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ST CAMILLUS HEALTH CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST CAMILLUS HEALTH CENTER INC (EIN 39-1079224)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-08
IRS object ID
201402209349300245
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-08-08T13:27:46-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391079224EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CAMILLUS HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTCANameControl
Phone4142598320Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVENUEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN SCHWABName
TitleCHIEF FINANCIAL OFFICERTitle
Phone4142581814Phone
Date Signed2014-08-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
PTINP01360892PTIN
Phone4144319300Phone
Date Prepared2014-08-06DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN SCHWABNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode
FieldValueIRS element (for citing)
Gross Receipts16103660GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STCAM.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1923YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionBY 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year122416ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14700852ProgramServiceRevenuePriorYear
Program Service Revenue CY16103654ProgramServiceRevenueCY
Investment Income Prior Year69InvestmentIncomePriorYear
Investment Income Current Year6InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14823337TotalRevenuePriorYear
Total Revenue Current Year16103660TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8834560SalariesEtcPriorYear
Salaries Etc Current Year7209612SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8100761OtherExpensePriorYear
Other Expenses Current Year10345278OtherExpensesCurrentYear
Total Expenses Prior Year16935321TotalExpensesPriorYear
Total Expenses Current Year17554890TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2111984RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1451230RevenuesLessExpensesCY
Total Assets BOY22981386TotalAssetsBOY
Total Assets EOY22976937TotalAssetsEOY
Total Liabilities BOY36075811TotalLiabilitiesBOY
Total Liabilities EOY36863372TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-13094425NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-13886435NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionBY 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8928487Expense
Revenue9523700Revenue
DescriptionSKILLED NURSING FACILITIES - ST. CAMILLUS HEALTH CENTER PROVIDES IN-HOUSE NURSING SERVICES TO ITS RESIDENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2059259Expense
Revenue2196539Revenue
DescriptionHOME HEALTH CARE AGENCY - ST. CAMILLUS HEALTH CENTER OFFERS NURSING SERVICES TO THE RESIDENTS OF THE INDEPENDENT LIVING FACILITY, ASSISTED LIVING FACILITY AND TO OTHER COMMUNITY RESIDENTS IN NEED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4109459Expense
Revenue4383415Revenue
DescriptionASSISTED LIVING FACILITY - A 76-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense15097205TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ST CAMILLUS HEALTH CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4142581814TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HARRY W WHELPLEY
CHAIRPERSON2.00XX000
FR RICHARD O'DONNELL MI
VICE CHAIRPERSON2.00XX000
FR LEANDRO BLANCO MI
TREASURER2.00XX000
FR PEDRO TRAMONTIN MI
BOARD OF DIRECTOR2.00X000
BR MARIO CRIVELLO MI
BOARD OF DIRECTOR2.00X000
FREDERICK A MUTH JR
BOARD OF DIRECTOR2.00X000
MARK E SLESAR
BOARD OF DIRECTOR2.00X000
ROSEMARIE MATHEUS
BOARD OF DIRECTOR2.00X000
NICK LAUBUSCH
BOARD OF DIRECTOR2.00X000
JIM WESSON
BOARD OF DIRECTOR2.00X000
RICK L JOHNSON
PRESIDENT40.00X024278818368
MARIE D'AMICO
VICE PRESIDENT & SECRETARY40.00X01224486886
KEVIN SCHWAB
CFO40.00X017665612899
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs541892TotalReportableCompFrmRltdOrgs
Total Other Compensation38153TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MORRISON MANAGEMENT SPECIALISTS INC
PO BOX 102289ATLANTAGA30368FOOD SERVICE1727584
REHABCARE GROUP INC
PO BOX 503534ST LOUISMO53150THERAPY PROVIDER1183563
OMNICARE
PO BOX 715268COLUMUSOH43271PHARMACY273958
BAY TOWEL INC
PO BOX 12115GREEN BAYWI53407LAUNDRY SERVICES153858
MCKESSON MEDICAL SURGICAL
PO BOX 630693CINCINNATIOH45263SUPPLIES146534
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES6230001341513213415132
MONTHLY SERVICE FEES62300016556221655622
OTHER SUPPORT SERVICES62300010329001032900
FieldValueIRS element (for citing)
Total Program Service Revenue16103654TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6TotalRevenueColumn
Exclusion$6ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16103660TotalRevenueColumn
Related Or Exempt Function Income16103654RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$6ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5994917Total
Program Services5155629ProgramServices
Management And General839288ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total786790Total
Program Services676639ProgramServices
Management And General110151ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total427905Total
Program Services367998ProgramServices
Management And General59907ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2486607Total
Program Services2138482ProgramServices
Management And General348125ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total17754Total
Program Services15268ProgramServices
Management And General2486ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total333403Total
Program Services286727ProgramServices
Management And General46676ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2757986Total
Program Services2371868ProgramServices
Management And General386118ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total8088Total
Program Services6956ProgramServices
Management And General1132ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total884370Total
Program Services760558ProgramServices
Management And General123812ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1193894Total
Program Services1026749ProgramServices
Management And General167145ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total14446Total
Program Services12424ProgramServices
Management And General2022ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total581Total
Program Services500ProgramServices
Management And General81ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total556088Total
Program Services478236ProgramServices
Management And General77852ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total894173Total
Program Services768989ProgramServices
Management And General125184ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total114726Total
Program Services98664ProgramServices
Management And General16062ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
RAW FOOD / GROCERIES62336953609787272
DUES & SUBSCRIPTIONS15929013698922301
BAD DEBT EXPENSE858267381012016
MAINTENANCE718306177410056

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total142847Total
Program Services122848ProgramServices
Management And General19999ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17554890Total
Program Services15097205ProgramServices
Management And General2457685ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY600BOY
EOY600EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1122514BOY
EOY2057604EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY22587BOY
EOY20753EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY90575BOY
EOY85645EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis33035933LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14342564LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19243199BOY
EOY18693369EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2501911BOY
EOY2118966EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22981386BOY
EOY22976937EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY575332BOY
EOY513171EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12140000BOY
EOY11600000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23360479BOY
EOY24750201EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY36075811BOY
EOY36863372EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-13094425BOY
EOY-13886435EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-13094425BOY
EOY-13886435EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22981386BOY
EOY22976937EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1451230ReconcilationRevenueExpenses
Reconcilation Other Changes659220ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2124CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years94581CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18173CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year122416CurrentTaxYearMinus1Year
Total237294Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12133358CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12802856CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14781188CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14700852CurrentTaxYearMinus1Year
Current Tax Year16103654CurrentTaxYear
Total70521908Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12135482CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12897437CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14799361CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14823268CurrentTaxYearMinus1Year
Current Tax Year16103654CurrentTaxYear
Total70759202Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50970759202PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13791CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21813CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2081CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23CurrentTaxYearMinus1Year
Current Tax Year6CurrentTaxYear
Total37714Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13791CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21813CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2081CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23CurrentTaxYearMinus1Year
Current Tax Year6CurrentTaxYear
Total37714Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12149273CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12919250CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14801442CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14823291CurrentTaxYearMinus1Year
Current Tax Year16103660CurrentTaxYear
Total70796916Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99950PublicSupportPercentage509
Prior Year Support Percentage0.99880PriorYearSupportPercentage
Investment Income Percentage0.00050InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00120PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis61278OtherCostOrOtherBasis
Book Value61278BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis25842732OtherCostOrOtherBasis
Depreciation8207540Depreciation
Book Value17635192BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis20219OtherCostOrOtherBasis
Depreciation16895Depreciation
Book Value3324BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6732209OtherCostOrOtherBasis
Depreciation5810582Depreciation
Book Value921627BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis379495OtherCostOrOtherBasis
Depreciation307547Depreciation
Book Value71948BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18693369TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESIDENT FUNDS HELD FOR SAFE KEEPING10639
DUE FROM RELATED PARTY2108327
FieldValueIRS element (for citing)
Total Book Value Other Assets2118966TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
RESIDENT FUNDS HELD FOR SAFE KEEPING$2,470
DUE TO RELATED PARTY$23,439,080
REFUNDABLE ENTRANCE FEES$104,952
INTEREST SWAP$1,203,699
FieldValueIRS element (for citing)
Total Of Amounts24750201TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt16762880TotRevenueEtcAuditedFinclStmt
Other Revenues659220OtherRevenues
Revenue Not Rptd F990659220RevenueNotRptdF990
Revenue Subtotal16103660RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99016103660TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt17554890TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal17554890ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99017554890TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM AND ITS COMBINED 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 COMBINED AFFILIATES RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2011 OR 2010. FEDERAL RETURNS FOR THE YEARS ENDED SEPTEMBER 30, 2010, 2009, AND 2008, REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 7,252. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 651,968.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICK L JOHNSON
PRESIDENT02070590267480898101100007368026115600
KEVIN SCHWAB
CFO0140655031500045010733205567018955500

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Date Issued2012-02-29DateIssued
Issue Price12655000IssuePrice
Description Of PurposeREFINANCE 1995 BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired540000AmountRetired
Total Proceeds12655000TotalProceeds
Issuance Costs From Proceeds80801IssuanceCostsFromProceeds
Other Spent Proceeds12574199OtherSpentProceeds
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed1Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1US BANKBusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE 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 7ATHE SOLE MEMBER ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE 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 11THE 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 12CTHE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE 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 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,371,868. MANAGEMENT AND GENERAL EXPENSES 386,118. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,757,986.OTHER FEES
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 651,968. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 7,252.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ST CAMILLUS HEALTH SYSTEM INC
10101 W WISCONSIN AVENUEWAUWATOSAWI53226390806167ADMINISTRATIVE AND MANAGEMENT SERVICESWI501(C)(3)11(B)N/A0
ST CAMILLUS COMMUNITIES INC
10101 W WISCONSIN AVENUEWAUWATOSAWI53226391843041RESIDENTIAL FACILITIESWI501(C)(3)11(B)0ST CAMILLUS HEALTH SYSTEM INC
SAN CAMILLO INC
10200 W BLUEMOUND ROADWAUWATOSAWI53226391487306ASSISTED LIVINGWI501(C)(3)90ST CAMILLUS HEALTH SYSTEM INC
ORDER OF ST CAMILLUS FOUNDATION INC
10200 W BLUEMOUND ROADWAUWATOSAWI53226391925879FUND-RAISING SUPPORTWI501(C)(3)11(B)0ST CAMILLUS HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg