MERCY FOUNDATION INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MERCY FOUNDATION INC (EIN 23-7275336)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201501349349301910
- 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 | 237275336 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 6087566000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAVON BEA | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6087566000 | 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 | JAVON BEA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,115,742 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $309,732 | PYContributionsGrantsAmt |
| CY Contributions Grants | $427,450 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $121,500 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $106,800 | CYProgramServiceRevenueAmt |
| PY Investment Income | $65,610 | PYInvestmentIncomeAmt |
| CY Investment Income | $225,982 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$11,031 | PYOtherRevenueAmt |
| CY Other Revenue | -$12,838 | CYOtherRevenueAmt |
| PY Total Revenue | $485,811 | PYTotalRevenueAmt |
| CY Total Revenue | $747,394 | 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 | $106,018 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $113,160 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $132,386 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $295,919 | PYOtherExpensesAmt |
| CY Other Expenses | $334,362 | CYOtherExpensesAmt |
| PY Total Expenses | $401,937 | PYTotalExpensesAmt |
| CY Total Expenses | $447,522 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $83,874 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $299,872 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,616,594 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,871,870 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,200 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,600,394 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,871,870 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $184,794 | ExpenseAmt |
| Desc | HOUSE OF MERCY, A HOMELESS SHELTER, PROVIDED 7,605 SHELTER NIGHTS. A TOTAL OF 295 INDIVIDUALS (162 ADULTS AND 133 CHILDREN) WERE SERVED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $51,038 | ExpenseAmt |
| Revenue | $106,800 | RevenueAmt |
| Desc | MERCY FOUNDATION PROVIDES SUBSIDY FUNDING FOR THE MERCY HEALTH SYSTEM RESIDENCY PROGRAM. USE OF THESE DONATIONS ARE FOR EDUCATIONAL NECESSITIES OUTSIDE THE NORMAL OPERATING BUDGET OF THE MERCY RESIDENCY PROGRAM. FUNDS COVERED EXPENSES OF A MEDICAL MISSION TO GUATEMALA (IN CONJUNCTION WITH THE SHOULDER TO SHOULDER, INC. ORGANIZATION). | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $36,875 | ExpenseAmt |
| Desc | OTHER MISCELLANEOUS PROGRAM EXPENSES | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $36,875 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $272,707 | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | Yes (1) | 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 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | 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 | 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 | WI | 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 (5 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 |
|---|---|---|---|---|---|---|---|
| LARRY E SQUIRE | |||||||
| TREASURER & DIRECTOR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $3,718 | $0 |
| MARK GOELZER | |||||||
| SECRETARY & DIRECTOR | 1.00 | 55.00 | Yes (X) | Yes (X) | $0 | $433,237 | $28,418 |
| JAVON R BEA | |||||||
| PRESIDENT & DIRECTOR | 1.00 | 55.00 | Yes (X) | Yes (X) | $0 | $5,220,365 | $36,645 |
| RICHARD GRUBER | |||||||
| VICE-PRESIDENT | 1.00 | 55.00 | Yes (X) | $0 | $207,379 | $27,888 | |
| BARB BORTNER | |||||||
| VICE-PRESIDENT | 1.00 | 55.00 | Yes (X) | $0 | $198,844 | $34,313 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,063,543 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $127,264 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $160,822 | FundraisingAmt |
| Government Grants | $1,500 | GovernmentGrantsAmt |
| All Other Contributions | $265,128 | AllOtherContributionsAmt |
| Total Contributions | $427,450 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FAMILY PRACTICE RESIDENCY PROGRAM | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $106,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $106,800 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $106,800 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,340 | TotalRevenueColumnAmt |
| Exclusion | $36,340 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,451,553 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,261,911 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $189,642 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $189,642 | TotalRevenueColumnAmt |
| Exclusion | $189,642 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $93,599 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $160,822 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $106,437 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,838 | TotalRevenueColumnAmt |
| Exclusion | -$12,838 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $747,394 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $106,800 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $213,144 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,599 | TotalAmt |
| Fundraising | $105,599 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,097 | TotalAmt |
| Fundraising | $2,097 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,464 | TotalAmt |
| Fundraising | $5,464 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,250 | TotalAmt |
| Management And General | $10,250 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,912 | TotalAmt |
| Management And General | $14,912 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,974 | TotalAmt |
| Management And General | $6,604 | ManagementAndGeneralAmt |
| Fundraising | $1,370 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,482 | TotalAmt |
| Fundraising | $2,482 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $797 | TotalAmt |
| Program Services | $797 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| HOUSE OF MERCY EXP (HOM | $184,794 | $184,794 | ||
| RESIDENCY PROGRAM EXPEN | $51,038 | $51,038 | ||
| OTHER EXPENSES | $33,772 | $23,365 | $10,407 | |
| OTHER FUNDRAISING EXPEN | $14,788 | $14,788 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,555 | TotalAmt |
| Program Services | $12,713 | ProgramServicesAmt |
| Management And General | $256 | ManagementAndGeneralAmt |
| Fundraising | $586 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,522 | TotalAmt |
| Program Services | $272,707 | ProgramServicesAmt |
| Management And General | $42,429 | ManagementAndGeneralAmt |
| Fundraising | $132,386 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,163 | BOYAmt |
| EOY | $139,902 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,515,431 | BOYAmt |
| EOY | $1,697,921 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $34,047 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,616,594 | BOYAmt |
| EOY | $1,871,870 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,200 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,200 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600,394 | BOYAmt |
| EOY | $1,871,870 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600,394 | BOYAmt |
| EOY | $1,871,870 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,616,594 | BOYAmt |
| EOY | $1,871,870 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $299,872 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$28,396 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| MERCY ASSISTED CARE INC | |||||
| 391035110 | 9 | Yes (1) | 0 | Yes (1) | $0 |
| MERCY HEALTH SYSTEM CORPORATION | |||||
| 390816848 | 3 | Yes (1) | 0 | Yes (1) | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | VARIOUS INVESTMENTS | Desc |
| Book Value | $1,697,921 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,697,921 | TotalBookValueSecuritiesAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | CHARITY BALL | NameOfEvent1Amt |
| Gross Receipts Event1 | $163,097 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $104,870 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $58,227 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $7,500 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $1,500 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,733 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $13,235 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $48,021 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | JINGLE MINGLE | NameOfEvent2Amt |
| Gross Receipts Event2 | $85,089 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $55,952 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $29,137 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $6,170 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $1,600 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $600 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $6,885 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $568 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $14,557 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $6,235 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $6,235 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,068 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $254,421 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $160,822 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $93,599 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $13,670 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $3,100 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,333 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $20,120 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $3,568 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $63,646 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $106,437 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$12,838 | NetIncomeSummaryAmt |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK GOELZER | ||||||||||||||
| SECRETARY & DIRECTOR | $0 | $428,028 | $0 | $0 | $0 | $5,209 | $0 | $15,576 | $0 | $12,842 | $0 | $461,655 | $0 | $0 |
| JAVON R BEA | ||||||||||||||
| PRESIDENT & DIRECTOR | $0 | $1,005,629 | $0 | $883,870 | $0 | $3,330,866 | $0 | $16,851 | $0 | $19,794 | $0 | $5,257,010 | $0 | $0 |
| RICHARD GRUBER | ||||||||||||||
| VICE-PRESIDENT | $0 | $136,675 | $0 | $62,153 | $0 | $8,551 | $0 | $13,329 | $0 | $14,559 | $0 | $235,267 | $0 | $0 |
| BARB BORTNER | ||||||||||||||
| VICE-PRESIDENT | $0 | $135,533 | $0 | $62,671 | $0 | $640 | $0 | $13,029 | $0 | $21,284 | $0 | $233,157 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT REVIEWS FORM 990 PRIOR TO FILING AND FORM 990 IS AVAILABLE TO THE BOARD |
| 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. |
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 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 HEALTH SYSTEM CORPORATION | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390816848 | MEDICAL HEALTHCARE | WI | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
| 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 HARVARD HOSPITAL INC | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | MEDICAL HEALTHCARE | IL | 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 | 0 |
| MERCYCARE INSURANCE COMPANY | |||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | 0 |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | |||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | 0 |
| 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 | 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 | 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 |