Civic Intelligence

Gundersen Clinic Ltd.

990 • Fiscal year 2015 • EIN 39-1028657

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 15, 2016

1836 South AvenueLa Crosse, WI 54601

(608) 782-7300

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

99th percentile

2.57x

Higher debt load relative to assets than 99% of similar nonprofits.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2015

Liabilities / Revenue

86th percentile

2.66x

Higher debt load relative to revenue than 86% of similar nonprofits.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2015

Net Margin

10th percentile

-11%

Higher net margin than 10% of similar nonprofits.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2015

Top Officer Pay

86th percentile

$1,312,325

Higher top officer pay than 86% of similar nonprofits.

Top officer pay equals 0.8% of source-year revenue.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2015

Asset Growth

51st percentile

1.7%

Faster asset growth than 51% of similar nonprofits.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Annualized from 2014 to 2015

Revenue Growth

20th percentile

-8.2%

Faster revenue growth than 20% of similar nonprofits.

2015 filings • 501(c)3 • $100M-$250M nonprofits • Annualized from 2014 to 2015

Assets

Up

$176,008,200

Up $2,866,392 (+1.7%) from 2014

Net Assets

Down

-$276,488,881

Down $19,489,171 (-7.6%) from 2014

Liabilities

Up

$452,497,081

Up $22,355,563 (+5.2%) from 2014

Revenue

Down

$169,843,167

Down $15,085,490 (-8.2%) from 2014

Expenses

Down

$189,332,338

Down $30,809,499 (-14%) from 2014

Net Income

Up

-$19,489,171

Up $15,724,009 (+45%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$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

2015

Assets$176,008,200
Liabilities$452,497,081
Net Assets-$276,488,881

Operations Trend

Revenue, expenses, and net income across loaded years, with this 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

2015

Revenue$169,843,167
Expenses$189,332,338
Net Income-$19,489,171
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 15, 2016
Return Version
2015v2.1
Gross Receipts
$169,982,775
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$144,311,256$137,843,692▼ $6,467,564
Accounts Receivable$11,783,625$20,902,295▲ $9,118,670
Investments in Publicly Traded Securities$9,757,070$10,640,464▲ $883,394
Inventories for Sale or Use$3,138,304$2,833,036▼ $305,268
Savings and Temporary Cash Investments$586,180$0▼ $586,180
Prepaid Expenses and Deferred Charges$701,319$457,977▼ $243,342
Cash and Non-Interest-Bearing Accounts$0$182,156▲ $182,156
Investments Other Securities$20,000$20,000→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Program Related$0$0→ $0
Intangible Assets$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$173,141,808$176,008,200▲ $2,866,392
Other Assets Total$2,844,054$3,128,580▲ $284,526
Liabilities
Other Liabilities$419,642,706$438,332,884▲ $18,690,178
Accounts Payable and Accrued Expenses$10,498,812$14,164,197▲ $3,665,385
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$430,141,518$452,497,081▲ $22,355,563
Net Assets / Fund Balance
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Unrestricted Net Assets$-256,999,710$-276,488,881▼ $19,489,171
Total Net Assets Fund Balance$-256,999,710$-276,488,881▼ $19,489,171
Total Liabilities and Net Assets / Fund Balance$173,141,808$176,008,200▲ $2,866,392

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$111,019,598$84,235,562$195,255,160
Equipment$16,859,938$67,537,410$84,397,348
Land$9,417,988-$9,417,988
Leasehold Improvements$546,168$1,219,876$1,766,044
Compensation and Service Providers

Board Members and Trustees

NameTitle
Scott Rathgaber MDCEO, Med VP, Board Chair
Mary Kuffel MDMedical Vice President
Stephanie Carroll MDMedical Vice President
Debra RislowSenior Vice President
Gerald ArndtSenior Vice President
Kathleen KlockSenior Vice President
Mark PlattSenior Vice President
Bryan ErdmannVice President
Elizabeth Smith-HouskampVice President
Kelly BartonVice President
Kraig SchusterVice President
Julio Bird MDBoard of Governors - Exec VP
Brian Mulrennan MDBoard of Governors - Member
Brian Sieck MDBoard of Governors - Member
Frank Aberger MDBoard of Governors - Member
Jonathan Zlabek MDBoard of Governors - Member
Kelley Bahr MDBoard of Governors - Member
Sigurd Gundersen III MDBoard of Governors - Member
Stephen Shapiro MDBoard of Governors - Member
Greg Thompson M DBoard of Governors, CMO
Jeffrey Thompson MDChief Executive Officer
Michael AllenChief Financial Officer
Dara BartelsInterim CFO
Marilu Bintz MDMed VP, Sr VP
Douglas Hughes MDMedical Doctor
Edward Riley II MDMedical Doctor
Jeffrey Lawrence MDMedical Doctor
Jerry Davis MDMedical Doctor
Mark Topolski MDMedical Doctor
William Agger MDMedical Doctor
Michael Dolan MDMVP, Exec VP, Med COO
Mary Lu GerkeNurse Executive
P Michael Jacobs DPMSecretery/Treasurer, MVP

Highest Paid Contractors

ContractorServicesLocationCompensation
Gundersen Lutheran Admin ServicesServices/Supplies1910 South Avenue, La Crosse, WI 54601$246,604,448
Revenue and Support

Revenue Composition

Contributions and Grants
$1,620,820
Program Service Revenue
$168,247,129
Investment Income
$-15,032
Other Revenue
$-9,750
All Other Contributions
$30,115
Change in Net Assets
$-19,489,171
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$98,736,594
Other Expenses$87,835,105
Grants and Similar Amounts Paid$2,760,639
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$70,540,501$1,106,544-$71,647,045
Payments to Affiliates$16,786,283$33,830,423-$50,616,706
Other Employee Benefits$9,943,667$23,161-$9,966,828
Pension Plan Contributions$9,280,966$155,919-$9,436,885
Occupancy$3,160,438$4,079,945-$7,240,383
Depreciation Depletion$2,597,026$4,440,041-$7,037,067
Current Officers, Directors, Trustees, and Key Employees$3,974,405--$3,974,405
Fees for Services Other-$3,912,476-$3,912,476
Payroll Taxes$3,630,474$80,957-$3,711,431
Grants to Domestic Individuals$1,782,275--$1,782,275
Office Expenses$1,279,889$188,100-$1,467,989
Insurance-$1,323,119-$1,323,119
Grants to Domestic Orgs$978,364--$978,364
Other Expenses$929,397$50,901-$929,397
Travel$630,411$1,432-$631,843
Fees for Services Legal$196,520--$196,520
Information Technology$185,571--$185,571
Fees for Services Lobbying$19,985--$19,985
Total Functional Expenses$140,139,320$49,193,018$0$189,332,338
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Gundersen Lutheran Medical Foundation IncLa Crosse, WI501 (c) (3)Support of GLMF, Inc. LUTHERAN MEDICAL FOUNDATION, INC.$978,364
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
Subject to proxy tax
No
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$427,892,884
Lt Malpractice Claim Rsv$7,117,490
Reserve Malpractice Claims$1,799,676
Asset Retirement Oblig-fin47$1,515,950
Lease Contract Payable$6,884
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
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
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

Gundersen lutheran health system, inc. Is the sole member of this organization.

Form 990, Part VI, Line 7A

Gundersen lutheran health system, inc.

Form 990, Part VI, Section A, Line 7B

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 board of governors, subject to certain approval powers of the board of governors and board of trustees of the parent corporation.

Form 990, Part VI, Section B, Line 11

The form 990 will be available for all board members at a board meeting and the gundersen lutheran health system finance committee receives a copy of the 990 before filing. Upon further review from the cfo the 990s are approved and filed.

Form 990, Part VI, Section B, Line 12C

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

Form 990, Part VI, Section B, Line 15

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, Section C, Line 19

Requests for all documents are made through the legal department and the appropriate documents are made available for inspection in the legal department.

Form 990, Part VII, Section A, Line 1

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

Form 990, Part VII, Section B, Line 1

All payments to vendors are made by gundersen lutheran administrative services, inc.

Form 990, Part VIII, Line 2A

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
In Care Of
% DARA BARTELS
Phone
6087827300
Address
1836 South Avenue, La Crosse, WI 54601

Signing Officer

Name
Dara Bartels
Title
CFO
Signed
2016-11-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Scott Rathgaber Md
Formed
1963
Legal Domicile
Wi
Voting Board Members
10
Independent Board Members
0
Employees
0
Volunteers
0

Preparer

Firm
Kpmg Llp
Address
4200 WELLS FARGO CTR 90 S 7TH ST, MINNEAPOLIS, MN 55402
Preparer
Ann K Lamoureux
Phone
6123055000
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1

Description of organization 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.

Form 990, Part III, Line 4A

Program service accomplishments: gundersen clinic, ltd. (the clinic) has 522 physicians representing nearly every specialty serving a 19 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 1,001,000 patient encounters for 2015. The clinic provided uncompensated care related to charity, $1,392,637; medicare, $41,036,319; and medicaid, $14,447,049 for the total amount of $56,876,005 at cost based on policies and contracts arranged to help support the community's needs. The $56,876,005 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 write-offs 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. Unreimbursed cost is the amount the cost exceeds the net revenue.

Form 990, Part IV, Line 24A

Tax exempt bonds gundersen clinic,ltd. 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 balance sheet of gundersen lutheran administrative services, inc. Fein 39-1606449.

Form 990, Part XII, Line 2C

The 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 XII, Line 3A

Gundersen clinic, ltd. Operates in conjunction with a group of other affiliated corporations governed by gundersen lutheran health system, inc. As such, any federal awards to gundersen clinic, ltd . Undergo an audit as set forth in the single audit act and omb circular a-133.

Financial Statement Notes

Form Sch D, Part X, Line 2

The obligated group has reviewed its tax positions for all open years and has concluded that no liabilities exist for uncertain tax positions at december 31, 2015 or 2014. The obligated group's income tax returns are generally no longer subject to examination for 2011, and prior years.

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IRS990/Form990PartVIISectionAGrp/PersonNm0Scott Rathgaber MD
IRS990/Form990PartVIISectionAGrp/PersonNm1Julio Bird MD
IRS990/Form990PartVIISectionAGrp/PersonNm2Sigurd Gundersen III MD
IRS990/Form990PartVIISectionAGrp/PersonNm3Brian Sieck MD
IRS990/Form990PartVIISectionAGrp/PersonNm4Stephen Shapiro MD
IRS990/Form990PartVIISectionAGrp/PersonNm5Brian Mulrennan MD
IRS990/Form990PartVIISectionAGrp/PersonNm6Jonathan Zlabek MD
IRS990/Form990PartVIISectionAGrp/PersonNm7Greg Thompson M D
IRS990/Form990PartVIISectionAGrp/PersonNm8Kelley Bahr MD
IRS990/Form990PartVIISectionAGrp/PersonNm9P Michael Jacobs DPM
IRS990/Form990PartVIISectionAGrp/PersonNm10Jeffrey Thompson MD
IRS990/Form990PartVIISectionAGrp/PersonNm11Michael Dolan MD
IRS990/Form990PartVIISectionAGrp/PersonNm12Dara Bartels
IRS990/Form990PartVIISectionAGrp/PersonNm13Michael Allen
IRS990/Form990PartVIISectionAGrp/PersonNm14Mary Kuffel MD
IRS990/Form990PartVIISectionAGrp/PersonNm15Marilu Bintz MD
IRS990/Form990PartVIISectionAGrp/PersonNm16Stephanie Carroll MD
IRS990/Form990PartVIISectionAGrp/PersonNm17Kraig Schuster
IRS990/Form990PartVIISectionAGrp/PersonNm18Elizabeth Smith-Houskamp
IRS990/Form990PartVIISectionAGrp/PersonNm19Bryan Erdmann
IRS990/Form990PartVIISectionAGrp/PersonNm20Kelly Barton
IRS990/Form990PartVIISectionAGrp/PersonNm21Kathleen Klock
IRS990/Form990PartVIISectionAGrp/PersonNm22Gerald Arndt
IRS990/Form990PartVIISectionAGrp/PersonNm23Mark Platt
IRS990/Form990PartVIISectionAGrp/PersonNm24Debra Rislow
IRS990/Form990PartVIISectionAGrp/PersonNm25Jeffrey Lawrence MD
IRS990/Form990PartVIISectionAGrp/PersonNm26Edward Riley II MD
IRS990/Form990PartVIISectionAGrp/PersonNm27Jerry Davis MD
IRS990/Form990PartVIISectionAGrp/PersonNm28Mark Topolski MD
IRS990/Form990PartVIISectionAGrp/PersonNm29Douglas Hughes MD
IRS990/Form990PartVIISectionAGrp/PersonNm30Frank Aberger MD
IRS990/Form990PartVIISectionAGrp/PersonNm31William Agger MD
IRS990/Form990PartVIISectionAGrp/PersonNm32Mary Lu Gerke
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IRS990/Form990PartVIISectionAGrp/TitleTxt0CEO, Med VP, Board Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt1Board of Governors - Exec VP
IRS990/Form990PartVIISectionAGrp/TitleTxt2Board of Governors - Member
IRS990/Form990PartVIISectionAGrp/TitleTxt3Board of Governors - Member
IRS990/Form990PartVIISectionAGrp/TitleTxt4Board of Governors - Member

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

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
2015Detailed filing. Detailed filing data is available for this year.$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