MERCY HEALTH SYSTEM CORPORATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH SYSTEM CORPORATION (EIN 39-0816848)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201521349349301912
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
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 | 390816848 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH SYSTEM CORPORATION | 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 | CEO | PersonTitleTxt |
| Phone | 6087566000 | PhoneNum |
| Signature | 2015-05-11 | 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 | 2015-05-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | 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 | $564,694,255 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 3868 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $10,145,886 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $192,379 | PYContributionsGrantsAmt |
| CY Contributions Grants | $263,821 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $482,875,091 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $515,758,827 | CYProgramServiceRevenueAmt |
| PY Investment Income | $906,429 | PYInvestmentIncomeAmt |
| CY Investment Income | $293,559 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,487,239 | PYOtherRevenueAmt |
| CY Other Revenue | $2,856,252 | CYOtherRevenueAmt |
| PY Total Revenue | $488,461,138 | PYTotalRevenueAmt |
| CY Total Revenue | $519,172,459 | 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 | $283,427,073 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $297,341,530 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $186,769,727 | PYOtherExpensesAmt |
| CY Other Expenses | $206,767,003 | CYOtherExpensesAmt |
| PY Total Expenses | $470,196,800 | PYTotalExpensesAmt |
| CY Total Expenses | $504,108,533 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $18,264,338 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $15,063,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $460,754,384 | TotalAssetsBOYAmt |
| Total Assets EOY | $497,525,602 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $305,574,103 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $303,051,697 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $155,180,281 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $194,473,905 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $405,273,227 | ExpenseAmt |
| Revenue | $505,367,904 | RevenueAmt |
| Desc | HOSPITAL DISCHARGES 8,416, NURSING HOME ADMISSIONS 319, BIRTHS 1,006, OUTPATIENT VISITS 1,181,947MERCY HEALTH SYSTEM CONTINUES ITS TRADITION OF GIVING BACK TO EACH OF THE COMMUNITIES WE SERVE IN A WIDE VARIETY OF FASHIONS. ONE OF THE LARGER AREAS OF CONTRIBUTION IS IN THE AREA OF PUBLIC HEALTH SERVICES. THIS INCLUDES EXTENSIVE DONATIONS OF TIME AND SUPPLIES TO HEALTHNET OF ROCK COUNTY, A LARGE FREE PRIMARY CARE CLINIC SERVING THE REGION. MORE THAN EIGHTY PERCENT OF THE PHYSICIAN SERVICES PROVIDED AT THE CLINIC ARE SUPPLIED THROUGH MERCY HEALTH SYSTEM. WE HAVE A SIMILAR COMMITMENT TO OPEN ARMS FREE CLINIC THAT SERVICES LOW INCOME RESIDENTS IN WALWORTH COUNTY. ADDITIONALLY, WE PROVIDE HEALTH SCREENING AND RELATED SERVICES AT NUMEROUS EVENTS IN ROCK AND WALWORTH COUNTIES IN WISCONSIN AND MCHENRY COUNTY IN ILLINOIS. IN FACT, IN 2014, MORE THAN 138,000 PARTICIPANTS FROM THESE COUNTIES RECEIVED SERVICES DURING OUR WELLNESS CLINICS.IN THAT SAME PERIOD OF TIME, MERCY ALSO PROVIDED MORE THAN $416,000 IN FINANCIAL AND IN KIND CONTRIBUTIONS TO OTHER PRIVATE NOT FOR PROFIT HEALTH RELATED AGENCIES AND ORGANIZATION IN OUR SERVICE AREA. BENEFICIARIES INCLUDED BUT ARE NOT LIMITED TO THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, UNITED WAY ORGANIZATIONS IN ROCK, WALWORTH, AND MCHENRY COUNTIES, YWCA CARE HOUSE, YMCA, AMERICAN LUNG ASSOCIATION, WALWORTH COUNTY ALLIANCE FOR CHILDREN, TURNING POINT WOMEN'S CENTER IN MCHENRY, OPEN ARMS FREE CLINIC, AND THE RED CROSS, TO NAME JUST A FEW RECIPIENTS.MERCY ALSO ENCOURAGES ITS PARTNERS (EMPLOYEES) TO DONATE THEIR TIME AND ENERGY TO SUPPORT A WHOLE HOST OF COMMUNITY BASED CAUSES. THOUSANDS OF HOURS EACH YEAR ARE DONATED TO NOT FOR PROFIT AND PUBLIC AGENCIES THROUGHOUT OUR SERVICE AREA. EXAMPLES OF VOLUNTEER ACTIVITIES BEING SUPPORTED INCLUDE NURSING SERVICES AT COMMUNITY AND FREE CLINICS THROUGHOUT THE REGION, MEALS ON WHEELS DELIVERY ACTIVITIES, ACTIVE INVOLVEMENT AS GOVERNING BOARD MEMBERS FOR SUCH ORGANIZATIONS AS UNITED WAY, CRIME STOPPERS, ROTARY BOTANICAL GARDENS, HEALTHNET, AND MANY OTHER ORGANIZATIONS.ANOTHER EXAMPLE OF MERCY'S COMMITMENT TO COMMUNITY IS ITS SUPPORT OF THE OPERATIONS THROUGH OFFERING SAFE RESIDENCE TO HOMELESS WOMEN AND THEIR CHILDREN AT THE HOUSE OF MERCY HOMELESS CENTER. SINCE ITS OPENING IN 1996, THE CENTER HAS SERVED MORE THAN 5500 PERSONS, MOST OF WHOM ARE UNDER THE AGE OF 18 AT THE CENTER. THE CENTER OFFERS A SAFE HARBOR FOR THESE INDIVIDUALS AS WELL AS CASE MANAGEMENT, ASSISTANCE WITH JOB SEARCHES, FINDING PERMANENT HOUSING AND EDUCATION. | Desc |
| Total Program Service Expenses | $405,273,227 | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 382 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3868 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| 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 (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROWLAND MCCLELLAN | ||||||||
| CHAIRPERSON & DIRECTOR | 1.00 | Yes (X) | $1,097 | $0 | $0 | |||
| THOMAS POOL | ||||||||
| VICE-CHAIRPERSON & DIRECTO | 1.00 | Yes (X) | $15,000 | $0 | $0 | |||
| LARRY SQUIRE | ||||||||
| TREASURER & DIRECTOR | 1.00 | Yes (X) | $3,718 | $0 | $0 | |||
| ELIZABETH HANSCH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVE SYVERSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $15,000 | $0 | $0 | |||
| MARK GOELZER MD | ||||||||
| DIRECTOR/PHYSICIAN | 55.00 | $433,237 | $0 | $28,418 | Yes (X) | |||
| ROBERT CONSIGNY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHERINE SCHACK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $2,205 | $0 | $0 | |||
| MARK KOPP | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BARB BORTNER | ||||||||
| VICE-PRESIDENT | 55.00 | $198,844 | $0 | $34,313 | Yes (X) | |||
| DAN COLBY | ||||||||
| VICE-PRESIDENT | 55.00 | $266,553 | $0 | $28,819 | Yes (X) | |||
| DAVID KURTZ | ||||||||
| VICE-PRESIDENT | 55.00 | $209,510 | $0 | $28,280 | Yes (X) | |||
| JOHN COOK | ||||||||
| VICE-PRESIDENT | 55.00 | $378,933 | $0 | $37,682 | Yes (X) | |||
| KATHY HARRIS | ||||||||
| VICE-PRESIDENT | 55.00 | $137,243 | $0 | $27,926 | Yes (X) | |||
| RUTH YARBROUGH | ||||||||
| VICE-PRESIDENT | 55.00 | $255,040 | $0 | $23,432 | Yes (X) | |||
| RICHARD GRUBER | ||||||||
| VICE-PRESIDENT | 55.00 | $207,379 | $0 | $27,888 | Yes (X) | |||
| RALPH TOPINKA | ||||||||
| VICE-PRESIDENT | 55.00 | $286,672 | $0 | $15,725 | Yes (X) | |||
| JOSEPH NEMETH | ||||||||
| VICE-PRESIDENT | 55.00 | $212,999 | $0 | $25,731 | Yes (X) | |||
| SUE RIPSCH | ||||||||
| VICE-PRESIDENT | 55.00 | $375,874 | $0 | $32,971 | Yes (X) | |||
| JENNIFER HALLATT | ||||||||
| VICE-PRESIDENT | 1.00 | $225,038 | $0 | $37,244 | Yes (X) | |||
| PAUL VAN DEN HEUVEL | ||||||||
| VICE-PRESIDENT | 1.00 | $101,778 | $0 | $4,809 | Yes (X) | |||
| JAVON BEA | ||||||||
| PRESIDENT & DIRECTOR | 55.00 | Yes (X) | $5,220,365 | $0 | $36,645 | Yes (X) | ||
| VIKRAM KHANNA | ||||||||
| PHYSICIAN | 40.00 | $1,820,022 | $0 | $49,172 | Yes (X) | |||
| BRADLEY FIDELER | ||||||||
| PHYSICIAN | 40.00 | $1,308,704 | $0 | $41,515 | Yes (X) | |||
| CHRISTOPHER STURM | ||||||||
| PHYSICIAN | 40.00 | $1,186,786 | $0 | $39,311 | Yes (X) | |||
| ROBB WHINNEY | ||||||||
| PHYSICIAN | 40.00 | $1,255,377 | $0 | $31,733 | Yes (X) | |||
| DANIEL HOFFMAN | ||||||||
| PHYSICIAN | 40.00 | $1,056,481 | $0 | $36,899 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $15,173,855 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $588,513 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAGILL CONSTRUCTION COMPANY | |||||
| 977 KOOPMAN LANE | ELKHORN | WI | 53121 | CONSTRUCTION | $5,222,884 |
| EPIC SYSTEMS CORPORATION | |||||
| 1979 MILKY WAY | VERONA | WI | 53593 | SOFTWARE/SYSTEM MAINTENANCE | $3,697,926 |
| WALSH CONSTRUCTION COMPANY II LLC | |||||
| 929 WEST ADAMS | CHICAGO | IL | 60607 | CONSTRUCTION | $2,732,097 |
| HAYES LOCUMS LLC | |||||
| 6700 N ANDREWS AVE STE 600 | FORT LAUDERDALE | FL | 33309 | PHYSICIAN LOCUM | $1,322,393 |
| BABCOCK OUTDOOR ADVERTISING | |||||
| 966 CENTER AVE | JANESVILLE | WI | 53546 | ADVERTISING | $1,105,491 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 49 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $129,080 | RelatedOrganizationsAmt |
| Government Grants | $114,899 | GovernmentGrantsAmt |
| All Other Contributions | $19,842 | AllOtherContributionsAmt |
| Total Contributions | $263,821 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $504,383,272 | $504,383,272 | ||
| UNRELATED BUSINESS INCOME | 561000 | $10,145,886 | $10,145,886 | ||
| CAFETERIA | 722210 | $1,229,669 | $1,229,669 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $515,758,827 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $383,643 | TotalRevenueColumnAmt |
| Exclusion | $383,643 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,322,056 | SecuritiesAmt |
| Other | $109,656 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,407,916 | SecuritiesAmt |
| Other | $113,880 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$85,860 | SecuritiesAmt |
| Other | -$4,224 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$90,084 | TotalRevenueColumnAmt |
| Exclusion | -$90,084 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER INVESTMENTS | 900099 | $2,830,329 | $2,830,329 |
| MISCELLANEOUS | 900099 | $25,923 | $25,923 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,856,252 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $519,172,459 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $504,383,272 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $10,145,886 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,379,480 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,829,156 | TotalAmt |
| Management And General | $8,829,156 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,176,326 | TotalAmt |
| Program Services | $192,939,869 | ProgramServicesAmt |
| Management And General | $43,236,457 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,398,033 | TotalAmt |
| Program Services | $5,494,816 | ProgramServicesAmt |
| Management And General | $1,903,217 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,012,904 | TotalAmt |
| Program Services | $21,722,276 | ProgramServicesAmt |
| Management And General | $9,290,628 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,925,111 | TotalAmt |
| Program Services | $10,459,254 | ProgramServicesAmt |
| Management And General | $3,465,857 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $686,837 | TotalAmt |
| Management And General | $686,837 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,300 | TotalAmt |
| Management And General | $44,300 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,457 | TotalAmt |
| Management And General | $37,457 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,182,292 | TotalAmt |
| Program Services | $15,822,770 | ProgramServicesAmt |
| Management And General | $11,359,522 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,646,504 | TotalAmt |
| Program Services | $17,662 | ProgramServicesAmt |
| Management And General | $3,628,842 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,798,512 | TotalAmt |
| Program Services | $78,905,551 | ProgramServicesAmt |
| Management And General | $4,892,961 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,238,001 | TotalAmt |
| Program Services | $408,239 | ProgramServicesAmt |
| Management And General | $829,762 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,946,478 | TotalAmt |
| Program Services | $8,025,617 | ProgramServicesAmt |
| Management And General | $920,861 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,092,350 | TotalAmt |
| Program Services | $465,864 | ProgramServicesAmt |
| Management And General | $626,486 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,660,793 | TotalAmt |
| Program Services | $1,063,586 | ProgramServicesAmt |
| Management And General | $597,207 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,358,292 | TotalAmt |
| Program Services | $8,395,043 | ProgramServicesAmt |
| Management And General | $963,249 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,842,703 | TotalAmt |
| Program Services | $23,065,719 | ProgramServicesAmt |
| Management And General | $2,776,984 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,506,889 | TotalAmt |
| Program Services | $3,109,737 | ProgramServicesAmt |
| Management And General | $1,397,152 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $28,097,312 | $28,097,312 | |
| EQUIPMENT REPAIRS & MAI | $7,254,669 | $4,825,185 | $2,429,484 |
| WI MEDICAID & OTHER TAX | $6,701,005 | $6,701,005 | |
| INTER-ENTITY TRANSACTIO | -$5,837,201 | -$4,861,877 | -$975,324 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,509,810 | TotalAmt |
| Program Services | $615,599 | ProgramServicesAmt |
| Management And General | $1,894,211 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,108,533 | TotalAmt |
| Program Services | $405,273,227 | ProgramServicesAmt |
| Management And General | $98,835,306 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,285 | BOYAmt |
| EOY | $24,990 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,996,299 | BOYAmt |
| EOY | $19,975,876 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,130,447 | BOYAmt |
| EOY | $87,097,875 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,104,452 | BOYAmt |
| EOY | $10,737,552 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,603,206 | BOYAmt |
| EOY | $5,824,521 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $533,925,660 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $245,335,466 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,762,282 | BOYAmt |
| EOY | $288,590,194 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,226,624 | BOYAmt |
| EOY | $73,661,949 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,908,789 | BOYAmt |
| EOY | $11,612,645 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,754,384 | BOYAmt |
| EOY | $497,525,602 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,498,293 | BOYAmt |
| EOY | $60,162,338 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,084,631 | BOYAmt |
| EOY | $7,104,728 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,991,179 | BOYAmt |
| EOY | $235,784,631 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $305,574,103 | BOYAmt |
| EOY | $303,051,697 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,180,281 | BOYAmt |
| EOY | $194,473,905 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,180,281 | BOYAmt |
| EOY | $194,473,905 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,754,384 | BOYAmt |
| EOY | $497,525,602 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $15,063,926 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $370,495 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $23,859,203 | 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 | $27,078,424 | OtherCostOrOtherBasisAmt |
| Book Value | $27,078,424 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $296,003,827 | OtherCostOrOtherBasisAmt |
| Depreciation | $106,255,768 | DepreciationAmt |
| Book Value | $189,748,059 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,259,189 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,882,255 | DepreciationAmt |
| Book Value | $1,376,934 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $193,247,672 | OtherCostOrOtherBasisAmt |
| Depreciation | $130,155,230 | DepreciationAmt |
| Book Value | $63,092,442 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,336,548 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,042,213 | DepreciationAmt |
| Book Value | $7,294,335 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $288,590,194 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (5 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| INVEST. - FUTURE REPLACE OF PROP, PLANT & EQUIPMENT | $32,812,437 | C |
| ASSETS UNDER BOND INDENTURE AGREEMENT | $4,344,304 | C |
| DEFERRED COMPENSATION | $9,969,659 | C |
| INVESTMENT IN MERCYCARE | $21,815,602 | C |
| INVESTMENTS - OTHER | $4,719,947 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $73,661,949 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $9,969,659 |
| PENSION LIABILITY | $23,773,000 |
| CAPITAL LEASES PAYABLE | $195,658 |
| DUE TO RELATED PARTY | $201,846,314 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $235,784,631 | 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $4,303,830 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,303,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00850 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,562,299 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $35,208,378 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,353,921 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06220 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,766,020 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,311,063 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,454,957 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $76,632,149 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,519,441 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,112,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07560 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,563,349 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $204,853 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,358,496 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,304,291 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $782,389 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,521,902 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,626,742 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,332,172 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,294,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $506,780 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $506,780 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,001,162 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,319,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,681,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01730 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94,633,311 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,838,855 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,794,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09290 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,040 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $53,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,640 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,680 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $34,680 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $140,760 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $140,760 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,493,404 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,517,129 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $56,735,174 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $74,331,057 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,595,883 | 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 | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Teaching HospitalTeachingHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|
| MERCY HOSPITAL | |||||||||
| 1 | 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |||||||||
| 2 | N2950 STATE ROAD 67 | LAKE GENEVA | WI | 53147 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Rpt Available Upon RequestRptAvailableUponRequestInd | Adopt Implementation StrategyAdoptImplementationStrategyInd | Exec Implementation StrategyExecImplementationStrategyInd | Develop Community Wide PlanDevelopCommunityWidePlanInd | Exec Community Wide PlanExecCommunityWidePlanInd | Include Operational PlanIncludeOperationalPlanInd | Adopt BudgetAdoptBudgetInd | Prioritize Health NeedsPrioritizeHealthNeedsInd | Prioritize ServicesPrioritizeServicesInd | All Needs AddressedAllNeedsAddressedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareInd | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Explained BasisExplainedBasisInd | Income LevelIncomeLevelInd | Asset LevelAssetLevelInd | Medical IndigencyMedicalIndigencyInd | Insurance StatusInsuranceStatusInd | Uninsured DiscountUninsuredDiscountInd | Medicaid MedicareMedicaidMedicareInd | ResidencyResidencyInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | Posted On WebsitePostedOnWebsiteInd | Posted In Emergency RoomPostedInEmergencyRoomInd | Available On RequestAvailableOnRequestInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit Report To Credit AgencyPermitReportToCreditAgencyInd | Collection ActivitiesCollectionActivitiesInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY HOSPITAL AND TRAUMA CENTER | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | Yes (1) | Yes (1) | Yes (X) | MERCYHEALTHSYSTEM.ORG | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | 0 | Yes (1) | Yes (1) | 150.000000000000 | Yes (1) | 300.000000000000 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) | Yes (X) | 0 | 0 |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | Yes (1) | Yes (1) | Yes (X) | MERCYHEALTHSYSTEM.ORG | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | 0 | Yes (1) | Yes (1) | 150.000000000000 | Yes (1) | 300.000000000000 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HOSPITAL AND TRAUMA CENTER | PART V, SECTION B, LINE 3: MERCY HEALTH SYSTEM (MHS) SET OUT TO GATHER INFORMATION ON THE COMMUNITY OF ROCK COUNTY, WISCONSIN. MHS COLLABORATED WITH BELOIT HEALTH SYSTEM, ROCK COUNTY HEALTH DEPARTMENT, UNIVERSITY OF WISCONSIN- EXTENSION ROCK COUNTY, ROCK COUNTY, HEALTHNET OF ROCK COUNTY, EDGERTON HOSPITAL AND HEALTH SERVICES, SSM HEALTHCARE OF WISCONSIN. THE GROUP GATHERED INFORMATION THROUGH HOUSEHOLD SURVEYS AND SECONDARY DATA SOURCES.MERCY HEALTH SYSTEM DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF ROCK COUNTY RESIDENTS. THE FIFTY QUESTION SURVEY WAS DISTRIBUTED TO 2,000 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 32.8% 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 WISCONSIN COUNTY HEALTH RANKINGS, WISCONSIN DEPARTMENT OF TRANSPORTATION, DEPARTMENT OF EDUCATION, WISCONSIN DEPARTMENT OF HEALTH SERVICES, U.S. CENSUS BUREAU, AND OTHERS. 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 ROCK COUNTY AND THE COMMUNITY AS A WHOLE. |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | PART V, SECTION B, LINE 3: MERCY HEALTH SYSTEM DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF WALWORTH COUNTY RESIDENTS. THE SURVEY, DISTRIBUTED TO 2000 MEMBERS OF THE COMMUNITY, COVERED VARIOUS TOPICS, INCLUDING ACCESS TO CARE, QUALITY OF LIFE, CHRONIC ILLNESSES, AND LIFESTYLE FACTORS. A RESPONSE WAS RECEIVED FROM 14.4% OF HOUSEHOLDS THAT RECEIVED THE SURVEY (288 SURVEYS). ONCE THE SURVEY RESPONSES WERE TABULATED, THE SURVEY RESULTS WERE EVALUATED AND ANALYZED FOR HEALTH AND DEMOGRAPHIC TRENDS. 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, WISCONSIN DEPARTMENT OF PUBLIC HEALTH, AND THE UNITED STATES CENSUS BUREAU. 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 WALWORTH COUNTY. |
| MERCY HOSPITAL AND TRAUMA CENTER | PART V, SECTION B, LINE 4: BELOIT, EDGERTON, ST MARY'S JANESVILLE |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | PART V, SECTION B, LINE 4: AURORA LAKELAND MEDICAL CENTER |
| MERCY HOSPITAL AND TRAUMA CENTER | PART V, SECTION B, LINE 14G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | PART V, SECTION B, LINE 14G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. |
| MERCY HOSPITAL AND TRAUMA CENTER | PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY USED THE AVERAGE COMMERCIAL CHARGE. |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY USED THE AVERAGE COMMERCIAL CHARGE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 50 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (50 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| MERCY MANOR TRANSITION CENTER | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | SKILLED NURSING/SUB-ACUTE CARE FACILITY |
| MERCY REGIONAL CANCER CENTER | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | RADIATION ONCOLOGY CLINIC/RADIATION THERAPY FACILITY |
| HOUSE OF MERCY HOMELESS SHELTER | ||||
| 320 LINCOLN STREET | JANESVILLE | WI | 53548 | HOMELESS CENTER |
| MERCY ALGONQUIN MEDICAL CENTER | ||||
| 2401 HARNISH DRIVE SUITE 101 | ALGONQUIN | WI | 60102 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BARIATRIC WELLNESS CENTER | ||||
| 250 E CENTER DRIVE SUITE 201 | VERNON HILLS | WI | 60061 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BARRINGTON MEDICAL CENTER | ||||
| 500 WEST HIGHWAY 22 | BARRINGTON | WI | 60010 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BELOIT MEDICAL CENTER | ||||
| 2825 PRAIRIE AVENUE | BELOIT | WI | 53511 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY BRODHEAD MEDICAL CENTER | ||||
| 2310 FIRST CENTER AVENUE | BRODHEAD | WI | 53520 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CENTER FOR CORRECTIVE EYE SURGERY | ||||
| 5400 W ELM STREET SUITE 120 | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CENTER FOR CORRECTIVE EYE SURGERY | ||||
| 8780 W GOLF ROAD STE 304 | NILES | IL | 60714 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CLINIC EAST | ||||
| 3524 EAST MILWAUKEE STREET | JANESVILLE | WI | 53546 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY CLINIC EAST PHARMACY | ||||
| 3524 EAST MILWAUKEE STREET | JANESVILLE | WI | 53546 | RETAIL PHARMACY |
| MERCY CLINIC SOUTH | ||||
| 849 KELLOGG AVENUE | JANESVILLE | WI | 53546 | RESIDENCY PROGRAM / OUTPATIENT PHYSICIAN CLINIC |
| MERCY CLINIC WEST | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC & MEDICAL ONCOLOGY |
| MERCY CLINIC WEST PHARMACY | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | RETAIL PHARMACY |
| MERCY CRYSTAL LAKE CHIROPRACTIC AND REHA | ||||
| 330 W TERRA COTTA ROAD RTE 176 | CRYSTAL LAKE | IL | 60014 | CHIROPRACTOR |
| MERCY CRYSTAL LAKE MEDICAL CENTER EAST | ||||
| 390 CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE MEDICAL CENTER WEST | ||||
| 350 CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE OBGYN | ||||
| 750 E TERRA COTTA STE B | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE MEDICAL CENTER SOUTH | ||||
| 415-A CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY DELAVAN MEDICAL CENTER | ||||
| 1038 E GENEVA ST | DELAVAN | WI | 53115 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY EDGERTON MEDICAL CENTER | ||||
| 217 N MAIN STREET | EDGERTON | WI | 53534 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY EVANSVILLE MEDICAL CENTER | ||||
| 300 UNION STREET | EVANSVILLE | WI | 53536 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY HARVARD CLINIC SOUTH | ||||
| 348 S DIVISION | HARVARD | IL | 60033 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY HEALTH MALL | ||||
| 1010 NORTH WASHINGTON | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY HEALTH MALL PHARMACY | ||||
| 1010 NORTH WASHINGTON | JANESVILLE | WI | 53548 | RETAIL PHARMACY |
| MERCY LAKE GENEVA MEDICAL CENTER | ||||
| 350 PELLER ROAD | LAKE GENEVA | WI | 53147 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY LAKESIDE ORTHOPAEDICS | ||||
| 352 PELLER ROAD | LAKE GENEVA | WI | 53147 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MCHENRY INTERNAL MEDICINE CENTER | ||||
| 633 RIDGEVIEW DRIVE | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MCHENRY MEDICAL CENTER | ||||
| 3922 MERCY DRIVE | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MILTON MEDICAL CENTER | ||||
| 725 SOUTH JANESVILLE STREET | MILTON | WI | 53563 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MILTON PHARMACY | ||||
| 725 SOUTH JANESVILLE STREET | MILTON | WI | 53563 | RETAIL PHARMACY |
| MERCY NORTHWEST WOMEN'S GROUP | ||||
| 47 WEST ACORN LANE | LAKE IN THE HILLS | IL | 601564804 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY OPTIONS-COOPERATIVE CHILDCARE INST | ||||
| 20 EAST COURT STREET | JANESVILLE | WI | 53548 | TREATMENT FACILITY FOR ADOLESCENTS |
| MERCY OPTIONS-JANESVILLE | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | PHYSICIAN & THERAPIST SERVICES: MENTAL HEALTH & ADDICTION TREATMENT |
| MERCY REGIONAL DIALYSIS CENTER | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | DIALYSIS CENTER |
| MERCY REGIONAL LUNG CENTER | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | PHYSICIANS CLINIC & SLEEP DISORDER CENTER |
| MERCY RICHMOND MEDICAL CENTER | ||||
| 9715 PRAIRIE RIDGE | RICHMOND | IL | 60071 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY SHARON MEDICAL CENTER | ||||
| 118 PLAIN STREET | SHARON | WI | 53585 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY SPORTS MEDICINE AND REHABILITATION | ||||
| 557 NORTH WASHINGTON | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY |
| MERCY TERRACE | ||||
| 510 N TERRACE STREET | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WALWORTH PHARMACY | ||||
| N2950 STATE ROAD 67 | LAKE GENEVA | WI | 53147 | RETAIL PHARMACY |
| MERCY WHITEWATER MEDICAL CENTER | ||||
| 507 WEST MAIN STREET | WHITEWATER | WI | 53190 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WHITEWATER SPORTS MEDICINE & REHAB | ||||
| 519 WEST MAIN STREET | WHITEWATER | WI | 53190 | OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY |
| MERCY WOODSTOCK MEDICAL CENTER | ||||
| 2000 LAKE AVENUE | WOODSTOCK | IL | 60098 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY WOODSTOCK PHARMACY | ||||
| 2000 LAKE AVENUE | WOODSTOCK | IL | 60098 | RETAIL PHARMACY |
| MERCY WOMEN'S HEALTHCARE CENTER - ALCONQ | ||||
| 2230 N HUNTINGTON DR | ALGONQUIN | IL | 60102 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WOMEN'S HEALTHCARE CENTER - ELGIN | ||||
| 750 FLETCHER DR STE 206 | ELGIN | IL | 60123 | OUTPATIENT PHYSICIAN CLINIC |
| WOMEN'S HEALTH CENTER - HOFFMAN ESTATES | ||||
| 1555 BARRINGTON RD STE 2300A | HOFFMAN ESTATES | IL | 60169 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY ELKHORN MEDICAL CENTER | ||||
| 839 N WISCONSIN ST | ELKHORN | WI | 53121 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | MERCY HEALTH SYSTEM, CORP. (MHS) SUBMITS AN ANNUAL COMMUNITY BENEFIT STATEMENT TO THE WISCONSIN HOSPITAL ASSOCIATION. PERIODICALLY, IT PUBLISHES A PAMPHLET EXPLAINING THE COMMUNITY BENEFITS THAT MERCY HEALTH SYSTEM CORP, AND THE RELATED ORGANIZATIONS OF MHS PROVIDE TO THE COMMUNITIES THEY SERVE. MHS HAS SUPPLIED SUPPLEMENTAL COMMUNITY BENEFIT STATEMENT INFORMATION WITH ITS 990 TAX RETURN SINCE FISCAL YEAR 2006 (TAX FORM 2005). MHS ISSUED A PRESS RELEASE RELATING TO THE HEALTH SYSTEM'S PRIOR YEAR'S COMMUNITY BENEFITS AND HAS THE SAME ON ITS WEBSITE; IT FURTHER REFERENCES THE AVAILABILITY OF WHA'S REPORT. |
| 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; HEALTH PROFESSIONS EDUCATION; 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: | THE SUBSIDIZED HEALTH CARE LINE INCLUDES $3,306,659 OF EXPENSES (COLUMN C) AND $1,447,230 OF NET EXPENSES (COLUMN E) ATTRIBUTABLE TO THE COSTS OF TRAUMA SURGEONS. THESE SURGEONS STAFF THE LEVEL II TRAUMA PROGRAM OF MERCY HEALTH SYSTEM CORPORATION 24/7. MERCY SOUTH - FAMILY PRACTICE CLINIC WAS ALSO INCLUDED IN THIS LINE: EXPENSES IN COLUMN C TOTALED $3,573,088 AND COLUMN E HAD $259,487 OF NET EXPENSES. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $28,097,312 INCLUDED ON FORM 990, PART IX, LINE 25, WAS EXCLUDED FROM EXPENSES WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MERCY'S MANY HEALTH IMPROVEMENT AND BENEFIT SERVICES/OPERATIONS WERE THE RESULT OF MERCY FILLING A COMMUNITY NEED. MERCY'S COLLABORATIVE EFFORTS AND THE EFFORTS OF ITS RELATED ENTITIES HAVE BROUGHT ASSISTANCE TO THE AREA'S UNDERSERVED (AS DETAILED IN #2 ABOVE). |
| 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 HEALTH SYSTEM CORPORATION AND SUBSIDIARIES). 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, MHSC ANALYZES HISTORICAL LOSS EXPERIENCE ON REVENUE FOR ALL PAYORS. USING THE LOSS EXPERIENCE RATE, MHSC 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 MERCY'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 13.2%. 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 MERCY'S TWO HOSPITALS' MEDICARE COST REPORTS. |
| PART III, LINE 9B: | PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MERCY'S COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MERCY'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MERCY'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: | MERCY HEALTH SYSTEM CORPORATION DOES COMMUNITY NEEDS ASSESSMENTS IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI), AND MCHENRY (IL) COUNTIES EVERY 18 MONTHS. MERCY HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS OF NEARBY COMMUNITIES TO ASSESS HEALTH NEEDS. 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 HOSPITAL AND TRAUMA CENTER IS LOCATED IN JANESVILLE, WI: ROCK COUNTY. IT IS ONE OF TWO ACUTE CARE HOSPITALS IN JANESVILLE, WI. IT IS LICENSED FOR 240 ACUTE BEDS. IT HAS 24/7 EMERGENCY SERVICES, WITH A TRAUMA II DESIGNATION. IT IS A TEACHING HOSPITAL WITH A RESIDENCY PROGRAM.UNEMPLOYMENT IN ROCK COUNTY (2013) WAS AT 8.6% WHILE THE STATE (WI) AND THE NATION WERE AT 7.0% AND 7.5%, RESPECTIVELY. MEDIAN HOUSEHOLD INCOME (2012) WAS $50,316 IN ROCK COUNTY, WHICH IS LOWER THAN BOTH THE STATES $52,627 AND NATIONAL MEDIAN OF $53,046. IN 2012, 13.5% OF ROCK COUNTY RESIDENTS LIVED BELOW THE POVERTY LEVEL; THIS IS LARGER THAN THE STATES AVERAGE OF 12.5%, BUT LESS THAN THE NATIONAL AVERAGE OF 14.9%. OVER 50% OF STUDENTS IN THE JANESVILLE SCHOOL DISTRICT WERE ECONOMICALLY DISADVANTAGED STUDENTS (SCHOOL YEAR 2012-2013).MERCY WALWORTH HOSPITAL IS LOCATED IN LAKE GENEVA WI WHICH IS IN WALWORTH COUNTY, WI. IT IS A CRITICAL ACCESS HOSPITAL LICENSED FOR 25 ACUTE BEDS THAT PROVIDES 24/7 EMERGENCY SERVICES. MERCY HEALTH SYSTEM DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF WALWORTH COUNTY RESIDENTS. THE SURVEY, DISTRIBUTED TO 2000 MEMBERS OF THE COMMUNITY, COVERED VARIOUS TOPICS, INCLUDING ACCESS TO CARE, QUALITY OF LIFE, CHRONIC ILLNESSES, AND LIFESTYLE FACTORS. A RESPONSE WAS RECEIVED FROM 14.4% OF HOUSEHOLDS THAT RECEIVED THE SURVEY (288 SURVEYS). ONCE THE SURVEY RESPONSES WERE TABULATED, THE SURVEY RESULTS WERE EVALUATED AND ANALYZED FOR HEALTH AND DEMOGRAPHIC TRENDS. 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, WISCONSIN DEPARTMENT OF PUBLIC HEALTH, AND THE UNITED STATES CENSUS BUREAU. 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 WALWORTH COUNTY. UNEMPLOYMENT IN WALWORTH COUNTY (2013) WAS AT 7.0%; THIS MATCHED THE STATES (WI) RATE AND WAS BETTER THAN THE NATIONAL AVERAGE OF 7.5%. APPROXIMATELY 50% OF STUDENTS IN THE LAKE GENEVA J1 SCHOOL DISTRICT WERE ECONOMICALLY DISADVANTAGED STUDENTS (SCHOOL YEAR 2012-2013).MERCY HEALTH SYSTEM CORPS PAYOR DEMOGRAPHICS FOR ITS HOSPITALS INCLUDE 39.6% MEDICARE, AND 14.4% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2013 JUNE 30, 2014 (AS DETERMINED BY CHARGES BILLED). |
| PART VI, LINE 5: | MERCY HEALTH SYSTEM CORP HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREAS. MERCY HEALTH SYSTEM CORP. HAS A GOVERNING BODY COMPRISED OF A MAJORITY OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY. |
| PART VI, LINE 6: | MERCY HEALTH SYSTEM CORPORATION HAS TWO HOSPITALS THAT PROVIDE ACUTE CARE SERVICES IN ROCK AND WALWORTH COUNTIES OF WISCONSIN. MERCY HEALTH SYSTEM CORP ALSO OPERATES COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND 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 HARVARDHOSPITAL, INC., AND MERCY ASSISTED CARE INC. MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY, ILLINOIS. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES, HOSPICE, 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 PER YEAR THE LAST THREE YEARS.MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCYS VOLUNTEERS. VOLUNTEERS NUMBERED 1,470 IN CALENDAR YEAR 2013. THIS ORGANIZATION NOT ONLY SUPPORTS MERCYS SERVICES, BUT PROVIDES BENEFITS TO THE COMMUNITY AS A WHOLE. IN CONJUNCTION WITH MERCY HEALTH SYSTEMS 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) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Payments For Use Of Residence | Yes (X) | PaymentsForUseOfResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Personal Services | Yes (X) | PersonalServicesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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 MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $428,028 | $0 | $0 | $0 | $5,209 | $0 | $15,576 | $0 | $12,842 | $0 | $461,655 | $0 | $0 | $0 |
| BARB BORTNER | ||||||||||||||
| VICE-PRESIDENT | $135,533 | $0 | $62,671 | $0 | $640 | $0 | $13,029 | $0 | $21,284 | $0 | $233,157 | $0 | $0 | $0 |
| DAN COLBY | ||||||||||||||
| VICE-PRESIDENT | $179,806 | $0 | $68,085 | $0 | $18,662 | $0 | $16,851 | $0 | $11,968 | $0 | $295,372 | $0 | $0 | $0 |
| DAVID KURTZ | ||||||||||||||
| VICE-PRESIDENT | $136,730 | $0 | $62,671 | $0 | $10,109 | $0 | $13,111 | $0 | $15,169 | $0 | $237,790 | $0 | $0 | $0 |
| JOHN COOK | ||||||||||||||
| VICE-PRESIDENT | $258,028 | $0 | $115,445 | $0 | $5,460 | $0 | $16,851 | $0 | $20,831 | $0 | $416,615 | $0 | $0 | $0 |
| KATHY HARRIS | ||||||||||||||
| VICE-PRESIDENT | $87,296 | $0 | $40,977 | $0 | $8,970 | $0 | $8,056 | $0 | $19,870 | $0 | $165,169 | $0 | $0 | $0 |
| RUTH YARBROUGH | ||||||||||||||
| VICE-PRESIDENT | $167,541 | $0 | $74,487 | $0 | $13,012 | $0 | $16,223 | $0 | $7,209 | $0 | $278,472 | $0 | $0 | $0 |
| RICHARD GRUBER | ||||||||||||||
| VICE-PRESIDENT | $136,675 | $0 | $62,153 | $0 | $8,551 | $0 | $13,329 | $0 | $14,559 | $0 | $235,267 | $0 | $0 | $0 |
| RALPH TOPINKA | ||||||||||||||
| VICE-PRESIDENT | $183,819 | $0 | $91,483 | $0 | $11,370 | $0 | $13,026 | $0 | $2,699 | $0 | $302,397 | $0 | $0 | $0 |
| JOSEPH NEMETH | ||||||||||||||
| VICE-PRESIDENT | $140,908 | $0 | $63,877 | $0 | $8,214 | $0 | $13,602 | $0 | $12,129 | $0 | $238,730 | $0 | $0 | $0 |
| SUE RIPSCH | ||||||||||||||
| VICE-PRESIDENT | $247,499 | $0 | $111,778 | $0 | $16,597 | $0 | $16,851 | $0 | $16,120 | $0 | $408,845 | $0 | $0 | $0 |
| JENNIFER HALLATT | ||||||||||||||
| VICE-PRESIDENT | $151,395 | $0 | $69,829 | $0 | $3,814 | $0 | $14,830 | $0 | $22,414 | $0 | $262,282 | $0 | $0 | $0 |
| JAVON BEA | ||||||||||||||
| PRESIDENT & DIRECTOR | $1,005,629 | $0 | $883,870 | $0 | $3,330,866 | $0 | $16,851 | $0 | $19,794 | $0 | $5,257,010 | $0 | $0 | $0 |
| VIKRAM KHANNA | ||||||||||||||
| PHYSICIAN | $1,819,662 | $0 | $0 | $0 | $360 | $0 | $15,576 | $0 | $33,596 | $0 | $1,869,194 | $0 | $0 | $0 |
| BRADLEY FIDELER | ||||||||||||||
| PHYSICIAN | $1,307,876 | $0 | $0 | $0 | $828 | $0 | $15,576 | $0 | $25,939 | $0 | $1,350,219 | $0 | $0 | $0 |
| CHRISTOPHER STURM | ||||||||||||||
| PHYSICIAN | $1,186,246 | $0 | $0 | $0 | $540 | $0 | $15,576 | $0 | $23,735 | $0 | $1,226,097 | $0 | $0 | $0 |
| ROBB WHINNEY | ||||||||||||||
| PHYSICIAN | $1,255,017 | $0 | $0 | $0 | $360 | $0 | $15,576 | $0 | $16,157 | $0 | $1,287,110 | $0 | $0 | $0 |
| DANIEL HOFFMAN | ||||||||||||||
| PHYSICIAN | $1,005,821 | $0 | $0 | $0 | $50,660 | $0 | $15,576 | $0 | $21,323 | $0 | $1,093,380 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | RESIDENCE FOR PERSONAL USE - THE CEO IS PROVIDED WITH A RESIDENCE. THE COST OF RENTING THE RESIDENCE IS TREATED AS TAXABLE COMPENSATION. PAYMENTS FOR BUSINESS USE OF PERSONAL RESIDENCE - THE CEO IS REIMBURSED FOR INTERNET ACCESS AND COMMUNICATION COSTS USED FOR BUSINESS PURPOSES AT HIS PERSONAL RESIDENCE. THE REIMBURSEMENT IS TREATED AS TAXABLE COMPENSATION. HEALTH CLUB DUES - THE CEO IS REIMBURSED FOR HEALTH CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION. PERSONAL SERVICES - THE CEO IS REIMBURSED FOR INCOME TAX PREPARATION SERVICES. THIS IS TREATED AS TAXABLE COMPENSATION. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KRISTEN GOELZER | |||
| FAMILY MEMBER OF MARK GOELZER, DIRECTOR | $297,025 | EMPLOYMENT - PHYSICIAN | 0 |
| JAMIE KURTZ | |||
| FAMILY MEMBER OF DAVID KURTZ, OFFICER | $35,854 | EMPLOYMENT - PATIENT ACCOUNT REPRESENTATIVE | 0 |
| JOANNA BENNING | |||
| FAMILY MEMBER OF JAVON BEA, PRESIDENT & DIRECTOR | $142,126 | EMPLOYMENT - DIRECTOR | 0 |
| MEGAN KRAUSE | |||
| FAMILY MEMBER OF SUE RIPSCH, OFFICER | $90,815 | EMPLOYMENT - MANAGER | 0 |
| LAUREN GRUBER | |||
| FAMILY MEMBER OF RICHARD GRUBER, OFFICER | $48,641 | EMPLOYMENT - RN/HIB | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT REVIEWS THE FORM 990 BEFORE FILING.THE 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 B, LINE 15 | THE MERCY ALLIANCE COMPENSATION COMMITTEE IS COMPRISED OF THE BOARD CHAIRPERSON, SECRETARY, AND THE TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED BY INDEPENDENT LEGAL COUNCIL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNCIL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2012. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | NET AFFILIATES TRANSFER 23,600,000. CHANGES IN PENSION OBLIGATIONS 195,000. OTHER 64,203. |
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 MERCY HEALTH SYSTEM & THE HOUSE OF MERCY | WI | 501(C)(3) | 11A | Yes (1) | 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 | Yes (1) | 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 ALLIANCE 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 | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Share Of Total IncomeShareOfTotalIncomeAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | ||||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391520130 | MANAGEMENT ENTITY OF UNION EMPLOYEES | WI | MERCY HEALTH SYSTEM CORPORATION | C | $68,984 | 1.00000 | Yes (1) | |
| MERCYCARE INSURANCE COMPANY | ||||||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | $50,097,627 | 1.00000 | Yes (1) | $111,471,679 |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | ||||||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | 1.00000 | Yes (1) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCYCARE INSURANCE COMPANY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | Q | TransactionTypeTxt |
| Involved | $7,477,970 | InvolvedAmt |
| Method Of Amount Determination | COST OF SERVICES PROVIDED | MethodOfAmountDeterminationTxt |