MERCY HARVARD HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HARVARD HOSPITAL INC (EIN 31-1551871)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201501349349301775
- Schema version
- 2013v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T09:10:43-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | 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 VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MIDLAND COURT PO BOX 8130 | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535478130 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311551871 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARV | BusinessNameControlTxt |
| Phone | 8159435431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1 |
| City | HARVARD | City |
| State | IL | State |
| ZIP Code | 60033 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COOK | PersonNm |
| Person Title | CHAIRPERSON | PersonTitleTxt |
| Phone | 8159435431 | PhoneNum |
| Signature | 2015-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRADLEY S MCGUIRE CPA | PreparerPersonNm |
| PTIN | P00643763 | PTIN |
| Phone | 6087525835 | PhoneNum |
| Preparation | 2015-05-05 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KATHY SCHACK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1 |
| City | HARVARD | City |
| State | IL | State |
| ZIP Code | 60033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,307,775 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 242 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $19,416 | PYContributionsGrantsAmt |
| CY Contributions Grants | $50,632 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,343,986 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,115,249 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,142 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,106 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,209,229 | PYOtherRevenueAmt |
| CY Other Revenue | $135,788 | CYOtherRevenueAmt |
| PY Total Revenue | $24,575,773 | PYTotalRevenueAmt |
| CY Total Revenue | $25,307,775 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $10,353,198 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,375,562 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,088,956 | PYOtherExpensesAmt |
| CY Other Expenses | $14,496,499 | CYOtherExpensesAmt |
| PY Total Expenses | $23,442,154 | PYTotalExpensesAmt |
| CY Total Expenses | $24,872,061 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,133,619 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $435,714 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,344,043 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,527,397 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,694,850 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,442,490 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,649,193 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,084,907 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,059,016 | ExpenseAmt |
| Revenue | $25,136,164 | RevenueAmt |
| Desc | HOSPITAL DISCHARGES 379, EMERGENCY VISITS 6,152, OUTPATIENT SURGERY CASES 1,853, NURSING HOME DISCHARGES 159 | Desc |
| Total Program Service Expenses | $19,059,016 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 49 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 242 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | 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 | SHANNON DUNPHY-ALEXANDER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6087566642 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| KATHY SCHACK | ||||||||
| CHAIRPERSON & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WESLEY JOST | ||||||||
| VICE-CHAIR & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| P CASEY VORIS | ||||||||
| SECRETARY/TREAS & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JENI HALLATT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RON KIERAS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CARLOS AREVALO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY SCHULZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ALLEN CASTILLO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN COOK | ||||||||
| CFO | 1.00 | Yes (X) | $0 | $378,933 | $37,682 | 55.00 | ||
| WENDI AUBRY | ||||||||
| PHARMACIST TEAM LEAD | 40.00 | $149,575 | $0 | $16,107 | Yes (X) | |||
| CYNTHIA BANGERT | ||||||||
| DIRECTOR | 40.00 | $126,357 | $0 | $21,595 | Yes (X) | |||
| WYNN BIEDERMANN | ||||||||
| CHIEF NURSING OFFICER | 40.00 | $147,787 | $0 | $11,257 | Yes (X) | |||
| LAURA LEAHEY | ||||||||
| RN/HIB | 47.60 | $122,773 | $0 | $10,004 | Yes (X) | |||
| KHRISTINE SCHRADER | ||||||||
| SHIFT COORD | 47.80 | $138,036 | $0 | $18,308 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $684,528 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $378,933 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $114,953 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAGILL CONSTRUCTION COMPANY | |||||
| 977 KOOPMAN LN | ELKHORN | WI | 53121 | CONSTRUCTION | $187,248 |
| PER MAR SECURITY SERVICES | |||||
| PO BOX 1101 | DAVENPORT | IA | 528051101 | SECURITY SERVICES | $108,593 |
| PRN HEALTH | |||||
| 740 FORD STREET STE A | KIMBERLY | WI | 54136 | CONTRACT NURSING | $102,153 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $42,693 | GovernmentGrantsAmt |
| All Other Contributions | $7,939 | AllOtherContributionsAmt |
| Total Contributions | $50,632 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $25,035,002 | $25,035,002 | |
| CAFETERIA | 722210 | $80,247 | $80,247 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,115,249 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,106 | TotalRevenueColumnAmt |
| Exclusion | $6,106 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $101,162 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $101,162 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $101,162 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,162 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $34,626 | TotalRevenueColumnAmt |
| Exclusion | $34,626 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $34,626 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,307,775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,136,164 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $120,979 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,161,814 | TotalAmt |
| Program Services | $6,251,665 | ProgramServicesAmt |
| Management And General | $1,910,149 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,653 | TotalAmt |
| Program Services | $205,013 | ProgramServicesAmt |
| Management And General | $62,640 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,363,703 | TotalAmt |
| Program Services | $990,747 | ProgramServicesAmt |
| Management And General | $372,956 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,392 | TotalAmt |
| Program Services | $446,305 | ProgramServicesAmt |
| Management And General | $136,087 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,200 | TotalAmt |
| Management And General | $5,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,683,839 | TotalAmt |
| Program Services | $3,312,027 | ProgramServicesAmt |
| Management And General | $371,812 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,081 | TotalAmt |
| Program Services | $1,339 | ProgramServicesAmt |
| Management And General | $113,742 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,382,424 | TotalAmt |
| Program Services | $2,116,698 | ProgramServicesAmt |
| Management And General | $265,726 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,860 | TotalAmt |
| Management And General | $89,860 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $405,223 | TotalAmt |
| Program Services | $342,515 | ProgramServicesAmt |
| Management And General | $62,708 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,009 | TotalAmt |
| Program Services | $11,297 | ProgramServicesAmt |
| Management And General | $11,712 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,438 | TotalAmt |
| Program Services | $12,710 | ProgramServicesAmt |
| Management And General | $8,728 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $569,020 | TotalAmt |
| Program Services | $440,854 | ProgramServicesAmt |
| Management And General | $128,166 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,844,317 | TotalAmt |
| Program Services | $1,428,903 | ProgramServicesAmt |
| Management And General | $415,414 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $252,532 | TotalAmt |
| Program Services | $252,532 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $2,649,962 | $2,649,962 | |
| INTERCOMPANY EXPENSES | $885,437 | $885,437 | |
| OTHER TAXES | $835,047 | $52,603 | $782,444 |
| MAINTENANCE AND REPAIRS | $517,303 | $437,417 | $79,886 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,807 | TotalAmt |
| Program Services | $106,429 | ProgramServicesAmt |
| Management And General | $110,378 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,872,061 | TotalAmt |
| Program Services | $19,059,016 | ProgramServicesAmt |
| Management And General | $5,813,045 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $749,629 | BOYAmt |
| EOY | $896,201 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,449,360 | BOYAmt |
| EOY | $4,562,209 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $624,866 | BOYAmt |
| EOY | $568,271 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $213,365 | BOYAmt |
| EOY | $184,724 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $34,623,103 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,811,285 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,081,477 | BOYAmt |
| EOY | $12,811,818 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,225,346 | BOYAmt |
| EOY | $504,174 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,344,043 | BOYAmt |
| EOY | $19,527,397 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,126,758 | BOYAmt |
| EOY | $1,140,691 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,568,092 | BOYAmt |
| EOY | $16,301,799 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,694,850 | BOYAmt |
| EOY | $17,442,490 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,193 | BOYAmt |
| EOY | $2,084,907 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,193 | BOYAmt |
| EOY | $2,084,907 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,344,043 | BOYAmt |
| EOY | $19,527,397 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $435,714 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | FederalGrantAuditRequiredInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $222,604 | OtherCostOrOtherBasisAmt |
| Book Value | $222,604 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,826,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,285,138 | DepreciationAmt |
| Book Value | $8,541,591 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,573,770 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,526,147 | DepreciationAmt |
| Book Value | $4,047,623 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,811,818 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $16,297,590 |
| LONG-TERM CAPITAL LEASE | $4,209 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,301,799 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $139,124 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $139,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,440,170 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,974,217 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,465,953 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05890 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,293 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,402 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,891 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,587,587 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,979,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,607,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06460 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,185 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,185 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,374,670 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,599,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,774,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07140 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,108 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,432,963 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,599,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,833,156 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07370 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,020,550 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,579,426 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,441,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13830 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $782,279 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $106,703 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,549,548 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,601,768 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,052,220 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1 |
| City | HARVARD | City |
| State | IL | State |
| ZIP Code | 60033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | MERCYHEALTHSYSTEM.ORG/LOCATION/MERCY-HARV | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | MERCYHEALTHSYSTEM.ORG | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Residency | Yes (X) | ResidencyInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 3: MERCY HEALTH SYSTEM SET OUT TO GATHER INFORMATION ON THE COMMUNITY OF HARVARD, ILLINOIS AS WELL AS MCHENRY COUNTY AS A WHOLE. DATA WAS GATHERED THROUGH HOUSEHOLD SURVEYS AND SECONDARY DATA SOURCES.MERCY HEALTH SYSTEM DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF MCHENRY COUNTY RESIDENTS. THE FIFTY QUESTION SURVEY WAS DISTRIBUTED TO 1,245 MEMBERS OF THE COMMUNITY AND COVERED VARIOUS TOPICS, INCLUDING ACCESS TO CARE, QUALITY OF LIFE, CHRONIC ILLNESSES, AND LIFESTYLE FACTORS. A RESPONSE WAS RECEIVED FROM 10.4% OF HOUSEHOLDS THAT RECEIVED THE SURVEY. IN ADDITION TO THE DATA GATHERED FROM HOUSEHOLD SURVEYS AND FOCUS GROUPS, MERCY HEALTH SYSTEM ANALYZED HEALTH-RELATED DATA FROM A VARIETY OF EXISTING SOURCES, INCLUDING THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTES COUNTY HEALTH RANKINGS, ILLINOIS DEPARTMENT OF PUBLIC HEALTH, THE UNITED STATES CENSUS BUREAU, AND THE KAISER FAMILY FOUNDATION STATE HEALTH FACTS. SECONDARY SOURCE DATA, WHEN COMBINED WITH THE INFORMATION GATHERED FROM THE HOUSEHOLD SURVEYS, PROVIDED A PICTURE OF WHAT IS WORKING WELL IN ADDITION TO IDENTIFYING OPPORTUNITIES FOR IMPROVEMENT FOR THE HEALTHCARE INFRASTRUCTURE OF MCHENRY COUNTY AND SPECIFICALLY, THE HARVARD, ILLINOIS COMMUNITY. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 14G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY USED THE AVERAGE COMMERCIAL CHARGE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| MERCY HARVARD CARE CENTER | ||||
| 901 HAYES STREET | HARVARD | IL | 60033 | NURSING HOME FACILITY |
| MERCY HARVARD HOSPITAL CLINIC | ||||
| 1001 GRANT STREET | HARVARD | IL | 60033 | PHYSICIAN CLINIC |
| MERCY HARVARD REHABILITATION AND FITNESS | ||||
| 1000 HAYES STREET | HARVARD | IL | 60033 | REHABILITATION CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FAMILY SIZE AND LIMIT OF ASSETS |
| PART I, LINE 6A: | MERCY HARVARD HOSPITAL (MHH) HAS PREPARED A COMMUNITY BENEFIT REPORT FOR FILING WITH ITS 990 TAX RETURN PRIOR TO ITS REQUIREMENT. IT FOLLOWED A RECOMMENDED FORMAT AND MIRRORED THAT OF ITS SISTER ORGANIZATION, MERCY HEALTH SYSTEM CORPORATION'S, FILING OF COMMUNITY BENEFITS WITH THE WISCONSIN HOSPITAL ASSOCIATION. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE COSTS ASSOCIATED WITH CHARITY CARE, UNREIMBURSED MEDICAID, AND OTHER MEANS TESTED GOVERNMENT PROGRAMS. THE COST-TO-CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGE. THE COST OF THE OTHER BENEFITS REFERENCED IN THE TABLE OF LINE 7 (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS; SUBSIDIZED HEALTH SERVICES; CASH AND IN-KIND CONTRIBUTIONS) WERE DETERMINED USING ACTUAL DEPARTMENT/SERVICE SPECIFIC DATA AND/OR COST ACCOUNTING DERIVED DATA. |
| PART I, LINE 7G: | N/A |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $2,649,962 INCLUDED ON FORM 990, PART IX, LINE 25, WAS EXCLUDED FROM EXPENSES WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| PART III, LINE 4: | BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY ALLIANCE INC, AND AFFILIATES - MERCY ALLIANCE INC, IS THE PARENT COMPANY OF MERCY HARVARD HOSPITAL, INC.) PATIENT ACCOUNTS RECEIVABLE ARE RECORDED. . . NET OF CONTRACTUAL ADJUSTMENTS AND ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH REFLECTS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. . . IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ALLIANCE ANALYZES HISTORICAL LOSS EXPERIENCE ON REVENUE FOR ALL PAYORS. USING THE LOSS EXPERIENCE RATE, ALLIANCE ESTIMATES THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE COST OF BAD DEBT ON LINE 2 PART III WAS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO THOSE CHARGES ESTIMATED AND EXPENSED AS UNCOLLECTIBLE. THE ESTIMATE OF BAD DEBT DOLLARS THAT MAY HAVE BEEN COVERED THROUGH MHH'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 13.64%. THIS FIGURE WAS BASED ON THE PERCENT OF BAD DEBT ACCOUNT DOLLARS THAT ARE RECLASSIFIED FOR CHARITY AND/OR BANKRUPTCY PURPOSES. |
| PART III, LINE 8: | DATA FOR LINES 5 & 6 OF PART III AND THE MEDICARE SHORTFALL IS BASED ON MHH'S MEDICARE COST REPORT. |
| PART III, LINE 9B: | PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MHH'S COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MHH'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MHH'S COMMUNITY CARE PROGRAM. PATIENTS MUST APPLY FOR COMMUNITY CARE AND SUPPLY MERCY WITH THE NECESSARY FINANCIAL AND OTHER INFORMATION REQUIRED. PATIENTS WHO QUALIFY FOR COMMUNITY CARE BENEFITS WILL RECEIVE A REDUCTION IN THE BALANCE OWED, EXTENDED PAYMENT TERMS, OR BOTH. THE AMOUNT OF THE COMMUNITY CARE BENEFIT WILL BE BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE. |
| PART VI, LINE 2: | COMMUNITY NEEDS ASSESSMENTS ARE CONDUCTED EVERY 18 MONTHS. MHH AND MHH'S SISTER ORGANIZATION, MERCY HEALTH SYSTEM CORP (MHS) WORK IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI) AND MCHENRY (IL) COUNTIES TO COMPLETE. MERCY HARVARD HOSPITAL, INC. (MHH) COMPLETES AN ANNUAL CRITICAL ACCESS HOSPITAL ASSESSMENT. NEEDS ASSESSMENT SURVEYS ARE COMPLETED AS REQUIRED BY THE STATE OF ILLINOIS.MERCY HEALTH SYSTEM CORP. HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS TO ASSESS HEALTH NEEDS IN THE COMMUNITIES THAT MHH AND MHS SERVE. COLLABORATIVE EXAMPLES OF MERCY AND MERCY'S RELATED ENTITIES INCLUDE: I)THE COMMUNITY HEALTH CENTER AT MERCY CLINIC SOUTH: PARTNERSHIP WITH THE COMMUNITY HEALTH CENTER, INC. OF BELOIT, WI IN 2006, MERCY PARTNERED WITH COMMUNITY HEALTH CENTER, INC. TO OPEN THIS CLINIC IN JANESVILLE. IT PROVIDES FREE AND LOW-COST CARE TO LOW-INCOME, UNINSURED AND UNDERINSURED PATIENTS. THIS FIRST-OF-ITS-KIND PARTNERSHIP IS THE RESULT OF YEARS OF WORK WITH LOCAL PARTNERS AND THE FEDERAL GOVERNMENT TO DESIGN AND DEBUT A NEW MODEL OF CARE FOR THE UNDERSERVED. THE CLINIC SEES OVER 200 NEW PATIENTS EACH MONTH, HAS SIGNIFICANTLY IMPROVED PATIENT OUTCOMES, AND HAS SAVED MILLIONS IN UNNECESSARY EMERGENCY DEPARTMENT COSTS. II)HEALTHNET FREE CLINIC IN JANESVILLE: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. MERCY ALSO DONATES LAB, RADIOLOGY AND OTHER ANCILLARY SERVICES TO PATIENTS. III)FAMILY HEALTH PARTNERSHIP CLINIC AND WELL CHILD CLINIC IN WOODSTOCK, IL AND HARVARD FREE CLINIC IN MCHENRY COUNTY, IL: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. IV)FAMILY HEALTH PARTNERSHIP CLINIC: MCHENRY COUNTY DEPARTMENT OF HEALTH COLLABORATION TO PROVIDE MAMMOGRAMS AT MERCY FACILITIES FOR WOMEN WHO CANNOT OTHERWISE AFFORD THE SERVICE. V)ROCK COUNTY HEALTH DEPARTMENT: BIOTERRORISM READINESS PROJECT. VI)RED CROSS: BLOOD DRIVE AND COOPERATIVE VOLUNTEER EFFORTS. VII)UNITED WAY: FUND RAISING CAMPAIGN AND ROCK COUNTY NEEDS ASSESSMENT SURVEY CONTRIBUTOR VIII)AREA POLICE AND FIRE DEPARTMENTS: PROVIDE PORTABLE DEFIBRILLATORS FOR POLICE VEHICLES AND FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES. IX)COMMUNITY ACTION, INC.: MERCY LEADERSHIP SERVES ON STRATEGIC PLANNING COMMITTEE AND COMMUNITY ACTION DEVELOPMENT BOARD. |
| PART VI, LINE 3: | ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL AIDE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEM'S WEBSITE, IN OUR EMERGENCY ROOMS, FINANCIAL SERVICES OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED. |
| PART VI, LINE 4: | MERCY HARVARD HOSPITAL IS LOCATED IN MCHENRY COUNTY, ILLINOIS. IT IS A LICENSED FOR 25 ACUTE AND 45 LONG TERM CARE BEDS. IT IS A CRITICAL ACCESS HOSPITAL WITH 24/7 EMERGENCY SERVICES AND OUTPATIENT SURGERY. SINCE 2003, AND ITS AFFILIATION WITH MERCY HEALTH SYSTEM CORP., MHH HAS BEEN ABLE TO PROVIDE A NEW LEVEL OF CARE AND MORE MEDICAL SPECIALTIES. MEDIAN HOUSEHOLD INCOME IN HARVARD IS $45,991, WHICH IS LOWER THAN BOTH THE COUNTY AND STATE MEDIANS OF $76,482 AND $55,735, RESPECTIVELY. IN 2010 HARVARD HAD A GREATER PROPORTION OF RESIDENTS WHO WERE UNEMPLOYED, COMPARED TO THE COUNTY AND STATE RATES. IN 2012, MCHENRY COUNTY HAD AN UNEMPLOYMENT RATE OF 8.4% COMPARED TO ILLINOIS' 8.9% AND US RATE OF 8.1%.APPROXIMATELY 20% OF HARVARD RESIDENTS HAD EARNINGS BELOW THE POVERTY LEVEL IN 2010. THIS PROPORTION EXCEEDS BOTH THE COUNTY (4.2%) AND STATE (9.2%) RATES. ONE IN FOUR HARVARD FAMILIES LIVE IN POVERTY. SLIGHTLY MORE THAN TWO PERCENT OF FAMILIES IN THE HARVARD COMMUNITY RECEIVE CASH PUBLIC ASSISTANCE, COMPARED TO 1.2% ACROSS MCHENRY COUNTY AND 2.0% ACROSS ILLINOIS. SIMILARLY, 12.9% OF FAMILIES RECEIVED FOOD STAMP BENEFITS IN 2010, WHICH IS GREATER THAN BOTH THE MCHENRY COUNTY AND ILLINOIS RATES OF 3.8% AND 9.1%, RESPECTIVELY.THE HOSPITALS' PAYOR DEMOGRAPHICS INCLUDE 36.0% MEDICARE, AND 16.8% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2013 - JUNE 30, 2014 (AS DETERMINED BY CHARGES BILLED). |
| PART VI, LINE 5: | MERCY HARVARD HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. MERCY HARVARD HOSPITAL HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY. |
| PART VI, LINE 6: | MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTHCARE SYSTEM AND IS AFFILIATED WITH OTHER SEPARATELY REPORTED ORGANIZATIONS. MERCY ALLIANCE INC. IS THE PARENT COMPANY OF MERCY HEALTH SYSTEM CORPORATION, MERCY ASSISTED CARE INC, AND MERCY HARVARD HOSPITAL INC. MERCY HEALTH SYSTEM CORPORATION OPERATES TWO HOSPITALS AND HAS COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES AND DME (DURABLE MEDICAL EQUIPMENT) SERVICES; THUS PROVIDING CONTINUATION OF CARE TO MERCY HEALTH SYSTEM PATIENTS AND THE COMMUNITY AS A WHOLE. MERCY HEALTH SYSTEM CORP. WORKS WITH THE MERCY FOUNDATION, INC. TO OPERATE A HOMELESS SHELTER IN JANESVILLE, WI: THE HOUSE OF MERCY HOMELESS CENTER PROVIDES SHELTER, SUPPORT, AND TRAINING TO WOMEN, CHILDREN, AND FAMILIES TO HELP FIGHT HOMELESSNESS. IT OPENED IN 1996, AND NOW SHELTERS AN AVERAGE OF 290 INDIVIDUALS/YEAR THE LAST THREE YEARS.MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 1,470 IN CALENDAR YEAR 2013. THIS ORGANIZATION NOT ONLY SUPPORTS MERCY'S SERVICES, BUT PROVIDES BENEFITS TO THE COMMUNITY AS A WHOLE. IN CONJUNCTION WITH MERCY HEALTH SYSTEM'S MEAL PREPARATION, THE VOLUNTEERS PARTICIPATE IN AND OVERSEE A MEALS ON WHEELS PROGRAM: PARTICIPANT/NUTRITION SPECIFIC MEALS ARE PREPARED AND DELIVERED TO THE ELDERLY NEEDING ASSISTANCE IN JANESVILLE. THE VOLUNTEER ASSOCIATION RUNS A HOSPITALITY HOUSE IN WHICH FAMILY MEMBERS OF PATIENTS ARE OFFERED FREE HOUSING DURING THEIR LOVED ONES EXTENDED HOSPITAL STAY AND REHABILITATION. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI,IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN COOK | ||||||||||||||
| CFO | $0 | $258,028 | $0 | $115,445 | $0 | $5,460 | $0 | $16,851 | $0 | $20,831 | $0 | $416,615 | $0 | $0 |
| WENDI AUBRY | ||||||||||||||
| PHARMACIST TEAM LEAD | $149,456 | $0 | $0 | $0 | $119 | $0 | $7,848 | $0 | $8,259 | $0 | $165,682 | $0 | $0 | $0 |
| WYNN BIEDERMANN | ||||||||||||||
| CHIEF NURSING OFFICER | $147,569 | $0 | $0 | $0 | $218 | $0 | $7,497 | $0 | $3,760 | $0 | $159,044 | $0 | $0 | $0 |
| KHRISTINE SCHRADER | ||||||||||||||
| SHIFT COORD | $137,789 | $0 | $0 | $0 | $247 | $0 | $6,995 | $0 | $11,313 | $0 | $156,344 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | REVIEW IS COMPLETED BY MANAGEMENT OF ORGANIZATION AND AVAILABLE TO BOARD FOR REVIEW |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REPORT ALL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR INVESTIGATING ALL CONFLICTS AND REPORTING TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 3,312,027. MANAGEMENT AND GENERAL EXPENSES 371,812. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,683,839. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY ALLIANCE INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391679859 | MANAGEMENT OF HEALTHCARE ORGANIZATIONS | WI | 501(C)(3) | 11A | N/A | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 237275336 | TO SUPPORT THE HOUSE OF MERCY HOMELESS SHELTER | WI | 501(C)(3) | 11A | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390912682 | TO SUPPORT MERCY HEALTH SYSTEM CORPORATION | WI | 501(C)(3) | 11C | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY ASSISTED CARE INC | |||||||||||
| 901 MINERAL POINT | JANESVILLE | WI | 535475003 | 391035110 | HOME HEALTH CARE & SERVICES | WI | 501(C)(3) | 9 | 0 | MERCY ALLIANCE INC | |
| MERCY HEALTH SYSTEM CORPORATION | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390816848 | MEDICAL HEALTHCARE | WI | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
| HARVARD MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 364308662 | TO SUPPORT MERCY HARVARD HOSPITAL, INC. | IL | 501(C)(3) | 11A | 0 | MERCY HARVARD HOSPITAL INC | |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 201673011 | NONE | IL | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | |||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391520130 | MANAGEMENT ENTITY OF UNION EMPLOYEES | WI | MERCY HEALTH SYSTEM CORPORATION | C | Yes (1) |
| MERCYCARE INSURANCE COMPANY | |||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | Yes (1) |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | |||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | Yes (1) |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |