2025-11-04T13:08:00-06:00 2024-12-31 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2024-01-01 390452970 MARSHFIELD CLINIC INC MARS 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 NICHOLAS OLSON EVP, CFO 6053331000 2025-11-04 1 0 JESS WAGENER P01622613 3128792000 2024 2025-03-06 01:10:19Z BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 639011914 0 X WWW.MARSHFIELDCLINIC.ORG X 1916 WI WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 11 0 1382 400 6190864 196892 38600784 31391785 582938276 543271185 12035563 21574392 13503 292925 633588126 596530287 691520 603000 0 0 358306664 344428493 0 0 0 259276145 246463812 618274329 591495305 15313797 5034982 800024445 663208222 615460091 515871205 184564354 147337017 WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 0 0 583814165 603000 543271185 MARSHFIELD CLINIC, INC., FOUNDED IN 1916, IS A NOT-FOR-PROFIT GROUP MEDICAL PRACTICE ENGAGED IN PROVIDING HEALTHCARE, HEALTHCARE EDUCATION, MEDICAL RESEARCH, AND COMMUNITY SERVICE. MARSHFIELD CLINIC RESEARCH INSTITUTE, A DIVISION OF MARSHFIELD CLINIC, ENGAGES IN MEDICAL AND SCIENTIFIC RESEARCH AND THE PROMOTION OF PUBLIC HEALTH, MEDICAL EDUCATION, AND COMMUNITY SERVICE. 583814165 1 1 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 1 X 0 0 1382 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X NICHOLAS OLSON EVP CFO 6053331000 2301 EAST 60TH STREET SIOUX FALLS SD 57104 ALPA SHAH MD CHAIR (THRU MAR 2024) 38.00 5.00 X X 283360 0 9460 MATTHEW OELSTROM MD CHAIR 53.00 3.00 X X 499726 0 37964 ELVIS PETER MD VICE CHAIR 53.00 4.00 X X 812372 0 48068 KENT RAY DO SECRETARY 53.00 3.00 X X 405006 0 48974 MATTHEW THOMAS MD TREASURER 52.00 3.00 X X 877617 0 41999 TYLER DAHL MD BOARD MEMBER (THRU MAR 2024) 52.00 2.00 X 1169680 0 39311 JAYANTH VEDRE MD BOARD MEMBER 52.00 2.00 X 711891 0 36310 BART ISAACSON MD BOARD MEMBER (THRU MAR 2024) 52.00 2.00 X 322040 0 38947 BARBARA BOYER MD BOARD MEMBER 52.00 2.00 X 429508 0 43301 DAVID JUNKER MD BOARD MEMBER 52.00 3.00 X 929786 0 51612 PATRICK WOLF DO BOARD MEMBER (THRU MAR 2024) 52.00 3.00 X 65500 0 4352 JESSICA WERNBERG MD BOARD MEMBER 52.00 4.00 X 459068 0 40681 CHRISTOPHER ADLER MD BOARD MEMBER 52.00 2.00 X 367109 0 23561 KATHERINE WINIARCZYK DO BOARD MEMBER 52.00 2.00 X 332455 0 37544 SANJAY KUMAR MD BOARD MEMBER 52.00 2.00 X 1072801 0 42168 BRIAN HOERNEMAN MD INTERIM MCHS CEO 1.00 54.00 X 0 1584168 39013 JEANETTE WOJTALEWICZ INTERIM MCHS CFO 1.00 54.00 X 0 972510 0 SAMANTHA KLEBE DO CHIEF MEDICAL OFFICER 1.00 54.00 X 0 703503 36357 KATHY BRESSLER MCHS COO 1.00 54.00 X 0 985571 37461 JERARD JENSEN MCHS GENERAL COUNSEL (THRU JAN 2024) 1.00 54.00 X 0 889281 11274 LISA BOERO MCHS GENERAL COUNSEL 1.00 54.00 X 0 415495 10811 VIVEKANANDA GONUGUNTA MD PHYSICIAN 50.00 0.00 X 2682634 0 10830 ADEDAYO ONITILO MD PHYSICIAN 50.00 0.00 X 1557817 0 44169 MOHAMMAD ALAOUA MD PHYSICIAN 50.00 0.00 X 1449119 0 48955 OLATILEWA AWE MD PHYSICIAN 50.00 0.00 X 1431408 0 23942 WILLIAM MCCORMICK MD PHYSICIAN 50.00 0.00 X 1332801 0 41973 SUSAN TURNEY MD FORMER MCHS CEO 0.00 0.00 X 0 2241715 0 CATHY BUKOWSKI FORMER MCHS CFO 0.00 0.00 X 0 631969 0 WILLIAM MELMS MD FORMER CHIEF MEDICAL OFFICER 0.00 0.00 X 0 199385 0 17191698 8623597 849037 674 1 1 0 TWEET GAROT MECHANICAL INC PO BOX 8706 CAROL STREAM IL 60197 CONSTRUCTION 2967397 MAYO CLINIC LABORATORIES PO BOX 9146 MINNEAPOLIS MN 55480 LAB SERVICES 2779335 BECKMAN COULTER INC DEPT CH 10164 PALATINE IL 60055 LAB SERVICES 1176403 CIOX HEALTH LLC PO BOX 409669 ATLANTA GA 30384 PROFESSIONAL SERVICES 1109558 MCKESSON PHARMACY SYSTEMS LLC PO BOX 100884 ATLANTA GA 30384 PROFESSIONAL SERVICES 652722 69 4263623 27128162 31391785 NET PATIENT SERVICE RE 621110 276524185 270333814 6190371 INTERCOMPANY REVENUE 621110 266497440 266497440 MISC OTHER OPERATING R 621110 249560 249560 543271185 7418748 493 7418255 -196490 -196490 457428 164503 292925 292925 292925 56305020 364238 42306245 10879 13998775 353359 14352134 14352134 596530287 537080814 6190864 21866824 603000 603000 9282171 9282171 2272573 2272573 319748120 317839591 1908529 1320511 1290590 29921 8205093 7897055 308038 3600025 3518799 81226 515 515 559563 559563 13425867 13416035 9832 8994 8994 5152466 4193617 958849 408841 406990 1851 1356027 1351883 4144 547867 518773 29094 15261 1763 13498 18317042 18317042 19612795 19612795 3129100 3129100 MEDICAL SUPPLIES 178216472 178206316 10156 I/C PURCHASED SERVICES 4097952 384696 3713256 EQUIP REPAIRS & MAINT 1222596 1222509 87 DUES, SUBSCRIPTIONS, LI 275732 223571 52161 116722 116302 420 591495305 583814165 7681140 0 4897039 0 22700411 5685046 788595 1450442 41643220 14278024 17874334 16170970 13284778 10299035 3603271 4317934 583902692 335280427 263292022 248622265 228052409 237276202 112259319 123084738 90204732 0 370691 370691 1053624 1652875 800024445 663208222 272522256 76953312 207102 129883 229328890 319882114 1947 0 113399896 118905896 615460091 515871205 X 183474318 146246981 1090036 1090036 184564354 147337017 800024445 663208222 X 5034982 -5151888 -37110431 X 0 1 X 1 1 1 X MCHS HOSPITALS INC MARSHFIELD WI RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3527576 X 0 22685049 22685049 506856649 297705814 209150835 2844071 2431011 413060 33496528 23614804 9881724 18020395 11528798 6491597 248622265 LTD PTNSHP COMM INV 123084738 F 123084738 0 DEFERRED COMPENSATION 105329520 MALPRACTICE CLAIMS RESERVE 12557720 SEVERANCE & SABBATICAL LIABILITY 692788 OPERATING LEASE PAYABLE LT 325868 118905896 X PART III, LINE 4: THE MISSION OF MARSHFIELD CLINIC IS TO SERVE PATIENTS THROUGH ACCESSIBLE, HIGH QUALITY HEALTH CARE, RESEARCH AND EDUCATION. AS PART OF SERVING PATIENTS, THE CLINIC STRIVES TO PROVIDE AN INVITING ATMOSPHERE TO TREAT PATIENTS AND ASSIST IN THE HEALING PROCESS. PLEASANT FACILITIES AND GROUNDS, PLUS APPROPRIATE WORKS OF ART ALL ASSIST IN THIS HEALING PROCESS, AS WELL AS SERVE TO ENHANCE THE CLINIC'S EDUCATIONAL MISSION BY DISPLAYING ART WORK FOR SCHOOL CHILDREN AS WELL AS PATIENTS AND VISITORS. 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, 2024 OR DECEMBER 31, 2023. 1 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS N/A 912419 0 0 0 0 0 0 912419 0 912419 1 0 0 1 1 0 1 FAMILY HEALTH CENTER OF MARSHFIELD INC 1000 N OAK AVE MARSHFIELD WI 54449 391681547 501(C)(3) 603000 0 N/A N/A GENERAL SUPPORT 1 0 PART I, LINE 2: MARSHFIELD CLINIC, INC. PROVIDES ASSISTANCE (PRIMARILY CONTRIBUTIONS) TO A VARIETY OF ORGANIZATIONS, ALL OF WHICH ARE 501(C)(3). MARSHFIELD CLINIC MAKES DETERMINATIONS ON GRANTS AND OTHER ASSISTANCE BASED ON THE RECIPIENT ORGANIZATION'S MISSION, REPUTATION, AND THE ORGANIZATION'S INTENDED USE OF FUNDS. X X 1 1 1 1 0 0 0 0 0 1 0 VIVEKANANDA GONUGUNTA MD PHYSICIAN 2153315 0 502347 0 26972 0 8625 0 2205 0 2693464 0 0 0 SUSAN TURNEY MD FORMER MCHS CEO 0 0 0 0 0 2241715 0 0 0 0 0 2241715 0 0 BRIAN HOERNEMAN MD INTERIM MCHS CEO 0 1043925 0 516277 0 23966 0 8625 0 30388 0 1623181 0 0 ADEDAYO ONITILO MD PHYSICIAN 1526685 0 5000 0 26132 0 8625 0 35544 0 1601986 0 0 0 MOHAMMAD ALAOUA MD PHYSICIAN 1446953 0 0 0 2166 0 8625 0 40330 0 1498074 0 0 0 OLATILEWA AWE MD PHYSICIAN 1147273 0 258549 0 25586 0 8625 0 15317 0 1455350 0 0 0 WILLIAM MCCORMICK MD PHYSICIAN 1245347 0 61658 0 25796 0 8625 0 33348 0 1374774 0 0 0 TYLER DAHL MD BOARD MEMBER (THRU MAR 2024) 1065184 0 78910 0 25586 0 8625 0 30686 0 1208991 0 0 0 SANJAY KUMAR MD BOARD MEMBER 1046669 0 0 0 26132 0 8625 0 33543 0 1114969 0 0 0 KATHY BRESSLER MCHS COO 0 711231 0 241650 0 32690 0 8625 0 28836 0 1023032 0 0 DAVID JUNKER MD BOARD MEMBER 903654 0 0 0 26132 0 8625 0 42987 0 981398 0 0 0 JEANETTE WOJTALEWICZ INTERIM MCHS CFO 0 0 0 0 0 972510 0 0 0 0 0 972510 0 0 MATTHEW THOMAS MD TREASURER 796625 0 54860 0 26132 0 8625 0 33374 0 919616 0 0 0 JERARD JENSEN MCHS GENERAL COUNSEL (THRU JAN 2024) 0 54195 0 0 0 835086 0 0 0 11274 0 900555 0 0 ELVIS PETER MD VICE CHAIR 793788 0 0 0 18584 0 8625 0 39443 0 860440 0 0 0 JAYANTH VEDRE MD BOARD MEMBER 467329 0 218976 0 25586 0 8625 0 27685 0 748201 0 0 0 SAMANTHA KLEBE DO CHIEF MEDICAL OFFICER 0 476625 0 201334 0 25544 0 8625 0 27732 0 739860 0 0 CATHY BUKOWSKI FORMER MCHS CFO 0 0 0 0 0 631969 0 0 0 0 0 631969 0 0 MATTHEW OELSTROM MD CHAIR 377912 0 121394 0 420 0 8625 0 29339 0 537690 0 0 0 JESSICA WERNBERG MD BOARD MEMBER 455936 0 0 0 3132 0 8625 0 32056 0 499749 0 0 0 BARBARA BOYER MD BOARD MEMBER 425536 0 0 0 3972 0 7614 0 35687 0 472809 0 0 0 KENT RAY DO SECRETARY 401874 0 0 0 3132 0 8625 0 40349 0 453980 0 0 0 LISA BOERO MCHS GENERAL COUNSEL 0 411868 0 0 0 3627 0 8625 0 2186 0 426306 0 0 CHRISTOPHER ADLER MD BOARD MEMBER 364498 0 161 0 2450 0 8625 0 14936 0 390670 0 0 0 KATHERINE WINIARCZYK DO BOARD MEMBER 332093 0 0 0 362 0 7463 0 30081 0 369999 0 0 0 BART ISAACSON MD BOARD MEMBER (THRU MAR 2024) 320234 0 0 0 1806 0 8625 0 30322 0 360987 0 0 0 ALPA SHAH MD CHAIR (THRU MAR 2024) 279695 0 0 0 3665 0 7562 0 1898 0 292820 0 0 0 WILLIAM MELMS MD FORMER CHIEF MEDICAL OFFICER 0 0 0 0 0 199385 0 0 0 0 0 199385 0 0 PART I, LINE 1A THE ORGANIZATION MAY OCCASIONALLY REIMBURSE OR PROVIDE A HOUSING ALLOWANCE FOR KEY EXECUTIVES IN ORDER TO ASSIST WITH RELOCATING TO THE AREA. THE ORGANIZATION MAY ALSO CONTRIBUTE TO OR REIMBURSE FOR HEALTH AND SOCIAL CLUB DUES AS DEEMED NECESSARY IN ORDER TO SUPPORT A BUSINESS NEED. 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 2024, SUSAN TURNEY, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $1,879,544, WILLIAM MELMS, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $199,385, CATHY BUKOWSKI RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $631,969 AND JERARD JENSEN RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $753,004. 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 - $362,171 PART I, LINE 7 SEVERAL INDIVIDUALS MAY RECEIVE INCENTIVE COMPENSATION BASED ON A VARIETY OF FACTORS, INCLUDING NOT ONLY FINANCIAL MEASURES SUCH AS REVENUE GROWTH OR EARNINGS, BUT ALSO QUALITY, SERVICE, MARKET EXPANSION, COMMUNITY & EMPLOYEE ENGAGEMENT, AND OTHER OUTCOMES OR EXPECTATIONS SET BY THE BOARD AND/OR CEO. ANY PERFORMANCE BONUS IS SUBJECT TO REVIEW BY THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE FOR REASONABLENESS. SHANA VIFIAN RAY MD FAMILY RELATIONSHIP WITH KENT RAY, DO 514515 EMPLOYMENT 0 MILIND SHAH MD FAMILY RELATIONSHIP WITH ALPA SHAH, MD 876658 EMPLOYMENT 0 TANYA HOERNEMAN MD FAMILY RELATIONSHIP WITH BRIAN HOERNEMAN, MD 109810 EMPLOYMENT 0 JAIME BOERO MD FAMILY RELATIONSHIP WITH LISA BOERO 771590 EMPLOYMENT 0 PART IV, LINE 4: MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING MARSHFIELD CLINIC) 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 1C: COMPENSATION REPORTED FOR THE INDEPENDENT CONTRACTORS HAS BEEN PAID BY A RELATED ORGANIZATION AND CENTRAL PURCHASING ORGANIZATION, MARSHFIELD CLINIC HEALTH SYSTEM, EIN 46-1495343. COMPENSATION REPORTED REPRESENTS SERVICES SOLELY PROVIDED TO MARSHFIELD CLINIC, INC SO IS INCLUDED AS IF PAID BY THE ORGANIZATION. MARSHFIELD CLINIC HEALTH SYSTEM HAS COMPLIED WITH A/P FILING REQUIREMENTS. PART V, LINE 2A: ALL PERSONNEL SERVICES FOR MARSHFIELD CLINIC, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. ALL PHYSICIAN SERVICES FOR MARSHFIELD CLINIC, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC, INC. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS TWO CLASSES OF MEMBERS: (I) CLASS A MEMBERS, WHO SHALL BE INDIVIDUALS MEETING THE REQUIREMENTS SET FORTH IN THE CORPORATION'S BYLAWS, AND (II) A SINGLE CLASS B MEMBER, MARSHFIELD CLINIC HEALTH SYSTEM, INC., WHICH SHALL BE THE SOLE CORPORATE MEMBER. CLASS A MEMBERS HAVE THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY AND APPROVE CERTAIN SIGNIFICANT DECISIONS OF THE GOVERNING BODY. THE CLASS B MEMBER HAS THE RIGHT TO APPROVE CERTAIN SIGNIFICANT DECISIONS OF THE GOVERNING BODY AND TO RECEIVE THE REMAINING ASSETS OF THE CORPORATION (OR DIRECT DISTRIBUTION OF THE ASSETS TO OTHER 501(C)(3) ORGANIZATIONS) UPON DISSOLUTION. FORM 990, PART VI, SECTION A, LINE 7A CLASS A MEMBERS HAVE THE RIGHT TO ELECT THE ORGANIZATION'S OFFICERS AND DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B ALL MEMBERS HAVE THE RIGHT TO APPROVE ANY CHANGES TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS AND TO APPROVE ANY DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE EXECUTIVE MANAGEMENT TEAM. AN EXTERNAL ACCOUNTING FIRM REVIEWS AND SIGNS THE RETURN. BEFORE THE RETURN IS FILED, A COMPLETE COPY IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES. 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, 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 XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS 53,094,301. DECONSOLIDATION OF FAMILY HEALTH CENTER -90,204,732. SECURITY HEALTH PLAN OF WISCONSIN INC 1515 N ST JOSEPH AVE MARSHFIELD WI 54449 391572880 HMO WI 501(C)(4) N/A MCHS 0 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 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 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 MCHS HOSPITALS INC 1000 N OAK AVE MARSHFIELD WI 54449 810977948 HOSPITAL WI 501(C)(3) LINE 3 MCHS 0 MCHS FOUNDATION INC 1000 N OAK AVE MARSHFIELD WI 54449 812822823 PHILANTHROPY WI 501(C)(3) LINE 7 MCHS 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 DICKINSON COUNTY HEALTHCARE SYSTEM 1721 S STEPHENSON AVE IRON MOUNTAIN MI 49801 382780429 HOSPITAL MI 501(C)(3) LINE 3 MCHS HOSP 0 0 1 1 1 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 SECURITY HEALTH PLAN OF WISCONSIN INC L 13603306 COST SCH R, PART I: MARSHFIELD CLINIC HEALTH SYSTEM, INC. (A 501(C)3 ORGANIZATION) IS THE PARENT ORGANIZATION OF MARSHFIELD CLINIC, INC. THE FOLLOWING COMPANIES ARE RELATED TO MARSHFIELD CLINIC, INC. THROUGH BROTHER/SISTER RELATIONSHIPS DUE TO A COMMON PARENT ORGANIZATION: SECURITY HEALTH PLAN OF WISCONSIN, INC. MCHS HOSPITALS, INC. MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION, INC.