ROCKFORD HEALTH PHYSICIANS: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ROCKFORD HEALTH PHYSICIANS (EIN 36-3907436)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202331359349310788
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-15T13:49:59-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MIDLAND COURT PO BOX 8130 | AddressLine1Txt |
| City | JANESVILLE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535478130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363907436 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROCKFORD HEALTH PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ROCK | BusinessNameControlTxt |
| Phone | 8159715000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N ROCKTON AVE | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAVON BEA | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 8159715000 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAVON | PersonFirstNm |
| Person Last | BEA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TROY MARINE CPA | PreparerPersonNm |
| PTIN | P00187863 | PTIN |
| Phone | 6087525835 | PhoneNum |
| Preparation | 2023-05-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCYHEALTH PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAVON BEA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N ROCKTON AVE | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $132,700,780 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE AND PROTECT THE HEALTH AND WELFARE OF THE COMMUNITY, WE HAVE 260 PROVIDERS IN 65 SPECIALTIES. OUR PHYSICIANS ALSO PROVIDE STAFF FOR JAVON BEA HOSPITAL PATIENTS' NEEDS. (IE LEVEL I TRAUMA CENTER, BRAIN & SPINE CENTER, LEVEL III REGIONAL PERINATAL CENTER & NEONATAL ICU). | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1006 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,803,895 | PYContributionsGrantsAmt |
| CY Contributions Grants | $234,036 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $97,556,158 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $90,630,605 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$132,640 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,902 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,858,668 | PYOtherRevenueAmt |
| CY Other Revenue | $41,820,214 | CYOtherRevenueAmt |
| PY Total Revenue | $154,086,081 | PYTotalRevenueAmt |
| CY Total Revenue | $132,686,757 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $126,167,905 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $117,531,547 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $48,344,255 | PYOtherExpensesAmt |
| CY Other Expenses | $40,992,749 | CYOtherExpensesAmt |
| PY Total Expenses | $174,514,160 | PYTotalExpensesAmt |
| CY Total Expenses | $158,524,296 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$20,428,079 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$25,837,539 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $129,644,299 | TotalAssetsBOYAmt |
| Total Assets EOY | $119,382,238 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $67,282,223 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $62,748,157 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $62,362,076 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $56,634,081 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE AND PROTECT THE HEALTH AND WELFARE OF THE COMMUNITY IN ACCORDANCE WITH OUR MISSION, THE MISSION OF JAVON BEA HOSPITAL IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER". WITH A VISION OF QUALITY- EXCELLENCE IN PATIENT CARE, SERVICE - EXCEPTIONAL PATIENT AND CUSTOMER CARE, PARTNERING- BEST PLACE TO WORK AND COST - COST-EFFECTIVE CARE AND A COMMITMENT TO THE VALUES OF: HEALING IN THE BROADEST SENSE, PATIENTS COME FIRST, TREAT EACH OTHER LIKE FAMILY AND ALWAYS SEEK EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $127,963,509 | ExpenseAmt |
| Revenue | $71,362,262 | RevenueAmt |
| Desc | ROCKFORD HEALTH PHYSICIANS (RHPH) IS A MULTI-SPECIALTY PHYSICIAN GROUP OF 260 PHYSICIANS THAT HAS 14 SATELLITE AMBULATORY OFFICES AS WELL AS 2 CONVENIENT CARE LOCATIONS THAT PROVIDE FOR NON-LIFE THREATENING EMERGENCIES AFTER REGULAR OFFICE HOURS. OUR PATIENTS HAVE ACCESS TO BOARD CERTIFIED PRIMARY CARE PHYSICIANS WHO COORDINATE CARE WITHIN OUR PATIENT CENTERED MEDICAL HOME WITH BOARD CERTIFIED SPECIALTY PHYSICIANS. RHPH ALSO OFFERS A COMPREHENSIVE, PATIENT CENTERED, COLLEGE OF SURGEON'S ACCREDITED CANCER TREATMENT CENTER WHICH INCLUDES RADIATION ONCOLOGY, AND IMAGE GUIDED TREATMENTS UTILIZING STATE OF THE ART LINEAR ACCELERATOR TECHNOLOGY. THE WOMEN'S CENTER AT RHPH PROVIDES DIGITAL MAMMOGRAPHY, BREAST ULTRASOUND, STEREOTACTIC BIOPSY, OSTEOPOROSIS TESTING AND UROGYNECOLOGY SERVICES THROUGH OUR FELLOWSHIP TRAINED PHYSICIANS AND NURSE PRACTITIONERS. IN ADDITION, OUR POST ACUTE CARE TEAM PROVIDES SHORT AND LONG TERM CARE TO MORE THAN 125 PATIENTS EACH MONTH IN 2 FACILITIES ACROSS NORTHERN ILLINOIS. INPATIENT SERVICES PROVIDED AT JAVON BEA HOSPITAL INCLUDE A LEVEL I TRAUMA CENTER, ADULT INTENSIVE CARE UNITS, A DESIGNATED CHILDREN'S MEDICAL CENTER, AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, ACROSS TWO HOSPITAL CAMPUSES. PHYSICIANS ARE AVAILABLE ON CALL 24-7. THERE WERE 325,870 OFFICE VISITS IN FY2022. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $16,088,056 | ExpenseAmt |
| Revenue | $18,896,105 | RevenueAmt |
| Desc | ANCILLARY MEDICAL SERVICES WERE PERFORMED TO ALLOW PHYSICIANS TO PROVIDE THE PROPER CARE TO ACHIEVE THE BEST OUTCOME FOR EACH PATIENT. THERE WERE 539,893 ANCILLARY TESTS AND PROCEDURES PERFORMED DURING FY2022. RHPH PROVIDED THESE SERVICES IN CLINICAL AREAS SUCH AS LABORATORY AND RADIOLOGY INCLUDING CT SCANS AND MAMMOGRAPHY. OTHER SUPPORT SERVICES INCLUDED CARDIAC TESTING, GENETIC SERVICES, PULMONARY FUNCTION TESTING, BONE SCANS, PAIN MANAGEMENT, AND PHYSICAL THERAPY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $308,870 | ExpenseAmt |
| Revenue | $403,184 | RevenueAmt |
| Desc | RHPH PARTICIPATES IN A MEDICARE PHYSICIAN QUALITY REPORT INCENTIVE PROGRAM TO MEASURE DATA FOR QUALITY EVALUATION. RHPH IS COMMITTED TO PROVIDING SERVICES FOR MATERNAL AND CHILD CARE THROUGH ILLINOIS HEALTH CONNECT, A MEANS-TESTED PROGRAM THAT HELPS KIDS AND FAMILIES GET HEALTH CARE AND STAY HEALTHY BY CHOOSING A MEDICAL HOME. RHPH PARTNERS WITH NEIGHBORING SCHOOLS TO PROVIDE FREE PHYSICALS AND COMMUNITY ORGANIZATIONS TO PROVIDE FREE SCREENINGS. STAFF AND PHYSICIANS PARTICIPATED IN VARIOUS HEALTH FAIRS AND HOSTED EDUCATIONAL FORUMS IN THE COMMUNITIES TO BRING RESIDENTS AN AWARENESS OF HEALTH/WELLNESS RELATED TOPICS- HEART DISEASE AND PREVENTION, HEALTHY EATING, CHILDREN'S HEALTH CONCERNS, AND AGING ISSUES. RHPH ALSO PARTNERS WITH A LOCAL CHURCH IN THE BRIDGE CLINIC TO SERVE UNINSURED AND/OR HOMELESS PEOPLE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $144,360,435 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1006 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TODD ANDERSON VP & CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8159716738 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N ROCKTON AVE | AddressLine1Txt |
| City | ROCKFORD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JAVON R BEA | |||||||||
| PRESIDENT & CEO (SEE PAGES 32-35) | 1.00 | 66.00 | Yes (X) | Yes (X) | $0 | $11,908,792 | $619,061 | ||
| MARK L GOELZER MD | |||||||||
| DIRECTOR/PHYSICIAN | 1.00 | 45.00 | Yes (X) | $0 | $444,609 | $28,511 | |||
| ROWLAND J MCCLELLAN | |||||||||
| CHAIR & DIRECTOR | 1.00 | 6.00 | Yes (X) | Yes (X) | $0 | $14,276 | $0 | ||
| THOMAS R POOL | |||||||||
| VICE CHAIR | 1.00 | 6.00 | Yes (X) | Yes (X) | $0 | $13,500 | $0 | ||
| THOMAS D BUDD | |||||||||
| SECRETARY & TREASURER | 1.00 | 6.00 | Yes (X) | Yes (X) | $0 | $13,691 | $0 | ||
| DAVE L SYVERSON | |||||||||
| DIRECTOR | 1.00 | 6.00 | Yes (X) | $0 | $15,306 | $0 | |||
| KATHERINE A SCHACK | |||||||||
| DIRECTOR | 1.00 | 6.00 | Yes (X) | $0 | $13,500 | $0 | |||
| WESLEY M JOST | |||||||||
| DIRECTOR | 1.00 | 6.00 | Yes (X) | $0 | $13,693 | $0 | |||
| TODD ANDERSON | |||||||||
| VICE PRESIDENT/CFO | 1.00 | 56.00 | Yes (X) | $0 | $767,925 | $45,782 | |||
| KIMBERLY SCACCIA | |||||||||
| VP - REVENUE CYCLE | 1.00 | 40.00 | Yes (X) | $0 | $432,755 | $52,988 | |||
| MICHAL ZLOWODZKI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,084,105 | $0 | $117,307 | Yes (X) | |||
| BHARATI ROY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,111,976 | $0 | $73,284 | Yes (X) | |||
| VIBHAV K BANSAL | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,107,155 | $0 | $71,934 | Yes (X) | |||
| SHADI OBEIDAT | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,012,842 | $0 | $96,802 | Yes (X) | |||
| ABDULLAH ALTAYEH | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,058,068 | $0 | $42,749 | Yes (X) | |||
| SHANNON DUNPHY-ALEXANDER | |||||||||
| SR EXECUTIVE DIRECTOR | 1.00 | 56.00 | $0 | $319,804 | $16,364 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,374,146 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $13,957,851 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,164,782 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 252 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTHCHG COMPANIES INC | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | HEALTHCARE SERVICES | $6,113,658 |
| HAYES HEALTHCARE | |||||
| 6700 N ANDREWS AVE SUITE 600 | FT LAUDERDALE | FL | 33309 | HEALTHCARE SERVICES | $3,445,931 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | HEALTHCARE SERVICES | $1,442,045 |
| UW MEDICAL FOUNDATION | |||||
| FINANCE DEPT PO BOX 620993 | MIDDLETON | WI | 535620993 | HEALTHCARE SERVICES | $774,774 |
| VIRTUAL RADIOLOGIC PROF OF IL | |||||
| 11995 SINGLETREE LANE SUITE 500 | EDEN PRARIE | MN | 55344 | HEALTHCARE SERVICES | $585,702 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $14,546 | RelatedOrganizationsAmt |
| Government Grants | $219,490 | GovernmentGrantsAmt |
| Total Contributions | $234,036 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PHYSICIAN MEDICAL SERVICES | 621110 | $39,492,893 | $39,492,893 |
| MEDICARE/MEDICAID PAYMENTS | 621110 | $31,869,369 | $31,869,369 |
| ANCILLARY MEDICAL SERVICES | 621400 | $17,017,987 | $17,017,987 |
| HEALTH CONNECT/PQRI/MCH | 621400 | $372,238 | $372,238 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,878,118 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,878,118 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $90,630,605 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $122,854 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,925 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $109,929 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,929 | TotalRevenueColumnAmt |
| Exclusion | $109,929 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,098 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,902 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,902 | TotalRevenueColumnAmt |
| Exclusion | $1,902 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| HOSPITAL BASED PHYSICIANS | 900099 | $41,679,339 | $41,679,339 | |
| MANAGED CARE INCENTIVE | 900099 | $30,946 | $30,946 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $41,710,285 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,686,757 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $90,661,551 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $41,791,170 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,657,269 | TotalAmt |
| Program Services | $97,908,504 | ProgramServicesAmt |
| Management And General | $4,748,765 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,255,180 | TotalAmt |
| Program Services | $2,150,859 | ProgramServicesAmt |
| Management And General | $104,321 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,649,845 | TotalAmt |
| Program Services | $7,295,975 | ProgramServicesAmt |
| Management And General | $353,870 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,969,253 | TotalAmt |
| Program Services | $4,584,468 | ProgramServicesAmt |
| Management And General | $384,785 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,541 | TotalAmt |
| Program Services | $805 | ProgramServicesAmt |
| Management And General | $459,736 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,227 | TotalAmt |
| Management And General | $80,227 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $892,252 | TotalAmt |
| Program Services | $336,964 | ProgramServicesAmt |
| Management And General | $555,288 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,402 | TotalAmt |
| Program Services | $110,402 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,296,926 | TotalAmt |
| Program Services | $211,300 | ProgramServicesAmt |
| Management And General | $1,085,626 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,675 | TotalAmt |
| Program Services | $94,342 | ProgramServicesAmt |
| Management And General | $24,333 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $743,292 | TotalAmt |
| Program Services | $232,396 | ProgramServicesAmt |
| Management And General | $510,896 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,596,157 | TotalAmt |
| Management And General | $5,596,157 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,778,810 | TotalAmt |
| Program Services | $3,778,810 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| HEALTHCARE SERVICES | $14,142,792 | $13,993,769 | $149,023 |
| DRUGS & MEDICAL SUPPLIE | $5,932,809 | $5,912,728 | $20,081 |
| BAD DEBT EXPENSE | $5,240,990 | $5,240,990 | |
| OTHER PURCHASED SERVICE | $2,503,623 | $2,503,623 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,253 | TotalAmt |
| Program Services | $4,500 | ProgramServicesAmt |
| Management And General | $90,753 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,524,296 | TotalAmt |
| Program Services | $144,360,435 | ProgramServicesAmt |
| Management And General | $14,163,861 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,936 | BOYAmt |
| EOY | $230,752 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,507,245 | BOYAmt |
| EOY | $8,960,796 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,111 | BOYAmt |
| EOY | $572,504 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,029 | BOYAmt |
| EOY | $85,364 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $171,576,637 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $82,860,103 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,870,760 | BOYAmt |
| EOY | $88,716,534 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,160,218 | BOYAmt |
| EOY | $20,816,288 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,644,299 | BOYAmt |
| EOY | $119,382,238 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,988,033 | BOYAmt |
| EOY | $43,677,363 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $142,990 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,294,190 | BOYAmt |
| EOY | $18,927,804 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,282,223 | BOYAmt |
| EOY | $62,748,157 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,364,076 | BOYAmt |
| EOY | $56,634,081 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,362,076 | BOYAmt |
| EOY | $56,634,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,644,299 | BOYAmt |
| EOY | $119,382,238 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$25,837,539 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $2,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $20,107,544 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,196,715 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$272,954 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $27,446 | OtherExpendituresAmt |
| Administrative Expenses | $331 | AdministrativeExpensesAmt |
| End Year Balance | $2,895,984 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,648,416 | BeginningYearBalanceAmt |
| Contributions | $200 | ContributionsAmt |
| Investment Earnings Or Losses | $588,122 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $39,727 | OtherExpendituresAmt |
| Administrative Expenses | $295 | AdministrativeExpensesAmt |
| End Year Balance | $3,196,715 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,413,097 | BeginningYearBalanceAmt |
| Contributions | $37,162 | ContributionsAmt |
| Investment Earnings Or Losses | $204,132 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,588 | OtherExpendituresAmt |
| Administrative Expenses | $387 | AdministrativeExpensesAmt |
| End Year Balance | $2,648,416 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,378,983 | BeginningYearBalanceAmt |
| Contributions | $3,382 | ContributionsAmt |
| Investment Earnings Or Losses | $196,133 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $162,555 | OtherExpendituresAmt |
| Administrative Expenses | $2,846 | AdministrativeExpensesAmt |
| End Year Balance | $2,413,097 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,264,534 | BeginningYearBalanceAmt |
| Contributions | $2,045 | ContributionsAmt |
| Investment Earnings Or Losses | $225,842 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $107,530 | OtherExpendituresAmt |
| Administrative Expenses | $5,908 | AdministrativeExpensesAmt |
| End Year Balance | $2,378,983 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.16870 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.34640 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.48490 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,389,430 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $8,136,142 | OtherCostOrOtherBasisAmt |
| Book Value | $9,525,572 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,179,574 | OtherCostOrOtherBasisAmt |
| Depreciation | $64,607,040 | DepreciationAmt |
| Book Value | $74,572,534 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,860,238 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,253,063 | DepreciationAmt |
| Book Value | $4,607,175 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,253 | OtherCostOrOtherBasisAmt |
| Book Value | $11,253 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $88,716,534 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED COMPENSATION | $18,023,788 |
| DUE FROM RELATED PARTIES | $866,318 |
| OTHER RECEIVABLES | $1,259,736 |
| LEASE RIGHT OF USE | $666,446 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $20,816,288 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $18,416,378 |
| ASSET RETIREMENT OBLIGATION | $150,000 |
| CAPITAL ACCUMULATION LIABILITY | $22,921 |
| LEASE LIABILITY | $308,280 |
| DUE TO MERCY HEALTH SYSTEM CORPORATION | $30,225 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $18,927,804 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | FUNDS WERE USED TO PROVIDE A LECTURE SERIES, FOR CONTINUING EDUCATION FOR EMPLOYEES WANTING TO IMPROVE THEIR CREDENTIALS OR TO FOCUS ON A NEW SKILL OR SOME TECHNOLOGY NOT CURRENTLY AVAILABLE IN THE ROCKFORD COMMUNITY. THERE WERE ALSO MISCELLANEOUS PROJECTS DESIGNATED BY THE FOUNDATION BOARD IN ACCORDANCE WITH THE SPECIFIC ENDOWMENT. ALL FUNDS WERE EXPENDED PER THE SPECIFIC DIRECTION OF EACH ENDOWMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAVON R BEA | ||||||||||||||
| PRESIDENT & CEO (SEE PAGES 32-35) | $0 | $1,570,273 | $0 | $1,475,763 | $0 | $8,862,756 | $0 | $602,150 | $0 | $16,911 | $0 | $12,527,853 | $0 | $5,837,133 |
| MICHAL ZLOWODZKI | ||||||||||||||
| PHYSICIAN | $1,042,935 | $0 | $40,150 | $0 | $1,020 | $0 | $72,610 | $0 | $44,697 | $0 | $1,201,412 | $0 | $0 | $0 |
| BHARATI ROY | ||||||||||||||
| PHYSICIAN | $819,756 | $0 | $290,192 | $0 | $2,028 | $0 | $59,662 | $0 | $13,622 | $0 | $1,185,260 | $0 | $0 | $0 |
| VIBHAV K BANSAL | ||||||||||||||
| PHYSICIAN | $1,056,449 | $0 | $39,500 | $0 | $11,206 | $0 | $50,269 | $0 | $21,665 | $0 | $1,179,089 | $0 | $0 | $0 |
| SHADI OBEIDAT | ||||||||||||||
| PHYSICIAN | $775,552 | $0 | $236,450 | $0 | $840 | $0 | $70,714 | $0 | $26,088 | $0 | $1,109,644 | $0 | $0 | $0 |
| ABDULLAH ALTAYEH | ||||||||||||||
| PHYSICIAN | $782,847 | $0 | $273,913 | $0 | $1,308 | $0 | $31,100 | $0 | $11,649 | $0 | $1,100,817 | $0 | $0 | $0 |
| TODD ANDERSON | ||||||||||||||
| VICE PRESIDENT/CFO | $0 | $545,321 | $0 | $211,257 | $0 | $11,347 | $0 | $11,600 | $0 | $34,182 | $0 | $813,707 | $0 | $0 |
| KIMBERLY SCACCIA | ||||||||||||||
| VP - REVENUE CYCLE | $0 | $310,535 | $0 | $120,856 | $0 | $1,364 | $0 | $11,600 | $0 | $41,388 | $0 | $485,743 | $0 | $0 |
| MARK L GOELZER MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $0 | $324,023 | $0 | $116,186 | $0 | $4,400 | $0 | $11,600 | $0 | $16,911 | $0 | $473,120 | $0 | $0 |
| SHANNON DUNPHY-ALEXANDER | ||||||||||||||
| SR EXECUTIVE DIRECTOR | $0 | $244,896 | $0 | $74,682 | $0 | $226 | $0 | $11,600 | $0 | $4,764 | $0 | $336,168 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO IS PAID FROM A RELATED ORGANIZATION, MERCY HEALTH SYSTEM CORPORATION (MHSC). MHSC USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATION, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE MERCY COMPENSATION COMMITTEE OF MHSC IS COMPRISED OF THE BOARD CHAIRPERSON, VICE CHAIR AND SECRETARY/TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED 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 2021. |
| PART I, LINE 4B | INCENTIVE PLAN DISTRIBUTION: JAVON R. BEA - $5,837,133. |
| PART II, LINE 1: | JAVON 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 $3.4 BILLION IN FY2022. THIS HAS ALLOWED THE HEALTH SYSTEM TO GO FROM SERVING 89,000 PATIENTS IN 1989 TO OVER 1.9 MILLION PATIENTS TODAY WORKING TOGETHER WITH OVER 7,000+ 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 11 STRAIGHT YEARS. THE TURNAROUND OF 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 TWO 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE 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 THREE 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, SECTION A, LINE 6 | MERCY HEALTH CORPORATION (MHC) IS THE SOLE CORPORATE MEMBER OF ROCKFORD HEALTH PHYSICIANS (RHPH). THE SOLE MEMBER SHALL HAVE POWERS AND VOTING RIGHTS TO DO THE FOLLOWING: (A) APPOINT ALL THE DIRECTORS OF RHPH (B) NOMINATE TO RHPH'S BOARD OF DIRECTORS ALL CANDIDATES FOR SELECTION AS THE RHPH PRESIDENT (C) APPROVE EXPRESSLY ALL AMENDMENTS TO RHPH'S ARTICLES OF INCORPORATION AND BY-LAWS (D) APPROVE ANNUAL BUDGETS, AND STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS OF RHPH (E) APPROVE ALL CONTRACTS (INCLUDING CONTRACTS OF INDEBTEDNESS) EFFECTIVE FOR LONGER THAN EIGHTEEN MONTHS (F) APPROVE ALL PLANS OF MERGER OR CONSOLIDATION (G) APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF RHPH (H) APPROVE A VOLUNTARY DISSOLUTION OF RHPH (I) APPROVE MATERIAL AMENDMENTS TO RHPH'S STANDARD FORM OF PHYSICIAN EMPLOYMENT AGREEMENT (J) APPROVE MATERIAL AMENDMENTS TO THE STANDARD COMPENSATION SYSTEM USED BY RHPH TO ESTABLISH INDIVIDUAL PHYSICIAN COMPENSATION (K) REQUIRE RHPH TO TAKE ANY ACTION (INCLUDING AMENDING THE ARTICLES OF INCORPORATION OR BY-LAWS), 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 MEMBER'S OR RHPH'S FAILURE TO OBTAIN OR MAINTAIN ITS EXEMPTION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE NARRATIVE FOR PART VI, LINE 6. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE NARRATIVE FOR PART VI, LINE 6. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT REVIEWS THE FORM 990 BEFORE FILING AND IT IS AVAILABLE TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BY 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 2022, WHEN THE QUESTIONNAIRES WERE SENT TO ADDRESS ANY 2021 CONFLICTS IDENTIFIED. MHC AND RHPH 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, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | CHANGES IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -298,839. POST RETIREMENT MEDICAL BENEFIT ADJUSTMENT -4,020. NET TRANSFER FROM AFFILIATED ORGANIZATION 20,410,403. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JAVON BEA HOSPITAL | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 362167847 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | MERCY HEALTH CORPORATION | 0 | |
| MERCY ASSISTED CARE INC | |||||||||||
| 901 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 391035110 | HEALTHCARE | WI | 501(C)(3) | LINE 10 | MERCY HEALTH CORPORATION | 0 | |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | |||||||||||
| 200 LAKE AVE | WOODSTOCK | IL | 60098 | 201673011 | NONE | IL | 501(C)(3) | LINE 3 | MERCY HEALTH CORPORATION | 0 | |
| MERCY HARVARD HOSPITAL INC | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | MERCY HEALTH CORPORATION | 0 | |
| MERCY HEALTH CORPORATION | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 472158680 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 390912682 | SUPPORT OF HEALTHCARE | WI | 501(C)(3) | LINE 12C, III-FI | MERCY HEALTH SYSTEM CORPORATION | 0 | |
| MERCY HEALTH SYSTEM CORPORATION | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 390816848 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | MERCY HEALTH CORPORATION | 0 | |
| MERCYHEALTH DEVELOPMENT FOUNDATION | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 363197918 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 12A, I | MERCY HEALTH CORPORATION | 0 | |
| MERCYHEALTH VISITING NURSES ASSOCIATION | |||||||||||
| 4223 E STATE STREET | ROCKFORD | IL | 61108 | 362167945 | HEALTHCARE | IL | 501(C)(3) | LINE 10 | MERCY HEALTH CORPORATION | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROCKFORD HEALTH INSURANCE LTD | |||||||||||||
| WELLESLEY HOUSE SO 2ND FL | PEMBROKE HM | BD | INSURANCE | BD | N/A | C | 0 | ||||||
| JANESVILLE MEDICAL CENTER INC | |||||||||||||
| MANAGEMENT OF UNION EMPLOYEES | N/A | C | 0 | 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 391520130 | WI | ||||
| MERCYCARE INSURANCE COMPANY | |||||||||||||
| INSURANCE | N/A | C | 0 | 580 N WASHINGTON ST | JANESVILLE | WI | 53546 | 391768192 | WI | ||||
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | |||||||||||||
| INSURANCE | N/A | C | 0 | 580 N WASHINGTON ST | JANESVILLE | WI | 53546 | 201482553 | WI | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |