2026-08-13T16:58:53+00:00 2025-09-30 135565207 KPMG LLP 200 EAST RANDOLPH DRIVE SUITE 5500 CHICAGO IL 606016436 990 2024-10-01 410693877 SAINT ELIZABETH'S HOSPITAL OF WABASHA SAIN 6515654531 1200 GRANT BLVD WEST WABASHA MN 55981 JIM ROOT ADMINISTRATOR 2026-08-13 true ZELJKO POPOVIC P01795951 3126651000 2026-08-12 2024 2025-03-06 01:10:19Z GUNDERSEN ST ELIZABETH'S HOSPITAL AND CLINICS JIM ROOT 1200 GRANT BLVD WEST WABASHA MN 55981 58694955 false X WWW.GUNDERSENHEALTH.ORG/LOCATIONS/ST-ELIZABETHS X 1955 MN TOGETHER, WE WILL INSPIRE YOUR BEST LIFE BY RELENTLESSLY CARING, LEARNING AND INNOVATING. 9 5 478 54 2398764 180456 2687404 990308 51529485 57269981 309606 370309 75095 64357 54601590 58694955 5925 438684 0 0 34605334 37185439 0 0 0 16296000 17117871 50907259 54741994 3694331 3952961 30832586 35787093 8153853 9155399 22678733 26631694 TOGETHER, WE INSPIRE YOUR BEST LIFE BY RELENTLESSLY CARING, LEARNING AND INNOVATING. false false 47368321 438684 57269981 SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. IS A 163-BED HOSPITAL CAMPUS (25 HOSPITAL BEDS, 100 NURSING HOME BEDS, 38 ASSISTED LIVING APARTMENT BEDS) PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2025, SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. HAD PATIENT DAYS OF SERVICE COMPRISED OF 449 ACUTE INPATIENT DAYS, 2,196 SWING BED DAYS, 125 OBSERVATION DAYS, 26,843 NH DAYS, AND 13,086 APARTMENT DAYS. THE HOSPITAL ALSO PROVIDED SERVICES FOR 15,636 CLINIC VISITS, 3,075 EMERGENCY ROOM VISITS, 450 OUTPATIENT SURGERIES AND 5,946 HOME HEALTH VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 47368321 true true false false false false false false false false true false false false true true false true false false false false false false false false true true true true true false false false false false false false false false false false false false false false true false false false false true 54 0 true 478 true true true false false false false false false false false false false false X 9 5 false false false false true true true true true false false false true true true true true true false false false false MN X JOHN WOLFE 6515655553 1200 GRANT BLVD WEST WABASHA MN 55981 CINDY DENK BOARD OF DIRECTORS, SECRETARY 2.0 0 X X 0 0 0 DARLENE THEISMANN BOARD OF DIRECTORS, CHAIRMAN 2.0 0 X X 0 0 0 PAUL FISCH BOARD OF DIRECTORS, VICE CHAIRMAN, DIRECTOR, MEDICAL MEDIA 2.0 2.0 X X 0 2599 0 BEVERLY YOUNGBAUER BOARD OF DIRECTORS 2.0 0 X 0 0 0 DANIEL COENEN BOARD OF DIRECTORS, ADMINISTRATOR 2.0 48.0 X 0 165449 47722 EMILY DURAND BOARD OF DIRECTORS 2.0 0 X 0 0 0 KIMBERLY BESELER BOARD OF DIRECTORS, PROGRAM MANAGER, EMERGENCY MEDICAL SERVICES 2.0 48.0 X 0 117460 16157 LLOYD HAAS BOARD OF DIRECTORS, SOLUTION OWNER 2.0 48.0 X 0 133428 18913 MICHAEL EBERSOLD MD BOARD OF DIRECTORS, MD 2.0 48.0 X 0 126900 0 REECE RYKAL BOD, CLINICAL OPERATIONS DIRECTOR, GI SERVICES, GENERAL & TRAUMA SURGERY SERVICES, (BEG 1.1.25) 2.0 48.0 X 0 112242 38017 JAMES ROOT ADMINISTRATOR 50.0 0.0 X 0 214429 34522 JOHN CEELEN CHIEF FINANCIAL OFFICER 1.0 49.0 X 0 728316 54052 JOHN WOLFE FINANCE ADMINISTRATOR 50.0 0.0 X 0 187716 48685 SCOTT RATHGABER MD CEO 1.0 49.0 X 0 1324275 73275 KIMBERLY WOLTER DIRECTOR, INPATIENT SERVICES - ST. 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ELIZABETH 50.0 0 X 174935 0 64977 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0.0 0.0 X 0 209856 0 1245098 3322670 569756 45 true true false AEGIS THERAPIES INC PO BOX 936653 ATLANTA GA 31193 REHAB SERVICES (PT,OT,ST) 310038 STAFFENCY 221 W COLLEGE ACE FLOOR 2 APPLETON WI 54911 CONTRACT SERVICES FOR LAB, RAD 171029 BWBR 380 SAINT PETER STREET STE600 SAINT PAUL MN 55102 ARCHITECTURAL FEES 170474 BURLINGTON HEALTHCARE PROVIDERS INC DELAFIELD WI 53018 CONTRACTUAL SERVICES FOR PHYSICIAN ED CO 166941 WIPFLI LLP PO BOX 3160 MILWAUKEE WI 53201 FINANCIAL SERVICES 105460 6 708542 281766 990308 NET PATIENT REVENUE 621990 50647896 50647896 PHARMACY REVENUE 456110 6571955 4173191 2398764 NURSING CONTRACT REVENUE 48930 48930 1200 1200 0 0 57269981 370309 370309 3346 3346 0 3346 3346 0 0 CAFETERIA 722514 25655 25655 35356 0 0 35356 61011 58694955 54871217 2398764 434666 10050 10050 428634 428634 219807 219807 29126496 26685175 2441321 2603754 2484717 119037 3546776 3164492 382284 1688606 1514361 174245 1932287 842 1931445 55650 55650 1803036 1389463 413573 0 14889 12983 1906 780366 371103 409263 49183 48542 641 765507 765472 35 83679 81757 1922 14889 12983 1906 7183 7183 1570160 1548325 21835 123893 123893 MEDICAL SUPPLIES 7554801 7522488 32313 SUPPLIES 1160318 1129195 31123 BAD DEBT 998657 998657 REPAIRS AND MAINTENANCE 203373 197739 5634 0 0 0 0 54741994 47368321 7373673 0 1215870 2065004 3156994 4814544 9108424 11376846 0 0 14625 9103 1042577 1050300 87810 98783 16236276 7981977 8488772 8254299 7252419 7566108 0 0 465095 552106 30832586 35787093 3050359 4784491 717362 270932 0 4386132 4099976 8153853 9155399 X 22678733 26631694 22678733 26631694 30832586 35787093 3952961 0 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 250000 250000 11470186 5423459 6046727 3947475 2479437 1468038 568615 79081 489534 8254299 FEDERAL INCOME TAXES OTHER PAY 3RD PARTY SETTLEMENTS 267104 SALES TAX PAYABLE 467 LEASE CONTRACTS PAYABLE 156267 ASSET RETIREMENT OBLIG-FIN47 59399 DUE TO/ FROM GLAS 3559328 CURRENT LEASE PAYABLE FINANCE 55476 CURRENT LEASE PAYABLE OPERATING 1935 4099976 X 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART X, LINE 2 THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE SYSTEM AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, AND HAVE BEEN FULLY RESERVED. true true X true X true X true true true false true true 342378 342378 0.00637 2711368 1516905 1194463 0.02223 0 0.0 0 0 3053746 1516905 1536841 0.02860 42306 1200 41106 0.00076 95197 95197 0.00177 12804666 9813248 2991418 0.05566 0 0.0 16722 16722 0.00031 0 0 12958891 9814448 3144443 0.05851 0 0 16012637 11331353 4681284 0.08710 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 572 572 0.00001 4706 4706 0.00009 0 0 5278 0 5278 0.00010 true 925402 0 10588126 10868414 -280288 X true true 1 1 SAINT ELIZABETH'S HOSPITAL OF WABASHA 1200 GRANT BLVD WEST WABASHA MN 55981 WWW.GUNDERSENHEALTH.ORG/ST-ELIZABETHS 410340 X X X X SAINT ELIZABETH'S HOSPITAL OF WABASHA 1 false false true X X X X X X X X X 25 true false true true X WWW.GUNDERSENHEALTH.ORG/COMMUNITY-ASSESSMENT X true 25 true WWW.GUNDERSENHEALTH.ORG/COMMUNITY-ASSESSMENT false true X 200.0 400.0 X X X X true true X X X X true X HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 FACILITY , 1 - SAINT ELIZABETH'S HOSPITAL OF WABASHA INC:. GUNDERSEN ST. ELIZABETH'S HOSPITAL AND CLINICS IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. SAINT ELIZABETH'S AND WABASHA COUNTY PUBLIC HEALTH USED THE FOLLOWING METHODS TO GAIN KEY STAKEHOLDERS AND COMMUNITY FEEDBACK ON THE STRENGTHS AND CHALLENGES OF BEING A HEALTHY COMMUNITY. THESE METHODS PROVIDED US WITH ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING OUR COMMUNITIES. INPUT FROM COMMUNITY: A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS JOINTLY CONDUCTED BY GUNDERSEN ST. ELIZABETH'S AND WABASHA COUNTY PUBLIC HEALTH DEPARTMENT IN SUMMER 2022. COUNTY DATA AND HEALTH INDICATORS WERE COLLECTED AND REVIEWED BY A CHNA LEADERSHIP TEAM. IN ADDITION, SIMILAR COLLABORATIVE WORK BETWEEN THESE TWO ENTITIES WAS UNDERTAKEN TO COMPLETE OUR 2025 CHNA AND FOR 2026-2028 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) DURING SPRING AND SUMMER 2025. FOLLOWING AN EXTENSIVE ANALYSIS OF ALL DATA, TRENDS, AND OTHER ASSESSMENTS CONDUCTED BY AGENCIES AND ORGANIZATIONS SERVING WABASHA COUNTY RESIDENTS, THE LEADERSHIP TEAM SOUGHT ENGAGEMENT FROM KEY STAKEHOLDERS, HEALTH PROVIDERS, COMMUNITY LEADERS AND COUNTY RESIDENTS TO PRIORITIZE WABASHA COUNTY'S TOP TWO HEALTH NEEDS. GUNDERSEN ST. ELIZABETH'S AND WABASHA COUNTY PUBLIC HEALTH ARE COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. GUNDERSEN ST. ELIZABETH'S AND THE WABASHA COUNTY PUBLIC HEALTH DEPARTMENT USED A MASS COMMUNICATION EFFORT TO GAIN AN UNDERSTANDING OF COMMUNITY MEMBERS' THOUGHTS ON THE STRENGTHS AND CHALLENGES OF BEING A HEALTHY COMMUNITY. THIS METHOD PROVIDED US WITH ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING OUR COMMUNITIES. A CHNA PRIORITY SURVEY WAS PREPARED AND DISTRIBUTED THROUGH MULTIPLE EMAIL DISTRIBUTION LISTS, WEBSITES, AND SOCIAL MEDIA PLATFORMS. RESIDENTS WITHOUT ACCESS TO A COMPUTER OR INTERNET WERE INVITED TO UTILIZE RESOURCES AT THEIR LOCAL LIBRARY OR GUNDERSEN ST. ELIZABETH'S TO COMPLETE THE SURVEY. ORGANIZATIONS SERVING LOW-INCOME AND VULNERABLE POPULATIONS WERE PROVIDED WITH RESOURCES TO ENCOURAGE SURVEY PARTICIPATION AMONG THEIR CLIENTS. PRESS RELEASES, NEWSLETTERS, POSTERS, AND SOCIAL MEDIA POSTS WERE USED TO DRAW ATTENTION TO THE IMPORTANCE OF PUBLIC PARTICIPATION. FOLLOWING THE CLOSE OF THE SURVEY (A TWO-WEEK WINDOW PROVIDED AMPLE OPPORTUNITY FOR SURVEY RESPONSE), CHNA LEADERSHIP TEAM MEMBERS COLLATED AND EVALUATED SURVEY RESPONSE AND RESULTS. THE 2025 PRIORITIZATION PROCESS INCLUDED MULTIPLE STEPS: 1. REVIEWED PREVIOUS 2022 CHNA AND PROGRESS ON PREVIOUS 2023-2025 CHIP PRIORITIES 2. REVIEWED BROAD AND COUNTY-LEVEL NATIONALLY AVAILABLE RESOURCES 3. COLLECTED AND REVIEWED EXISTING PRIMARY DATA ASSESSMENTS AND RESOURCES FROM LOCAL ORGANIZATIONS AND AGENCIES 4. IDENTIFIED THE TOP FIVE PRIORITIES (AFFORDABLE HOUSING, FINANCIAL STABILITY, MENTAL HEALTH, SENIOR HEALTH, TRANSPORTATION) 5. OFFERED LOCAL SURVEY OF THESE FIVE TO ADD MORE INFORMATION AND INPUT FROM A BROADER REPRESENTATION OF OUR COMMUNITY 6. IDENTIFIED TOP TWO ACTIONABLE PRIORITIES THE FOLLOWING HEALTH ISSUES WERE SELECTED AS THE PRIORITIES FOR THE 2026-2028 CHIP: NUMBER 1: SENIOR HEALTH NUMBER 2: MENTAL HEALTH THE CHNA LEADERSHIP TEAM IS FUELED BY A COMMITMENT TO HUMAN DIGNITY, THE COMMON GOOD, JUSTICE AND SOLIDARITY. WE BELIEVE THE CHNA PROCESS MUST BE INFORMED BY DIRECT INPUT FROM PEOPLE WHO EXPERIENCE HEALTH DISPARITIES BASED ON INCOME AND/OR RACE AND ETHNICITY. WITH THAT IN MIND, THE CHNA PRIORITY SURVEY INCLUDED POINTED QUESTIONS ABOUT NEEDS AND SATISFACTION LEVELS OF THE LOW-INCOME POPULATION. THE PROCESS TO SELECT THE HEALTH PRIORITIES CONTINUES TO GIVE STRONG CONSIDERATION TO HOW INDIVIDUALS WHO ARE MORE VULNERABLE ARE IMPACTED BY HEALTH ISSUES. SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY , 1 FACILITY , 1 - SAINT ELIZABETH'S HOSPITAL OF WABASHA INC:. GUNDERSEN ST. ELIZABETH'S CONDUCTED THE CHNA AND IMPROVEMENT PLAN DEVELOPMENT JOINTLY WITH WABASHA COUNTY PUBLIC HEALTH DEPARTMENT. SUPPORT AND BACKGROUND DATA WERE PROVIDED BY THE EMPLIFY HEALTH DEPARTMENT OF POPULATION HEALTH. IN ADDITION, OTHER AGENCIES, ORGANIZATIONS, AND CITIZENS ACTIVELY PARTICIPATED IN THE DEVELOPMENT OF IMPROVEMENT STRATEGIES FOR THE PRIORITIES SELECTED. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 FACILITY , 1 - SAINT ELIZABETH'S HOSPITAL OF WABASHA IN. SENIOR HEALTH: ONGOING COLLABORATION WITHIN THE COMMUNITY TO SUPPORT OUR AGE-FRIENDLY MEMBERSHIP, INCLUDING GATHERING COMMUNITY/PARTNERS' INPUT, WORKING ON PROGRAMMING FOR FALLS PREVENTION AND HOME MODIFICATIONS, AND UPDATING LOCAL RESOURCE DIRECTORY WORKING TO EXPAND MEMBERSHIP TO OTHER SURROUNDING COMMUNITIES BOOST GRANT FROM CITY OF WABASHA RECEIVED TO SUPPORT SENIOR SERVICES OFFERED THROUGH OUR CONNECTIONS CAFE REMOVED MEMORY KITS FROM CIRCULATION AND REDISTRIBUTED ITEMS COMBINED OUR SENIOR HEALTH AND AGE-FRIENDLY GROUPS INTO ONE TEAM/SINGLE MEETINGS TO STREAMLINE WORK MENTAL HEALTH: * CHALLENGES WITH THIS WORK AS ONE OF OUR MAJOR COMMUNITY PARTNERS HAD SIGNIFICANT TRANSITIONS/VACANCIES IN LEADERSHIP DURING 2025 * ANOTHER CHALLENGE RELATED TO OUR IMPACT PERFORMANCE INDICATOR WAS IDENTIFIED AS THE COUNTY HEALTH RANKINGS THAT WE HAVE USED IN THE PAST LOST FUNDING/WILL NO LONGER BE RELEASED * WABASHA CLINIC MENTAL HEALTH PROVIDER SERVICES REMAINED STEADY DURING 2025 * LOCAL EDUCATION SESSIONS COMPLETED RELATED TO MENTAL HEALTH FIRST AID, ACES TRAIN THE TRAINER 4 GUNDERSEN ST ELIZABETH'S CARE CENTER 1200 GRANT BLVD WEST WABASHA MN 55981 NURSING HOME GUNDERSEN ST ELIZABETH'S WABASHA CLINIC 1200 GRANT BLVD WEST WABASHA MN 55981 PROVIDER BASED RURAL HEALTH CLINIC GUNDERSEN ST ELIZABETH'S SENIOR LIVING 1200 GRANT BLVD WEST WABASHA MN 55981 RESIDENTAL HOUSING WITH SERVICES ALMA COMMUNITY CLINIC 204 S MAIN STREET ALMA WI 54610 PROVIDER BASED RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 3C PATIENTS WITH DEMONSTRATED FINANCIAL NEEDS WITH INCOME GREATER THAN 400% OF THE FPL MAY BE ELIGIBLE FOR CONSIDERATION UNDER A "MEANS TEST" FOR SOME DISCOUNT OF THEIR CHARGES FOR SERVICES FROM THE ORGANIZATION BASED ON A SUBSTANTIVE ASSESSMENT OF THEIR ABILITY TO PAY. THIS TEST CAPS TOTAL BALANCE DUE AT 25% OF TOTAL INCOME. A PATIENT ELIGIBLE FOR THE "MEANS TEST" DISCOUNT WILL NOT BE CHARGED MORE THAN THE CALCULATED AGB CHARGES. SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES THE HOSPITAL'S SUBSIDIZED HEALTH SERVICES INCLUDE THE EMERGENCY DEPARTMENT AND RURAL HEALTH CLINICS. SCHEDULE H, PART I, LINE 7 BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION 998657 SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF-PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES SAINT ELIZABETH'S MEDICAL CENTER SUPPORTS A YOUTH READING PROGRAM. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, BETTER EDUCATED INDIVIDUALS LIVE LONGER, HEALTHIER LIVES THAN THOSE WITH LESS EDUCATION, AND THEIR CHILDREN ARE MORE LIKELY TO THRIVE. THIS IS TRUE EVEN WHEN FACTORS LIKE INCOME ARE TAKEN INTO ACCOUNT. SAINT ELIZABETH'S LEADERS PARTICIPATE IN MANY LOCAL ORGANIZATIONS AND COLLABORATIVE EFFORTS THAT HELP IMPROVE THE COMMUNITY. THESE INCLUDE THE LOCAL CHAMBER OF COMMERCE AND THE WABASHA AREA COMMUNITY RESOURCE CENTER. BY WORKING TOGETHER WITH OTHER ORGANIZATIONS IN THE COMMUNITY, WE EXPECT TO HAVE A GREATER IMPACT ON HEALTH. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, WITH A SHARED VISION AND COMMITMENT TO IMPROVED HEALTH, WORKING TOGETHER CAN YIELD BETTER RESULTS THAN WORKING ALONE. SAINT ELIZABETH MEDICAL CENTER PROVIDED JOB SHADOWING EXPERIENCES TO STUDENTS. ASSURING THAT RURAL COMMUNITIES HAVE A VIBRANT HEALTH CARE WORKFORCE IN THE FUTURE WILL HELP INCREASE ACCESS TO QUALITY OF CARE IN THE FUTURE. SAINT ELIZABETH MEDICAL CENTER ALSO CONDUCTS A COMMUNITY SHARPS PROGRAM. BY SAFELY REMOVING SHARPS FROM THE ENVIRONMENT, WE MAKE THE COMMUNITY SAFER IN TERMS OF INJURY AND INFECTION. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY GUNDERSEN HEALTH SYSTEM. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE WAS $0 IN 2023. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE ORGANIZATION IS PART OF THE GUNDERSEN HEALTH SYSTEM'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGE 8. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ST. ELIZABETH'S HOSPITAL OF WABASHA, INC. FOLLOWS THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE THE ORGANIZATION FOLLOWS GUNDERSEN HEALTH SYSTEM'S GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - SAINT ELIZABETH'S HOSPITAL OF WABASHA: LINE 16A URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - SAINT ELIZABETH'S HOSPITAL OF WABASHA: LINE 16B URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - SAINT ELIZABETH'S HOSPITAL OF WABASHA: LINE 16C URL: HTTPS://WWW.GUNDERSENHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, SAINT ELIZABETH'S MEDICAL CENTER USES BOTH HOSPITAL DATA AND RELIABLE, THIRD-PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. SAINT ELIZABETH'S MEDICAL CENTER UTILIZES THIS INFORMATION TO DETERMINE DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S SAINT ELIZABETH'S HOSPITAL OF WABASHA 41-0693877 STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION GOES TO GREAT LENGTHS IN ORDER TO INFORM AND EDUCATE PATIENTS/PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE CHARITY CARE POLICY AND APPLICATION IS POSTED ON THE ORGANIZATION'S WEBSITE. ADMISSIONS, SOCIAL SERVICES, AND OTHER KEY AREAS CONTAIN SUMMARY INFORMATION OF THE CHARITY CARE POLICY. AS PART OF THE INTAKE/DISCHARGE PROCESS, PATIENTS ARE PROVIDED WITH A COPY OF THE POLICY AND OTHER IMPORTANT INFORMATION FOR FINANCIAL ASSISTANCE. IF DURING THE COURSE OF THE PATIENT REGISTRATION PROCESS, CARE ENCOUNTER, TREATMENT, OR UPON DISCHARGE IT BECOMES EVIDENT THAT A PATIENT MAY NEED FINANCIAL ASSISTANCE; THE PATIENT SHALL BE REFERRED TO THE ORGANIZATION'S COMMUNITY CARE PROGRAM. PATIENTS MAY BE IDENTIFIED AS NEEDING FINANCIAL ASSISTANCE AT ANY TIME DURING THE COURSE OF AN ENCOUNTER. A REFERRAL FOR CONSIDERATION OF COMMUNITY CARE FINANCIAL ASSISTANCE CAN BE INITIATED BY ANY MEMBER OF THE HOSPITAL'S WORKFORCE, INCLUDING MEDICAL STAFF MEMBERS, WHO BECOME AWARE OF THE PATIENT'S POTENTIAL NEED FOR COMMUNITY CARE FINANCIAL ASSISTANCE. THE COMMUNITY CARE POLICY WAS ALSO TRANSLATED INTO DIALECTS PREVALENT IN THE COMMUNITY IN ORDER TO REACH OUT TO THOSE THAT MAY SPEAK ANOTHER LANGUAGE (SPANISH). PATIENT REGISTRATION STAFF AND FINANCIAL COUNSELORS ARE PROVIDED WITH SCRIPTS TO FOLLOW WHEN INTERACTING WITH PATIENTS. AS PART OF THE CHARITY CARE PROCESS, PATIENTS MUST REGISTER WITH THE COUNTY PUBLIC ASSISTANCE TO SEE IF THEY MAY QUALIFY UNDER ANY OTHER FEDERAL OR STATE PROGRAMS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION SAINT ELIZABETH'S MEDICAL CENTER PRIMARILY SERVES THE RESIDENTS OF WABASHA COUNTY, MINNESOTA, AND THE SURROUNDING COUNTIES IN A RURAL AREA OF EASTERN MINNESOTA AND WESTERN WISCONSIN. THE POPULATION OF WABASHA COUNTY IS APPROXIMATELY 21,000, WITH 7% OF RESIDENTS LIVING AT OR BELOW THE FEDERAL POVERTY THRESHOLD. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $62,000. APPROXIMATELY 5% OF THE INDIVIDUALS LIVING IN THE COUNTY ARE UNINSURED AND 12.7% RECEIVE MEDICAID. WABASHA COUNTY IS A DESIGNATED PRIMARY CARE SHORTAGE AREA. THERE IS ONE HOSPITAL (SAINT ELIZABETH'S MEDICAL CENTER) IN WABASHA COUNTY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE ORGANIZATION STRIVES TO FURTHER ITS EXEMPT PURPOSES BY THE FOLLOWING: -THE ORGANIZATION'S GOVERNING BOARD CONSISTS OF A COMBINATION OF PERSONS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION, AS WELL AS REPRESENTATIVES AND EMPLOYEES OF OUR CORPORATE SPONSOR, GUNDERSEN HEALTH SYSTEM. -AS MENTIONED, THE ORGANIZATION PROVIDES SEVERAL SERVICES WHICH ARE NOT OTHERWISE AVAILABLE BEING IN A RURAL SETTING. -BASED ON THE ORGANIZATION'S MISSION, EMERGENCY ROOMS ARE MADE AVAILABLE TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY. -THE ORGANIZATION ALSO PARTICIPATES IN THE EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH INTERNSHIP PROGRAMS. -THE HOSPITAL PARTICIPATES IN GOVERNMENT -SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID, CHAMPUS, TRICARE). -THE HOSPITAL OFFERS VOLUNTEER OPPORTUNITIES TO THE COMMUNITY OR EVIDENCE OF THE ORGANIZATION'S RESPONSIVENESS TO THE COMMUNITY, INCLUDING OPPORTUNITIES FOR COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS. EXAMPLES OF PROGRAMS THAT WERE ESTABLISHED IN THE TAX YEAR THAT RESPONDED TO COMMUNITY NEEDS INCLUDE: -THE FACILITY STRIVES TO BE A LOW-COST/LOW-CHARGE FACILITY. -ADVOCATE COMMUNITY WIDE, STATE OR NATIONAL EFFORTS TO IMPROVE HEALTH OF THE POPULATION AND INCREASE ACCESS. - PARTNERSHIPS WITH OTHERS IN THE COMMUNITY (INCLUDING PUBLIC HEALTH DEPARTMENTS) TO IMPROVE COMMUNITY HEALTH AND WELL-BEING. - THE ROLE OF THE EMERGENCY DEPARTMENT AND URGENT CARE UNITS IN SERVING ALL PERSONS REGARDLESS OF ABILITY TO PAY. - AVAILABILITY OF FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS AND CHANGES TO FINANCIAL ASSISTANCE OR COLLECTION POLICIES THAT WOULD BE VIEWED AS CONSTRUCTIVE. - THE ORGANIZATION IS A SOLE COMMUNITY HOSPITAL. - COMMUNITY MEMBERS UTILIZE THE HOSPITAL AS A VEHICLE TO CONNECT WITH AND CONTRIBUTE TO INDIVIDUALS AND THE OVERALL COMMUNITY THROUGH PHILANTHROPY AND VOLUNTEERING. - PROGRAMS ARE HAVING AN IMPACT ON COMMUNITY HEALTH ESPECIALLY PREVENTION ACTIVITIES, EFFORTS TO IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES AND REDUCING HEALTH CARE COSTS. BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO DIALYSIS, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, SURGICAL SERVICES, EXTENDED CARE, LABORATORY AND RADIOLOGY SERVICES, REHAB SERVICE, PRIMARY CARE, SPECIALTY MEDICINE, SLEEP ASSESSMENT SERVICES, RETAIL PHARMACY AND RESPIRATORY THERAPY SERVICES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC IS AFFILIATED WITH EMPLIFY. EMPLIFY IS AN INTEGRATED HEALTH CARE SYSTEM THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO PATIENTS PRIMARILY IN WISCONSIN, AS WELL AS IN IOWA AND MINNESOTA, BY OPERATING HOSPITALS, CLINICS, HEALTH PLANS, LONG-TERM CARE FACILITIES, AMBULANCE SERVICES, A FOUNDATION, AND AN ENERGY-PRODUCING COMPANY, IN ADDITION TO PROVIDING MEDICAL AND HEALTH/WELLNESS EDUCATION AND COMMUNITY OUTREACH, AND CONDUCTING MEDICAL EDUCATION AND CLINICALLY BASED RESEARCH. AS PART OF ITS OVERALL STRATEGY, THE SYSTEM HAS AFFILIATED WITH SEVERAL CRITICAL ACCESS HOSPITALS (CAHS) THAT ENABLE HIGHLY TRAINED PHYSICIANS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND CLINICAL CARE SERVICES TO PATIENTS IN THEIR COMMUNITIES. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT MN true CHARITY CARE 32 428634 BOOK CHARITY CARE SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS THE FUNDS MADE TO INDIVIDUALS ARE GIVEN TO HELP PAY FOR MEDICAL BILLS OWED TO ST. ELIZABETH'S HOSPITAL THROUGH A CHARITY CARE APPLICATION PROCESS. false true false false false false false false false DANIEL COENEN BOARD OF DIRECTORS, ADMINISTRATOR 0 133985 0 0 0 31464 0 23568 0 24154 0 213171 0 0 LLOYD HAAS BOARD OF DIRECTORS, SOLUTION OWNER 0 133158 0 0 0 270 0 18642 0 271 0 152341 0 0 REECE RYKAL BOD, CLINICAL OPERATIONS DIRECTOR, GI SERVICES, GENERAL & TRAUMA SURGERY SERVICES, (BEG 1.1.25) 0 109315 0 0 0 2927 0 14458 0 23559 0 150259 0 0 STEVE LITTLE FORMER CHIEF FINANCIAL OFFICER 0 209856 0 0 0 0 0 0 0 0 0 209856 0 0 JOHN CEELEN CHIEF FINANCIAL OFFICER 0 598104 0 129468 0 744 0 29147 0 24905 0 782368 0 0 SCOTT RATHGABER MD CEO 0 1278368 0 0 0 45907 0 48300 0 24975 0 1397550 0 0 JAMES ROOT ADMINISTRATOR 0 213252 0 0 0 1177 0 29964 0 4558 0 248951 0 0 JOHN WOLFE FINANCE ADMINISTRATOR 0 174659 0 4449 0 8608 0 26808 0 21877 0 236401 0 0 KIMBERLY WOLTER DIRECTOR, INPATIENT SERVICES - ST. ELIZABETH 163115 0 4072 0 2233 0 23496 0 13920 0 206836 0 0 0 KURT HENN DIRECTOR, OUTPATIENT OPERATIONS & PHARMACY - ST. ELIZABETH 202953 0 4858 0 737 0 29094 0 1467 0 239109 0 0 0 TRACY HENN DIRECTOR, BUSINESS OPERATIONS - ST. ELIZABETH 169526 0 4501 0 908 0 25837 0 39140 0 239912 0 0 0 STACY SASS PHARMACIST - ST. ELIZABETH 168782 0 4051 0 494 0 23002 0 3750 0 200079 0 0 0 AMANDA STERRY CRNA - ST. ELIZABETH 261154 0 13077 0 1963 0 38392 0 339 0 314925 0 0 0 MARK SWENSON CRNA - ST. ELIZABETH 240704 0 0 0 1970 0 30529 0 9447 0 282650 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CERTAIN INDIDVIDUALS LISTED IN SCHEDULE J, PART II, PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH THE ORGANIZATION MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN FOR CALENDAR YEAR 2024: JOHN CEELEN SCHEDULE J, PART I, LINE 3 ALL PERSONNEL SERVICES ARE PERFORMED BY EMPLOYEES OF GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. FORM 990, PART VI, LINE 15A COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. FORM 990, PART VI, LINE 15B SENIOR LEADERS: COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION. COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. HAS A SINGLE CORPORATE MEMBER, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC HAS A SINGLE CORPORATE MEMBER, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., WHO CAN ELECT MEMBERS TO THE GOVERNING BODY OF SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC., FINANCIAL INFORMATION, OR CORPORATION ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 IS REVIEWED BY THE ACCOUNTING MANAGER AND PRINCIPAL OFFICER. IT WILL BE MADE AVAILABLE FOR ALL BOARD MEMBERS BEFORE FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES, INC. (GLAS) ANNUALLY REQUIRES EXECUTIVE LEADERSHIP (VICE PRESIDENTS AND ABOVE), BOARD MEMBERS, MEDICAL GOVERNORS AND FOUNDATION BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED DISCLOSURE STATEMENTS ARE REVIEWED BY A CONFLICT OF INTEREST REVIEW PANEL WHICH INCLUDES REPRESENTATIVES FROM LEGAL, COMPLIANCE, MEDICAL LEADERSHIP, HUMAN RESOURCES AND SUPPLY CHAIN. INDIVIDUALS REPORTING A POTENTIAL CONFLICT OF INTEREST ARE SENT A RESOLUTION THANKING THEM FOR THEIR SERVICE TO THE ORGANIZATION, ADVISING THEM OF ANY RESTRICTIONS RELATED TO THEIR CONFLICT (I.E. INDIVIDUALS WITH A RELATIONSHIP TO ANOTHER ORGANIZATION ARE ADVISED THAT THEY MUST ABSTAIN FROM DECISION MAKING THAT WOULD DIRECTLY AND SOLELY IMPACT GLAS) AND REMINDING THEM OF THEIR CONFIDENTIALITY OBLIGATIONS WITH RESPECT TO GLAS' HEALTHCARE, EMPLOYMENT AND PROPRIETARY INFORMATION. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC REQUESTS FOR ALL DOCUMENTS ARE MADE THROUGH THE LEGAL DEPARTMENT AND THE APPROPRIATE DOCUMENTS ARE MADE AVAILABLE FOR INSPECTION IN THE LEGAL DEPARTMENT. 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