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MERCY HEALTH SYSTEM CORPORATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MERCY HEALTH SYSTEM CORPORATION (EIN 39-0816848)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201231379349300913
Schema version
2010v3.4
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)
Timestamp2012-05-15T13:41:57-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 MIDLAND COURT PO BOX 8130AddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535478130ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390816848EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameJAVON BEAName
TitleCEOTitle
Phone6087566000Phone
Date Signed2012-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM T MURPHY CPAName
Phone6087525835Phone
Date Prepared2012-05-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 - 1000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode
FieldValueIRS element (for citing)
Gross Receipts483850130GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MERCYHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees3553TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI10690442TotalGrossUBI
Net Unrelated Business Txbl Income-53158NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year239288ContributionsGrantsPriorYear
Contributions Grants Current Year248889ContributionsGrantsCurrentYear
Program Service Revenue Prior Year419084944ProgramServiceRevenuePriorYear
Program Service Revenue CY448360006ProgramServiceRevenueCY
Investment Income Prior Year658102InvestmentIncomePriorYear
Investment Income Current Year969845InvestmentIncomeCurrentYear
Other Revenue Prior Year1891518OtherRevenuePriorYear
Other Revenue Current Year3692206OtherRevenueCurrentYear
Total Revenue Prior Year421873852TotalRevenuePriorYear
Total Revenue Current Year453270946TotalRevenueCurrentYear
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 Year254680596SalariesEtcPriorYear
Salaries Etc Current Year262293640SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year150038775OtherExpensePriorYear
Other Expenses Current Year165283940OtherExpensesCurrentYear
Total Expenses Prior Year404719371TotalExpensesPriorYear
Total Expenses Current Year427577580TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17154481RevenuesLessExpensesPriorYear
Revenues Less Expenses CY25693366RevenuesLessExpensesCY
Total Assets BOY342696939TotalAssetsBOY
Total Assets EOY387688494TotalAssetsEOY
Total Liabilities BOY243539510TotalLiabilitiesBOY
Total Liabilities EOY252414775TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY99157429NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY135273719NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF MERCY HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES RESULTING IN HEALING IN THE BROADEST SENSE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense351580812Expense
Revenue436647657Revenue
DescriptionHOSPITAL DISCHARGES 9,786, NURSING HOME ADMISSIONS 315, BIRTHS 1,152, OUTPATIENT VISITS 1,132,938Description
Total Program Service Expense351580812TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096292NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3553NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormerHighest Compensated EmployeeHighestCompensatedEmployee
ROWLAND MCCLELLAN
CHAIRPERSON & DIRECTOR1.00X45500
THOMAS POOL
VICE-CHAIRPERSON & DIRECTO1.00X1350000
LARRY SQUIRE
TREASURER & DIRECTOR1.00X72800
SIMA WEXLER
SECRETARY & DIRECTOR1.00X000
DAVE SYVERSON
DIRECTOR1.00X1350000
MARK GOELZER MD
DIRECTOR1.00X000
ROBERT CONSIGNY
DIRECTOR1.00X6200
STEVE VAN GALDER
DIRECTOR1.00X72800
KATHERINE SCHACK
DIRECTOR1.00X106200
BARB BORTNER
VICE-PRESIDENT55.00201251021805X
DAN COLBY
VICE-PRESIDENT55.00280650039562X
DAVID KURTZ
VICE-PRESIDENT55.00215552041605X
JOHN COOK
VICE-PRESIDENT55.00342847037355X
KATHY HARRIS
VICE-PRESIDENT55.00137935016483X
RUTH YARBROUGH
VICE-PRESIDENT55.00257040040105X
RICHARD GRUBER
VICE-PRESIDENT55.00209385024078X
RALPH TOPINKA
VICE-PRESIDENT55.00382714039699X
JOSEPH NEMETH
FORMER VICE-PRESIDENT55.00217326041498X
SUE RIPSCH
VICE-PRESIDENT55.00359970026105X
JAVON BEA
PRESIDENT & DIRECTOR55.00X226961501500328X
BRADLEY FIDELER
PHYSICIAN40.0026311590230080X
CAROL NEUMAN
PHYSICIAN40.001584033096523X
CHRISTOPHER STURM
PHYSICIAN40.001552218050257X
JAMES KIRSCHBAUM
PHYSICIAN40.001148906055440X
VIKRAM KHANNA
PHYSICIAN40.001065665055029X
FieldValueIRS element (for citing)
Total Reportable Comp From Org12886301TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation2315952TotalOtherCompensation
Number Individuals GT100 K356NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MAGILL CONSTRUCTION COMPANY
977 KOOPMAN LANEELKHORNWI53121CONSTRUCTION3605462
WALSH CONSTRUCTION COMPANY II LLC
929 WEST ADAMSCHICAGOIL60607CONSTRUCTION3078086
ELLERBE BECKET
NW 8400 PO BOX 1450MINNEAPOLISMN554858400ARCHITECTUAL SERVICES2747922
MANN BROS INC
PO BOX 48ELKHORNWI53121CONSTRUCTION1285571
QUEST DIAGNOSTICS
PO BOX 12989CHICAGOIL60693LAB SERVICES1271089
FieldValueIRS element (for citing)
Number Of Contractors GT100 K39NumberOfContractorsGT100K
All Other Contributions248889AllOtherContributions
Total Contributions248889TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PATIENT SERVICE REVENU621110436647657436647657
UNRELATED BUSINESS INC5610001069044210690442
CAFETERIA7222101021907$1,021,907
FieldValueIRS element (for citing)
Total Program Service Revenue448360006TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column861887TotalRevenueColumn
Exclusion$861,887ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30359980Securities
Other327162Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities30122316Securities
Other456868Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities237664Securities
Other-129706Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column107958TotalRevenueColumn
Exclusion$107,958ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER INVESTMENTS9000993458443$3,458,443
MISCELLANEOUS900099233763$233,763
FieldValueIRS element (for citing)
Total Other Revenue3692206TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column453270946TotalRevenueColumn
Related Or Exempt Function Income436647657RelatedOrExemptFunctionIncome
Unrelated Business Revenue10690442UnrelatedBusinessRevenue
Exclusion$5,683,958ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6474119Total
Management And General6474119ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total208697203Total
Program Services169814132ProgramServices
Management And General38883071ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9519964Total
Program Services6980428ProgramServices
Management And General2539536ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total25125177Total
Program Services18663168ProgramServices
Management And General6462009ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12477177Total
Program Services9529306ProgramServices
Management And General2947871ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total728812Total
Management And General728812ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48300Total
Management And General48300ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total77388Total
Management And General77388ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19088958Total
Program Services10139793ProgramServices
Management And General8949165ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3170779Total
Program Services70186ProgramServices
Management And General3100593ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total76119009Total
Program Services72306642ProgramServices
Management And General3812367ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1090127Total
Program Services383195ProgramServices
Management And General706932ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7249665Total
Program Services6559497ProgramServices
Management And General690168ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total728008Total
Program Services302415ProgramServices
Management And General425593ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1320457Total
Program Services931113ProgramServices
Management And General389344ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5021698Total
Program Services4543632ProgramServices
Management And General478066ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19596159Total
Program Services17712398ProgramServices
Management And General1883761ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total5464602Total
Program Services4509354ProgramServices
Management And General955248ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS204164472041644700
WI MEDICAID & OTHER TAX6802235680223500
EQUIPMENT REPAIRS & MAI5688351393995617483950
MEMBERSHIPS & DUES12193127919964273160
INTER-ENTITY TRANSACTIO-11227652-2873831-83538210

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2681285Total
Program Services58750ProgramServices
Management And General2622535ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total427577580Total
Program Services351580812ProgramServices
Management And General75996768ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16320BOY
EOY17070EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY13332054BOY
EOY15650700EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY67615922BOY
EOY61920944EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY9501828BOY
EOY9690306EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4648927BOY
EOY4665485EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis394028926LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec175726717LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY173375036BOY
EOY218302209EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY66794118BOY
EOY71251414EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7412734BOY
EOY6190366EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY342696939BOY
EOY387688494EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY63452408BOY
EOY65708246EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY37224761BOY
EOY40071547EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY142862341BOY
EOY146634982EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY243539510BOY
EOY252414775EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY99157429BOY
EOY135273719EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY99157429BOY
EOY135273719EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY342696939BOY
EOY387688494EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses25693366ReconcilationRevenueExpenses
Reconcilation Other Changes10422924ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis26460912OtherCostOrOtherBasis
Book Value26460912BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis168928204OtherCostOrOtherBasis
Depreciation76886032Depreciation
Book Value92042172BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5207960OtherCostOrOtherBasis
Depreciation3272312Depreciation
Book Value1935648BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis140844768OtherCostOrOtherBasis
Depreciation91232570Depreciation
Book Value49612198BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52587082OtherCostOrOtherBasis
Depreciation4335803Depreciation
Book Value48251279BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings218302209TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVEST. - FUTURE REPLACE OF PROP, PLANT & EQUIPMENT23840162F
ASSETS UNDER BOND INDENTURE AGREEMENT9178249F
DEFERRED COMPENSATION9098020F
INVESTMENT IN MERCYCARE17641429F
INVESTMENTS - OTHER4440610F
BOND PROJECT FUND7052944F
FieldValueIRS element (for citing)
Total Of Book Value Securities71251414TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$9,098,020
PENSION LIABILITY$25,399,000
CAPITAL LEASES PAYABLE$256,135
DUE TO RELATED PARTY$111,281,827
DUE TO THIRD-PARTY PAYORS$600,000
FieldValueIRS element (for citing)
Total Of Amounts146634982TotalOfAmounts
Total Revenue453270946TotalRevenue
Total Expenses427577580TotalExpenses
Excess Or Deficit For Year25693366ExcessOrDeficitForYear
Net Unrealized GL On Investments-71076NetUnrealizedGLOnInvestments
Other$10,494,000OtherAmount
Total Adjustments10422924TotalAdjustments
Excess Or Deficit Per FS36116290ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt453270946TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal453270946RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990453270946TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt427577580TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal427577580ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990427577580TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPART XI, LINE 8 - OTHER ADJUSTMENTS:Identifier
ExplanationCHANGES IN PENSION OBLIGATIONS 17,494,000. TRANSFER TO MERCY ALLIANCE, INC. -7,000,000.Explanation

Schedule H IRS990ScheduleH

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

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4253924TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4253924NetCommunityBenefitExpense
Percent Of Total Expense0.01040PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense55954751TotalCommunityBenefitExpense
Direct Offsetting Revenue37634292DirectOffsettingRevenue
Net Community Benefit Expense18320459NetCommunityBenefitExpense
Percent Of Total Expense0.04500PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense5259927TotalCommunityBenefitExpense
Direct Offsetting Revenue3914793DirectOffsettingRevenue
Net Community Benefit Expense1345134NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense65468602TotalCommunityBenefitExpense
Direct Offsetting Revenue41549085DirectOffsettingRevenue
Net Community Benefit Expense23919517NetCommunityBenefitExpense
Percent Of Total Expense0.05870PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1433214TotalCommunityBenefitExpense
Direct Offsetting Revenue190872DirectOffsettingRevenue
Net Community Benefit Expense1242342NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4340733TotalCommunityBenefitExpense
Direct Offsetting Revenue890273DirectOffsettingRevenue
Net Community Benefit Expense3450460NetCommunityBenefitExpense
Percent Of Total Expense0.00850PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense11127623TotalCommunityBenefitExpense
Direct Offsetting Revenue7711479DirectOffsettingRevenue
Net Community Benefit Expense3416144NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Research Research

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

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense599432TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense599432NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17501002TotalCommunityBenefitExpense
Direct Offsetting Revenue8792624DirectOffsettingRevenue
Net Community Benefit Expense8708378NetCommunityBenefitExpense
Percent Of Total Expense0.02150PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense82969604TotalCommunityBenefitExpense
Direct Offsetting Revenue50341709DirectOffsettingRevenue
Net Community Benefit Expense32627895NetCommunityBenefitExpense
Percent Of Total Expense0.08020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense50000TotalCommunityBuildingExpense
Net Community Building Expense50000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense25000TotalCommunityBuildingExpense
Net Community Building Expense25000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense25000TotalCommunityBuildingExpense
Net Community Building Expense25000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense35000TotalCommunityBuildingExpense
Net Community Building Expense35000NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense135000TotalCommunityBuildingExpense
Net Community Building Expense135000NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$8,787,582BadDebtExpenseAmount
Amount Attributable To1177536AmountAttributableTo
Amount Reimbursed By Medicare51065944AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare63840309CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-12774365MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

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

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

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

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

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities46NumberOfOtherFacilities

Other Facilities OtherFacilities (46 entries)

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 6A: MERCY HEALTH SYSTEM, CORP. (MHS) SUBMITS AN ANNUAL COMMUNITY BENEFIT STATEMENT TO THE WISCONSIN HOSPITAL ASSOCIATION. PERIODICALLY, IT PUBLISHES A PAMPHLET EXPLAINING THE COMMUNITY BENEFITS THAT MERCY HEALTH SYSTEM CORP, AND THE RELATED ORGANIZATIONS OF MHS PROVIDE TO THE COMMUNITIES THEY SERVE. MHS HAS SUPPLIED SUPPLEMENTAL COMMUNITY BENEFIT STATEMENT INFORMATION WITH ITS 990 TAX RETURN SINCE FISCAL YEAR 2006 (TAX FORM 2005).
PART I, LINE 7: A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE COSTS ASSOCIATED WITH CHARITY CARE, UNREIMBURSED MEDICAID, AND OTHER MEANS TESTED GOVERNMENT PROGRAMS. THE COST-TO-CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2 RATIO OF PATIENT CARE COST-TO-CHARGE. THE COST OF THE OTHER BENEFITS REFERENCED IN THE TABLE OF LINE 7 (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS; HEALTH PROFESSIONS EDUCATION; SUBSIDIZED HEALTH SERVICES; CASH AND IN-KIND CONTRIBUTIONS) WERE DETERMINED USING ACTUAL DEPARTMENT/SERVICE SPECIFIC DATA AND/OR COST ACCOUNTING DERIVED DATA.
PART I, LINE 7G: THE SUBSIDIZED HEALTH CARE LINE INCLUDES $2,350,436 OF EXPENSES (COLUMN C) AND $1,071,319 OF NET EXPENSES (COLUMN E) ATTRIBUTABLE TO THE COSTS OF TRAUMA SURGEONS. THESE SURGEONS STAFF THE LEVEL II TRAUMA PROGRAM OF MERCY HEALTH SYSTEM CORPORATION 24/7.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $20,416,447 INCLUDED ON FORM 990, PART IX, LINE 25, WAS EXCLUDED FROM EXPENSES WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN.
PART II: MERCY'S MANY HEALTH IMPROVEMENT AND BENEFIT SERVICES/OPERATIONS WERE THE RESULT OF MERCY FILLING A COMMUNITY NEED. MERCY'S COLLABORATIVE EFFORTS AND THE EFFORTS OF ITS RELATED ENTITIES HAVE BROUGHT ASSISTANCE TO THE AREA'S UNDERSERVED (AS DETAILED IN #2 ABOVE).
PART III, LINE 4: BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH SYSTEM CORPORATION AND SUBSIDIARIES). 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 MERCY'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 13.4%. THIS FIGURE WAS BASED ON THE PERCENT OF BAD DEBT ACCOUNT DOLLARS THAT ARE RECLASSIFIED FOR CHARITY AND/OR BANKRUPTCY PURPOSES.
PART III, LINE 8: DATA FOR LINES 5 & 6 OF PART III AND THE MEDICARE SHORTFALL IS BASED ON MERCY'S TWO HOSPITALS' MEDICARE COST REPORTS.
PART III, LINE 9B: PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MERCY'S COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MERCY'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MERCY'S COMMUNITY CARE PROGRAM. PATIENTS MUST APPLY FOR COMMUNITY CARE AND SUPPLY MERCY WITH THE NECESSARY FINANCIAL AND OTHER INFORMATION REQUIRED. PATIENTS WHO QUALIFY FOR COMMUNITY CARE BENEFITS WILL RECEIVE A REDUCTION IN THE BALANCE OWED, EXTENDED PAYMENT TERMS, OR BOTH. THE AMOUNT OF THE COMMUNITY CARE BENEFIT WILL BE BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE.
PART V, SECTION B, LINE 13G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS.MERCY HOSPITAL
PART V, SECTION B, LINE 13G: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS.MERCY WALWORTH HOSPITAL AND MEDICAL CENT
PART VI, LINE 2: MERCY HEALTH SYSTEM CORPORATION DOES COMMUNITY NEEDS ASSESSMENTS IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI), AND MCHENRY (IL) COUNTIES EVERY 18 MONTHS. MERCY HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS OF NEARBY COMMUNITIES TO ASSESS HEALTH NEEDS. COLLABORATIVE EXAMPLES OF MERCY AND MERCY'S RELATED ENTITIES INCLUDE: I) THE COMMUNITY HEALTH CENTER AT MERCY CLINIC SOUTH: PARTNERSHIP WITH THE COMMUNITY HEALTH CENTER, INC. OF BELOIT, WI IN 2006, MERCY PARTNERED WITH COMMUNITY HEALTH CENTER, INC. TO OPEN THIS CLINIC IN JANESVILLE. IT PROVIDES FREE AND LOW-COST CARE TO LOW-INCOME, UNINSURED AND UNDERINSURED PATIENTS. THIS FIRST-OF-ITS-KIND PARTNERSHIP IS THE RESULT OF YEARS OF WORK WITH LOCAL PARTNERS AND THE FEDERAL GOVERNMENT TO DESIGN AND DEBUT A NEW MODEL OF CARE FOR THE UNDERSERVED. THE CLINIC SEES OVER 200 NEW PATIENTS EACH MONTH, HAS SIGNIFICANTLY IMPROVED PATIENT OUTCOMES, AND HAS SAVED MILLIONS IN UNNECESSARY EMERGENCY DEPARTMENT COSTS. II) HEALTHNET FREE CLINIC IN JANESVILLE: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. MERCY ALSO DONATES LAB, RADIOLOGY AND OTHER ANCILLARY SERVICES TO PATIENTS. III) COOPERATIVE CHILD CARE INSTITUTE: COLLABORATION WITH JANESVILLE PUBLIC SCHOOL DISTRICT AND ROCK COUNTY HUMAN SERVICES TO SERVE EMOTIONALLY CHALLENGED CHILDREN. IV) FAMILY HEALTH PARTNERSHIP CLINIC AND WELL CHILD CLINIC IN WOODSTOCK, IL AND HARVARD FREE CLINIC IN MCHENRY COUNTY, IL: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. V) FAMILY HEALTH PARTNERSHIP CLINIC: MCHENRY COUNTY DEPARTMENT OF HEALTH COLLABORATION TO PROVIDE MAMMOGRAMS AT MERCY FACILITIES FOR WOMEN WHO CANNOT OTHERWISE AFFORD THE SERVICE. VI) ROCK COUNTY HEALTH DEPARTMENT: BIOTERRORISM READINESS PROJECT. VII) RED CROSS: BLOOD DRIVE AND COOPERATIVE VOLUNTEER EFFORTS. VIII) UNITED WAY: FUND RAISING CAMPAIGN AND ROCK COUNTY NEEDS ASSESSMENT SURVEY CONTRIBUTOR IX) AREA POLICE AND FIRE DEPARTMENTS: PROVIDE PORTABLE DEFIBRILLATORS FOR POLICE VEHICLES AND FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES. X) COMMUNITY ACTION, INC.: MERCY LEADERSHIP SERVES ON STRATEGIC PLANNING COMMITTEE AND COMMUNITY ACTION DEVELOPMENT BOARD.
PART VI, LINE 3: ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL AIDE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEM'S WEBSITE, IN OUR EMERGENCY ROOMS, FINANCIAL SERVICES OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED.
PART VI, LINE 4: ONE HOSPITAL OF MERCY HEALTH SYSTEM CORPORATION IS LOCATED IN JANESVILLE, WI. IT WAS THE ONLY GENERAL ACUTE CARE HOSPITAL LOCATED IN JANESVILLE, WI, DURING THIS REPORTING PERIOD AND IS THE LARGEST OF SIX HOSPITALS WITHIN A 30-MILE RADIUS. IT IS LICENSED FOR 240 BEDS AND IS LOCATED IN ROCK COUNTY, WI, WHERE APPROXIMATELY 11% OF THE POPULATION IS BELOW THE POVERTY LEVEL (BASED ON LAST YEAR'S FIGURES). MEDIAN HOUSEHOLD INCOME IN ROCK CO. IS BELOW THE STATE'S AVERAGE. ROCK COUNTY'S UNEMPLOYMENT RATE AS OF FEBRUARY, 2010 WAS AT 12.7%; DUE IN LARGE PART TO THE CLOSING OF GENERAL MOTORS ASSEMBLE PLANT IN DECEMBER 2008. GENERAL MOTORS USED TO BE THE LARGEST EMPLOYER IN THE AREA. MERCY HEALTH SYSTEM'S SECOND HOSPITAL IS IN WALWORTH COUNTY. IT IS DESIGNATED AS A CRITICAL ACCESS 6 BED HOSPITAL. WALWORTH COUNTY WAS ALSO ESTIMATED TO HAVE APPROXIMATELY 11% OF THE POPULATION BELOW THE POVERTY LEVEL (BASED ON LAST YEAR'S FIGURES). WALWORTH'S UNEMPLOYMENT RATE AS OF FEBRUARY, 2010 WAS AT 10.7%. THE TWO HOSPITALS' PAYOR DEMOGRAPHICS INCLUDED 39.8% MEDICARE, AND 14.6% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2010 - JUNE 30, 2011 (AS DETERMINED BY CHARGES BILLED).
PART VI, LINE 6: THE HOSPITALS OF MERCY HEALTH SYSTEM HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. MERCY HEALTH SYSTEM HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY.
PART VI, LINE 7: MERCY HEALTH SYSTEM CORPORATION OPERATES TWO HOSPITALS AND HAS COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTH SYSTEM AND AFFILIATED WITH OTHER SEPARATELY REPORTED ORGANIZATIONS. MERCY ALLIANCE INC. IS THE PARENT COMPANY OF MERCY HEALTH SYSTEM CORPORATION, MERCY ASSISTED CARE INC, AND MERCY HARVARD HOSPITAL INC. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES AND DME (DURABLE MEDICAL EQUIPMENT) SERVICES; THUS PROVIDING CONTINUATION OF CARE TO MERCY HEALTH SYSTEM PATIENTS AND THE COMMUNITY AS A WHOLE. MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY ILLINOIS. MERCY HEALTH SYSTEM CORP. WORKS WITH THE MERCY FOUNDATION, INC. TO OPERATE A HOMELESS SHELTER IN JANESVILLE, WI.: THE HOUSE OF MERCY HOMELESS CENTER PROVIDES SHELTER, SUPPORT, AND TRAINING TO WOMEN, CHILDREN, AND FAMILIES TO HELP FIGHT HOMELESSNESS. IT 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.
WIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (16 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
BARB BORTNER
13322206537402655000218050223056000
DAN COLBY
18156008988409206000395620320212000
DAVID KURTZ
133222071762010568000416050257157000
JOHN COOK
231079010350008268000373550380202000
KATHY HARRIS
8710704634004488000164830154418000
RUTH YARBROUGH
155768086880014392000401050297145000
RICHARD GRUBER
13322207188904274000240780233463000
RALPH TOPINKA
250000012588406830000396990422413000
JOSEPH NEMETH
13578407292908613000414980258824000
SUE RIPSCH
237610011931403046000261050386075000
JAVON BEA
846616077208806509110145932304100503769943000
BRADLEY FIDELER
11885230001442636019895003113002861239000
CAROL NEUMAN
2707830714770124177307145002507301680556000
CHRISTOPHER STURM
658345087737301650001895003130701602475000
JAMES KIRSCHBAUM
4756030139287053401601895003649001204346000
VIKRAM KHANNA
468996058016901650001895003607901120694000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 1AReturnReference
ExplanationRESIDENCE FOR PERSONAL USE - THE CEO IS PROVIDED WITH A RESIDENCE. THE COST OF RENTING THE RESIDENCE IS TREATED AS TAXABLE COMPENSATION. PAYMENTS FOR BUSINESS USE OF PERSONAL RESIDENCE - THE CEO IS REIMBURSED FOR INTERNET ACCESS AND COMMUNICATION COSTS USED FOR BUSINESS PURPOSES AT HIS PERSONAL RESIDENCE. THE REIMBURSEMENT IS TREATED AS TAXABLE COMPENSATION. HEALTH CLUB DUES - THE CEO IS REIMBURSED FOR HEALTH CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION. PERSONAL SERVICES - THE CEO IS REIMBURSED FOR INCOME TAX PREPARATION SERVICES. THIS IS TREATED AS TAXABLE COMPENSATION.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
KRISTEN GOELZER
FAMILY MEMBER OF MARK GOELZER, DIRECTOR291325EMPLOYMENT - PHYSICIAN0
JAMIE KURTZ
FAMILY MEMBER OF DAVID KURTZ, OFFICER34111EMPLOYMENT - PATIENT ACCOUNT REPRESENTATIVE0
JAMES NEMETH
FAMILY MEMBER OF JOSEPH NEMETH, FORMER OFFICER27830EMPLOYMENT - FINANCE MANAGER0
JOANNA BEA
FAMILY MEMBER OF JAVON BEA, PRESIDENT & DIRECTOR80998EMPLOYMENT - MANAGER ARCHITECTURAL & INTERIOR DESIGN0
MEGAN KRAUSE
FAMILY MEMBER OF SUE RIPSCH, OFFICER54599EMPLOYMENT - REVENUE CYCLE COORDINATOR0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11NO REVIEW WAS OR WILL BE CONDUCTED
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 B, LINE 12C
THE MERCY ALLIANCE COMPENSATION COMMITTEE IS COMPRISED OF THE BOARD CHAIRPERSON, SECRETARY, AND THE TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED BY INDEPENDENT LEGAL COUNCIL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNCIL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2011.FORM 990, PART VI, SECTION B, LINE 15
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED LOSSES ON INVESTMENTS: -71,076. CHANGES IN PENSION OBLIGATIONS 17,494,000. TRANSFER TO MERCY ALLIANCE, INC. -7,000,000. TOTAL TO FORM 990, PART XI, LINE 5: 10,422,924.FORM 990, PART XI, LINE 5:
TOTAL NUMBER OF VOLUNTEERSMERCY HEALTH SYSTEM CORPORATION HAS REPORTED ZERO FOR THE TOTAL NUMBER OF VOLUNTEERS. THIS IS DUE TO THE FACT THAT ALL 1,209 VOLUNTEERS FOR THE MERCY HEALTH SYSTEM CORPORATION ARE TECHNICALLY VOLUNTEERS OF THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS AND AS SUCH HAVE BEEN REPORTED ON THEIR TAX RETURN. PLEASE SEE THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS TAX RETURN FOR MORE INFORMATION ON MERCY VOLUNTEER ACTIVITIES.FORM 990, PART I, LINE 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MERCY ALLIANCE INC
1000 MINERAL POINTJANESVILLEWI535475003391679859MANAGEMENT OF HEALTHCARE ORGANIZATIONSWI501(C)(3)11AN/A0
MERCY FOUNDATION INC
1000 MINERAL POINTJANESVILLEWI535475003237275336TO SUPPORT MERCY HEALTH SYSTEM & THE HOUSE OF MERCYWI501(C)(3)11A0MERCY HEALTH SYSTEM CORPORATION
MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS
1000 MINERAL POINTJANESVILLEWI535475003390912682TO SUPPORT MERCY HEALTH SYSTEM CORPORATIONWI501(C)(3)11C0MERCY HEALTH SYSTEM CORPORATION
MERCY ASSISTED CARE INC
901 MINERAL POINTJANESVILLEWI535475003391035110HOME HEALTH CARE & SERVICESWI501(C)(3)90MERCY ALLIANCE INC
MERCY ALLIANCE INC
901 GRANT STREETHARVARDIL60033311551871MEDICAL HEALTHCAREIL501(C)(3)30MERCY ALLIANCE INC
HARVARD MEMORIAL HOSPITAL FOUNDATION
901 GRANT STREETHARVARDIL60033364308662TO SUPPORT MERCY HARVARD HOSPITAL, INC.IL501(C)(3)11A0MERCY HARVARD HOSPITAL INC
MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER
1000 MINERAL POINTJANESVILLEWI535475003201673011NONEIL501(C)(3)30MERCY ALLIANCE INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncome
JANESVILLE MEDICAL CENTER INC
1000 MINERAL POINTJANESVILLEWI535475003391520130MANAGEMENT ENTITY OF UNION EMPLOYEESWIMERCY HEALTH SYSTEM CORPORATIONC116341.00000
MERCYCARE INSURANCE COMPANY
3430 PALMER DRIVEJANESVILLEWI53545391768192INSURANCE COMPANYWIMERCY HEALTH SYSTEM CORPORATIONC462986321.00000113057915
MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO
3430 PALMER DRIVEJANESVILLEWI53545201482553INSURANCE COMPANYWIMERCY HEALTH SYSTEM CORPORATIONC1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1MERCYCARE INSURANCE COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved5877834AmountInvolved
Method Of Amt DeterminationCOST OF SERVICES PROVIDEDMethodOfAmtDetermination