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MERCY HEALTH SYSTEM CORPORATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MERCY HEALTH SYSTEM CORPORATION (EIN 39-0816848)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201331359349306528
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

FieldValueIRS element (for citing)
Timestamp2013-05-15T15:50:39-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390859910EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 MIDLAND COURT PO BOX 8130AddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535478130ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390816848EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HEALTH SYSTEM CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone6087566000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 - 1000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAVON BEAName
TitleCEOTitle
Phone6087566000Phone
Date Signed2013-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM T MURPHY CPAName
PTINP00074580PTIN
Phone6087525835Phone
Date Prepared2013-05-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAVON BEANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 - 1000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode
FieldValueIRS element (for citing)
Gross Receipts519602818GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MERCYHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees3768TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI11582430TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year248889ContributionsGrantsPriorYear
Contributions Grants Current Year269195ContributionsGrantsCurrentYear
Program Service Revenue Prior Year448360006ProgramServiceRevenuePriorYear
Program Service Revenue CY464397477ProgramServiceRevenueCY
Investment Income Prior Year969845InvestmentIncomePriorYear
Investment Income Current Year465256InvestmentIncomeCurrentYear
Other Revenue Prior Year3692206OtherRevenuePriorYear
Other Revenue Current Year-2530008OtherRevenueCurrentYear
Total Revenue Prior Year453270946TotalRevenuePriorYear
Total Revenue Current Year462601920TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year262293640SalariesEtcPriorYear
Salaries Etc Current Year274568874SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year165283940OtherExpensePriorYear
Other Expenses Current Year172508843OtherExpensesCurrentYear
Total Expenses Prior Year427577580TotalExpensesPriorYear
Total Expenses Current Year447077717TotalExpensesCurrentYear
Revenues Less Expenses Prior Year25693366RevenuesLessExpensesPriorYear
Revenues Less Expenses CY15524203RevenuesLessExpensesCY
Total Assets BOY387688494TotalAssetsBOY
Total Assets EOY453287213TotalAssetsEOY
Total Liabilities BOY252414775TotalLiabilitiesBOY
Total Liabilities EOY319217698TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY135273719NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY134069515NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense362336834Expense
Revenue463223881Revenue
DescriptionHOSPITAL DISCHARGES 9,038, NURSING HOME ADMISSIONS 287, BIRTHS 1,062, OUTPATIENT VISITS 1,148,129Description
Total Program Service Expense362336834TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096399NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3768NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN COOKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6087566642TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ROWLAND MCCLELLAN
CHAIRPERSON & DIRECTOR1.00XX38500
THOMAS POOL
VICE-CHAIRPERSON & DIRECTO1.00XX1504600
LARRY SQUIRE
SECRETARY/TREAS & DIRECTOR1.00XX258000
DAVE SYVERSON
DIRECTOR1.00X1500000
MARK GOELZER MD
DIRECTOR/PHYSICIAN1.00X4292240699536
ROBERT CONSIGNY
DIRECTOR1.00X113700
STEVE VAN GALDER
DIRECTOR1.00X30700
KATHERINE SCHACK
DIRECTOR1.00X337600
ELIZABETH HANSCH
DIRECTOR1.00X000
MARK KOPP
DIRECTOR1.00X000
BARB BORTNER
VICE-PRESIDENT55.00X197581032674
DAN COLBY
VICE-PRESIDENT55.00X277144024660
DAVID KURTZ
VICE-PRESIDENT55.00X210543025971
JOHN COOK
VICE-PRESIDENT55.00X358763045555
RUTH YARBROUGH
VICE-PRESIDENT55.00X254496026118
RICHARD GRUBER
VICE-PRESIDENT55.00X210752030131
RALPH TOPINKA
VICE-PRESIDENT55.00X445241026986
JOSEPH NEMETH
VICE-PRESIDENT55.00X210785022960
KATHY HARRIS
VICE-PRESIDENT55.00X144668025285
SUE RIPSCH
VICE-PRESIDENT55.00X365038029508
JAVON BEA
PRESIDENT & DIRECTOR55.00XX4028129034261
CHRISTOPHER STURM
PHYSICIAN40.0017819520121545X
JOHN BUSSA
PHYSICIAN40.0017288580210534X
VIKRAM KHANNA
PHYSICIAN40.001204985083027X
BRADLEY FIDELER
PHYSICIAN40.0011464940183029X
LANDON RIGGS
PHYSICIAN40.00961107079809X
FieldValueIRS element (for citing)
Total Reportable Comp From Org13993591TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1701589TotalOtherCompensation
Number Individuals GT100 K382NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WALSH CONSTRUCTION COMPANY II LLC
929 WEST ADAMSCHICAGOIL60607CONSTRUCTION20341718
MAGILL CONSTRUCTION COMPANY
977 KOOPMAN LANEELKHORNWI53121CONSTRUCTION11276909
AECOM TECHNICAL SERVICES
929 WEST ADAMSCHICAGOIL60607ARCHITECTUAL/ENGINEERING2205691
H&H ELECTRIC CO
3201 LATHAM DRMADISONWI53713ELECTRICIANS/ELECTRICAL CONSTR1694558
JP CULLEN & SONS
PO BOX 1957JANESVILLEWI53547CONSTRUCTION1590851
FieldValueIRS element (for citing)
Number Of Contractors GT100 K53NumberOfContractorsGT100K
Related Organizations139500RelatedOrganizations
Government Grants78108GovernmentGrants
All Other Contributions51587AllOtherContributions
Total Contributions269195TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PATIENT SERVICE REVENU621110451641451451641451
UNRELATED BUSINESS INC5610001158243011582430
CAFETERIA7222101173596$1,173,596
FieldValueIRS element (for citing)
Total Program Service Revenue464397477TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column485627TotalRevenueColumn
Exclusion$485,627ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities56929501Securities
Other51026Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities56770347Securities
Other230551Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities159154Securities
Other-179525Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-20371TotalRevenueColumn
Exclusion-$20,371ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MISCELLANEOUS900099567312$567,312
OTHER INVESTMENTS900099-3097320-$3,097,320
FieldValueIRS element (for citing)
Total Other Revenue-2530008TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column462601920TotalRevenueColumn
Related Or Exempt Function Income451641451RelatedOrExemptFunctionIncome
Unrelated Business Revenue11582430UnrelatedBusinessRevenue
Exclusion-$891,156ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total8193840Total
Management And General8193840ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total219185078Total
Program Services178756896ProgramServices
Management And General40428182ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8023310Total
Program Services5929887ProgramServices
Management And General2093423ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total26220058Total
Program Services18299135ProgramServices
Management And General7920923ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12946588Total
Program Services9741817ProgramServices
Management And General3204771ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1104725Total
Management And General1104725ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total49000Total
Management And General49000ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total51008Total
Management And General51008ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total23368230Total
Program Services13479026ProgramServices
Management And General9889204ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total4992731Total
Program Services39843ProgramServices
Management And General4952888ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total78226748Total
Program Services73649320ProgramServices
Management And General4577428ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1045058Total
Program Services330211ProgramServices
Management And General714847ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7395119Total
Program Services6628245ProgramServices
Management And General766874ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1042437Total
Program Services449437ProgramServices
Management And General593000ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1432642Total
Program Services984997ProgramServices
Management And General447645ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5845089Total
Program Services5238953ProgramServices
Management And General606136ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total22079743Total
Program Services19771838ProgramServices
Management And General2307905ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6041969Total
Program Services4887184ProgramServices
Management And General1154785ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS162723551627235500
WI MEDICAID & OTHER TAX6694958669495800
EQUIPMENT REPAIRS & MAI6054771398106620737050
INTER-ENTITY TRANSACTIO-11238733-3654619-75841140

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2050993Total
Program Services856285ProgramServices
Management And General1194708ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total447077717Total
Program Services362336834ProgramServices
Management And General84740883ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY17070BOY
EOY21020EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15650700BOY
EOY5873542EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY61920944BOY
EOY67719511EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY9690306BOY
EOY10180930EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4665485BOY
EOY4618871EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis486686359LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec196959888LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY218302209BOY
EOY289726471EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY71251414BOY
EOY68047607EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6190366BOY
EOY7099261EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY387688494BOY
EOY453287213EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY65708246BOY
EOY63856664EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY40071547BOY
EOY4853930EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY146634982BOY
EOY250507104EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY252414775BOY
EOY319217698EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY135273719BOY
EOY134069515EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY135273719BOY
EOY134069515EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY387688494BOY
EOY453287213EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses15524203ReconcilationRevenueExpenses
Reconcilation Other Changes-16728407ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis26700912OtherCostOrOtherBasis
Book Value26700912BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis239884726OtherCostOrOtherBasis
Depreciation85043817Depreciation
Book Value154840909BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5207960OtherCostOrOtherBasis
Depreciation3475622Depreciation
Book Value1732338BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis162602210OtherCostOrOtherBasis
Depreciation103850723Depreciation
Book Value58751487BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52290551OtherCostOrOtherBasis
Depreciation4589726Depreciation
Book Value47700825BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings289726471TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVEST. - FUTURE REPLACE OF PROP, PLANT & EQUIPMENT22805909F
ASSETS UNDER BOND INDENTURE AGREEMENT4339198F
DEFERRED COMPENSATION6123945F
INVESTMENT IN MERCYCARE14544109F
INVESTMENTS - OTHER4612436F
BOND PROJECT FUND15622010F
FieldValueIRS element (for citing)
Total Of Book Value Securities68047607TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$6,123,945
PENSION LIABILITY$33,051,203
CAPITAL LEASES PAYABLE$344,219
DUE TO RELATED PARTY$210,987,737
FieldValueIRS element (for citing)
Total Of Amounts250507104TotalOfAmounts
Total Revenue462601920TotalRevenue
Total Expenses447077717TotalExpenses
Excess Or Deficit For Year15524203ExcessOrDeficitForYear
Net Unrealized GL On Investments-234407NetUnrealizedGLOnInvestments
Other-$16,494,000OtherAmount
Total Adjustments-16728407TotalAdjustments
Excess Or Deficit Per FS-1204204ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt462601920TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal462601920RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990462601920TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt447077717TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal447077717ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990447077717TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPART XI, LINE 8 - OTHER ADJUSTMENTS:Identifier
ExplanationCHANGES IN PENSION OBLIGATIONS -11,494,000. TRANSFER TO MERCY ALLIANCE, INC. -5,000,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: -16,494,000.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5687809TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5687809NetCommunityBenefitExpense
Percent Of Total Expense0.01270PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense56075602TotalCommunityBenefitExpense
Direct Offsetting Revenue33020180DirectOffsettingRevenue
Net Community Benefit Expense23055422NetCommunityBenefitExpense
Percent Of Total Expense0.05160PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense5465153TotalCommunityBenefitExpense
Direct Offsetting Revenue3372765DirectOffsettingRevenue
Net Community Benefit Expense2092388NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense67228564TotalCommunityBenefitExpense
Direct Offsetting Revenue36392945DirectOffsettingRevenue
Net Community Benefit Expense30835619NetCommunityBenefitExpense
Percent Of Total Expense0.06900PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1532744TotalCommunityBenefitExpense
Direct Offsetting Revenue196612DirectOffsettingRevenue
Net Community Benefit Expense1336132NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4192628TotalCommunityBenefitExpense
Direct Offsetting Revenue882245DirectOffsettingRevenue
Net Community Benefit Expense3310383NetCommunityBenefitExpense
Percent Of Total Expense0.00740PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense16552327TotalCommunityBenefitExpense
Direct Offsetting Revenue12909444DirectOffsettingRevenue
Net Community Benefit Expense3642883NetCommunityBenefitExpense
Percent Of Total Expense0.00810PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense508354TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense508354NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22786053TotalCommunityBenefitExpense
Direct Offsetting Revenue13988301DirectOffsettingRevenue
Net Community Benefit Expense8797752NetCommunityBenefitExpense
Percent Of Total Expense0.01960PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense90014617TotalCommunityBenefitExpense
Direct Offsetting Revenue50381246DirectOffsettingRevenue
Net Community Benefit Expense39633371NetCommunityBenefitExpense
Percent Of Total Expense0.08860PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense52000TotalCommunityBuildingExpense
Net Community Building Expense52000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense32000TotalCommunityBuildingExpense
Net Community Building Expense32000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense20000TotalCommunityBuildingExpense
Net Community Building Expense20000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense34000TotalCommunityBuildingExpense
Net Community Building Expense34000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense138000TotalCommunityBuildingExpense
Net Community Building Expense138000NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,994,860BadDebtExpenseAmount
Amount Attributable To1329023AmountAttributableTo
Amount Reimbursed By Medicare48190786AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare61889748CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-13698962MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursCritical Access HospitalCriticalAccessHospital
MERCY HOSPITAL
11000 MINERAL POINT AVENUEJANESVILLEWI53548XXXX
MERCY WALWORTH HOSPITAL AND MEDICAL CENT
2N2950 STATE ROAD 67LAKE GENEVAWI53147XXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyAverage Negotiated RatesAverageNegotiatedRatesAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
MERCY HOSPITAL AND TRAUMA CENTER
111150.0000000000001300.0000000000001XXXXXX11XXX1X01X00
MERCY WALWORTH HOSPITAL AND MEDICAL CENT
211150.0000000000001300.0000000000001XXXXXX11XXX1X01X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities49NumberOfOtherFacilities

Other Facilities OtherFacilities (49 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MERCY MANOR TRANSITION CENTER
1000 MINERAL POINT AVENUEJANESVILLEWI53548SKILLED NURSING/SUB-ACUTE CARE FACILITY
MERCY REGIONAL CANCER CENTER
1000 MINERAL POINT AVENUEJANESVILLEWI53548RADIATION ONCOLOGY CLINIC/RADIATION THERAPY FACILITY
HOUSE OF MERCY HOMELESS SHELTER
320 LINCOLN STREETJANESVILLEWI53548HOMELESS CENTER
MERCY ALGONQUIN MEDICAL CENTER
2401 HARNISH DRIVE SUITE 101ALGONQUINWI60102OUTPATIENT PHYSICIAN CLINIC
MERCY BARIATRIC WELLNESS CENTER
250 E CENTER DRIVE SUITE 201VERNON HILLSWI60061OUTPATIENT PHYSICIAN CLINIC
MERCY BARRINGTON MEDICAL CENTER
500 WEST HIGHWAY 22BARRINGTONWI60010OUTPATIENT PHYSICIAN CLINIC
MERCY BELOIT MEDICAL CENTER
2825 PRAIRIE AVENUEBELOITWI53511OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY
MERCY BRODHEAD MEDICAL CENTER
2310 FIRST CENTER AVENUEBRODHEADWI53520OUTPATIENT PHYSICIAN CLINIC
MERCY CENTER FOR CORRECTIVE EYE SURGERY
5400 W ELM STREET SUITE 120MCHENRYIL60050OUTPATIENT PHYSICIAN CLINIC
MERCY CENTER FOR CORRECTIVE EYE SURGERY
8780 W GOLF ROAD STE 304NILESIL60714OUTPATIENT PHYSICIAN CLINIC
MERCY CLINIC EAST
3524 EAST MILWAUKEE STREETJANESVILLEWI53546OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY
MERCY CLINIC EAST PHARMACY
3524 EAST MILWAUKEE STREETJANESVILLEWI53546RETAIL PHARMACY
MERCY CLINIC SOUTH
849 KELLOGG AVENUEJANESVILLEWI53546RESIDENCY PROGRAM / OUTPATIENT PHYSICIAN CLINIC
MERCY CLINIC WEST
1000 MINERAL POINT AVENUEJANESVILLEWI53548OUTPATIENT PHYSICIAN CLINIC & MEDICAL ONCOLOGY
MERCY CLINIC WEST PHARMACY
1000 MINERAL POINT AVENUEJANESVILLEWI53548RETAIL PHARMACY
MERCY CRYSTAL LAKE CHIROPRACTIC AND REHA
330 W TERRA COTTA ROAD RTE 176CRYSTAL LAKEIL60014CHIROPRACTOR
MERCY CRYSTAL LAKE MEDICAL CENTER EAST
390 CONGRESS PARKWAYCRYSTAL LAKEIL60014OUTPATIENT PHYSICIAN CLINIC
MERCY CRYSTAL LAKE MEDICAL CENTER WEST
350 CONGRESS PARKWAYCRYSTAL LAKEIL60014OUTPATIENT PHYSICIAN CLINIC
MERCY CRYSTAL LAKE OBGYN
750 E TERRA COTTA STE BCRYSTAL LAKEIL60014OUTPATIENT PHYSICIAN CLINIC
MERCY CRYSTAL LAKE MEDICAL CENTER SOUTH
415-A CONGRESS PARKWAYCRYSTAL LAKEIL60014OUTPATIENT PHYSICIAN CLINIC
MERCY DELAVAN MEDICAL CENTER
1038 E GENEVA STDELAVANWI53115OUTPATIENT PHYSICIAN CLINIC
MERCY EDGERTON MEDICAL CENTER
217 N MAIN STREETEDGERTONWI53534OUTPATIENT PHYSICIAN CLINIC
MERCY EVANSVILLE MEDICAL CENTER
300 UNION STREETEVANSVILLEWI53536OUTPATIENT PHYSICIAN CLINIC
MERCY HARVARD CLINIC SOUTH
348 S DIVISIONHARVARDIL60033OUTPATIENT PHYSICIAN CLINIC
MERCY HEALTH MALL
1010 NORTH WASHINGTONJANESVILLEWI53548OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY
MERCY HEALTH MALL PHARMACY
1010 NORTH WASHINGTONJANESVILLEWI53548RETAIL PHARMACY
MERCY LAKE GENEVA MEDICAL CENTER
350 PELLER ROADLAKE GENEVAWI53147OUTPATIENT PHYSICIAN CLINIC
MERCY LAKESIDE ORTHOPAEDICS
352 PELLER ROADLAKE GENEVAWI53147OUTPATIENT PHYSICIAN CLINIC
MERCY MCHENRY INTERNAL MEDICINE CENTER
633 RIDGEVIEW DRIVEMCHENRYIL60050OUTPATIENT PHYSICIAN CLINIC
MERCY MCHENRY MEDICAL CENTER
3922 MERCY DRIVEMCHENRYIL60050OUTPATIENT PHYSICIAN CLINIC
MERCY MILTON MEDICAL CENTER
725 SOUTH JANESVILLE STREETMILTONWI53563OUTPATIENT PHYSICIAN CLINIC
MERCY MILTON PHARMACY
725 SOUTH JANESVILLE STREETMILTONWI53563RETAIL PHARMACY
MERCY NORTHWEST WOMEN'S GROUP
47 WEST ACORN LANELAKE IN THE HILLSIL601564804OUTPATIENT PHYSICIAN CLINIC
MERCY OPTIONS-COOPERATIVE CHILDCARE INST
20 EAST COURT STREETJANESVILLEWI53548TREATMENT FACILITY FOR ADOLESCENTS
MERCY OPTIONS-JANESVILLE
903 MINERAL POINT AVENUEJANESVILLEWI53548PHYSICIAN & THERAPIST SERVICES: MENTAL HEALTH & ADDICTION TREATMENT
MERCY REGIONAL DIALYSIS CENTER
903 MINERAL POINT AVENUEJANESVILLEWI53548DIALYSIS CENTER
MERCY REGIONAL LUNG CENTER
903 MINERAL POINT AVENUEJANESVILLEWI53548PHYSICIANS CLINIC & SLEEP DISORDER CENTER
MERCY RICHMOND MEDICAL CENTER
9715 PRAIRIE RIDGERICHMONDIL60071OUTPATIENT PHYSICIAN CLINIC
MERCY SHARON MEDICAL CENTER
118 PLAIN STREETSHARONWI53585OUTPATIENT PHYSICIAN CLINIC
MERCY SPORTS MEDICINE AND REHABILITATION
557 NORTH WASHINGTONJANESVILLEWI53548OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY
MERCY TERRACE
510 N TERRACE STREETJANESVILLEWI53548OUTPATIENT PHYSICIAN CLINIC
MERCY WALWORTH PHARMACY
N2950 STATE ROAD 67LAKE GENEVAWI53147RETAIL PHARMACY
MERCY WHITEWATER MEDICAL CENTER
507 WEST MAIN STREETWHITEWATERWI53190OUTPATIENT PHYSICIAN CLINIC
MERCY WHITEWATER SPORTS MEDICINE & REHAB
519 WEST MAIN STREETWHITEWATERWI53190OUTPATIENT PHYSICIAN CLINIC AND REHABILITATION FACILITY
MERCY WOODSTOCK MEDICAL CENTER
2000 LAKE AVENUEWOODSTOCKIL60098OUTPATIENT PHYSICIAN CLINIC/URGENT CARE FACILITY
MERCY WOODSTOCK PHARMACY
2000 LAKE AVENUEWOODSTOCKIL60098RETAIL PHARMACY
MERCY WOMEN'S HEALTHCARE CENTER - ALCONQ
2230 N HUNTINGTON DRALGONQUINIL60102OUTPATIENT PHYSICIAN CLINIC
MERCY WOMEN'S HEALTHCARE CENTER - ELGIN
750 FLETCHER DR STE 206ELGINIL60123OUTPATIENT PHYSICIAN CLINIC
WOMEN'S HEALTH CENTER - HOFFMAN ESTATES
1555 BARRINGTON RD STE 2300AHOFFMAN ESTATESIL60169OUTPATIENT PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanationIdentifierIdentifierReturn 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 $2,574,892 OF EXPENSES (COLUMN C) AND $592,683 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'S SOUTH - FAMILY PRACTICE CLINIC WAS ALSO INCLUDED IN THIS LINE: EXPENSES IN COLUMN C TOTALED $3,179,703 AND COLUMN E HAD 148,296 OF NET EXPENSES.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $16,272,355 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 19%. 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 13G: 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 13G: 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%. 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 11% OF THE POPULATION BELOW THE POVERTY LEVEL. WALWORTH'S UNEMPLOYMENT RATE AS OF FEBRUARY, 2010 WAS AT 10.7%. THE TWO HOSPITALS' PAYOR DEMOGRAPHICS INCLUDED 39.0% MEDICARE, AND 13.8% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2011 - JUNE 30, 2012 (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 NOW SHELTERS AN AVERAGE OF 280 INDIVIDUALS EACH YEAR. MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 1,138 IN CALENDAR YEAR 2011. 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.
WIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Payments For Use Of ResidenceXPaymentsForUseOfResidence
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARK GOELZER MD
317681011154300067642802310801128760000
BARB BORTNER
130267064245030690117860208880230255000
DAN COLBY
18124508624109658016733079270301804000
DAVID KURTZ
132324068407098120122130137580236514000
JOHN COOK
23365001114350136780208370247180404318000
RUTH YARBROUGH
1583190848490113280149900111280280614000
RICHARD GRUBER
132858070359075350122220179090240883000
RALPH TOPINKA
249954018755107736023522034640472227000
JOSEPH NEMETH
137053065480082520124760104840233745000
KATHY HARRIS
85168046004013496072050180800169953000
SUE RIPSCH
2387920121676045700150140144940394546000
JAVON BEA
88693907858000235539001501401924704062390000
CHRISTOPHER STURM
130463104773210008757603396901903497000
JOHN BUSSA
1380615034824300018025003028401939392000
VIKRAM KHANNA
52906406759210004418003884701288012000
BRADLEY FIDELER
110036804612600014895003407901329523000
LANDON RIGGS
65982503012820004443703537201040916000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 1AReturnReference
ExplanationRESIDENCE 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)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
KRISTEN GOELZER
FAMILY MEMBER OF MARK GOELZER, DIRECTOR295578EMPLOYMENT - PHYSICIAN0
JAMIE KURTZ
FAMILY MEMBER OF DAVID KURTZ, OFFICER34261EMPLOYMENT - PATIENT ACCOUNT REPRESENTATIVE0
LAUREN GRUBER
FAMILY MEMBER OF RICH GRUBER, OFFICER45227EMPLOYMENT - RN/HIB0
MEGAN KRAUSE
FAMILY MEMBER OF SUE RIPSCH, OFFICER73833EMPLOYMENT - MANAGER0
JOANNA BENNING
FAMILY MEMBER OF JAVON BEA, PRESIDENT & DIRECTOR89966EMPLOYMENT - MANAGER0
LISA NEMETH
FAMILY MEMBER OF JOSEPH NEMETH, OFFICER31565EMPLOYMENT - REIMBURSEMENT ANALYST0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11NO REVIEW WAS OR WILL BE CONDUCTED
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, 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 15THE 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 2011.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -234,407. CHANGES IN PENSION OBLIGATIONS -11,494,000. TRANSFER TO MERCY ALLIANCE, INC. -5,000,000. TOTAL TO FORM 990, PART XI, LINE 5: -16,728,407.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART I, LINE 6MERCY HEALTH SYSTEM CORPORATION HAS REPORTED ZERO FOR THE TOTAL NUMBER OF VOLUNTEERS. THIS IS DUE TO THE FACT THAT ALL 1,138 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/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MERCY ALLIANCE INC
1000 MINERAL POINTJANESVILLEWI535475003391679859MANAGEMENT OF HEALTHCARE ORGANIZATIONSWI501(C)(3)11AN/A0
MERCY FOUNDATION INC
1000 MINERAL POINTJANESVILLEWI535475003237275336TO SUPPORT MERCY HEALTH SYSTEM & THE HOUSE OF MERCYWI501(C)(3)11A0MERCY HEALTH SYSTEM CORPORATION
MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS
1000 MINERAL POINTJANESVILLEWI535475003390912682TO SUPPORT MERCY HEALTH SYSTEM CORPORATIONWI501(C)(3)11C0MERCY HEALTH SYSTEM CORPORATION
MERCY ASSISTED CARE INC
901 MINERAL POINTJANESVILLEWI535475003391035110HOME HEALTH CARE & SERVICESWI501(C)(3)90MERCY ALLIANCE INC
MERCY ALLIANCE INC
901 GRANT STREETHARVARDIL60033311551871MEDICAL HEALTHCAREIL501(C)(3)30MERCY ALLIANCE INC
HARVARD MEMORIAL HOSPITAL FOUNDATION
901 GRANT STREETHARVARDIL60033364308662TO SUPPORT MERCY HARVARD HOSPITAL, INC.IL501(C)(3)11A0MERCY HARVARD HOSPITAL INC
MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER
1000 MINERAL POINTJANESVILLEWI535475003201673011NONEIL501(C)(3)30MERCY ALLIANCE INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncome
JANESVILLE MEDICAL CENTER INC
1000 MINERAL POINTJANESVILLEWI535475003391520130MANAGEMENT ENTITY OF UNION EMPLOYEESWIMERCY HEALTH SYSTEM CORPORATIONC648261.00000
MERCYCARE INSURANCE COMPANY
3430 PALMER DRIVEJANESVILLEWI53545391768192INSURANCE COMPANYWIMERCY HEALTH SYSTEM CORPORATIONC385064891.00000112273630
MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO
3430 PALMER DRIVEJANESVILLEWI53545201482553INSURANCE COMPANYWIMERCY HEALTH SYSTEM CORPORATIONC1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1MERCYCARE INSURANCE COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved6857389AmountInvolved
Method Of Amt DeterminationCOST OF SERVICES PROVIDEDMethodOfAmtDetermination