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ST CAMILLUS HEALTH CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST CAMILLUS HEALTH CENTER INC (EIN 39-1079224)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201332259349303218
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)
Timestamp2013-08-13T16:25:41-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391079224EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN SCHWABName
TitleCHIEF FINANCIAL OFFICERTitle
Phone4142581814Phone
Date Signed2013-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
PTINP01360892PTIN
Phone4144319300Phone
Date Prepared2013-08-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14823337GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STCAM.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1923YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionBY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year18173ContributionsGrantsPriorYear
Contributions Grants Current Year122416ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14781188ProgramServiceRevenuePriorYear
Program Service Revenue CY14700852ProgramServiceRevenueCY
Investment Income Prior Year2081InvestmentIncomePriorYear
Investment Income Current Year69InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year14801442TotalRevenuePriorYear
Total Revenue Current Year14823337TotalRevenueCurrentYear
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 Year8492471SalariesEtcPriorYear
Salaries Etc Current Year8834560SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7480698OtherExpensePriorYear
Other Expenses Current Year8100761OtherExpensesCurrentYear
Total Expenses Prior Year15973169TotalExpensesPriorYear
Total Expenses Current Year16935321TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1171727RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2111984RevenuesLessExpensesCY
Total Assets BOY23585439TotalAssetsBOY
Total Assets EOY22981386TotalAssetsEOY
Total Liabilities BOY34099652TotalLiabilitiesBOY
Total Liabilities EOY36075811TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-10514213NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-13094425NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionBY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8613372Expense
Revenue8694084Revenue
DescriptionSKILLED NURSING FACILITIES - ST. CAMILLUS HEALTH CENTER PROVIDES IN-HOUSE NURSING SERVICES TO ITS RESIDENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1986581Expense
Revenue2005196Revenue
DescriptionHOME HEALTH CARE AGENCY - ST. CAMILLUS HEALTH CENTER OFFERS NURSING SERVICES TO THE RESIDENTS OF THE INDEPENDENT LIVING FACILITY, ASSISTED LIVING FACILITY AND TO OTHER COMMUNITY RESIDENTS IN NEED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3964423Expense
Revenue4001572Revenue
DescriptionASSISTED LIVING FACILITY - A 76-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense14564376TotalProgramServiceExpense
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 Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HARRY W WHELPLEY
CHAIRPERSON2.00XX000
FR RICHARD O'DONNELL MI
VICE CHAIRPERSON2.00XX000
FR EUGENE DUTKIEWICZ SJ
TREASURER2.00XX000
FR LOUIS LUSSIER MIMD PHD
BOARD OF DIRECTOR2.00X000
PAULA HOGAN
BOARD OF DIRECTOR2.00X000
FR PEDRO TRAMONTIN MI
BOARD OF DIRECTOR2.00X000
BR MARIO CRIVELLO OS CAM
BOARD OF DIRECTOR2.00X000
ATTY FREDERICK A MUTH JR
BOARD OF DIRECTOR2.00X000
MARK E SLESAR
BOARD OF DIRECTOR2.00X000
NICK LAUBUSCH
BOARD OF DIRECTOR2.00X000
ROSEMARIE MATHEUS RN MSN
BOARD OF DIRECTOR2.00X000
JIM WESSON
BOARD OF DIRECTOR2.00X000
DAN MATTES
BOARD OF DIRECTOR2.00X000
RICK L JOHNSON
PRESIDENT40.00X023391110562
KEVIN SCHWAB
CFO40.00X01522417119
MARIE D'AMICO
VICE PRESIDENT & SECRETARY40.00X01190833100
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs505235TotalReportableCompFrmRltdOrgs
Total Other Compensation20781TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MORRISON MANAGEMENT SPECIALISTS INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 102289AddressLine1
CityATLANTACity
StateGAState
ZIP Code30368ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesFOOD SERVICEDescriptionOfServices
Compensation230145Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations122416RelatedOrganizations
Total Contributions122416TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES6230001277521812775218
MONTHLY SERVICE FEES62300011384561138456
OTHER SUPPORT SERVICES623000787178787178
FieldValueIRS element (for citing)
Total Program Service Revenue14700852TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column23TotalRevenueColumn
Exclusion$23ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other46Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other46Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column46TotalRevenueColumn
Exclusion$46ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14823337TotalRevenueColumn
Related Or Exempt Function Income14700852RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$69ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7348093Total
Program Services6319360ProgramServices
Management And General1028733ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total944324Total
Program Services812119ProgramServices
Management And General132205ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total542143Total
Program Services466243ProgramServices
Management And General75900ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2521319Total
Program Services2168334ProgramServices
Management And General352985ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total48760Total
Program Services41934ProgramServices
Management And General6826ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1099943Total
Program Services945951ProgramServices
Management And General153992ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11341Total
Program Services9753ProgramServices
Management And General1588ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total888269Total
Program Services763911ProgramServices
Management And General124358ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1125661Total
Program Services968068ProgramServices
Management And General157593ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total16202Total
Program Services13934ProgramServices
Management And General2268ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total574099Total
Program Services493725ProgramServices
Management And General80374ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total870074Total
Program Services748264ProgramServices
Management And General121810ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total126844Total
Program Services109086ProgramServices
Management And General17758ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
RAW FOOD / GROCERIES52147344846773006
MAINTENANCE1145829854116041
BAD DEBT EXPENSE714806147310007

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total110714Total
Program Services95213ProgramServices
Management And General15501ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total16935321Total
Program Services14564376ProgramServices
Management And General2370945ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY500BOY
EOY600EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1117977BOY
EOY1122514EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY28226BOY
EOY22587EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY294078BOY
EOY90575EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis32702662LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec13459463LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19773148BOY
EOY19243199EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2371510BOY
EOY2501911EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY23585439BOY
EOY22981386EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY553971BOY
EOY575332EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12565000BOY
EOY12140000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY20980681BOY
EOY23360479EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY34099652BOY
EOY36075811EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-10514213BOY
EOY-13094425EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-10514213BOY
EOY-13094425EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23585439BOY
EOY22981386EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2111984ReconcilationRevenueExpenses
Reconcilation Other Changes-468228ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12511CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2124CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years94581CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year18173CurrentTaxYearMinus1Year
Current Tax Year122416CurrentTaxYear
Total249805Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11727489CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12133358CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12802856CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14781188CurrentTaxYearMinus1Year
Current Tax Year14924780CurrentTaxYear
Total66369671Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11740000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12135482CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12897437CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14799361CurrentTaxYearMinus1Year
Current Tax Year15047196CurrentTaxYear
Total66619476Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50966619476PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years41778CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13791CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21813CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2081CurrentTaxYearMinus1Year
Current Tax Year23CurrentTaxYear
Total79486Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years41778CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13791CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21813CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2081CurrentTaxYearMinus1Year
Current Tax Year23CurrentTaxYear
Total79486Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11781778CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12149273CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12919250CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14801442CurrentTaxYearMinus1Year
Current Tax Year15047219CurrentTaxYear
Total66698962Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99880PublicSupportPercentage509
Prior Year Support Percentage0.99820PriorYearSupportPercentage
Investment Income Percentage0.00120InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00180PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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 Basis61278OtherCostOrOtherBasis
Book Value61278BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis25842732OtherCostOrOtherBasis
Depreciation7533341Depreciation
Book Value18309391BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis20219OtherCostOrOtherBasis
Depreciation15832Depreciation
Book Value4387BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6382882OtherCostOrOtherBasis
Depreciation5610939Depreciation
Book Value771943BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis395551OtherCostOrOtherBasis
Depreciation299351Depreciation
Book Value96200BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19243199TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESIDENT FUNDS HELD FOR SAFE KEEPING6891
DUE FROM RELATED PARTY2495020
FieldValueIRS element (for citing)
Total Book Value Other Assets2501911TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
RESIDENT FUNDS HELD FOR SAFE KEEPING$3,089
DUE TO RELATED PARTY$23,238,679
REFUNDABLE ENTRANCE FEES$118,711
FieldValueIRS element (for citing)
Total Of Amounts23360479TotalOfAmounts
Total Revenue14823337TotalRevenue
Total Expenses16935321TotalExpenses
Excess Or Deficit For Year-2111984ExcessOrDeficitForYear
Other-$468,228OtherAmount
Total Adjustments-468228TotalAdjustments
Excess Or Deficit Per FS-2580212ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14257076TotRevenueEtcAuditedFinclStmt
Other Revenues-468228OtherRevenues
Revenue Not Rptd F990-468228RevenueNotRptdF990
Revenue Subtotal14725304RevenueSubtotal
Other Revenues Not Included98033OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt98033RevenueNotRptdOnFinStmt
Total Revenue Per Form99014823337TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16935321TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal16935321ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99016935321TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM AND ITS COMBINED AFFILIATES DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE SYSTEM AND ITS COMBINED AFFILIATES RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2011 OR 2010. FEDERAL RETURNS FOR THE YEARS ENDED SEPTEMBER 30, 2010, 2009, AND 2008, REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -473,300. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 5,072. TOTAL TO SCHEDULE D, PART XI, LINE 8: -468,228.
PART XII, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 5,072. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -473,300.
PART XII, LINE 4B - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 98,033.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

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
RICK L JOHNSON
00020878302512800010562024447300
KEVIN SCHWAB
0001402410120000007119015936000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

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

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired515000AmountRetired
Total Proceeds12655000TotalProceeds
Issuance Costs From Proceeds80801IssuanceCostsFromProceeds
Other Spent Proceeds12574199OtherSpentProceeds
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

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

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1US BANKBusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATION HAS A SINGLE CLASS OF MEMBERS AND THE SOLE MEMBER OF THAT CLASS IS ST. CAMILLUS HEALTH SYSTEM, INC., A WISCONSIN NONSTOCK CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE BOARD OF DIRECTORS SHALL NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE MEMBER: TO DEFINE THE PHILOSOPHY, MISSION AND PURPOSE OF THE CORPORATION AND TO ADOPT, AMEND OR REPEAL ANY STATEMENTS OF MISSION OR PHILOSOPHY FOR THE CORPORATION; TO ADOPT, APPROVE, RESTATE, REVISE, OR AMEND THESE AMENDED AND RESTATED ARTICLES OF INCORPORATION AND THE BY-LAWS OF THE CORPORATION; TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION AND DETERMINE THE NUMBER (WHICH MAY NOT BE LESS THAN THREE) OF SUCH DIRECTORS; TO AUTHORIZE OR MAKE OTHER DECISIONS RELATING TO THE TRANSFER OR SALE OF OR CREATION OF AN ENCUMBRANCE (E.G. MORTGAGE, PLEDGE OR GRANT OF SECURITY INTEREST) UPON FIXED ASSETS OF THE CORPORATION WITH A VALUE IN EXCESS OF $500,000; TO AUTHORIZE THE INCURRENCE BY THE CORPORATION OF DEBT FOR MONEY BORROWED IN AMOUNTS IN EXCESS OF $500,000; TO ADOPT AMEND OR REPEAL ANY PLAN OF DISSOLUTION, CONSOLIDATION OR MERGER OF THE CORPORATION, ANY CONTRACT OR AGREEMENT FOR THE MANAGEMENT OF THE CORPORATION OR ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; TO CREATE, ACQUIRE, SELL, PURCHASE, DISSOLVE OR MAKE OTHER DISPOSITION OF ANY ENTITY OWNED OR CONTROLLED OR TO BE OWNED OR CONTROLLED BY THE CORPORATION OR ANY OWNERSHIP INTEREST IN ANY SUCH ENTITY; TO APPROVE ANY ACTIONS OR EXERCISE ANY POWER RESERVED TO THE CORPORATION AS A MEMBER OR SHAREHOLDER OF ANOTHER ENTITY; TO APPROVE THE INITIAL ELECTION BY THE BOARD OF DIRECTORS OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION (BUT NOT SUBSEQUENT RE-ELECTIONS OF THOSE PERSONS TO SERVE CONSECUTIVE TERMS IN SUCH RESPECTIVE OFFICES) AND TO REMOVE THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION WHETHER OR NOT SUCH REMOVAL IS APPROVED BY THE BOARD OF DIRECTORS; AND TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AND TO DETERMINE THE TERM OF THE PRESIDENT'S APPOINTMENT, SUCH TERM NOT TO EXCEED THREE YEARS.
FORM 990, PART VI, SECTION B, LINE 11THE CEO, CFO AND CONTROLLER REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS. A COPY IS KEPT ON HAND FOR PUBLIC VIEWING.
FORM 990, PART VI, SECTION B, LINE 12CTHE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD REVIEWS SALARIES WHICH ARE THEN COMPARED TO MANAGEMENT RESOURCE ASSOCIATION DATA. THE ORGANIZATION ALSO COMPARES THEIR SALARIES TO OTHER COMPANIES THAT ARE SIMILAR IN NATURE VIA 990'S.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 5:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -473,300. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 5,072. TOTAL TO FORM 990, PART XI, LINE 5: -468,228.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

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