PROHEALTH MEDICAL GROUP INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PROHEALTH MEDICAL GROUP INC (EIN 39-1083015)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-07
- IRS object ID
- 201542199349300709
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-07T08:27:13-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391083015 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH CARE MEDICAL ASSOCIATES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROH | BusinessNameControlTxt |
| Phone | 2629284740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE NO 200 | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 53188 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD FARR | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2629284740 | PhoneNum |
| Signature | 2015-07-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 2483522500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN EDWARDS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE NO 200 | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 53188 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $121,346,500 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1965 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | SERVE THE HEALTH CARE AND HUMAN SERVICE NEEDS OF PERSONS RESIDING IN SOUTHEAST WISCONSIN AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1056 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $427,979 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $111,725 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $107,168,033 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $119,597,666 | CYProgramServiceRevenueAmt |
| PY Investment Income | $321,485 | PYInvestmentIncomeAmt |
| CY Investment Income | $496,509 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,149,176 | PYOtherRevenueAmt |
| CY Other Revenue | $72,156 | CYOtherRevenueAmt |
| PY Total Revenue | $109,638,694 | PYTotalRevenueAmt |
| CY Total Revenue | $120,166,331 | 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 | $84,503,319 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $89,945,719 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,327,467 | PYOtherExpensesAmt |
| CY Other Expenses | $44,261,777 | CYOtherExpensesAmt |
| PY Total Expenses | $124,830,786 | PYTotalExpensesAmt |
| CY Total Expenses | $134,207,496 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$15,192,092 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$14,041,165 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $103,040,593 | TotalAssetsBOYAmt |
| Total Assets EOY | $105,110,437 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $69,860,377 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $74,072,072 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $33,180,216 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $31,038,365 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CONTINOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $113,770,836 | ExpenseAmt |
| Revenue | $119,169,687 | RevenueAmt |
| Desc | PHCMA OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHCMA FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHCMA PROVIDED 432,729 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014. | Desc |
| Total Program Service Expenses | $113,770,836 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 70 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1056 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | 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 | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD FARR | PersonNm |
| Phone | 2629284740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE SUITE | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 53188 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | |||||||||
| CHAIRPERSON | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $960,406 | $768,577 | ||
| NANINE NELSON | |||||||||
| CFO - PHC BOARD - PART YEAR | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $410,111 | $23,345 | ||
| JIM GANNON | |||||||||
| TREASURER - PHC BOARD | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM PACKEE | |||||||||
| SECRETARY - PHC BOARD | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN RAASCH | |||||||||
| VICE CHAIR-PART YEAR/DIRECTOR | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JANET SWANDBY | |||||||||
| CHAIRPERSON - PHC BOARD | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BETTY ARNDT | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| DIXON BENZ | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| HELEN FORSTER | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG HASTAD | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK MOHR | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| ELLEN MURPHY | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| RALPH RAMIREZ | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID ROELKE | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIE SCHROEDER | |||||||||
| DIRECTOR - PHC BOARD | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER GEISS | |||||||||
| CLINIC PRESIDENT - PART YEAR | 2.00 | 40.00 | Yes (X) | $0 | $1,880,337 | $21,369 | |||
| DAVID EBEL | |||||||||
| INTERIM CFO | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | |||
| RONALD FARR | |||||||||
| CFO | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN DYER | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $295,609 | $0 | $47,502 | Yes (X) | |||
| PAUL JASINSKI | |||||||||
| VICE PRESIDENT OF OPERATIONS | 40.00 | 0.00 | $248,319 | $0 | $40,286 | Yes (X) | |||
| IMAD KHATIB | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $734,048 | $0 | $47,579 | Yes (X) | |||
| PAUL LEMARBRE | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $601,808 | $0 | $39,290 | Yes (X) | |||
| DAVID NIENHUIS | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $729,965 | $0 | $41,346 | Yes (X) | |||
| PETER JOHNSON | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $551,459 | $0 | $39,497 | Yes (X) | |||
| DANIEL CHENG | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $550,668 | $0 | $47,733 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,711,876 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,250,854 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,116,524 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 187 | 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 |
|---|---|---|---|---|---|
| RILEY CONSTRUCTION CO INC | |||||
| 5301-99TH AVE | KENOSHA | WI | 53144 | CONSTRUCTION SERVICES | $3,104,802 |
| ABCO BUILDING CORPORATION | |||||
| 12665 W TOWNSEND ST | BROOKFIELD | WI | 53005 | CONSTRUCTION SERVICES | $385,629 |
| FROEDTERT HEALTH MEDICAL GR | |||||
| PO BOX 9030 | MENOMONEE FALLS | WI | 53052 | PROVIDER SERVICES | $326,788 |
| PAUL CRANDALL & ASSOCIATES | |||||
| 1645 N PORT WASHINGTON RD | GRAFTON | WI | 53024 | ROOFING CONTRACTOR | $278,152 |
| AT&T | |||||
| PO BOX 5080 | CAROL STREAM | IL | 60197 | PHONE & CABLE SERVICES | $240,097 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 621400 | $107,755,013 | $107,327,034 | $427,979 |
| PHYSICIAN SUBSIDIES | 621110 | $6,907,852 | $6,907,852 | |
| LEASED PHYSICIANS | 621110 | $2,348,679 | $2,348,679 | |
| MEANINGFUL USE | 900099 | $1,047,348 | $1,047,348 | |
| RENTAL REV-AFFILIATES | 532000 | $528,880 | $528,880 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,009,894 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,009,894 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $119,597,666 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,477 | TotalRevenueColumnAmt |
| Exclusion | $26,477 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,252,325 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,180,169 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $72,156 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,156 | TotalRevenueColumnAmt |
| Exclusion | $72,156 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $470,032 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $470,032 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $470,032 | TotalRevenueColumnAmt |
| Exclusion | $470,032 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $120,166,331 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $119,169,687 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $427,979 | UnrelatedBusinessRevenueAmt |
| Exclusion | $568,665 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,512 | TotalAmt |
| Program Services | $323,796 | ProgramServicesAmt |
| Management And General | $252,716 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,599,940 | TotalAmt |
| Program Services | $70,633,912 | ProgramServicesAmt |
| Management And General | $1,966,028 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,225,314 | TotalAmt |
| Program Services | $4,214,910 | ProgramServicesAmt |
| Management And General | $10,404 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,573,426 | TotalAmt |
| Program Services | $8,567,860 | ProgramServicesAmt |
| Management And General | $5,566 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,970,527 | TotalAmt |
| Program Services | $3,844,550 | ProgramServicesAmt |
| Management And General | $125,977 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,246,753 | TotalAmt |
| Program Services | $1,246,753 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,578,372 | TotalAmt |
| Program Services | $2,005,277 | ProgramServicesAmt |
| Management And General | $573,095 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,249,940 | TotalAmt |
| Program Services | $3,249,940 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,384,754 | TotalAmt |
| Program Services | $3,530,741 | ProgramServicesAmt |
| Management And General | $1,854,013 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,677 | TotalAmt |
| Program Services | $70,308 | ProgramServicesAmt |
| Management And General | $19,369 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,982 | TotalAmt |
| Program Services | $520,586 | ProgramServicesAmt |
| Management And General | $19,396 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,736,737 | TotalAmt |
| Program Services | $1,425,978 | ProgramServicesAmt |
| Management And General | $310,759 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,840,617 | TotalAmt |
| Management And General | $14,840,617 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,145,961 | TotalAmt |
| Program Services | $4,000,720 | ProgramServicesAmt |
| Management And General | $145,241 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,350,765 | TotalAmt |
| Program Services | $1,231,474 | ProgramServicesAmt |
| Management And General | $119,291 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS | $4,002,866 | $4,002,866 | |
| BAD DEBT | $2,739,251 | $2,739,251 | |
| MEDICAL SUPPLIES | $1,485,076 | $1,485,076 | |
| DUES, FEES AND LICENSES | $792,345 | $669,484 | $122,861 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,681 | TotalAmt |
| Program Services | $7,354 | ProgramServicesAmt |
| Management And General | $71,327 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,207,496 | TotalAmt |
| Program Services | $113,770,836 | ProgramServicesAmt |
| Management And General | $20,436,660 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,889,646 | BOYAmt |
| EOY | $5,714,652 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,955,352 | BOYAmt |
| EOY | $7,925,761 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,902 | BOYAmt |
| EOY | $303,620 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,477,061 | BOYAmt |
| EOY | $1,291,045 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $74,001,817 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,994,760 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,443,328 | BOYAmt |
| EOY | $51,007,057 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,527,345 | BOYAmt |
| EOY | $5,527,345 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,186,959 | BOYAmt |
| EOY | $33,340,957 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,040,593 | BOYAmt |
| EOY | $105,110,437 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,268,761 | BOYAmt |
| EOY | $11,512,914 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,496,095 | BOYAmt |
| EOY | $5,023,536 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,014,791 | BOYAmt |
| EOY | $19,198,280 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,080,730 | BOYAmt |
| EOY | $38,337,342 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,860,377 | BOYAmt |
| EOY | $74,072,072 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,180,216 | BOYAmt |
| EOY | $31,038,365 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,180,216 | BOYAmt |
| EOY | $31,038,365 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,040,593 | BOYAmt |
| EOY | $105,110,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$14,041,165 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $11,899,314 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,186,626 | OtherCostOrOtherBasisAmt |
| Book Value | $6,186,626 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,617,157 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,439,123 | DepreciationAmt |
| Book Value | $33,178,034 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,504,657 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,012,977 | DepreciationAmt |
| Book Value | $4,491,680 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,011,437 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,431,535 | DepreciationAmt |
| Book Value | $4,579,902 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,681,940 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,111,125 | DepreciationAmt |
| Book Value | $2,570,815 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $51,007,057 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ASSETS HELD FOR SALE | $5,358,000 |
| DEFERRED COMPENSATION/VALUATION | $21,969,179 |
| OTHER ASSETS | $1,228,668 |
| DUE FROM AFFILIATES | $4,785,110 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $33,340,957 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCUMULATED MIN PENSION LIABILITY | $11,671,640 |
| DEFERRED COMPENSATION | $21,969,179 |
| DUE TO AFFILIATES | $4,694,651 |
| OTHER LIABILITIES | $1,872 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $38,337,342 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FIN48 DISCLOSURE: PHC, WMH, OMH, NATIONAL REGENCY, PHCMA, PHCF, AND PHHC ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. ALL OF THESE ENTITIES ARE, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. WHS IS A FOR-PROFIT CORPORATION THAT ACCOUNTS FOR INCOME TAXES UNDER THE ASSET AND LIABILITY METHOD OF ACCOUNTING. A CURRENT TAX LIABILITY OR ASSET IS RECOGNIZED FOR THE ESTIMATED TAXES PAYABLE OR REFUNDABLE ON TAX RETURNS FOR THE YEAR. DEFERRED TAX LIABILITIES OR ASSETS ARE RECOGNIZED FOR THE ESTIMATED FUTURE TAX EFFECTS OF TEMPORARY DIFFERENCES BETWEEN FINANCIAL REPORTING AND TAX ACCOUNTING. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS AND IS CURRENTLY BEING AUDITED FOR THE 2012 TAX PERIOD FOR WAUKESHA MEMORIAL HOSPITAL, INC. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2011. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | ||||||||||||||
| CHAIRPERSON | $0 | $775,024 | $0 | $185,382 | $0 | $0 | $0 | $750,007 | $0 | $18,570 | $0 | $1,728,983 | $0 | $185,382 |
| NANINE NELSON | ||||||||||||||
| CFO - PHC BOARD - PART YEAR | $0 | $327,182 | $0 | $0 | $0 | $82,929 | $0 | $11,214 | $0 | $12,131 | $0 | $433,456 | $0 | $275,124 |
| PETER GEISS | ||||||||||||||
| CLINIC PRESIDENT - PART YEAR | $0 | $1,646,625 | $0 | $0 | $0 | $233,712 | $0 | $10,860 | $0 | $10,509 | $0 | $1,901,706 | $0 | $1,530,118 |
| JOHN DYER | ||||||||||||||
| MEDICAL DIRECTOR | $279,306 | $0 | $16,303 | $0 | $0 | $0 | $22,742 | $0 | $24,760 | $0 | $343,111 | $0 | $0 | $0 |
| PAUL JASINSKI | ||||||||||||||
| VICE PRESIDENT OF OPERATIONS | $205,539 | $0 | $35,480 | $0 | $7,300 | $0 | $18,618 | $0 | $21,668 | $0 | $288,605 | $0 | $0 | $0 |
| IMAD KHATIB | ||||||||||||||
| PHYSICIAN | $579,604 | $0 | $154,444 | $0 | $0 | $0 | $18,360 | $0 | $29,219 | $0 | $781,627 | $0 | $0 | $0 |
| PAUL LEMARBRE | ||||||||||||||
| PHYSICIAN | $584,308 | $0 | $17,500 | $0 | $0 | $0 | $12,551 | $0 | $26,739 | $0 | $641,098 | $0 | $0 | $0 |
| DAVID NIENHUIS | ||||||||||||||
| PHYSICIAN | $527,078 | $0 | $202,887 | $0 | $0 | $0 | $18,360 | $0 | $22,986 | $0 | $771,311 | $0 | $0 | $0 |
| PETER JOHNSON | ||||||||||||||
| PHYSICIAN | $533,959 | $0 | $17,500 | $0 | $0 | $0 | $12,236 | $0 | $27,261 | $0 | $590,956 | $0 | $0 | $0 |
| DANIEL CHENG | ||||||||||||||
| PHYSICIAN | $451,693 | $0 | $98,975 | $0 | $0 | $0 | $37,218 | $0 | $10,515 | $0 | $598,401 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT |
| PART I, LINES 4A-B | LINE 4A: NANINE NELSON RECEIVED SEVERANCE PAYMENTS TOTALING $82,929 DURING THE 2013 CALENDAR YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER AN 18 MONTH PERIOD PER THE AGREEMENT BETWEEN NANINE NELSON AND PROHEALTH CARE, INC. PETER GEISS RECEIVED SEVERANCE PAYMENTS TOTALING $229,301 DURING THE TAX YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER AN 18 MONTH PERIOD PER THE AGREEMENT SIGNED BY THE PARTIES ON 6/26/13. LINE 4B: NAME: CURRENT FISCAL YEAR PAYOUT PETER GEISS $1,507,987 NANINE NELSON $186,460 SUSAN EDWARDS IMAD KATIB PAUL LEMARBRE DAVID NIENHUIS PETER JOHNSON PROHEALTH CARE MEDICAL ASSOCIATES INC. (PHCMA) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. |
| PART I, LINE 6 | PRO HEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEVERAL BOARD MEMBERS ARE ON THE BOARD OF BOTH PHC AND PHCMA. | RelationshipDescriptionTxt |
| Transaction | $20,551,906 | TransactionAmt |
| Transaction | PHC PERFORMS SERVICES AND REIMBURSES EXPENSES FOR PHCMA. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: PROHEALTH CARE MEDICAL ASSOCIATES, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:NELSON, EDWARDS, GEISS, ARNDT, BENZ, FARR, FORSTER, EBEL, GANNON, HASTAD, MOHR, MURPHY, PACKEE, RAMIREZ, ROELKE, RAASCH, SCHROEDER AND SWANDBY WERE ON THE BOARDS OF BOTH PHC AND PHCMA.(D) DESCRIPTION OF TRANSACTION: PHC PERFORMS SERVICES AND REIMBURSES EXPENSES FOR PHCMA. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | DAVID EBEL WAS COMPENSATED BY WARBIRD CONSULTING, A MANAGEMENT COMPANY, FOR SERVICES AS INTERIM CFO FOR PROHEALTH CARE MEDICAL ASSOCIATES, INC. AND RELATED ORGANIZATIONS. COMPENSATION WAS PAID TO WARBIRD CONSULTING BY PROHEALTH CARE, INC., THE PARENT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | PROHEALTH CARE, INC. IS THE SOLE CORPROATE MEMBER |
| FORM 990, PART VI, SECTION A, LINE 7B | PROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11 | AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION. |
| FORM 990, PART VI, SECTION B, LINE 15 | AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO/PRESIDENT, EXECUTIVE DIRECTOR, VICE-PRESIDENT, SENIOR VICE-PRESIDENT AND ABOVE. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2014. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 16B: | THE PROCESS IS TO HAVE ALL JOINT VENTURE ARRANGEMENTS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE IT MEETS ALL LEGAL REQUIREMENTS AND TO ENSURE THAT PHCMA MAY RETAIN ITS EXEMPT STATUS. |
| FORM 990, PART XI, LINE 9: | LOSS ON DISPOSAL OF ASSET HELD FOR SALE -1,135,768. EQUITY TRANSFER FROM AFFILIATES 17,160,000. CHANGE IN MINIMUM PENSION LIABILITY -3,339,334. FORGIVENESS OF INTERCOMPANY LOAN -785,584. |
| FORM 990, PART XII, LINE 2C | THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OCONOMOWOC MEMORIAL HOSPITAL INC | |||||||||||
| 791 SUMMIT AVENUE | OCONOMOWOC | WI | 53066 | 390794174 | HOSPITAL | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH HOME CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 200067392 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
| NATIONAL REGENCY OF NEW BERLIN INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 391077992 | HEALTHCARE | WI | 501(C)(3) | LINE 9 | PROHEALTH CARE INC | Yes (1) | |
| WAUKESHA MEMORIAL HOSPITAL INC | |||||||||||
| 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | 390910727 | HOSPITAL | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE FOUNDATION INC | |||||||||||
| 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | 391314542 | CHARITABLE SUPPORT | WI | 501(C)(3) | LINE 7 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 391786873 | MANAGEMENT | WI | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| PROHEALTH ALIGNED LLC (DBA MSC) | |||||||
| 1111 DELAFIELD STREET STE 1 | WAUKESHA | WI | 53188 | 263324572 | SURGERY CENTER | WI | N/A |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | |||||||
| 1625 COLDWATER CREEK DRIVE | WAUKESHA | WI | 53188 | 262332250 | INPATIENT REHABILITATION | WI | N/A |
| THE ORTHOPEDIC SURGERY CENTER LLC | |||||||
| W238 N1610 BUSSE ROAD | WAUKESHA | WI | 53188 | 208356016 | ORTHOPEDIC SURGICAL SERVICES | WI | N/A |
| PROHEALTH SOLUTIONS LLC | |||||||
| 2000 PEWAUKEE RD SUITE C | WAUKESHA | WI | 53188 | 273863494 | ACCOUNTABLE CARE ORGANIZATION | WI | N/A |
| LAKE COUNTRY ENDOSCOPY CENTER | |||||||
| 1185 CORPORATE CENTER DR | OCONOMOWOC | WI | 53066 | 261572986 | ENDOSCOPY SERVICES | WI | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| WAUKESHA HEALTH SYSTEM INC | |||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391507910 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA PACIFIC INC | |||||||||
| 31416 AGOURA RD STE 180 | WESTLAKE VILLAGE | CA | 91361 | 953070501 | HEALTHCARE | CA | N/A | C | 0 |
| NATIONAL AVENUE DEVELOPMENT CORPORATION | |||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391417226 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA INC | |||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391567366 | HEALTHCARE | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (15 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| A | $515,137 | ACTUAL AMOUNT RECEIVED |
| WAUKESHA HEALTH SYSTEM INC | ||
| A | $107,402 | ACTUAL AMOUNT RECEIVED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| K | $1,009,336 | ACTUAL COSTS INCURRED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| K | $168,978 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH SYSTEM INC | ||
| K | $199,517 | ACTUAL COSTS INCURRED |
| NATIONAL REGENCY OF NEW BERLIN INC | ||
| K | $140,619 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE INC | ||
| M | $10,686,954 | ACTUAL COSTS INCURRED |
| PROHEALTH SOLUTIONS LLC | ||
| M | $397,705 | ACTUAL COSTS INCURRED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| P | $28,097,877 | ACTUAL COSTS INCURRED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| Q | $397,159 | ACTUAL COSTS INCURRED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| Q | $3,910,109 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE INC | ||
| Q | $9,864,952 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH SYSTEM INC | ||
| Q | $1,841,314 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE INC | ||
| B | $785,584 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE INC | ||
| C | $17,160,000 | ACTUAL AMOUNT RECEIVED |