Mercy Alliance Inc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- Mercy Alliance Inc (EIN 39-1679859)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201321359349306527
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T15:50:39-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | 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 | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391679859 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY ALLIANCE INC | 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 | 2013-05-13 | 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 | 2013-05-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 55275588 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | MERCY ALLIANCE, INC. IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES, SPECIFICALLY TO MEET THE COMMUNITY'S NEEDS FOR HOSPITAL AND MEDICAL SERVICES FOR THE CARE AND TREATMENT OF SICK OR INJURED PERSONS, TO PROMOTE WELLNESS IN THE COMMUNITY, AND ENGAGE IN MEDICAL AND SCIENTIFIC RESEARCH, DEVELOPMENT, AND EDUCATIONAL ACTIVITIES IN FURTHERANCE OF ITS OBJECTIVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 16500347 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7222728 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | -3361684 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16500347 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3861044 | 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 | 1911866 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1759739 | 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 | 4357731 | OtherExpensePriorYear |
| Other Expenses Current Year | 4063365 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6269597 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5823104 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 10230750 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1962060 | RevenuesLessExpensesCY |
| Total Assets BOY | 442267785 | TotalAssetsBOY |
| Total Assets EOY | 526409137 | TotalAssetsEOY |
| Total Liabilities BOY | 142121262 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 222728395 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 300146523 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 303680742 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MERCY ALLIANCE, INC. IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES, SPECIFICALLY TO MEET THE COMMUNITY'S NEEDS FOR HOSPITAL AND MEDICAL SERVICES FOR THE CARE AND TREATMENT OF SICK OR INJURED PERSONS, TO PROMOTE WELLNESS IN THE COMMUNITY, AND ENGAGE IN MEDICAL AND SCIENTIFIC RESEARCH, DEVELOPMENT, AND EDUCATIONAL ACTIVITIES IN FURTHERANCE OF ITS OBJECTIVES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 0 | Expense |
| Grants | 0 | Grants |
| Revenue | 0 | Revenue |
| Description | NONE | Description |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | 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 | 0 | 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 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | 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 | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| 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 (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | FormerFormer |
|---|---|---|---|---|---|---|---|
| THOMAS R POOL | |||||||
| VICE CHAIRPERSON & DIRECTO | 1.00 | X | X | 0 | 0 | 0 | |
| LARRY SQUIRE | |||||||
| SECRETARY/TREAS & DIRECTOR | 1.00 | X | X | 0 | 0 | 0 | |
| ROWLAND J MCCLELLAN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DAVE SYVERSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARK L GOELZER MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 429224 | 699536 | ||
| JOSEPH NEMETH | |||||||
| FORMER OFFICER | 0.00 | 0 | 210785 | 22960 | X | ||
| JAVON R BEA | |||||||
| PRESIDENT & DIRECTOR | 1.00 | X | X | 0 | 4028129 | 34261 | |
| JOHN COOK | |||||||
| VICE-PRESIDENT | 1.00 | X | 0 | 358763 | 45555 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 5026901 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 802312 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRIESS ASSOCIATES LLC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 576 | AddressLine1 |
| City | JACKSON | City |
| State | WY | State |
| ZIP Code | 83001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | INVESTMENT MANAGEMENT SERVICES | DescriptionOfServices |
| Compensation | 108107 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6577633 | TotalRevenueColumn |
| Exclusion | $6,577,633 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 52059639 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 51414544 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 645095 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 645095 | TotalRevenueColumn |
| Exclusion | $645,095 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| LOSS ON BOND REFINANCE | 900099 | -1245760 | -$1,245,760 |
| REALIZED SWAP LOSS | 900099 | -2115924 | -$2,115,924 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -3361684 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3861044 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,861,044 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1747609 | Total |
| Management And General | 1747609 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12130 | Total |
| Management And General | 12130 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42000 | Total |
| Management And General | 42000 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163283 | Total |
| Management And General | 163283 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3624107 | Total |
| Management And General | 3624107 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| CONSULTING | 142203 | 142203 |
| OTHER INVESTMENT EXPENS | 80418 | 80418 |
| MISCELLANEOUS | 11354 | 11354 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5823104 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 5823104 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1438107 | BOY |
| EOY | 506680 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 294213071 | BOY |
| EOY | 297263673 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146616607 | BOY |
| EOY | 228638784 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 442267785 | BOY |
| EOY | 526409137 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3308 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139603429 | BOY |
| EOY | 221231495 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2514525 | BOY |
| EOY | 1496900 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 142121262 | BOY |
| EOY | 222728395 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300146523 | BOY |
| EOY | 303680742 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300146523 | BOY |
| EOY | 303680742 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 442267785 | BOY |
| EOY | 526409137 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1962060 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5496279 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| MERCY HEALTH SYSTEM CORPORATION | |||||
| 390816848 | 3 | 1 | 0 | 1 | $0 |
| MERCY ASSISTED CARE INC | |||||
| 391035110 | 9 | 1 | 0 | 1 | $0 |
| HARVARD MEMORIAL HOSPITAL INC | |||||
| 311551871 | 3 | 1 | 0 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 139883015 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENTS IN NOTES, BONDS, & SECURITIES | Description |
| Book Value | 157380658 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 297263673 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ACCRUED INTEREST | 98975 |
| DUE FROM RELATED PARTY | 228468941 |
| BOND PROJECT FUNDS | 70868 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 228638784 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INTEREST PAYABLE | $1,092,673 |
| DUE TO RELATED PARTY | $404,227 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1496900 | TotalOfAmounts |
| Total Revenue | 3861044 | TotalRevenue |
| Total Expenses | 5823104 | TotalExpenses |
| Excess Or Deficit For Year | -1962060 | ExcessOrDeficitForYear |
| Other | $5,496,279 | OtherAmount |
| Total Adjustments | 5496279 | TotalAdjustments |
| Excess Or Deficit Per FS | 3534219 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART XI, LINE 8 - OTHER ADJUSTMENTS: | Identifier |
| Explanation | REVENUES/GAINS IN EXCESS OF EXPENSES - SUBSIDIARIES 5,938,015. UNREALIZED GAIN - MERCY ALLIANCE, INC. -2,274,032. AMORTIZATION OF CUMULATIVE LOSS ON SWAP DUE TO TERMINATION 1,817,666. MERCY ALLIANCE - LESS THAN TEMP - UNREALIZED LOSS - ADJUSTMENT TO PY 14,630. TOTAL TO SCHEDULE D, PART XI, LINE 8: 5,496,279. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 (4 entries)
| 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 L GOELZER MD | |||||||||||||
| 0 | 317681 | 0 | 111543 | 0 | 0 | 0 | 676428 | 0 | 23108 | 0 | 1128760 | 0 | 0 |
| JOSEPH NEMETH | |||||||||||||
| 0 | 137053 | 0 | 65480 | 0 | 8252 | 0 | 12476 | 0 | 10484 | 0 | 233745 | 0 | 0 |
| JAVON R BEA | |||||||||||||
| 0 | 886939 | 0 | 785800 | 0 | 2355390 | 0 | 15014 | 0 | 19247 | 0 | 4062390 | 0 | 0 |
| JOHN COOK | |||||||||||||
| 0 | 233650 | 0 | 111435 | 0 | 13678 | 0 | 20837 | 0 | 24718 | 0 | 404318 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710BWD0 | 2010-06-09 | 48445000 | REFINANCE OF '03/'07 BONDS, CAPITAL EXPENDITURE, RENOVATION AND CONSTRUCTION | 0 | 0 | 0 |
| WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710BV41 | 2012-05-24 | 169475000 | REFINANCE OF '99/'05/'09 BONDS, CAPITAL EXPENDITURE, RENOVATION & CONSTRUCT | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capitalized InterestCapitalizedInterest | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 8320000 | 49203186 | 4841745 | 682820 | 2012 | 1 | 0 | 1 | 1 | |||
| 180504676 | 1746855 | 2013 | 1 | 0 | 0 | 1 | 245176 | 36963292 | 15567291 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 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 C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | REVENUES/GAINS IN EXCESS OF EXPENSES - SUBSIDIARIES 5,938,015. UNREALIZED GAIN - MERCY ALLIANCE, INC. -2,274,032. AMORTIZATION OF CUMULATIVE LOSS ON SWAP DUE TO TERMINATION 1,817,666. MERCY ALLIANCE - LESS THAN TEMP - UNREALIZED LOSS - ADJUSTMENT TO PY 14,630. TOTAL TO FORM 990, PART XI, LINE 5: 5,496,279. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MERCY HEALTH SYSTEM CORPORATION | ||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390816848 | MEDICAL HEALTHCARE | WI | 501(C)(3) | 3 | MERCY ALLIANCE INC | 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 | MERCY HEALTH SYSTEM CORPORATION | 0 |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | ||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390912682 | TO SUPPORT MERCY HEALTH SYSTEM CORPORATION | WI | 501(C)(3) | 11C | MERCY HEALTH SYSTEM CORPORATION | 0 |
| MERCY ASSISTED CARE INC | ||||||||||
| 901 MINERAL POINT | JANESVILLE | WI | 535475003 | 391035110 | HOME HEALTH CARE & SERVICES | WI | 501(C)(3) | 9 | MERCY ALLIANCE INC | 0 |
| MERCY HARVARD HOSPITAL INC | ||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | MEDICAL HEALTHCARE | IL | 501(C)(3) | 3 | MERCY ALLIANCE INC | 0 |
| HARVARD MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 364308662 | TO SUPPORT MERCY HARVARD HOSPITAL, INC. | IL | 501(C)(3) | 11A | MERCY HARVARD HOSPITAL INC | 0 |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | ||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 201673011 | NONE | IL | 501(C)(3) | 3 | MERCY ALLIANCE INC | 0 |
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 |
|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | ||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391520130 | MANAGEMENT ENTITY OF UNION EMPLOYEES | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| MERCYCARE INSURANCE COMPANY | ||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | ||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| 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 | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |