TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Ken Mogren...................................................................... Chair	3.00 ................. 3.00	X	X	0	0
(2) Steve Blue...................................................................... Director	3.00 ................. 3.00	X		0	0
(3) Matthew Broghammer MD...................................................................... Director	40.00 ................. 3.00	X		577,445	93,153
(4) E Allen Beguin MD...................................................................... Director	40.00 ................. 3.00	X		274,105	57,812
(5) Hugh Miller...................................................................... Director	3.00 ................. 3.00	X		0	0
(6) Sandra Burke...................................................................... Director	3.00 ................. 3.00	X		0	0
(7) Greg Evans...................................................................... Director	3.00 ................. 3.00	X		0	0
(8) Nicholas Modjeski MD...................................................................... Director	40.00 ................. 3.00	X		252,641	50,808
(9) Brian Semling...................................................................... Director	3.00 ................. 3.00	X		0	0
(10) Robert Williams...................................................................... Director	3.00 ................. 3.00	X		0	0
(11) David Vaselaar...................................................................... Director	3.00 ................. 3.00	X		0	0
(12) Fatima Said...................................................................... Director	3.00 ................. 3.00	X		0	0
(13) Todd Paulson...................................................................... Director	3.00 ................. 3.00	X		0	0
(14) Dave Gilmer...................................................................... Director	3.00 ................. 3.00	X		0	0
(15) Katrina Hammel MD...................................................................... Director	40.00 ................. 3.00	X		364,813	69,860
(16) Toni Highum...................................................................... Director (Until Dec 23)	3.00 ................. 3.00	X		0	0
(17) Rachelle Heising-Schultz...................................................................... President/CEO/Director	46.00 ................. 4.00	X	X	598,839	58,288

(A) Name and business address	(B) Description of services	(C) Compensation
Cerner Corp P O Box 959156 St Louis,MO63105	Services/Contracted	4,415,608
Staffency 221 W College Ave Floor 2 Appleton,WI54911	Contracted Labor	1,623,033
Mayo Collaborative P O Box 9146 Minneapolis,MN55480	Contracted Laboratory	952,169
American Security LLC PO Box 1150 Minneapolis,MN55480	Contracted Security	459,991
Cardinal Health Pharmacy Services 21377 Network Place Chicago,IL60673	Contracted Pharmacy Services	430,962
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 27

- TIN:

SCHEDULE A
(Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Winona Health Services

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization Winona Health Services		Employer identification number 41-0713914

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Winona Health Services			Employer identification number 41-0713914
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	25,150,143	23,233,445	28,478,937	25,510,634	24,524,012
b	Contributions ...	170,073	162,293	1,277,453	243,094	180,653
c	Net investment earnings, gains, and losses	5,214,334	2,948,962	-5,975,726	4,075,919	1,896,815
d	Grants or scholarships ...	1,713,975	1,194,557	547,219	1,350,710	1,090,846
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	28,820,575	25,150,143	23,233,445	28,478,937	25,510,634

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

6.440 %

Permanent endowment right arrow

93.560 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. 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 .....	5,140,751		5,140,751
b	Buildings ....	56,062,938	43,727,038	12,335,900
c	Leasehold improvements
d	Equipment ....	32,805,563	23,390,145	9,415,418
e	Other .....	8,000,412	2,784,902	5,215,510
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				32,107,579

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Due from Affiliated Organizations				3,463,454
(2)Operating Lease Right of Use Asset				14,815,693
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				18,279,147

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Deferred Compensation Obligation	9,267,131
Payable to Affiliated Organizations	7,237,812
Deferred Revenue from Third Party Payor	72,500
Finance Lease Liability	2,741,865
Operating Lease Liability	14,815,243




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	34,134,551
2. Liability for uncertain tax positions. 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) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) 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. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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

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.

Return Reference

Explanation

Part V, Line 4:

Winona Health Foundation endowments have multiple purposes; all of which deliver on the mission to inspire, recognize and empower the caregiver in all of us. The largest fund is the Ben & Adith Miller Patient Care Fund that pays the medical bills of Winona Health patients/residents who are under or uninsured. Other funds include the Senior Services Fund which is made up of the Glenn Fund for home care/hospice licensure and training, the Hospice Fund for general hospice services, the Alzheimer Fund for Alzheimer-related projects, and funds for unrestricted use by Winona Senior Services. There are also funds for general operating expenses.

Part X, Line 2:

The Corporation believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and, as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Corporation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		279,000		279,000	0.240 %
b	Medicaid (from Worksheet 3, column a) . . . . .		15,646,345	12,548,174	3,098,171	2.630 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		15,925,345	12,548,174	3,377,171	2.870 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	10,458	116,763		116,763	0.100 %
f	Health professions education (from Worksheet 5) . . .	683	1,359,245		1,359,245	1.150 %
g	Subsidized health services (from Worksheet 6) . . . .		43,776,740	35,588,020	8,188,720	6.940 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	5,942	110,057		110,057	0.090 %
j	Total. Other Benefits . .	17,083	45,362,805	35,588,020	9,774,785	8.280 %
k	Total. Add lines 7d and 7j .	17,083	61,288,150	48,136,194	13,151,956	11.150 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development		31	450		450	0 %
3	Community support		2,736	2,250		2,250	0 %
4	Environmental improvements		2	3,200		3,200	0 %
5	Leadership development and training for community members		85	1,925		1,925	0 %
6	Coalition building
7	Community health improvement advocacy		996	20,513		20,513	0.020 %
8	Workforce development
9	Other
10	Total		3,850	28,338		28,338	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,284,003

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

913,601

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

7,204,551

Enter Medicare allowable costs of care relating to payments on line 5.....

9,964,380

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-2,759,829

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Other (describe)
1	Winona Health Services 855 Mankato Avenue Winona,MN55987 www.winonahealth.org 00701	X	X	X	Urgent care & 2 provider based clinics

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Winona Health Services
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Section C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Section C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Winona Health Services
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Part V, Section C

The FAP application form was widely available on a website (list url):

See Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	Winona Health Services
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Winona Health Services
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Winona Health Services	Part V, Section B, Line 5: In conducting the 2022 Winona County CHNA, a systematic process was used to get a comprehensive overview of Winona County residents, examining indicators of population health, identifying critical issues, gathering input from community members, and determining strategic priorities to improve the health of the community. The CHNA process involved collecting population data and community input. Additional indicators of community health status were identified using existing local, state, and national secondary data sources.It was essential that information was gathered about community members whose voices and health statuses may not be represented through local, regional and national secondary data sources, specifically the Hmong, Laotian and Hispanic populations. Project FINE (Focus on Integrating Newcomers through Education) was engaged to translate surveys and administer the CHNA to the immigrant and refugee populations in the community.After reviewing the survey results, a series of seven listening sessions were hosted at a variety of locations in May and June 2022 to gain feedback related to the findings. All Winona County residents were invited to participate in listening sessions which were held in person and virtually. All but three sessions were open to the general public. Population-specific sessions were held at the Winona Community Day Center for those experiencing housing insecurity and later sessions were held in St. Charles and Winona for populations needing translation assistance from Project FINE. A total of 78 people attended listening sessions. In addition to community members, representatives of the following organizations participated in listening sessions:- Engage Winona- Family & Children's Center- Hiawatha Valley Mental Health Center- Live Well Winona- Project FINE- SEMCAC- SEMCIL- Winona Area Public Schools- Winona County Alliance for Substance Abuse Prevention (ASAP)- Winona County Board- Winona County Health & Human Services- Winona Family YMCA- Winona Health- Winona Volunteer Services
Winona Health Services	Part V, Section B, Line 6b: The assessment was done collaboratively between Winona Health and Winona County Human Services.
Winona Health Services	Part V, Section B, Line 11: The following health priorities were determined during the Winona County 2022 community health needs assessment. Each priority has specific goals and activities identified. The implementation plan is not a stagnant document, but a dynamic resource that adjusts based on feedback and need. As learnings, partnerships, and new ideas emerge, new solutions will be brought forth to impact these areas in collaboration with others in the community. Community change is a long-term process and requires everyone. Winona Health and Winona County Public Health created sub-committees around each of the different priority areas to mobilize interested community members to positively impact health. This is done in partnership and will be outlined in more detail in the Community Health Improvement Plan (CHIP) led by Winona County Public Health. These documents will be aligned and complementary to each other. The implementation plan below highlights strategies that engage Winona Health resources, and it was adopted by the Winona Health Board of Directors in August of 2022. Priority 1: Mental Health and Wellbeing Support the mental health and wellbeing of Winona County residents. This includes: * Expanding treatment and service options to individuals with diagnosed mental illness. * Creating awareness of mental health needs and treatment options. * Supporting the overall mental health of all residents resulting in an increased sense of purpose and wellbeing. Over the course of the last four CHNA periods (2013, 2016, 2019, 2022), there has been a consistent increasingly negative trend around mental health and wellbeing. As comparison points, in 2013 15.6% of mailed survey respondents indicated they have been told by a medical doctor they have anxiety or panic attacks. In 2022, that same percentage increased to 30.5%. Priority 2: Health Equity Strive for equity to foster a healthy and thriving community for all. This includes: * Improving awareness and access to culturally appropriate resources and education.* Improving communication between individuals who have different cultural backgrounds and beliefs. Creating or supporting existing systems that positively impact determinants of health. * Recognizing and systematically measuring disparities in health so they can be eliminated.The World Health Organization (WHO) defines health inequities as "the differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age." Work in this priority area focuses on creating a space where all people can achieve their health potential, regardless of these factors. Evidence of this priority area was expressed via questions around discrimination, disparities in health seen in secondary data sources, and differences in risk factors and health based on income, gender, race, ethnicity, and other determinants of health. Priority 3: Healthy Behaviors Support behaviors that promote health and result in the reduction of chronic disease. * Increase access to education on health behaviors related to weight management, substance use, and physical activity. * Increase the percentage of community members living with a healthy weight. * Decrease incidence of chronic disease via increased physical activity and improved nutritional habits. * Reduce health risks by leveraging affordable strategies that reach all people for self-management of chronic disease. Body Mass Index (BMI) data indicated that more than 65% of mailed survey respondents are considered overweight or obese. While there are acknowledged limitations of using BMI, it is still a useful measure because it has been shown to correlate with measures of body fat percentage. More than 50% of mailed survey respondents also indicated that they were trying to lose weight. Though many express a desire to lose weight, still 62.9% of respondents to the mailed survey were not meeting physical activity guidelines. Additional Consideration: Social Connectedness Encourage social connectedness across the community. Though explicitly stated tactics around social connectedness were not addressed in this plan, there is recognized association between social connectedness and each of the other priority areas of healthy behaviors, health equity, and mental health and wellbeing. As a result, social connectedness is an underlying tenet to any activity in this plan and in the future. In particular, 44% of mailed survey respondents expressed they lost social connectedness related to the COVID-19 pandemic. An additional question inquired about the role of social support for healthy behaviors. This measure showed that 33% of mailed survey respondents cited no one to exercise with as the reason they did not get enough physical activity. These statistics, in addition to feelings of isolation during social distancing, emphasize the need for community building across our county.The following represents actions taken in the current year:Winona Health (WH), in collaboration with the Winona Area Public Schools (WAPS), has established four school-based health clinics within the district. Clinics at Winona Middle School and Winona Senior High School opened during the 2022-2023 school year. A clinic was opened at Winona Area Learning Center in the Fall semester of the 2024-2025 school year, and another clinic was opened at Jefferson Elementary School in the Spring semester of the 2024-2025 school year. These on-site clinics have served as convenient locations for students to access essential services, including:* Well Visits/full Child and Teen Checkup* Social Needs Screening* Problem Visits* Immunizations* Medication Management (including behavioral health medications)* Health Education* Sports Physicals* Prescribe oral birth control* Mental Health Counseling at Area Learning Center and Jefferson Elementary SchoolFunding continues to be a barrier for some as evidenced by the payer information collected across all four school-based health clinic sites. There has been increased access to private payers via our uncompensated care fund as in 2023-2024 only 5% were private payers compared to 10% in 2024-2025.A recently identified need was allowing parents to attend appointments virtually with their children to decrease barriers related to transportation, work schedules, lack of time off/PTO, illness, etc. The solution was providing iPads at all school-based health clinic sites to allow parents to attend appointments virtually.Another technology solution to increase parent engagement involved using a free phone app called Doximity which allows providers to call parents/guardians from their personal phone while the app protects their personal contact information using a Winona Health caller ID that parents/guardians will recognize. The app is fully HIPPA compliant and allows providers to call families during the appointment or shortly after. This allows parents/guardians to be a part of their child's care without needing to attend appointments in-person. There are a variety of ways that cultural and linguistic needs of student and family populations are met. To meet the needs of those who speak Spanish as their primary language, Winona Health's Spanish Interpreter is readily available for interpreting needs. Interpretation and translation services have been offered in a variety of modalities, including in-person or over speaker phone for appointments, translating intake forms into Spanish versions, translating health education handouts into Spanish versions, providing a Spanish version of our "Request an Appointment" form on the Winona Health website, and relaying messages to patients/parents/guardians from providers. Winona Health also has a doctor that conducts her appointments in Spanish at patient/parent/guardian request.Alternatively, the school-based health clinic will have the use of MARTTI tablets that provide translation of 250+ languages. This technology can be utilized during appointments at all sites. Winona Area Public Schools also has Spanish speaking staff in the building that can assist in helping families with language barriers understand all of the options that are available to them.Winona Health has utilized Project FINE to create Hmong versions of the SBHC flyers that are also available in Spanish and English. Project FINE is a nonprofit organization that helps newcomers integrate into the community. They provide foreign language interpreters and translators as well as opportunities for education, information, referral, and empowerment for immigrants and refugees. See continuation..
Winona Health Services	Part V, Section B, Line 13h: Amount generally billed (AGB) will not be more than the amount generally billed to individuals with insurance. Winona Health has chosen to calculate the AGB annually using a look-back method based on the previous fiscal year's (October to September) contractual rates for Medicare and all private health insurers, divided by total gross revenue. The calculations for the AGB rate through 10/31/25 will be a 48.7% (percent) discount to the charges billed to patients eligible for financial assistance based on Winona Health's Fiscal Year 2024.
Schedule H, Part V, Line 7 and 10:	https://www.winonahealth.org/wp-content/uploads/WC-WH-Community-Health-Needs-Assessment-2022.pdfhttps://www.winonahealth.org/wp-content/uploads/2025/05/WC-CHNA-Implementation-Plan-2022.pdf
Schedule H, Part V, Line 16a-c:	https://www.winonahealth.org/wp-content/uploads/2025/06/WH-028-Financial-Assistance-and-Payment-Rev.-11-2024-signed.pdfhttps://www.winonahealth.org/wp-content/uploads/2990A-Financial-Assistance-Application-031423.pdfhttps://www.winonahealth.org/patients-and-visitors/patients/billing-insurance/financial-assistance-program/
Schedule H, Part V, Line 11 (continued)	Continued....This past year, Winona Health paid Project FINE to post these flyers on their Facebook pages to reach more families who may not know about the clinics and the services that we provide. We plan to continue this activity in the coming years Winona Health has also continued its work with the Winona Community HUB and recently added a community health worker specifically to work with older adults (65+) experiencing health-related social needs. In addition, Winona Health has continued to promote worksite wellbeing through its HealthyU program. Winona Health has also continued to participate in the Statewide Health Improvement Partnership (SHIP) leadership team.Winona Health's Intensive Outpatient Program is in full operation, and has maintained an average census of 10 patients with low readmissions and positive data reports. The Winona County Community Health Improvement Plan (CHIP) is an extension of the Implementation Plan, including work that has been done from 2023-2025. Representatives from Winona Health and other Winona County organizations participated in a series of meetings to discuss ongoing efforts to address identified health priorities and to brainstorm additional plans to improve health. Initially these meetings were broken into subgroups by priority category: Mental Health, Healthy Behaviors, Health Equity, and Social Connectedness. After several meetings, some effective policies and programs were identified for potential inclusion in the CHIP, but additional input from the community was needed. The CHIP Community Engagement Survey was launched to get community input to assist in choosing essential services that would be incorporated into the CHIP. Respondents were asked to identify what they felt was most important to be addressed in each priority area. Results included:Mental Health 522 Responses1. Affordability of mental health services: 183 or 35%2. Increase knowledge of existing crisis services: 121 or 23%3. Navigation of mental health services: 110 or 21%4. Coordination of mental health services in the emergency department: 108 or 21%Health Equity 428 Responses1. Free or sliding-fee scale dental clinics: 115 or 27%2. Support to overcome potential barriers (navigation, scheduling, translation, childcare and transportation): 81 or 19%3. Improve access to healthcare: 79 or 18%4. Support policies that support affordable housing: 77 or 18%5. Improve access to dental care through policy changes, incentives and collaborations: 76 or 18%Healthy Behaviors 392 Responses1. Affordable homes for all: 121 or 31%2. Practice reducing stigma of focusing on mental health, wellness and being healthy: 100 or 26%3. Increase awareness of mental health services: 88 or 22%4. Use/collect data to identify places in need of better access: 83 or 21%Social Connectedness 386 Responses1. Community funding to support low cost or free activities: 121 or 31%2. Provide resources to support local events and initiatives: 100 or 26%3. Advocate for multilingual documents: 84 or 22%4. Budget to sustain community programs: 81 or 21%This information was utilized to formalize the CHIP Actionable plan that identifies key partners, goals and strategies, baselines, and targets for each priority area. This plan will be updated after the final 2025 Community Health Needs Assessment report and Implementation Plan are published.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address		Type of Facility (describe)
1	1 - Lake Winona Manor 865 Mankato Avenue Winona,MN55987	Skilled Nursing Facility
2	2 - Watkins Manor 175 E Wabasha Street Winona,MN55987	Assisted Living
3	3 - Adith Miller Manor 885 Mankato Avenue Winona,MN55987	Memory Care Assisted Living
4	4 - Roger Metz Manor 875 Mankato Avenue Winona,MN55987	Memory Care Assisted Living
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 6a:	The community benefit report is included in the annual report which is posted on the Winona Health website: https://www.winonahealth.org/.
Part I, Line 7:	Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b and subsidized health services line 7g was calculated using the costing methods to prepare the cost reports. Line 7e Community health improvement services, line 7f health professions education, and line 7i cash and in-kind donations were actual expenses compiled using the expenses tracked and compiled by Winona Health staff.
Part II, Community Building Activities:	Winona Health supports community building activities in a variety of ways. Whether via community boards, mental health coalitions, community support activities, or wellbeing collaboratives, Winona Health operates as a cornerstone of the community. Winona Health is one of the largest employers in the area, and operates as a trusted resource in the community. As a result, leadership and caregivers are often tapped to lead and participate in activities that advance the health of our community and create a place where all people can thrive. Winona Health supports and encourages these activities, and provides resources as able. This all aligns with Winona Health's mission of "inspiring, recognizing, and empowering the caregiver in all of us."
Part III, Line 2:	The corporation determines its estimate of implicit price concessions based on its historical collection experience with each class of patients and residents.
Part III, Line 3:	WHS estimates that 40% of implicit price concession accounts would likely qualify for the Organization's charity care guidelines if the patient would have been identified and followed through on the application process. This percentage is based on historical knowledge of those who were provided applications and those who completed and submitted application to qualify.
Part III, Line 4:	The footnote to the organization's financial statements that describes implicit price concessions is located on page 12-14 of the attached financial statements.
Part III, Line 8:	WHS provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit. The Organization reported only those allowable costs and Medicare reimbursements reported in the Medicare cost report for the year.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.
Part III, Line 9b:	In keeping with the mission, vision and values of Winona Health Services, our Organization is committed to giving a patient every opportunity to pay their medical debt in full or to make arrangements based on organizational policy. When a patient is in the process of applying for financial assistance, whether charity care or an interest free payment plan, there will be no collection efforts. Collection efforts include phone contacts, letters, patient interviews and filing a judgement against the patient and potential garnishment of wages. After a determination of financial assistance, any personal portion due follows the same collection procedures as other accounts. Accounts will be recalled from collection if an application is completed within 240 days of the date of the first invoice.
Part VI, Line 2:	Winona Health Services (WHS) uses a variety of methods to listen to its customers, and the methodologies vary by customer groups. WHS uses point of care feedback comment cards, focus groups, advisory committees comprised of community individuals, and web and consumer newsletter surveys to capture feedback from patients/residents and community. Immediate feedback is obtained from patients/residents and community through pre- and post-service calls, rounding, and informal surveys. WHS also works with local non-profit organizations gathering feedback from local agencies and their boards to ensure community needs are being met.
Part VI, Line 3:	WHS places pamphlets that contain information about our charity care programs and policies throughout the Organization, including all patient access areas. In addition, information can be found on our statement, website or by calling the WHS business office either locally or toll-free. WHS also has a plain language brochure which explains options for financial assistance, charity care, government program assistance, and our uninsured discount program. In addition, the WHS social services department and/or a contracted patient advocate may meet with in-house or recently discharged patients to go over all the payment options which include charity care, governmental programs, or other alternative payment options. WHS works with the county to help initiate a screening process for applying for governmental programs by offering the patients an opportunity to lock in an effective date for those programs if subsequently found eligible. WHS also is contracted with MNSure and has Certified Application Counselors onsite to assist patients in applying for insurance coverage through the State run exchange.
Part VI, Line 4:	WHS defines its primary service area as the zip code of Winona and the immediate surrounding area with a population base of approximately 35,000 residents. Its secondary service area encompasses a 20-mile radius from Winona representing another 12,000 residents. WHS is located between two large, well-known tertiary health care centers, Mayo and Emplify Health. WHS has focused on fulfilling its community need: a full primary care facility. WHS defines itself as a primary care health system and provides its patients and residents connections to tertiary level services to meet their needs regionally or nationally, as the patient chooses. In 2020, Winona had a median household income of $60,020 and 11% of persons were below the poverty level. The majority of our patients live in Winona which has a population of over 26,772 people. Approximately 18.1% of our patients are uninsured and/or Medicaid recipients.
Part VI, Line 5:	As the sole community hospital, WHS offers emergency and urgent care, primary care for all ages, surgical and specialty care, inpatient care, and senior services. Our Board is comprised of physicians and primarily community members. The Board and medical staff are involved in our strategic planning which focuses on the health of our community members. As an integrated rural healthcare system, WHS continues to thrive because of its ongoing commitment to its mission: To inspire, recognize, and empower the caregiver in all of us. WHS' services address the spectrum of the community's primary healthcare needs from birth through end-of-life. To meet the needs of our community, services include a 49-bed acute care hospital, emergency department, urgent care, multispecialty clinic, outpatient diagnostic center, 80-bed skilled nursing facility, and two memory care residences. Additionally, WHS has a hospice program to assist in management of patient care in the community. WHS also operates a 53-unit assisted living residence in Winona, an onsite retail pharmacy, rehabilitation services (housed in the Winona Family YMCA adjacent to the hospital campus), and a satellite primary care clinic in the community of Rushford. WHS continues to be one of the city's largest employers, and benefits from the efforts of over 200 community volunteers. Because of WHS' non-profit status, excess funds are reinvested and used for patient care and facility upgrades to continue supporting our community and mission.To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified through licensure in the state of Minnesota. In a normal year, staff actively participate in several on-site and off-site health fairs offering free blood pressure checks, glucose screenings and expertise on health questions, as well as offering free community health talks for community members on certain health topics.Additional programs that benefit the community include:Health Professional Training: WHS works closely with nurse and health professional education programs at Winona State University, St. Mary's University, Viterbo College, and Minnesota State College Southeast, in addition to several others regional universities and technical schools. Along with training nursing students on site, WHS also offers training and internship opportunities for other students going into fields of athletic training, social work, dietetics, lab, radiology, physical therapy, respiratory therapy and health care administration. Shadowing opportunities have also been made available for high school students who are interested in health care careers. WHS also hosts medical students, as part of their medical residencies, who are interested in working in a rural community.Preventive Care: WHS encourages preventive care through a number of resources. My Winona Health is a free web-tool that allows patients to have access to their Winona Health Services records anytime, anywhere with an internet connection. Patients can document their health history, access information on their acute and chronic conditions, receive lab and imaging test results, and track on preventative services. Winona Health Services offers a number of educational opportunities for the community, from CPR classes to free or low-cost screenings. Community Health Talks provide individuals with educational information on a variety of health topics and are free throughout the year. The Winona Health Services Occupational Health department presents various preventive programs geared toward business leaders and HR professionals. The staff also participates in many community collaborative healthcare events.Employee Health: The Healthy U Program is WHS' workplace wellbeing program that is designed to support and encourage caregivers and their families to live a life of wellbeing. The program reinforces the emphasis on prevention, mental health and weight management, and provides support and resources. Additionally, WHS caregivers and their families are able to support their healthy habits through a subsidy to the Winona Family YMCA.Emergency Care: WHS provides 24-hour-a-day, 365-days-per-year emergency care to the community. It employs full-time physicians and several mid-level providers as the service continues to grow. Winona Health Services has excellent relations with neighboring tertiary facilities and transports patients as needed to La Crosse and Rochester.Community Relations & Education: Caregivers actively participate in several on-site and off-site health promotion activities. Examples of this include, but not limited to, offering blood pressure screenings, providing a free skin cancer screening day where community members had the opportunity to schedule a screening with a provider in our dermatology department, having dietitians go to local schools and offer nutrition education to students, as well as offering a variety of other free community health talks and health education for community members. WHS employees are also involved in several non-profit committees, donating their time to support our community. Additional regular community education programming includes free or reduced-fee classes on childbirth and parenting, support groups for breastfeeding, cardio-pulmonary resuscitation, first aid, and smoking cessation. WHS volunteers offer free healthcare directives educational sessions throughout the year.
Part VI, Line 7, Reports Filed With States	MN

Schedule H (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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 on 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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Andrew Millis MD Orthopedic Physician	(i) (ii)	712,103 ------------- 0	384,412 ------------- 0	0 ------------- 0	64,916 ------------- 0	25,466 ------------- 0	1,186,897 ------------- 0	0 ------------- 0
2George Ripeckyj MD Radiologist	(i) (ii)	475,998 ------------- 0	332,489 ------------- 0	0 ------------- 0	42,336 ------------- 0	5,889 ------------- 0	856,712 ------------- 0	0 ------------- 0
3Matthew Broghammer MD Director	(i) (ii)	499,872 ------------- 0	77,573 ------------- 0	0 ------------- 0	57,919 ------------- 0	37,045 ------------- 0	672,409 ------------- 0	0 ------------- 0
4Hans Serleth MD Surgeon	(i) (ii)	461,541 ------------- 0	120,227 ------------- 0	0 ------------- 0	51,600 ------------- 0	33,660 ------------- 0	667,028 ------------- 0	0 ------------- 0
5Chad Weaver MD Dermatologist	(i) (ii)	546,615 ------------- 0	97,859 ------------- 0	0 ------------- 0	10,788 ------------- 0	2,509 ------------- 0	657,771 ------------- 0	0 ------------- 0
6Rachelle Heising-Schultz President/CEO/Director	(i) (ii)	522,660 ------------- 0	53,679 ------------- 0	22,500 ------------- 0	18,300 ------------- 0	39,988 ------------- 0	657,127 ------------- 0	0 ------------- 0
7Katrina Hammel MD Director	(i) (ii)	331,747 ------------- 0	33,066 ------------- 0	0 ------------- 0	34,712 ------------- 0	37,363 ------------- 0	436,888 ------------- 0	0 ------------- 0
8E Allen Beguin MD Director	(i) (ii)	271,772 ------------- 0	2,333 ------------- 0	0 ------------- 0	25,200 ------------- 0	33,888 ------------- 0	333,193 ------------- 0	0 ------------- 0
9Nicholas Modjeski MD Director	(i) (ii)	250,308 ------------- 0	2,333 ------------- 0	0 ------------- 0	22,911 ------------- 0	29,717 ------------- 0	305,269 ------------- 0	0 ------------- 0
10Michael Donnenwerth Chief Medical Officer	(i) (ii)	248,862 ------------- 0	0 ------------- 0	0 ------------- 0	22,950 ------------- 0	29,287 ------------- 0	301,099 ------------- 0	0 ------------- 0
11Sara Gabrick Chief Nursing Officer	(i) (ii)	207,254 ------------- 0	12,909 ------------- 0	6,454 ------------- 0	12,689 ------------- 0	24,466 ------------- 0	263,772 ------------- 0	0 ------------- 0
12Robin Hoeg Chief Operating Officer	(i) (ii)	212,361 ------------- 0	6,702 ------------- 0	6,702 ------------- 0	12,987 ------------- 0	24,404 ------------- 0	263,156 ------------- 0	0 ------------- 0
13Rebecca Lamberty Chief Administrative Officer	(i) (ii)	196,327 ------------- 0	9,288 ------------- 0	22,031 ------------- 0	11,861 ------------- 0	3,163 ------------- 0	242,670 ------------- 0	0 ------------- 0
14Jessica Remington CFO/Treasurer	(i) (ii)	177,174 ------------- 0	4,735 ------------- 0	3,215 ------------- 0	5,475 ------------- 0	24,080 ------------- 0	214,679 ------------- 0	0 ------------- 0
15Randall Norgard MD Orthopedic Physician	(i) (ii)	165,160 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	3,294 ------------- 0	168,454 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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.

Return Reference

Explanation

Part I, Line 4b

The following individuals received employer contributions to a supplemental non-qualified retirement plan, which is available to executive, physicians, and mid-level providers as determined by the Board of Directors. It is funded by employer contributions, and employees are vested within five years. An alternative plan is available which is funded by employee contributions and not subject to forfeiture. CY2023 Matthew Broghammer, MD $28,219 Katrina Hammel, MD $5,012 Andrew Millis, MD $35,216 George Ripeckyj, MD $12,636 Hans Serleth, MD $21,900 Chad Weaver, MD $10,788

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Kelly Schultz	Daughter of CEO Rachelle Heising-Schultz	63,245	Employee compensation & benefits		No
(2) Krista Brand	Daughter of COO Robin Hoeg	110,268	Employee compensation & benefits		No
(3) Courtney Wieser	Daughter of COO Robin Hoeg	40,190	Employee compensation & benefits		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Return Reference	Explanation
Form 990, Part VI, Section A, line 1a	The Executive Committee has the authority to act on behalf of the governing board in between board meetings. The Executive Committee consists of the Board Chair, the chair of each Standing Committee, the President/CEO of the organization and one at-large board member.
Form 990, Part VI, Section A, line 2	The following individuals have business relationships: Hugh Miller and Todd Paulson Matt Broghammer, Nicholas Modjeski and E. Allen Beguin Fatima Said and David Vaselaar
Form 990, Part VI, Section A, line 4	The Bylaws were updated to include Winona Area Ambulance Services as a related entity.
Form 990, Part VI, Section B, line 11b	The return is reviewed initially by the CFO and CEO. It is then reviewed by the Executive Committee before it is filed. In addition, the Form 990 is available to the full governing board prior to filing with the IRS.
Form 990, Part VI, Section B, line 12c	The conflict of interest policy covers Senior Leaders, Directors, Officers and Board Committee Members. The policy is signed annually and reviewed by the CEO for conflicts. Any conflicts are brought to the Board for discussion. If a Board Member has a potential conflict, they must abstain from voting.
Form 990, Part VI, Section B, line 15	The Executive Committee has a process in place for determining annual compensation for the CEO based on results of a compensation study, which is completed by an independent consultant every 3 years. An annual review is conducted and documented, with final decisions made by the full board. The same consultant provides market reviews and recommendations for the senior leadership team. This is reviewed by the executive compensation committee; however, the CEO is responsible for adjustments made for this team.
Form 990, Part VI, Section C, line 19	The organization makes its governing documents, conflict of interest policy and financial statements available upon request. The financial statements are also attached to the Form 990.
Form 990, Part IX, line 11g	Collection Agency Fees: Program service expenses 305,664. Management and general expenses 0. Fundraising expenses 0. Total expenses 305,664. Consulting Fees: Program service expenses 9,878. Management and general expenses 390,564. Fundraising expenses 0. Total expenses 400,442. Contracted Physician Fees: Program service expenses 1,240,677. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,240,677. Contracted Services: Program service expenses 5,041,645. Management and general expenses 2,898,246. Fundraising expenses 0. Total expenses 7,939,891. Provider Recruiting: Program service expenses 174,370. Management and general expenses 13,500. Fundraising expenses 0. Total expenses 187,870. Repair and Maintenance: Program service expenses 1,222,056. Management and general expenses 691. Fundraising expenses 0. Total expenses 1,222,747. Purchased Services: Program service expenses 576,329. Management and general expenses 0. Fundraising expenses 0. Total expenses 576,329.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Winona Health Services

Employer identification number

41-0713914

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on 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

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on 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?
(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	Yes	No
(1)Winona Senior Services Inc 855 Mankato Avenue Winona,MN55987 41-1936536	Long-term care	MN	501(c)(3)	Line 3	Winona Health Services	Yes
(2)Winona Health Foundation 855 Mankato Avenue Winona,MN55987 41-1879744	Fundraising	MN	501(c)(3)	Line 7	Winona Health Services	Yes
(3)Winona Area Ambulance Service 370 West 2nd Street Suite 300 Winona,MN55987 41-1845488	Emergency services	MN	501(c)(3)	Line 3	Winona Health Services	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on 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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on 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?
(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	Yes	No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on 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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Winona Senior Services Inc	O	179,256	Due to/from net change in balance
(2) Winona Senior Services Inc	S	14,763,022	Due to/from net change in balance
(3) Winona Senior Services Inc	R	14,878,301	Due to/from net change in balance
(4) Winona Health Foundation	O	157,042	Due to/from net change in balance
(5) Winona Health Foundation	C	243,229	Due to/from net change in balance
(6) Winona Health Foundation	R	79,229	Due to/from net change in balance
(7) Winona Area Ambulance Service	R	16,635	Due to/from net change in balance
(8) Winona Area Ambulance Service	C	1,896,971	Due to/from net change in balance
(9) Winona Area Ambulance Service	S	6,343	Due to/from net change in balance

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on 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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Hospital Services
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	996
6	Total number of volunteers (estimate if necessary) .............	6	265
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,424,820
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	189,643

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,110,715	1,432,718
9	Program service revenue (Part VIII, line 2g) .........	105,631,545	106,129,156
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,379,206	3,234,928
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	-326,728
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	111,121,466	110,470,074
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	56,735	5,987
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)	68,344,888	69,500,758
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	53,818,029	48,442,633
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	122,219,652	117,949,378
19	Revenue less expenses. Subtract line 18 from line 12.......	-11,098,186	-7,479,304
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	116,360,896	111,213,239
21	Total liabilities (Part X, line 26).............	61,301,763	61,196,567
22	Net assets or fund balances. Subtract line 21 from line 20.....	55,059,133	50,016,672

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 100,164,047 including grants of $ 5,987 ) (Revenue $ 103,704,336 )
	Winona Health Services (WHS), a 49-bed hospital, has provided care to its community and services from birth to death for 125 plus years. It is the sole community hospital in the Winona, Minnesota area. In fiscal year 2024, WHS had 1,271 admissions, 177 births, 3,337 inpatient and outpatient surgeries, and 12,261 visits to the emergency room.To fulfill its mission of community service, the Corporation provides care to patients and residents who meet certain criteria under its charity care and community benefit policy without charge or at amounts less than its established rates. Because the Corporation does not pursue collection of amounts determined to qualify as charity care, (Continued on Schedule O)they are not reported as patient and resident service revenue.Charity Care: WHS provides medical care to the community regardless of an individual's ability to pay. The estimated cost of providing these services was approximately $279,000 for fiscal year 2024. In furtherance of its charitable purpose, the Corporation provides a wide variety of benefits to the community. These services and donations account for a measurable portion of the Corporation's costs and serve to promote healthy lifestyles, community development, health education, and affordable access to care.The Corporation maintains records to identify and monitor the level of community benefit services it provides. Those records include management's estimate of the cost to provide charity care, the cost of services and supplies furnished for community benefit programs and costs in excess of program payments for treating Medical Assistance patients.In addition to community benefit costs, the Corporation provides additional community contributions such as services to Medicare and Medicaid patients below the costs for treatment, other uncompensated care, discounted pricing to the uninsured, and pays taxes and fees

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses100,164,047

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Jessica Remington........................................................................ CFO/Treasurer	48.00 .......................2.00	X			185,124	0	28,713
(19) Michael Donnenwerth........................................................................ Chief Medical Officer	40.00 .......................0.00		X		248,862	0	50,910
(20) Sara Gabrick........................................................................ Chief Nursing Officer	40.00 .......................0.00		X		226,617	0	36,177
(21) Robin Hoeg........................................................................ Chief Operating Officer	40.00 .......................0.00		X		225,765	0	36,392
(22) Rebecca Lamberty........................................................................ Chief Administrative Officer	40.00 .......................0.00		X		227,646	0	14,111
(23) Andrew Millis MD........................................................................ Orthopedic Physician	40.00 .......................0.00			X	1,096,515	0	88,572
(24) George Ripeckyj MD........................................................................ Radiologist	40.00 .......................0.00			X	808,487	0	46,415
(25) Chad Weaver MD........................................................................ Dermatologist	40.00 .......................0.00			X	644,474	0	11,487
(26) Hans Serleth MD........................................................................ Surgeon	40.00 .......................0.00			X	581,768	0	83,450
(27) Randall Norgard MD........................................................................ Orthopedic Physician	40.00 .......................0.00			X	165,160	0	3,294

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	6,478,261	0	729,442

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,215,759
e	Government grants (contributions)		1e	211,559

f	All other contributions, gifts, grants, and similar amounts not included above		1f	5,400

g	Noncash contributions included in lines 1a - 1f:$		1g	5,400

h Total. Add lines 1a-1f.......		1,432,718

		Business Code
2a	Patient Service Revenue	900099	87,844,273	87,844,273
b	Pharmacy Revenue	456110	11,017,052	8,863,421	2,153,631
c	Purchased Service Revenue	900099	3,765,354	3,765,354
d	Supporting Revenue	900099	3,408,041	3,136,852	271,189
e
f	All other program service revenue.		94,436	94,436
g	Total. Add lines 2a–2f .....		106,129,156

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,324,636			3,324,636
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	94,434
b	Less: cost or other basis and sales expenses	7b	0	184,142
c	Gain or (loss)	7c	94,434	-184,142
d	Net gain or (loss).........			-89,708			-89,708
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	Loss on Financing		900099	-326,728			-326,728
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			-326,728
12	Total revenue. See instructions.....			110,470,074	103,704,336	2,424,820	2,908,200

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	5,987	5,987
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,705,899	1,739,866	1,966,033
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	213,703	213,703
7	Other salaries and wages........	50,596,640	46,337,815	4,258,825
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,788,778	1,716,584	72,194
9	Other employee benefits .......	9,721,849	8,372,220	1,349,629
10	Payroll taxes ...........	3,473,889	3,090,233	383,656
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	150,174		150,174
c	Accounting ...........	118,444		118,444
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	19,515		19,515
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	11,873,620	8,570,619	3,303,001
12	Advertising and promotion ....	296,246	68	296,178
13	Office expenses .......	2,587,417	2,232,042	355,375
14	Information technology ......	4,234,959	344,197	3,890,762
15	Royalties ..
16	Occupancy ...........	2,552,340	2,551,865	475
17	Travel ............	328,519	270,520	57,999
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	17,228	17,228
20	Interest ...........	439,748	259,857	179,891
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,027,872	3,847,839	1,180,033
23	Insurance ...	965,566	762,419	203,147
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	Medical Supplies	12,699,700	12,699,700
b	Winona Clinic Pharmacy	5,722,649	5,722,649
c	MN Care Tax	994,171	994,171
d	Income Tax Expense	1,804	1,804
e	All other expenses	412,661	412,661
25	Total functional expenses. Add lines 1 through 24e	117,949,378	100,164,047	17,785,331	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			7,143,165	2	6,173,749
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			14,667,452	4	15,326,234
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			3,198,610	8	3,338,971
9	Prepaid expenses and deferred charges ......			1,248,763	9	958,248
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	102,009,664
b	Less: accumulated depreciation	10b	69,902,085	34,514,978	10c	32,107,579
11	Investments—publicly traded securities .			29,972,956	11	27,463,352
12	Investments—other securities. See Part IV, line 11 .....			6,447,643	12	5,551,421
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			2,014,538	14	2,014,538
15	Other assets. See Part IV, line 11 ...........			17,152,791	15	18,279,147
16	Total assets. Add lines 1 through 15 (must equal line 33)...			116,360,896	16	111,213,239

17	Accounts payable and accrued expenses .....	11,722,705	17	12,351,502
18	Grants payable ...		18
19	Deferred revenue .........		19	50,000
20	Tax-exempt bond liabilities .........	15,935,272	20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24	14,660,514
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	33,643,786	25	34,134,551
26	Total liabilities. Add lines 17 through 25..	61,301,763	26	61,196,567

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	55,059,133	27	50,016,672
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	55,059,133	32	50,016,672
33	Total liabilities and net assets/fund balances ........	116,360,896	33	111,213,239