Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 10-01-2012 , 2012, and ending 09-30-2013
BCheck if applicable:
CName of organization
MARSHFIELD CLINIC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1000 North Oak Avenue
Suite
Room/suite
City or town, state or country, and ZIP + 4
Marshfield, WI54449
D Employer identification number

39-0452970
E Telephone number

G Gross receipts $ 1,465,040,455
F Name and address of principal officer:
Brian Ewert MD President
1000 North Oak Avenue
Marshfield,WI54449
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.marshfieldclinic.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1916
M State of legal domicile: WI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: The mission of Marshfield Clinic is to serve patients through accessible high quality health care, research and education.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 8,980
6 Total number of volunteers (estimate if necessary) ............. 6 400
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 21,522,999
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -2,141,538
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,180,930 13,738,812
9 Program service revenue (Part VIII, line 2g) ......... 1,148,561,271 1,145,721,419
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 14,003,815 10,584,540
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,434,310 1,017,890
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,177,180,326 1,171,062,661
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 16,174,737 16,202,937
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 779,876,055 783,810,355
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,914,502    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 361,657,322 352,850,567
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,157,708,114 1,152,863,859
19 Revenue less expenses. Subtract line 18 from line 12....... 19,472,212 18,198,802
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,028,178,070 1,040,642,079
21 Total liabilities (Part X, line 26)............. 530,554,476 523,772,494
22 Net assets or fund balances. Subtract line 21 from line 20..... 497,623,594 516,869,585
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 899,345,353 including grants of $ 16,202,937 ) (Revenue $ 1,014,489,372 )
Patient Medical Care SEE SCHEDULE O
4b (Code:   ) (Expenses $ 52,938,201 including grants of $   ) (Revenue $ 14,049,299 )
MEDICAL RESEARCH AND EDUCATION SEE SCHEDULE O
4c (Code:   ) (Expenses $ 43,805,006 including grants of $   ) (Revenue $ 95,659,749 )
LABORATORY MEDICINE SEE SCHEDULE O
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet996,088,560
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
Yes
 
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
Yes
 
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
Yes
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II..........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............. Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
1,009
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
8,980
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCA
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
OH , WI
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletNARAYANA MURALI MD CORP SEC1000 N OAK AVEMarshfieldWI54449 (715) 387-5511
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Ivan B Schaller MD........................................................................
Internal Medicine - East
 55.0
.......................1.0 		X           209,010 0 51,839
(2) Dan Erickson MD........................................................................
Family Practitioner - Northwes
 55.0
.......................2.0 		X           216,249   48,483
(3) Matthew Thomas MD........................................................................
Urology - North
 55.0
.......................1.0 		X           411,580   46,645
(4) Ron Martin MD........................................................................
General Surgeon - Central 1
 55.0
.......................   		X           435,267   39,175
(5) John Przybylinski MD........................................................................
Internal Medicine - Central 2
 55.0
.......................   		X           178,995   34,019
(6) Seth Fagbemi MD........................................................................
Oncology - Central 3
 55.0
.......................   		X           475,926   59,981
(7) Jane Stark MD........................................................................
Occ Med - West
 55.0
.......................   		X           188,686   50,710
(8) Brian Ewert MD........................................................................
Nephrologist - President
 55.0
.......................   		X   X       580,597   53,947
(9) C Todd Stewart........................................................................
Peds Intensivist - Vice Presid
 55.0
.......................   		X   X       441,482   48,638
(10) Mark LePage MD........................................................................
Radiology - Treasurer
 55.0
.......................1.0 		X   X       442,203   54,031
(11) Narayana Murali MD........................................................................
Nephrology - Secretary
 55.0
.......................2.0 		X   X       280,939   51,879
(12) Douglas J Reding MD........................................................................
Oncologist/Hematologist
 55.0
.......................   		X   X       578,775   52,947
(13) Peter Meyer MD........................................................................
Emergency Medicine - Treasurer
 55.0
.......................   		X   X       169,658   45,192
(14) Caesar Gonzaga MD........................................................................
General Surgery - West
 55.0
.......................   		X           311,153   53,161
(15) David J Simenstad MD........................................................................
Orthopaedic Surgeon
 55.0
.......................   		      X     1,103,538   53,947
(16) Gary Jankowski........................................................................
CFO
 55.0
.......................1.0 		      X     430,763   51,704
(17) Jim Coleman........................................................................
COO
 55.0
.......................   		      X     445,981   53,826
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Ken Letkeman........................................................................
CIO
 55.0
.......................   		      X     314,656   22,813
(19) David Keefe........................................................................
DIRECTOR OF HUMAN RESOURCES
 55.0
.......................   		      X     281,764   38,402
(20) Steve Christianson........................................................................
DIRECTOR OF COMPENSATION
 55.0
.......................   		      X     225,253   50,552
(21) Tom Satkus........................................................................
TREASURY DIRECTOR
 55.0
.......................   		      X     252,415   54,634
(22) Laura Nelson MD........................................................................
Chief Medical Officer
 55.0
.......................   		      X     370,802   51,147
(23) Fred Bollow MD........................................................................
Division Medical Director - Ce
 55.0
.......................   		      X     355,941   49,412
(24) William Yanke MD........................................................................
Division Medical Director - Ce
 55.0
.......................   		      X     327,747   51,273
(25) Richard Mercier MD........................................................................
Service Line M.D. - Oncology
 55.0
.......................   		      X     534,820   54,826
(26) Timothy Swan MD........................................................................
Service Line M.D. Radiology
 55.0
.......................   		      X     500,156   48,638
(27) Rod Sorenson DO........................................................................
Chair of Physician Salary Comm
 55.0
.......................   		      X     435,248   48,638
(28) Greg Burnett MD........................................................................
Salary Committee Member
 55.0
.......................   		      X     292,561   53,826
(29) David Cook MD........................................................................
Salary Committee Member
 55.0
.......................   		      X     277,591   53,161
(30) Roderick Koehler MD........................................................................
Salary Committee Member
 55.0
.......................   		      X     297,838   53,826
(31) Gene Shaw MD........................................................................
Division Medical Director - La
 55.0
.......................   		      X     366,778   53,831
(32) Eric Penniman MD........................................................................
East District 4
 55.0
.......................   		      X     252,300   48,568
(33) Bradley Bekkum MD........................................................................
West District 1
 55.0
.......................   		      X     320,779   48,632
(34) Theodore Praxel MD........................................................................
Quality Improvement/Care Mgmt
 55.0
.......................   		      X     339,970   55,451
(35) Scott Paulman MD........................................................................
Retinal Surgeon
 55.0
.......................   		        X   1,268,211   33,402
(36) Sanjay Rao MD........................................................................
Neurosurgeon - Spine
 55.0
.......................   		        X   1,150,964   50,138
(37) Vivekananda Gonugunta MD........................................................................
Neurosurgeon - Spine
 55.0
.......................   		        X   1,048,169   33,818
(38) Adedayo Onitilo MD........................................................................
Hematology/Oncology
 55.0
.......................   		        X   965,648   55,942
(39) John Neal MD........................................................................
Nuerosurgeon - Spine
 55.0
.......................   		        X   849,955   53,632
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 17,930,368 0 1,914,686
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,259
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
AE BUSINESS SOLUTIONS, 2310 CROSSROADS DR STE 2800MADISONWI53718 SERVICE/CAP. EQUIP 5,348,946
KNUTSON CONSTRUCTION, 7715 WAYZATA BLVDMINNEAPOLISMN55426 REMODELING 7,170,841
BOLDT COMPANY, LOCK BOX 285MILWAUKEEWI532880285 REMODELING 5,780,072
BOLDT PROCUREMENT LLC, PO BOX 419APPLETONWI549120419 REMODELING 3,641,769
OLYMPUS AMERICA INC, PO BOX 120600DALLASTX753120600 MAINTENANCE & REPAIR 3,218,734
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet172
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 689,118
d Related organizations...1d 181,902
e Government grants (contributions)1e 8,626,281
f All other contributions, gifts, grants, and
similar amounts not included above1f 		4,241,511
g Noncash contributions included in lines
1a-1f:$ 		251,925
h Total. Add lines 1a-1f.......MediumBullet 13,738,812
Program Service Revenue Business Code
2a PATIENT MEDICAL CARE 621500 1,014,519,506 1,014,489,372 30,134  
b LABORATORY MEDICINE 621500 116,901,438 95,659,749 21,241,689  
c MEDICAL RESEARCH & EDUCATION 621500 14,300,475 14,049,299 251,176  
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,145,721,419
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 8,417,949     8,417,949
4 Income from investment of tax-exempt bond proceeds..MediumBullet -679,121     -679,121
5 Royalties...........MediumBullet 483,807     483,807
(i) Real (ii) Personal
6a Gross rents 270,996  
b Less: rental expenses 192,717  
c Rental income or (loss) 78,279 0
d Net rental income or (loss).......MediumBullet 78,279     78,279
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 233,141,482 9,857,904
b Less: cost or other basis and sales expenses 230,154,383 9,999,291
c Gain or (loss) 2,987,099 -141,387
d Net gain or (loss)..........MediumBullet 2,845,712     2,845,712
8a Gross income from fundraising events (not including
$ 689,118
of contributions reported on line 1c). See Part IV, line 18 ..
a 343,262
b Less: direct expenses ...b 288,638
c Net income or (loss) from fundraising events..MediumBullet 54,624   54,624
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 48,779
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 48,779     48,779
10a Gross sales of inventory, less
returns and allowances .
a 53,148,624
b Less: cost of goods sold ..b 53,342,765
c Net income or (loss) from sales of inventory..MediumBullet -194,141     -194,141
Miscellaneous Revenue Business Code
11a CAFETERIA SALES 900099 546,542     546,542
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 546,542
12 Total revenue. See Instructions......MediumBullet 1,171,062,661 1,124,198,420 21,522,999 11,602,430
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 16,202,937 16,202,937
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 13,395,463 4,952,563 8,442,900 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 590,102,100 518,123,472 70,949,517 1,029,111
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 55,179,695 47,598,677 7,480,818 100,200
9 Other employee benefits ....... 89,841,533 73,091,477 16,574,178 175,878
10 Payroll taxes ........... 35,291,564 30,026,701 5,191,964 72,899
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 692,232 56,533 635,699  
c Accounting ........... 208,559   208,559  
d Lobbying ........... 226,522   226,522  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 35,120,925 22,499,074 12,583,764 38,087
12 Advertising and promotion .... 7,814,072 32,702 7,778,470 2,900
13 Office expenses ....... 6,171,733 3,795,800 2,351,641 24,291
14 Information technology ...... 35,213,857 22,363,003 12,539,470 311,384
15 Royalties .. 131,139 131,139    
16 Occupancy ........... 21,095,106 18,277,752 2,782,189 35,165
17 Travel ............ 8,542,731 7,562,836 944,877 35,019
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 409,827 409,670 157  
20 Interest ........... 7,426,028 3,917,809 3,508,219  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 30,905,242 29,140,574 1,755,649 9,019
23 Insurance .............. 4,145,322 4,117,544 27,778  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a OPERATING SUPPLIES 174,081,357 173,831,337 177,653 72,367
b MAINTENANCE AND REPAIRS 7,422,236 7,111,597 307,820 2,819
c OPERATING EXPENSES 11,998,857 11,831,804 161,690 5,363
d OTHER EXPENSES 1,244,822 1,013,559 231,263  
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 1,152,863,859 996,088,560 154,860,797 1,914,502
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 35,612,751 1 55,973,383
2 Savings and temporary cash investments ......... 65,595,655 2 7,102,207
3 Pledges and grants receivable, net ........... 2,777,073 3 2,213,286
4 Accounts receivable, net ............. 161,012,770 4 165,120,911
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 29,710,569 7 28,681,521
8 Inventories for sale or use .............. 16,001,805 8 17,884,696
9 Prepaid expenses and deferred charges .......... 9,247,956 9 10,410,627
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 713,331,334
b Less: accumulated depreciation ..... 10b 337,866,824 339,577,954 10c 375,464,510
11 Investments—publicly traded securities .......... 166,671,940 11 207,669,691
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 9,080,903 13 11,299,537
14 Intangible assets ............... 4,758,783 14 4,673,435
15 Other assets. See Part IV, line 11 ........... 188,129,911 15 154,148,275
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,028,178,070 16 1,040,642,079
Liabilities 17 Accounts payable and accrued expenses ......... 110,688,303 17 121,476,686
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 1,145,000 19 1,694,004
20 Tax-exempt bond liabilities ............. 343,433,355 20 330,463,189
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 12,029,179 23 936,824
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 63,258,639 25 69,201,791
26 Total liabilities. Add lines 17 through 25......... 530,554,476 26 523,772,494
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 473,547,447 27 490,170,476
28 Temporarily restricted net assets ........... 23,860,064 28 26,483,026
29 Permanently restricted net assets ........... 216,083 29 216,083
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 497,623,594 33 516,869,585
34 Total liabilities and net assets/fund balances ........ 1,028,178,070 34 1,040,642,079
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,171,062,661
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,152,863,859
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
18,198,802
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
497,623,594
5
Net unrealized gains (losses) on investments ...............
5
-4,403,402
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
5,450,591
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
516,869,585
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
MARSHFIELD CLINIC
  		Employer identification number

39-0452970
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
MARSHFIELD CLINIC
  		Employer identification number

39-0452970
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
MARSHFIELD CLINIC
  		Employer identification number

39-0452970
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
100
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
853,213
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
853,313
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Description of the organization's lobbying activity:   Where its experience may be helpful, Marshfield Clinic may offer recommendations concerning legislation or regulations being considered. In addition, it may analyze and take positions on issues that have a relationship to the organization's operations.
PART II-B LINE 1 (D) OCCASIONALLY SEND MAIL TO MEMBERS OF CONGRESS, AND THEIR STAFF.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $ 1,045,957
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 43,172,004 35,848,004 34,049,063 29,443,159 27,221,448
b Contributions ........ 1,567,033 1,375,000 3,310,280 2,333,428 2,413,872
c Net investment earnings, gains, and losses 5,577,482 6,620,000 -266,824 2,927,520 614,273
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		1,244,246 671,000 1,244,515 655,044 806,434
f Administrative expenses ....          
g End of year balance ...... 49,072,273 43,172,004 35,848,004 34,049,063 29,443,159
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet67.500 %
b
Permanent endowment SchDMd Bullet32.500 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   20,958,547 20,958,547
b Buildings ................   345,381,596 141,559,545 203,822,051
c Leasehold improvements ............   7,872,881 2,509,056 5,363,825
d Equipment ................   271,577,304 187,550,082 84,027,222
e Other ................. 1,978,641 65,562,364 6,248,141 61,292,864
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 375,464,509
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) CASH FOR CURRENT BOND FUNDS 12,930,437
(2) TRUSTED FUND - REVENUE BONDS 43,902,329
(3) DEFERRED FINA COST AND OTHER 1,909,751
(4) LM OR RSTR BY DON FOR SPEC PUR 24,530,735
(5) LIMT OR RESTR FOR RETIRE PLAN 36,471,105
(6) RESTRICTED FOR SELF INSURANCE 17,776,401
(7) RESTRTD FOR UNEMPLOYMENT COMP 4,410,635
(8) RESTRICTED FUNDS - OTHER 12,216,882

Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 154,148,275
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
HEALTH PLAN PREPAYMENT 17,035,398
UNPAID PROFESSIONAL LIABILITY 9,490,636
457 PLAN PAYABLE 36,471,105
MISCELLANEOUS 6,204,652





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 69,201,791
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
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 WORK ENVIRONMENT FOR PHYSICIANS AND STAFF. QUALITY WORKS OF ART ALSO ENHANCE THE CLINIC'S EDUCATIONAL MISSION BY DISPLAYING ART WORK FOR SCHOOL CHILDREN AS WELL AS PATIENTS AND VISITORS.
PART V, LINE 4   MARSHFIELD CLINIC 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 ACTIVITES OF THE NAMED CHAIR OR AWARD RECIPIENT.
PART X, LINE 2   THE CLINIC 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. BASED ON AN ANALYSIS PREPARED BY THE CLINIC, IT WAS DETERMINED THAT THE APPLICATION OF ASC 740 HAD NO MATERIAL EFFECT ON THE CLINIC AT SEPTEMBER 30, 2013 OR 2012.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
North America 1 23 Program Services FOOD SAFETY TESTS 2,757,643
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 1 23 2,757,643
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 1 23 2,757,643
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
Part I, Line 3(1)   Marshfield Food Safety, LLC (MFS), a wholly owned subsidiary of Marshfield Clinic (MC) provides food safety testing services on-site at or nearby various food producers for the benefit of the public. MFS Canada Food Safety is a 100% owned subsidiary of MFS and maintains its operations in Canada. It commenced its operations in 2011 and included the same types of activities as MFS. For tax reporting purposes, MFS is a disregarded entity. The Canadian operational information is being disclosed on the Schedule F to assure compliance with 990 requirements. The listed employees are employees of MFS and not of Marshfield Clinic. The expenditures listed represent 100% (MC's share of MFS as of September 30, 2013) of operational expenses incurred by MFS Canada.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2012
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

Auction
(event type) 		(b) Event #2

Fore a Cure
(event type) 		(c) Other events

20
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 269,252 178,550 584,579 1,032,381
2 Less: Contributions . . 196,309 121,656 371,154 689,119
3 Gross income (line 1
minus line 2) . . . 		72,943 56,894 213,425 343,262
VerticalDirectExpenses 4 Cash prizes . . . 500   4,900 5,400
5 Noncash prizes . . 10,068 2,200 8,153 20,421
6 Rent/facility costs . . 28,763 28,101 34,762 91,626
7 Food and beverages . 3,828   24,790 28,618
8 Entertainment . . . 300   11,625 11,925
9 Other direct expenses . 20,260 10,617 99,771 130,648
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 288,638
11 Net income summary. Combine line 3, column (d), and line 10. .......... right arrow 54,624
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .     48,779 48,779
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow 48,779
9
Enter the state(s) in which the organization operates gaming activities: WI
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
28.000 %
b
An outside facility ........................
13b
72.000 %
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Joseph Baierl
Address right arrow
1000 N Oak Ave
Marshfield,WI54449
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Joseph Baierl
Gaming manager compensation right arrow $ 6,339
Description of services provided right arrow
Coord. & management of Clinic gaming activities
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Identifier Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number
39-0452970
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) FAMILY HEALTH CENTER
1515 ST JOSEPH AVE
MARSHFIELD,WI54449 		39-1681547 501(C)(3) 15,788,592       GENERAL SUPPORT
(2) MFLD AREA UNITED WAY
PO BOX 771
MARSHFIELD,WI54449 		39-1035073 501(C)(3) 72,000       GENERAL SUPPORT
(3) COMMUNITY FOUNDATION
500 3RD ST SUITE 310
WAUSAU,WI54403 		39-1577472 501(C)(3) 31,000       GENERAL SUPPORT
(4) NEW VISIONS GALLERY RENT
1000 N OAK AVE
MARSHFIELD,WI54449 		51-0190879 501(C)(3)   26,625 fmv rent GENERAL SUPPORT
(5) CITY OF EAU CLAIRE AMBULANCE SERVICE
PO BOX 1087
EAU CLAIRE,WI54702 		39-6005436 501(C)(3) 27,250       GENERAL SUPPORT
(6) FRIENDS OF ST JOSEPH'S
2661 COUNTY HWY I
CHIPPEWA FALLS,WI54729 		39-0810545 501(C)(3) 17,500       GENERAL SUPPORT
(7) COMPETITIVE WISCONSIN
22 N CARROLL STREET STE 200
MADISON,WI53703 		39-1398399 501(C)(3) 10,000       GENERAL SUPPORT
(8) WI WOMENS HEALTH FOUNDATION
2503 TODD DR
MADISON,WI53713 		39-1900678 501(C)(3) 10,000       GENERAL SUPPORT
(9) WMC FOUNDATION INC
PO BOX 352
MADISON,WI53701 		39-1394068 501(C)(3) 10,000       GENERAL SUPPORT
(10) UNITED WAY OF MARATHON
137 RIVER DRIVE
WAUSAU,WI54403 		39-0935496 501(C)(3) 32,202       GENERAL SUPPORT
(11) UNITED WAY OF MERRILL
813 E 1ST ST PO BOX 813
MERRILL,WI54452 		39-1286800 501(C)(3) 5,614       GENERAL SUPPORT
(12) WHA WISCONSIN HOSPITAL ASSOC
PO BOX 259038
MADISON,WI53725 		39-0969552 501(C)(3) 10,000       GENERAL SUPPORT
(13) HERITAGE FOUNDATION
1000 N OAK AVE
MARSHFIELD,WI54449 		39-1865942 501(C)(3) 14,538       GENERAL SUPPORT
(14) MARSHFIELD AREA COMMUNITY FOUNDATION
PO Box 1087
Marshfield,WI544490456 		39-6578767 501(C)(3) 22,000       General Support
(15) UNITED WAY OF CHIPPEWA
3603 N Hastings Way Ste 200
Eau Claire,WI547020232 		39-1077901 501(C)(3) 20,000       General Support
(16) COMMUNITY FOUNDATION OF CENTRAL WI
1501 Clark St PO Box 968
Stevens Point,WI544810968 		39-0827885 501(C)(3) 12,500       General Support
(17) CENTERGY INC
500 1st St STE 15
Wausau,WI54403 		39-1643470 501(C)(3) 10,000       General Support
(18) MARSHFIELD AREA YMCA
410 W McMillian St
Marshfield,WI54449 		39-1557086 501(C)(3) 7,500       General Support
(19) FOUNDATION OF ST JOSEPH HOSPITAL
611 St Josheph Ave
Marshfield,WI54449 		39-1684957 501(C)(3) 6,000       General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
19
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Schedule I, Part I, Line 2   Marshfield Clinic (the Clinic) provides assistance (primarily contributions) to a variety of organizations, most of which are 501 (C)(3) and some of which are affiliates for financial reporting purposes (i.e., Family Health Center and Heritage Foundation). The Clinic makes determinations on grant assistance and other assistance (i.e., contributions) based on the recipient organization's mission, reputation, and the organization's intended use of funds. The largest contribution is to Family Health Center (FHC), which is a member of the Clinic's obligated group and included in the Clinic's consolidated financial statements. FHC's mission and use of funds are aligned with the Clinic's mission as a 501(C)(3) organization, and monitored closely.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Brian Ewert MDInternal Medicine - East (i)
(ii)		 207,204
0 		0
0 		1,806
0 		30,540
0 		21,299
0 		260,849
0 		0
0
(2)Dan Erickson MDFamily Practitioner - Northwes (i)
(ii)		 214,443
  		 
  		1,806
  		30,540
  		17,943
  		264,732
  		 
 
(3)Matthew Thomas MDUrology - North (i)
(ii)		 411,160
  		 
  		420
  		30,540
  		16,105
  		458,225
  		 
 
(4)Ron Martin MDGeneral Surgeon - Central 1 (i)
(ii)		 417,301
  		 
  		17,966
  		30,540
  		8,635
  		474,442
  		 
 
(5)John Przybylinski MDInternal Medicine - Central 2 (i)
(ii)		 176,540
  		 
  		2,455
  		23,652
  		10,367
  		213,014
  		 
 
(6)Seth Fagbemi MDOncology - Central 3 (i)
(ii)		 457,960
  		 
  		17,966
  		30,540
  		29,441
  		535,907
  		 
 
(7)Jane Stark MDOcc Med - West (i)
(ii)		 187,294
  		 
  		1,392
  		27,939
  		22,771
  		239,396
  		 
 
(8)Brian Ewert MDNephrologist - President (i)
(ii)		 562,631
  		 
  		17,966
  		30,540
  		23,407
  		634,544
  		 
 
(9)C Todd StewartPeds Intensivist - Vice Presid (i)
(ii)		 440,852
  		 
  		630
  		30,540
  		18,098
  		490,120
  		 
 
(10)Mark LePage MDRadiology - Treasurer (i)
(ii)		 428,343
  		 
  		13,860
  		30,540
  		23,491
  		496,234
  		 
 
(11)Narayana Murali MDNephrology - Secretary (i)
(ii)		 262,810
  		 
  		18,129
  		30,540
  		21,339
  		332,818
  		 
 
(12)Douglas J Reding MDOncologist/Hematologist (i)
(ii)		 569,219
  		7,750
  		1,806
  		30,540
  		22,406
  		631,721
  		 
 
(13)David J Simenstad MDOrthopaedic Surgeon (i)
(ii)		 1,085,572
  		 
  		17,966
  		30,540
  		23,407
  		1,157,485
  		 
 
(14)Gary JankowskiCFO (i)
(ii)		 403,361
  		 
  		27,402
  		30,540
  		21,164
  		482,467
  		 
 
(15)Jim ColemanCOO (i)
(ii)		 435,138
  		375
  		10,468
  		30,540
  		23,286
  		499,807
  		 
 
(16)Ken LetkemanCIO (i)
(ii)		 314,026
  		 
  		630
  		2,080
  		20,733
  		337,469
  		 
 
(17)David KeefeDIRECTOR OF HUMAN RESOURCES (i)
(ii)		 263,798
  		 
  		17,966
  		30,540
  		7,862
  		320,166
  		 
 
(18)Steve ChristiansonDIRECTOR OF COMPENSATION (i)
(ii)		 218,414
  		 
  		6,839
  		30,409
  		20,143
  		275,805
  		 
 
(19)Tom SatkusTREASURY DIRECTOR (i)
(ii)		 228,852
  		 
  		23,563
  		30,540
  		24,094
  		307,049
  		 
 
(20)Laura Nelson MDChief Medical Officer (i)
(ii)		 353,172
  		 
  		17,630
  		30,540
  		20,607
  		421,949
  		 
 
(21)Fred Bollow MDDivision Medical Director - Ce (i)
(ii)		 336,635
  		 
  		19,306
  		30,540
  		18,872
  		405,353
  		 
 
(22)William Yanke MDDivision Medical Director - Ce (i)
(ii)		 325,941
  		 
  		1,806
  		30,540
  		20,733
  		379,020
  		 
 
(23)Richard Mercier MDService Line M.D. - Oncology (i)
(ii)		 533,014
  		 
  		1,806
  		30,540
  		24,286
  		589,646
  		 
 
(24)Timothy Swan MDService Line M.D. Radiology (i)
(ii)		 481,350
  		 
  		18,806
  		30,540
  		18,098
  		548,794
  		 
 
(25)Rod Sorenson DOChair of Physician Salary Comm (i)
(ii)		 432,406
  		70
  		2,772
  		30,540
  		18,098
  		483,886
  		 
 
(26)Greg Burnett MDSalary Committee Member (i)
(ii)		 288,095
  		3,000
  		1,466
  		30,540
  		23,286
  		346,387
  		 
 
(27)David Cook MDSalary Committee Member (i)
(ii)		 274,608
  		 
  		2,983
  		30,540
  		22,621
  		330,752
  		 
 
(28)Roderick Koehler MDSalary Committee Member (i)
(ii)		 296,872
  		 
  		966
  		30,540
  		23,286
  		351,664
  		 
 
(29)Gene Shaw MDDivision Medical Director - La (i)
(ii)		 347,972
  		 
  		18,806
  		30,540
  		23,291
  		420,609
  		 
 
(30)Scott Paulman MDRetinal Surgeon (i)
(ii)		 1,250,406
  		175
  		17,630
  		30,540
  		2,862
  		1,301,613
  		 
 
(31)Sanjay Rao MDNeurosurgeon - Spine (i)
(ii)		 1,150,334
  		 
  		630
  		30,540
  		19,598
  		1,201,102
  		 
 
(32)Vivekananda Gonugunta MDNeurosurgeon - Spine (i)
(ii)		 1,030,539
  		 
  		17,630
  		30,540
  		3,278
  		1,081,987
  		 
 
(33)Adedayo Onitilo MDHematology/Oncology (i)
(ii)		 898,696
  		14,000
  		52,952
  		30,540
  		25,402
  		1,021,590
  		 
 
(34)Peter Meyer MDEmergency Medicine - Treasurer (i)
(ii)		 168,032
  		 
  		1,626
  		25,594
  		19,598
  		214,850
  		 
 
(35)Caesar Gonzaga MDGeneral Surgery - West (i)
(ii)		 307,445
  		 
  		3,708
  		30,540
  		22,621
  		364,314
  		 
 
(36)Eric Penniman MDEast District 4 (i)
(ii)		 251,670
  		 
  		630
  		30,540
  		18,028
  		300,868
  		 
 
(37)Bradley Bekkum MDWest District 1 (i)
(ii)		 312,727
  		7,632
  		420
  		30,540
  		18,092
  		369,411
  		 
 
(38)Theodore Praxel MDQuality Improvement/Care Mgmt (i)
(ii)		 338,164
  		 
  		1,806
  		30,540
  		24,911
  		395,421
  		 
 
(39)John Neal MDNuerosurgeon - Spine (i)
(ii)		 831,149
  		 
  		18,806
  		30,540
  		23,092
  		903,587
  		 
 
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number
39-0452970
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A WI Health & Education Facility Authority
  		39-1337855 97710vzy7 01-31-2006 71,634,384 Building & Equipment   X   X   X
B WI Health & Education Facility Authority
  		39-1337855 97710vzy7 01-31-2006 65,000,000 Building & Equipment   X   X   X
C WI Health & Education Facility Authority
  		39-1337855   04-03-2012 130,115,000 Refunding Rev Bonds   X   X   X
D WI Health & Education Facility Authority
  		39-1337855 97710bz54 06-13-2012 104,090,000 Building & Equipment   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 1,745,000 1,770,000 8,985,000 295,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 71,634,384 65,000,000 130,115,000 104,090,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 6,595,566 0 1,037,199 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 699,591 829,612 298,298 424,385
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 68,522,365 68,178,577 129,816,702 67,592,764
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 36,497,236
13 Year of substantial completion . . . . . . . . . . . . 2008 2008 2012 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X     X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0% 0% 0%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0%   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . . X   X   X   X  
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X   X   X     X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of. 0% 0% 0%   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . . X   X   X     X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X X     X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X     X   X  
b Exception to rebate? . . . . . . . .   X       X   X
c No rebate due? . . . . . . . . . .
X         X   X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X X     X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
PART IV: 0 2/23/13
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 15 3,885 fmv/sales price
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 2,005 fmv/sales price
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 9 17,389 fmv/sales price
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 23 11,590 fmv/sales price
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( FOOD & BEVERAGE ) X 24 5,760 fmv/sales price
26 Other Right pointing arrow large image ( JEWELRY ) X 17 8,761 fmv/sales price
27 Other Right pointing arrow large image ( LIVESTOCK ) X 46 41,215 fmv/sales price
28 Other Right pointing arrow large image ( Miscellaneous ) X 195 75,485 fmv/sales price
Other Right pointing arrow large image ( Sporting Goods ) X 5 4,225 FMV/SALE PRICE
Other Right pointing arrow large image ( Tickets ) X 28 14,926 FMV/SALES PRICE
Other Right pointing arrow large image ( Travel/Experience ) X 47 66,684 FMV/SALE PRICE
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2012)
Schedule M (Form 990) (2012)
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) (2012)
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Identifier Return Reference Explanation
Part III, Organization`s Mission, Ln 1   THE MISSION OF MARSHFIELD CLINIC IS TO SERVE PATIENTS THROUGH ACCESSIBLE, HIGH QUALITY HEALTH CARE, RESEARCH AND EDUCATION. THROUGH RESEARCH, EDUCATION AND STANDARDIZATION OF QUALITY, OUR VISION IS TO REDUCE THE BURDEN OF DISEASE, DISABILITY AND COST FOR OUR PATIENTS AND COMMUNITIES. Part III Statement of Program Service Accomplishments- Ln 4a Medical Care: The Marshfield Clinic system provides patient care, research and education throughout northern, central and western Wisconsin, with locations in 37 communities. Marshfield Clinic (the Clinic) has 746 physicians in 86 medical specialties and subspecialties. For 97 years, the Clinic has provided medical care to all patients regardless of their ability to pay. Charity care determinations are based on financial information provided by the patient and analysis of other relevant information. Because the Clinic anticipates either no or nominal payment for these services, the amounts are excluded from revenues. There were approximately 3,900,000 patient encounters for fiscal year 2013. The Clinic provided Charity Care of $7,883,000 in fiscal year 2013 based on the cost of providing care to patients who cannot afford to pay in accordance with its Charity Care Policy. The Clinic also provides substantial community support through the provision of services to individuals supported by public programs such as general relief, Medicare and Medicaid. The Clinic's cost of providing services under these programs in excess of reimbursement received by the Clinic, and the estimated unreimbursed cost of providing care to low income underinsured and uninsured patients through the Clinics partnership with Family Health Center, a federally funded community health center was $203,015,000 in fiscal year 2013. Medical Research and Education, Ln 4b Through its research division, Marshfield Clinic Research Foundation (MCRF), the Clinic is engaged in medical and scientific research on national and international levels. The MCRF mission is to discover and communicate scientific knowledge that substantially improves human health and well-being. Since MCRFs establishment in 1959, research discoveries by MCRF scientists and Clinic physicians have expanded knowledge in multiple fields of human health and reduced the burden of disease and disability. Areas of focus include clinical research, rural and agricultural health and safety, human genetics, epidemiology, and biomedical informatics. The Marshfield Clinic Education Division also has a history of strong commitment to education and public service. Full residency programs for recent medical school graduates include internal medicine, pediatrics, medicine and pediatrics, dermatology, and general surgery. All programs are fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) of the American Medical Association. The Clinic has exemplary accreditation status with the Accreditation Council on Continuing Medical Education [ACCME] as a longstanding provider of Continuing Medical Education to area physicians and allied health providers. Additionally, we serve as an academic clinical campus of the University of Wisconsin School of Medicine and Public Health. We have over 80 national post-secondary academic affiliations and over 30 State post-secondary academic affiliations for student, resident, and fellowship training. Marshfield Clinic is recognized as a Training Center for the American Heart Association and also sponsors educational events and training for the public including diabetes education mental health programs. Laboratory Medicine, Ln 4c Marshfield Labs provides comprehensive anatomical and high-complexity diagnostic testing services to patients of Marshfield Clinic and other area medical facilities. In addition to the primary laboratory located in Marshfield, Marshfield Labs is serving the needs of surrounding communities with smaller labs at many Marshfield Clinic centers throughout central and northern Wisconsin. Proximity to our laboratories provides convenience and expeditious service to Marshfield Clinic patients. Marshfield Labs has become a center for the latest technologies and most advanced testing methods utilized today. Some of the advanced tests and emerging technologies offered by Marshfield Labs would not otherwise be available to patients in rural areas.
Part VI, Governance, Management, and Disclosure, Ln 6   As of September 30, 2013 the Marshfield Clinic has 634 physicians who are referred to as "shareholders." As disclosed in the organization`s original 1023, all shareholders sign an agreement that provides that the assets of the organization are held in trust for charitable, educational and scientific purpose. "Shareholders" do not build up equity in the organization and, in the event of dissolution of Marshfield Clinic, all of the assets of the organization would be distributed to another charitable organization.
Part VI, Governance, Management, and Disclosure, Ln 7a   The shareholders have the right to elect the organization's officers and directors.
Part VI, Governance, Management, and Disclosure, Ln 7b   The shareholders have the right to approve any changes to the organization's Articles of Incorporation and Bylaws by a vote of two-thirds of the shareholders present at each of two consecutive shareholder meetings at which a quorum is present. The shareholders have the right to terminate the employment of a physician-shareholder by a vote of four-fifths of the outstanding shares entitled to vote. The shareholders have the right to approve any dissolution or liquidation of the organization by a vote of four-fifths of the shareholders. In the event of liquidation or dissolution of the organization, after payment of liabilities, the shareholders by majority vote of the shareholders shall select the educational, scientific or charitable organizations to which the organization's assets shall be transferred.
Part VI, Governance, Management, and Disclosure, Ln 11a   Describe the process the Organization uses to review the Form 990. (Excerpts from Marshfield Clinics 990/990-T Review Policy) The Chief Financial Officer and Controller shall review the completed Form 990 and Form 990-T in-depth. After their review and prior to filing Form 990 and Form 990-T with the IRS, the CFO or his/her designee will provide to each member of the Board of Directors a copy in electronic or paper form of the completed Form 990 (and all required schedules) and the completed Form 990-T (and all required schedules). Thereafter, at the next Board meeting (or at a special meeting called for this purpose), the CFO and/or his/her designee shall review the forms and schedules with the board members and answer any questions. In addition, the FY13 form 990 was reviewed by KPMG prior to filing.
Part VI, Governance, Management, and Disclosure, Ln 12c   Describe how the Organization regularly and consistently monitors and enforces compliance with its Conflict of Interest Policy. (Excerpts from Marshfield Clinics Conflict of Interest Policy) "Each disclosing individual shall complete and submit the disclosure form to the Secretary of the Board of Directors on or before January 1st of each year, or, if earlier, within one month after the individual qualifies as a disclosing individual. Each disclosing individual shall update his/her disclosure form during the year as necessary. The secretary shall maintain the completed disclosure forms in a confidential manner. The Secretary shall make the completed disclosure forms available to the executive committee and/or Board of Directors as necessary to make conflict of interest determinations and decisions concerning the fairness and reasonableness of transactions to Marshfield Clinic. In addition, the Secretary shall disclose the completed forms as necessary to those Clinic employees responsible for completion of the Clinic's IRS Form 990."
Part VI, Governance, Management, and Disclosure, Lines 15a, and 15b   (Excerpts from Compensation Policy) "The Clinic's Independent Compensation Committee (Compensation Committee) shall have final authority for approving compensation of Directors and other "disqualified persons" as that term is defined in 26 CFR sec. 53.4958-3. It shall be the responsibility of the Compensation Committee to insure that the Clinic 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 26 CFR 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: their own independent knowledge and expertise; compensation levels paid by similarly situated organizations for comparable positions; the availability of similar services in the Clinic's geographic area; current compensation surveys compiled by independent firms; and actual written job offers from similar institutions. The Compensation Committee shall timely document its determination of reasonableness of compensation."
Part VI, Governance, Management, and Disclosure, Ln 19   Marshfield Clinic does not make its current governing documents, Conflict of Interest Policy or financial statements available to the public. Federal tax law does not require that such documents be made publicly available unless they were included on a form that is publicly available. Marshfield Clinic does make available its Form 1023, as required.
Part XI, Line 5 - Reconciliation of Net Assets   Net Asset Transfers: Transfer of asset from Family Health Center $34 Transfer of startup cash to Marshfield Clinic Health System ($750,000) Transfer of earnings from Lakeview Medical Center $6,219,000 TOTAL NET ASSET TRANSFERS $5,469,034 Reduction in shareholder equity ($11,000) Miscellaneous adjustments ($7,443) TOTAL OTHER CHANGES IN NET ASSETS $ 5,450,591 Schedule A, Part I Per IRS instructions for the Form 990, "the definition of hospitals for Schedule A (Form 990 or 990-EZ), Part I, is different from the definition for Schedule H (Form 990), hospitals. Accordingly, an Organization that checks this box may or may not be required to complete Schedule H (Form 990)". Marshfield Clinic is not recognized by any State as a hospital. Therefore, we are not required to complete Schedule H.
Marshfield Clinic Health System, Inc.   Marshfield Clinic Health System, Inc. (the "Organization") is a Wisconsin non-stock, not-for-profit corporation. The Organization was incorporated on October 12, 2012, as part of the reorganization of certain activities historically conducted by the Marshfield Clinic (the "Clinic") and its affiliates. On February 19, 2014, the Organization received a decision from the US Tax Court, which declared, adjudged and decided that the Organization was qualified as an organization described in IRC section 501(c)(3) and IRC section 509(a)(3), and was exempt from taxation under IRC section 501(a), effective October 12, 2012. The IRS subsequently sent a determination letter on March 7th, 2014 providing that the organization was exempt from federal income tax under 501(c)(3) of the Internal Revenue Code, with an effective date of October 12, 2012. Effective February 28, 2014, the Organization became the sole corporate member of the Clinic and Lakeview Medical Center, Inc. of Rice Lake ("Lakeview") (replacing the Clinic) and one of two corporate members (replacing the Clinic) of Flambeau Hospital, Inc. ("Flambeau"). The Organization is a supporting organization and the supported organizations are the Clinic, Lakeview, and Flambeau (collectively, the "Supported Organizations"). On May 6th, 2014, the Organization also became the sole corporate member of Security Health Plan (the "Plan"). Over a period of four years, the Clinic's leadership and physician shareholders (now Class A Members) engaged in numerous discussions and planning meetings in developing a plan of reorganization for the purpose of creating a comprehensive healthcare system under the strategic direction and control of a common parent entity. The Organization was formed to serve as that parent entity, with its board of directors (the "Board") serving as an overarching governing body exercising fiduciary responsibilities on behalf of the System as a whole. In this regard, the Organization's Board, which is comprised of representatives from each of the Supported Organizations and the Plan, including all eleven of the members of the Clinic's board of directors, as well as thirteen community board members, is tasked with promoting the efficient and effective operation of the System. Up until the time the Organization received confirmation from the IRS recognizing it as an exempt organization described in Section 501(c)(3) of the Code, its activities were conducted largely by its Board and through the lease of certain employees of the Supported Organizations. Since February 28, 2014, the Organization has been in a period of transition, carrying out steps to consolidate certain administrative functions (currently carried on by each Supported Organization and the Plan) at the System level, with the intent of transitioning appropriate personnel and other resources to the Organization accordingly. Such administrative functions will include Fiscal Affairs, Human Resources, Marketing, Corporate Communications, Facilities and Properties, Legal Services, Government Relations, Development and Materials Management. In addition, certain other actions will be taken to more fully integrate the Organization, the Supported Organizations and the Plan within the System. Specifically, as of June 1, 2014, the Organization became a member of the obligated group associated with tax-exempt bonds that have been issued on behalf of the Clinic and Lakeview.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MARSHFIELD CLINIC
 
Employer identification number

39-0452970
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) Marshfield Food Safety LLC
1000 N OAK AVE
MARSHFIELD,WI54449
20-1056380 		Food Testing WI 22,727,027 11,619,701 MC
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) Security Health Plan Of Wisconsin Inc

1515 N St Josephs Ave

Marshfield,WI54449
39-1572880 		HMO WI 501(c)(4) N/A NA
 
 
No
(2) Lakeview Medical Center Auxiliary Inc

1100 N Main Street

Rice Lake,WI54868
39-1329084 		Support Org WI 501(c)(3) 11,III-O NA
 
 
No
(3) Flambeau Hospital Inc

98 Sherry Ave

Park Falls,WI54552
39-0973724 		hospital WI 501(c)(3) 3 NA
 
 
No
(4) Lakeview Medical Center of Rice Lake

1700 West Stout St

Rice Lake,WI54868
39-0837206 		Hospital WI 501(c)(3) 3 na
 
 
No
(5) Marshfield Clinic Heritage Fndtn Inc

1000 N OAK AVE

MARSHFIELD,WI54449
39-1865942 		Honor indvdls WI 501(c)(3) 11-Type I NA
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Dgnstc Treatmnt Ctr

3401 Cranberry Blvd
Weston,WI54476
20-0691634 		medical svcs WI NA
  		Related 6,782,086 6,710,898   No     No 50.000 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) SECURITY HEALTH PLAN OF WISCONSIN INC

 1A 27,027 COST
(2) SECURITY HEALTH PLAN OF WISCONSIN INC

 1C 180,000 COST
(3) SECURITY HEALTH PLAN OF WISCONSIN INC

 1D 4,298,797 COST
(4) SECURITY HEALTH PLAN OF WISCONSIN INC

 1K 52,656 COST
(5) SECURITY HEALTH PLAN OF WISCONSIN INC

 IL 225,365,811 COST
(6) SECURITY HEALTH PLAN OF WISCONSIN INC

 1M 78,116,634 COST
(7) SECURITY HEALTH PLAN OF WISCONSIN INC

 1Q 41,969,206 COST
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


Software ID:  
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