MERCY ASSISTED CARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY ASSISTED CARE INC (EIN 39-1035110)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349307929
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T15:50:39-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390859910 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MIDLAND COURT PO BOX 8130 | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535478130 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391035110 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY ASSISTED CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 6087542201 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 901 MINERAL POINT AVE | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAVON BEA | Name |
| Title | CEO | Title |
| Phone | 6087542201 | Phone |
| Date Signed | 2013-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM T MURPHY CPA | Name |
| PTIN | P00074580 | PTIN |
| Phone | 6087525835 | Phone |
| Date Prepared | 2013-05-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAVON BEA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5003 - 901 MINERAL POINT AVE | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11307296 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF MERCY ASSISTED CARE IS TO PROVIDE:1) THE HIGHEST QUALITY OF HOME CARE SERVICES AS POSSIBLE WHICH RESULTS IN HEALING, INDEPENDENCE AND DIGNITY OF LIFE IN IT'S BROADEST SENSE.2) COMPREHENSIVE NETWORK OF HOME CARE AND SUPPORT SERVICES BASED ON COMMUNITY AND CLIENT NEEDS.3) COST EFFECTIVE HOME CARE AND SUPPORT SERVICES WITHOUT SACRIFICING QUALITY, SERVICE AND CONVENIENCE.4) EDUCATIONAL PROGRAMS AND HEALTH PROMOTION SERVICES THAT IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITY.THIS WILL BE ACCOMPLISHED WITH A QUALIFIED, CARING STAFF AND THE RESPONSIBLE UTILIZATION OF RESOURCES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 176 | TotalNbrEmployees |
| Total Nbr Volunteers | 22 | TotalNbrVolunteers |
| Total Gross UBI | 625508 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 106691 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 20589 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 38474 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7446643 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7835679 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1932 | InvestmentIncomePriorYear |
| Investment Income Current Year | 555 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1258143 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1307076 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8727307 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9181784 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5337883 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5939653 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3179246 | OtherExpensePriorYear |
| Other Expenses Current Year | 2939678 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8517129 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8879331 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 210178 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 302453 | RevenuesLessExpensesCY |
| Total Assets BOY | 8825129 | TotalAssetsBOY |
| Total Assets EOY | 8361814 | TotalAssetsEOY |
| Total Liabilities BOY | 5463773 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4698005 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3361356 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3663809 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF MERCY ASSISTED CARE IS TO PROVIDE:1) THE HIGHEST QUALITY OF HOME CARE SERVICES AS POSSIBLE WHICH RESULTS IN HEALING, INDEPENDENCE AND DIGNITY OF LIFE IN IT'S BROADEST SENSE.2) COMPREHENSIVE NETWORK OF HOME CARE AND SUPPORT SERVICES BASED ON COMMUNITY AND CLIENT NEEDS.3) COST EFFECTIVE HOME CARE AND SUPPORT SERVICES WITHOUT SACRIFICING QUALITY, SERVICE AND CONVENIENCE.4) EDUCATIONAL PROGRAMS AND HEALTH PROMOTION SERVICES THAT IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITY.THIS WILL BE ACCOMPLISHED WITH A QUALIFIED, CARING STAFF AND THE RESPONSIBLE UTILIZATION OF RESOURCES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7868412 | Expense |
| Revenue | 9139319 | Revenue |
| Description | VISITS: SKILLED NURSING 18,671, EXTENDED HOMECARE 5,804, HOSPICE HOMECARE 4,795DAYS: CCI 4,366HOSPITAL COMMUNITY BENEFIT REPORT - IRS FORM 990, SUPPLEMENT PART IIITHE COMMUNITY BENEFIT CONTRIBUTION OF MERCY ASSISTED CARE, INC. INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW:SECTION 1: QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE ORGANIZATION'S COMMUNITY BENEFIT MISSION, HOW THE MISSION IS TRANSLATED INTO A PROACTIVE APPROACH DESIGNED TO MEET COMMUNITY HEALTH NEEDS, HOW THE ORGANIZATION MEETS TAX-EXEMPT REQUIREMENTS, AND A DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT HIGHLIGHT THE ORGANIZATION'S IMPACT ON COMMUNITY HEALTH.SECTION 2: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE ORGANIZATION'S COMMUNITY BENEFIT CONTRIBUTION IN FINANCIAL TERMS PRESENTING THE AMOUNT OF CHARITY CARE, THE UNPAID SHORTFALL FROM GOVERNMENT HEALTH CARE FOR THE INDIGENT, AND THE NET EXPENSE OF COMMUNITY BENEFIT SERVICES.SECTION 1-QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT1. MERCY ASSISTED CARE INC.'S COMMITMENT TO PROVIDING COMMUNITY BENEFIT - NOTE: *A. THE MISSION OF THE MERCY ASSISTED CARE, INC. IS "TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES RESULTING IN HEALING IN ITS BROADEST SENSE." MERCY ASSISTED CARE PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MERCY ASSISTED CARE, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING ITS MISSION, MERCY ASSISTED CARE ROUTINELY PROVIDES: 1.) FREE CARE AND/OR SUBSIDIZED CARE, 2.) CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT ARE REIMBURSED BELOW COST, AND 3.) HEALTH ACTIVITIES AND EDUCATIONAL AND SUPPORT PROGRAMS TO THE COMMUNITIES IT SERVES IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. MANY OF THE SERVICES OF MERCY ASSISTED CARE ARE FOCUSED ON KEEPING THE ELDERLY AND MEDICALLY FRAIL IN THE TYPE OF INDEPENDENT SETTING MOST APPROPRIATE TO THEIR MEDICAL CONDITION.B. MERCY ASSISTED CARE CONSIDERS ITS TARGET POPULATIONS TO BE RESIDENTS OF ROCK AND WALWORTH COUNTIES IN WISCONSIN, AS WELL AS PARTS OF MCHENRY COUNTY IN ILLINOIS. THE SYSTEM USES MULTIPLE STRATEGIES TO IDENTIFY NEEDS IN THESE COMMUNITIES. THESE STRATEGIES INCLUDE ONE-ON-ONE MEETINGS WITH LOCAL COMMUNITY LEADERS, FORMAL SURVEYS, PARTICIPATION ON COMMUNITY TASK FORCES, SUGGESTIONS FROM PATIENTS, AND DIRECT INPUT FROM ITS EMPLOYEES. AMONG THE TRENDS IDENTIFIED: POOR RE-INTEGRATION BACK INTO THE COMMUNITY OF ADOLESCENTS WHO ARE SENT TO FACILITIES FOR INTENSIVE BEHAVIORAL TREATMENT. MERCY ASSISTED CARE HAS WORKED WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP MEET THESE NEEDS:1) MERCY ASSISTED CARE, INC. COLLABORATES WITH THE SCHOOL SYSTEM AND COUNTY SOCIAL SERVICES TO PROVIDE RESIDENTIAL TREATMENT IN JANESVILLE FOR ADOLESCENTS FROM COUNTIES THROUGHOUT SOUTHERN WISCONSIN. THIS ALLOWS FAMILIES AND SCHOOL SYSTEMS TO KEEP IN CONTACT WITH THE RESIDENTS, REDUCING THE TRAUMA ASSOCIATED WITH RE-INTEGRATION TO THE COMMUNITY.2.) MERCY ASSISTED CARE SUBSIDIZES ITS HOSPICE PROGRAM (THROUGH FUNDRAISING/DONATIONS FROM MERCY FOUNDATION) SO THAT THIS PROGRAM IS AVAILABLE TO THOSE IN NEED WITHIN THE COMMUNITY.3) IT PROVIDES HEALTH SCREENINGS AND HEALTH EDUCATION SEMINARS AT PUBLIC EVENTS AND AT ITS OWN SITES THROUGHOUT THE TARGET AREA.4) ALONG WITH ITS SISTER-CORPORATION (MERCY HEALTH SYSTEM CORPORATION), MERCY ASSISTED CARE, PROVIDES TRAINING OPPORTUNITIES FOR NURSES, PHYSICIANS, AND OTHER HEALTH PROFESSIONALS. C. COMMUNITY/CHARITY CARE IS PROVIDED BY MERCY ASSISTED CARE TO CUSTOMERS WHO ARE UNABLETO PAY FOR ALL OR A PORTION OF THEIR CHARGES AND WHO MEET ELIGIBILITY REQUIREMENTS. ELIGIBILITY IS BASED ON THE FOLLOWING: INDIVIDUAL OR FAMILY INCOME, INDIVIDUAL OR FAMILY ASSETS, FAMILY SIZE, AND OTHER SOURCES OF PAYMENT FOR SERVICES. ELIGIBILITY FOR ALL OTHER CATEGORICAL AIDS IS A PREREQUISITE BEFORE QUALIFYING FOR COMMUNITY CARE. PATIENTS THAT QUALIFY WILL RECEIVE A REDUCTION IN THE BALANCE OWED AND EXTENDED PAYMENT TERMS. THE AMOUNT OF THE COMMUNITY CARE BENEFIT IS BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE. IF PATIENT INCOME AND FAMILY ASSETS ARE LESS THAN 150% OF THE FEDERAL POVERTY GUIDELINES, THEN MERCY WILL COVER 100% OF THEIR OUTSTANDING BALANCE VIA ITS COMMUNITY CARE PROGRAM. IF PATIENT INCOME AND FAMILY ASSETS FALL BETWEEN 150% AND 300% OF THE FEDERAL POVERTY GUIDELINE, THEN A PATIENT'S BALANCE CAN BE REDUCED AS MUCH AS 90%. MERCY HAS PROCEDURES IN PLACE TO INFORM THE PUBLIC ABOUT THE AVAILABILITY OF FINANCIAL AID/CHARITY CARE. INFORMATION IS MADE AVAILABLE AT THE TIME OF REGISTRATION, THROUGH PATIENT FINANCIAL COUNSELORS, AND AT THE CUSTOMER SERVICE PATIENT ACCOUNTS AREAS. TRAINING IS PROVIDED TO PERSONNEL AS TO HOW TO COMMUNICATE THIS PROGRAM'S AVAILABILITY TO PATIENTS AND HOW TO DIRECT PATIENT'S INQUIRIES. TRANSLATION SERVICES ARE AVAILABLE AS NEEDED.2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION- MERCY ASSISTED CARE, INC HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY.- MERCY ASSISTED CARE, INC. PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS.3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMSMERCY ASSISTED CARE OFFERS MANY REDUCED PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH MERCY ASSISTED CARE, INC. BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THE PROGRAMS INCLUDE:- COOPERATIVE CHILDCARE INSTITUTE - A RESIDENTIAL TREATMENT FACILITY FOR ADOLESCENTS- PARTICIPATION IN HEALTH FAIRS, AND FLU CLINICS.- SUPPORT OF DIABETES AND FOOT CLINICS.- PARTICIPATION IN HOSPICE SUPPORT GROUPS.- PARTICIPATION IN A RADIO HEALTH LINE. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATIONMERCY HEALTH SYSTEM'S WEB PAGE: WWW.MERCYHEALTHSYSTEM.ORG *MUCH OF THE COMMUNITY BENEFIT FOR ALL THE ENTITIES OF THE ENTIRE MERCY ALLIANCE, INC. (PARENT COMPANY OF MERCY ASSISTED CARE, INC.) IS PROVIDED AT THE MERCY HEALTH SYSTEM CORPORATION LEVEL, SINCE THAT IS THE LARGEST OPERATING ENTITY IN THE ALLIANCE.SECTION 2 - QUANTIFIABLE COMMUNITY BENEFITFISCAL YEAR ENDED JUNE 30, 20121.) CHARITY CARE - AT COST $23,667 2.) MEDICAID SHORTFALL - NET EXPENSE 122,655 3.) COMMUNITY BENEFIT PROGRAMS - NET EXPENSE COMMUNITY HEALTH SERVICES: COMMUNITY EDUCATION AND OUTREACH 680 SUBSIDIZED HEALTH SERVICES: EXTENDED HOMECARE 36,758 FINANCIAL AND IN-KIND DONATIONS: 8,701TOTAL QUANTIFIABLE COMMUNITY BENEFIT $192,461 | Description |
| Total Program Service Expense | 7868412 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 21 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 176 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN COOK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6087566642 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 MINERAL POINT | AddressLine1 |
| City | JANESVILLE | City |
| State | WI | State |
| ZIP Code | 535475003 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| TAMMY MCDONALD | ||||||
| VICE-PRESIDENT & DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| DARLENE BECKER | ||||||
| SECRETARY & DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| ANITA KROPF | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| KEITH KONKOL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOSEPH NEMETH | ||||||
| TREASURER & DIRECTOR | 1.00 | X | X | 0 | 210785 | 22960 |
| JAVON R BEA | ||||||
| PRESIDENT & DIRECTOR | 1.00 | X | X | 0 | 4028129 | 34261 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4238914 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 57221 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 38474 | AllOtherContributions |
| Total Contributions | 38474 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT SERVICE REVENU | 621110 | 7210171 | 7210171 | |
| UNRELATED BUSINESS INC | 561000 | 625508 | 625508 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7835679 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1467 | TotalRevenueColumn |
| Exclusion | $1,467 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 912 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -912 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -912 | TotalRevenueColumn |
| Exclusion | -$912 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 3428240 | GrossSalesOfInventory |
| Cost Of Goods Sold | 2124600 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1303640 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1303640 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 3436 | TotalRevenueColumn |
| Exclusion | $3,436 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3436 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9181784 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8513811 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 625508 | UnrelatedBusinessRevenue |
| Exclusion | $3,991 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4707596 | Total |
| Program Services | 4357361 | ProgramServices |
| Management And General | 350235 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164009 | Total |
| Program Services | 151807 | ProgramServices |
| Management And General | 12202 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 727533 | Total |
| Program Services | 672482 | ProgramServices |
| Management And General | 55051 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340515 | Total |
| Program Services | 315770 | ProgramServices |
| Management And General | 24745 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9221 | Total |
| Program Services | 2221 | ProgramServices |
| Management And General | 7000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 277794 | Total |
| Program Services | 258716 | ProgramServices |
| Management And General | 19078 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38910 | Total |
| Program Services | 1138 | ProgramServices |
| Management And General | 37772 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 365560 | Total |
| Program Services | 314035 | ProgramServices |
| Management And General | 51525 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26342 | Total |
| Program Services | 26342 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 297198 | Total |
| Program Services | 227594 | ProgramServices |
| Management And General | 69604 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262930 | Total |
| Program Services | 261647 | ProgramServices |
| Management And General | 1283 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17135 | Total |
| Program Services | 10408 | ProgramServices |
| Management And General | 6727 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212680 | Total |
| Program Services | 175434 | ProgramServices |
| Management And General | 37246 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 517722 | Total |
| Program Services | 427056 | ProgramServices |
| Management And General | 90666 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13200 | Total |
| Program Services | 10109 | ProgramServices |
| Management And General | 3091 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| INTER-ENTITY CHARGES - | 523249 | 364773 | 158476 | 0 |
| EQUIPMENT REPAIRS & MAI | 188944 | 105824 | 83120 | 0 |
| BAD DEBT | 147660 | 147660 | 0 | 0 |
| MISCELLANEOUS | 41133 | 38035 | 3098 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8879331 | Total |
| Program Services | 7868412 | ProgramServices |
| Management And General | 1010919 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1100 | BOY |
| EOY | 1009 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1973211 | BOY |
| EOY | 1373185 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2267009 | BOY |
| EOY | 2462721 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 521315 | BOY |
| EOY | 496880 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89468 | BOY |
| EOY | 97520 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10818505 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6949232 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3907075 | BOY |
| EOY | 3869273 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65951 | BOY |
| EOY | 61226 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8825129 | BOY |
| EOY | 8361814 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 792121 | BOY |
| EOY | 714335 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4671652 | BOY |
| EOY | 3983670 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5463773 | BOY |
| EOY | 4698005 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3361356 | BOY |
| EOY | 3663809 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3361356 | BOY |
| EOY | 3663809 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8825129 | BOY |
| EOY | 8361814 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 302453 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 103060 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 18290 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13971 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 20589 | CurrentTaxYearMinus1Year |
| Current Tax Year | 38474 | CurrentTaxYear |
| Total | 194384 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12017236 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 11249477 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11479671 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10705443 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11263919 | CurrentTaxYear |
| Total | 56715746 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12120296 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 11267767 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11493642 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10726032 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11302393 | CurrentTaxYear |
| Total | 56910130 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 56910130 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2535 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2265 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2702 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1932 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1467 | CurrentTaxYear |
| Total | 10901 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2535 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2265 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2702 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1932 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1467 | CurrentTaxYear |
| Total | 10901 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 158 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 449 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3018 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4326 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2524 | CurrentTaxYear |
| Total | 10475 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12122989 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 11270481 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11499362 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10732290 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11306384 | CurrentTaxYear |
| Total | 56931506 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99960 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99960 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00020 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00020 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6969067 | OtherCostOrOtherBasis |
| Depreciation | 4242330 | Depreciation |
| Book Value | 2726737 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 396894 | OtherCostOrOtherBasis |
| Depreciation | 256334 | Depreciation |
| Book Value | 140560 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1833659 | OtherCostOrOtherBasis |
| Depreciation | 1592729 | Depreciation |
| Book Value | 240930 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1618885 | OtherCostOrOtherBasis |
| Depreciation | 857839 | Depreciation |
| Book Value | 761046 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3869273 | TotalOfBookValueLandBuildings |
| Total Revenue | 9181784 | TotalRevenue |
| Total Expenses | 8879331 | TotalExpenses |
| Excess Or Deficit For Year | 302453 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 302453 | ExcessOrDeficitPerFS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOSEPH NEMETH | |||||||||||||
| 0 | 137053 | 0 | 65480 | 0 | 8252 | 0 | 12476 | 0 | 10484 | 0 | 233745 | 0 | 0 |
| JAVON R BEA | |||||||||||||
| 0 | 886939 | 0 | 785800 | 0 | 2355390 | 0 | 15014 | 0 | 19247 | 0 | 4062390 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | NO REVIEW WAS OR WILL BE CONDUCTED |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REPORT ALL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR INVESTIGATING ALL CONFLICTS AND REPORTING TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY ALLIANCE INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391679859 | MANAGEMENT OF HEALTHCARE ORGANIZATIONS | WI | 501(C)(3) | 11A | N/A | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 237275336 | TO SUPPORT MERCY HEALTH SYSTEM & THE HOUSE OF MERCY | WI | 501(C)(3) | 11A | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390912682 | TO SUPPORT MERCY HEALTH SYSTEM CORPORATION | WI | 501(C)(3) | 11C | 0 | MERCY HEALTH SYSTEM CORPORATION | |
| MERCY HEALTH SYSTEM CORPORATION | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 390816848 | MEDICAL HEALTHCARE | WI | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
| MERCY HARVARD HOSPITAL INC | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | MEDICAL HEALTHCARE | IL | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
| HARVARD MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 364308662 | TO SUPPORT MERCY HARVARD HOSPITAL, INC. | IL | 501(C)(3) | 11A | 0 | MERCY HARVARD HOSPITAL INC | |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | |||||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 201673011 | NONE | IL | 501(C)(3) | 3 | 0 | MERCY ALLIANCE INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | ||||||||
| 1000 MINERAL POINT | JANESVILLE | WI | 535475003 | 391520130 | MANAGEMENT ENTITY OF UNION EMPLOYEES | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| MERCYCARE INSURANCE COMPANY | ||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 391768192 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | ||||||||
| 3430 PALMER DRIVE | JANESVILLE | WI | 53545 | 201482553 | INSURANCE COMPANY | WI | MERCY HEALTH SYSTEM CORPORATION | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |