MERCY HEALTH SYSTEM CORPORATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH SYSTEM CORPORATION (EIN 39-0816848)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-13
- IRS object ID
- 201441339349300234
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-13T10:50:02-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390859910 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MIDLAND COURT PO BOX 8130 | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535478130 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816848 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH SYSTEM CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 6087566000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAVON BEA | Name |
| Title | CEO | Title |
| Phone | 6087566000 | Phone |
| Date Signed | 2014-05-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM T MURPHY CPA | Name |
| PTIN | P00074580 | PTIN |
| Phone | 6087525835 | Phone |
| Date Prepared | 2014-05-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | JAVON BEA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 503893124 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCYHEALTHSYSTEM.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 3841 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 10489650 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 269195 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 192379 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 464397477 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 482875091 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 465256 | InvestmentIncomePriorYear |
| Investment Income Current Year | 906429 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -2530008 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4487239 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 462601920 | TotalRevenuePriorYear |
| Total Revenue Current Year | 488461138 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 274568874 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 283427073 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 172508843 | OtherExpensePriorYear |
| Other Expenses Current Year | 186769727 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 447077717 | TotalExpensesPriorYear |
| Total Expenses Current Year | 470196800 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 15524203 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 18264338 | RevenuesLessExpensesCY |
| Total Assets BOY | 453287213 | TotalAssetsBOY |
| Total Assets EOY | 460754384 | TotalAssetsEOY |
| Total Liabilities BOY | 319217698 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 305574103 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 134069515 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 155180281 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 377709347 | Expense |
| Revenue | 474547840 | Revenue |
| Description | HOSPITAL DISCHARGES 8,400, NURSING HOME ADMISSIONS 274, BIRTHS 859, OUTPATIENT VISITS 1,145,410 | Description |
| Total Program Service Expense | 377709347 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 450 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 3841 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN COOK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6087566642 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| ROWLAND MCCLELLAN | |||||||
| CHAIRPERSON & DIRECTOR | 1.00 | X | 1097 | 0 | 0 | ||
| THOMAS POOL | |||||||
| VICE-CHAIRPERSON & DIRECTO | 1.00 | X | 15000 | 0 | 0 | ||
| LARRY SQUIRE | |||||||
| TREASURER & DIRECTOR | 1.00 | X | 3718 | 0 | 0 | ||
| ELIZABETH HANSCH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DAVE SYVERSON | |||||||
| DIRECTOR | 1.00 | X | 15000 | 0 | 0 | ||
| MARK GOELZER MD | |||||||
| DIRECTOR/PHYSICIAN | 55.00 | X | 474156 | 0 | 29991 | ||
| ROBERT CONSIGNY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| STEVE VAN GALDER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| KATHERINE SCHACK | |||||||
| DIRECTOR | 1.00 | X | 12561 | 0 | 0 | ||
| MARK KOPP | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| BARB BORTNER | |||||||
| VICE-PRESIDENT | 55.00 | 185153 | 0 | 35086 | X | ||
| DAN COLBY | |||||||
| VICE-PRESIDENT | 55.00 | 210562 | 0 | 21232 | X | ||
| DAVID KURTZ | |||||||
| VICE-PRESIDENT | 55.00 | 197682 | 0 | 27817 | X | ||
| JOHN COOK | |||||||
| VICE-PRESIDENT | 55.00 | 347668 | 0 | 35301 | X | ||
| KATHY HARRIS | |||||||
| VICE-PRESIDENT | 55.00 | 129791 | 0 | 27341 | X | ||
| RUTH YARBROUGH | |||||||
| VICE-PRESIDENT | 55.00 | 233056 | 0 | 21569 | X | ||
| RICHARD GRUBER | |||||||
| VICE-PRESIDENT | 55.00 | 162287 | 0 | 23142 | X | ||
| RALPH TOPINKA | |||||||
| VICE-PRESIDENT | 55.00 | 364700 | 0 | 20539 | X | ||
| JOSEPH NEMETH | |||||||
| VICE-PRESIDENT | 55.00 | 194728 | 0 | 23671 | X | ||
| SUE RIPSCH | |||||||
| VICE-PRESIDENT | 55.00 | 347224 | 0 | 31533 | X | ||
| JENNIFER HALLATT | |||||||
| VICE-PRESIDENT | 1.00 | 202544 | 0 | 34453 | X | ||
| JAVON BEA | |||||||
| PRESIDENT & DIRECTOR | 55.00 | X | 5169487 | 0 | 34716 | X | |
| VIKRAM KHANNA | |||||||
| PHYSICIAN | 40.00 | 1549258 | 0 | 48572 | X | ||
| BRADLEY FIDELER | |||||||
| PHYSICIAN | 40.00 | 1495019 | 0 | 41424 | X | ||
| DAVID PITTENGER | |||||||
| PHYSICIAN | 40.00 | 1368843 | 0 | 40949 | X | ||
| ROBB WHINNEY | |||||||
| PHYSICIAN | 40.00 | 1184988 | 0 | 31743 | X | ||
| LANDON RIGGS | |||||||
| PHYSICIAN | 40.00 | 1087939 | 0 | 40533 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 14952461 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 569612 | TotalOtherCompensation |
| Number Individuals GT100 K | 377 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WALSH CONSTRUCTION COMPANY II LLC | |||||
| 929 WEST ADAMS | CHICAGO | IL | 60607 | CONSTRUCTION | 8860311 |
| MAGILL CONSTRUCTION COMPANY | |||||
| 977 KOOPMAN LANE | ELKHORN | WI | 53121 | CONSTRUCTION | 7657106 |
| ELLERBE BECKET INC | |||||
| 1178 PAYSPHERE CIR | CHICAGO | IL | 60674 | ARCHITECTUAL/ENGINEERING SERVICES | 1905898 |
| QUEST DIAGNOSTICS | |||||
| 12989 COLLECTIONS CENTER DR | CHICAGO | IL | 606930129 | LABORATORY DIAGNOSTIC SERVICES | 1390348 |
| EPIC SYSTEMS CORPORATION | |||||
| 1979 MILKY WAY | VERONA | WI | 53593 | SOFTWARE/SYSTEM MAINTENANCE | 1341704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 41 | NumberOfContractorsGT100K |
| Related Organizations | 148000 | RelatedOrganizations |
| Government Grants | 32444 | GovernmentGrants |
| All Other Contributions | 11935 | AllOtherContributions |
| Total Contributions | 192379 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | 471210590 | 471210590 | ||
| UNRELATED BUSINESS INCOME | 561000 | 10489650 | 10489650 | ||
| CAFETERIA | 722210 | 1174851 | $1,174,851 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 482875091 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 725637 | TotalRevenueColumn |
| Exclusion | $725,637 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15604311 | Securities |
| Other | 8467 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15431918 | Securities |
| Other | 68 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 172393 | Securities |
| Other | 8399 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 180792 | TotalRevenueColumn |
| Exclusion | $180,792 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| OTHER INVESTMENTS | 900099 | 4441164 | $4,441,164 |
| MISCELLANEOUS | 900099 | 46075 | $46,075 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4487239 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 488461138 | TotalRevenueColumn |
| Related Or Exempt Function Income | 471210590 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 10489650 | UnrelatedBusinessRevenue |
| Exclusion | $6,568,519 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8128658 | Total |
| Management And General | 8128658 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 225061909 | Total |
| Program Services | 183460792 | ProgramServices |
| Management And General | 41601117 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6772208 | Total |
| Program Services | 5474419 | ProgramServices |
| Management And General | 1297789 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30039541 | Total |
| Program Services | 22901534 | ProgramServices |
| Management And General | 7138007 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13424757 | Total |
| Program Services | 10069842 | ProgramServices |
| Management And General | 3354915 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 893967 | Total |
| Management And General | 893967 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42700 | Total |
| Management And General | 42700 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41932 | Total |
| Management And General | 41932 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25547057 | Total |
| Program Services | 14927898 | ProgramServices |
| Management And General | 10619159 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3898426 | Total |
| Program Services | 31973 | ProgramServices |
| Management And General | 3866453 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78162239 | Total |
| Program Services | 73638441 | ProgramServices |
| Management And General | 4523798 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1099785 | Total |
| Program Services | 355020 | ProgramServices |
| Management And General | 744765 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8753506 | Total |
| Program Services | 7852508 | ProgramServices |
| Management And General | 900998 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1034109 | Total |
| Program Services | 428349 | ProgramServices |
| Management And General | 605760 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1416527 | Total |
| Program Services | 980592 | ProgramServices |
| Management And General | 435935 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8149506 | Total |
| Program Services | 7310677 | ProgramServices |
| Management And General | 838829 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24594488 | Total |
| Program Services | 22068244 | ProgramServices |
| Management And General | 2526244 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1038040 | Total |
| Program Services | -181404 | ProgramServices |
| Management And General | 1219444 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBTS | 20828853 | 20828853 | 0 | 0 |
| WI MEDICAID & OTHER TAX | 6935306 | 6935306 | 0 | 0 |
| EQUIPMENT REPAIRS & MAI | 6705531 | 4479573 | 2225958 | 0 |
| INTER-ENTITY TRANSACTIO | -6070228 | -4947629 | -1122599 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3697983 | Total |
| Program Services | 1094359 | ProgramServices |
| Management And General | 2603624 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 470196800 | Total |
| Program Services | 377709347 | ProgramServices |
| Management And General | 92487453 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21020 | BOY |
| EOY | 22285 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5873542 | BOY |
| EOY | 9996299 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67719511 | BOY |
| EOY | 78130447 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10180930 | BOY |
| EOY | 10104452 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4618871 | BOY |
| EOY | 5603206 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 512233047 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 220470765 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 289726471 | BOY |
| EOY | 291762282 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68047607 | BOY |
| EOY | 50226624 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7099261 | BOY |
| EOY | 14908789 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 453287213 | BOY |
| EOY | 460754384 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63856664 | BOY |
| EOY | 56498293 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4853930 | BOY |
| EOY | 7084631 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250507104 | BOY |
| EOY | 241991179 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 319217698 | BOY |
| EOY | 305574103 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134069515 | BOY |
| EOY | 155180281 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134069515 | BOY |
| EOY | 155180281 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 453287213 | BOY |
| EOY | 460754384 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 18264338 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -427572 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 3274000 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27078424 | OtherCostOrOtherBasis |
| Book Value | 27078424 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 285409615 | OtherCostOrOtherBasis |
| Depreciation | 95232538 | Depreciation |
| Book Value | 190177077 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5264360 | OtherCostOrOtherBasis |
| Depreciation | 3681205 | Depreciation |
| Book Value | 1583155 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 183821537 | OtherCostOrOtherBasis |
| Depreciation | 116729259 | Depreciation |
| Book Value | 67092278 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10659111 | OtherCostOrOtherBasis |
| Depreciation | 4827763 | Depreciation |
| Book Value | 5831348 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 291762282 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (6 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVEST. - FUTURE REPLACE OF PROP, PLANT & EQUIPMENT | 14204848 | C |
| ASSETS UNDER BOND INDENTURE AGREEMENT | 4299716 | C |
| DEFERRED COMPENSATION | 7493141 | C |
| INVESTMENT IN MERCYCARE | 18985273 | C |
| INVESTMENTS - OTHER | 4634237 | C |
| BOND PROJECT FUND | 609409 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 50226624 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED COMPENSATION | $7,493,141 |
| PENSION LIABILITY | $28,175,000 |
| CAPITAL LEASES PAYABLE | $269,577 |
| DUE TO RELATED PARTY | $206,053,461 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 241991179 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 488461138 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 488461138 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 488461138 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 470196800 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 470196800 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 470196800 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5844677 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5844677 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01240 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 58788928 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 35130927 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 23658001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05030 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5318936 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3166257 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2152679 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00460 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 69952541 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38297184 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 31655357 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06730 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1580407 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 195976 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1384431 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4740364 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 870003 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3870361 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00820 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14426491 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11215984 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3210507 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00680 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 416993 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 416993 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21164255 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12281963 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8882292 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01880 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 91116796 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 50579147 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 40537649 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08610 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 52000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 52000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 32000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 32000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 34000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 34000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 138000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 138000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $8,800,311 | BadDebtExpenseAmount |
| Amount Attributable To | 1126440 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 57136944 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 69203901 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -12066957 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Teaching HospitalTeachingHospital | Er24 HoursEr24Hours | Critical Access HospitalCriticalAccessHospital |
|---|---|---|---|---|---|---|---|---|---|
| MERCY HOSPITAL | |||||||||
| 1 | 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | X | X | X | X | |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |||||||||
| 2 | N2950 STATE ROAD 67 | LAKE GENEVA | WI | 53147 | X | X | X | X | |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber | CHNA ConductedCHNAConducted | Community DefinitionCommunityDefinition | Community DemographicsCommunityDemographics | Existing ResourcesExistingResources | How Data ObtainedHowDataObtained | Community Health NeedsCommunityHealthNeeds | Other Health IssuesOtherHealthIssues | Identifying ProcessIdentifyingProcess | Consulting ProcessConsultingProcess | Needs Assessment ConductedNeedsAssessmentConducted | Take Into AccountTakeIntoAccount | Other FacilitiesOtherFacilities | CHNA Widely AvailableCHNAWidelyAvailable | Own WebsiteOwnWebsite | On RequestOnRequest | Adopt Implement StrategyAdoptImplementStrategy | Execute Implement StrategyExecuteImplementStrategy | Develop Community PlanDevelopCommunityPlan | Participate Community PlanParticipateCommunityPlan | Include Operational PlansIncludeOperationalPlans | Adopt BudgetAdoptBudget | Prioritize Health NeedsPrioritizeHealthNeeds | Prioritize ServicesPrioritizeServices | All Needs AddressedAllNeedsAddressed | Organization Incur Excise TaxOrganizationIncurExciseTax | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Asset LevelAssetLevel | Medical IndigencyMedicalIndigency | Insurance StatusInsuranceStatus | Uninsured DiscountUninsuredDiscount | Medicaid MedicareMedicaidMedicare | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Posted On WebsitePostedOnWebsite | Available On RequestAvailableOnRequest | Other PublicityOtherPublicity | Actions On NonpaymentActionsOnNonpayment | Permit Report To Credit AgencyPermitReportToCreditAgency | Collection ActivitiesCollectionActivities | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Average Negotiated RatesAverageNegotiatedRates | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY HOSPITAL AND TRAUMA CENTER | |||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 1 | X | X | X | X | X | X | X | X | 12 | 1 | 1 | 1 | X | X | X | X | X | X | X | X | X | X | 1 | 0 | 1 | 1 | 150.000000000000 | 1 | 300.000000000000 | 1 | X | X | X | X | X | X | 1 | 1 | X | X | X | 1 | X | 0 | 1 | X | 0 | 0 |
| MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 1 | X | X | X | X | X | X | X | X | 12 | 1 | 1 | 1 | X | X | X | X | X | X | X | X | X | X | 1 | 0 | 1 | 1 | 150.000000000000 | 1 | 300.000000000000 | 1 | X | X | X | X | X | X | 1 | 1 | X | X | X | 1 | X | 0 | 1 | X | 0 | 0 |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 50 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (50 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MERCY MANOR TRANSITION CENTER | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | SKILLED NURSING/SUB-ACUTE CARE FACILITY |
| MERCY REGIONAL CANCER CENTER | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | RADIATION ONCOLOGY CLINIC/RADIATION THERAPY FACILITY |
| HOUSE OF MERCY HOMELESS SHELTER | ||||
| 320 LINCOLN STREET | JANESVILLE | WI | 53548 | HOMELESS CENTER |
| MERCY ALGONQUIN MEDICAL CENTER | ||||
| 2401 HARNISH DRIVE SUITE 101 | ALGONQUIN | WI | 60102 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BARIATRIC WELLNESS CENTER | ||||
| 250 E CENTER DRIVE SUITE 201 | VERNON HILLS | WI | 60061 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BARRINGTON MEDICAL CENTER | ||||
| 500 WEST HIGHWAY 22 | BARRINGTON | WI | 60010 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY BELOIT MEDICAL CENTER | ||||
| 2825 PRAIRIE AVENUE | BELOIT | WI | 53511 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY BRODHEAD MEDICAL CENTER | ||||
| 2310 FIRST CENTER AVENUE | BRODHEAD | WI | 53520 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CENTER FOR CORRECTIVE EYE SURGERY | ||||
| 5400 W ELM STREET SUITE 120 | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CENTER FOR CORRECTIVE EYE SURGERY | ||||
| 8780 W GOLF ROAD STE 304 | NILES | IL | 60714 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CLINIC EAST | ||||
| 3524 EAST MILWAUKEE STREET | JANESVILLE | WI | 53546 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY CLINIC EAST PHARMACY | ||||
| 3524 EAST MILWAUKEE STREET | JANESVILLE | WI | 53546 | RETAIL PHARMACY |
| MERCY CLINIC SOUTH | ||||
| 849 KELLOGG AVENUE | JANESVILLE | WI | 53546 | RESIDENCY PROGRAM / OUTPATIENT PHYSICIAN CLINIC |
| MERCY CLINIC WEST | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC & MEDICAL ONCOLOGY |
| MERCY CLINIC WEST PHARMACY | ||||
| 1000 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | RETAIL PHARMACY |
| MERCY CRYSTAL LAKE CHIROPRACTIC AND REHA | ||||
| 330 W TERRA COTTA ROAD RTE 176 | CRYSTAL LAKE | IL | 60014 | CHIROPRACTOR |
| MERCY CRYSTAL LAKE MEDICAL CENTER EAST | ||||
| 390 CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE MEDICAL CENTER WEST | ||||
| 350 CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE OBGYN | ||||
| 750 E TERRA COTTA STE B | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY CRYSTAL LAKE MEDICAL CENTER SOUTH | ||||
| 415-A CONGRESS PARKWAY | CRYSTAL LAKE | IL | 60014 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY DELAVAN MEDICAL CENTER | ||||
| 1038 E GENEVA ST | DELAVAN | WI | 53115 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY EDGERTON MEDICAL CENTER | ||||
| 217 N MAIN STREET | EDGERTON | WI | 53534 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY EVANSVILLE MEDICAL CENTER | ||||
| 300 UNION STREET | EVANSVILLE | WI | 53536 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY HARVARD CLINIC SOUTH | ||||
| 348 S DIVISION | HARVARD | IL | 60033 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY HEALTH MALL | ||||
| 1010 NORTH WASHINGTON | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY HEALTH MALL PHARMACY | ||||
| 1010 NORTH WASHINGTON | JANESVILLE | WI | 53548 | RETAIL PHARMACY |
| MERCY LAKE GENEVA MEDICAL CENTER | ||||
| 350 PELLER ROAD | LAKE GENEVA | WI | 53147 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY LAKESIDE ORTHOPAEDICS | ||||
| 352 PELLER ROAD | LAKE GENEVA | WI | 53147 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MCHENRY INTERNAL MEDICINE CENTER | ||||
| 633 RIDGEVIEW DRIVE | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MCHENRY MEDICAL CENTER | ||||
| 3922 MERCY DRIVE | MCHENRY | IL | 60050 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MILTON MEDICAL CENTER | ||||
| 725 SOUTH JANESVILLE STREET | MILTON | WI | 53563 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY MILTON PHARMACY | ||||
| 725 SOUTH JANESVILLE STREET | MILTON | WI | 53563 | RETAIL PHARMACY |
| MERCY NORTHWEST WOMEN'S GROUP | ||||
| 47 WEST ACORN LANE | LAKE IN THE HILLS | IL | 601564804 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY OPTIONS-COOPERATIVE CHILDCARE INST | ||||
| 20 EAST COURT STREET | JANESVILLE | WI | 53548 | TREATMENT FACILITY FOR ADOLESCENTS |
| MERCY OPTIONS-JANESVILLE | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | PHYSICIAN & THERAPIST SERVICES: MENTAL HEALTH & ADDICTION TREATMENT |
| MERCY REGIONAL DIALYSIS CENTER | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | DIALYSIS CENTER |
| MERCY REGIONAL LUNG CENTER | ||||
| 903 MINERAL POINT AVENUE | JANESVILLE | WI | 53548 | PHYSICIANS CLINIC & SLEEP DISORDER CENTER |
| MERCY RICHMOND MEDICAL CENTER | ||||
| 9715 PRAIRIE RIDGE | RICHMOND | IL | 60071 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY SHARON MEDICAL CENTER | ||||
| 118 PLAIN STREET | SHARON | WI | 53585 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY SPORTS MEDICINE AND REHABILITATION | ||||
| 557 NORTH WASHINGTON | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY |
| MERCY TERRACE | ||||
| 510 N TERRACE STREET | JANESVILLE | WI | 53548 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WALWORTH PHARMACY | ||||
| N2950 STATE ROAD 67 | LAKE GENEVA | WI | 53147 | RETAIL PHARMACY |
| MERCY WHITEWATER MEDICAL CENTER | ||||
| 507 WEST MAIN STREET | WHITEWATER | WI | 53190 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WHITEWATER SPORTS MEDICINE & REHAB | ||||
| 519 WEST MAIN STREET | WHITEWATER | WI | 53190 | OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY |
| MERCY WOODSTOCK MEDICAL CENTER | ||||
| 2000 LAKE AVENUE | WOODSTOCK | IL | 60098 | OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY |
| MERCY WOODSTOCK PHARMACY | ||||
| 2000 LAKE AVENUE | WOODSTOCK | IL | 60098 | RETAIL PHARMACY |
| MERCY WOMEN'S HEALTHCARE CENTER - ALCONQ | ||||
| 2230 N HUNTINGTON DR | ALGONQUIN | IL | 60102 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY WOMEN'S HEALTHCARE CENTER - ELGIN | ||||
| 750 FLETCHER DR STE 206 | ELGIN | IL | 60123 | OUTPATIENT PHYSICIAN CLINIC |
| WOMEN'S HEALTH CENTER - HOFFMAN ESTATES | ||||
| 1555 BARRINGTON RD STE 2300A | HOFFMAN ESTATES | IL | 60169 | OUTPATIENT PHYSICIAN CLINIC |
| MERCY ELKHORN MEDICAL CENTER | ||||
| 839 N WISCONSIN ST | ELKHORN | WI | 53121 | OUTPATIENT PHYSICIAN CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 6A: MERCY HEALTH SYSTEM, CORP. (MHS) SUBMITS AN ANNUAL COMMUNITY BENEFIT STATEMENT TO THE WISCONSIN HOSPITAL ASSOCIATION. PERIODICALLY, IT PUBLISHES A PAMPHLET EXPLAINING THE COMMUNITY BENEFITS THAT MERCY HEALTH SYSTEM CORP, AND THE RELATED ORGANIZATIONS OF MHS PROVIDE TO THE COMMUNITIES THEY SERVE. MHS HAS SUPPLIED SUPPLEMENTAL COMMUNITY BENEFIT STATEMENT INFORMATION WITH ITS 990 TAX RETURN SINCE FISCAL YEAR 2006 (TAX FORM 2005). | ||
| PART I, LINE 7: A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE COSTS ASSOCIATED WITH CHARITY CARE, UNREIMBURSED MEDICAID, AND OTHER MEANS TESTED GOVERNMENT PROGRAMS. THE COST-TO-CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGE. THE COST OF THE OTHER BENEFITS REFERENCED IN THE TABLE OF LINE 7 (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS; HEALTH PROFESSIONS EDUCATION; SUBSIDIZED HEALTH SERVICES; CASH AND IN-KIND CONTRIBUTIONS) WERE DETERMINED USING ACTUAL DEPARTMENT/SERVICE SPECIFIC DATA AND/OR COST ACCOUNTING DERIVED DATA. | ||
| PART I, LINE 7G: THE SUBSIDIZED HEALTH CARE LINE INCLUDES $2,866,033 OF EXPENSES (COLUMN C) AND $754,173 OF NET EXPENSES (COLUMN E) ATTRIBUTABLE TO THE COSTS OF TRAUMA SURGEONS. THESE SURGEONS STAFF THE LEVEL II TRAUMA PROGRAM OF MERCY HEALTH SYSTEM CORPORATION 24/7. MERCY SOUTH - FAMILY PRACTICE CLINIC WAS ALSO INCLUDED IN THIS LINE: EXPENSES IN COLUMN C TOTALED $3,199,672 AND COLUMN E HAD $82,736 OF NET EXPENSES. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $20,828,853 INCLUDED ON FORM 990, PART IX, LINE 25, WAS EXCLUDED FROM EXPENSES WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN. | ||
| PART II: MERCY'S MANY HEALTH IMPROVEMENT AND BENEFIT SERVICES/OPERATIONS WERE THE RESULT OF MERCY FILLING A COMMUNITY NEED. MERCY'S COLLABORATIVE EFFORTS AND THE EFFORTS OF ITS RELATED ENTITIES HAVE BROUGHT ASSISTANCE TO THE AREA'S UNDERSERVED (AS DETAILED IN #2 ABOVE). | ||
| PART III, LINE 4: BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH SYSTEM CORPORATION AND SUBSIDIARIES). PATIENT ACCOUNTS RECEIVABLE ARE RECORDED. . . NET OF CONTRACTUAL ADJUSTMENTS AND ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH REFLECTS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. . . IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, MHSC ANALYZES HISTORICAL LOSS EXPERIENCE ON REVENUE FOR ALL PAYORS. USING THE LOSS EXPERIENCE RATE, MHSC ESTIMATES THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COST OF BAD DEBT ON LINE 2 PART III WAS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO THOSE CHARGES ESTIMATED AND EXPENSED AS UNCOLLECTIBLE. THE ESTIMATE OF BAD DEBT DOLLARS THAT MAY HAVE BEEN COVERED THROUGH MERCY'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 12.8%. THIS FIGURE WAS BASED ON THE PERCENT OF BAD DEBT ACCOUNT DOLLARS THAT ARE RECLASSIFIED FOR CHARITY AND/OR BANKRUPTCY PURPOSES. | ||
| PART III, LINE 8: DATA FOR LINES 5 & 6 OF PART III AND THE MEDICARE SHORTFALL IS BASED ON MERCY'S TWO HOSPITALS' MEDICARE COST REPORTS. | ||
| PART III, LINE 9B: PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MERCY'S COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MERCY'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MERCY'S COMMUNITY CARE PROGRAM. PATIENTS MUST APPLY FOR COMMUNITY CARE AND SUPPLY MERCY WITH THE NECESSARY FINANCIAL AND OTHER INFORMATION REQUIRED. PATIENTS WHO QUALIFY FOR COMMUNITY CARE BENEFITS WILL RECEIVE A REDUCTION IN THE BALANCE OWED, EXTENDED PAYMENT TERMS, OR BOTH. THE AMOUNT OF THE COMMUNITY CARE BENEFIT WILL BE BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE. | ||
| PART V, SECTION B, LINE 3: THE STEERING COMMITTEE FOR THE ROCK COUNTY NEEDS ASSESSMENT SURVEY WAS COMPOSED OF A CORE GROUP OF AGENCIES AND COMMUNITY MEMBERS WHO REPRESENTED THE SPECTRUM OF THE HEALTHCARE INFRASTRUCTURE WITHIN THE COUNTY. COMMUNITY PARTNERS ENGAGED IN THIS PROCESS INCLUDE REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS:- BELOIT MEMORIAL HOSPITAL - BELOIT AREA COMMUNITY HEALTH CENTER- EDGERTON HOSPITAL - HEALTHNET OF ROCK COUNTY - MERCY HEALTH SYSTEM - ROCK COUNTY PUBLIC HEALTH DEPARTMENT- ROCK COUNTY HUMAN SERVICES - ST. MARY'S JANESVILLE HOSPITAL - THE UNIVERSITY OF WISCONSIN EXTENSION OFFICE STEERING COMMITTEE MEMBERS CONDUCTED NINE FOCUS GROUPS WITH ROCK COUNTY RESIDENTS FROM EACH MAJOR COMMUNITY. THE FOCUS GROUPS SOUGHT FEEDBACK FROM COMMUNITY MEMBERS REGARDING THEIR PERCEPTIONS OF HEALTH SERVICES IN THE AREA. OVER THE NINE FOCUS SESSIONS, RESIDENTS OF ROCK COUNTY OFFERED VARIOUS PERSPECTIVES ON OPPORTUNITIES FOR IMPROVEMENT AND ANSWERED THE QUESTION, "WHAT CONSTITUTES A HEALTHY COMMUNITY?" TO COMPLEMENT THE FOCUS GROUP DISCUSSIONS, THE STEERING COMMITTEE DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF ROCK COUNTY RESIDENTS. THE FORTY-NINE QUESTION SURVEY, DISTRIBUTED TO 1,300 MEMBERS OF THE COMMUNITY, COVERED A WAIDE RANGE OF TOPICS RANGING FROM ACCESS TO CARE, QUALITY OF LIFE, CHRONIC ILLNESSES, AND LIFESTYLE FACTORS. RESPONSE RATE WAS 19.6%. ONCE THE SURVEY RESPONSES WERE TABULATED, THE SURVEY RESULTS WERE EVALUATED AND ANALYZED FOR HEALTH AND DEMOGRAPHIC TRENDS. A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) WAS CONDUCTED. THIS PROVIDED A COMPREHENSIVE ASSESSMENT OF ALL THE ORGANIZATIONS AND ENTITIES THAT CONTRIBUTE TO THE DELIVERY OF HEALTH SERVICES IN THE AREA. IT MEASURED THE CAPABILITIES AND NEEDS OF THE HEALTH INFRASTRUCTURE ITSELF. IN ADDITION TO THE DATA GATHERED FROM HOUSEHOLD SURVEYS AND FOCUS GROUPS, THE COMMITTEE ALSO ANALYZED HEALTH-RELATED DATA FROM A VARIETY OF EXISTING SOURCES, INCLUDING THE WISCONSIN DEPARTMENT OF TRANSPORTATION, WISCONSIN COUNTY HEALTH RANKINGS, DEPARTMENT OF EDUCATION AND WISCONSIN DEPARTMENT OF HEALTH SERVICES. SECONDARY SOURCE DATA, WHEN COMBINED WITH THE QUALITATIVE AND QUANTITATIVE INFORMATION GATHERED FROM THE MAPP ASSESSMENTS, PROVIDED THE STEERING COMMITTEE WITH A CLEAR PICTURE OF WHAT IS WORKING WELL IN ADDITION TO IDENTIFYING OPPORTUNITIES FOR IMPROVEMENT FOR THE HEALTHCARE INFRASTRUCTURE OF ROCK COUNTY. -- INFORMATION TAKEN DIRECTLY FROM ROCK COUNTY'S NEEDS ASSESSMENT DOCUMENT | MERCY HOSPITAL AND TRAUMA CENTER | |
| PART V, SECTION B, LINE 3: WALWORTH COUNTIES COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS (CHIPP) STEERING COMMITTEE MEMBERS WAS COMPRISED OF REPRESENTATIVES OF THE COMMUNITY, LEADERS WITH KNOWLEDGE OF THE COMMUNITY, AND INDIVIDUALS INTERESTED AND COMMITTED TO CREATING A HEALTHIER COMMUNITY.CHIPP STEERING COMMITTEE MEMBERS:AURORA LAKELAND MEDICAL CENTER, ELKHORN SCHOOLS, ROCK-WALWORTH COMMUNITY ACTION, MERCY HEALTH SYSTEMS (WALWORTH HOSPITAL), ELKHORN SCHOOL DISTRICT, COMMUNITY HEALTH SYSTEMS INC., AURORA HEALTH CARE, GATEWAY TECHNICAL COLLEGE, WALWORTH COUNTY JOB CENTER, AURORA HEALTH CARE EAST TROY, UW-WHITEWATER, ST. BENEDICT CHURCH, FORT HEALTH CARE, UNIV. HEALTH & COUNSELING CENTER, GODFREY, LEIBSLE, BLACKBURN, & HOWARTH, DENTAL PERFECTIONS, UW-EXTENSION, LAKELAND ANIMAL SHELTER, FRANKLIN HEALTH DEPARTMENT, MEDICAL COLLEGE OF WISCONSIN - WALWORTH, BENEFIT CONCEPTS INC., ROCK-WALWORTH COMPREHENSIVE FAMILY SRV, CO. PUBLIC HEALTH STUDENT, DUNCAN MEDICATION & CONSULTING SRV LLC, VIP SERVICES INC. EXPERTISE WAS ALSO DERIVED FROM A PLAN DEVELOPED BY THE STATE OF WISCONSIN AND FROM COUNTY HEALTH RANKINGS: HEALTHIEST WISCONSIN 2020 IMPROVEMENT PLAN, IDENTIFIES 12 HEALTH FOCUS PRIORITY AREAS AND 9 HEALTH INFRASTRUCTURE PRIORITY AREAS THAT ARE THE UNDERLYING AND INTERRELATED CAUSES OF MANY DISEASES AND HEALTH CONDITIONS IN THE STATE OF WISCONSIN. (THESE AREAS WERE IDENTIFIED DURING A TWO YEAR, INTERDISCIPLINARY STATEWIDE STUDY). THE COUNTY HEALTH RANKINGS, A SURVEY APPLIED NATIONWIDE TO DETERMINE THE HEALTH STATUS OF COUNTIES IN A VARIETY OF DIFFERENT AREAS, AND TO ALLOW COMPARISONS BETWEEN THE HEALTH STATUS ACROSS STATES, WAS USED PRIMARILY IN THE IDENTIFICATION OF STRATEGIC ISSUES AND TO HELP PUT INTO CONTEXT THE STATE OF HEALTH IN WALWORTH COUNTY. FOCUS GROUPS WERE CONDUCTED DURING THE COURSE OF THE COMMUNITY HEALTH IMPROVEMENT PROCESS TO GAIN A BETTER UNDERSTANDING OF WHAT HEALTH ISSUES AFFECT WALWORTH COUNTY RESIDENTS AND HOW HEALTH IS PERCEIVED IN THE COUNTY. RESPONSES WERE COLLECTED FROM THE SCHOOL NURSES OF WALWORTH COUNTY, SCHOOL SYSTEMS, THE PUBLIC HEALTH STAFF, WIC STAFF, DHHS MANAGEMENT TEAM AND EARLY HEAD START STAFF. RESULTS FROM THIS SECTION REFLECT OPINION AND PERCEPTION AND MAY NOT ACTUALLY BE INDICATIVE OF THE ACTUAL HEALTH STATUS, BUT HELPED THE STEERING COMMITTEE TO UNDERSTAND COMMUNITY PERCEPTION OF HEALTH. -- INFORMATION TAKEN DIRECTLY FROM THE WALWORTH COUNTY CHIP DOCUMENT | MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |
| PART V, SECTION B, LINE 4: BELOIT, EDGERTON, ST MARY'S JANESVILLE | MERCY HOSPITAL AND TRAUMA CENTER | |
| PART V, SECTION B, LINE 4: AURORA LAKELAND MEDICAL CENTER | MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |
| PART V, SECTION B, LINE 14G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. | MERCY HOSPITAL AND TRAUMA CENTER | |
| PART V, SECTION B, LINE 14G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. | MERCY WALWORTH HOSPITAL AND MEDICAL CENT | |
| PART VI, LINE 2: MERCY HEALTH SYSTEM CORPORATION DOES COMMUNITY NEEDS ASSESSMENTS IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI), AND MCHENRY (IL) COUNTIES EVERY 18 MONTHS. MERCY HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS OF NEARBY COMMUNITIES TO ASSESS HEALTH NEEDS. COLLABORATIVE EXAMPLES OF MERCY AND MERCY'S RELATED ENTITIES INCLUDE: I) THE COMMUNITY HEALTH CENTER AT MERCY CLINIC SOUTH: PARTNERSHIP WITH THE COMMUNITY HEALTH CENTER, INC. OF BELOIT, WI IN 2006, MERCY PARTNERED WITH COMMUNITY HEALTH CENTER, INC. TO OPEN THIS CLINIC IN JANESVILLE. IT PROVIDES FREE AND LOW-COST CARE TO LOW-INCOME, UNINSURED AND UNDERINSURED PATIENTS. THIS FIRST-OF-ITS-KIND PARTNERSHIP IS THE RESULT OF YEARS OF WORK WITH LOCAL PARTNERS AND THE FEDERAL GOVERNMENT TO DESIGN AND DEBUT A NEW MODEL OF CARE FOR THE UNDERSERVED. THE CLINIC SEES OVER 200 NEW PATIENTS EACH MONTH, HAS SIGNIFICANTLY IMPROVED PATIENT OUTCOMES, AND HAS SAVED MILLIONS IN UNNECESSARY EMERGENCY DEPARTMENT COSTS. II) HEALTHNET FREE CLINIC IN JANESVILLE: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. MERCY ALSO DONATES LAB, RADIOLOGY AND OTHER ANCILLARY SERVICES TO PATIENTS. III) COOPERATIVE CHILD CARE INSTITUTE: COLLABORATION WITH JANESVILLE PUBLIC SCHOOL DISTRICT AND ROCK COUNTY HUMAN SERVICES TO SERVE EMOTIONALLY CHALLENGED CHILDREN. IV) FAMILY HEALTH PARTNERSHIP CLINIC AND WELL CHILD CLINIC IN WOODSTOCK, IL AND HARVARD FREE CLINIC IN MCHENRY COUNTY, IL: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. V) FAMILY HEALTH PARTNERSHIP CLINIC: MCHENRY COUNTY DEPARTMENT OF HEALTH COLLABORATION TO PROVIDE MAMMOGRAMS AT MERCY FACILITIES FOR WOMEN WHO CANNOT OTHERWISE AFFORD THE SERVICE. VI) ROCK COUNTY HEALTH DEPARTMENT: BIOTERRORISM READINESS PROJECT. VII) RED CROSS: BLOOD DRIVE AND COOPERATIVE VOLUNTEER EFFORTS. VIII) UNITED WAY: FUND RAISING CAMPAIGN AND ROCK COUNTY NEEDS ASSESSMENT SURVEY CONTRIBUTOR IX) AREA POLICE AND FIRE DEPARTMENTS: PROVIDE PORTABLE DEFIBRILLATORS FOR POLICE VEHICLES AND FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES. X) COMMUNITY ACTION, INC.: MERCY LEADERSHIP SERVES ON STRATEGIC PLANNING COMMITTEE AND COMMUNITY ACTION DEVELOPMENT BOARD. | ||
| PART VI, LINE 3: ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL AIDE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEM'S WEBSITE, IN OUR EMERGENCY ROOMS, FINANCIAL SERVICES OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED. | ||
| PART VI, LINE 4: ONE HOSPITAL OF MERCY HEALTH SYSTEM CORPORATION IS LOCATED IN JANESVILLE, WI. IT IS NOW ONE OF TWO ACUTE CARE HOSPITALS LOCATED IN JANESVILLE, WI. IT IS LICENSED FOR 240 BEDS AND IS LOCATED IN ROCK COUNTY, WI. ABOUT 13% OF ROCK COUNTY RESIDENTS LIVED BELOW THE POVERTY LEVEL IN 2009. THIS PROPORTION EXCEEDS THE STATE AVERAGE (12.4%) BUT IS LESS THAN THE NATIONAL AVERAGE (15.1%). APPROXIMATELY 16% OF CHILDREN LIVE IN POVERTY, WHICH IS GREATER THAN BOTH THE STATE AVERAGE (14%) AND NATIONAL BENCHMARK (11%). MEDIAN HOUSEHOLD INCOME IS $49,347, WHICH IS LOWER THAN BOTH THE STATE AND NATIONAL AVERAGES OF $49,994 AND $51,425, RESPECTIVELY. HIGH UNEMPLOYMENT RATES AND A DECREASING LABOR FORCE ARE TWO FACTORS CONTRIBUTING TO THE OVERALL ECONOMIC CLIMATE IN THE COUNTY. ROCK COUNTY HAS EXPERIENCED UNEMPLOYMENT RATES GREATER THAN THE STATE AND NATIONAL AVERAGES FOR SEVERAL YEARS; HOWEVER, THE COUNTY'S RATE HAS BEEN ON A DOWNWARD TREND SINCE 2009. WHILE THE LABOR FORCE DECLINED CONSIDERABLY FROM 2006 THROUGH 2010, ECONOMIC DEVELOPMENT EFFORTS HAVE RESULTED IN LABOR FORCE GROWTH IN 2010 AND 2011. ROCK COUNTY'S UNEMPLOYMENT RATE AS OF 2011 WAS AT 9.8%, COMPARED TO WISCONSIN'S 7.6%. MERCY HEALTH SYSTEM'S SECOND HOSPITAL IS IN WALWORTH COUNTY. IT IS DESIGNATED AS A CRITICAL ACCESS 25 BED HOSPITAL. WALWORTH COUNTY WAS ALSO ESTIMATED TO HAVE APPROXIMATELY 10.3% OF THE POPULATION BELOW THE POVERTY LEVEL; THIS REPRESENTS A SIGNIFICANT INCREASE SINCE 2000. WALWORTH'S UNEMPLOYMENT RATE IN 2011 WAS 7.9%. THE TWO HOSPITALS' PAYOR DEMOGRAPHICS INCLUDED 38.8% MEDICARE, AND 14.2% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2012 - JUNE 30, 2013 (AS DETERMINED BY CHARGES BILLED). | ||
| PART VI, LINE 5: THE HOSPITALS OF MERCY HEALTH SYSTEM HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. MERCY HEALTH SYSTEM HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY. | ||
| PART VI, LINE 6: MERCY HEALTH SYSTEM CORPORATION OPERATES TWO HOSPITALS AND HAS COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTH SYSTEM AND AFFILIATED WITH OTHER SEPARATELY REPORTED ORGANIZATIONS. MERCY ALLIANCE INC. IS THE PARENT COMPANY OF MERCY HEALTH SYSTEM CORPORATION, MERCY ASSISTED CARE INC, AND MERCY HARVARD HOSPITAL INC. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES AND DME (DURABLE MEDICAL EQUIPMENT) SERVICES; THUS PROVIDING CONTINUATION OF CARE TO MERCY HEALTH SYSTEM PATIENTS AND THE COMMUNITY AS A WHOLE. MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY ILLINOIS. MERCY HEALTH SYSTEM CORP. WORKS WITH THE MERCY FOUNDATION, INC. TO OPERATE A HOMELESS SHELTER IN JANESVILLE, WI.: THE HOUSE OF MERCY HOMELESS CENTER PROVIDES SHELTER, SUPPORT, AND TRAINING TO WOMEN, CHILDREN, AND FAMILIES TO HELP FIGHT HOMELESSNESS. IT OPENED IN 1996, AND SHELTERED AN AVERAGE OF 290 INDIVIDUALS/YEAR THE LAST THREE YEARS. MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 1,037 IN CALENDAR YEAR 2012. THIS ORGANIZATION NOT ONLY SUPPORTS MERCY'S SERVICES, BUT PROVIDES BENEFITS TO THE COMMUNITY AS A WHOLE. IN CONJUNCTION WITH MERCY HEALTH SYSTEM'S MEAL PREPARATION, THE VOLUNTEERS PARTICIPATE IN AND OVERSEE A MEALS ON WHEELS PROGRAM: PARTICIPANT/NUTRITION SPECIFIC MEALS ARE PREPARED AND DELIVERED TO THE ELDERLY NEEDING ASSISTANCE IN JANESVILLE. THE VOLUNTEER ASSOCIATION RUNS A HOSPITALITY HOUSE IN WHICH FAMILY MEMBERS OF PATIENTS ARE OFFERED FREE HOUSING DURING THEIR LOVED ONES EXTENDED HOSPITAL STAY AND REHABILITATION. | ||
| WI | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Payments For Use Of Residence | X | PaymentsForUseOfResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Personal Services | X | PersonalServices |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK GOELZER MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | 468860 | 0 | 0 | 0 | 5296 | 0 | 16548 | 0 | 13443 | 0 | 504147 | 0 | 0 | 0 |
| BARB BORTNER | ||||||||||||||
| VICE-PRESIDENT | 129477 | 0 | 51734 | 0 | 3942 | 0 | 12073 | 0 | 23013 | 0 | 220239 | 0 | 0 | 0 |
| DAN COLBY | ||||||||||||||
| VICE-PRESIDENT | 180252 | 0 | 22695 | 0 | 7615 | 0 | 13117 | 0 | 8115 | 0 | 231794 | 0 | 0 | 0 |
| DAVID KURTZ | ||||||||||||||
| VICE-PRESIDENT | 132598 | 0 | 51734 | 0 | 13350 | 0 | 12550 | 0 | 15267 | 0 | 225499 | 0 | 0 | 0 |
| JOHN COOK | ||||||||||||||
| VICE-PRESIDENT | 248191 | 0 | 93750 | 0 | 5727 | 0 | 16548 | 0 | 18753 | 0 | 382969 | 0 | 0 | 0 |
| KATHY HARRIS | ||||||||||||||
| VICE-PRESIDENT | 85197 | 0 | 33826 | 0 | 10768 | 0 | 7567 | 0 | 19774 | 0 | 157132 | 0 | 0 | 0 |
| RUTH YARBROUGH | ||||||||||||||
| VICE-PRESIDENT | 161459 | 0 | 60489 | 0 | 11108 | 0 | 14800 | 0 | 6769 | 0 | 254625 | 0 | 0 | 0 |
| RICHARD GRUBER | ||||||||||||||
| VICE-PRESIDENT | 135240 | 0 | 17245 | 0 | 9802 | 0 | 10039 | 0 | 13103 | 0 | 185429 | 0 | 0 | 0 |
| RALPH TOPINKA | ||||||||||||||
| VICE-PRESIDENT | 254147 | 0 | 95625 | 0 | 14928 | 0 | 16548 | 0 | 3991 | 0 | 385239 | 0 | 0 | 0 |
| JOSEPH NEMETH | ||||||||||||||
| VICE-PRESIDENT | 138223 | 0 | 52729 | 0 | 3776 | 0 | 12347 | 0 | 11324 | 0 | 218399 | 0 | 0 | 0 |
| SUE RIPSCH | ||||||||||||||
| VICE-PRESIDENT | 242195 | 0 | 92270 | 0 | 12759 | 0 | 16548 | 0 | 14985 | 0 | 378757 | 0 | 0 | 0 |
| JENNIFER HALLATT | ||||||||||||||
| VICE-PRESIDENT | 143999 | 0 | 56250 | 0 | 2295 | 0 | 13340 | 0 | 21113 | 0 | 236997 | 0 | 0 | 0 |
| JAVON BEA | ||||||||||||||
| PRESIDENT & DIRECTOR | 940949 | 0 | 755086 | 0 | 3473452 | 0 | 16548 | 0 | 18168 | 0 | 5204203 | 0 | 0 | 0 |
| VIKRAM KHANNA | ||||||||||||||
| PHYSICIAN | 1547550 | 0 | 0 | 0 | 1708 | 0 | 16548 | 0 | 32024 | 0 | 1597830 | 0 | 0 | 0 |
| BRADLEY FIDELER | ||||||||||||||
| PHYSICIAN | 1493401 | 0 | 0 | 0 | 1618 | 0 | 16548 | 0 | 24876 | 0 | 1536443 | 0 | 0 | 0 |
| DAVID PITTENGER | ||||||||||||||
| PHYSICIAN | 1367225 | 0 | 0 | 0 | 1618 | 0 | 16548 | 0 | 24401 | 0 | 1409792 | 0 | 0 | 0 |
| ROBB WHINNEY | ||||||||||||||
| PHYSICIAN | 1183922 | 0 | 0 | 0 | 1066 | 0 | 16548 | 0 | 15195 | 0 | 1216731 | 0 | 0 | 0 |
| LANDON RIGGS | ||||||||||||||
| PHYSICIAN | 1086609 | 0 | 0 | 0 | 1330 | 0 | 15236 | 0 | 25297 | 0 | 1128472 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1A | ReturnReference |
| Explanation | RESIDENCE FOR PERSONAL USE - THE CEO IS PROVIDED WITH A RESIDENCE. THE COST OF RENTING THE RESIDENCE IS TREATED AS TAXABLE COMPENSATION. PAYMENTS FOR BUSINESS USE OF PERSONAL RESIDENCE - THE CEO IS REIMBURSED FOR INTERNET ACCESS AND COMMUNICATION COSTS USED FOR BUSINESS PURPOSES AT HIS PERSONAL RESIDENCE. THE REIMBURSEMENT IS TREATED AS TAXABLE COMPENSATION. HEALTH CLUB DUES - THE CEO IS REIMBURSED FOR HEALTH CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION. PERSONAL SERVICES - THE CEO IS REIMBURSED FOR INCOME TAX PREPARATION SERVICES. THIS IS TREATED AS TAXABLE COMPENSATION. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| KRISTEN GOELZER | |||
| FAMILY MEMBER OF MARK GOELZER, DIRECTOR | 341463 | EMPLOYMENT - PHYSICIAN | 0 |
| JAMIE KURTZ | |||
| FAMILY MEMBER OF DAVID KURTZ, OFFICER | 35308 | EMPLOYMENT - PATIENT ACCOUNT REPRESENTATIVE | 0 |
| LISA NEMETH | |||
| FAMILY MEMBER OF JOSEPH NEMETH, OFFICER | 15159 | EMPLOYMENT - REIMBURSEMENT ANALYST | 0 |
| JOANNA BENNING | |||
| FAMILY MEMBER OF JAVON BEA, PRESIDENT & DIRECTOR | 98844 | EMPLOYMENT - DIRECTOR | 0 |
| MEGAN KRAUSE | |||
| FAMILY MEMBER OF SUE RIPSCH, OFFICER | 82436 | EMPLOYMENT - MANAGER | 0 |
| LAUREN GRUBER | |||
| FAMILY MEMBER OF RICHARD GRUBER, OFFICER | 50531 | EMPLOYMENT - RN/HIB | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | NO REVIEW WAS OR WILL BE CONDUCTED | |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REPORT ALL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR INVESTIGATING ALL CONFLICTS AND REPORTING TO THE BOARD. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE MERCY ALLIANCE COMPENSATION COMMITTEE IS COMPRISED OF THE BOARD CHAIRPERSON, SECRETARY, AND THE TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED BY INDEPENDENT LEGAL COUNCIL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNCIL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2012. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | CHANGES IN PENSION OBLIGATIONS 3,274,000. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART I, LINE 6 | MERCY HEALTH SYSTEM CORPORATION HAS REPORTED ZERO FOR THE TOTAL NUMBER OF VOLUNTEERS. THIS IS DUE TO THE FACT THAT ALL 1,037 VOLUNTEERS FOR THE MERCY HEALTH SYSTEM CORPORATION ARE TECHNICALLY VOLUNTEERS OF THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS AND AS SUCH HAVE BEEN REPORTED ON THEIR TAX RETURN. PLEASE SEE THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS TAX RETURN FOR MORE INFORMATION ON MERCY VOLUNTEER ACTIVITIES. | TOTAL NUMBER OF VOLUNTEERS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY ALLIANCE INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391679859 | MANAGEMENT OF HEALTHCARE ORGANIZATIONS | WI | 501(C)(3) | 11A | N/A | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 237275336 | TO SUPPORT MERCY HEALTH SYSTEM & THE HOUSE OF MERCY | WI | 501(C)(3) | 11A | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390912682 | TO SUPPORT MERCY HEALTH SYSTEM CORPORATION | WI | 501(C)(3) | 11C | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY ASSISTED CARE INC | |||||||||||
| 901 MINERAL POINT | JANESVILLE | WI | 535475003 | 391035110 | HOME HEALTH CARE & SERVICES | WI | 501(C)(3) | 9 | 0 | MERCY ALLIANCE INC | |
| MERCY ALLIANCE INC | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | MEDICAL HEALTHCARE | IL | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
| HARVARD MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 364308662 | TO SUPPORT MERCY HARVARD HOSPITAL, INC. | IL | 501(C)(3) | 11A | 0 | MERCY HARVARD HOSPITAL INC | |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 201673011 | NONE | IL | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Share Of Total IncomeShareOfTotalIncome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | ||||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391520130 | MANAGEMENT ENTITY OF UNION EMPLOYEES | WI | MERCY HEALTH SYSTEM CORPORATION | C | 72500 | 1.00000 | 0 | |
| MERCYCARE INSURANCE COMPANY | ||||||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | 42645419 | 1.00000 | 0 | 115756854 |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | ||||||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C | 1.00000 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCYCARE INSURANCE COMPANY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | Q | TransactionType |
| Amount Involved | 7152400 | AmountInvolved |
| Method Of Amt Determination | COST OF SERVICES PROVIDED | MethodOfAmtDetermination |