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 237275336 MERCY FOUNDATION INC MERC 6087566000 PO BOX 5003 - 1000 MINERAL POINT JANESVILLE WI 535475003 JAVON BEA 6087566000 2012-05-08 1 WILLIAM T MURPHY CPA 6087525835 2012-05-08 2010 2016-02-24 21:20:13Z JAVON BEA PO BOX 5003 - 1000 MINERAL POINT JANESVILLE WI 535475003 1261410 0 X N/A X 1972 WI TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. 2 1 0 80 0 0 208992 212810 129300 164300 4812 76207 -43423 -26496 299681 426821 0 0 0 0 39480 141465 0 0 157134 202769 280507 242249 421972 57432 4849 1260791 1484330 8717 120465 1252074 1363865 X TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. 0 0 185702 0 HOUSE OF MERCY, A HOMELESS SHELTER, PROVIDED 7,418 SHELTER NIGHTS. A TOTAL OF 282 INDIVIDUALS (150 ADULTS AND 132 CHILDREN) WERE SERVED. 40377 164300 MERCY FOUNDATION PROVIDES SUBSIDY FUNDING FOR THE MERCY HEALTH SYSTEM RESIDENCY PROGRAM. USE OF THESE DONATIONS ARE FOR EDUCATIONAL NECESSITIES OUTSIDE THE NORMAL OPERATING BUDGET OF THE MERCY RESIDENCY PROGRAM. EXPENSES IN FISCAL YEAR 2011 INCLUDED PAYING FOR A MEDICAL MISSION TO HONDURAS IN CONJUNCTION WITH THE SHOULDER TO SHOULDER, INC. ORGANIZATION. DOCTOR JAMES HORTON AND RESIDENTS SPENT THEIR TIME PROVIDING PREVENTATIVE CARE/TREATMENT. OTHER EXPENSES INCLUDED STIPENDS PAID TO PHYSICIANS FOR THEIR PRECEPTOR TIME AND THEIR TIME SPENT COORDINATING THE ROTATION OF THEIR STUDENTS. 6000 0 MERCY FOUNDATION PROVIDES SUBSIDY FUNDING FOR THE MERCY ASSISTED CARE HOSPICE PROGRAM. THE HOSPICE HOMECARE PROGRAM PROVIDED 5,788 VISITS TO PATIENTS NEEDING RNS, HEALTH AIDES, THERAPISTS, AND SOCIAL WORKERS DURING THE YEAR. FUNDING FROM THE FOUNDATION, ALLOWED THIS PROGRAM TO CONTINUE TO PROVIDE HOSPICE CARE TO THE COMMUNITY. 1887 0 OTHER MISCELLANEOUS PROGRAM EXPENSES 1887 233966 1 1 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 1 0 0 0 0 0 0 0 0 0 0 0 X 2 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 WI X JOHN COOK 6087566642 1000 MINERAL POINT JANESVILLE WI 535475003 LARRY E SQUIRE 1.00 X X 0 728 0 SIMA WEXLER 1.00 X X 0 0 0 JAVON R BEA 1.00 X X 0 2269615 1500328 RICHARD GRUBER 1.00 X 0 209385 24078 BARB BORTNER 1.00 X 0 201251 21805 0 2680979 1546211 0 0 1 0 0 128110 84700 212810 FAMILY PRACTICE RESIDE 900099 164300 164300 164300 34362 34362 742496 700651 41845 41845 41845 107442 128110 133938 -26496 -26496 426821 164300 0 49711 130190 130190 3904 3904 7371 7371 8063 8063 10075 10075 9576 5532 4044 3471 3471 HOUSE OF MERCY EXP (HOM 185702 185702 0 0 STUDENT ACTIVITY EXPENS 28165 28165 0 0 COMMUNITY DEVELOPMENT F 15619 0 0 15619 RESIDENCY PROGRAM EXPEN 6800 6800 0 0 HOSPICE PATIENT EXPENSE 6000 6000 0 0 7036 1767 5219 50 421972 233966 30872 157134 71740 94624 1187609 1360517 1442 29189 1260791 1484330 8717 120465 8717 120465 X 1252074 1363865 1252074 1363865 1260791 1484330 X 4849 106942 X 0 1 1 X 0 X X 0 0 0 MERCY ASSISTED CARE INC 391035110 9 1 0 1 6000 MERCY HEALTH SYSTEM CORPORATION 390816848 3 1 0 1 0 2 6000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 VARIOUS INVESTMENTS 1360517 F 1360517 DUE TO RELATED PARTY 120465 120465 426821 421972 4849 106942 106942 111791 CHARITY BALL 159212 99959 59253 8500 2000 1754 13802 4496 53452 JINGLE MINGLE 65576 28151 37425 1000 15748 0 5975 1000 18249 1 10764 0 10764 0 0 0 0 0 7962 235552 128110 107442 9500 17748 1754 19777 5496 79663 133938 -26496 0 0 0 0 0 0 0 0 0 JAVON R BEA 0 846616 0 772088 0 650911 0 1459323 0 41005 0 3769943 0 0 RICHARD GRUBER 0 133222 0 71889 0 4274 0 0 0 24078 0 233463 0 0 BARB BORTNER 0 133222 0 65374 0 2655 0 0 0 21805 0 223056 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 106,942. MERCY ALLIANCE INC 1000 MINERAL POINT JANESVILLE WI 535475003 391679859 MANAGEMENT OF HEALTHCARE ORGANIZATIONS WI 501(C)(3) 11A N/A 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 HEALTH SYSTEM CORPORATION 1000 MINERAL POINT JANESVILLE WI 535475003 390816848 MEDICAL HEALTHCARE WI 501(C)(3) 3 MERCY ALLIANCE INC 0 MERCY ASSISTED CARE INC 901 MINERAL POINT JANESVILLE WI 535475003 391035110 HOME HEALTH CARE & SERVICES WI 501(C)(3) 9 MERCY ALLIANCE INC 0 MERCY HARVARD HOSPITAL INC 901 GRANT STREET HARVARD IL 60033 311551871 MEDICAL HEALTHCARE IL 501(C)(3) 3 MERCY ALLIANCE INC 0 HARVARD MEMORIAL HOSPITAL FOUNDATION 901 GRANT STREET HARVARD IL 60033 364308662 TO SUPPORT MERCY HARVARD HOSPITAL, INC. IL 501(C)(3) 11A MERCY HARVARD HOSPITAL INC 0 MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 1000 MINERAL POINT JANESVILLE WI 535475003 201673011 NONE IL 501(C)(3) 3 MERCY ALLIANCE INC 0 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 0 0 0 0 0 0 0 0 0 1 1 0 0 0