Civic Intelligence

Gundersen Clinic Ltd

EIN 39-1028657 • 501(c)3 • LA Crosse, WI

Profile

To 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.

1836 South AvenueLA Crosse, WI 54601

www.gundersenhealth.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

100th percentile

4.74x

Higher debt load relative to assets than 100% of similar nonprofits.

501(c)3 • $100M-$250M nonprofits • Source year 2024

Liabilities / Revenue

91st percentile

4.27x

Higher debt load relative to revenue than 91% of similar nonprofits.

501(c)3 • $100M-$250M nonprofits • Source year 2024

Net Margin

6th percentile

-34%

Higher net margin than 6% of similar nonprofits.

501(c)3 • $100M-$250M nonprofits • Source year 2024

Top Officer Pay

Score unavailable

No value available

No filing with officer rows is available for this organization yet.

Asset Growth

28th percentile

0.8%

Faster asset growth than 28% of similar nonprofits.

501(c)3 • $100M-$250M nonprofits • Annualized from 2023 to 2024

Revenue Growth

90th percentile

52%

Faster revenue growth than 90% of similar nonprofits.

501(c)3 • $100M-$250M nonprofits • Annualized from 2023 to 2024

Assets

Up

$220,088,578

Up $1,784,159 (+0.8%) from 2023

Liabilities

Up

$1,042,632,494

Up $84,515,849 (+8.8%) from 2023

Net Assets

Down

-$822,543,916

Down $82,731,690 (-11%) from 2023

Revenue

Up

$244,302,568

Up $84,009,598 (+52%) from 2023

Expenses

Up

$327,479,756

Up $99,686,399 (+44%) from 2023

Net Income

Down

-$83,177,188

Down $15,676,801 (-23%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$1.5B$1.0B$500M$0-$500M-$1.0BAssets 2010: $378,967,775Liabilities 2010: $345,915,921Net Assets 2010: $33,051,8542010Assets 2011: $403,938,911Liabilities 2011: $378,486,280Net Assets 2011: $25,452,6312011Assets 2012: $401,080,849Liabilities 2012: $402,843,261Net Assets 2012: -$1,762,4122012Assets 2013: $171,892,241Liabilities 2013: $393,678,771Net Assets 2013: -$221,786,5302013Assets 2014: $173,141,808Liabilities 2014: $430,141,518Net Assets 2014: -$256,999,7102014Assets 2015: $176,008,200Liabilities 2015: $452,497,081Net Assets 2015: -$276,488,8812015Assets 2016: $188,524,543Liabilities 2016: $458,894,390Net Assets 2016: -$270,369,8472016Assets 2017: $179,574,945Liabilities 2017: $439,301,369Net Assets 2017: -$259,726,4242017Assets 2018: $195,462,356Liabilities 2018: $539,070,683Net Assets 2018: -$343,608,3272018Assets 2019: $222,201,328Liabilities 2019: $654,389,913Net Assets 2019: -$432,188,5852019Assets 2020: $210,830,345Liabilities 2020: $753,676,217Net Assets 2020: -$542,845,8722020Assets 2021: $196,742,108Liabilities 2021: $798,844,453Net Assets 2021: -$602,102,3452021Assets 2022: $198,877,511Liabilities 2022: $871,161,059Net Assets 2022: -$672,283,5482022Assets 2023: $218,304,419Liabilities 2023: $958,116,645Net Assets 2023: -$739,812,2262023Assets 2024: $220,088,578Liabilities 2024: $1,042,632,494Net Assets 2024: -$822,543,9162024

Highlighted filing

2024

Assets$220,088,578
Liabilities$1,042,632,494
Net Assets-$822,543,916

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$600M$400M$200M$0-$200M-$400MExpenses 2010: $518,251,1552010Expenses 2011: $535,737,6212011Expenses 2012: $543,646,2962012Revenue 2013: $193,786,436Expenses 2013: $413,810,554Net Income 2013: -$220,024,1182013Revenue 2014: $184,928,657Expenses 2014: $220,141,837Net Income 2014: -$35,213,1802014Revenue 2015: $169,843,167Expenses 2015: $189,332,338Net Income 2015: -$19,489,1712015Revenue 2016: $185,276,248Expenses 2016: $179,144,818Net Income 2016: $6,131,4302016Revenue 2017: $207,154,964Expenses 2017: $196,443,609Net Income 2017: $10,711,3552017Revenue 2018: $159,351,688Expenses 2018: $243,203,980Net Income 2018: -$83,852,2922018Revenue 2019: $164,171,225Expenses 2019: $252,921,512Net Income 2019: -$88,750,2872019Revenue 2020: $159,193,400Expenses 2020: $269,927,525Net Income 2020: -$110,734,1252020Revenue 2021: $170,123,058Expenses 2021: $229,129,867Net Income 2021: -$59,006,8092021Revenue 2022: $202,179,692Expenses 2022: $271,698,125Net Income 2022: -$69,518,4332022Revenue 2023: $160,292,970Expenses 2023: $227,793,357Net Income 2023: -$67,500,3872023Revenue 2024: $244,302,568Expenses 2024: $327,479,756Net Income 2024: -$83,177,1882024

Highlighted filing

2024

Revenue$244,302,568
Expenses$327,479,756
Net Income-$83,177,188

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$220$1,043$823$244$327$83.2
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$218$958$740$160$228$67.5
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$199$871$672$202$272$69.5
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$197$799$602$170$229$59.0
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$211$754$543$159$270$111
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$222$654$432$164$253$88.8
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$195$539$344$159$243$83.9
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$180$439$260$207$196$10.7
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$189$459$270$185$179$6.13
2015XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$176$452$276$170$189$19.5
2014XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$173$430$257$185$220$35.2
2013Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$172$394$222$194$414$220
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$401$403$1.76$544
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$404$378$25.5$536
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$379$346$33.1$518
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2023 to Sep 30, 2024
Signed
Aug 14, 2025
Return Version
2023v6.0
Gross Receipts
$244,409,936
Mission and Program Overview

Mission

To 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.

See Schedule O

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$177,968,162$170,044,765▼ $7,923,397
Accounts Receivable$12,675,090$20,036,711▲ $7,361,621
Inventories for Sale or Use$9,675,280$12,565,031▲ $2,889,751
Investments in Publicly Traded Securities$10,234,045$8,964,680▼ $1,269,365
Intangible Assets$2,031,994$2,218,422▲ $186,428
Prepaid Expenses and Deferred Charges-$252,498-
Cash and Non-Interest-Bearing Accounts$101,757$102,658▲ $901
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0--
Investments Program Related$0--
Loans From Officers Directors$0$0→ $0
Total Assets$218,304,419$220,088,578▲ $1,784,159
Other Assets Total$5,618,091$5,903,813▲ $285,722
Liabilities
Other Liabilities$954,440,941$1,039,382,523▲ $84,941,582
Accounts Payable and Accrued Expenses$3,675,704$3,249,971▼ $425,733
Deferred Revenue$0$0→ $0
Total Liabilities$958,116,645$1,042,632,494▲ $84,515,849
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$-739,812,226$-822,543,916▼ $82,731,690
Total Net Assets Fund Balance$-739,812,226$-822,543,916▼ $82,731,690
Total Liabilities and Net Assets / Fund Balance$218,304,419$220,088,578▲ $1,784,159

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$136,273,503$149,924,356$286,197,859
Equipment$23,642,024$96,437,467$120,079,491
Land$8,284,604-$8,284,604
Other Land Buildings$1,844,634$1,991,293$3,835,927
Compensation and Service Providers

Board Members and Trustees

NameTitle
Jennifer Kleven MdMedical Governors - Chair
Heather Schimmers RnSouthern Counties Regional President, Ex-officio
Kraig SchusterAdministrative Vice President
Michael MckeeAdministrative Vice President
Pamela MaasFormer Vice President Business Services
Jonathan Zlabek MdMedical Vice President
P Michael Jacobs MdMedical Vice President
Todd Kowalski MdMedical Vice President
Kari AdankVice President Compliance
Janine LuzVice President Learning
Praveen ChopraChief Digital and Information Officer
Scott Rathgaber MdChief Executive Officer
John CeelenChief Financial Officer, Treasurer (begin 2/24)
William FarrellChief Innovation & Strategy Officer
Stephen Shapiro MdChief Medical Foundation Officer
Andrea Hauser RnChief Nursing Officer and Admin VP
Bryan ErdmannChief Operating Officer
Leanne AndersenChief People Officer
Marilu Bintz MdChief Population Health Officer
Andrea WernerChief Population Officer
Lisa HartonChief Quality Officer
Gerald OetzelFormer Chief Financial Officer
Daniel LillyGeneral Counsel
Steve LittleInterim Chief Financial Officer, Treasurer (thru 2/24)
Mary Kuffel MdInterim Medical VP, Cross-functional Care
Douglas Hughes MdMedical Doctor
Jeffrey M Lawrence MdMedical Doctor
Jerry Davis MdMedical Doctor
Mark S Topolski MdMedical Doctor
Steven Whitford MdMedical Doctor
Benjamin Jarman MdMedical Governors - Member
Benjamin Orozco MdMedical Governors - Member
Christopher Eberlein MdMedical Governors - Member
Elizabeth Cogbill MdMedical Governors - Member
Stephanie Carroll MdMedical Governors - Member
David GerhardMedical Governors - Member (begin 10/24)
Paul BerglMedical Governors - Member (begin 10/24)
Robyn Borge MdMedical Governors - Member (thru 1/24)
Trey Folkers MdMedical Governors - Member (thru 7/24)
Ezana Azene MdMedical Governors - Secretary & Treasurer
Michael Dolan MdSouthern Chief Clinical Officer
Ellen Pedretti-fendtVP Application Services
Krister MattsonVP Enterprise Analytics
Eric DehnVP Enterprise Architecture and Solution Design
Shannon MulliganVP Hr & Total Rewards
Revenue and Support

Revenue Composition

Contributions and Grants
$1,187,295
Program Service Revenue
$242,398,618
Investment Income
$323,956
Other Revenue
$392,699
All Other Contributions
$26,250
Change in Net Assets
$-83,177,188
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$323,887,609
Grants and Similar Amounts Paid$3,592,147
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Management$84,749,413$10,902,133-$95,651,546
Fees for Services Other$13,202,493$408,811$0$13,611,304
Depreciation Depletion$7,334,231$5,328,408-$12,662,639
Occupancy$3,385,263$2,212,335-$5,597,598
Grants to Domestic Individuals$2,226,517--$2,226,517
Insurance$71,610$2,104,554-$2,176,164
Office Expenses$1,845,580$66,987-$1,912,567
Grants to Domestic Orgs$1,365,630--$1,365,630
Travel$697,852$1,782-$699,634
Information Technology$562,678$62,047-$624,725
Other Expenses$180,433$890-$181,323
All Other Expenses$159,298$2,247$0$161,545
Conferences and Meetings$40,780--$40,780
Fees for Services Lobbying$27,515--$27,515
Advertising$22,751--$22,751
Fees for Service Investment Mgmnt Fees-$6,600-$6,600
Fees for Services Legal$6,102--$6,102
Total Functional Expenses$290,206,794$37,272,962$0$327,479,756
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Gundersen Lutheran Medical Foundation IncLa Crosse, WI501(c)(3)Operations Support$1,309,464
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Intercompany Payable$1,026,194,798
Malpractice Claim Reserve$7,799,628
Operating Lease Obligations$4,069,069
Asset Retirement Obligations$1,319,028
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
Yes

Governance Explanations

Form 990, Part VI, Line 15 A AND B - PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL

All 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 proposed salaries are independently reviewed by an outside auditing firm. The compensation recommendations, audit reports, along with the market data, are presented to a committee made up of the community members of the board of trustees. The compensation amounts are not effective until the board committee approves them. Meeting minutes are taken and kept at the meetings where the board reviews and approves the compensation of the key employees.

Form 990, Part VI, Line 3 Delegation of management duties

All management and personnel services for gundersen clinic, ltd. Are performed by employees of gundersen lutheran administrative service, inc.

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

The corporation's sole shareholder is gundersen lutheran health system, inc. The bylaws may be amended by the board with approval of the parent corporation, or by the vote of the sole shareholder. Also, the affairs of the corporation shall be managed under the direction of the corporation's medical governors, subject to certain approval powers of the board of trustees of the parent corporation.

Form 990, Part VI, Line 11B Review of form 990 by governing body

The form 990 will be available for all board members before filing and upon further review by the cfo, vice-president of finance or director of finance, the 990s are approved and filed.

Form 990, Part VI, Line 12C Conflict of interest policy

Gundersen clinic, ltd. Monitors conflicts on an annual basis by reviewing disclosures on completed conflict of interest statements.

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.

Form 990, Part VII, Section A, Line 1A, Column (C) FORMER REPORTING

The following individuals are no longer considered officers for purposes of form 990 reporting: stephen shapiro, md the following individuals are no longer considered key employees for purposes of form 990 reporting: daniel lilly todd kowalski, md johnathan zlabek, md marilu bintz, md eric dehn krister mattson shannon mulligan kari adank janine luz ellen pedretti-fendt p michael jacobs, md bryan erdmann mary kuffell, md kraig schuster michael mckee andrea hauser, rn

Form 990, Part VIII, Line 2A - Program Service Revenue

The provision of medical services in a manner beneficial to the community furthers gundersen clinic, ltd.'s charitable purpose of promotion of health.

Filing and Contact Details

Filer

Filer Name
Gundersen Clinic Ltd
EIN
39-1028657
Phone
6087827300
Address
1836 SOUTH AVENUE, LA CROSSE, WI 54601

Signing Officer

Name
John Ceelen
Title
CFO
Signed
2025-08-14
Discuss with paid preparer
Yes

Organization Details

Formed
1963
Legal Domicile
Wi
Voting Board Members
9
Independent Board Members
0
Employees
0
Volunteers
0

Preparer

Firm
Ernst & Young US Llp
Address
155 N WACKER DRIVE, CHICAGO, IL 60606
Preparer
Emily Beckerman
Phone
3128792000
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 4A Program Service Accomplishments

Gundersen clinic, ltd. (the clinic) has 738 physicians representing nearly every specialty serving a 21 county region in western wisconsin, northeastern iowa and southeastern minnesota. The clinic provides medical care to all patients regardless of their ability to pay. Charity care and/or financial assistance is determined based on financial information provided by the patient and analysis of other relevant information. There were approximately 1,144,681 patient encounters for fy2024 (oct-sep). The clinic provided uncompensated care related to charity at cost, $1,822,561; medicare, $142,043,878; and medicaid, $48,952,997 for the total amount of $192,819,436 at cost based on policies and contracts arranged to help support the community's needs. The $192,819,436 is the sum of unreimbursed medicare & medicaid cost plus charity at cost. All of these are calculated using the same method utilized for the hospital calculation of charity cost and unreimbursed medicare and medicaid costs. The cost of charity is calculated by allocating the cost to provide services to a patient between any payments, bad debt, and charity writeoffs where total payments are less than the cost of services provided. The unreimbursed medicare and medicaid costs are calculated by comparing the cost of services to medicare and medicaid patients to the net revenue for those same patients. The unreimbursed cost is the amount the cost exceeds the net revenue for those same patients. Medicare and medicaid patients to the net revenue for those same patients. The unreimbursed cost is the amount the cost exceeds the net revenue for those same patients.

Form 990, Part V, Line 1A AND Line 2

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. Hence lines 1 & 2 indicate zero (0) filings.

FORM 990, PART I, LINE 1 - ORGANIZATION'S MISSION

To 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.

Financial Statement Notes

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

INCOME TAX MATTERS (DOLLARS IN THOUSANDS) THE SYSTEM QUALIFIES AS A TAX-EXEMPT ORGANIZATIO UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), WITH THE EXCEPTION OF GUNDERSEN LUTHERAN ENVISION, LLC AND GUNDERSEN EDGE, LLC, WHICH ARE FOR-PROFIT ENTITIES. At September 30, 2024 and 2023, net deferred tax assets of $11,395 and $10,512, respectively, which primarily are related to net operating loss carryforwards, have valuation allowances of $11,395 and $10,512, respectively, recorded against them due to the uncertainty of realizing those benefits in the future. At September 30, 2024, the System's federal net operating loss carryforwards were approximately $43,489, and the state net operating loss carryforwards were approximately $41,989, which will expire between 2032 and 2041. The System has reviewed its tax positions for all open years and has concluded that no liabilities exist for uncertain tax positions. The System's income tax returns are no longer subject to examination for 2018 and prior years.

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