Gundersen Clinic Ltd

What it reported doing in 2024

Gundersen clinic, ltd. (the clinic) has 700 physicians representing nearly every specialty serving a 21 county region in western Wisconsin, northeastern Iowa and southeastern Minnesota. The clinic provides medical care to all patients regardless of their ability to pay. Charity care and/or financial assistance is determined based on financial information provided by the patient and analysis of other relevant information. There were approximately 1,257,683 patient encounters for fiscal year 2025 (oct '24-sep '25). The clinic provided uncompensated care related to charity at cost, $2,216,661; medicare, $470,613,243; and medicaid, $129,801,332 for the total amount of $602,631,227 at cost based on policies and contracts arranged to help support the community's needs. The $602,631,227 is the sum of unreimbursed medicare & medicaid cost plus charity at cost. All of these are calculated using the same method utilized for the hospital calculation of charity cost and unreimbursed medicare and medicaid costs. The cost of charity is calculated by allocating the cost to provide services to a patient between any payments, bad debt, and charity writeoffs where total payments are less than the cost of services provided. The unreimbursed medicare and medicaid costs are calculated by comparing the cost of services to medicare and medicaid patients to the net revenue for those same patients. The unreimbursed cost is the amount the cost exceeds the net revenue for those same patients. Medicare and medicaid patients to the net revenue for those same patients. The unreimbursed cost is the amount the cost exceeds the net revenue for those same patients.

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 92.1%; rating input score 92
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: 99.6%; rating input score 100; 42nd percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 0%; rating input score 0; 4th percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -38.7%; rating input score 2; 2nd percentile among comparable filings
• Total-asset coverage ratio: 0.88; rating input score 35; 35th percentile among comparable filings
• Liabilities to assets ratio: 3.73; rating input score 1; 1st percentile among comparable filings
• Officer compensation ratio: 0.3%; rating input score 88; 88th percentile among comparable filings

Growth

• Program expense growth: 4.5% per year; rating input score 100; 35th percentile among comparable filings
• Revenue growth: -6.8% per year; rating input score 0; 1st percentile among comparable filings
• Asset growth: -2.9% per year; rating input score 0; 3rd percentile among comparable filings