2026-08-13T16:55:01+00:00 2025-09-30 135565207 KPMG LLP 200 EAST RANDOLPH DRIVE SUITE 5500 CHICAGO IL 606016436 990 2024-10-01 390845590 MEMORIAL HOSPITAL OF BOSCOBEL MEMO 6083754112 205 PARKER STREET BOSCOBEL WI 53805 JENNIFER BOIGENZAHN FINANCE ADMINISTRATOR 2026-08-13 true ZELJKO POPOVIC P01795951 3126651000 2026-08-12 2024 2025-03-06 01:10:19Z GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS JENNIFER BOIGENZAHN 205 PARKER STREET BOSCOBEL WI 53805 38693047 false X WWW.GUNDERSENHEALTH.ORG/BOSCOBEL X 1952 WI TOGETHER, WE INSPIRE YOUR BEST LIFE BY RELENTLESSLY CARING, LEARNING AND INNOVATING. 7 4 219 50 0 0 256555 36610 34506649 37352728 844080 1122667 43021 181042 35650305 38693047 0 897252 0 0 17080110 16230324 0 0 0 14297519 18456633 31377629 35584209 4272676 3108838 41476573 50638732 3528380 8880129 37948193 41758603 X LEADING WITH LOVE, WE COURAGEOUSLY COMMIT TO A FUTURE OF HEALTHY PEOPLE AND THRIVING COMMUNITIES. true false 23935480 897252 30414447 GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS ("THE ORGANIZATION") PROVIDES INPATIENT, OUTPATIENT, EMERGENCY HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. SERVICES PROVIDED TO PATIENTS INCLUDE COLONOSCOPIES, LAPAROSCOPIC SURGERIES, AND KNEE REPLACEMENTS, AMONG OTHERS. THE ORGANIZATION IS AFFILIATED WITH GUNDERSEN HEALTH SYSTEM. THIS AFFILIATION PROVIDES LOCAL SERVICES IN CARDIOLOGY, NEUROLOGY, PODIATRY, DERMATOLOGY, UROLOGY, AND VASCULAR MEDICINE AS WELL AS MANY OTHER SERVICES. CONSISTENT WITH THE MISSION OF THE ORGANIZATION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE EITHER UNDERINSURED OR WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS THE MEDICAID PROGRAM, ARE ALSO CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE. (SEE ADDITIONAL INFORMATION REGARDING THE COST OF PROVIDING SERVICES TO MEDICAID PATIENTS IN SCHEDULE H OF THE FORM 990.) PATIENTS WHO MEET CERTAIN CRITERIA FOR CHARITY CARE, GENERALLY BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE AT A SIGNIFICANTLY REDUCED RATE, DETERMINED BASED ON QUALIFYING CRITERIA AS DEFINED IN THE ORGANIZATION'S CHARITY CARE POLICY AND FORM APPLICATIONS COMPLETED BY PATIENTS AND THEIR FAMILIES. (SEE ADDITIONAL INFORMATION REGARDING THE COST OF PROVIDING SERVICES TO CHARITY CARE RECIPIENTS IN SCHEDULE H OF THE FORM 990.) BENEFITS FOR SERVING THE COMMUNITY ALSO INCLUDE UNPAID COSTS OF TREATING THE ELDERLY, HEALTH SCREENINGS, COMMUNITY EDUCATION THROUGH SEMINARS AND CLASSES, AND OTHER HEALTH-RELATED SERVICES. DURING FY25, THERE WERE 326 MEDICAL/SURGICAL INPATIENT DAYS, 1,435 SWING BED DAYS, 3,731 EMERGENCY ROOM VISITS, AND 431 SURGICAL OUTPATIENT VISITS. 4656920 0 7119323 THE ORGANIZATION OPERATES FAMILY PRACTICE CLINICS IN THREE LOCATIONS TO ENSURE COMMUNITY MEMBERS HAVE ACCESS TO CONVENIENT, QUALITY PRIMARY CARE. DURING 2025, TOTAL OUTPATIENT ENCOUNTERS AT THESE CLINICS TOTALED 14,936. THE THREE CLINICS ARE DESIGNATED AS RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND BY DEFINITION PROVIDE HEALTH CARE TO AREAS DESIGNATED AS MEDICAL PROFESSIONAL SHORTAGE AREAS WHERE WITHOUT THESE CLINICS THERE WOULD BE LIMITED ACCESS TO PRIMARY CARE CLINICAL SERVICES. IN ADDITIONAL, THE ORGANIZATION'S CHARITY CARE PROGRAM IS ALSO AVAILABLE TO PATIENTS OF THE CLINICS AND IS INCLUDED IN THE CHARITY CARE AMOUNT REPORTED FOR THE HOSPITAL AS CHARITY CARE BENEFITS GIVEN TO CLINIC PATIENTS IN SCHEDULE H OF THE FORM 990. 28592400 true true false true false false false false false false true false false false true true false true false false false false false false false false true true false true true false false false false false false false false false false false false false false false true false false false false true 53 0 true 219 true false false false false false false false false false false false false X 7 4 false false false false true true true true true false false false true true true true true true false false false false WI X KYLE STANEK 6083754112 205 PARKER STREET BOSCOBEL WI 53805 ANDREW NAHAS BOARD OF DIRECTORS, VICE PRESIDENT, OD 2.0 48.0 X X 0 296707 66495 CYNDE LARSEN BOARD OF DIRECTORS, TREASURER 2.0 0 X X 0 0 0 GARY BOUGHTON BOARD OF DIRECTORS, SECRETARY 2.0 0 X X 0 0 0 JERRY BERGE BOARD OF DIRECTORS, PRESIDENT 2.0 0 X X 0 0 0 KEITH FRYE BOARD OF DIRECTORS, CLINICAL OPERATIONS DIRECTOR (END 1.28.25) 2.0 48.0 X X 0 165632 47114 ALAN EBER BOARD OF DIRECTORS, DIRECTOR, ENVISION 2.0 0.0 X 0 118881 15645 DAWN THORSTEN BOARD OF DIRECTORS, SENIOR CONSULTANT, QUALITY & HIGH RELIABILITY, (END 1.28.25) 2.0 48.0 X 0 136070 46209 EMILY MCCORMICK BOARD OF DIRECTORS 2.0 0 X 0 0 0 JAMES KLOCK BOARD OF DIRECTORS, DIR-BUSINESS PARTNERING, (END 8.4.25) 2.0 48.0 X 0 199924 53719 KIMBERLY HARDY MD BOD, MD (BEG 1.1.25 & END 9.30.25) 2.0 23.0 X 0 382748 71725 KRISTER MATTSON BOARD OF DIRECTORS, VICE PRESIDENT, ENTERPRISE ANALYTICS AND DATA SCIENCE, (END 9.30.25) 2.0 48.0 X 0 305605 56203 TIM WILSON BOARD OF DIRECTORS, DIRECTOR, FACILITY OPS (BEG 1.28.25) 2.0 48.0 X 0 152743 21441 JENNIFER BOIGENZAHN FINANCE ADMINISTRATOR 25.0 25.0 X 0 157042 22084 JOHN CEELEN CHIEF FINANCIAL OFFICER 1.0 49.0 X 0 728316 54052 SCOTT RATHGABER MD CEO 1.0 49.0 X 0 1324275 73275 THERESA BRAUDT ADMINISTRATOR 50.0 0.0 X 0 195810 51180 JENNIFER DAX DIRECTOR, OUTPATIENT OPERATIONS - BOSCOBEL 50.0 0 X 134839 0 44431 KERRY CAMPBELL RN, ACUTE HOSPITAL (WEO) - BOSCOBEL 36.0 0 X 137800 0 46654 LISA WITTER PHARMACIST - BOSCOBEL 36.0 0 X 156370 0 60814 TARA WOOD MANAGER, PHARMACY 50.0 0 X 198307 0 54820 WENDI STITZER MANAGER, EMERGENCY SERVICES - BOSCOBEL 25.0 0 X 133962 0 34132 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0.0 0.0 X 0 209856 0 761278 4373609 819993 5 true true false WAPITI MEDICAL STAFFING 107 FLYNN DRIVE SUITE 600 MILBANK SD 57252 STAFFING SERVICES 2011208 STAFFENCY 221 W COLLEGE AVE FLOOR 2 APPLETON WI 54911 STAFFING SERVICES 763696 NUWEST GROUP HOLDINGS LLC PO BOX 94104 SEATLE WA 98124 STAFFING SERVICES 260033 COMPHEALTH PO BOX 972651 DALLAS TX 75397 STAFFING SERVICES 152716 HAYES LOCUMS LLC PO BOX 844543 DALLAS TX 75284 STAFFING SERVICES 134201 5 36610 0 36610 HOSPITAL PATIENT REVENUE 621110 32274910 32274910 CLINIC REVENUE 621110 3448745 3448745 PHARMACY REVENUE 456110 1540875 1540875 SURGERY 621110 43231 43231 CARDIOPULMONARY REHAB 621110 8608 8608 36359 36359 0 0 37352728 1122667 1122667 0 0 0 0 FACILITIES 900099 110899 110899 ADMINISTRATION 900099 68565 68565 1578 1578 0 0 181042 38693047 37533770 0 1122667 X 897252 897252 11830101 9371849 2458252 1455105 1199527 255578 2073083 1457950 615133 872035 687301 184734 1033404 1033404 45100 45100 4518 4518 781 781 9423819 8455869 967950 0 124164 225 123939 233849 131876 101973 10465 7092 3373 468978 97910 371068 126927 118109 8818 7828 7828 1116163 642628 473535 80372 80372 MEDICAL SUPPLIES 4271587 4232694 38893 BAD DEBT CROSSOVER/BAD DEBT 1186864 1186864 EQUIP MAINTENANCE/BUILDING MODIFICATIONS 142906 36930 105976 BUILDING REPAIR SERVICES 72521 934 71587 106387 59562 46825 0 35584209 28592400 6991809 0 43142 2353 30227940 37224103 0 0 2943201 5333934 0 0 0 0 0 0 463623 420386 90756 155274 24732412 18541204 6875859 6191208 0 0 0 0 0 0 832052 1311474 41476573 50638732 2793247 3303095 0 0 135904 135904 0 0 0 0 0 0 265945 190429 0 0 333284 5250701 3528380 8880129 X 37948193 41758603 0 0 0 0 0 0 0 0 37948193 41758603 41476573 50638732 X 3108838 561833 139739 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4518 4518 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS (THE GANIZATION") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PAID PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE WHA HAS NOTIFIED THE ORGANIZATION THAT $2271 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR THE ORGANIZATION PAYS MEMBERSHIP FEES TO RWHC. RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO PROVIDES AN ANALYSIS OF CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES A SMALL AMOUNT OF LOBBYING ON THE PART OF THE MEMBER HOSPITALS. THE RWHC DETERMINED THAT $1421 OF THE FEES PAID BY THE ORGANIZATION IN FISCAL YEAR 2025 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 0 537666 537666 0 14840453 10829514 4010939 0 512765 322537 190228 0 7224963 6201712 1023251 0 1616565 1187441 429124 6191208 FEDERAL INCOME TAXES 3RD PARTY SETTLEMENT PAYABLE 244046 DUE TO RELATED PARTIES 5006655 5250701 X 0 0 0 0 0 0 0 0 0 0 0 0 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. true true X true X true X true true false true true 437538 0 437538 0.01272 4195973 3696096 499877 0.01453 0 0 0 0.0 0 0 4633511 3696096 937415 0.02725 71697 0 71697 0.00208 142514 0 142514 0.00414 9564008 10731241 0 0.0 0 0 0 0.0 11358 0 11358 0.00033 0 0 9789577 10731241 225569 0.00656 0 0 14423088 14427337 1162984 0.03381 0 0.0 4756 4756 0.00014 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 4756 0 4756 0.00014 false 970457 452233 10241594 11300037 -1058443 X true true 1 1 MEMORIAL HOSPITAL OF BOSCOBEL 205 PARKER ST BOSCOBEL WI 53805 WWW.GUNDERSENHEALTH.ORG/BOSCOBEL 1048 X X X X MEMORIAL HOSPITAL OF BOSCOBEL 1 false false true X X X X X X X X X 24 true true true true X HTTP://WWW.GUNDERSENHEALTH.ORG/COMMUNITY-ASSESSMENT X true 24 true HTTP://WWW.GUNDERSENHEALTH.ORG/COMMUNITY-ASSESSMENT/ false true X 200.0 400.0 X X X X X X true true X X X X true X https://www.gundersenhealth.org/patients-visitors/financial-assistance X https://www.gundersenhealth.org/patients-visitors/financial-assistance X https://www.gundersenhealth.org/patients-visitors/financial-assistance X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 FACILITY , 1 - MEMORIAL HOSPITAL OF BOSCOBEL. INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY SERVED BY GBAHC WAS COLLECTED THROUGH ONLINE AND PAPER SURVEYS. THE SURVEY WAS ALSO MADE AVAILABLE IN SPANISH. THIS SURVEY MEASURED PERSPECTIVES ON HEALTHCARE AND HEALTH NEEDS, STRENGTHS, WEAKNESSES, OPPORTUNITIES, AND CHALLENGES. THE SURVEY WAS PROMOTED VIA THE COLLABORATIVE PARTNERS SOCIAL MEDIA PAGES, EMAIL, PUBLICITY EFFORTS, FAIRS, COUNTY HEALTH DEPARTMENTS AND DIRECT MAIL. A TOTAL OF 1,640 RESPONSES WERE COLLECTED. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY , 1 FACILITY , 1 - MEMORIAL HOSPITAL OF BOSCOBEL. THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS: 1. CROSSING RIVERS HEALTH 2. GRANT REGIONAL HEALTH CENTER, INC. 3. SOUTHWEST HEALTH CENTER SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY , 1 FACILITY , 1 - MEMORIAL HOSPITAL OF BOSCOBEL. THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER ORGANIZATIONS: 1. CRAWFORD COUNTY PUBLIC HEALTH DEPARTMENT 2. GRANT COUNTY PUBLIC HEALTH DEPARTMENT SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 FACILITY , 1 - MEMORIAL HOSPITAL OF BOSCOBEL. BETWEEN THE CLOSE OF FY2024 (9/30/2024) AND FEBRUARY 15, 2025, GBAHC DEVELOPED AND ADOPTED NEW SIGNIFICANT NEEDS, WHICH WERE APPROVED BY OUR BOD ON FEBRUARY 14, 2025. THE CHIP ADDRESSED THE TOP THREE PRIORITIZED COMMUNITY HEALTH NEEDS AS NOTED IN OUR 2024 CHNA (BELOW), AND INCLUDED GOALS, TACTICS, RESOURCES, PARTNERS, AND OUTCOME MEASURES FOR EACH. MENTAL HEALTH: 1. SYSTEM-WIDE EMPHASIS WAS PLACED ON SCREENING PATIENTS ANNUALLY FOR DEPRESSION/RISK FOR DEPRESSION. 2. GBAHC INVESTIGATED OPPORTUNITIES TO INCREASE SWCAP CARE COORDINATION NETWORK (CCN) REFERRALS FOR PATIENTS (INITIATED WITH SDOH SCREENING). 3. GBAHC INCREASED AWARENESS OF COMMUNITY-BASED MENTAL HEALTH RESOURCES. 4. GBAHC SUPPORTED COMMUNITY INITIATIVES THAT IMPROVED MENTAL HEALTH OR ACCESS TO MENTAL HEALTH RESOURCES FOR ALL POPULATIONS. SUBSTANCE MISUSE: 1.GBAHC CONTINUED TO OFFER TOBACCO CESSATION INTERVENTIONS TO PATIENTS. 2. GBAHC PROVIDED OR SUPPORTED EDUCATION AND RESOURCES THAT ENGAGED THE COMMUNITY (INCLUDING TOBACCO, VAPING, AND OTHER DRUG AND SUBSTANCE USE). 3. GBAHC INVESTIGATED DRUG-RELATED EMERGENCY ROOM VISITS DUE TO OPIOID USE AND DEVELOPED STRATEGIES TO ADDRESS FINDINGS. 4. GBAHC MONITORED THE NUMBER OF PATIENTS EXPOSED TO OPIOIDS IN THE MANAGEMENT OF PAIN (ACTION/MEASURE MAY HAVE CHANGED BASED ON ORGANIZATIONAL STRATEGY). CHRONIC CONDITIONS: 1.GBAHC EXPLORED GAPS IN CARE SPECIFIC TO CANCER SCREENING. 2. GBAHC CONTINUED ITS FOCUS ON CONTROLLING HIGH BLOOD PRESSURE. 3. GBAHC MONITORED PATIENTS WHO FELL ON THE DIABETIC REGISTRY AND EXPLORED GAPS FOR THOSE WHOSE DIABETES WAS NOT CONSIDERED OPTIMALLY CONTROLLED. 4. GBAHC CONTINUED TO MAKE THE MOVIN MORE PROGRAM ACCESSIBLE TO PATIENTS WHO PREVIOUSLY OPTED NOT TO ENROLL DUE TO COST. MOVIN' & MORE VOUCHERS CONTINUED TO BE FUNDED THROUGH THE HOSPITAL FOUNDATION TO SUPPORT ONE COMPLIMENTARY MONTH IN THE PROGRAM FOR ALL CARDIOPULMONARY REHABILITATION GRADUATES. OTHER: GBAHC CONTINUED TO PROVIDE LOW-COST OR FREE EDUCATIONAL SEMINARS AND TRAININGS FOR COMMUNITY MEMBERS, EMPLOYERS, AND LOCAL ENTITIES TO SUPPORT IMPROVED PHYSICAL AND MENTAL WELL-BEING. OTHER COMMUNITY HEALTH PRIORITIES WERE IDENTIFIED THROUGH THE ASSESSMENT PROCESS THAT WERE NOT ADDRESSED; HOWEVER, GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS PROVIDED SUPPORT TO AREA ORGANIZATIONS AND PARTNERS WHEN REQUIRED, INCLUDING: 1. LACK OF PUBLIC TRANSPORTATION 2. NARROWING NETWORKS AND HIGH DEDUCTIBLE HEALTH PLANS 3. DENTAL SERVICES SCHEDULE H, PART V, SECTION B, LINE 13 FACILITY , 1 FACILITY , 1 - MEMORIAL HOSPITAL OF BOSCOBEL. GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINCS (GBAHC) UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE FORMAL FINANCIAL ASSISTANCE APPLICATION. OTHER INFORMATION MAY BE UTILIZED BY GBAHC TO DETERMINE WHETHER A PATIENT'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY. PRESUMPTIVE ELIGIBILITY MAY BE GRANTED TO PATIENTS BASED ON THEIR ELIGIBILITY FOR OTHER PROGRAMS OR LIFE CIRCUMSTANCES SUCH AS: 1 . PATIENTS OR GUARANTORS WHO HAVE DECLARED BANKRUPTCY, IN CASES INVOLVING BANKRUPTCY, ONLY THE ACCOUNT BALANCE AS OF THE DATE THE BANKRUPTCY IS DISCHARGED WILL BE WRITTEN OFF. 2. PATIENTS OR GUARANTORS WHO ARE DECEASED WITH NO ESTATE IN PROBATE. 3. PATIENTS OR GUARANTORS DETERMINED TO BE HOMELESS. 4. ACCOUNTS RETURNED BY THE COLLECTION AGENCY AS UNCOLLECTIBLE DUE TO ANY OF THE ABOVE REASONS. 5. PATIENTS OR GUARANTORS WHO QUALIFY FOR STATE MEDICAID PROGRAMS, WILL BE ELIGIBLE FOR ASSISTANCE FOR ANY COST-SHARING OBLIGATIONS ASSOCIATED WITH THE PROGRAM OR UNCOVERED SERVICES. GBAHC UNDERSTANDS THAT CERTAIN PATIENTS MAY BE NON-RESPONSIVE TO GBAHC'S APPLICATION PROCESS. UNDER THESE CIRCUMSTANCES, GBAHC MAY UTILIZE OTHER SOURCES OF INFORMATION TO MAKE AN INDIVIDUAL ASSESSMENT OF FINANCIAL NEED. THIS INFORMATION WILL ENABLE GBAHC TO MAKE AN INFORMED DECISION ON THE FINANCIAL NEED OF NON- RESPONSIVE PATIENTS UTILIZING THE BEST ESTIMATES AVAILABLE IN THE ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT. GBAHC MAY UTILIZE A THIRD-PARTY TO CONDUCT AN ELECTRONIC REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THIS PREDICTIVE MODEL INCORPORATES PUBLIC RECORD DATA TO CALCULATE A SOCIO-ECONOMIC AND FINANCIAL CAPACITY SCORE THAT INCLUDES ESTIMATES FOR INCOME, ASSETS AND LIQUIDITY. THE ELECTRONIC TECHNOLOGY IS DESIGNED TO ASSESS EACH PATIENT TO THE SAME STANDARDS AND IS CALIBRATED AGAINST HISTORICAL APPROVALS FOR GBAHC FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE ELECTRONIC TECHNOLOGY, WHEN UTILIZED, WILL BE DEPLOYED PRIOR TO BAD DEBT ASSIGNMENT AFTER ALL OTHER ELIGIBILITY AND PAYMENT SOURCES HAVE BEEN EXHAUSTED. THIS ALLOWS GBAHC TO SCREEN ALL PATIENTS FOR FINANCIAL ASSISTANCE PRIOR TO PURSUING ANY EXTRAORDINARY COLLECTION ACTIONS. THE DATA RETURNED FROM THIS ELECTRONIC ELIGIBILITY REVIEW WILL CONSTITUTE ADEQUATE DOCUMENTATION OF FINANCIAL NEED UNDER THIS POLICY.WHEN ELECTRONIC ENROLLMENT IS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT LEVELS WILL BE GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DOES NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT MAY STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS.PATIENT ACCOUNTS GRANTED PRESUMPTIVE ELIGIBILITY WILL BE RECLASSIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. THEY WILL NOT BE SENT TO COLLECTION AND WILL NOT BE INCLUDED IN THE HOSPITAL'S BAD DEBT EXPENSE. 3 GUNDERSEN BOSCOBEL CLINIC 208 PARKER ST BOSCOBEL WI 53805 PROVIDER BASED RURAL HEALTH CLINIC GUNDERSEN FENNIMORE CLINIC 220 LINCOLN AVE FENNIMORE WI 53809 PROVIDER BASED RURAL HEALTH CLINIC GUNDERSEN MUSCODA CLINIC 525 NORTH WISCONSIN AVENUE MUSCODA WI 53573 PROVIDER BASED RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3C CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES AS ONE MEANS OF DETERMINING ELIGIBILITY FOR CHARITY CARE. THE FEDERAL POVERTY GUIDELINES ARE UPDATED AND PUBLISHED ANNUALLY BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. AS A RULE, A PATIENT'S INCOME, BASED ON FAMILY SIZE, MUST BE AT OR BELOW 201% OF THE FEDERAL POVERTY GUIDELINES TO BE ELIGIBLE FOR THE CHARITY CARE PROGRAM. A SLIDING SCALE BASED ON THE PATIENT'S INCOME LEVEL UNDER THE FEDERAL POVERTY GUIDELINES WILL BE USED TO DETERMINE THE PRECISE AMOUNT OF CHARITY CARE FOR WHICH A PATIENT WILL BE ELIGIBLE. SOME PATIENTS MAY EXCEED 201% OF THE FEDERAL POVERTY GUIDELINES BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS CATASTROPHIC MEDICAL COSTS ARE CONSIDERED. CATASTROPHIC MEDICAL CARE COSTS ARE DETERMINED ON A CASE-BY-CASE BASIS TO PATIENTS WHO DUE TO A SIGNIFICANT OR RECURRENCE OF MEDICAL BILLS MAY NEED ADDITIONAL COMMUNITY SUPPORT TO HELP A PATIENT OR THEIR FAMILY THROUGH A DIFFICULT TIME SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES AT GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS INCLUDE THE OPERATION OF THREE RURAL HEALTH CLINICS. THE OPERATION OF THREE RURAL HEALTH CLINICS IS ALSO PROVIDED AS A SUBSIDIZED HEALTH SERVICE IN ORDER TO MEET HEALHT CARE NEEDS IN THE SURROUNDING COMMUNITIES. GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS CURRENTLY OPERATES RURAL HEALTH CLINICS IN BOSCOBEL, FENNIMIRE, AND MUSCODA, WISCONSIN. IT IS THE GOAL OF THE HOSPITAL TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE HOSPITAL. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES WHILE THERE IS GROWING AGREEMENT IN THE US ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. GUNDERSEN BOSOCBEL AREA HOSPITAL AND CLINICS PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS, AS DEFINED BY THE IRS, AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH CAN NOT BE QUANTIFIED. GUNDERSEN BOSCOBEL, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE. BEYOND INPATIENT HOSPITALIZATION, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING, BUT NOT LIMITED TO; DIAGNOSTIC, EMERGENCY MEDICINE, INFUSION SERVICES, SWING BED, CLINICAL AND LABORATORY SERVICES, REHABILITATION, SPECIALTY MEDICINE, SPEECH PATHOLOGY, SURGICAL SERVICES, AND WOMEN'S SERVICES. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COSTTOCHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COSTTOCHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELFPAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSSPATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE- OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY PAYOR COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRDPARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, RESPIRATORY THERAPY PROFESSIONAL SERVICES, RADIOLOGIST PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELLBEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT GUNDERSEN BOSCOBEL HOSPITAL AND CLINICS PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE PERIOD ENDED SEPTEMBER 30, 2025, AND DOES NOT CONSIDER MEDICARE NONALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NONALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAXEXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELFPAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELFPAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - MEMORIAL HOSPITAL OF BOSCOBEL: LINE 16A URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - MEMORIAL HOSPITAL OF BOSCOBEL: LINE 16B URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - MEMORIAL HOSPITAL OF BOSCOBEL: LINE 16C URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COSTEFFECTIVE MANNER TO BE CONSISTENT WITH THE HOSPITAL'S MISSION IN THE COMMUNITY. GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE HOSPITAL ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND ITS PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. DURING FISCAL YEAR 2024, THE HOSPITAL COLLABORATED WITH OTHER AREA HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THROUGH THE CHNA PROCESS THE HOSPITAL CONSIDERED, COUNTY HEALTH STATISTICS, MEDICAL RESOURCES, SAFETY FACTORS, SOCIOECONOMIC INDICATORS, TRANSPORTATION ISSUES, ACCESS TO RESOURCES, AND ENVIRONMENTAL QUALITY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS IN NEED OF FINANCIAL ASSISTANCE CAN MEET WITH THE HOSPITAL'S FINANCIAL COUNSELOR EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAID OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. THE HOSPITAL ALSO PROVIDES CERTIFIED APPLICATION COUNSELORS FOR ASSISTING PATIENTS WITH OBTAINING COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION THE PRIMARY SERVICE AREA FOR GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE HOSPITAL. THE HOSPITAL ALSO DETERMINED THAT PRIMARY CLINICAL HEALTH CARE WAS A NEEDED SERVICE IN TWO SURROUNDING COMMUNITIES, SO THE HOSPITAL IN BOSCOBEL, POPULATION 3242, ALSO OPERATES PROVIDER BASED RURAL HEALTH CLINICS IN FENNIMORE , POPULATION 2752, AND MUSCODA, POPULATION 1119, WISCONSIN. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OFFERS HEALTH SCREENINGS, EDUCATIONAL DISPLAYS, AND PRESENTATIONS ON A VARIETY OF TOPICS SUCH AS HEALTHY EATING, EXERCISE, HEART HEALTH, CHOLESTEROL, ETC. TO MEMBERS OF THE COMMUNITY. PROGRAMS AND SERVICES ARE ALSO CONSIDERED BY THE HOSPITAL'S BOARD OF DIRECTORS, WHICH INCLUDES FIVE LOCAL COMMUNITY MEMBERS WHO RESIDE WITHIN A THIRTYMILE RADIUS OF THE HOSPITAL. THE HOSPITAL ALSO CONSIDERS A RELATIVELY OPEN MEDICAL STAFF POLICY ALLOWING PROPERLY CREDENTIALED PROVIDERS THE ABILITY TO PRACTICE MEDICINE AND FOLLOWUP WITH PATIENTS UTILIZING THE HOSPITAL'S FACILITIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM THE ORGANIZATION IS A PART OF EMPLIFY HEALTH WHICH IS THE COMBINATION OF GUNDERSEN HEALTH AND BELLIN HEALTH SYSTEMS. IT IS A NOTFORPROFIT ORGANIZATION DEDICATED TO ENHANCING THE PHYSICAL AND EMOTIONAL WELLBEING OF INDIVIDUALS IN. IN COLLABORATION WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE SUPPORT INDIVIDUALS AND FAMILIES ON THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. OUR COMMITMENT LIES IN DELIVERING SAFE, RELIABLE, AND COSTEFFECTIVE COMPREHENSIVE HEALTH SOLUTIONS, ALL WHILE UPHOLDING THE VALUES OF RESPECT AND COMPASSION. THROUGH OUR INNOVATIVE INITIATIVES, WE AIM TO TRANSFORM HEALTHCARE DELIVERY NOT ONLY IN OUR REGION BUT ALSO ON A GLOBAL SCALE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT WI true CHARITY CARE 63 897252 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE FUNDS ARE MONITORED BY MANAGEMENT AND THE BOARD OF TRUSTEES false true false false false false false false false KEITH FRYE BOARD OF DIRECTORS, CLINICAL OPERATIONS DIRECTOR (END 1.28.25) 0 163502 0 0 0 2130 0 23450 0 23664 0 212746 0 0 ANDREW NAHAS BOARD OF DIRECTORS, VICE PRESIDENT, OD 0 263471 0 3000 0 30236 0 41628 0 24867 0 363202 0 0 KRISTER MATTSON BOARD OF DIRECTORS, VICE PRESIDENT, ENTERPRISE ANALYTICS AND DATA SCIENCE, (END 9.30.25) 0 305177 0 0 0 428 0 38458 0 17745 0 361808 0 0 KIMBERLY HARDY MD BOD, MD (BEG 1.1.25 & END 9.30.25) 0 377918 0 0 0 4830 0 48300 0 23425 0 454473 0 0 JAMES KLOCK BOARD OF DIRECTORS, DIR-BUSINESS PARTNERING, (END 8.4.25) 0 190991 0 4852 0 4081 0 28552 0 25167 0 253643 0 0 DAWN THORSTEN BOARD OF DIRECTORS, SENIOR CONSULTANT, QUALITY & HIGH RELIABILITY, (END 1.28.25) 0 135064 0 0 0 1006 0 19756 0 26453 0 182279 0 0 TIM WILSON BOARD OF DIRECTORS, DIRECTOR, FACILITY OPS (BEG 1.28.25) 0 150959 0 0 0 1784 0 21134 0 307 0 174184 0 0 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0 209856 0 0 0 0 0 0 0 0 0 209856 0 0 JOHN CEELEN CHIEF FINANCIAL OFFICER 0 598104 0 129468 0 744 0 29147 0 24905 0 782368 0 0 SCOTT RATHGABER MD CEO 0 1278368 0 0 0 45907 0 48300 0 24975 0 1397550 0 0 JENNIFER BOIGENZAHN FINANCE ADMINISTRATOR 0 155482 0 0 0 1560 0 21767 0 317 0 179126 0 0 THERESA BRAUDT ADMINISTRATOR 0 192528 0 0 0 3282 0 27513 0 23667 0 246990 0 0 KERRY CAMPBELL RN, ACUTE HOSPITAL (WEO) - BOSCOBEL 134117 0 2574 0 1109 0 20116 0 26538 0 184454 0 0 0 JENNIFER DAX DIRECTOR, OUTPATIENT OPERATIONS - BOSCOBEL 133912 0 0 0 927 0 19398 0 25033 0 179270 0 0 0 WENDI STITZER MANAGER, EMERGENCY SERVICES - BOSCOBEL 127383 0 0 0 6579 0 19081 0 15051 0 168094 0 0 0 LISA WITTER PHARMACIST - BOSCOBEL 151225 0 4051 0 1094 0 23147 0 37667 0 217184 0 0 0 TARA WOOD MANAGER, PHARMACY 191664 0 4858 0 1785 0 28451 0 26369 0 253127 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CERTAIN INDIDVIDUALS 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 FUTUTE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN FOR CALENDAR YEAR 2024: JOHN CEELEN SCHEDULE J, PART I, LINE 3 A REALTED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OF STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PLEASE REFERE TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED. FORM 990, PART III, LINE 2 NEW PROGRAM SERVICES WE STARTED AN OUTPATIENT PROGRAM CALLED SENIOR LIFE SOLUTIONS. THIS IS AN OUTPATIENT MENTAL HEALTH PROGRAM FOR OLDER ADULTS, TYPICALLY 65 AND OLDER FOR PATIENTS IN A RURAL COMMUNITY WHO ARE EXPERIENCING SYMPTOMS OF ANXIETY, DEPRESSION, AND OTHER MENTAL HEALTH DISORDERS. THIS PROGRAM IS MEANT TO IMPROVE THE LIVES OF PATIENTS WITHIN THESE COMMUNITIES. FORM 990, PART VI, LINE 15A COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. 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. FORM 990, PART VI, LINE 15B SENIOR LEADERS: COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE ARTICLES OF INCORPORATION OF GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS PROVIDES FOR ONE MEMBER OF THE CORPORATION. THE SOLE CORPORATE MEMBER OF GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS IS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY AS THE SOLE CORPORATE MEMBER AND UNDER THE TERMS OF THE AFFILIATION AGREEMENT, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. MAY APPOINT, REMOVE, OR ELECT CERTAIN OFFICERS AND/OR MEMBERS OF THE BOARD OF DIRECTORS OF GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS. GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. MAY APPOINT SIX MEMBERS OF THE BOARD OF DIRECTORS OF GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS THE SOLE MEMBER, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. HAS THE FOLLOWING RESERVE RIGHTS OF APPROVAL: THE INCURRENCE OF DEBT (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS OR DEBT INCLUDED IN APPROVED BUDGETS) AND THE GRANT OF ANY SECURITY INTEREST, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND DIRECT EXECUTION OF ANY DOCUMENTS AND THE TAKING OF ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT: AND THE ANNUAL OPERATING BUDGET AND CAPITAL EXPENDITURES. 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 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ABBREVIATED FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION AND THE COMPLETE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE ALSO AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VIII, LINE 2F OTHER PROGRAM SERVICE REVENUE OTHER PROGRAM SERVICES REVENUE - TOTAL REVENUE: 36359, RELATED OR EXEMPT FUNCTION REVENUE: 36359, UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: ; FORM 990, PART VIII, LINE 11D OTHER MISCELLANEOUS REVENUE - TOTAL REVENUE: 1578, RELATED OR EXEMPT FUNCTION REVENUE: 1578, UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: ; FORM 990, PART IX, LINE 11G OTHER FEES PURCHASED SERVICE - TOTAL EXPENSE: 2027433, PROGRAM SERVICE EXPENSE: 1697045, MANAGEMENT AND GENERAL EXPENSES: 330388, FUNDRAISING EXPENSES: ; CONTRACT LABOR - TOTAL EXPENSE: 7214820, PROGRAM SERVICE EXPENSE: 6743032, MANAGEMENT AND GENERAL EXPENSES: 471788, FUNDRAISING EXPENSES: ; CONSULTING - TOTAL EXPENSE: 143875, PROGRAM SERVICE EXPENSE: 15750, MANAGEMENT AND GENERAL EXPENSES: 128125, FUNDRAISING EXPENSES: ; LAB SERVICES - TOTAL EXPENSE: 42, PROGRAM SERVICE EXPENSE: 42, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; COLLECTIONS - TOTAL EXPENSE: 37649, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 37649, FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES ACCT 80225 FOUNDATION TRANSFER - 139739; TOTAL - 139739; BELLIN GUNDERSEN HEALTH SYSTEM INC 1836 SOUTH AVENUE LA CROSSE WI 54601 920504278 SUPPORT ORG WI 501(C)(3) TYPE III-FI NA false GUNDERSEN LUTHERAN HEALTH SYSTEM INC 1836 SOUTH AVE LA CROSSE WI 54601 391866425 SUPPORT ORG WI 501(C)(3) TYPE II BGHS false GUNDERSEN LUTHERAN MEDICAL CENTER INC 1910 SOUTH AVE LA CROSSE WI 54601 390813416 HEALTHCARE WI 501(C)(3) 3 GLHS false GUNDERSEN CLINIC LTD 1836 SOUTH AVENUE LA CROSSE WI 54601 391028657 HEALTHCARE WI 501(C)(3) 3 GLHS false GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC 1910 SOUTH AVE LA CROSSE WI 54601 391606449 SUPPORT ORG WI 501(C)(3) TYPE II GLHS false GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391249705 FOUNDATION WI 501(C)(3) 7 GLHS false TRI-COUNTY MEMORIAL HOSPITAL INC 18601 LINCOLN STREET WHITEHALL WI 54773 390704510 HEALTHCARE WI 501(C)(3) 3 GLHS false HARMONY COUMMUNITY HEALTHCARE INC 815 MAIN AVE SOUTH HARMONY MN 55939 410711606 HEALTHCARE WI 501(C)(3) 10 GLHS false TWEETEN LUTHERAN HEALTHCARE CENTER INC 125 FIFTH AVE SE SPRING GROVE MN 55974 411565003 HEALTHCARE WI 501(C)(3) 10 GLHS false TRI STATE AMBULANCE INC 235 CAUSEWAY BOULEVARD LA CROSSE WI 54603 391965415 MEDICAL TRANSPORT WI 501(C)(3) 3 GLHS false TRI-STATE REGIONAL AMBULANCE INC 235 CAUSEWAY BOULEVARD LA CROSSE WI 54603 391962965 MEDICAL TRANSPORT WI 501(C)(3) 10 GLHS false LUTHERAN REAL ESTATE HOLDING CORPORATION 1910 SOUTH AVENUE LA CROSSE WI 54601 391480826 HOUSING WI 501(C)(3) TYPE III-FI GLHS false COMMUNITY HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391586700 INDEPENDENT LIVING WI 501(C)(3) 10 LREH CORP false LUTHERAN HOUSING OF LA CROSSE INC 1900 SOUTH AVENUE LA CROSSE WI 54601 391751934 INDEPENDENT LIVING WI 501(C)(3) 10 LREH CORP false ST JOSEPH'S HEALTH SERVICES INC 400 WATER AVE HILLSBORO WI 54634 390929538 HEALTHCARE WI 501(C)(3) 3 GLHS false ST JOSEPH MEMORIAL FOUNDATION INC 400 WATER AVE HILLSBORO WI 54634 391455787 FOUNDATION WI 501(C)(3) TYPE I STJ HLTH SVC false TRI-COUNTY MEMORIAL FOUNDATION INC 18601 LINCOLN STREET WHITEHALL WI 54773 300093022 FOUNDATION WI 501(C)(3) TYPE I TCH false PALMER LUTHERAN HEALTH CENTER INC 112 JEFFERSON STREET WEST UNION IA 52175 421320763 HEALTHCARE WI 501(C)(3) 3 GLHS false MOUNDVIEW MEMORIAL HOSPITALS AND CLINICS 402 WEST LAKE STREET FRIENDSHIP WI 53934 390944012 HEALTHCARE WI 501(C)(3) 3 GLHS false MEMORIAL HEALTHCARE FOUNDATION INC (MOUNDVIEW) 402 WEST LAKE STREET FRIENDSHIP WI 53934 391775074 FOUNDATION WI 501(C)(3) TYPE I MDV HOSP false SAINT ELIZABETH'S HOSPITAL OF WABASHA INC WABASHA 1200 FIFTH GRANT BLVD WEST WABASHA MN 55981 410693877 HEALTHCARE WI 501(C)(3) 3 GLHS false BELLIN HEALTH SYSTEMS INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512904 SUPPORT ORG WI 501(C)(3) TYPE II BGHS false LAKE MICHIGAN HEALTH SERVICES INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 391512903 SUPPORT ORG WI 501(C)(3) TYPE II BHS false BELLIN COLLEGE INC 3201 EATON ROAD GREEN BAY WI 54311 391620530 EDUCATION WI 501(C)(3) 2 BHS false BELLIN PSYCHIATRIC CENTER INC PO BOX 23725 GREEN BAY WI 54301 391657627 HEALTHCARE WI 501(C)(3) 3 BHS false BELLIN MEMORIAL HOSPITAL INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54301 390884478 HEALTHCARE WI 501(C)(3) 3 BHS false THE BELLIN HEALTH FOUNDATION INC PO BOX 23400 GREEN BAY WI 54301 391809171 FOUNDATION WI 501(C)(3) 7 BHS false OCONTO HOSPITAL & MEDICAL CENTER INC 820 ARBUTUS AVENUE OCONTO WI 54153 061745397 HEALTHCARE WI 501(C)(3) 3 BMH false GUNDERSEN LUTHERAN ENVISION LLC 1836 SOUTH AVENUE LA CROSSE WI 54601 264706546 RENEWABLE ENERGY WI NA C CORPORATION false BEL-REGIONAL HOME MEDICAL INC 617 S ROOSEVELT GREEN BAY WI 54301 391504766 DURABLE MEDICAL EQUIPMENT RETAIL WI NA C CORPORATION false GUNDERSEN EDGE LLC 836 SOUTH AVENUE LA CROSSE WI 54601 921783811 INNOVATION WI NA C CORPORATION false BG ASSURANCE COMPANY 20 GENESIS CLOSE PO BOX 30600 GEORGE TOWN GRAND CAYMAN CJ KY11203 SELF INSURANCE CJ NA C CORPORATION false false false false false false false false false false false false false true true true true true false false