Title: Note 1: General
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Gundersen Lutheran Health System, Inc. (“Gundersen Health System”), based in La Crosse, Wisconsin, is an integrated healthcare system that provides comprehensive medical care to patients primarily in Wisconsin, as well as in Iowa and Minnesota, by operating hospitals, clinics, long-term care facilities, ambulance services, a foundation, and an energy-producing company. Gundersen Health System also provides medical and health and wellness education, including community outreach services, and provides medical education and conducts clinically based research for the benefit of its patients and the communities it serves.
Title: Note 2: Basis of Presentation
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
The accompanying schedule of expenditures of federal and state awards and DHS reimbursement award schedule (“Schedules”) includes the federal and state award activity of Gundersen Health System. The information in these schedules are presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the “Uniform Guidance”) and the State of Wisconsin Single Audit Guidelines. Because the schedules present only a selected portion of the operations of Gundersen Health System, they are not intended to and do not present the financial position, changes in net assets, or cash flows of Gundersen Health System.
The Schedules include expenditures of the following entities within Gundersen Health System:
Legal entity Name Tax Identification Number
Gundersen Lutheran Health System, Inc. 39-1866425
Gundersen Lutheran Medical Center, Inc. 39-0813416
Gundersen Clinic, Ltd. 39-1028657
Gundersen Lutheran Medical Foundation, Inc. 39-1249705
Tri-County Memorial Hospital, Inc. 39-0704510
Harmony Community Healthcare, Inc. 41-0711606
Tweeten Lutheran Healthcare Center, Inc. 41-1565003
Tri-State Ambulance, Inc. 39-1965415
Tri-State Regional Ambulance, Inc. 39-1962965
Lutheran Housing of La Crosse, Inc. 39-1751934
Community Housing of La Crosse, Inc. 39-1586700
St. Joseph's Health Services, Inc. 39-0929538
Memorial Hospital of Boscobel 39-0845590
Palmer Lutheran Health Center, Inc. 42-1320763
Moundview Memorial Hospital & Clinics 39-0944012
Saint Elizabeth's Hospital of Wabasha, Inc. 41-0693877
Title: Note 3: Summary of Significant Accounting Policies
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
Title: Note 4: Indirect Cost
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Title: Note 5: Subrecipients
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
Gundersen Health System passed no federal awards through to subrecipients during the year ended September 30, 2024.
Title: Note 6: Loan Outstanding Balances
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
The Supportive Housing for the Elderly (Assistance Listing 14.157) loans are considered a federal award until the outstanding balance is paid in full. The outstanding loan balances at September 30, 2023, totaling $332,828 are considered current year federal expenditures. There were no new loans made during the year ended September 30, 2024. The outstanding balance of the remaining loans at September 30, 2024 was $305,125.
Title: Note 7: Subsequent Events
Accounting Policies: Expenditures on the Schedule are reported on the accrual basis of accounting and are recognized following the cost principles contained in the Uniform Guidance and State of Wisconsin Single Audit Guidelines, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: N
Rate Explanation: Gundersen Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance.
The Schedules and related disclosures include evaluation of events through June 29, 2025, which is the date the Schedules were available to be issued.