2012-09-27T11:17:25-05:00 2011-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 500 MIDLAND COURT PO BOX 8130 JANESVILLE WI 535478130 990 2011-01-01 390912682 MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS MERC 6087566000 1000 MINERAL POINT AVE JANESVILLE WI 53545 ELAINE LAWRENCE 6087566000 2012-09-12 1 WILLIAM T MURPHY CPA P00074580 6087525835 2012-09-12 2011 2016-02-24 21:20:13Z ELAINE LAWRENCE 1000 MINERAL POINT AVE JANESVILLE WI 53545 550652 0 X N/A X 1963 WI THE MISSION OF THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS IS TO:PERFORM THE HIGHEST QUALITY OF VOLUNTEER SERVICES FOR IMPROVED HEALTHCARE, ACT AS AMBASSADORS OF GOODWILL FOR MERCY HOSPITAL IN THE SOUTHERN WISCONSIN AREA, AND PROVIDE FINANCIAL ASSISTANCE THROUGH FUND RAISING PROJECTS IN THE QUEST FOR HEALTHCARE AT THE LOWEST POSSIBLE COST WITHOUT SACRIFICING QUALITY, SERVICE, AND CONVENIENCE. 22 22 0 1138 0 0 10444 9185 543804 535949 725 130 4708 3686 559681 548950 9000 11500 0 0 0 0 0 0 0 540661 492127 549661 503627 10020 45323 260363 305686 0 0 260363 305686 X THE MISSION OF THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS IS TO:PERFORM THE HIGHEST QUALITY OF VOLUNTEER SERVICES FOR IMPROVED HEALTHCARE, ACT AS AMBASSADORS OF GOODWILL FOR MERCY HOSPITAL IN THE SOUTHERN WISCONSIN AREA, AND PROVIDE FINANCIAL ASSISTANCE THROUGH FUND RAISING PROJECTS IN THE QUEST FOR HEALTHCARE AT THE LOWEST POSSIBLE COST WITHOUT SACRIFICING QUALITY, SERVICE, AND CONVENIENCE. 0 0 110507 109266 MEALS ON WHEELS:REPRESENTS THE COST OF MEALS PREPARED BY MERCY HOSPITAL AND DELIVERED BY VOLUNTEERS TO SHUT-INS OR HOME PATIENTS. APPROXIMATELY 120 MEALS DELIVERED EACH DAY. 99072 207037 LIFELINE:REPRESENTS THE COST OF COMMUNICATIONS EQUIPMENT PROVIDED TO INDIVIDUALS IN THEIR HOMES FOR MONITORING AND NOTIFICATION OF EMERGENCY SITUATIONS. STAFFED BY VOLUNTEERS. 950 INDIVIDUALS RECEIVE LIFELINE SERVICES. 84339 122952 GIFT SHOP:STAFFED BY VOLUNTEERS. PROVIDES MERCHANDISE TO PATIENTS AND THEIR FAMILIES AND FRIENDS. 209709 96694 CASTAWAYS THRIFT STORE:STAFFED BY VOLUNTEERS. SALES OF USED CLOTHING AND HOUSEHOLD ITEMS TO GENERATE CONTRIBUTIONS TO MERCY HOSPITAL.CONTRIBUTION TO MERCY HOSPITAL:CONTINUAL CONTRIBUTION TO MERCY HOSPITAL FROM FUNDS GENERATED BY ASSOCIATION OF VOLUNTEERS. 209709 96694 503627 1 0 0 0 0 0 0 0 0 0 1 0 0 0 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 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 0 0 X MERCY HEALTH SYSTEM ASSOC OF VOLUN 6087566000 1000 MINERAL POINT RD JANESVILLE WI 53545 X ELAINE LAWRENCE 1.00 X X 0 0 0 KATHLEEN COOPER 1.00 X X 0 0 0 NAOMI HACKBARTH 1.00 X X 0 0 0 MARGARET MORTENSEN 1.00 X X 0 0 0 JUDY JAGGARD 1.00 X X 0 0 0 NANCY VERHOEVEN 1.00 X 0 0 0 DARLENE BECKER 1.00 X 0 0 0 DIANA PEARSE 1.00 X 0 0 0 JOANN BROWN 1.00 X 0 0 0 JOAN ROOT 1.00 X 0 0 0 CORAL NYQUIST 1.00 X 0 0 0 LEO KNUTH 1.00 X 0 0 0 VERGEAN JURS 1.00 X 0 0 0 CORINNE CAREY 1.00 X 0 0 0 DORIS HENNING 1.00 X 0 0 0 SUE DEAN BUCKHOLZ 1.00 X 0 0 0 SONIA HULL 1.00 X 0 0 0 MARY ANN HARRIS 1.00 X 0 0 0 JOANN REED 1.00 X 0 0 0 PAM GOVERT 1.00 X 0 0 0 JEAN STOLL 1.00 X 0 0 0 STEVE GAFFNEY 1.00 X 0 0 0 0 0 0 0 0 0 0 0 2785 6400 9185 LIFELINE 900099 207037 207037 GIFT SHOP 900099 122952 122952 MEALS ON WHEELS 624210 109266 109266 CASTAWAYS 900099 80838 80838 MEMBERSHIP FUNDS 900099 8956 8956 6900 6900 535949 130 130 5388 1702 3686 3686 548950 535949 0 3816 11500 11500 1169 1169 18111 18111 11371 11371 6055 6055 9424 9424 CONTRIBUTION TO MERCY H 164513 164513 MEALS FOR MEALS ON WHEE 104559 104559 LIFELINE EQUIPMENT 88035 88035 GIFT SHOP MERCHANDISE 80284 80284 8606 8606 503627 503627 0 0 96106 107327 158834 192936 5423 5423 5423 260363 305686 0 0 X 260363 305686 260363 305686 260363 305686 45323 0 X 0 0 0 X X X 0 0 0 MERCY HEALTH SYSTEM CORPORATION 390816848 3 1 1 1 143013 1 143013 5423 5423 5423 1 SCHOLARSHIPS 13 11500 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS AN APPLICATION PROCEDURE IN PLACE FOR DETERMINING QUALIFICATIONS FOR THOSE APPLYING FOR FINANCIAL SCHOLARSHIPS IN THE MEDICAL FIELD. APPLICATIONS ARE OBTAINED AND REVIEWED BY THE BOARD OF DIRECTORS TO DETERMINE IF THE APPLICANT FITS THE STANDARDS SET FORTH BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT KEEP RECORDS OF MINUTES FOR ANY ADDITIONAL COMMITTEES THAT CAN ACT ON BEHALF OF THE GOVERNING BODY EXCEPT FOR THE BOARD OF DIRECTORS MEETINGS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS REVIEWED BY THE BOARD PRESIDENT PRIOR TO FILING. A COPY OF THE FORM 990 IS AVAILABLE FOR EACH BOARD MEMBER TO REVIEW BUT IS NOT REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C AS STATED IN THE ORGANIZATION'S BYLAWS, ANY MEMBER ON THE BOARD OF DIRECTORS IS REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST. IF A CONFLICT OF INTEREST ARISES BETWEEN A MEMBER AND THE ORGANIZATION, THAT MEMBER MUST ABSTAIN FROM VOTING ON A RELATED MATTER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ALL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT JANESVILLE WI 53547 390816848 HOSPITAL WI 501(C)(3) LINE 3 N/A 0 MERCY FOUNDATION INC 1000 MINERAL POINT JANESVILLE WI 53547 237275336 SUPPORT MERCY HOSPITAL AND RELATED ORGANIZATIONS WI 501(C)(3) LINE 11A, I MERCY HEALTH SYSTEM CORPORATION 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MERCY HEALTH SYSTEM CORPORATION B 143013 FAIR MARKET VALUE - CASH MERCY FOUNDATION INC B 21500 FAIR MARKET VALUE - CASH