2020-08-14T16:44:25-05:00 2019-09-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2018-10-01 391079224 ST CAMILLUS HEALTH CENTER INC STCA 4142596333 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 JUSTIN MUNZEL CHIEF FINANCIAL OFFICER 4142598355 2020-08-14 1 CHLOE CHIUMINATTO P01924323 4144319300 2020-08-10 184.59.22.73 2020-08-14 12:46:03 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CC322FB1B7FC8ED290785ACCB7D2994D8745AEAD 2018 2020-09-23 17:36:50Z KEVIN SCHWAB 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 24177411 0 0928 X WWW.STCAM.COM X 1923 WI BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 15 15 0 50 0 0 2500 7436 21377799 24169975 -49 0 0 0 21380250 24177411 0 0 0 0 10927212 12157914 0 0 0 12530709 13565633 23457921 25723547 -2077671 -1546136 18814243 18570241 38198748 39849471 -19384505 -21279230 X BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 0 0 7747576 0 7830654 SKILLED NURSING FACILITIES - ST. CAMILLUS HEALTH CENTER PROVIDES IN-HOUSE NURSING SERVICES TO ITS RESIDENTS. 5388457 0 5082393 MEMORY CARE FACILITY - A 72-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS. 4922036 0 5494965 ASSISTED LIVING FACILITY - A 76-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS. 4064181 0 5761963 HOME HEALTH CARE AGENCY - ST. CAMILLUS HOME CARE AGENCY OFFERS NURSING SERVICES, PRIVATE DUTY AND HOSPICE SERVICES TO THE RESIDENTS OF THE INDEPENDENT LIVING FACILITY, ASSISTED LIVING FACILITY AND TO OTHER COMMUNITY RESIDENTS IN NEED. 4064181 0 5761963 22122250 1 0 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 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X JUSTIN MUNZEL 4142596333 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 BR MARIO CRIVELLO MI DIRECTOR 1.00 2.00 X 0 0 0 TOM DEISINGER DIRECTOR 1.00 2.00 X 0 0 0 MARGO FRANKLIN DIRECTOR 1.00 1.00 X 0 0 0 KELLY GAGLIONE DIRECTOR 1.00 1.00 X 0 0 0 NICK LAUBUSCH DIRECTOR 1.00 1.00 X 0 0 0 DR RAUL MATEO DIRECTOR 1.00 1.00 X 0 0 0 ROSEMARIE MATHEUS RN MSN DIRECTOR 1.00 1.00 X 0 0 0 DAVID NILES DIRECTOR (THRU 1/19) 1.00 1.00 X 0 0 0 FR RICHARD O'DONNELL MI DIRECTOR 1.00 2.00 X 0 0 0 FR AGUSTIN OROSA DIRECTOR 1.00 43.00 X 0 0 0 PATRICIA SCHROEDER DIRECTOR 1.00 1.00 X 0 0 0 MARK E SLESAR DIRECTOR 1.00 1.00 X 0 0 0 JUDIE TAYLOR DIRECTOR 1.00 1.00 X 0 0 0 TOM VANHIMBERGEN DIRECTOR (THRU 1/19) 1.00 1.00 X 0 0 0 FRANCIS WIESNER CHAIRPERSON OF THE BOARD 1.00 1.00 X X 0 0 0 FR PEDRO TRAMONTIN MI VICE CHAIR OF THE BOARD 1.00 43.00 X X 0 0 0 FR LEANDRO BLANCO MI TREASURER 1.00 43.00 X X 0 0 0 KEVIN SCHWAB CHIEF EXECUTIVE OFFICER 1.00 43.00 X 0 208887 33567 JUSTIN MUNZEL CHIEF FINANCIAL OFFICER 1.00 43.00 X 0 150433 31265 PAMELA LOVELESS DIRECTOR OF HUMAN RESOURCES 1.00 43.00 X 0 106012 17216 0 465332 82048 0 0 1 0 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 REHABILITATION SERVICES 1447357 BAY TOWEL INC PO BOX 12115 GREEN BAY WI 54307 LAUNDRY SERVICES 302343 ALIXARX LLC PO BOX 645331 PITTSBURGH PA 15264 PHARMACY SERVICES 230158 TOP TECHS TEMPORARIES 150 N SUNNYSLOPE ROAD SUITE 215 BROOKFIELD WI 53005 TEMPORARY NURSING SERVICES 112380 4 7436 7436 RESIDENT SERVICE REVENUE 623000 11759491 11759491 MONTHLY SERVICE FEE REVENUE 623000 10750826 10750826 SUPPORT SERVICE REVENUE 623990 1659658 1659658 24169975 24177411 24169975 0 0 10042798 8636806 1405992 1531886 1317422 214464 583230 501578 81652 4183428 3597748 585680 28693 24676 4017 8681 7466 1215 2036509 1751398 285111 5959 5125 834 1106257 951381 154876 3423688 2944372 479316 37308 32085 5223 3097 2663 434 356705 306766 49939 912253 784538 127715 179174 154090 25084 RAW FOOD & GROCERIES 710576 611095 99481 DUES & SUBSCRIPTIONS 176624 151897 24727 REPAIRS & MAINTENANCE 152722 131341 21381 BAD DEBT EXPENSE 103564 89065 14499 140395 120738 19657 25723547 22122250 3601297 0 1050 1050 1394256 1310929 74034 76236 3731 6224 33374806 18453810 15401667 14920996 1939505 2254806 18814243 18570241 534915 646565 8820000 8309678 28843833 30893228 38198748 39849471 X -19384505 -21279230 -19384505 -21279230 18814243 18570241 X -1546136 -348589 X 0 1 X 1 0 X 17588 6200 2500 7436 33724 17865757 18966901 18508641 21377799 24169974 100889072 17883345 18973101 18508641 21380299 24177410 100922796 0 0 0 100922796 -3 -3 -3 -3 17883345 18973098 18508641 21380299 24177410 100922793 1.00000 1.00000 0.00000 0.00000 X 61278 61278 26215553 12562531 13653022 20219 20219 0 7061078 5871060 1190018 16678 16678 14920996 DUE FROM RELATED PARTY 2253620 RESIDENT FUNDS HELD FOR SAFEKEEPING 1186 2254806 DUE FROM RELATED PARTY 29959016 REFUNDABLE ENTRANCE FEES 196000 RESIDENT FUNDS HELD FOR SAFEKEEPING 3721 INTEREST RATE SWAP AGREEMENTS 734491 30893228 0 0 0 0 0 0 0 0 0 KEVIN SCHWAB CHIEF EXECUTIVE OFFICER 0 197136 0 1945 0 9806 0 9250 0 24317 0 242454 0 0 JUSTIN MUNZEL CHIEF FINANCIAL OFFICER 0 144249 0 1420 0 4764 0 7777 0 23488 0 181698 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-02-29 12655000 REFINANCE 1995 BONDS 0 0 0 A 4265000 12655000 80801 12574199 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 1 1 US BANK 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS A SINGLE CLASS OF MEMBERS AND THE SOLE MEMBER OF THAT CLASS IS ST. CAMILLUS HEALTH SYSTEM, INC., A WISCONSIN NONSTOCK CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS SHALL NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE MEMBER: TO DEFINE THE PHILOSOPHY, MISSION AND PURPOSE OF THE CORPORATION AND TO ADOPT, AMEND OR REPEAL ANY STATEMENTS OF MISSION OR PHILOSOPHY FOR THE CORPORATION; TO ADOPT, APPROVE, RESTATE, REVISE, OR AMEND THESE AMENDED AND RESTATED ARTICLES OF INCORPORATION AND THE BY-LAWS OF THE CORPORATION; TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION AND DETERMINE THE NUMBER (WHICH MAY NOT BE LESS THAN THREE) OF SUCH DIRECTORS; TO AUTHORIZE OR MAKE OTHER DECISIONS RELATING TO THE TRANSFER OR SALE OF OR CREATION OF AN ENCUMBRANCE (E.G. MORTGAGE, PLEDGE OR GRANT OF SECURITY INTEREST) UPON FIXED ASSETS OF THE CORPORATION WITH A VALUE IN EXCESS OF $500,000; TO AUTHORIZE THE INCURRENCE BY THE CORPORATION OF DEBT FOR MONEY BORROWED IN AMOUNTS IN EXCESS OF $500,000; TO ADOPT AMEND OR REPEAL ANY PLAN OF DISSOLUTION, CONSOLIDATION OR MERGER OF THE CORPORATION, ANY CONTRACT OR AGREEMENT FOR THE MANAGEMENT OF THE CORPORATION OR ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; TO CREATE, ACQUIRE, SELL, PURCHASE, DISSOLVE OR MAKE OTHER DISPOSITION OF ANY ENTITY OWNED OR CONTROLLED OR TO BE OWNED OR CONTROLLED BY THE CORPORATION OR ANY OWNERSHIP INTEREST IN ANY SUCH ENTITY; TO APPROVE ANY ACTIONS OR EXERCISE ANY POWER RESERVED TO THE CORPORATION AS A MEMBER OR SHAREHOLDER OF ANOTHER ENTITY; TO APPROVE THE INITIAL ELECTION BY THE BOARD OF DIRECTORS OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION (BUT NOT SUBSEQUENT RE-ELECTIONS OF THOSE PERSONS TO SERVE CONSECUTIVE TERMS IN SUCH RESPECTIVE OFFICES) AND TO REMOVE THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION WHETHER OR NOT SUCH REMOVAL IS APPROVED BY THE BOARD OF DIRECTORS; AND TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AND TO DETERMINE THE TERM OF THE PRESIDENT'S APPOINTMENT, SUCH TERM NOT TO EXCEED THREE YEARS. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CONTROLLER REVIEW THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. A COPY IS KEPT ON HAND FOR PUBLIC VIEWING. FORM 990, PART VI, SECTION B, LINE 12C THE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY. NO CONTRACT OR OTHER TRANSACTION BETWEEN THIS CORPORATION AND ONE OR MORE OF ITS DIRECTORS OR ANY OTHER CORPORATION, FIRM, ASSOCIATION, OR ENTITY IN WHICH ONE OR MORE OF ITS DIRECTORS ARE DIRECTORS OR OFFICERS OR HAS A MATERIAL FINANCIAL INTEREST, SHALL BE EITHER VOID OR VOIDABLE BECAUSE OF SUCH RELATIONSHIP OR INTEREST OR BECAUSE SUCH DIRECTOR OR DIRECTORS ARE PRESENT AT THE MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF WHICH AUTHORIZES, APPROVES OR RATIFIES SUCH CONTRACT OR TRANSACTION OR BECAUSE HIS OR THEIR VOTES ARE COUNTED FOR SUCH PURPOSE, IF (1) THE FACT OF SUCH RELATIONSHIP OR INTEREST IS DISCLOSED OR KNOWN TO THE BOARD OF DIRECTORS OR COMMITTEE WHICH AUTHORIZES, APPROVES OR RATIFIES THE CONTRACT OR TRANSACTION BY A VOTE OR CONSENT SUFFICIENT FOR THE PURPOSE WITHOUT COUNTING THE VOTES OR CONSENTS OF SUCH INTERESTED DIRECTORS; OR (2) THE FACT OF SUCH RELATIONSHIP OR INTEREST IS DISCLOSED OR KNOWN TO THE MEMBERS ENTITLED TO VOTE AND THEY AUTHORIZE, APPROVE OR RATIFY SUCH CONTRACT OR TRANSACTION BY VOTE OR WRITTEN CONSENT; OR (3) THE CONTRACT OR TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION. COMMON OR INTERESTED DIRECTORS MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM AT A MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF WHICH AUTHORIZES, APPROVES OR RATIFIES SUCH CONTRACT OR TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. AUDITED FINANCIAL STATEMENTS ARE PUT IN THE RESIDENT LIBRARY AND AVAILABLE TO PROSPECTIVE RESIDENTS. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -376,642. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 28,053. ST CAMILLUS HEALTH SYSTEM INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 390806167 ADMINISTRATIVE AND MANAGEMENT SERVICES WI 501(C)(3) LINE 12B, II N/A 0 ST CAMILLUS COMMUNITIES INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391843041 RESIDENTIAL FACILITIES WI 501(C)(3) LINE 12B, II ST CAMILLUS HEALTH SYSTEM INC 0 SAN CAMILLO INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391843041 ASSISTED LIVING WI 501(C)(3) LINE 10 ST CAMILLUS HEALTH SYSTEM INC 0 ORDER OF ST CAMILLUS FOUNDATION INC 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 391925879 FUND-RAISING SUPPORT WI 501(C)(3) LINE 12B, II ST CAMILLUS HEALTH SYSTEM INC 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0