2012-05-15T13:41:57-05:00 2011-06-30 BAKER TILLY VIRCHOW KRAUSE LLP 500 MIDLAND COURT PO BOX 8130 JANESVILLE WI 535478130 990 2010-07-01 311551871 MERCY HARVARD HOSPITAL INC HARV 8159435431 901 GRANT STREET HARVARD IL 60033 JOHN COOK 8159435431 2012-05-04 1 WILLIAM T MURPHY CPA 6087525835 2012-05-04 2010 2016-02-24 21:20:13Z JOHN COOK 901 GRANT STREET HARVARD IL 60033 24573036 0 X WWW.MERCYHEALTHSYSTEM.ORG X IL TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. 6 5 253 28 0 0 49014 29351 23318304 24497333 5848 -45541 23577 36999 23396743 24518142 0 0 0 0 10599057 11027064 0 0 0 12451330 12033103 23050387 23060167 346356 1457975 14515215 13837854 17202029 15066693 -2686814 -1228839 TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. 0 0 17996086 24407659 HOSPITAL DISCHARGES 594, EMERGENCY VISITS 5,612, OUTPATIENT SURGERY CASES 1,732, NURSING HOME DISCHARGES 151 17996086 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 32 0 1 253 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 IL X JOHN COOK 6087566642 1000 MINERAL POINT JANESVILLE WI 535475003 DOUGLAS HAWTHORNE 1.00 X 124 0 0 MYRNA O'CONNER 1.00 X 779 0 0 KATHY SCHACK 1.00 X 1062 0 0 JOSEPH LEVENSTEIN MD 1.00 X 0 0 0 WESLEY JOST 1.00 X 0 0 0 P CASEY VORIS 1.00 X 72 0 0 SUE RIPSCH 1.00 X 0 359970 26105 RON KIERAS 1.00 X 0 0 0 JOHN COOK 55.00 X 0 342847 37355 WENDI AUBRY 40.00 X 126053 0 16896 CYNTHIA BANGERT 40.00 X 123798 0 17316 WYNN BIEDERMANN 40.00 X 123836 0 9715 LAURA LEAHEY 44.00 X 119060 0 7869 KHRISTINE SCHRADER 44.00 X 113663 0 18938 608447 702817 134194 9 0 1 0 MORNING STAR MEDIA GROUP 2254 OAKLAND DR SYCAMORE IL 60178 ADVERTISING 190824 UNITED SHOCKWAVE SERVICES LTD PO BOX 2178 DES PLAINES IL 600172178 LITHOTRIPSY 155550 DIAGNOSTIC HEALTH SERVICES PO BOX 972288 DALLAS TX 75397 NUCLEAR MEDICINE SERVICES 120875 HLS WHEELING LLC 13028 COLLECTION CENTER DR CHICAGO IL 606930130 LAUNDRY SERVICES 101650 4 16297 13054 29351 PATIENT SERVICE REVENU 621110 24407659 24407659 CAFETERIA 722210 89674 89674 24497333 5753 5753 3600 54894 -51294 -51294 -51294 MISCELLANEOUS 900099 36999 36999 36999 24518142 24407659 0 81132 8805506 6687653 2117853 340443 258561 81882 1244483 945167 299316 636632 488628 148004 5000 5000 2319989 2055256 264733 312077 1328 310749 2970733 2649420 321313 115812 115812 469099 416194 52905 21040 12161 8879 23523 17886 5637 531142 471292 59850 1274064 1130375 143689 61800 61800 BAD DEBTS 2220606 2220606 0 0 INTERCOMPANY EXPENSES 960572 173336 787236 0 MAINTENANCE AND REPAIRS 376069 327581 48488 0 OTHER TAXES 194360 0 194360 0 MEMBERSHIPS & DUES 94474 40124 54350 0 82743 38718 44025 23060167 17996086 5064081 0 705397 631925 3260941 2853651 681410 648042 161234 108381 26485642 17116833 9678384 9368809 27849 227046 14515215 13837854 1309456 1193300 15892573 13873393 17202029 15066693 X -2686814 -1228839 -2686814 -1228839 14515215 13837854 1457975 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 222604 222604 16915691 10036001 6879690 9001662 7080832 1920830 345685 345685 9368809 DUE TO RELATED PARTIES 13864442 LONG-TERM CAPITAL LEASE 8951 13873393 24518142 23060167 1457975 1457975 1 1 X 1 X 1 X 1 1 1 0 1 1 209205 0 209205 0.01000 2335098 1438754 896344 0.04300 31488 19016 12472 0.00060 2575791 1457770 1118021 0.05360 30933 0 30933 0.00150 0 0 7589155 5560209 2028946 0.09740 0 0 5200 0 5200 0.00020 7625288 5560209 2065079 0.09910 10201079 7017979 3183100 0.15270 1 629914 92849 3627281 5348152 -1720871 X 1 1 1 1 MERCY HARVARD HOSPITAL

901 GRANT STREET HARVARD IL 60033

X X X X MERCY HARVARD HOSPITAL 1 1 1 150.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X 1 X 0 1 X 0 0 3 MERCY HARVARD CARE CENTER

901 HAYES STREET HARVARD IL 60033

NURSING HOME FACILITY MERCY HARVARD HOSPITAL CLINIC

1001 GRANT STREET HARVARD IL 60033

PHYSICIAN CLINIC MERCY HARVARD REHABILITATION AND FITNESS

1000 HAYES STREET HARVARD IL 60033

REHABILITATION CENTER PART I, LINE 6A: MERCY HARVARD HOSPITAL (MHH) HAS PREPARED A COMMUNITY BENEFIT REPORT FOR FILING WITH ITS 990 TAX RETURN PRIOR TO ITS REQUIREMENT. IT FOLLOWED A RECOMMENDED FORMAT AND MIRRORED THAT OF ITS SISTER ORGANIZATION, MERCY HEALTH SYSTEM CORPORATION'S, FILING OF COMMUNITY BENEFITS WITH THE WISCONSIN HOSPITAL ASSOCIATION. 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; 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: N/A PART I, L7 COL(F): BAD DEBT EXPENSE OF $2,220,606 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 RELATE 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 ALLIANCE INC, AND AFFILIATES - MERCY ALLIANCE INC, IS THE PARENT COMPANY OF MERCY HARVARD HOSPITAL, INC.) THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE.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 MHH'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 14.74%. 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 MHH'S MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MHH'S COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MHH'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MHH'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. MERCY HARVARD HOSPITAL PART V, SECTION B, LINE 13G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENTS ARE CONDUCTED EVERY 18 MONTHS. MHH AND MHH'S SISTER ORGANIZATION, MERCY HEALTH SYSTEM CORP (MHS) WORK IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI) AND MCHENRY (IL) COUNTIES TO COMPLETE. MERCY HARVARD HOSPITAL, INC. (MHH) COMPLETES AN ANNUAL CRITICAL ACCESS HOSPITAL ASSESSMENT. NEEDS ASSESSMENT SURVEYS ARE COMPLETED AS REQUIRED BY THE STATE OF ILLINOIS.MERCY HEALTH SYSTEM CORP. HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS TO ASSESS HEALTH NEEDS IN THE COMMUNITIES THAT MHH AND MHS SERVE. 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: MERCY HARVARD HOSPITAL IS LOCATED IN MCHENRY COUNTY, ILLINOIS. IT IS A LICENSED FOR 25 ACUTE AND 45 LONG TERM CARE BEDS. IN MCHENRY COUNTY, 5.6% OF THE POPULATION IS BELOW THE POVERTY LEVEL (PER PRIOR YEAR'S DATA). IT IS A CRITICAL ACCESS HOSPITAL WITH 24/7 EMERGENCY SERVICES AND OUTPATIENT SURGERY. SINCE 2003, AND ITS AFFILIATION WITH MERCY HEALTH SYSTEM CORP., MHH HAS BEEN ABLE TO PROVIDE A NEW LEVEL OF CARE AND MORE MEDICAL SPECIALTIES. POPULATION GROWTH OF 8.7% WAS EXPECTED IN MCHENRY COUNTY OVER A 5 YEAR PERIOD WITH HARVARD LOOKING TO INCREASE 9.1%, PER LAST YEAR'S DATA. THE HOSPITALS' PAYOR DEMOGRAPHICS INCLUDE 30.3% MEDICARE, AND 14.1% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2010 - JUNE 30, 2011 (AS DETERMINED BY CHARGES BILLED). PART VI, LINE 6: OTHER - MERCY HARVARD HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. MERCY HARVARD HOSPITAL HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY. PART VI, LINE 7: MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTHCARE SYSTEM AND IS 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 HEALTH SYSTEM CORPORATION OPERATES TWO HOSPITALS AND HAS COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. 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 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 SHELTERED OVER 4,700 INDIVIDUALS SINCE IT OPENED IN 1996. MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 1,223 IN CALENDAR YEAR 2010. 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. REPORTS FILED WITH STATES PART VI, LINE 7 WI 0 0 0 0 0 0 0 0 0 SUE RIPSCH 0 237610 0 119314 0 3046 0 0 0 26105 0 386075 0 0 JOHN COOK 0 231079 0 103500 0 8268 0 0 0 37355 0 380202 0 0 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. 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 THE HOUSE OF MERCY HOMELESS SHELTER WI 501(C)(3) 11A MERCY HEALTH SYSTEM CORPORATION 0 MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS 1000 MINERAL POINT JANESVILLE WI 535475003 390912682 TO SUPPORT MERCY HEALTH SYSTEM CORPORATION WI 501(C)(3) 11C MERCY HEALTH SYSTEM CORPORATION 0 MERCY ASSISTED CARE INC 901 MINERAL POINT JANESVILLE WI 535475003 391035110 HOME HEALTH CARE & SERVICES WI 501(C)(3) 9 MERCY ALLIANCE INC 0 MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT JANESVILLE WI 535475003 390816848 MEDICAL HEALTHCARE WI 501(C)(3) 3 MERCY ALLIANCE INC 0 HARVARD MEMORIAL HOSPITAL FOUNDATION 901 GRANT STREET HARVARD IL 60033 364308662 TO SUPPORT MERCY HARVARD HOSPITAL, INC. IL 501(C)(3) 11A MERCY HARVARD HOSPITAL INC 0 MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 1000 MINERAL POINT JANESVILLE WI 535475003 201673011 NONE IL 501(C)(3) 3 MERCY ALLIANCE INC 0 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 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0