2015-12-15T14:08:41-06:00 2015-01-31 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2014-02-01 391664109 MILWAUKEE HEALTH SERVICES INC MILW 4143728080 2555 N MARTIN LUTHER KING DRIVE MILWAUKEE WI 53212 TITO IZARD MD PRESIDENT & CEO 4143728080 2015-12-15 1 DAVE GLOBIG P01356041 4144319300 2015-12-14 2014 2016-03-07 17:11:31Z TITO IZARD MD 2555 N MARTIN LUTHER KING DRIVE MILWAUKEE WI 53212 17040586 0 X WWW.MHSI.ORG X 1989 WI TO PROVIDE MEDICAL AND DENTAL PRIMARY CARE SERVICES TO A MEDICALLY UNDERSERVED POPULATION. 10 10 260 10 37000 31505 4890489 5458239 3272940 11053667 31494 738 141091 527942 8336014 17040586 0 0 0 0 14769416 10290008 0 0 0 6188414 5328181 20957830 15618189 -12621816 1422397 15107142 15000390 20226384 19257631 -5119242 -4257241 TO PROVIDE ACCESSIBLE, QUALITY PRIMARY AND RELATED HEALTH CARE SERVICES TO MILWAUKEE RESIDENTS, WITH OUR CONTINUING EMPHASIS ON MEDICALLY-UNDERSERVED FAMILIES AND INDIVIDUALS. 0 0 12880776 0 11094417 TO PROVIDE MEDICAL AND DENTAL PRIMARY CARE SERVICES TO A MEDICALLY UNDERSERVED POPULATION. 23,982 PATIENTS WERE SERVED DURING THE YEAR 12880776 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 42 0 1 260 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X DONNA WOLAK 4143728080 2555 N MARTIN LUTHER KING DRIVE MILWAUKEE WI 53212 DR RICHARD EVANS BOARD MEMBER 1.00 X 0 0 0 GINA GREEN-HARRIS BOARD MEMBER 1.00 X 0 0 0 ATTORNEY EMERY HARLAN BOARD MEMBER 1.00 X 0 0 0 CURTISS HARRIS BOARD MEMBER 1.00 X 0 0 0 CASSANDRA MCSHERPARD BOARD MEMBER 1.00 X 0 0 0 PAULA LUCEY BOARD MEMBER 1.00 X 0 0 0 SENATOR SPENCER COGGS CHAIRPERSON 1.00 X X 0 0 0 KAREN BAKER SECRETARY 1.00 X X 0 0 0 THOMAS TERRY VICE CHAIR 1.00 X X 0 0 0 AUDREY SELLERS INTERIM TREASURER 1.00 X X 0 0 0 DR TITO IZARD PRESIDENT, CEO, & CHIEF MED. OFFICER 40.00 X 262713 0 11368 DR JANICE A LITZA CHIEF MEDICAL OFFICER (THRU 9/14) 40.00 X 102033 0 1783 KENNETH WALLER CHIEF OPERATIONS OFFICER (BEG 10/14) 40.00 X 34726 0 0 CLOVER BARNES CHIEF OPERATIONS OFFICER (THRU 10/14) 40.00 X 41063 0 0 DONNA WOLAK CHIEF FINANCE OFFICER 40.00 X 104928 0 1664 ILVA VAN VALKENBURGH PHYSICIAN 40.00 X 154615 0 0 ENID OKONKON PHYSICIAN 40.00 X 144969 0 9765 845047 0 24580 5 0 1 0 GRANT THORNTON LLP 175 W JACKSON ST CHICAGO IL 60604 CONSULTANTS 347500 JENNIFER KING MD N52W21717 TAYLORS WOODS DRIVE MENOMONEE FALLS WI 53051 PHYSICIAN-BEHAVIORAL HEALTH 194025 WHYTE HIRSCHBOECK DUDEK SC 555 WELLS ST MILWAUKEE WI 53202 LEGAL SERVICES 187932 PLATINUM SECURITY 544 E OGDEN STE 700 MILWAUKEE WI 53202 SECURITY 183324 ABM JANITORIAL SERVICES LLC 411 E WISCONSIN AVE STE L115 MILWAUKEE WI 53202 JANITORIAL 155425 7 3663234 1795005 5458239 MEDICARE MEDICADE PAYMENTS 624100 10201622 10201622 SELF PAY 624100 451041 451041 OTHER THIRD PARTY 624100 401004 401004 11053667 738 738 37000 0 37000 37000 37000 MEDICAL RECORDS 624100 40750 40750 450192 450192 490942 17040586 11094417 37000 450930 549963 465194 84769 7703414 6516045 1187369 1428894 1428894 607737 607737 72351 72351 53400 53400 1356222 737576 618646 261590 249599 11991 1391285 1348063 43222 38732 38247 485 318424 318424 992007 674565 317442 PHARMACEUTICALS 652784 652784 191386 162072 29314 15618189 12880776 2737413 0 13144 26402 52977 2034 687459 933076 2178006 2529583 110091 59396 74439 53767 19921878 8525746 11991026 11396132 15107142 15000390 12882554 12402229 7343830 6855402 20226384 19257631 X -5553066 -4257241 433824 0 -5119242 -4257241 15107142 15000390 1422397 -560396 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 599599 599599 13427884 4365468 9062416 416893 416893 0 4952374 3500843 1451531 525128 242542 282586 11396132 X X X X X X 0 0 0 0 0 0 0 1 0 DR TITO IZARD PRESIDENT, CEO, & CHIEF MED. OFFICER 262713 0 0 0 0 0 0 0 11368 0 274081 0 0 0 ILVA VAN VALKENBURGH PHYSICIAN 154615 0 0 0 0 0 0 0 0 0 154615 0 0 0 ENID OKONKON PHYSICIAN 144969 0 0 0 0 0 0 0 9765 0 154734 0 0 0 PART I, LINE 7 INCENTIVES ARE ACCRUED FOR PROVIDERS BASED UPON PRODUCTION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE COMPTROLLER, CHIEF FINANCIAL OFFICER, AND PRESIDENT/CEO OF THE ORGANIZATION. AFTER SATISFACTORY REVIEW, IT IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THAT ALL EMPLOYEES AND BOARD MEMBERS DISCLOSE IN WRITING AND UPDATE AT LEAST ANNUALLY, ALL BUSINESS AND IMMEDIATE FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST. IN ADDITION, EMPLOYEES MUST DISCLOSE TO THE PRESIDENT/CEO, AND PRESIDENT/CEO MUST DISCLOSE TO THE BOARD CHAIRPERSON, IN WRITING THE SPECIFICS OF ANY PLAN TO ACCEPT OUTSIDE EMPLOYMENT SO THAT OUTSIDE EMPLOYMENT MAY BE DETERMINED IF POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS INTERVIEWS, HIRES, AND NEGOTIATES THE SALARY OF THE CEO. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 IS MADE AVAILABLE UPON REQUEST.