2014-08-08T13:27:46-05:00 2013-09-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2012-10-01 391079224 ST CAMILLUS HEALTH CENTER INC STCA 4142598320 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 KEVIN SCHWAB 4142581814 2014-08-08 1 JAY ADKISSON CPA P01360892 4144319300 2014-08-06 2012 2015-11-30 17:44:51Z KEVIN SCHWAB 10101 W WISCONSIN AVE WAUWATOSA WI 53226 16103660 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 20 0 0 122416 0 14700852 16103654 69 6 0 0 14823337 16103660 0 0 0 0 8834560 7209612 0 0 0 8100761 10345278 16935321 17554890 -2111984 -1451230 22981386 22976937 36075811 36863372 -13094425 -13886435 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 8928487 9523700 SKILLED NURSING FACILITIES - ST. CAMILLUS HEALTH CENTER PROVIDES IN-HOUSE NURSING SERVICES TO ITS RESIDENTS. 2059259 2196539 HOME 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. 4109459 4383415 ASSISTED LIVING FACILITY - A 76-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS. 15097205 1 0 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 ST CAMILLUS HEALTH CARE CENTER 4142581814 10101 W WISCONSIN AVE WAUWATOSA WI 53226 HARRY W WHELPLEY 2.00 X X 0 0 0 FR RICHARD O'DONNELL MI 2.00 X X 0 0 0 FR LEANDRO BLANCO MI 2.00 X X 0 0 0 FR PEDRO TRAMONTIN MI 2.00 X 0 0 0 BR MARIO CRIVELLO MI 2.00 X 0 0 0 FREDERICK A MUTH JR 2.00 X 0 0 0 MARK E SLESAR 2.00 X 0 0 0 ROSEMARIE MATHEUS 2.00 X 0 0 0 NICK LAUBUSCH 2.00 X 0 0 0 JIM WESSON 2.00 X 0 0 0 RICK L JOHNSON 40.00 X 0 242788 18368 MARIE D'AMICO 40.00 X 0 122448 6886 KEVIN SCHWAB 40.00 X 0 176656 12899 0 541892 38153 0 0 1 0 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 1727584 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 53150 THERAPY PROVIDER 1183563 OMNICARE PO BOX 715268 COLUMUS OH 43271 PHARMACY 273958 BAY TOWEL INC PO BOX 12115 GREEN BAY WI 53407 LAUNDRY SERVICES 153858 MCKESSON MEDICAL SURGICAL PO BOX 630693 CINCINNATI OH 45263 SUPPLIES 146534 8 NET PATIENT SERVICES 623000 13415132 13415132 MONTHLY SERVICE FEES 623000 1655622 1655622 OTHER SUPPORT SERVICES 623000 1032900 1032900 16103654 6 6 16103660 16103654 0 6 X 5994917 5155629 839288 786790 676639 110151 427905 367998 59907 2486607 2138482 348125 17754 15268 2486 333403 286727 46676 2757986 2371868 386118 8088 6956 1132 884370 760558 123812 1193894 1026749 167145 14446 12424 2022 581 500 81 556088 478236 77852 894173 768989 125184 114726 98664 16062 RAW FOOD / GROCERIES 623369 536097 87272 DUES & SUBSCRIPTIONS 159290 136989 22301 BAD DEBT EXPENSE 85826 73810 12016 MAINTENANCE 71830 61774 10056 142847 122848 19999 17554890 15097205 2457685 0 600 600 1122514 2057604 22587 20753 90575 85645 33035933 14342564 19243199 18693369 2501911 2118966 22981386 22976937 575332 513171 12140000 11600000 23360479 24750201 36075811 36863372 X -13094425 -13886435 -13094425 -13886435 22981386 22976937 X -1451230 659220 X 0 1 X 1 0 X 2124 94581 18173 122416 237294 12133358 12802856 14781188 14700852 16103654 70521908 12135482 12897437 14799361 14823268 16103654 70759202 0 0 0 70759202 13791 21813 2081 23 6 37714 13791 21813 2081 23 6 37714 12149273 12919250 14801442 14823291 16103660 70796916 0.99950 0.99880 0.00050 0.00120 X 61278 61278 25842732 8207540 17635192 20219 16895 3324 6732209 5810582 921627 379495 307547 71948 18693369 RESIDENT FUNDS HELD FOR SAFE KEEPING 10639 DUE FROM RELATED PARTY 2108327 2118966 RESIDENT FUNDS HELD FOR SAFE KEEPING 2470 DUE TO RELATED PARTY 23439080 REFUNDABLE ENTRANCE FEES 104952 INTEREST SWAP 1203699 24750201 X 16762880 659220 659220 16103660 0 16103660 17554890 0 17554890 0 17554890 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. X X X X 0 0 0 0 0 0 0 0 0 RICK L JOHNSON 0 207059 0 26748 0 8981 0 11000 0 7368 0 261156 0 0 KEVIN SCHWAB 0 140655 0 31500 0 4501 0 7332 0 5567 0 189555 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 2012-02-29 12655000 REFINANCE 1995 BONDS 0 0 0 A 540000 12655000 80801 12574199 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 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. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,371,868. MANAGEMENT AND GENERAL EXPENSES 386,118. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,757,986. CHANGES IN NET ASSETS OR FUND BALANCES: 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. 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 SAN CAMILLO INC 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 391487306 ASSISTED LIVING WI 501(C)(3) 9 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 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1