2015-08-03T11:22:37-05:00 2014-09-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2013-10-01 391487306 SAN CAMILLO INC SANC 4142598320 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 KEVIN SCHWAB CHIEF FINANCIAL OFFICER 4142581814 2015-07-30 1 JAY ADKISSON CPA P01360892 4144319300 2015-07-29 2013 2016-02-25 16:41:14Z KEVIN SCHWAB 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 13746018 0 0928 X WWW.STCAM.COM X 1923 WI BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 10 10 0 0 0 0 441168 10219 14459099 13695533 0 1274 34642 38992 14934909 13746018 0 0 0 0 2848902 3859026 0 0 0 9677445 9083989 12526347 12943015 2408562 803003 55075011 57150879 37803555 59448636 17271456 -2297757 X BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 0 0 7398647 8354275 OPERATES A 288 UNIT INDEPENDENT LIVING FACILITY FOR SENIOR RESIDENTS 4730283 5341258 OPERATES A 109 UNIT ASSISTED LIVING FACILITY PROVIDING HEALTHCARE AND OTHER SERVICES TO THE FRAIL ELDERLY 12128930 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X X SAN CAMILLO INC 4142581814 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 HARRY W WHELPLEY CHAIRPERSON 1.00 X X 0 0 0 FR RICHARD O'DONNELL MI VICE CHAIRPERSON 20.00 X X 0 0 0 FR LEANDRO BLANCO MI TREASURER 40.00 X X 0 0 0 FR PEDRO TRAMONTIN MI BOARD MEMBER 40.00 X 0 0 0 BR MARIO CRIVELLO MI BOARD MEMBER 40.00 X 0 0 0 FREDERICK A MUTH JR BOARD MEMBER 1.00 X 0 0 0 MARK E SLESAR BOARD MEMBER 1.00 X 0 0 0 ROSEMARIE MATHEUS BOARD MEMBER 1.00 X 0 0 0 NICK LAUBUSCH BOARD MEMBER 1.00 X 0 0 0 JIM WESSON BOARD MEMBER 1.00 X 0 0 0 RICK L JOHNSON PRESIDENT & CEO 40.00 X 0 246115 26956 KEVIN SCHWAB CHIEF FINANCIAL OFFICER 40.00 X 0 172729 24374 MARIE D'AMICO SECRETARY & VICE PRESIDENT 40.00 X 131435 0 21496 131435 418844 72826 1 0 1 0 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 887577 DIERKS WAUKESHA PB BOX 0469 WAUKESHA WI 53187 FOOD SERVICE 431685 CARPETLAND USA 11316 W ROGERS ST WEST ALLIS WI 53227 FLOORING 204364 STEIGERWALD CONSTRUCTION INC 5310 W STATE ST MILWAUKEE WI 53208 CONSTRUCTION 180653 4 10219 10219 MONTHLY SERVICE FEES 900099 12223116 12223116 SUPPORTING SERVICES 900099 875585 875585 RESIDENT SERVICES 900099 582028 582028 AMORTIZATION REVENUE 900099 14804 14804 13695533 1274 1274 38992 0 38992 38992 38992 13746018 13695533 0 40266 3374162 3205454 168708 285133 270876 14257 199731 189744 9987 2516355 2390537 125818 16334 2940 13394 200461 36083 164378 778815 739874 38941 400853 380810 20043 789665 750182 39483 153299 145634 7665 1401881 1331787 70094 1036 984 52 613 582 31 234931 223184 11747 1396582 1326753 69829 85174 80915 4259 RAW FOOD / GROCERIES 941948 894851 47097 MAINTENANCE 119908 113913 5995 CATERING 9452 8979 473 36682 34848 1834 12943015 12128930 814085 0 2154460 2254418 312196 114384 28160 37101 29133 24869 45054363 29510319 16030666 15544044 36520396 39176063 55075011 57150879 377121 506142 930711 4595359 4505000 3935000 31990723 50412135 37803555 59448636 X 17271456 -2297757 17271456 -2297757 55075011 57150879 X 803003 -20372216 X 0 0 0 X 2591 1375 4117 441168 10219 459470 12349255 12417849 13243427 14459099 13695533 66165163 12351846 12419224 13247544 14900267 13705752 66624633 0 0 0 66624633 32071 29311 25175 34642 40266 161465 32071 29311 25175 34642 40266 161465 12383917 12448535 13272719 14934909 13746018 66786098 0.99760 0.99680 0.00240 0.00320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1037314 1037314 30369832 19578764 10791068 920850 846769 74081 12206254 8734695 3471559 520113 350091 170022 15544044 DUE FROM RELATED PARTY 39176063 39176063 REFUNDABLE ENTRANCE FEES 40984427 RESIDENT FUNDS HELD FOR SAFE KEEPING 998 DUE TO RELATED PARTY 9426710 50412135 X 13868178 132379 132379 13735799 10219 10219 13746018 12943015 0 12943015 0 12943015 PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM AND ITS CONSOLIDATED AFFILIATES DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE SYSTEM AND ITS CONSOLIDATED AFFILIATES RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2014 OR 2013. FEDERAL TAX RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION HAS CERTAIN ACTIVITIES WHICH ARE CONSIDERED UNRELATED TO THEIR EXEMPT PURPOSE AND, ACCORDINGLY, ARE TAXABLE IN ACCORDANCE WITH THE CODE. THESE ACTIVITIES ARE NOT SIGNIFICANT AND NO PROVISION FOR TAXES HAS BEEN RECORDED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS 132,379. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS FROM RELATED ORGANIZATIONS 10,219. X X X X X 0 0 0 0 0 0 0 0 0 RICK L JOHNSON PRESIDENT & CEO 0 225640 0 20475 0 0 0 11419 0 15537 0 273071 0 0 KEVIN SCHWAB CHIEF FINANCIAL OFFICER 0 151050 0 17043 0 4636 0 8636 0 15738 0 197103 0 0 MARIE D'AMICO SECRETARY & VICE PRESIDENT 110709 0 20726 0 0 0 3463 0 18033 0 152931 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 2012-02-29 5580000 REFINANCE 1995 BONDS 0 0 0 A 1645000 5580000 35883 5546117 2012 1 0 0 0 A 0 0 0 0 0 1 0 0 A 1 1 1 US BANK 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS A SINGLE CLASS OF MEMBERS AND THE SOLE MEMBER OF THAT CLASS IS ST. CAMILLUS HEALTH SYSTEM, INC., A WISCONSIN NONSTOCK CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS SHALL NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE MEMBER: TO DEFINE THE PHILOSOPHY, MISSION AND PURPOSE OF THE CORPORATION AND TO ADOPT, AMEND OR REPEAL ANY STATEMENTS OF MISSION OR PHILOSOPHY FOR THE CORPORATION; TO ADOPT, APPROVE, RESTATE, REVISE, OR AMEND THESE AMENDED AND RESTATED ARTICLES OF INCORPORATION AND THE BY-LAWS OF THE CORPORATION; TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION AND DETERMINE THE NUMBER (WHICH MAY NOT BE LESS THAN THREE) OF SUCH DIRECTORS; TO AUTHORIZE OR MAKE OTHER DECISIONS RELATING TO THE TRANSFER OR SALE OF OR CREATION OF AN ENCUMBRANCE (E.G. MORTGAGE, PLEDGE OR GRANT OF SECURITY INTEREST) UPON FIXED ASSETS OF THE CORPORATION WITH A VALUE IN EXCESS OF $500,000; TO AUTHORIZE THE INCURRENCE BY THE CORPORATION OF DEBT FOR MONEY BORROWED IN AMOUNTS IN EXCESS OF $500,000; TO ADOPT AMEND OR REPEAL ANY PLAN OF DISSOLUTION, CONSOLIDATION OR MERGER OF THE CORPORATION, ANY CONTRACT OR AGREEMENT FOR THE MANAGEMENT OF THE CORPORATION OR ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; TO CREATE, ACQUIRE, SELL, PURCHASE, DISSOLVE OR MAKE OTHER DISPOSITION OF ANY ENTITY OWNED OR CONTROLLED OR TO BE OWNED OR CONTROLLED BY THE CORPORATION OR ANY OWNERSHIP INTEREST IN ANY SUCH ENTITY; TO APPROVE ANY ACTIONS OR EXERCISE ANY POWER RESERVED TO THE CORPORATION AS A MEMBER OR SHAREHOLDER OF ANOTHER ENTITY; TO APPROVE THE INITIAL ELECTION BY THE BOARD OF DIRECTORS OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION (BUT NOT SUBSEQUENT RE-ELECTIONS OF THOSE PERSONS TO SERVE CONSECUTIVE TERMS IN SUCH RESPECTIVE OFFICES) AND TO REMOVE THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION WHETHER OR NOT SUCH REMOVAL IS APPROVED BY THE BOARD OF DIRECTORS; AND TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AND TO DETERMINE THE TERM OF THE PRESIDENT'S APPOINTMENT, SUCH TERM NOT TO EXCEED THREE YEARS. FORM 990, PART VI, SECTION B, LINE 11 THE CEO, CFO AND CONTROLLER REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS. A COPY IS KEPT ON HAND FOR PUBLIC VIEWING. FORM 990, PART VI, SECTION B, LINE 12C THE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS SALARIES WHICH ARE THEN COMPARED TO MANAGEMENT RESOURCE ASSOCIATION DATA. THE ORGANIZATION ALSO COMPARES THEIR SALARIES TO OTHER COMPANIES THAT ARE SIMILAR IN NATURE VIA 990'S. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 132,379. REFUNDABLE ENTRANCE FEES ACCUMULATED AMORTIZATION -20,503,066. TRANSFERS -1,529. ST CAMILLUS HEALTH SYSTEM INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 390806167 ADMINISTRATIVE AND MANAGEMENT SERVICES WI 501(C)(3) 11(B) N/A 0 ST CAMILLUS COMMUNITIES INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391843041 RESIDENTIAL FACILITIES WI 501(C)(3) 11(B) ST CAMILLUS HEALTH SYSTEM INC 0 ORDER OF ST CAMILLUS FOUNDATION INC 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 391925879 FUND-RAISING SUPPORT WI 501(C)(3) 11(B) ST CAMILLUS HEALTH SYSTEM INC 0 ST CAMILLUS HEALTH CENTER INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391079224 HEALTH SERVICES WI 501(C)(3) 9 ST CAMILLUS HEALTH SYSTEM INC 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1