2024-07-30T12:13:32-05:00 2023-09-30 381357951 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2022-10-01 391083015 PROHEALTH MEDICAL GROUP INC PROH 2629284740 N17 W24100 RIVERWOOD DRIVE 130 WAUKESHA WI 53188 ANDREW GUTIERREZ CHIEF FINANCIAL OFFICER 2629284740 2024-07-26 1 1 DAVID LOWENTHAL P00378651 2483522500 2024-06-28 2022 2024-08-08 14:25:15Z SUSAN EDWARDS N17 W24100 RIVERWOOD DRIVE 130 WAUKESHA WI 53188 193099761 0 X WWW.PROHEALTHCARE.ORG X 1965 WI SERVE THE HEALTH CARE AND HUMAN SERVICE NEEDS OF PERSONS RESIDING IN SOUTHEAST WISCONSIN AND SURROUNDING AREAS. 3 2 1256 2 171027 30358 599730 64330 184882835 191124337 118701 89405 613254 482235 186214520 191760307 0 25000 0 0 140246758 141882023 0 0 0 62948304 72993941 203195062 214900964 -16980542 -23140657 153810375 165400015 64355243 64215540 89455132 101184475 CONTINOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. 0 0 199900224 25000 190953310 PHMG OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHMG FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHMG PROVIDED 550,083 VISITS (CLINIC, URGENT CARE, AND VIRTUAL VISITS) AS WELL AS 18,091 IMAGING PROCEDURES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. 199900224 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 72 0 1 1256 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANDREW GUTIERREZ 2629282453 N17 W24100 RIVERWOOD DRIVE SUITE WAUKESHA WI 53188 X SUSAN EDWARDS PRESIDENT AND CEO - PHC 2.00 50.00 X X 0 2193635 681826 GARY BEYER CHAIRPERSON 2.00 8.00 X X 0 0 0 JOHN HALLETT VICE CHAIRPERSON 2.00 8.00 X X 0 0 0 ANDREW GUTIERREZ CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 515387 142213 KENNETH PRICE CHIEF OPERATING OFFICER 2.00 48.00 X 0 886988 311188 ARTHUR COFFEY PHYSICIAN/ CHIEF PHYS OPS OFFICER 25.00 25.00 X 998305 0 49395 CHRISTOPHER BURNETT PHYSICIAN 50.00 0.00 X 1154929 0 54908 THOMAS WOZNIAK PHYSICIAN/ VP SPECIALTY CA 50.00 0.00 X 941980 0 68013 MATTHEW WEINBERG PHYSICIAN 50.00 0.00 X 970709 0 55849 FIRAS GHANEM PHYSICIAN 50.00 0.00 X 917829 0 7292 4983752 3596010 1370684 301 0 1 0 JP CULLEN & SONS INC PO BOX 5957 JANESVILLE WI 53547 CONSTRUCTION SERVICE 9486889 GOODMAN CAMPBELL BRAIN & SP 13345 ILLINOIS STREET CARMEL IN 46032 PROFESSIONAL SERVICES 2824987 RILEY CONSTRUCTION CO LLC 5301-99TH AVENUE KENOSHA WI 53144 CONSTRUCTION SERVICE 1958326 GCBS MANAGEMENT CO LLC 13345 ILLINOIS STREET CARMEL IN 46032 PROFESSIONAL SERVICES 1829000 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 PROFESSIONAL SERVICES 1518006 19 64330 64330 PATIENT SERVICES 621400 179962669 179791642 171027 PHS DISTRIBUTION REVENUE 621110 5136990 5136990 PHYSICIAN SUBSIDIES 621110 3840428 3840428 RENTAL REV-AFFILIATES 532000 1370488 1370488 CMS QPP 900099 540718 540718 273044 273044 191124337 91200 91200 1817449 1335214 482235 482235 482235 2445 4240 -1795 -1795 -1795 191760307 190953310 171027 571640 25000 25000 118404545 116387175 2017370 3532650 3532650 13554590 13554146 444 6390238 6287136 103102 18389717 18004738 384979 649932 493237 156695 7878465 7860263 18202 45728 43987 1741 598819 588743 10076 2048226 2048226 17141449 4988162 12153287 8003544 7995713 7831 523364 523364 DRUGS 6397027 6397027 BAD DEBT 4318743 4318743 MEDICAL SUPPLIES 2289468 2289468 UBI TAXES 48285 48285 4661174 4562446 98728 214900964 199900224 15000740 0 3323270 4402831 13861165 13390230 1092397 1042630 145120196 39348388 95921930 105771808 8541937 8479698 31069676 32312818 153810375 165400015 26051443 26587398 55532 38386 38248268 37589756 64355243 64215540 X 89455132 101184475 89455132 101184475 153810375 165400015 X -23140657 34870000 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4917624 4917624 96871857 18690854 78181003 21231842 8896218 12335624 18735698 10592651 8143047 3363175 1168665 2194510 105771808 DEFERRED COMPENSATION/VALUATION 19140071 OTHER ASSETS 1136844 DUE FROM AFFILIATES 9451000 ROU LEASE ASSET - OPERATING LEASE 2584903 32312818 DEFERRED COMPENSATION 19140071 LEASE PAYABLE 17689235 OTHER LIABILITIES 760450 37589756 1 UNITED WAY OF GREATER MILWAUKEE AND WAUKESHA PO BOX 88110 MILWAUKEE WI 53288 390806190 501(C)3 25000 0 N/A N/A TO AID THE ORGANIZATION IN ITS CHARITABLE MISSION. 1 0 PART I, LINE 2: UNITED WAY WAS CHOSEN TO BE THE RECIPIENT OF A ONE-TIME DONATION OF $25,000 BY MEMBERS OF THE SENIOR EXECUTIVE TEAM. THE UNITED WAY IS A LONG-STANDING AND STRONG PARTNER OF PROHEALTH CARE AND HAS A DIVERSE PORTFOLIO OF PROGRAM PARTNERS. WHEN OUR DONATION WAS COMBINED WITH THOSE FROM THOUSANDS OF OTHER DONORS, WE WERE ABLE TO ASSIST IN FUNDING OVER 220 PROGRAMS IN OUR COMMUNITY THAT HAVE A DIRECT IMPACT ON THE HEALTH, EDUCATION AND FINANCIAL STABILITY OF OUR COMMUNITY AND NEIGHBORHOODS. 0 1 0 0 0 0 0 1 0 SUSAN EDWARDS PRESIDENT AND CEO - PHC 0 1184879 0 731247 0 277509 0 644097 0 37729 0 2875461 0 277509 CHRISTOPHER BURNETT PHYSICIAN 861660 0 293269 0 0 0 10250 0 44658 0 1209837 0 0 0 KENNETH PRICE CHIEF OPERATING OFFICER 0 498039 0 280082 0 108867 0 257829 0 53359 0 1198176 0 108867 ARTHUR COFFEY PHYSICIAN/ CHIEF PHYS OPS OFFICER 912163 0 86142 0 0 0 0 0 49395 0 1047700 0 0 0 MATTHEW WEINBERG PHYSICIAN 846346 0 124363 0 0 0 10250 0 45599 0 1026558 0 0 0 THOMAS WOZNIAK PHYSICIAN/ VP SPECIALTY CA 895104 0 46876 0 0 0 13500 0 54513 0 1009993 0 0 0 FIRAS GHANEM PHYSICIAN 764334 0 153495 0 0 0 2803 0 4489 0 925121 0 0 0 ANDREW GUTIERREZ CHIEF FINANCIAL OFFICER 0 342349 0 173038 0 0 0 96614 0 45599 0 657600 0 0 PART I, LINE 3 THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT PART I, LINE 4B PROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THIS SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. SERP PAYMENTS DURING THE YEAR ARE AS FOLLOWS: KENNETH PRICE: $108,867 SUSAN EDWARDS: $277,509 PART I, LINE 7 PROHEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY. FORM 990, PART VI, SECTION A, LINE 6 PROHEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE GOVERNING DOCUMENTS, THE BOARD OF THE FILING ORGANIZATION IS THE SAME AS THE BOARD OF THE SOLE CORPORATE MEMBER, PROHEALTH CARE, INC. FORM 990, PART VI, SECTION A, LINE 7B PROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS. FORM 990, PART VI, SECTION B, LINE 11B AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, WHO THEN FORMALLY APPROVED THE FORM 990, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO, SENIOR EXECUTIVE TEAM MEMBERS, AND VICE-PRESIDENTS. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2023. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII ARTHUR COFFEY IS EMPLOYED BY PROHEALTH MEDICAL GROUP, INC. AS A PHYSICIAN. HE ALSO DEVOTES TIME TO PROHEALTH CARE INC, THE SOLE CORPORATE MEMBER, AS THE CHIEF PHYSICIAN OPERATIONS OFFICER. WHILE COFFEY SPLITS HIS TIME BETWEEN THE TWO POSITIONS, ALL COMPENSATION IS HANDLED BY PROHEALTH MEDICAL GROUP INC. THOMAS WOZNIAK IS EMPLOYED BY PROHEALTH MEDICAL GROUP, INC. AS A PHYSICIAN. HE ALSO DEVOTES TIME AS THE VP SPECIALTY CARE. THE SPLIT IN TIME AND COMPENSATION BETWEEN THE TWO POSITIONS IS 0.75 PHYSICIAN, 0.25 VP SPECIALTY CARE. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATES 34,870,000. FORM 990, PART XII, LINE 2C THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC 791 SUMMIT AVENUE OCONOMOWOC WI 53066 390794174 HOSPITAL WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 PROHEALTH HOME CARE INC N17 W24100 RIVERWOOD DR SUITE 130 WAUKESHA WI 53188 200067392 HEALTHCARE WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 NATIONAL REGENCY OF NEW BERLIN INC N17 W24100 RIVERWOOD DR SUITE 130 WAUKESHA WI 53188 391077992 HEALTHCARE WI 501(C)(3) LINE 10 PROHEALTH CARE INC 1 PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC 725 AMERICAN AVENUE WAUKESHA WI 53188 390910727 HOSPITAL WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 PROHEALTH CARE FOUNDATION INC 725 AMERICAN AVENUE WAUKESHA WI 53188 391314542 CHARITABLE SUPPORT WI 501(C)(3) LINE 7 PROHEALTH CARE INC 1 PROHEALTH CARE INC N17 W24100 RIVERWOOD DR SUITE 130 WAUKESHA WI 53188 391486873 MANAGEMENT WI 501(C)(3) LINE 12B, II N/A 0 PROHEALTH ALIGNED LLC (DBA PROHEALTH CARE MORELAND SURGERY CENTER) 1111 DELAFIELD STREET STE 1 WAUKESHA WI 53188 263324572 SURGERY CENTER WI N/A 0 0 REHABILITATION HOSPITAL OF WISCONSIN LLC 1625 COLDWATER CREEK DRIVE WAUKESHA WI 53188 262332250 INPATIENT REHABILITATION WI N/A 0 0 THE ORTHOPEDIC SURGERY CENTER LLC W238 N1610 BUSSE ROAD WAUKESHA WI 53188 208356016 ORTHOPEDIC SURGICAL SERVICES WI N/A 0 0 PROHEALTH SOLUTIONS LLC N17 W24100 RIVERWOOD DR STE 130 WAUKESHA WI 53188 273863494 ACCOUNTABLE CARE ORGANIZATION WI N/A 0 0 LAKE COUNTRY ENDOSCOPY CENTER 1185 CORPORATE CENTER DR OCONOMOWOC WI 53066 261572986 ENDOSCOPY SERVICES WI N/A 0 0 WAUKESHA IMAGING LLC N17 W24100 RIVERWOOD DR STE 130 WAUKESHA WI 53188 392036860 RADIOLOGY SERVICES WI N/A 0 0 PHCOAW CO-MANAGEMENT COMPANY LLC N17 W24100 RIVERWOOD DR STE 130 WAUKESHA WI 53188 811823911 MANAGEMENT SERVICES WI N/A 0 0 GI SPECIALISTS LLC (DBA MORELAND ENDOSCOPY CENTER) 1111 DELAFIELD STREET STE 1 WAUKESHA WI 53188 205269133 ENDOSCOPY SERVICES WI N/A 0 0 SOUTHERN LAKES ENDOSCOPY CENTER 240 MAPLE AVENUE MUKWONAGO WI 53149 824245460 ENDOSCOPY SERVICES WI N/A 0 0 WAUKESHA HEALTH SYSTEM INC N17 W24100 RIVERWOOD DRIVE STE 130 WAUKESHA WI 53188 391507910 HEALTHCARE WI N/A C 0 EMPATHIA PACIFIC INC 31416 AGOURA RD STE 180 WESTLAKE VILLAGE CA 91361 953070501 HEALTHCARE CA N/A C 0 NATIONAL AVENUE DEVELOPMENT CORPORATION N17 W24100 RIVERWOOD DRIVE STE 130 WAUKESHA WI 53188 391417226 HEALTHCARE WI N/A C 0 EMPATHIA INC N17 W24100 RIVERWOOD DRIVE STE 130 WAUKESHA WI 53188 391567366 HEALTHCARE WI N/A C 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 PROHEALTH CARE INC S 34870000 ACTUAL AMOUNT RECEIVED PROHEALTH CARE INC M 17141449 ACTUAL COST INCURRED PROHEALTH SOLUTIONS LLC L 5136990 ACTUAL AMOUNT RECEIVED PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC P 3680306 ACTUAL COST INCURRED PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC Q 3528914 ACTUAL AMOUNT RECEIVED PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC K 2864462 ACTUAL COST INCURRED PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC M 2794417 ACTUAL COST INCURRED PROHEALTH SOLUTIONS LLC M 714154 ACTUAL COST INCURRED PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC A 712324 ACTUAL AMOUNT RECEIVED PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC A 581546 ACTUAL AMOUNT RECEIVED NATIONAL REGENCY OF NEW BERLIN INC K 440425 ACTUAL COST INCURRED PROHEALTH HOME CARE INC Q 278809 ACTUAL AMOUNT RECEIVED WAUKESHA HEALTH SYSTEM INC K 243369 ACTUAL COST INCURRED LAKE COUNTRY ENDOSCOPY CENTER A 238762 ACTUAL AMOUNT RECEIVED PROHEALTH CARE INC P 198264 ACTUAL COST INCURRED WAUKESHA HEALTH SYSTEM INC A 76618 ACTUAL AMOUNT RECEIVED WAUKESHA HEALTH SYSTEM INC Q 66000 ACTUAL AMOUNT RECEIVED PROHEALTH CARE FOUNDATION INC C 64330 ACTUAL AMOUNT RECEIVED