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MERCY ASSISTED CARE INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
MERCY ASSISTED CARE INC (EIN 39-1035110)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-15
IRS object ID
202421369349317702
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-15T17:54:07+00:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 Midland Court PO Box 8130AddressLine1Txt
CityJanesvilleCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53547ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391035110EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mercy Assisted Care IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMERCBusinessNameControlTxt
Phone6087542201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 901 MINERAL POINT AveAddressLine1Txt
CityJANESVILLECityNm
State AbbreviationWIStateAbbreviationCd
ZIP535485003ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJavon BeaPersonNm
Person TitlePresident/CeoPersonTitleTxt
Signature2024-05-15SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJavonPersonFirstNm
Person LastBeaPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTroy E Marine CPAPreparerPersonNm
PTINP00187863PTIN
Phone6087525835PhoneNum
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MERCYHEALTH AT HOMEBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JAVON BEABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 901 MINERAL POINT AveAddressLine1Txt
CityJANESVILLECityNm
State AbbreviationWIStateAbbreviationCd
ZIP535485003ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,908,808GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTPS://MERCYASSISTEDCARE.ORG/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionEXCEPTIONAL HEALTHCARE SERVICES RESULTING IN HEALING IN ITS BROADEST SENSE.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee112TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$1,271,609TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$474,946NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$81,563PYContributionsGrantsAmt
CY Contributions Grants$226,181CYContributionsGrantsAmt
PY Program Service Revenue$10,366,693PYProgramServiceRevenueAmt
CY Program Service Revenue$11,260,860CYProgramServiceRevenueAmt
PY Investment Income$165PYInvestmentIncomeAmt
CY Investment Income-$13,371CYInvestmentIncomeAmt
PY Other Revenue$2,162,088PYOtherRevenueAmt
CY Other Revenue$3,482,810CYOtherRevenueAmt
PY Total Revenue$12,610,509PYTotalRevenueAmt
CY Total Revenue$14,956,480CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,836,380PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,745,883CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,697,256PYOtherExpensesAmt
CY Other Expenses$3,112,217CYOtherExpensesAmt
PY Total Expenses$10,533,636PYTotalExpensesAmt
CY Total Expenses$12,858,100CYTotalExpensesAmt
PY Revenues Less Expenses$2,076,873PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,098,380CYRevenuesLessExpensesAmt
Total Assets BOY$11,848,284TotalAssetsBOYAmt
Total Assets EOY$14,233,277TotalAssetsEOYAmt
Total Liabilities BOY$2,497,566TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,784,179TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,350,718NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,449,098NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF MERCY ASSISTED CARE, INC. (MAC) IS TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES RESULTING IN HEALING IN ITS BROADEST SENSE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,384,000ExpenseAmt
Revenue$13,031,305RevenueAmt
DescVISITS: SKILLED NURSING 18,397, HOSPICE HOMECARE 8,338. HOSPITAL COMMUNITY BENEFIT REPORT - IRS FORM 990, SUPPLEMENT PART III: The community benefit contribution of Mercy Assisted Care, Inc. includes programs and activities that improve access to health care and improve health in our communities. In order to portray the full breadth of our contribution, our community benefit information is described below: Section 1: Qualitative Description of Community Benefit - describes the organization's community benefit mission, how the mission is translated into a proactive approach designed to meet community health needs, how the organization meets tax-exempt requirements, and a description of community benefit programs and services that highlight the organization's impact on community health. Section 2: Quantitative Description of Community Benefit - describes the organization's community benefit contribution in financial terms presenting the amount of charity care, the unpaid shortfall from government health care for the indigent, and the net expense of community benefit services. SECTION 1-QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. Mercy Assisted Care Inc.'s Commitment to Providing Community Benefit: A. The Mission of the Mercy Assisted Care, Inc. is "to provide exceptional healthcare services resulting in healing in its broadest sense." Mercy Assisted Care provides quality medical care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Mercy Assisted Care, it is recognized that not all individuals possess the ability to purchase essential medical services. Therefore, in keeping its Mission, Mercy Assisted Care routinely provides: 1.) free care and/or subsidized care, 2.) care to persons covered by governmental programs that are reimbursed below cost, and 3.) health activities and educational and support programs to the communities it serves in southern Wisconsin and northern Illinois. These activities include wellness programs, community education programs, special programs for the elderly, handicapped, medically underserved, and a variety of broad community support activities. Many of the services of Mercy Assisted Care are focused on keeping the elderly and medically frail in the type of independent setting most appropriate to their medical condition. B. Mercy Assisted Care considers its target populations to be residents of Rock and Walworth Counties in Wisconsin, as well as parts of McHenry County in Illinois. The System uses multiple strategies to identify needs in these communities. These strategies include one-on-one meetings with local community leaders, formal surveys, participation on community task forces, suggestions from patients, and direct input from its employees. Mercy Assisted Care has worked with various community organizations to help meet these needs: 1.) Mercy Assisted Care subsidizes its Hospice program (through fundraising/donations from Mercy Foundation) so that this program is available to those in need within the community. 2) It provides health screenings and health education seminars at public events and at its own sites throughout the target area. 3) Along with its sister-corporation (Mercy Health System Corporation), Mercy Assisted Care, provides training opportunities for nurses, physicians, and other health professionals. C. Community/Charity Care is provided by Mercy Assisted Care to customers who are unable to pay for all or a portion of their charges and who meet eligibility requirements. Eligibility is based on the following: individual or family income, individual or family assets, family size, and other sources of payment for services. Eligibility for all other categorical aids is a prerequisite before qualifying for community care. Patients that qualify will receive a reduction in the balance owed and extended payment terms. The amount of the Community Care benefit is based on the patient's ability to pay and the size of the outstanding balance. If patient income and family assets are less than 200% of the federal poverty guidelines, then Mercy will cover 100% of their outstanding balance via its Community Care Program. If patient income and family assets fall between 201% and 300% of the federal poverty guideline, then a patient's balance can be reduced as much as 90%. Mercy has procedures in place to inform the public about the availability of financial aid/charity care. Information is made available at the time of registration, through patient financial counselors, and at the customer service patient accounts areas. Training is provided to personnel as to how to communicate this program's availability to patients and how to direct patients' inquiries. Translation services are available as needed. 2. Organizational Description for Tax Exemption - Mercy Assisted Care, Inc has a governing body in which independent persons representative of the community comprise a majority. - Mercy Assisted Care, Inc. participates in Medicaid, Medicare, CHAMPUS, Tricare, and other government-sponsored health care programs. 3. Description of Community Benefit Programs Mercy Assisted Care offers many reduced price services and free programs throughout the year based upon activities and services which Mercy Assisted Care, Inc. believes will serve a bona fide community health need. Some of the programs include: - Participation in health fairs - Participation in Hospice Support Groups. 4. Links to Additional Community Benefit Information Mercy Health System's web page: www.mercyhealthsystem.org Much of the Community Benefit for all the entities of the entire Mercyhealth organization (parent company of Mercy Assisted Care, Inc.) is provided at the Mercy Health System Corporation. SECTION 2 - QUANTIFIABLE COMMUNITY BENEFIT FISCAL YEAR ENDED JUNE 30, 2023: 1) CHARITY CARE - AT COST $31,334 2) MEDICAID SHORTFALL - NET EXPENSE $192,996 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $224,330Desc
Total Program Service Expenses$11,384,000TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee112EmployeeCnt
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TODD ANDERSON VP & CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8159716738PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line18201 E Riverside BlvdAddressLine1Txt
CityROCKFORDCityNm
State AbbreviationILStateAbbreviationCd
ZIP61114ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Javon R Bea
PRESIDENT/CEO (see schedule J, pages 32 - 33)1.066.0Yes (X)Yes (X)$0$11,130,143$430,877
Rowland J McClellan
Chair & Director1.06.0Yes (X)Yes (X)$0$19,324$0
Thomas D Budd
secretary & treasurer1.06.0Yes (X)Yes (X)$0$12,086$0
Thomas R Pool
Vice Chair & Director1.06.0Yes (X)Yes (X)$0$13,500$0
Dave L Syverson
Director1.06.0Yes (X)$0$17,334$0
Katherine A Schack
Director1.06.0Yes (X)$0$13,500$0
Mark L Goelzer MD
Director/Physician1.061.0Yes (X)$0$504,123$29,529
Wesley M Jost
Director1.06.0Yes (X)$0$13,955$0
Kimberly Scaccia
VP - Revenue Cycle1.061.0Yes (X)$0$499,300$64,924
Todd Anderson
Vice President/CFO1.061.0Yes (X)$0$828,491$76,813
Brandon Cooley
Home Health Therapy Supervisor40.00.0$142,434$0$12,078Yes (X)
Dawn Klockow
Director of Home Health40.00.0$155,368$0$36,008Yes (X)
Kaylie Fuhrman
RN HOME HEALTH HOSPICE 554.70.0$162,051$0$38,468Yes (X)
Shelley Herbst-Nguyen
Home Health Therapy Supervisor40.00.0$123,885$0$5,226Yes (X)
Traci Heitzelman
RN HOME HEALTH HOSPICE 154.00.0$161,022$0$20,865Yes (X)
James Davis
former VICE-PRESIDENT0.00.0$0$213,871$34,294Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$744,760TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$13,265,627TotReportableCompRltdOrgAmt
Total Other Compensation$749,082TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K15IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ROCK HAVEN
PO BOX 920JANESVILLEWI535470920HOSPITALIZATION SERIVCES-HOSPICE$196,437
SOUTHERN WISCONSIN ROOFING
3202 KINGSLEY WAYMADISONWI53713WATERPROOFING/ROOF WORK$110,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$226,181GovernmentGrantsAmt
Total Contributions$226,181TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621610$10,828,522$10,828,522
RENT FROM AFFILIATED Organization531190$432,338$432,338

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,260,860TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,120TotalRevenueColumnAmt
Exclusion$2,120ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$15,491OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$15,491OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$15,491TotalRevenueColumnAmt
Exclusion-$15,491ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$7,411,229GrossSalesOfInventoryAmt
Cost Of Goods Sold$3,936,837CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,474,392TotalRevenueColumnAmt
Related Or Exempt Func Income$2,202,783RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,271,609UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$8,418TotalRevenueColumnAmt
Exclusion$8,418ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$8,418OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,956,480TotalRevenueColumnAmt
Related Or Exempt Func Income$13,031,305RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,271,609UnrelatedBusinessRevenueAmt
Exclusion$427,385ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,876,772TotalAmt
Program Services$6,812,402ProgramServicesAmt
Management And General$1,064,370ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$250,004TotalAmt
Program Services$219,771ProgramServicesAmt
Management And General$30,233ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,068,895TotalAmt
Program Services$926,554ProgramServicesAmt
Management And General$142,341ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$550,212TotalAmt
Program Services$502,971ProgramServicesAmt
Management And General$47,241ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Management And General$5,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$470,626TotalAmt
Program Services$460,745ProgramServicesAmt
Management And General$9,881ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,217TotalAmt
Program Services$2,217ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$71,163TotalAmt
Program Services$62,820ProgramServicesAmt
Management And General$8,343ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$234,834TotalAmt
Program Services$234,834ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$334,708TotalAmt
Program Services$333,811ProgramServicesAmt
Management And General$897ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,355TotalAmt
Management And General$1,355ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$828,073TotalAmt
Program Services$750,858ProgramServicesAmt
Management And General$77,215ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$29,000TotalAmt
Program Services$29,000ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS & MEDICAL SUPPLIES$367,124$363,337$3,787
EQUIPMENT REPAIRS & MAINTENANCE$440,639$361,332$79,307
BAD DEBT$253,777$253,777
UNREL. BUS. INC. TAX$55,015$55,015

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,686TotalAmt
Program Services$14,556ProgramServicesAmt
Management And General$4,130ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,858,100TotalAmt
Program Services$11,384,000ProgramServicesAmt
Management And General$1,474,100ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$900BOYAmt
EOY$850EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,402,473BOYAmt
EOY$5,106,788EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,771,945BOYAmt
EOY$2,422,673EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$858,590BOYAmt
EOY$1,238,013EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,420BOYAmt
EOY$4,668EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,138,260LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,417,800LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,785,176BOYAmt
EOY$3,720,460EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,780BOYAmt
EOY$1,739,825EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,848,284BOYAmt
EOY$14,233,277EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,411,938BOYAmt
EOY$2,336,636EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,085,628BOYAmt
EOY$447,543EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,497,566BOYAmt
EOY$2,784,179EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,350,718BOYAmt
EOY$11,449,098EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,350,718BOYAmt
EOY$11,449,098EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,848,284BOYAmt
EOY$14,233,277EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,098,380ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$89CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$12,288CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$81,563CurrentTaxYearMinus1YearAmt
Current Tax Year$226,181CurrentTaxYearAmt
Total$320,121TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,974,628CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,568,210CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,770,583CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,875,608CurrentTaxYearMinus1YearAmt
Current Tax Year$16,816,887CurrentTaxYearAmt
Total$75,005,916TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,974,717CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,568,210CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,782,871CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,957,171CurrentTaxYearMinus1YearAmt
Current Tax Year$17,043,068CurrentTaxYearAmt
Total$75,326,037TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$75,326,037PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,164CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,515CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$554CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$165CurrentTaxYearMinus1YearAmt
Current Tax Year$2,120CurrentTaxYearAmt
Total$5,518TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$129,651CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$104,689CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$140,916CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$231,965CurrentTaxYearMinus1YearAmt
Current Tax Year$474,946CurrentTaxYearAmt
Total$1,082,167TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$130,815CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$106,204CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$141,470CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$232,130CurrentTaxYearMinus1YearAmt
Current Tax Year$477,066CurrentTaxYearAmt
Total$1,087,685TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$877CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$804CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,095CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,116CurrentTaxYearMinus1YearAmt
Current Tax Year$8,418CurrentTaxYearAmt
Total$22,310TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,106,409CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,675,218CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,928,436CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,197,417CurrentTaxYearMinus1YearAmt
Current Tax Year$17,528,552CurrentTaxYearAmt
Total$76,436,032TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9855PublicSupportCY509Pct
Public Support PY5090.9902PublicSupportPY509Pct
Investment Income CY0.01InvestmentIncomeCYPct
Investment Income PY0.01InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule A, Part III, Line 12EXPLANATION FOR OTHER INCOME: MISCELLANEOUS
Schedule A, Part III, Line 12 Other IncomeDESCRIPTION - MISCELLANEOUS, COLUMN A - 877.0, COLUMN B - 804.0, COLUMN C - 4095.0, COLUMN D - 8116.0, COLUMN E - 8418.0, COLUMN F - 22310.0;

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,993,185OtherCostOrOtherBasisAmt
Depreciation$6,094,275DepreciationAmt
Book Value$1,898,910BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$224,958OtherCostOrOtherBasisAmt
Depreciation$198,996DepreciationAmt
Book Value$25,962BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,920,117OtherCostOrOtherBasisAmt
Depreciation$5,124,529DepreciationAmt
Book Value$1,795,588BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,720,460TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Due from MERCY HEALTH CORPORATION$11,750
Due from MERCYHEALTH VISITING NURSES ASSOCIATION
Due from MERCY HEALTH SYSTEM CORPORATION$1,320,028
Due from MERCY HARVARD HOSPITAL$408,047
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,739,825TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
THIRD PARTY PAYABLES$263,718
DUE TO MERCY HEALTH SYSTEM CORPORATION
DUE TO MERCY HARVARD HOSPITAL$326
DUE TO ROCKFORD HEALTH SYSTEM$9,587
Due to MERCYHEALTH VISITING NURSES ASSOCIATION$173,912
FieldValueIRS element (for citing)
Total Liability$447,543TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Javon R Bea
PRESIDENT/CEO (see schedule J, pages 32 - 33)$0$2,193,820$0$1,660,233$0$7,276,090$0$413,098$0$17,779$0$11,561,020$0$4,953,609
Mark L Goelzer MD
Director/Physician$0$312,319$0$187,404$0$4,400$0$12,200$0$17,329$0$533,652$0$0
James Davis
former VICE-PRESIDENT$0$79,369$0$0$0$134,502$0$4,471$0$29,823$0$248,165$0$0
Todd Anderson
Vice President/CFO$0$564,084$0$252,851$0$11,556$0$40,746$0$36,067$0$905,304$0$0
Kimberly Scaccia
VP - Revenue Cycle$0$314,004$0$147,040$0$38,256$0$21,669$0$43,255$0$564,224$0$0
Kaylie Fuhrman
RN HOME HEALTH HOSPICE 5$155,023$0$0$0$7,028$0$3,229$0$35,239$0$200,519$0$0$0
Dawn Klockow
Director of Home Health$126,217$0$21,006$0$8,145$0$6,516$0$29,492$0$191,376$0$0$0
Traci Heitzelman
RN HOME HEALTH HOSPICE 1$147,090$0$3,642$0$10,290$0$6,501$0$14,364$0$181,887$0$0$0
Brandon Cooley
Home Health Therapy Supervisor$126,766$0$15,668$0$0$0$5,697$0$6,381$0$154,512$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationTHE CEO IS PAID FROM A RELATED ORGANIZATION, MERCY HEALTH SYSTEM OF THE CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE VICE CHAIR, AND SECRETARY/TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED CORPORATION (MHSC). MHSC USES THE FOLLOWING TO ESTABLISH THE COMPENSATION FORM 990 OF OTHER ORGANIZATION, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION MERCY COMPENSATION COMMITTEE OF MHSC IS COMPRISED OF THE BOARD CHAIRPERSON, BY INDEPENDENT LEGAL COUNSEL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNSEL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2022.
Schedule J, Part I, Line 4a Severance or change-of-control paymentJames Davis received 26 weeks severance pay $119,025 in 2022.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planINCENTIVE PLAN DISTRIBUTION: JAVON R. BEA - $4,953,609 Todd Anderson participated in the 457(f) plan during Calendar year 2022. However, he did not receive a payout during calendar year 2022.
Schedule J, Part IIJAVON R. BEA - DEFERRED COMPENSATION PAYMENT MR. BEA HAS BEEN EMPLOYED BY MHSC AS PRESIDENT AND CEO OVER THE PAST 30 YEARS. DURING THIS TIME, MR. BEA HAS LED AN INCREDIBLE TRANSFORMATION TAKING A SMALL, SINGLE, STAND-ALONE COMMUNITY HOSPITAL AND CREATING A VERTICALLY INTEGRATED HEALTH SYSTEM WITH 85 FACILITIES IN 50 COMMUNITIES THROUGHOUT SOUTHERN WISCONSIN AND NORTHERN ILLINOIS, INCREASING GROSS REVENUE FROM $33 MILLION TO OVER $3.6 BILLION IN FY2023. THIS HAS ALLOWED THE HEALTH SYSTEM TO GO FROM SERVING 89,000 PATIENTS IN 1989 TO OVER 1.8 MILLION PATIENTS TODAY WORKING TOGETHER WITH OVER 7,500+ PARTNERS IN HEALTH CARE. TODAY, MHSC HAS BECOME THE LARGEST EMPLOYER IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. THIS GROWTH CAN BE ATTRIBUTED TO MR. BEA'S VISIONARY LEADERSHIP. LEADERSHIP THAT HAS LED TO MHSC RECEIVING NUMEROUS NATIONAL RECOGNIZED AWARDS INCLUDING BEING NAMED THE FIRST FULLY INTEGRATED HEALTH SYSTEM TO RECEIVE THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD, THE MAGNET RECOGNITION AWARD, BEING RANKED #1 AND #2 ON AARP'S TOP 100 BEST PLACES TO WORK FOR WORKERS OVER 50 AND BEING RANKED IN THE TOP 25 ON THE TOP 100 INTEGRATED HEALTHCARE NETWORKS LIST BY MODERN HEALTHCARE FOR OVER 12 STRAIGHT YEARS. THE TURNAROUND OF THE MHSC IMPLEMENTED BY MR. BEA IS UNPARALLELED. BY PIONEERING A "PARTNERSHIP MODEL" OF COMPENSATION AND DESIGNING A CUSTOM CULTURE OF EXCELLENCE, MR. BEA IS VITAL TO THE DECADES-LONG AND CONTINUING GROWTH AT MHSC. THIS SUCCESS HAS MADE MR. BEA A HIGHLY SOUGHT AFTER SPEAKER AND CONSULTANT AS HE IS NOW WELL-RENOWNED FOR HIS INNOVATIONS IN THE AREAS OF INTEGRATED HEALTHCARE AND PHYSICIAN PARTNERSHIP MODELS. THE TREMENDOUS SUCCESS OF MHSC UNDER THE LEADERSHIP OF MR. BEA HAS ALLOWED HIM TO RECEIVE PAYOUTS FROM A DEFERRED COMPENSATION PACKAGE WHICH MHSC HAS BEEN PAYING INTO OVER MANY YEARS. THESE PAYMENTS ONLY BECAME PAYABLE IF MHSC ATTAINED CERTAIN DEFINED FINANCIAL AND STRATEGIC GOALS AND THE AMOUNTS ARE AT RISK EVERY SINGLE YEAR. AS INDICATED ABOVE, MANY OF THESE GOALS WERE ACHIEVED WITHIN THE PAST FEW YEARS RESULTING IN A RELEASE OF THESE DEFERRED PAYMENTS WHICH IMPACTED MR. BEA'S COMPENSATION REPORTING. THE SETTING OF THESE GOALS WERE LAID OUT BY THE BOARD OF DIRECTORS IN COOPERATION WITH NATIONALLY RECOGNIZED COMPENSATION ATTORNEYS AND CONSULTANTS TO MAKE SURE ALL FACTORS WERE TAKEN INTO CONSIDERATION. MR. BEA'S COMPENSATION HAS ALSO BEEN SCRUTINIZED BY NUMEROUS OUTSIDE ORGANIZATIONS AND MOST IMPORTANTLY, THE INTERNAL REVENUE SERVICE; AND HAS PASSED INSPECTION IN EACH CASE. TOTAL COMPENSATION IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS OF MHSC.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 1a Delegate broad authority to a committeeTHE VOTING MEMBERS OF THE EXECUTIVE COMMITTEE CONSISTS OF EIGHT INDIVIDUALS, EACH OF WHOM SHALL HAVE A VOTE, INCLUDING THE CEO, THE CHAIRMAN, VICE-CHAIRMAN, IMMEDIATE PAST CHAIRMAN, TREASURER, AND TWO ADDITIONAL DIRECTORS OF THE BOARD. AT LEAST ONE MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE A PHYSICIAN. THE EXECUTIVE COMMITTEE SHALL IN ALL INSTANCES BE COMPRISED OF AT LEAST 51% COMMUNITY MEMBERS. IN THE EVENT THAT ONE OR MORE OF THE AFOREMENTIONED VOTING MEMBERS OF THE EXECUTIVE COMMITTEE IS UNABLE TO SERVE IN SUCH CAPACITY, THEN THE CHAIRMAN OF THE CORPORATION SHALL DESIGNATE A REPLACEMENT FROM AMONG THE BOARD MEMBERS. THE EXECUTIVE COMMITTEE SHALL MEET AS NEEDED. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS, DUTIES, RESPONSIBILITIES AND AUTHORITY OF THE BOARD, EXCEPT AS PROHIBITED BY LAW.
Form 990, Part VI, Line 6 Classes of members or stockholdersMERCY HEALTH CORPORATION (MHC) IS THE SOLE CORPORATE MEMBER OF MERCY ASSISTED CARE, INC. (MAC). THE SOLE MEMBER SHALL HAVE POWERS AND VOTING RIGHTS TO DO THE FOLLOWING: (A) APPOINT ALL THE DIRECTORS OF THE CORPORATION (B) NOMINATE TO THE CORPORATION'S BOARD OF DIRECTORS ALL CANDIDATES FOR SELECTION AS THE CORPORATION PRESIDENT (C) APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS (D) APPROVE ANNUAL BUDGETS, AND STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS OF THE CORPORATION (E) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AUTHORIZING THE PLEDGE OR TRANSFER OF ASSETS TO MHC OR AS DIRECTED BY MHC, OR THE EXECUTION OF CONTRACTS) WHICH WOULD IMPROVE THE CREDIT WORTHINESS OR OTHERWISE RESULT IN FINANCIAL BENEFIT TO MHC AND ITS TAX-EXEMPT AFFILIATED CORPORATIONS (PROVIDED THAT UNDER NO CIRCUMSTANCES MAY MHC REQUIRE TRANSFER OF ASSETS IN VIOLATION OF LAW OR THE TERMS OF ANY CHARITABLE TRUST OR DONATION) (F) APPROVE ALL CONTRACTS OF INDEBTEDNESS EFFECTIVE FOR LONGER THAN EIGHTEEN MONTHS (G) APPROVE ALL PLANS OF MERGER OR CONSOLIDATION (H) APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION (I) APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION (J) APPROVE MATERIAL AMENDMENTS TO THE CORPORATION'S STANDARD FORM OF PHYSICIAN EMPLOYMENT AGREEMENT, PROVIDED THE CORPORATION SHALL HAVE THE AUTHORITY TO NEGOTIATE THE TERMS AND CONDITIONS OF INDIVIDUAL PHYSICIAN MERCY ASSISTED CARE, INC. 39-1035110 EMPLOYMENT AGREEMENTS SO LONG AS THE NEGOTIATED TERMS AND CONDITIONS ARE CONSISTENT WITH THE REQUIREMENTS OF APPLICABLE LAW AND THE STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS APPROVED BY MHC (K) APPROVE MATERIAL AMENDMENTS TO THE STANDARD COMPENSATION SYSTEM USED BY THE CORPORATION TO ESTABLISH INDIVIDUAL PHYSICIAN COMPENSATION (L) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AMENDING THE ARTICLES OF INCORPORATION OR BYLAWS), OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, IF MHC DETERMINES THAT FAILURE TO TAKE THE ACTION, OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, MAY RESULT IN THE CORPORATIONS FAILURE TO OBTAIN OR MAINTAIN ITS EXEMPTION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodySEE NARRATIVE FOR PART VI, LINE 6.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersSEE NARRATIVE FOR PART VI, LINE 6.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyMANAGEMENT REVIEWS THE FORM 990 BEFORE FILING AND IT IS AVAILABLE TO THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 12c Conflict of interest policyBY WRITTEN POLICY, MHC SENDS OUT, ON AN ANNUAL BASIS, THE CORPORATE CONFLICT AND DUALITY OF INTEREST POLICY TO ALL BOARD MEMBERS, CORPORATE OFFICERS AND OTHER KEY INDIVIDUALS (THOSE HAVING RESPONSIBILITY AND AUTHORITY TO MAKE FINAL DECISIONS REGARDING THE ACQUISITION OF PRODUCTS OR SERVICES). EACH RECIPIENT IS REQUIRED TO COMPLETE A FINANCIAL INTEREST DISCLOSURE STATEMENT, WHICH IS SUBMITTED TO THE MHC COMPLIANCE DEPARTMENT FOR REVIEW. WITH RESPECT TO PHYSICIANS AND MANAGERS WHO ARE KEY INDIVIDUALS, ANY POTENTIAL CONFLICT OF INTEREST IS REVIEWED WITH THE APPROPRIATE EXECUTIVE STAFF MEMBER FOR FOLLOW UP WITH THE DISCLOSING PARTY IN ORDER TO REVIEW THE MATTER IN MORE DETAIL. THIS INCLUDES EMPHASIZING THAT THE DISCLOSING PARTY IS NOT PERMITTED TO PARTICIPATE IN ANY NEGOTIATIONS FOR THE PURCHASE OF ANY PRODUCTS OR SERVICES WHERE THE CONFLICT IS DEEMED MATERIAL, OR AUTHORIZE THE SUBSEQUENT PURCHASE OF RELATED GOODS AND SERVICES. THE DISCLOSING PARTY IS ALSO REQUIRED TO IDENTIFY EACH AND EVERY INSTANCE OF A POTENTIAL CONFLICT AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. A SIMILAR PROCESS IS FOLLOWED FOR THE BOARD OF DIRECTORS, EXCEPT THAT ANY POTENTIAL CONFLICT IS REVIEWED BY THE BOARD'S GOVERNANCE COMMITTEE. BOARD MEMBERS MAY COMMENT ON TRANSACTIONS WHERE THERE IS A POTENTIAL CONFLICT, BUT CANNOT VOTE ON THE RELATED MATTER AND MAY BE REQUIRED TO LEAVE ANY MEETING WHERE THE POTENTIAL CONFLICT IS REVIEWED BY THE BOARD OR WHERE THE BOARD TAKES ACTION TO EITHER APPROVE OR NOT APPROVE THE PROPOSED TRANSACTION. A BOARD MEMBER ALSO HAS A CONTINUING DUTY TO REPORT ANY CONFLICTS AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. IN THE EVENT THAT A POTENTIAL CONFLICT OF INTEREST IS REPORTED OR DISCOVERED OUTSIDE THE ESTABLISHED PROCESS, APPROPRIATE REVIEW AND ACTION WOULD BE TAKEN. THIS PROCESS WAS LAST COMPLETED IN DEC. 2021, WHEN THE QUESTIONNAIRES WERE SENT TO ADDRESS ANY 2021 CONFLICTS IDENTIFIED. MHC AND MAC HAVE THE SAME BOARD, AND THEREFORE THE MHC QUESTIONNAIRE IS USED TO ALSO ADDRESS POTENTIAL AND ACTUAL CONFLICTS FOR THE FILING ORGANIZATION. THE MHC CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
Form 990, Part VI, Line 19 Required documents available to the publicNO DOCUMENTS AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS
1000 MINERAL POINT AVEJANESVILLEWI53548390912682HEALTHCAREWI501(c)(3)Type III-FIMERCY HEALTH SYSTEM CORPORATIONfalse
MERCY HEALTH SYSTEM CORPORATION
1000 MINERAL POINT AVEJANESVILLEWI53548390816848HEALTHCAREWI501(c)(3)3MERCY HEALTH CORPORATIONfalse
MERCY HARVARD HOSPITAL INC
901 GRANT STREETHARVARDIL60033311551871HEALTHCAREIL501(c)(3)3MERCY HEALTH CORPORATIONfalse
MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER
200 LAKE AVEWOODSTOCKIL60098201673011HEALTHCAREIL501(c)(3)3MERCY HEALTH CORPORATIONfalse
MERCY HEALTH CORPORATION
8201 E Riverside BlvdROCKFORDIL61114472158680HEALTHCAREIL501(c)(3)Type INAfalse
JAVON BEA HOSPITAL
8201 E Riverside BlvdRockfordIL61114362167847HEALTHCAREIL501(c)(3)3MERCY HEALTH CORPORATIONfalse
MERCYHEALTH DEVELOPMENT FOUNDATION
8201 E Riverside BlvdROCKFORDIL61114363197918HEALTHCAREIL501(c)(3)Type IMERCY HEALTH CORPORATIONfalse
MERCYHEALTH VISITING NURSES ASSOCIATION
4223 E STATE STREETROCKFORDIL61108362167945HEALTHCAREIL501(c)(3)10MERCY HEALTH CORPORATIONfalse
ROCKFORD HEALTH PHYSICIANS
8201 E Riverside BlvdROCKFORDIL61114363907436HEALTHCAREIL501(c)(3)3MERCY HEALTH CORPORATIONfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
JANESVILLE MEDICAL CENTER INC
1000 MINERAL POINTJANESVILLEWI53548391520130MANAGEMENT OF UNION EMPLOYEESWINAC Corporationfalse
MERCYCARE INSURANCE COMPANY
580 N WASHINGTON STJANESVILLEWI53546391768192INSURANCEWINAC Corporationfalse
MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO
580 N WASHINGTON STJANESVILLEWI53546201482553INSURANCEWINAC Corporationfalse
ROCKFORD HEALTH INSURANCE LTD
INSURANCENAC CorporationfalseBD
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd