2021-11-24T14:35:44-06:00 2020-12-31 ERNST & YOUNG US LLP 155 N Wacker Drive Chicago IL 60606 990 2020-01-01 390929538 ST JOSEPH'S HEALTH SERVICES INC % ROBIN NELSON STJO 6084898000 PO BOX 527 400 WATER AVENUE HILLSBORO WI 54634 ROBIN NELSON CFO 6084898000 2021-11-24 true ROBIN NELSON 999009999 JESS WAGENER P01622613 3128792000 2021-11-24 3 2020 2022-09-23 18:48:47Z GUNDERSEN ST JOSEPHS HOSP AND CLINIC ROBIN NELSON PO BOX 527 400 WATER AVENUE HILLSBORO WI 54634 25824555 false X WWW.GUNDERSENHEALTH.ORG/ST-JOSEPHS X 1949 WI WE WILL ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES WHILE ENRICHING EVERY LIFE WE TOUCH, INCLUDING PATIENTS, FAMILIES, AND STAFF. 9 3 233 0 0 64862 3697741 25009364 22000065 100122 17954 0 108795 25174348 25824555 0 0 0 0 11830171 12462461 0 0 0 10330019 11828411 22160190 24290872 3014158 1533683 40489299 51905059 17605835 27337561 22883464 24567498 X WE WILL DISTINGUISH OURSELVES THROUGH PATIENT CARE, EDUCATION, RESEARCH AND IMPROVED HEALTH IN THE COMMUNITIES WE SERVE. false false 16932733 0 18131011 ST. JOSEPH'S HEALTH SERVICES, INC. PROVIDES INPATIENT, OUTPATIENT, AND 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. THE ORGANIZATION OPERATES A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING ACUTE CARE SERVICES TO THE HILLSBORO, WISCONSIN AREA. INPATIENT SERVICES INCLUDE ACUTE CARE FOR MEDICAL, SURGICAL, SWING BED, AND HOSPICE PATIENTS. ST. JOSEPH'S HEALTH SERVICES, INC. ALSO PROVIDES DIAGNOSTIC SERVICES TO PATIENTS, SUCH AS X-RAY, LAB, AND THERAPY SERVICES. THE HOSPITAL HAD 1065 TOTAL INPATIENT DAYS DURING THE FISCAL YEAR. OF THOSE PATIENT DAYS 732 WERE RELATED TO ACUTE INPATIENT SERVICES AND 333 DAYS OF CARE PROVIDED TO HOSPICE AND SWING BED PATIENTS. THE HOSPITAL'S SWING BED PROGRAM PROVIDES CARE TO PATIENTS NEEDING EITHER SKILLED NURSING OR REHABILITATIVE PROGRAMS IN THE HOSPITAL SETTING. THE SWING BED PROGRAM IS A VITAL SERVICE TO THE COMMUNITY AS THERE CURRENTLY IS NO SKILLED NURSING FACILITY IN HILLSBORO, WISCONSIN, AND THIS PROGRAM ALLOWS MANY PATIENTS THE OPPORTUNITY TO BE CARED FOR IN THEIR COMMUNITY. ST. JOSEPH'S HEALTH SERVICES ALSO PROVIDES VARIOUS OUTPATIENT SERVICES INCLUDING EMERGENCY AND URGENT CARE SERVICES; DIAGNOSTIC PROCEDURES, SUCH AS X-RAYS, CT SCANS, MRI'S, AND LABORATORY TESTING; SURGICAL PROCEDURES; AND THERAPY PROGRAMS INCLUDING PHYSICAL, OCCUPATIONAL, SPEECH, AND RESPIRATORY THERAPY SERVICES ARE AMONG THE MANY SERVICES PROVIDED BY THE HOSPITAL. ST. JOSEPH'S HEALTH SERVICES, INC. PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITH MINIMAL CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. IN ADDITION, ST. JOSEPH'S IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THIS PROGRAM, THE ORGANIZATION IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES. (SEE ADDITIONAL INFORMATION ON THE COST OF PROVIDING THESE SERVICES INCLUDED IN SCHEDULE H OF THE FORM 990.) IN ADDITION TO PROVIDING INPATIENT AND OUTPATIENT SERVICES, ST. JOSEPH'S HEALTH SERVICES, INC. ALSO SPONSORS VARIOUS PROGRAMS THAT ARE OUTSIDE OUR WALLS AND ARE AVAILABLE TO MEMBERS OF THE COMMUNITY AT LITTLE TO NO COST. ST. JOSEPH'S HEALTH SERVICES OFFERS A SAFE SITTER PROGRAM, WHICH TEACHES TEENS HOW TO PROPERLY CARE FOR CHILDREN WHILE BABYSITTING AND WHAT ACTIONS TO TAKE IF AN EMERGENCY ARISES, AND A "CLUB SCRUB" EVENT, WHICH IS A TWO-DAY EVENT THAT FEATURES HEALTH CARE CAREERS. ADDITIONAL PROGRAMS PROVIDED TO THE COMMUNITY INCLUDE: CPR, SCHOOL WELLNESS DAYS, FREE HEALTH FAIRS, FREE COOKING CLASSES FOR COMMUNITY, AS WELL AS MEETING SPACE FOR VARIOUS COMMUNITY ORGANIZATION MEETINGS THAT PROMOTE HEALTHCARE AND SENIOR CITIZEN ACTIVITIES. ST. JOSEPH'S SENIOR MEAL SITE LOCATION PROVIDES HEALTHY MEALS FOUR DAYS A WEEK AT A MINIMAL CHARGE TO SENIOR CITIZENS AND ACTIVITIES FOR LOCAL SENIOR CITIZENS. ST. JOSEPH'S COORDINATES THE HEALTH NEIGHBORS PROGRAM WHICH OFFERS A STRONG BODIES EXERCISE PROGRAM AND PRODUCE DISTRIBUTION. ST, JOSEPH'S OFFERS ADULT FITNESS IN OUR REHABILITATION GYM, HOME MONITORING EQUIPMENT FOR SENIORS SO THAT THEY CAN SAFELY GO HOME TO RECOVER. WE OFFER LIFELINES FOR SENIORS TO GIVE THEN SOME SECURITY IN THEIR OWN HOMES IN CASE OF EMERGENCY. ST. JOSEPH'S IS VERY INVOLVED IN THE CARE OF THE SCHOOL AGE CHILDREN IN OUR SERVICE AREA. WE EMPLOY THE SCHOOL NURSES, ATHLETIC TRAINING, AND BEHAVIORAL HEALTH THERAPISTS TO THE SCHOOLS. THIS ALLOWS THE SCHOOL TO CONTRACT OUT THESE SERVICES FROM OUR FACILITY AT A RATE THAT THEY CAN AFFORD. WE PROVIDE ALL THE TRAINING, CME, AND EDUCATION TO SUPPORT THESE PROVIDERS IN THE SCHOOL SYSTEM. 3680190 3869054 ST. JOSEPH'S HEALTH SERVICES, INC. ALSO OPERATES THREE CLINICS LOCATED IN HILLSBORO, ELROY, AND WONEWOC, WISCONSIN. DURING THE FISCAL YEAR THESE THREE CLINICS PROVIDED A TOTAL OF 12,469 VISITS TO PATIENTS. ALL THREE OF THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH BY DEFINITION ARE LOCATED IN DESIGNATED RURAL AND UNDERSERVED AREAS OF THE COUNTRY BY HEALTH CARE PRACTITIONERS. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO WITHOUT ACCESS TO CARE LOCALLY WOULD BE REQUIRED TO TRAVEL FURTHER DISTANCES FOR QUALITY HEALTHCARE. PATIENTS OF THE CLINICS ARE ALSO ELIGIBLE TO QUALIFY UNDER ST. JOSEPH'S HEALTH SERVICES FINANCIAL ASSISTANCE POLICY AS IT IS THE GOAL OF THE ORGANIZATION TO PROVIDE QUALITY HEALTHCARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 20612923 true false 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 false true false false false false false false true false false false false false false true true false false false true 37 0 true 233 true false false false false false false false false false false false false X 9 3 false true false false true true true true true false false true true true true true true false false false X ROBIN NELSON 6084898000 400 WATER AVENUE HILLSBORO WI 54634 X MIKE MCKEE Vice Chair 0.8 40.0 X X 0 227150 55760 SCOTT LARSON PHARMACIST 50.0 0.0 X 247332 0 22684 TONI TENGBLAD CHIEF OF CLINICAL OPERATIONS 50.0 0.0 X 148156 0 37482 ANDREA ANDERSON PROVIDER 40.0 0.0 X 145936 0 31893 ROBIN NELSON CHIEF FINANCIAL OFFICER 50.0 0.0 X 148846 0 25728 DENISE KROES NURSE 70.0 0.0 X 147459 0 23964 KRISTIE MCCOIC ADMINISTRATOR 0.0 50.0 X 0 139292 25949 RACHEL ALBRECHT MBA TREASURER/ADMINISTRATIVE DIR 0.8 40.0 X X 0 122964 16029 KEVIN FEYEN BOARD DIRECTOR/MGR CONSTRUCTN 0.8 40.0 X 0 109382 16690 JIM MLSNA CHAIR 0.8 0.0 X X 0 0 0 ANN BRADNAU HYNEK SECRETARY 0.8 0.0 X X 0 0 0 KATHY KLOCK BOARD DIRECTOR 0.8 0.0 X 0 0 0 MIKE RORAFF BOARD DIRECTOR 0.8 0.0 X 0 0 0 NATALIE ADAMS BOARD DIRECTOR 0.8 0.0 X 0 0 0 DANA MEYERS BOARD DIRECTOR 0.8 0.0 X 0 0 0 837729 598788 256179 5 false true false C D SMITH CONSTRUCTION INC PO BOX 1006 FOND DU LAC WI 549361006 CONSTRUCTION 8062373 GUNDERSEN HEALTH SYSTEM 1900 SOUTH AVE LA CROSSE WI 54601 HEALTH AND ADMIN SVC 5213555 QUARTZ HEALTH BENEFIT PLANS 2650 NOVATION PARK MADISON WI 53713 HEALTH SERVICES 2250090 ADP INC PO BOX 842875 BOSTON MA 02284 PAYROLL SERVICES 2155717 PRINCIPAL FINANCIAL GROUP PO BOX 2000 MASON CITY IA 50402 pension services 1077405 5 3697741 3697741 NET PATIENT SERVICE REVENUE 621400 21740572 21740572 0 0 CRITICAL CARE STIPEND 621400 168972 168972 0 0 MEDICAL DIRECTORSHIP 621400 2250 2250 ALL OTHER 900099 88271 88271 22000065 17954 0 0 17954 0 0 4050 4050 0 4050 4050 0 0 0 0 0 0 0 0 0 0 DIETARY/CAFETERIA 722210 104745 0 0 104745 104745 25824555 22000065 0 126749 X 0 0 0 0 544334 0 544334 0 0 8731770 7571449 1160321 0 338493 289205 49288 0 2190947 1862305 328642 0 656917 558380 98537 0 0 0 52225 0 52225 0 2050 2050 0 0 5821447 5821447 0 0 60857 0 60857 0 21973 0 21973 0 0 0 908464 550935 357529 0 27722 0 27722 0 0 99891 0 99891 0 0 0 1806125 1444900 361225 0 79060 0 79060 0 PROVISION FOR BAD DEBT 87617 0 87617 0 MEDICAL SUPPLIES 974822 974822 0 0 PHARMACY EXPENSE 1537430 1537430 0 0 ALL OTHER EXPENSES 348728 348728 0 24290872 20612923 3677949 0 950 950 7618634 11236659 0 107421 3138169 3728169 0 0 0 0 0 0 398353 431029 144945 99879 38922583 4141489 26262391 34781094 0 0 622521 0 0 0 0 0 2303336 1519858 40489299 51905059 5964992 3507978 0 0 0 449473 11208946 0 0 0 0 0 0 23070857 0 0 431897 309253 17605835 27337561 X 21481117 23743527 1402347 823971 22883464 24567498 40489299 51905059 X 1533683 150351 X false true X true false X true 2050 2050 false PART II-B, LINE 1, LOBBYING ACTIVITIES ST. JOSEPH'S HEALTH SERVICES, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING, HOWEVER, A PORTION OF THE ANNUAL DUES PAID TO THE WHA WAS USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 735914 735914 29806628 3321957 26484671 713678 28710 684968 7102995 567333 6535662 563368 223489 339879 34781094 0 DEFERRED PAYROLL TAXES (COVID) 166095 LT PORTION OF PART B NGS COVID ADVANCE 143158 309253 true true X true X true X false false false 321030 0 321030 0.01330 2344382 1476022 868360 0.03590 2665412 1476022 1189390 0.04920 712655 4792 707863 0.02920 670 670 713325 4792 708533 0.02920 3378737 1480814 1897923 0.07840 true 501446 250723 15268261 7634115 7634146 X true true 1 1 ST JOSEPH'S HEALTH SERVICES INC PO BOX 527 400 WATER AVENUE HILLSBORO WI 54634 WWW.GUNDERSENHEALTH.ORG/ST-JOSEPH 1005 X X X X PROVIDER BASED PHYSICIAN CLINCICS ST JOSEPH'S HEALTH SERVICES INC 1 false false true X X X X X X X X X 18 true true true true X SEE SUPPLEMENTAL INFORMATION X true 19 true SEE SUPPLEMENTAL INFORMATION false true X 200. 400. X X X X true true X X X X true X See Part V X See Part V X See Part V X X X X X X true X false X X X X true X false false ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, SECTION B, LINE 5: IN PREPARING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) , ST. JOSEPH'S HEALTH SERVICES, INC. GATHERED INFORMATION IN THREE WAYS: - A RANDOM HOUSEHOLD SURVEY - FOCUS GROUP DISCUSSIONS HELD WITH COMMUNITY MEMBERS FROM THE GUNDERSEN ST. JOSEPH'S SERVICE AREA - AN ANALYSIS OF KEY SOCIO-ECONOMIC INDICATORS - INPUT FROM GUNDERSEN ST. JOSEPH'S PATIENT AND FAMILY ADVISORY COUNCIL MEMBERS ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS: - TRI-COUNTY MEMORIAL HOSPITAL - GUNDERSEN LUTHERAN HEALTH CENTER - MAYO CLINIC HEALTH SYSTEM - TOMAH MEMORIAL HOSPITAL - VERNON MEMORIAL HEALTHCARE ST. JOSEPH'S HEALTH SERVICES, INC. PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER ORGANIZATIONS: - GREAT RIVERS UNITED WAY - LA CROSSE COMMUNITY FOUNDATION - LA CROSSE COUNTY HEALTH DEPARTMENT - MONROE COUNTY HEALTH DEPARTMENT - VERNON COUNTY HEALTH DEPARTMENT - TREMPEALEAU COUNTY HEALTH DEPARTMENT - HOUSTON COUNTY PUBLIC HEALTH DEPARTMENT ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, SECTION B, LINE 7A HTTPS://WWW.GUNDERSENHEALTH.ORG/APP/FILES/PUBLIC/11060/ST-JOSEPHS-COMMUN ITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-PLAN-2019-21.PDF ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, SECTION B, LINE 10A HTTPS://WWW.GUNDERSENHEALTH.ORG/APP/FILES/PUBLIC/11060/ST-JOSEPHS-COMMUN ITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-PLAN-2019-21.PDF ST. JOSEPH'S HEALTH SERVICES, INC. PART V, SECTION B, LINE 11: THE CHNA WAS COMPLETED IN 2018 AND THE IMPLEMENTATION STRATEGY WAS OFFICIALLY ADOPTED IN EARLY 2019. THE FOLLOWING ISSUES ARE ADDRESSES IN THE IMPLEMENTATION STRATEGY: ADDICTION AND SUBSTANCE ABUSE - REDUCE THE NUMBER OF OPIOID PRESCRIPTIONS WHILE INCREASING THE USE OF OTHER PAIN RELIEF MODALITIES. ADDICTION AND SUBSTANCE ABUSE - REDUCE THE USE OF TOBACCO PRODUCTS IN THE COMMUNITIES SERVED BY GUNDERSEN ST. JOSEPH'S. BEHAVIORAL HEALTH - GET AHEAD OF THE ISSUE BY PROMOTING AWARENESS OF ADVERSE CHILDHOOD EXPERIENCES. BEHAVIORAL HEALTH - INTEGRATE TRAUMA INFORMED CARE INTO THE DELIVERY OF PRIMARY CARE. ACCESS AND COST OF HEALTHCARE - EXPAND THE FREE HEALTH SCREENINGS PROGRAM DEVELOPED 2016-18. ACCESS AND COST OF HEALTHCARE - PROVIDE CONVENIENT ACCESS TO CARE CLOSE TO HOME THROUGH THE INTRODUCTION OF A NURSE MIDWIFE PROGRAM AND INCREASE THE NOTORIETY OF TELEMED SERVICES. ACCESS AND COST OF HEALTHCARE - RAISE AWARENESS OF LOCAL RESOURCES FOR ISSUES SUCH AS HOUSING, HEATING, FINANCIAL AID, FOOD INSECURITY. PROMOTE 2-1-1 IN THE AREA. ISSUES NOT ADDRESSED BY GUNDERSEN ST. JOSEPH'S INCLUDE CONCERNS REGARDING EMPLOYMENT AND LIVABLE WAGES ALTHOUGH THE ORGANIZATION WILL LEND SUPPORT TO AREA ORGANIZATIONS AND PARTNERS ON THIS TOPIC WHEN REQUIRED. ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, SECTION B, LINE 13B: FREE CARE, IN ADDITION TO FAMILY INCOME MEASUREMENT, IS BASED ON ASSETS BEING LESS THAN THE EQUIVALENT OF 600% OF THE FPL THRESHOLD. CATASTROPHIC CARE IS STILL PROVIDED, HOWEVER, FOR PATIENTS NOT MEETING THE FINANCIAL ASSISTANCE THRESHOLDS. THEY MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY HAVE INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY THE HOSPITAL THAT EXCEED 25% OF FAMILY INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% FPL THRESHOLD. PATIENTS, OR PATIENT GUARANTORS, MEETING ELIGIBILITY CRITERIA FOR CATASTROPHIC CARE WILL HAVE THEIR HOSPITAL CHARGES DISCOUNTED TO AN AMOUNT NO TO EXCEED 25% OF FAMILY INCOME. ST. JOSEPH'S HEALTH SERVICES, INC.: PART V, LINE 16A, FAP WEBSITE: HTTP://WWW.GUNDERSENHEALTH.ORG/PAY-MY- BILL/FINANCIAL-ASSISTANCE ST. JOSEPH'S HEALTH SERVICES, INC. PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTP://WWW.GUNDERSENHEALTH.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE ST. JOSEPH'S HEALTH SERVICES, INC. PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTP://WWW.GUNDERSENHEALTH.ORG/PAY-MY-BILL/FINANCIAL-ASSISTANCE 3 ST JOSEPH'S HEALTH SERVICES - ELROY 1705 OHMAHA STREET ELROY WI 53929 PHYSICIAN CLINIC ST JOSEPH'S HEALTH SERVICES - WONEWOC 301 RAILROAD STREET WONEWOC WI 53968 PHYSICIAN CLINIC ST JOSEPH'S HEALTH SERVICES - HILLSBORO 400 WATER STREET HILLSBORO WI 54634 PHYSICIAN CLINIC SCHEDULE H, GENERAL MANY PROGRAMS WERE TEMPORARILY SUSPENDED DUE TO COVID, ESPECIALLY COMMUNITY EVENTS. EVERY PRECAUTION WAS TAKEN TO LESSEN THE SPREAD OF COVID DURING 2020. PART I LINE 3C CATASTROPHIC CARE ASSISTANCE: FINANCIAL ASSISTANCE PROVIDED TO ELIGIBLE PATIENTS WITH ANNUALIZED FAMILY INCOMES IN EXCESS OF 400% OF THE FEDERAL POVERTY LEVEL, AND ASSETS OF LESS THAN THE EQUIVALENT OF 600% OF THE FEDERAL POVERTY LEVEL, AND FINANCIAL OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY GHS IN EXCESS OF 25% OF THE FAMILY INCOME. DISCOUNTED CARE: FINANCIAL ASSISTANCE THAT PROVIDES A DISCOUNT, FOR ELIGIBLE MEDICAL SERVICES PROVIDED BY GHS, BASED ON A SLIDING SCALE, FOR ELIGIBLE PATIENTS, OR PATIENT GUARANTORS, WITH ANNUALIZED FAMILY INCOMES BETWEEN 200-400% OF THE FEDERAL POVERTY LEVEL AND ASSETS AT OR BELOW SIX TIMES THE FEDERAL POVERTY LEVEL. 1. FAMILY INCOME ABOVE 200% FPL BUT EQUAL TO OR LESS THAN 225% FPL ARE ELIGIBLE TO RECEIVE A 80% DISCOUNT ON THE PATIENT BALANCE DUE. 2. FAMILY INCOME ABOVE 225% FPL BUT EQUAL TO OR LESS THAN 250% FPL ARE ELIGIBLE TO RECEIVE A 60% POLICY DISCOUNT ON THE PATIENT BALANCE DUE. 3. FAMILY INCOME ABOVE 250% FPL BUT EQUAL TO OR LESS THAN 275% FPL ARE ELIGIBLE TO RECEIVE A 40% DISCOUNT ON THE PATIENT BALANCE DUE. 4. FAMILY INCOME ABOVE 275% FPL BUT EQUAL TO OR LESS THAN 400% FPL ARE ELIGIBLE TO RECEIVE A 20% DISCOUNT ON THE PATIENT BALANCE DUE. FREE CARE: A 100% WAIVER OF PATIENT FINANCIAL OBLIGATION FOR ELIGIBLE MEDICAL SERVICES PROVIDED BY GHS FOR ELIGIBLE PATIENTS, OR THEIR GUARANTORS, WITH ANNUALIZED FAMILY INCOMES AT OR BELOW 200% OF THE FPL WITH ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL. UNINSURED DISCOUNT: PATIENTS WITH NO THIRD-PARTY COVERAGE WILL BE PROVIDED AN UNINSURED DISCOUNT, FOR ELIGIBLE SERVICES PROVIDED BY GHS UNDER THIS POLICY, AT THE TIME THAT THE UNDISCOUNTED CHARGES ARE RENDERED. SERVICES NOT ELIGIBLE FOR FINANCIAL ASSISTANCE INCLUDE THE FOLLOWING: 1. ELECTIVE PROCEDURES NOT MEDICALLY NECESSARY, AS WELL AS SERVICES TYPICALLY NOT COVERED BY MEDICARE OR DEFINED BY MEDICARE OR OTHER HEALTH INSURANCE COVERAGE AS NOT MEDICALLY NECESSARY. 2. LASIK SURGERY, CHIROPRACTIC CARE, FERTILITY SERVICES, CONTACTS/GLASSES, COSMETIC SURGERY/PLASTIC SERVICES, HEARING AIDS, ORTHODONTICS, DENTAL SERVICES. 3. SERVICES RECEIVED FROM CARE PROVIDERS NOT EMPLOYED BY GHS (E.G. PRIVATE AND/OR NON-GHS MEDICAL OR PHYSICIAN PROFESSIONALS, AMBULANCE TRANSPORT, ETC.). PATIENTS ARE ENCOURAGED TO CONTACT THESE PROVIDERS DIRECTLY TO INQUIRE INTO ANY AVAILABLE ASSISTANCE AND TO MAKE PAYMENT ARRANGEMENTS. SEE APPENDIX 3 FOR FULL LISTING OF PROVIDERS NOT COVERED UNDER THIS POLICY. 4. DEDUCTIBLES AND COINSURANCE ASSOCIATED WITH MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS OUT-OF-NETWORK AS DEFINED BY THEIR INSURERS. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'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. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT ST. JOSEPH'S HEALTH SERVICES, INC. INCLUDE THE OPERATION OF THE INPATIENT MEDICAL SURGICAL UNIT, EMERGENCY ROOM, AND RURAL HEALTH CLINICS. THE HOSPITAL AND CLINICS ARE OPERATED TO PROVIDE SUPPORT TO THE COMMUNITY BY PROVIDING HOSPITALIZATION, EMERGENCY, AND CLINICAL SERVICES TO THE SURROUNDING RURAL AREAS, WHICH WOULD OTHERWISE BE UNDERSERVED. IT IS THE GOAL OF ST. JOSEPH'S HEALTH SERVICES, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON THE COSTING METHODS USED IN THE HOSPITAL'S MEDICARE COST REPORT WHICH PROVIDES FOR A DIRECT ALLOCATION OF EXPENSES AS WELL AS PROVIDING THE SAME DATA TO THE MEDICARE PROGRAM AS WELL AS TO THE IRS FOR 990 PURPOSES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 87,617. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE 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 COST-TO-CHARGE 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 SELF- PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT 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. PART III, LINE 3: 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 A CREDIT TO ACCOUNTS RECEIVABLE. THE ORGANIZATION DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. PART III, LINE 4: ACCOUNTS RECEIVABLE AND CREDIT POLICY: ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ORGANIZATION EXPECTS TO BE ENTITLED , IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE ORGANIZATION ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. THE ORGANIZATION DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE ORGANIZATION AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, AND REVENUE 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, SURGICAL, AND CLINICAL PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT ST. JOSEPH'S HEALTH SERVICES, INC. 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, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT 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. PART III, LINE 9B: UNDER THE ORGANIZATION'S SELF PAY BALANCE AND COMMUNITY CARE POLICIES, ST. JOSEPH'S HEALTH SERVICES, INC, MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS, INCLUDED IN THE ORGANIZATION'S COMMUNITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE BY COMPLETING AN APPLICATION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE ORGANIZATION'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. PART VI, LINE 2: THE HOSPITAL LOOKS AT CURRENT SERVICES UTILIZATION AND THE AREA DEMOGRAPHICS TO EVALUATE IF THE CURRENT SERVICES OFFERED ARE MEETING THE NEEDS OF OUR PATIENTS, A COMMUNITY COMMITTEE WORKS WITH HOSPITAL STAFF TO PROVIDE FEEDBACK ON SERVICES CURRENTLY PROVIDED AND GIVE IDEAS FOR SERVICES THAT WOULD BENEFIT PATIENTS TO PROVIDE CARE CLOSE TO HOME. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION CAN BE OBTAINED IN MANY WAYS. THE INFORMATION IS INCLUDED WITH THE BILLING STATEMENT, AVAILABLE AT ALL CHECK AREAS, ON THE HOSPITAL WEBSITE, OR BY CALL THE PATIENT ACCOUNTS DEPARTMENT. PART VI, LINE 4: THE HOSPITAL PATIENT PROVIDES SERVICES TO PATIENTS FROM VARIOUS COUNTIES, VERNON, SAUK, MONROE, JUNEAU, AND RICHLAND; TYPICALLY A 30 MILE SERVICE AREA. MEDICARE AND MEDICAID COVERED PATIENTS MAKE A LARGE PART OF THE POPULATION. PART VI, LINE 5: THE HOSPITAL PROVIDES FREE HEALTH SCREENING FOR OUR LOCAL COMMUNITIES. HOSTS THE SENIOR MEAL SITE; WHICH PROVIDES MEALS AND ACTIVITIES AT THE HOSPITAL 4 DAYS PER WEEK. THERE ARE SEVERAL LOW COST EXERCISE PROGRAMS AND A SAFE SITE COURSE TO TEACH TEEN HOW TO CARE FOR CHILDREN AND HANDLE EMERGENCY SITUATIONS. SOME OF THESE PROGRAMS WERE LIMITED DUE TO COVID RESTRICTIONS IN 2020. PART VI, LINE 6: THROUGH THE HOSPITAL'S AFFILIATION WITH GUNDERSEN HEALTH SYSTEM SPECIALTY CARE SERVICES ARE PROVIDED AT OUR HILLSBORO LOCATION BRINGING CARE TO OUR LOCAL PATIENTS CLOSE TO HOME. PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: WI false false false false false false false false false SCOTT LARSON PHARMACIST 247332 0 0 0 0 0 9870 0 12814 0 270016 0 0 0 TONI TENGBLAD CHIEF OF CLINICAL OPERATIONS 148156 0 0 0 0 0 5894 0 31588 0 185638 0 0 0 ANDREA ANDERSON PROVIDER 145936 0 0 0 0 0 5834 0 26059 0 177829 0 0 0 ROBIN NELSON CHIEF FINANCIAL OFFICER 147310 0 1536 0 0 0 5917 0 19811 0 174574 0 0 0 KRISTIE MCCOIC ADMINISTRATOR 0 139292 0 0 0 0 0 4875 0 0 0 144167 0 0 MIKE MCKEE Vice Chair 0 226650 0 0 0 500 0 33764 0 25399 0 286313 0 0 DENISE KROES NURSE 147459 0 0 0 0 0 5898 0 18066 0 171423 0 0 0 SCHEDULE J, PART I, LINE 3 FOR THE PURPOSE OF DETERMINING EXECUTIVE COMPENSATION, ST. JOSEPH'S HEALTH SERVICES, INC. RELIED ON ITS AFFILIATED ORGANIZATION, GUNDERSEN LUTHERAN HEALTH SYSTEM, IN. TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION SURVEY OR STUDY, COMPENSATION COMMITTEE, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ANGIE NOVY SISTER OF OFFICER 36682 SALARY false DORIS SKEMP MOTHER OF OFFICER 12284 SALARY false FORM 990, PART I, DOING BUSINESS AS: GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS FORM 990, PART IV, LINE 24A THE ORGANIZATION SHARES THE PROCEEDS AND PURPOSE OF A TAX EXEMPT BOND ISSUED IN 2019 WITH RELATED ORGANIZATIONS, GUNDERSEN LUTHERAN HEALTH SERVICES, INC. (39-1866425) AND GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. THE DETAILS OF THE BOND CAN BE FOUND ON THE SCHEDULE K FILED WITH THE GUNDERSEN LUTHERAN HEALTH SERVICES, INC. 990. FORM 990, PART VI, SECTION A, LINE 3 AS AN AFFILIATE OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., ST. JOSEPH'S HEALTH SERVICES, INC. WILL ROUTINELY DELEGATE VARIOUS MANAGEMENT OR SUPPORT FUNCTIONS TO RELATED ENTITES. FOR EXAMPLE, MANAGEMENT AND SEVERAL MEMBERS OF THE BOARD OF DIRECTOR ARE EMPLOYEES OF GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. AND IT'S AFFILATED ORGANIZATIONS WHICH ARE ALSO TAX-EXEMPT ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 THE ARTICLES OF INCORPORATION OF ST. JOSEPH'S HEALTH SERVICES, INC. PROVIDES FOR ONE MEMBER OF THE CORPORATION. THE SOLE MEMBER OF ST. JOSEPH'S HEALTH SERVICES, INC. IS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE 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 ST. JOSEPH'S HEALTH SERVICES, INC. GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. MAY APPOINTMENT FIVE MEMBERS OF THE BOARD OF DIRECTORS OF ST. JOSEPH'S HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7B 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 INTERESTS, 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, SECTION B, LINE 11B THE FORM 990 RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT. A FINAL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE FORM 990 RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT. A FINAL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION QUESTIONNAIRE. THESE QUESTIONNAIRES ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. ALL NOTED CONFLICTS ARE DISCLOSED ANNUALLY TO THE BOARD AND ANY MEMBERS OF THE BOARD WITH CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE ISSUES. THE ORGANIZATION ALSO NOTES AND DOCUMENTS IF ANY BUSINESS OWNED BY BOARD MEMBERS OR EMPLOYEES DO BUSINESS WITH THE ORGANIZATION TO ENSURE THAT COMPETITIVE BIDS ARE SOUGHT FOR SERVICES. FORM 990, PART VI, SECTION B, LINE 15 FOR THE PURPOSES OF DETERMINING COMPENSATION, ST. JOSEPH'S HEALTH SERVICES, INC. RELIED ON IT'S AFFILIATED ORGANIZATION, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., TO ESTABLISH COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. GUNDERSON LUTHERAN HEALTH SYSTEM, INC. USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION SURVEY OR STUDY, COMPENSATION COMMITTEE, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION CURRENTLY DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990 IS MADE AVAILABLE TO THE PUBLIC AT ITS MAIN BUSINESS OFFICE DURING NORMAL BUSINESS HOURS. FORM 990 INCLUDES MUCH OF THE INFORMATION CONTAINED WITHIN THE ORGANIZATION'S GOVERNING DOCUMENTS. CONFLICTS OF INTEREST ARE ALSO NOTED ON FORM 990. THE AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS THEY ARE REQUIRED TO BE ATTACHED TO THE FORM 990. FORM 990, PART VII, EXPLANATION OF HOURS WORKED: SOME OFFICERS AND BOARD MEMBERS ARE EMPLOYED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. AND ITS AFFILIATES. GUNDERSEN LUTHERAN HEALTH SYSTEM'S PURPOSE IS TO SERVE AS A SUPPORTING ORGANIZATION TO MULTIPLE SUBSIDIARY ORGANIZATIONS AS LISTED IN SCHEDULE R AND THESE OFFICERS AND DIRECTORS OFTEN WORK IN EXCESS OF 40 HOURS PER WEEK PROVIDING SERVICES TO AFFILIATED ORGANIZATIONS. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART XI, LINE 9 CHANGE IN RESTRICTED ASSETS FROM THE FOUNDATION: $150,351 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED PHYSICIANS TOTAL FEES:5821447 GUNDERSEN LUTHERAN HEALTH SYSTEMS INC 1836 SOUTH AVENUE LA CROSSE WI 54601 391866425 SUPTNG ORG. 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