESTMENT EARNINGS IS THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE TOTAL PROCEEDS OF THE ISSUE. SCHEDULE K, PART II, LINE 3 TOTAL PROCEEDS OF ISSUE BOND F: FOR SERIES 2015 BONDS, THE DIFFERENCE BETWEEN THE ISSUE PRICE AND TOTAL PROCEEDS OF THE ISSUE IS DUE TO $44,549.90 IN INVESTMENT EARNINGS (INTEREST). SCHEDULE K, PART II, LINE 3 TOTAL PROCEEDS OF ISSUE BOND G: FOR SERIES 2020A BONDS, THE DIFFERENCE BETWEEN THE ISSUE PRICE AND TOTAL PROCEEDS OF THE ISSUE IS DUE TO $184.28 IN INVESTMENT EARNINGS (INTEREST). SCHEDULE K, PART III, LINE 7 PRIVATE SECURITY OR PAYMENT TEST HISTORICALLY, GUNDERSEN RESPONDED "YES" TO THIS QUESTION TO CONSERVATIVELY RESPOND AND TO REFLECT THAT IT DID MONITOR THE PRIVATE SECURITY TEST; GUNDERSEN IS NOW RESPONDING "NO" BECAUSE THERE IS NO PRIVATE USE, WHICH GUNDERSEN CAREFULLY MONITORS AND MANAGES. SCHEDULE K, PART III, LINE 8A SALE OF BONDFINANCED PROPERTY GUNDERSEN SOLD LOADING DOCK ASSET FROM THE 2008B BONDS. BONDS ALLOCABLE TO THE SALE PROCEEDS OF THAT ASSET IN AN AMOUNT OF $800.00 WERE REDEEMED ON 7/15/15 IN ORDER TO REMEDIATE THAT SALE. IN 2019, GUNDERSEN SOLD A BOND FINANCED ASSET FROM THE 2003 ISSUANCE FINANCED WITH THE PROCEEDS OF THE SERIES, REFUNDED BY THE SERIES 2009 BONDS, WHICH WAS SOLD AFTER ITS 15-YEAR USEFUL LIFE AND THEREFORE IS NOT REPORTED HERE. SCHEDULE K, PART IV, LINE 4B *MORGAN STANLEY CAPITAL SERVICES, LLC. **MERRILL LYNCH CAPITAL SERVICES, INC. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2022 ISSUANCE 391337855 2022-11-15 68505000 SEE PART VI false false false B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2015 ISSUANCE 391337855 2015-12-23 12000000 SEE PART VI false false false C WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY SERIES 2020A ISSUANCE 391337855 97712D654 2020-03-24 25002968 SEE PART VI false false false A 625000 0 68505000 0 0 0 250000 0 0 0 68255000 0 2022 true false true true B 10685000 0 12044550 0 0 0 0 0 0 12044550 0 0 2017 false false true true C 0 0 25003152 0 0 0 0 0 0 25003152 0 0 2020 false false true true A false false false false false false 0.0 0.0 0.0 false false 0 false true B false false false false false false 0.0 0.0 0.0 false false 0 false true C false false false false false false 0.0 0.0 0.0 false false 0 false true A false false true false false false 0 false false false 0 false false true B false false true false true false 0 false false false 0 false false true C false true false false false false 0 false false false 0 false false true A true B true C true DANIEL BREAZEALE EMPLOYEE - VP FINANCE SIGNING BONUS/RELOCA TION X 30000 6762 true true true 6762 APRIL FARRELL MD FAMILY MEMBER OF WILLIAM FARRELL, KEY EMPLOYEE, GLAS 1004154 EMPLOYMENT false EMILY DOLAN MD FAMILY MEMBER OF MICHAEL DOLAN, OFFICER, GLAS 401938 EMPLOYMENT false EVAN DOLAN FAMILY MEMBER OF MICHAEL DOLAN, OFFICER, GLAS 255613 EMPLOYMENT false JAMES KLEVEN MD FAMILY MEMBER OF JENNIFER KLEVEN, M.D., DIRECTOR, GLAS 556143 EMPLOYMENT false KARL BORGE MD FAIMLY MEMBER OF ROBYN BORGE, OFFICER, GLAS 284191 EMPLOYMENT false KATIE HAYES FAMILY MEMBER OF WILLIAM FARRELL, KEY EMPLOYEE, GLAS 10003 EMPLOYMENT false SHANNAN STEPHENS MD FAMILY MEMBER OF KELLEY BAHR, M.D., OFFICER, GLAS 389112 EMPLOYMENT false FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY THE CORPORATE MEMBER, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., HAS THE POWER TO APPOINT BOARD MEMBERS FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS 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, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 IS REVIEWED BY THE ACCOUNTING MANAGER AND PRINCIPAL OFFICER. IT WILL BE MADE AVAILABLE FOR ALL BOARD MEMBERS BEFORE FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. (GLAS) ANNUALLY REQUIRES EXECUTIVE LEADERSHIP (VICE PRESIDENTS AND ABOVE), BOARD MEMBERS, MEDICAL GOVERNORS AND FOUNDATION BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED DISCLOSURE STATEMENTS ARE REVIEWED BY A CONFLICT OF INTEREST REVIEW PANEL WHICH INCLUDES REPRESENTATIVES FROM LEGAL, COMPLIANCE, MEDICAL LEADERSHIP, HUMAN RESOURCES AND SUPPLY CHAIN. INDIVIDUALS REPORTING A POTENTIAL CONFLICT OF INTEREST ARE SENT A RESOLUTION THANKING THEM FOR THEIR SERVICE TO THE ORGANIZATION, ADVISING THEM OF ANY RESTRICTIONS RELATED TO THEIR CONFLICT (I.E. INDIVIDUALS WITH A RELATIONSHIP TO ANOTHER ORGANIZATION ARE ADVISED THAT THEY MUST ABSTAIN FROM DECISION MAKING THAT WOULD DIRECTLY AND SOLELY IMPACT GLAS) AND REMINDING THEM OF THEIR CONFIDENTIALITY OBLIGATIONS WITH RESPECT TO GLAS' HEALTHCARE, EMPLOYMENT AND PROPRIETARY INFORMATION. FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. CEO COMPENSATION: CEO PRESENTS RESULTS OF PERFORMANCE OBJECTIVES TO THE EXECUTIVE COMMITTEE IN JANUARY OF EACH YEAR. THE CHAIR APPLIES A FORMULA TO THE RESULTS AND COMES UP WITH A RECOMMENDATION. THE CHAIR FACILITIES GETTING APPROVAL FROM OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES SENIOR LEADERS: COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC REQUESTS FOR ALL DOCUMENTS ARE MADE THROUGH THE LEGAL DEPARTMENT, AND THE APPROPRIATE DOCUMENTS ARE MADE AVAILABLE FOR INSPECTION IN THE LEGAL DEPARTMENT. 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