2023-11-14T12:24:31-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-01-01 812822823 MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION INC MARS 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 CATHY BUKOWSKI CFO 7153875511 2023-11-08 1 CATHY BUKOWSKI 999009999 1 DAVID LOWENTHAL P01413237 2483757100 2023-11-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SUSAN TURNEY MD CEO 1000 N OAK AVENUE MARSHFIELD WI 54449 56270517 0 X WWW.MARSHFIELDCLINIC.ORG/GIVING X 2016 WI WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 16 12 0 12 0 0 10458672 9671212 0 0 10399686 9008449 210345 249897 21068703 18929558 5542552 5655275 0 0 0 0 0 0 351516 443609 351516 5986161 6006791 15082542 12922767 149772122 129935000 993669 682252 148778453 129252748 WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 0 0 5655275 5655275 MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. (MCHSF) WAS INCORPORATED IN MAY 2016 AS A NONPROFIT, NONSTOCK CORPORATION TO SUPPORT THE CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS) AND ITS TAX-EXEMPT AFFILIATES. MCHSF RECEIVED AN IRS DETERMINATION LETTER GRANTING IT TAX-EXEMPT STATUS ON AUGUST 12, 2016. 5655275 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 1 X 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 WI X JANETTE TOWNSEND VP OF FINANCE 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 X JESSICA WERNBERG MD BOARD CHAIR 1.00 50.00 X X 0 449464 55739 MICHAEL SMITH BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 SID SAMUELS BOARD MEMBER 1.00 0.00 X 0 0 0 DENNY PETERSON BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 AL NYSTROM BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 DAVE KRAUSE BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM HOCKING MD BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL SCHMIDT BOARD MEMBER 1.00 0.00 X 0 0 0 PAM HALLER BOARD MEMBER 1.00 0.00 X 0 0 0 ERIK DOVRE MD BOARD MEMBER 1.00 50.00 X 0 346121 43975 TAE GARDNER MD BOARD MEMBER 1.00 50.00 X 0 1227630 55739 REBECCA POPP PA BOARD MEMBER - PART YEAR 1.00 50.00 X 0 178612 26872 SALLY WINGER BOARD MEMBER 1.00 0.00 X 0 0 0 TREVOR WUETHRICH BOARD MEMBER 1.00 0.00 X 0 0 0 KATIE WEINBERGER BOARD MEMBER 1.00 50.00 X 0 90047 33852 BARB PETKOVSEK BOARD MEMBER 1.00 0.00 X 0 0 0 BEN WESTRA BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK WOLF DO BOARD MEMBER 1.00 54.00 X 0 410104 52082 EDNA DEVRIES MD BOARD MEMBER 1.00 0.00 X 0 199707 22272 SUSAN TURNEY MD MCHS CEO 1.00 54.00 X 0 3048492 315344 GORDON EDWARDS MCHS CFO/COO -PART YEAR 1.00 54.00 X 0 829645 31752 TERI WILCZEK MCHS CHIEF PHILANTHROPY OFFICER 50.00 0.00 X 393983 0 47854 JERARD JENSEN MCHS GENERAL COUNSEL 1.00 54.00 X 0 1058880 65255 WILLIAM MELMS MD CHIEF MEDICAL OFFICER 1.00 54.00 X 0 829413 57055 KATHY BRESSLER MCHS COO 1.00 54.00 X 0 370779 16874 NARAYANA MURALI MD FORMER MCHS CHIEF STRATEGY OFFICER 0.00 0.00 X 0 101328 5903 393983 9140222 830568 1 1 1 0 0 186196 9485016 173748 9671212 1346465 1346465 44873447 37211463 7661984 7661984 7661984 379393 186196 129496 249897 249897 18929558 0 0 9258346 5655275 5655275 252667 252667 39909 39909 58940 58940 6006791 5655275 0 351516 1272040 730432 5287625 3593643 6405 1919475 24850419 20536881 118267962 103066898 87671 87671 149772122 129935000 419962 134130 573707 548122 993669 682252 X 104189431 88295988 44589022 40956760 148778453 129252748 149772122 129935000 X 12922767 -31369442 -1079030 X 0 1 X 1 0 X 11840856 9625834 2902162 10458672 9671212 44498736 11840856 9625834 2902162 10458672 9671212 44498736 842987 43655749 1019007 1449856 437069 1436710 1346465 5689107 740086 344036 34688 301735 379393 1799938 51987781 0.83970 0.84980 X PART II: BECAUSE OF THE SHORT YEAR-END FILING, THE COLUMNS IN SCHEDULE A PART II CORRESPOND TO THE FOLLOWING TAX YEARS: 2018 = FYE 9/30/19 2019 = FYE 9/30/20 2020 = SHORT YEAR-END 12/31/20 2021 = FYE 12/31/21 2022 = FYE 12/31/22 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 110039821 2109999 -15164352 3215138 93770330 96650965 65654 13560680 237478 110039821 90782433 110626 8521615 2763709 96650965 85853663 85467 7632983 2789680 90782433 86787899 300695 1218659 2453590 85853663 0.71969 0.18911 0.09121 0 0 0 LTD PTNSHP COMM INV 103066898 F 103066898 LT GIFT ANNUITY PAYABLE 548122 548122 X PART V, LINE 4: MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. MAINTAINS ENDOWMENT FUNDS IN THE FOLLOWING CATEGORIES: GENERAL ENDOWMENT TO FUND OPERATIONS, ENDOWED PROGRAMS TO FUND VARIOUS PATIENT CARE, RESEARCH AND EDUCATION PROGRAMS SUCH AS ONCOLOGY RESEARCH, SUMMER STUDENT INTERN PROGRAMS, AND THE ANGEL FUND; AND ENDOWED CHAIRS AND ENDOWED DISTINGUISHED PHYSICIAN/SCIENTIST AWARDS TO FUND THE RESEARCH, EDUCATION OR ADMINISTRATIVE ACTIVITIES OF THE NAMED CHAIR OR AWARD RECIPIENT. PART X, LINE 2: THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. THE SYSTEM HAS DETERMINED THAT IT DOESN'T HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 OR DECEMBER 31, 2021. AUCTION OF CHAMPIONS 337585 116557 221028 1520 350 3139 15338 27545 CELEBRITY TRAP SHOOT 70450 22730 47720 300 1070 4233 7985 12433 5 157554 46909 110645 2200 491 3145 7645 9750 32352 565589 186196 379393 4020 1911 10517 30968 9750 72330 129496 249897 1 MARSHFIELD CLINIC INC 1000 N OAK AVENUE MARSHFIELD WI 54449 390452970 501(C)(3) 3843667 0 GENERAL SUPPORT MCHS HOSPITALS INC 1000 N OAK AVENUE MARSHFIELD WI 54449 810977948 501(C)(3) 1260600 0 GENERAL SUPPORT MARSHFIELD CLINIC HEALTH SYSTEM INC 1000 N OAK AVENUE MARSHFIELD WI 54449 461495343 501(C)(3) 290442 0 GENERAL SUPPORT UNIVERSITY OF WISCONSIN-STEVENS POINT FOUNDATION 2100 MAIN STREET SUITE 134 STEVENS POINT WI 54481 396098038 501(C)(3) 242133 0 HEALTHCARE WORKFORCE DEVELOPMENT FUND LAKEVIEW MEDICAL CENTER INC OF RICE LAKE 1700 W STOUT STREET RICE LAKE WI 54868 390837206 501(C)(3) 12490 0 GENERAL SUPPORT 5 0 PART I, LINE 2: MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. IS ORGANIZED AND OPERATED SPECIFICALLY TO SUPPORT AND BENEFIT MARSHFIELD CLINIC, INC., MCHS HOSPITALS, INC., LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE AND OTHER AFFILIATES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC (MCHS). THE FOUNDATION WORKS WITH THE MCHS STRATEGIC PHILANTHROPY COMMITTEE, COMPRISED OF KEY MCHS LEADERS, TO SET SYSTEM FUNDRAISING PRIORITIES AND MEETS WITH EACH STRATEGIC AREA TO APPROVE SPENDING PLANS AND ENSURE DONATED FUNDS ARE BEING USED FOR THE INTENDED PURPOSE. 1 1 0 0 0 0 0 0 0 SUSAN TURNEY MD MCHS CEO 0 1812322 0 910520 0 325650 0 287565 0 27779 0 3363836 0 258588 TAE GARDNER MD BOARD MEMBER 0 1189544 0 5000 0 33086 0 23031 0 32708 0 1283369 0 0 JERARD JENSEN MCHS GENERAL COUNSEL 0 801522 0 202859 0 54499 0 23031 0 42224 0 1124135 0 0 WILLIAM MELMS MD CHIEF MEDICAL OFFICER 0 784186 0 5000 0 40227 0 23031 0 34024 0 886468 0 0 GORDON EDWARDS MCHS CFO/COO -PART YEAR 0 560115 0 166037 0 103493 0 9150 0 22602 0 861397 0 0 JESSICA WERNBERG MD BOARD CHAIR 0 410697 0 5000 0 33767 0 23031 0 32708 0 505203 0 0 PATRICK WOLF DO BOARD MEMBER 0 393096 0 2070 0 14938 0 23031 0 29051 0 462186 0 0 TERI WILCZEK MCHS CHIEF PHILANTHROPY OFFICER 299389 0 78521 0 16073 0 23031 0 24823 0 441837 0 0 0 ERIK DOVRE MD BOARD MEMBER 0 310899 0 21250 0 13972 0 23031 0 20944 0 390096 0 0 KATHY BRESSLER MCHS COO 0 285062 0 25000 0 60717 0 8769 0 8105 0 387653 0 0 EDNA DEVRIES MD BOARD MEMBER 0 137843 0 0 0 61864 0 6042 0 16230 0 221979 0 0 REBECCA POPP PA BOARD MEMBER - PART YEAR 0 168450 0 10000 0 162 0 12131 0 14741 0 205484 0 0 NARAYANA MURALI MD FORMER MCHS CHIEF STRATEGY OFFICER 0 51404 0 0 0 49924 0 2986 0 2917 0 107231 0 0 PART I, LINE 3 THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS. PART I, LINES 4A-B LINE 4A: IN 2022, EDNA DEVRIES RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $35,467. LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION FROM OR HAD AMOUNTS VEST IN THE PLAN: SUSAN TURNEY, MD - $219,744 THE FOLLOWING INDIVIDUALS PARTICATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A DISTRIBUTION OR HAVE AN AMOUNT VEST IN THE PLAN. UNDER THE PLAN, AMOUNTS DO NOT VEST UNTIL TWO YEARS AFTER SEPARATION FROM THE ORGANIZATION: NARAYANA MURALI, MD JERARD JENSEN GORDON EDWARDS WILLIAM MELMS, MD TERI WILCZEK JESSICA WERNBERG, MD ERIK DOVRE, MD TAE GARDNER, MD PATRICK WOLF, DO EDNA DEVRIES, MD X 9 1508 FMV X 510 FMV X 1 200 FMV X LIVESTOCK 36 87253 FMV X MISC, SPORTING GOODS, TRAVEL EXPERIENCES 106 77120 FMV X FOOD & BEV 21 3647 FMV X JEWERLY 6 3510 FMV 0 1 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS FORM 990, PART IV, LINE 4: MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC.) IS A MEMBER OF VARIOUS HEALTHCARE ASSOCIATIONS (I.E. WISCONSIN HOSPITAL ASSOCIATION) THAT MAY PERFORM SOME LOBBYING ACTIVITY. ALL ASSOCIATED DUES ARE DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. FORM 990, PART V, LINE 2A: ALL PERSONNEL SERVICES FOR MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 6 MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A MARSHFIELD CLINIC HEALTH SYSTEM, INC. (AS THE SOLE MEMBER) HAS THE RESERVE POWER TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS OF MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7B MARSHFIELD CLINIC HEALTH SYSTEM, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. MARSHFIELD CLINIC HEALTH SYSTEM, INC. (THE SOLE MEMBER) HAS THE RIGHT TO INITIATE AND APPROVE LONG-TERM BORROWING AND OTHER FORMS OF LONG-TERM INDEBTEDNESS, INITIATE AND APPROVE THE PURCHASE, SALE OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY AND APPROVE OR DISAPPROVE ANNUAL OPERATING AND CAPITAL BUDGETS. MARSHFIELD CLINIC HEALTH SYSTEM, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B MARSHFIELD CLINIC HEALTH SYSTEM, INC. ENGAGES A PUBLIC ACCOUNTING FIRM TO PREPARE AND REVIEW THE FORM 990 IN ADDITION TO REVIEW BY THE SYSTEM CFO, VP OF FINANCE AND TAX DEPARTMENT. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETED FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTEE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. FORM 990, PART VI, SECTION B, LINE 15 THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. FORM 990, PART VII, SECTION A: COMPENSATION REPORTED FOR TERI WILCZEK HAS BEEN PAID BY A RELATED ORGANIZATION AND COMMON PAYMASTER, MARSHFIELD CLINIC HEALTH SYSTEM, EIN 46-1495343. SINCE ALL SERVICES PERFORMED BY THIS INDIVIDUAL WAS FOR MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC., THE COMPENSATION HAS BEEN REPORTED IN COLUMN D AS IF PAID BY THE ORGANIZATION. MARSHFIELD CLINIC HEALTH SYSTEM HAS COMPLIED WITH PAYROLL FILING REQUIREMENTS. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION 1,065,984. CHANGE IN SPLIT INTEREST AGREEMENTS -196,780. NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS -1,948,018. PRIOR PERIOD ADJUSTMENT -216. FLAMBEAU HOSPITAL INC 98 SHERRY AVE PARK FALLS WI 54552 390973724 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 LAKEVIEW MEDICAL CENTER INC 1700 W STOUT ST RICE LAKE WI 54868 390837206 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 VOLUNTEER PARTNERS OF LAKEVIEW MEDICAL 1700 W STOUT ST RICE LAKE WI 54868 391329084 SUPPORT ORG WI 501(C)(3) LINE 12D, III-O N/A 0 FAMILY HEALTH CENTER OF MARSHFIELD INC 1000 N OAK AVE MARSHFIELD WI 54449 391681547 COM HLTH CTR WI 501(C)(3) LINE 7 N/A 0 MARSHFIELD CLINIC INC 1000 N OAK AVE MARSHFIELD WI 54449 390452970 MEDICAL SVCS WI 501(C)(3) LINE 3 MCHS 0 SECURITY HEALTH PLAN OF WISCONSIN INC 1515 N ST JOSEPH AVE MARSHFIELD WI 54449 391572880 HMO WI 501(C)(4) N/A MCHS 0 MCHS HOSPITALS INC 1000 N OAK AVE MARSHFIELD WI 54449 810977948 HOSPITAL WI 501(C)(3) LINE 3 MCHS 0 MARSHFIELD CLINIC HEALTH SYSTEM INC 1000 N OAK AVE MARSHFIELD WI 54449 461495343 SUPPORT ORG WI 501(C)(3) LINE 12D, III-O N/A 0 BEAVER DAM COMMUNITY HOSPITALS INC 707 S UNIVERSITY AVE BEAVER DAM WI 53916 391157876 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 MEMORIAL HOSPITAL INC N3708 RIVER AVE NEILLSVILLE WI 54456 390806828 HOSPITAL WI 501(C)(3) LINE 3 MCHS HOSP 0 THE FOUNDATION OF MEMORIAL HOSPITAL INC N3708 RIVER AVE NEILLSVILLE WI 54456 383800811 PHILANTHROPY WI 501(C)(3) LINE 10 MCHS FOUNDATION 1 DICKINSON COUNTY HEALTHCARE SYSTEM 1721 S STEPHENSON AVE IRON MOUNTAIN MI 49801 382780429 HOSPITAL MI 501(C)(3) LINE 3 MCHS HOSP 0 THE DIAGNOSTIC & TREATMENT CENTER LLC 3401 CRANBERRY BLVD WESTON WI 54476 200691634 MEDICAL SVCS WI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 SCHEDULE R, PART V, LINE 1: MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A 501(C)(3) ORGANIZATION), IS THE PARENT ORGANIZATION OF MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. THE FOLLOWING COMPANIES ARE RELATED TO MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC. THROUGH BROTHER/SISTER RELATIONSHIPS DUE TO A COMMON PARENT ORGANIZATION: MARSHFIELD CLINIC, INC. SECURITY HEALTH PLAN OF WISCONSIN, INC. MCHS HOSPITALS, INC.