COVENANT MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT MEDICAL CENTER INC (EIN 42-1264647)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201241369349302784
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T11:11:02-04:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421264647 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COVE | NameControl |
| Phone | 3192728000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3421 West Ninth Street | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 507025499 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHELE M PANICUCCI | Name |
| Title | Senior VP and CFO | Title |
| Phone | 3192727300 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Jack Dusenbery | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3421 West Ninth Street | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 507025499 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 311424423 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.wheatoniowa.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | To provide inpatient and outpatient healthcare services. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2486 | TotalNbrEmployees |
| Total Nbr Volunteers | 424 | TotalNbrVolunteers |
| Total Gross UBI | 233302 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 846 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 35339335 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1926005 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 228803184 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 233841802 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2791152 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2799404 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4793327 | OtherRevenuePriorYear |
| Other Revenue Current Year | 6838095 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 271726998 | TotalRevenuePriorYear |
| Total Revenue Current Year | 245405306 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 401484 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 367176 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 128013914 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 130061762 | 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 | 103050113 | OtherExpensePriorYear |
| Other Expenses Current Year | 105517372 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 231465511 | TotalExpensesPriorYear |
| Total Expenses Current Year | 235946310 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 40261487 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9458996 | RevenuesLessExpensesCY |
| Total Assets BOY | 168102666 | TotalAssetsBOY |
| Total Assets EOY | 183332174 | TotalAssetsEOY |
| Total Liabilities BOY | 37091587 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 41073512 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 131011079 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 142258662 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | AS A MEMBER OF WHEATON FRANCISCAN HEALTHCARE, OUR AFFILIATES STRIVE TO LIVE OUT THE HEALING MINISTRY OF THE JUDEO-CHRISTIAN TRADITION WHILE PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTE THE DIGNITY AND WELL BEING OF THE PATIENTS AND COMMUNITIES WE SERVE. OUR VISION IS TO BE RECOGNIZED FOR SUPERIOR HEALTHCARE SERVICE, CLINICAL EXCELLENCE, AS THE HEALTHCARE EMPLOYER OF CHOICE, AND THE PREFERRED PARTNER OF PHYSICIANS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 210518498 | Expense |
| Grants | 367176 | Grants |
| Revenue | 236600516 | Revenue |
| Description | WHEATON FRANCISCAN SERVICES, INC. (WFSI) is a Catholic, not-for-profit health care and housing organization serving at sites in Wisconsin, Iowa, Illinois, and Colorado. The System includes 18 hospital sites, three transitional and extended-care facilities, two home health agencies, nearly 3,500 physicians, more than 70 clinic sites with 770 employed physicians, and approximately 2,800 units of assisted living and other housing, and the corporate services offices in Wheaton, Illinois, and Glendale, Wisconsin. Started more than 125 years ago and formally incorporated in 1983, WFSI is committed to living out the Mission and Values of its Sponsors, the Wheaton Franciscan Sisters, by providing excellent and compassionate health care and housing services to all, regardless of their ability to pay. WFSI was incorporated in 1983 to preserve and strengthen Judeo-Christian values, provide a framework for lay expertise and involvement, respond to an increasingly complex environment, ensure continuity of Franciscan sponsorship, and assure viability and excellence throughout the organization. As a not-for-profit organization, WFSI reinvests all net income into the communities it serves. Its multiple entities are dedicated to delivering quality health care to patients and residents through highly-trained staff, advanced technology, and superior and compassionate service; caring for each person's body, mind, and spirit with respect and dignity; working to improve the health of the communities; and ensuring health care access for everyone. WFSI is organized into market-based regional holding companies organized in the Southeast, Wisconsin region, the Fox Valley, Wisconsin region, as well as other regional holding companies conducting services in Illinois, Iowa, and Colorado. The System's housing and spiritual development services are organized under the holding company name of Franciscan Ministries, Inc. Since 2006, the "doing business as" name for WFSI's health care ministry has been Wheaton Franciscan Healthcare (WFH). In 2011 Wheaton Franciscan Healthcare in Southeast Wisconsin was recognized as one of the nation's top 25 most efficient, best-performing health care networks by SDI, the nation's premier integrated health network evaluation system. Wheaton Franciscan Healthcare ranked as the top integrated system in Southeast Wisconsin, is among the top 10 in the Midwest, and ranked 23 nationally. Other national recognitions include being named one of the best performing 50 systems in Thompson Reuters' 100 Top Hospitals: Health Systems Quality/Efficiency Study in 2009. Wheaton Franciscan Healthcare also received a 2009 VIP Award from McKesson Technology Solutions for its success in using information technology to enhance patient safety across nine hospital sites and more than 100 physician offices. The VIP Awards are presented annually to organizations that demonstrate vision, innovation and performance in the use of healthcare IT. Wheaton Franciscan Healthcare was one of five health care organizations selected by a panel of experts in the field of health care IT use to receive the award. Please see our full 2011 Annual Report online at: http://www.wfhealthcare.org/Wheaton/Documents/2011AnnualReport.pdf CORPORATE STRUCTURE: Parent Company: Wheaton Franciscan Services, Inc. DBA Wheaton Franciscan Healthcare Health care ministry: Wheaton Franciscan Healthcare Housing ministry: Franciscan Ministries, Inc. Health Care Mission: Wheaton Franciscan Healthcare is committed to living out the healing ministry of Jesus by providing exceptional and compassionate health care service that promotes the dignity and well being of the people we serve. Health Care Vision: Our health ministries will be recognized in each community we serve for superior and compassionate patient service, clinical excellence, as the health care employer of choice, and the preferred partner of physicians. Housing Mission: Franciscan Ministries is committed to providing quality and affordable housing in a compassionate environment that promotes wholeness of life within ourselves and the communities we serve. Housing Vision: Our housing ministries will be recognized for excellence in property management and a well-integrated network of support services that provide hope, growth, and opportunity. Values: Our common Values, which flow from our Mission and Catholic tradition, must have meaning for every one of us. Through them we put the healing ministry of Jesus into practice throughout the Wheaton Franciscan System. Respect: We value each person as sacred, created in the image and likeness of God, which gives worth and meaning to each person's life. Integrity: We value honesty and words and actions that build trust. Development: We value personal and professional growth that combines the physical, emotional, spiritual and relational aspects of life and work. Excellence: We value superior performance in our work and service. Stewardship: We value our responsibility to use human, financial, and natural resources entrusted to us for the common good, with special concern for those who are poor. WHEATON FRANCISCAN HEALTHCARE Wheaton Franciscan Services, Inc.'s health care division, doing business as Wheaton Franciscan Healthcare (WFH), consists of facilities in Illinois, Iowa, and Wisconsin. SYSTEM STATISTICS Hospital Sites: 18 Staffed Hospital beds: 2,114 Long-term Care Facilities: 3 Home Health Agencies: 2 Units of Housing: 2,681 Associates: 21,005 Affiliated Physicians: 2,710 Employed Physicians: 770 Emergency Room Visits: 374,436 Newborns: 10,519 Hospital Admissions: 84,924 Hospital Patient Days: 403,808 Skilled Nursing Unit Patient Days: 24,120 Long-term Care Facility Patient Days: 82,110 Hospital Outpatient Visits: 1,972,764 Hospice Days: 19,860 Home Health Visits: 115,253 Medical Group Physician Visits: 2,000,423 WFH ORGANIZATIONS Iowa Covenant Medical Center, Inc. Mercy Hospital of Franciscan Sisters, Inc. Sartori Memorial Hospital, Inc. Covenant Clinic Covenant Foundation, Inc. Sartori Health Care Foundation, Inc. Covenant Regional Services, Inc. Illinois Marianjoy Rehabilitation Hospital and Clinics Marianjoy Medical Group Marianjoy Foundation RUSH OAK PARK HOSPITAL, Inc. OSF Services Canticle Ministries Clara Pfaender Fund Wisconsin Wheaton Franciscan - St. Joseph and The Wisconsin Heart Hospital Campuses All Saints Elmbrook Memorial St. Francis Franklin Franciscan Woods The Terrace at St. Francis Wheaton Franciscan Home Health Wheaton Franciscan Hospice Wheaton Franciscan Laboratories Wheaton Franciscan Medical Group All Saints Foundation Volunteers in Partnership with Wheaton Franciscan Healthcare-All Saints St. Joseph Foundation Elmbrook Memorial Foundation Circle of Life Foundation The Foundation for St. Francis and Franklin AFFILIATIONS INCLUDE: Midwest Orthopedic Specialty Hospital - Franklin, WI Affinity Health System - Menasha, Wisconsin St. Elizabeth Hospital Mercy Medical Center of Oshkosh Calumet Medical Center Network Health Plan of Wisconsin Affinity Medical Group St. Elizabeth Hospital Foundation Mercy Health Foundation United Hospital System - Kenosha, Wisconsin St. Catherine's Medical Center and Kenosha Medical Center Campuses WHEATON FRANCISCAN HEALTHCARE COMMUNITY IMPACT FOR SYSTEM / 2011 Charity Care: $29,311,248. Charity Care is defined as free or discounted health services provided to those who cannot afford to pay and who meet all criteria for financial assistance. Charity care is based on actual costs, not charges, and does not include bad debt. Unreimbursed cost of public programs: $89,193,180. Unreimbursed cost of public programs is defined as the shortfall experienced when payments received are below the cost of treating public beneficiaries through Medicaid and other local public programs. Community Health Improvement Services: $2,921,540. Community Health Improvement Services are defined as clinical and non-clinical services designed to improve community health, which are provided to the community for free or for fees that did not cover costs. Financial contributions: $3,461,030. Financial contributions are defined as contributions, including cash, non-cash items such as food, furniture, equipment, supplies, and loaned staff for volunteer and charitable purposes, made to individuals, community groups, or nonprofit organizations for charitable purposes. Health professions education: $8,788,076. Health professions education is defined as direct costs incurred for accredited training and education programs for physicians, nurses, allied health professionals and technicians (does not include ongoing education for staff). Community building activities: $820,333. Community building activities are defined as programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental issues. Costs for these activities include cash and in-kind donations. Communit | Description |
| Total Program Service Expense | 210518498 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 109 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2486 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TIMOTHY HUBER | NamePerson |
| Telephone Number | 3192727607 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3421 WEST NINTH STREET | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 507025499 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (33 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Reportable Comp From OrganizationReportableCompFromOrganization | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Cynthia Goro | |||||||||
| Director | 1.0 | X | |||||||
| Sandie Graf | |||||||||
| Director | 1.0 | X | |||||||
| Jerry Harris | |||||||||
| Director | 1.0 | X | |||||||
| Eric Locke | |||||||||
| Director | 1.0 | X | |||||||
| Michael Mallaro | |||||||||
| Director | 1.0 | X | |||||||
| Wallace Rundle | |||||||||
| Director | 1.0 | X | |||||||
| Gregory Schmitz | |||||||||
| Director | 1.0 | X | |||||||
| Frank Seng | |||||||||
| Director | 1.0 | X | |||||||
| Edward Stachovic | |||||||||
| Director | 1.0 | X | |||||||
| Douglas Stanford MD | |||||||||
| Director | 1.0 | X | |||||||
| Ron Van Veldhuizen | |||||||||
| Director | 1.0 | X | |||||||
| Camille Hogan | |||||||||
| Chair/Vice Chair - Director | 1.0 | X | X | ||||||
| Becky Mudd | |||||||||
| Vice Chair - Director | 1.0 | X | X | ||||||
| Jack Dusenbery | |||||||||
| President - Director | 40.0 | X | X | 568344 | 67280 | ||||
| John Oliverio | |||||||||
| Treasurer/Secretary - Director | 40.0 | X | X | 1813218 | 157725 | ||||
| James Peterson MD | |||||||||
| Director | 40.0 | X | 42828 | 305586 | |||||
| Peter Hohnstein MD | |||||||||
| Director | 40.0 | X | 43796 | 431302 | |||||
| Michael Slavin DO | |||||||||
| Director | 40.0 | X | 34750 | 533234 | |||||
| Brian Sims DO | |||||||||
| Director | 40.0 | X | 41034 | 585658 | |||||
| Michele Panicucci | |||||||||
| Asst. Treas. | 40.0 | X | 383842 | 62871 | |||||
| Nancy Schaefer | |||||||||
| Asst. Secy | 40.0 | X | 6632 | 49111 | |||||
| Rose Fowler | |||||||||
| VP Operations / Site Administr | 40.0 | 181806 | 41958 | X | |||||
| Jeffrey Halverson | |||||||||
| VP Physician Networking | 40.0 | 295468 | 56283 | X | |||||
| Christopher Hyers | |||||||||
| VP Business Development | 40.0 | 236411 | 43958 | X | |||||
| Nancy Weber | |||||||||
| SVP - CHIEF NURSING OFFICER | 40.0 | 275762 | 168392 | X | |||||
| Paul Franke MD | |||||||||
| VP Medical Affairs | 40.0 | 29685 | 380259 | X | |||||
| CHRISTOPHER EAGAN MD | |||||||||
| PHYSICIAN EMPLOYEE | 40.0 | 44963 | 767628 | X | |||||
| TIMOTHY RYKEN MD | |||||||||
| PHYSICIAN EMPLOYEE | 40.0 | 42873 | 794059 | X | |||||
| VICTOR MUJICA MD | |||||||||
| PHYSICIAN EMPLOYEE | 40.0 | 40927 | 842101 | X | |||||
| GARY KNUDSON | |||||||||
| Physician Employee | 40.0 | 40341 | 1330455 | X | |||||
| RICHARD NAYLOR MD | |||||||||
| PHYSICIAN EMPLOYEE | 40.0 | 47445 | 1760949 | X | |||||
| Wayne Frangesch | |||||||||
| SVP-SYSTEM HUMAN RESOURCES/OD | 40.0 | 358370 | 60311 | X | |||||
| Jon Wachs | |||||||||
| Sr VP and Chief Operating Offi | 40.0 | 804963 | 309576 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7780342 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4918184 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1383628 | TotalOtherCompensation |
| Number Individuals GT100 K | 133 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Iowa Emergency Physicians LLP | |||||
| PO Box 793 | TRAVERSE CITY | MI | 496850793 | Physician Services | 1041976 |
| Quest Diagnostics | |||||
| PO Box 740709 | ATLANTA | GA | 303740709 | Medical Testing | 543274 |
| Tarik Ramahi MD | |||||
| 500 Prospect Street Apt 3F | NEW HAVEN | CT | 06511 | Physician Services | 346250 |
| Intranerve-Iowa LLC | |||||
| 5390 N Academy Blvd Suite 300 | COLORADO SPRINGS | CO | 80918 | Medical Testing | 301500 |
| Alliance Recruiting Resources | |||||
| PO Box 4356 Dept 611 | HOUSTON | TX | 772104356 | Medical Staffing | 301360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Related Organizations | 1926005 | RelatedOrganizations |
| Total Contributions | 1926005 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PROGRAM SERVICE REVENUE | 900099 | 107454302 | 107454302 | |
| MEDICARE/MEDICAID PAYMENTS | 900099 | 126154198 | 126154198 | |
| REFERRAL LAB | 621500 | 24916 | 24916 | |
| TECHS - PHYSICIAN | 621110 | 26392 | 26392 | |
| PHARMACY OPERATIONS | 446110 | 181994 | 181994 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 233841802 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1434024 | TotalRevenueColumn |
| Exclusion | $1,434,024 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 795504 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 609300 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 186204 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 186204 | TotalRevenueColumn |
| Exclusion | $186,204 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 66367546 | Securities |
| Other | 407651 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 65017853 | Securities |
| Other | 391964 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1349693 | Securities |
| Other | 15687 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1365380 | TotalRevenueColumn |
| Exclusion | $1,365,380 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA | 900099 | 1106818 | $1,106,818 | |
| MISC HOSPITAL REVENUE | 900099 | 1182106 | $1,182,106 | |
| PHARMACY REVENUE | 446110 | 1477429 | 1477429 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2885538 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1514587 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,370,951 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 6651891 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 245405306 | TotalRevenueColumn |
| Related Or Exempt Function Income | 236600516 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 233302 | UnrelatedBusinessRevenue |
| Exclusion | $6,645,483 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367176 | Total |
| Program Services | 367176 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2483875 | Total |
| Program Services | 2018188 | ProgramServices |
| Management And General | 465687 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103767094 | Total |
| Program Services | 103287590 | ProgramServices |
| Management And General | 479504 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7455189 | Total |
| Program Services | 7420739 | ProgramServices |
| Management And General | 34450 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10044089 | Total |
| Program Services | 9997676 | ProgramServices |
| Management And General | 46413 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6311515 | Total |
| Program Services | 6281799 | ProgramServices |
| Management And General | 29716 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9830903 | Total |
| Program Services | 9808118 | ProgramServices |
| Management And General | 22785 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69488 | Total |
| Program Services | 69488 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42801439 | Total |
| Program Services | 42776541 | ProgramServices |
| Management And General | 24898 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5609946 | Total |
| Program Services | 5609946 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249616 | Total |
| Program Services | 242973 | ProgramServices |
| Management And General | 6643 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67915 | Total |
| Program Services | 65541 | ProgramServices |
| Management And General | 2374 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 696870 | Total |
| Management And General | 696870 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 258210 | Total |
| Program Services | 258210 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8314449 | Total |
| Program Services | 8314042 | ProgramServices |
| Management And General | 407 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 566590 | Total |
| Program Services | 566590 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 8571491 | 8571491 | |
| DUES & SUBSCRIPTIONS | 364405 | 234933 | 129472 |
| INTERNS/RESIDENTS PROGRAM | 1553837 | 1553837 | |
| CORPORATE SERVICES ALLOCATION | 26488967 | 3000374 | 23488593 |
| SALES TAX | 59240 | 59240 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14006 | Total |
| Program Services | 14006 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235946310 | Total |
| Program Services | 210518498 | ProgramServices |
| Management And General | 25427812 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2645 | BOY |
| EOY | 3727 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51866578 | BOY |
| EOY | 62036084 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23629630 | BOY |
| EOY | 27759139 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2891774 | BOY |
| EOY | 3912603 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57152 | BOY |
| EOY | 58280 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 240764085 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 155932785 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87617661 | BOY |
| EOY | 84831300 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2037226 | BOY |
| EOY | 4731041 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168102666 | BOY |
| EOY | 183332174 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14651092 | BOY |
| EOY | 18589554 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18237566 | BOY |
| EOY | 16575043 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4202929 | BOY |
| EOY | 5908915 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37091587 | BOY |
| EOY | 41073512 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130873244 | BOY |
| EOY | 142105635 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 137835 | BOY |
| EOY | 153027 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 131011079 | BOY |
| EOY | 142258662 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 168102666 | BOY |
| EOY | 183332174 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9458996 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1788587 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $27,090 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $0 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 27090 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule C Disclosures | Identifier |
| Return Reference | Part II-B Line 1i | ReturnReference |
| Explanation | Wheaton Franciscan Healthcare and Franciscan Ministries are part of a controlled group of healthcare and housing organizations that are related through a common parent organization. Certain entities within this controlled group engage in limited lobbying activities that benefit each organization collectively. Wheaton Franciscan Healthcare employs one full time Vice President of Strategic Planning and Government Relations whose duties include a portion of lobbying activities. These lobbying activities approximate 20% of total annual salary. A benefits factor of 25% is added, and the total is allocated amongst the organizations receiving the benefit of these services. The lobbying activities include such things as preservation of Medicare and Medicaid funding; monitoring federal legislation that may impact the organization; participating in and coordinating visits with elected officials; coordinating advocacy activities in conjunction with relevant trade associations; and providing awareness on specific state related legislative issues when the need arises (e.g.: state hospital assessment legislation in Wisconsin). The portion of direct expenses related to annual employee business travel to Washington DC or other locations, in order to lobby for issues important to healthcare providers and patients, have been included if applicable. Finally, any trade association dues containing a percentage portion allocable to lobbying activities, has been added or estimated, as appropriate. Lobbying expenses incurred by each organization directly, are reflected on their respective IRS Form 990, and can be summarized as follows: Wheaton Franciscan Services, Inc. #36-3262111 $72,014 Wheaton Franciscan Healthcare - Southeast Wisconsin, Inc. #39-1566865 $32,020 Wheaton Franciscan, Inc. (formerly Wheaton Franciscan Healthcare - St. Joseph, Inc. and The Wisconsin Heart Hospital, Inc.) #39-0816857 $10,381 Wheaton Franciscan Healthcare - St. Francis, Inc. #39-0907740 $7,924 Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. #39-0853528 $4,012 Wheaton Franciscan Healthcare - All Saints, Inc. #39-1264986 $8,234 Wheaton Franciscan Healthcare - Franklin, Inc. #56-2592868 $1,516 Wheaton Franciscan Home Health and Hospice, Inc. #39-1559428 $ 962 Marianjoy, Inc. #36-3483589 $3,746 Marianjoy Rehabilitation Hospitals and Clinics, Inc. #36-2680776 $11,814 Wheaton Franciscan Healthcare - Iowa, Inc. #42-1177001 $3,746 Covenant Medical Center, Inc. #42-1264647 $27,090 Sartori Hospital, Inc. #42-0758901 $5,146 Mercy Hospital, Inc. #42-1178403 $2,400 TOTAL LOBBYING EXPENSES: $191,005 | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4033723 | OtherCostOrOtherBasis |
| Book Value | 4033723 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 91994616 | OtherCostOrOtherBasis |
| Depreciation | 45601990 | Depreciation |
| Book Value | 46392626 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 89618718 | OtherCostOrOtherBasis |
| Depreciation | 72857881 | Depreciation |
| Book Value | 16760837 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 55117028 | OtherCostOrOtherBasis |
| Depreciation | 37472914 | Depreciation |
| Book Value | 17644114 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 84831300 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATE | $5 |
| DUE TO THIRD PARTY PAYOR | $5,908,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5908915 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3591133 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3591133 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24938524 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21792951 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3145573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01380 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 28529657 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21792951 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6736706 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02960 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1149558 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21107 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1128451 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1618570 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1166876 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 451694 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7087302 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4399506 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2687796 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01180 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 579515 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 579515 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10434945 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5587489 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4847456 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02130 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38964602 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27380440 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11584162 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05090 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 57843 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 57843 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 57843 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 57843 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $8,571,491 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 50207385 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 41457861 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 8749524 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Medical Center Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3421 West Ninth Street | AddressLine1 |
| City | Waterloo | City |
| State | IA | State |
| ZIP Code | 50702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 39 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (39 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CMC's Horizons Substance Abuse | ||||
| 2101 KIMBALL AVENUE | WATERLOO | IA | 50702 | OUTPATIENT SUBSTANCE ABUSE SERVICES |
| Covenant Wellness Center | ||||
| 2101 KIMBALL AVENUE | WATERLOO | IA | 50702 | WELLNESS CENTER |
| Covenant Cancer Treatment Center | ||||
| 200 EAST RIDGEWAY AVENUE SUITE CTC | WATERLOO | IA | 50702 | OUTPATIENT CANCER TREATMENT |
| Covenant Clinic Hematology Oncology | ||||
| 200 EAST RIDGEWAY AVENUE SUITE 400 | WATERLOO | IA | 50702 | OUTPATIENT HEMATOLOGY AND ONCOLOGY SERVICES |
| Covenant Medical Center's Sleep Lab | ||||
| 2710 ST FRANCIS DRIVE SUITE 409 | WATERLOO | IA | 50702 | OUTPATIENT SLEEP DISORDER DIAGNOSTICS |
| Iowa Spine and Brain Institute | ||||
| 2710 ST FRANCIS DRIVE SUITE 110 | WATERLOO | IA | 50702 | OP NEURO SURGERY OP PAIN MANAGEMENT OP X-RAY SERVICES |
| Covenant Clinic Neurology | ||||
| 2710 ST FRANCIS DRIVE SUITE 104 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC- NEUROLOGY SERVICES |
| Covenant Clinic Convenient Care | ||||
| 2710 ST FRANCIS DRIVE SUITE 111 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC |
| Covenant Clinic Family Practice | ||||
| 2710 ST FRANCIS DRIVE SUITE 210 | WATERLOO | IA | 50702 | OP FAMILY PRACTICE, GYNECOLOGY, PODIATRY, LABORATORY SERVICES |
| Covenant Clinic Orthopedics | ||||
| 2710 ST FRANCIS DRIVE SUITE 319 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC- ORTHOPEDIC SERVICES |
| Covenant Clinic Cardiology | ||||
| 2710 ST FRANCIS DRIVE SUITE 320 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC- CARDIOLOGY SERVICES |
| Covenant Clinic Pulmonology | ||||
| 2710 ST FRANCIS DRIVE SUITE 402 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC- PULMONOLOGY SERVICES |
| Covenant Clinic Surgery | ||||
| 2710 ST FRANCIS DRIVE SUITE 410 | WATERLOO | IA | 50702 | OP GENERAL SURGERY, WOUND CARE, VASCULAR SURGERY SERVICES |
| Covenant Clinic Ent Allergies | ||||
| 2710 ST FRANCIS DRIVE SUITE 411 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC - EAR, NOSE & THROAT AND ALLERGY SERVICES |
| Cov Clinic Nephrology Podiatry Pediatr | ||||
| 2710 ST FRANCIS DRIVE SUITE 510 | WATERLOO | IA | 50702 | OP NEPHROLOGY, PODIATRY, AND PEDIATRIC SERVICES |
| Mammography Screening Center | ||||
| 432 KING DRIVE | WATERLOO | IA | 50702 | OUTPATIENT MAMMOGRAPHY IMAGING SERVICES |
| Covenant Clinic - Psychiatry | ||||
| 2750 ST FRANCIS DRIVE | WATERLOO | IA | 50702 | OUTPATIENT CLINIC - PSYCHIATRY SERVICES |
| Covenant Clinic - Psychiatry | ||||
| 2802 ORCHARD DRIVE | CEDAR FALLS | IA | 50613 | OUTPATIENT CLINIC- PSYCHIATRY SERVICES |
| Covenant Clinic - Arrowhead | ||||
| 226 BLUEBELL ROAD SUITE CC | CEDAR FALLS | IA | 50613 | OP FAMILY PRACTICE, PSYCHIATRY, PODIATRY, GYNECOLOGY SERVICES |
| Arrowhead Medical Center | ||||
| 226 BLUEBELL ROAD SUITE OPT | CEDAR FALLS | IA | 50613 | OP PHYSICAL THERAPY, OCCUPATIONAL HEALTH, RADIOLOGY SERVICES |
| Covenant Clinic- Rehabilitation Medicine | ||||
| 3421 WEST NINTH STREET SUITE 100 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC- PHYSIATRY SERVICES |
| Covenant Clinic | ||||
| 2055 KIMBALL SUITE 400 | WATERLOO | IA | 50702 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Family Practice | ||||
| 516 SOUTH DIVISION STREET SUITE 11 | CEDAR FALLS | IA | 50613 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic Bariatrics | ||||
| 516 SOUTH DIVISION STREET SUITE 10 | CEDAR FALLS | IA | 50613 | OUTPATIENT PHYSICIAN CLINIC - BARIATRICS SERVICES |
| Covenant Clinic Family Practice | ||||
| 516 SOUTH DIVISION STREET SUITE 10 | CEDAR FALLS | IA | 50613 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic Orthopedics | ||||
| 516 SOUTH DIVISION STREET SUITE 12 | CEDAR FALLS | IA | 50613 | OUTPATIENT CLINIC - ORTHOPEDIC SERVICES |
| Covenant Clinic Specialist | ||||
| 516 SOUTH DIVISION STREET SUITE 14 | CEDAR FALLS | IA | 50613 | OP CLINIC - ENT, ALLERGY, CARDIOLOGY, PAIN MANAGEMENT SERVICES |
| Covenant Clinic - Dysart | ||||
| 501 CLARK STREET | DYSART | IA | 52224 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Evansdale | ||||
| 3562 LAFAYETTE ROAD | EVANSDALE | IA | 50707 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Fairbank | ||||
| 105 SOUTH WALNUT STREET | FAIRBANK | IA | 50629 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Gladbrook | ||||
| 309 SECOND STREET | GLADBROOK | IA | 50635 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Jesup | ||||
| 1094 220TH STREET | JESUP | IA | 50648 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - LaPorte City | ||||
| 601 HIGHWAY 218 NORTH | LAPORTE CITY | IA | 50651 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Oelwein | ||||
| 129 EIGHT AVENUE SE | OELWEIN | IA | 50662 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Reinbeck | ||||
| 501 MAIN STREET | REINBECK | IA | 50669 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Shell Rock | ||||
| 309 SOUTH CHERRY STREET | SHELL ROCK | IA | 50670 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Traer | ||||
| 200 WALNUT STREET | TRAER | IA | 50673 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Tripoli | ||||
| 602 SEVENTH AVENUE SW | TRIPOLI | IA | 50676 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
| Covenant Clinic - Waverly | ||||
| 217 20TH STREET NW | WAVERLY | IA | 50677 | OUTPATIENT CLINIC - FAMILY PRACTICE SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule H Supplemental Information | Identifier |
| Return Reference | Various - see the following references | ReturnReference |
| Explanation | Schedule H Part 1 Line 4 Covenant Medical Center's policy is to provide free or discounted care to underinsured and uninsured patients whose annual income falls below 300 to 400% of the federal poverty guidelines. In addition, for these same patients, Covenant Medical Center provides further discounts in order that the patient's maximum out of pocket liability for medically necessary services does not exceed 15% of their gross household income. Covenant Medical Center refers to this policy as the Financial Assistance/Community Care Policy. In practice, for patients who have applied for but did not qualify under the Community Care Policy, Covenant Medical Center has provided financial relief in order that the patient's maximum out of pocket liability for medically necessary services did not exceed 15% of their gross household income. Schedule H Part 1 Line 6a The Annual Report that outlines the Hospital's community benefit information is contained in a report prepared by the system, Wheaton Franciscan Services, Inc. which is the ultimate parent organization of an integrated health care system operated in Wisconsin, Illinois, and Iowa. For more information, please see our annual report at www.mywheaton.org. It is available under "About Us" by clicking on "Community Impact," and scrolling down to "For more information." Schedule H Part 1 Line 7 Community Benefit amounts are reported using total actual costs per the hospital's managerial accounting system in use, which includes all patient segments including inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, Medicare HMO, uninsured, and self pay patients. Medicare is reported per the most recently filed cost report. Amounts are compiled using a software application recommended by the Catholic Health Association because it has the ability to provide the information in a format suitable for Schedule H presentation. After the data is entered by the Site Finance Directors, it's accuracy is verified by employees who are trained in community benefit reporting. The Manager of Strategic Planning and Community Benefit and the Vice President of Government Relations then review the community benefit amounts with the Chief Financial Officer and the President/CEO of the organization. Once amounts are verified and approved, community benefit amounts become finalized. Wheaton Franciscan Healthcare complies with Illinois state law which requires reporting to the Attorney General's Office. Additionally, Wheaton Franciscan Healthcare voluntarily reports community benefit information in Wisconsin and Iowa by making the information readily available on certain websites. Finally, the information is compiled with the assistance of the software, for presentation in IRS Forms 990 Schedule H and Statement of Program Service Accomplishments Part III. Schedule H Part 1 Line 7 Column f Wheaton Franciscan Healthcare organizations follow guidelines established by the Catholic Health Association, which recommends that bad debt expense not be included in community benefit amounts. As a result of this applied methodology, a total amount of $8,571,491 has not been included in the calculation of the percentages reported on Schedule H Line 7 Column f. Schedule H Part 1 Line 7g In Southeast Wisconsin, physician clinics are operated by a separate legal entity; Iowa region clinic operations are included as a department of the hospital, Covenant Medical Center, Inc. Clinic operations for the Iowa clinics are included only in the community benefit reporting of charity care, government sponsored health care, and Medicare shortfall. Therefore, for all entities, including Covenant Medical Center, Inc., costs related to physician clinics are not included in subsidized health services reported on Schedule H Part I Line 7g. Schedule H Part III Section A Line 4 As part of an annual process, affiliates of Wheaton Franciscan Healthcare complete a consolidated audit each year which does not provide any specific information as to the calculation and recording of bad debt expense. However, it is the practice of Wheaton Franciscan Healthcare to record actual bad debt expense for each organization at the time the amount due is determined to be uncollectible, and thus written off. Since the organization follows guidelines established by the Catholic Health Association and the related state counterpart in Wisconsin, Iowa, or Illinois as appropriate, Wheaton Franciscan Healthcare does not include any form of bad debt expense in its annual reporting of community benefit amounts. It is also the position of Wheaton Franciscan Healthcare that none of the patients resulting in uncollectible accounts would have qualified as charity care patients as this determination is made at the time of admission. Bad debt expense is determined after many months of collection efforts, and for this reason Part III Section A Line 3 is reported as none (ie at zero). Schedule H Part III Section B Line 8 Schedule H Part III Section B Line 6 reports "allowable costs of care" as taken from the most recently completed as-filed Medicare cost report. The Medicare cost report calculates its allowable total costs based on applicable Medicare regulations. Medicare and Medicaid cost is determined using individual cost center cost-to-charge ratios. This cost to charge ratio is determined using all payer cost and all payer charges. The cost to charge ratio is applied to the actual Medicare and Medicaid charges to determine the Medicare and Medicaid cost. Note this cost can be substantially different than the Medicare shortfall amounts that are footnoted in our annual community benefit report, because costs for this purpose are computed by using total actual costs per the managerial accounting system in use, which includes Medicare HMO (in addition to straight Medicare) among other differences. This organization has adopted the cost and charge practices as recommended by the Catholic Health Association and the Wisconsin, Iowa, or Illinois Hospital Association as applicable, and therefore, does not count any Medicare shortfall numbers, regardless of the method upon which the shortfall numbers were determined, in its annual reporting of Community Benefit amounts. Schedule H Part III Section C Line 9b Wheaton Franciscan Healthcare's Payment for Services Policy outlines all collection practices for patients who are known to qualify for government programs and for our charity care program. We make every attempt to assist the patient in enrolling in government insurance plans or our own charity care program allowing for free or discounted care. If the patient does not qualify for any type of aid or charity care, declines to establish a reasonable payment plan or pay the liability, the patient will be moved into a bad debt status, and the account is sent to a collection agency. This does not occur before the patient has received several notices and a final written warning. Schedule H Part V Section A and Section C Affiliates of Wheaton Franciscan Healthcare have defined and reported "hospital facilities" to include only those bricks and mortar buildings that actually have inpatient beds, in addition to meeting all other criteria under Wisconsin, Iowa, or Illinois state laws, as applicable, required for hospital licensing. Although there are other facilities within our system built to hospital standards, performing hospital-based billing, and conforming to other "hospital" standards under state law, until there is further guidance from the IRS, these facilities have been reported in Section C, due to their lack of having state certified inpatient beds and functioning as an all-encompassing hospital facility. Schedule H Part VI Line 2 Wheaton Franciscan Healthcare assesses the needs of the communities it serves by reviewing admission and discharge data, analyzing information from the community health departments and other community leaders, and by aligning our services with the Healthy People 2020 and other current year initiatives. Schedule H Part VI Line 3 Wheaton Franciscan Healthcare provides its patients with several opportunities to gain knowledge and awareness of its Community Care (Charity Care/Financial Assistance) program. Notices regarding the availability of financial assistance are displayed in highly visible locations where there is a significant volume of inpatient or outpatient traffic such as: patient admitting and registration areas in both inpatient and outpatient settings, physician offices, and emergency departments. Additionally, brochures describing the policy are available upon request in the same locations and on Wheaton Franciscan Healthcare's website. The policy is also discussed at the time of registration or pre-registration for all inpatient procedures. Schedule H Part VI Line 4 Please see detailed information provided at Schedule H Part VI Line 5 Schedule H Part VI Line 5 WHEATON FRANCISCAN HEALTHCARE IN IOWA Covenant Medical C | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|
| Covenant Foundation Inc | ||||||||
| 3421 West 9th St | Waterloo | IA | 507025499 | 421295784 | 501(c)(3) | 15000 | Book | Provide support |
| Schoitz Health Resources Inc | ||||||||
| 3421 West 9th St | Waterloo | IA | 507025499 | 421232935 | 501(c)(3) | 352176 | Book | Provide support |
| Clara Pfaender Fund Inc | ||||||||
| PO Box 667 | Wheaton | IL | 601870667 | 363353311 | 501(c)(3) | 258210 | Book | Provide support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule I Disclosures | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | Wheaton Franciscan Healthcare and Franciscan Ministries maintain files and records to manage the decision-making and award process for organizations that it provides community sponsorship dollars to. Decisions are made by a Community Sponsorship Committee with leaders who hold positions in Diversity, Strategic Planning, Mission Services, Marketing and Philanthropy. The Committee generally strives to sponsor organizations that have missions that align with the mission, vision and values of Wheaton Franciscan Healthcare and/or Franciscan Ministries. The committee also looks for certain other criteria when deciding which organizations will receive contributions, including but not limited to supporting healthcare or housing related activities within the Southeast Wisconsin, Iowa, and Illinois markets, supporting programming that work to further diversity and cultural competency, aligning with other WFH business relationships or service lines, supporting student academic achievement or workforce development initiatives, and finally, supporting environmental "green" initiatives. Leaders periodically meet with representatives of sponsored organizations to discuss objectives including how dollars will be spent. Currently, confirmation letters are sent to sponsored organizations when award dollars are given, that confirm the dollar amount awarded and the intended purpose, with a request that the recipient acknowledge receipt of the funds in written correspondence. Files are maintained in the Organizational Change and Leadership Performance Department to include copies of letters of request, award and denial letters along with acknowledgement receipts from sponsored organizations. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jack Dusenbery | ||||||||||||
| 371426 | 185400 | 11518 | 44333 | 22947 | 635624 | |||||||
| Rose Fowler | ||||||||||||
| 159860 | 20816 | 1130 | 19223 | 22735 | 223764 | |||||||
| Wayne Frangesch | ||||||||||||
| 263298 | 80700 | 14372 | 32282 | 28029 | 418681 | |||||||
| Jeffrey Halverson | ||||||||||||
| 203558 | 76400 | 15510 | 35437 | 20846 | 351751 | |||||||
| Christopher Hyers | ||||||||||||
| 171433 | 61300 | 3678 | 17481 | 26477 | 280369 | |||||||
| John Oliverio | ||||||||||||
| 918033 | 527500 | 367685 | 92775 | 64950 | 1970943 | 350448 | ||||||
| Michele Panicucci | ||||||||||||
| 239550 | 128700 | 15592 | 43096 | 19775 | 446713 | |||||||
| Jon Wachs | ||||||||||||
| 527805 | 147700 | 129458 | 257089 | 52487 | 1114539 | 98329 | ||||||
| Nancy Weber | ||||||||||||
| 192462 | 75400 | 7900 | 150922 | 17470 | 444154 | |||||||
| Paul Franke MD | ||||||||||||
| 290760 | 87900 | 1599 | 13198 | 16487 | 409944 | |||||||
| James Peterson MD | ||||||||||||
| 301123 | 4463 | 21311 | 21517 | 348414 | ||||||||
| Peter Hohnstein MD | ||||||||||||
| 428782 | 2520 | 21228 | 22568 | 475098 | ||||||||
| Michael Slavin DO | ||||||||||||
| 517648 | 15586 | 21230 | 13520 | 567984 | ||||||||
| Brian Sims DO | ||||||||||||
| 584366 | 1292 | 18031 | 23003 | 626692 | ||||||||
| CHRISTOPHER EAGAN MD | ||||||||||||
| 766121 | 1507 | 13306 | 31657 | 812591 | ||||||||
| TIMOTHY RYKEN MD | ||||||||||||
| 792109 | 1950 | 13148 | 29725 | 836932 | ||||||||
| VICTOR MUJICA MD | ||||||||||||
| 828605 | 13496 | 21134 | 19793 | 883028 | ||||||||
| GARY KNUDSON | ||||||||||||
| 1328142 | 2313 | 21325 | 19016 | 1370796 | ||||||||
| RICHARD NAYLOR MD | ||||||||||||
| 1758639 | 2310 | 17934 | 29511 | 1808394 | ||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule J Disclosures | Identifier |
| Return Reference | Various - See the following references | ReturnReference |
| Explanation | Schedule J Part 1 Line 3 The compensation of the filing organization's CEO and/or the Executive Director is determined at the parent organization level, using the process described in Schedule O related to Part VI Section B Line 15. The parent organization, Wheaton Franciscan Services, Inc. (FEIN: 36-3262111) uses a compensation committee, independent compensation consultants, and compensation surveys and studies to determine appropriate levels of compensation that are reflective of fair market value. All compensation is approved by the board and/or compensation committee. Schedule J Part 1 Line 4b John Oliverio received a 2010 taxable payout of $350,448 related to a supplemental nonqualified retirement plan known as the Wheaton Franciscan Services Benefit Restoration Plan. Jon Wachs received a 2010 taxable payout of $98,329 related to a supplemental nonqualified retirement plan known as the Wheaton Franciscan Services Benefit Restoration Plan. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Mary Halverson | |||
| Spouse of Jeff Halverson | 14537 | Employment | false |
| Linda Hildebrand | |||
| Edward Stachovic daughter | 42097 | Employment | false |
| Gail Stachovic | |||
| Edward Stachovic daughter | 79697 | Employment | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Schedule O Disclosures | Various - See the following references | IRS Form 990 Part VI Section A Line 2 Board Directors Mike Mallaro and Frank Seng have a business relationship at VGM Group, an unrelated organization, where they both serve as co-trustees of the companies ESOP Plan. IRS Form 990 Part I Line 6 Covenant Medical Center, Inc. received donated services through volunteers assisting in a variety of areas which include the information desk, escorts, medical runner, nursing units, ambulatory surgery, Cancer Treatment Center, rehabilitation therapies, and volunteer transportation services. Total estimated volunteer hours were 43,481. Total estimated value of these services was $729,176. IRS Form 990 Part VI Section A Lines 6-7b Covenant Medical Center, Inc. has one member which holds several reserved powers over Covenant Medical Center, Inc. These reserved powers include, but are not limited to, the election of members of the governing body and election of officers, approval of certain financial expenditures in accordance with policy, and approval of budgets and strategic plans; these approvals are based on recommendations from the governing body. IRS Form 990 Part VI Section B Line 10 Wheaton Franciscan Healthcare and Franciscan Ministries are part of a controlled group of health care and housing providers, controlled under a common parent organization Wheaton Franciscan Services, Inc. Some of these organizations are exempt through the Catholic Group Ruling and other organizations have a stand alone exemption (IRS determination) letter. As such, these related affiliates have certain policies and procedures that were adopted at the parent level, but are applicable to the entire controlled group of organizations. All policy and procedure matters are handled in a manner to ensure that all activities are consistent with the organization's overall exempt purposes. Please see Schedule R for a full listing of all related affiliate organizations. IRS Form 990 Part VI Section B Line 11 Affiliates of Wheaton Franciscan Healthcare use a multiple-level review process on all Federal and State information and tax returns to ensure accurate and timely filing for all organizations. Under the direction of the Tax Manager, the Accounting Department prepares Forms 990, 990-T, and associated state filings. When complete, the return is first reviewed by the Controller, who focuses on the income statement and balance sheet items, and all schedules where transactions of this type might be reported. If discrepancies are found, the item will be corrected prior to the next step in the review process. Once cleared through Accounting, the return is provided to the Tax Department, where the Tax Manager and Vice President of Treasury and Risk Management focus their review on consistency of reporting between all returns, accuracy of tax related information, and explanation and understanding of any outliers. Again, any problems or questions are investigated and corrected. Depending on the level of complexity of the year in question, as well as the individual issues specific to that filing, certain returns may be selected for outside review by a public accounting firm. This decision will vary from year to year based on many factors, and sometimes outside review is not utilized at all. Also, certain schedules, such as Schedule K, Schedule H, and Schedule J, may be selected for review by outside bond counsel, a community benefit associate, and/or the compensation committee respectfully and as needed. This decision will vary from year to year, again based on many factors. The Accounting Department, upon completion of all levels of review, will schedule an appointment with the Senior Vice President and CFO, who will perform a review prior to signing the return. Once signed, the return is cleared to provide to members of the Board of Directors. The parent organization, Wheaton Franciscan Services, Inc. has designated that the Audit Committee review the parent return in certain years. This is a cursory review, where the 990 is explained at a high level by management representatives, and any questions or concerns that the board has can be addressed. At a later date and prior to efiling, the full board is provided access to all 990's and 990-T's throughout the system via an online portal. A similar process exists at the regional holding company levels - a 990 is selected for review in certain years by the Finance and Operations Committee. Similarly, the 990 (and accompanying 990-T if any) is explained at a high level, and board questions or concerns are addressed. Members of the full board are provided access to all 990's and 990-T's within that region prior to efiling via an online portal. IRS Form 990 Part VI Section B Line 12 As part of an annual process, conflict of interest questions are sent out to all Officers, Directors, and other individuals in key positions using software designed to capture this information. The responses are analyzed in order to determine information on potential conflicts, as well as information on business and family relationships for purposes of answering certain questions on IRS Form 990. Responses to these questions are reviewed by the Vice President of Compliance and the Manager of Tax Compliance, and follow up action, if any, are documented within the software. After an approximate 3 and again at 6 weeks, names of all non responders are compiled, and these individuals receive either an email or letter reminding them to complete the information. Responses to questions continue to be reviewed and documented throughout this time period. Approximately 1 month prior to the filing deadline of IRS Form 990, responses to date are compiled. Any response requiring disclosure is entered into the information return. Also at this date, the remaining non responder names are determined, and a letter, along with the actual Conflict of Interest Policy, is sent to the Chairperson of each board. The letter outlines the current non responders, as well as any Officer or Board member that has disclosed a financial interest that might pose a potential conflict of interest. Depending upon the nature of the financial interest and work done by the board, several actions may be considered - the board member with a financial interest would need to voluntarily excuse him or herself from the deliberations and/or voting on such a matter; or, if necessary, the board would determine that the subject's financial interest was an actual conflict of interest, in which case the board member would be informed by the board Chairperson that he or she would not be allowed to vote in any such matters due to this real or perceived conflict of interest. Minutes of the board meeting would document this decision process, and reflect whatever action(s) are ultimately taken. The board chairperson is also required to discuss with non responders the repercussions of not responding after two attempts, and require the board member to complete the annual conflict of interest disclosure questions before being allowed to continue in any board matters. If the board member refuses, the Chairperson has the authority to determine the appropriate action, including, but not limited to prohibiting them from participating in deliberations, preventing them from voting, and/or removing them as a board member. |
| Schedule O Disclosures (cont'd) | Various - See the following references | IRS Form 990 Part VI Section B Line 15 The compensation of the CEO of Wheaton Franciscan Services Inc. (WFSI) and other officers and key employees of the filing organization is reviewed and approved on an annual basis by the Executive Committee of the WFSI Board of Directors, an independent board, acting in a manner consistent with its conflicts of interest policy. The board's decision is informed by an opinion on market comparable compensation data provided to the board by an independent compensation expert. The organization maintains contemporaneous documentation of the substantiation of the deliberation and decision by the board. Compensation for the organization's President and other officers and key management employees, is reviewed and approved, as part of the Wheaton Franciscan Services, Inc. Executive Compensation Plan, on an annual basis by the Executive Committee of the Wheaton Franciscan Services, Inc. Board of Directors (the "Executive Committee of the WFSI Board"), an independent board, acting in a manner consistent with its conflicts of interest policy. The Executive Committee of the WFSI Board's decision is informed by an opinion on market comparable compensation data provided to the board committee by an independent compensation expert. The Executive Committee of the WFSI Board maintains contemporaneous documentation of the substantiation of the deliberation and decisions it makes. For those officers and key employees that are paid for their services other than pursuant to the WFSI Executive Compensation Plan, the compensation terms are approved by the President of Covenant Medical Center, Inc. and Wheaton Franciscan Services - Iowa, Inc. In such case, decisions are made in accordance with the organization's conflict of interest requirements. Also, in such case, the compensation paid pursuant to a contract is determined with reference to market comparable information. Organizational policy requires that contemporaneous documentation of the same be maintained. IRS Form 990 Part VI Section C Line 19 Affiliates of Wheaton Franciscan Healthcare and Franciscan Ministries provide upon request certain documents including our financial statements, conflict of interest policy, and governing documents that support our tax exempt status, including, but not limited to, articles of incorporation and bylaws. Requests for information are considered on a case-by-case basis, and this process is outlined in our Public Disclosure Policy. As part of the requirements for tax exempt bond financing, the consolidated financial statements of Wheaton Franciscan Services, Inc. (#36-3262111), the parent corporation of Wheaton Franciscan Healthcare and Franciscan Ministries affiliates are required to be provided each quarter to the Municipal Securities Rule Making Board (MSRB). The vehicle used to accomplish this is through an external website (http://emma.msrb.org/) referred to as "EMMA" (Electronic Municipal Market Access System). The financial statements are uploaded each quarter to the website, and along with other information provided at the bond's inception, are available for viewing by the general public. IRS Form 990 Part VII Column B Wheaton Franciscan Healthcare and Franciscan Ministries are a controlled group of related healthcare and housing organizations. As such, many employees who are at the Vice President level or above, or who are Officers and/or Directors of organizations where Wheaton has common boards and other overlaps, spend significant time devoted to tasks not only for the filing organization, but also for related organizations. While there is no official time study tracking that is done, it is estimated that for each employee, tasks devoted to related organizations could approximate up to 80% of total hours. IRS Form 990 Part VIII Lines 2a and 2b MEDICARE MEDICAID OTHER REV 230,025,693 63,183,087 262,600,729 CONT ALLOW (140,628,501) (45,125,977) (127,449,621) CHARITY (8,763,608) UBI (639,387) TOTAL 89,397,192 18,057,110 125,748,113 IRS Form 990 Part XI Line 5 Certain related organizations utilize receivable/payable accounts throughout the year. These intercompany balances are settled through the equity account at the end of each fiscal year to bring the receivable/payable balances to zero. DISCLOSURE STATEMENT RELATED TO FORMS 5471 INFO RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: WHEATON FRANCISCAN SERVICES, INC. ADDRESS: 26 W171 ROOSEVELT ROAD, WHEATON, IL 60187 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 36-3262111 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (75 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| WHEATON FRANCISCAN SERVICES INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 363262111 | PARENT CORP | IL | 501(c)(3) | 11 - III-FI | NA |
| AFFINITY HEALTH SYSTEM | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54942 | 391638765 | HOLDING CO | IL | 501(c)(3) | 11 - I | WFSIMHC |
| AUXILIARY OF ST ELIZABETH HOSPITAL INC | |||||||||
| 1506 SOUTH ONEIDA STREET | APPLETON | WI | 54915 | 396077331 | AUXILIARY | WI | 501(c)(3) | 11 - III-O | ST ELIZ HOSP |
| CALUMET MEDICAL CENTER INC | |||||||||
| 614 MEMORIAL DRIVE | CHILTON | WI | 53014 | 390905385 | HOSPITAL | WI | 501(c)(3) | 3 | AFF HLTH SYS |
| MERCY MEDICAL CENTER OF OSHKOSH INC | |||||||||
| 500 SOUTH OAKWOOD ROAD | OSHKOSH | WI | 54904 | 390806268 | HOSPITAL | WI | 501(c)(3) | 3 | AFF HLTH SYS |
| NETWORK HEALTH SYSTEM INC | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54942 | 391127163 | MED GROUP | WI | 501(c)(3) | 3 | AFF HLTH SYS |
| ST ELIZABETH HOSPITAL COMMUNITY FNDN INC | |||||||||
| 1506 SOUTH ONEIDA STREET | APPLETON | WI | 54915 | 391256677 | FOUNDATION | WI | 501(c)(3) | 11 - I | AFF HLTH SYS |
| ST ELIZABETH HOSPITAL INC | |||||||||
| 1506 SOUTH ONEIDA STREET | APPLETON | WI | 54915 | 390816818 | HOSPITAL | WI | 501(c)(3) | 3 | AFF HLTH SYS |
| WFH - SOUTHEAST WISCONSIN INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391568865 | HOLDING CO | IL | 501(c)(3) | 11 - III-FI | WFSI |
| WFH - ALL SAINTS INC | |||||||||
| 3801 SPRING STREET | RACINE | WI | 53405 | 391264986 | HOSPITAL | WI | 501(c)(3) | 3 | WFH-SE WI |
| WFH - ALL SAINTS FOUNDATION INC | |||||||||
| 1320 WISCONSIN AVENUE | RACINE | WI | 53403 | 391570877 | FOUNDATION | WI | 501(c)(3) | 11 - I | WFH-AS INC |
| VOLUNTEERS IN PTNRSHIP WITH WFH-AS INC | |||||||||
| 3801 SPRING STREET | RACINE | WI | 53405 | 930838390 | FOUNDATION | WI | 501(c)(3) | 11 - III-O | WFH-AS INC |
| WFH - CIRCLE OF LIFE FOUNDATION INC | |||||||||
| 13950 WEST CAPITOL DRIVE | BROOKFIELD | WI | 53005 | 562426294 | FOUNDATION | WI | 501(c)(3) | 11 - I | WFH-PE |
| WHEATON FRAN HOME HEALTH & HOSPICE INC | |||||||||
| 3070 NORTH 51ST STREET STE 406 | MILWAUKEE | WI | 53210 | 391559428 | HOME HLTH | WI | 501(c)(3) | 3 | WFH-SE WI |
| WHEATON FRANCISCAN MEDICAL GROUP INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391791586 | MED GROUP | WI | 501(c)(3) | 3 | WFH-SE WI |
| WHEATON FRANCISCAN -ELMBROOK FNDN (1) | |||||||||
| 19333 WEST NORTH AVENUE | BROOKFIELD | WI | 53045 | 392028808 | FOUNDATION | WI | 501(c)(3) | 11 - I | WF INC |
| WHEATON FRANCISCAN INC (2) | |||||||||
| 19333 WEST NORTH AVENUE | BROOKFIELD | WI | 53045 | 390853528 | HOSPITAL | WI | 501(c)(3) | 3 | WFH-SE WI |
| WHEATON FRANCISCAN LABORATORIES INC | |||||||||
| 11020 WEST PLANK COURT | WAUWATOSA | WI | 53226 | 391701402 | LABORATORY | WI | 501(c)(3) | 9 | WFH-SE WI |
| WFH PHARMACY ENT AND FRAN WOODS INC | |||||||||
| 13950 WEST CAPITOL DRIVE | BROOKFIELD | WI | 53005 | 391613624 | PHARMACY | WI | 501(c)(3) | 9 | WFH-SE WI |
| WFH - ST FRANCIS INC | |||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 390907740 | HOSPITAL | WI | 501(c)(3) | 3 | WFH-SE WI |
| WF - ST JOSEPH FOUNDATION INC | |||||||||
| 5000 WEST CHAMBERS STREET | MILWAUKEE | WI | 53210 | 391636804 | FOUNDATION | WI | 501(c)(3) | 11 - I | WF INC |
| WHEATON FRANCISCAN INC | |||||||||
| 5000 WEST CHAMBERS STREET | MILWAUKEE | WI | 53210 | 390816857 | HOSPITAL | WI | 501(c)(3) | 3 | WFH-SE WI |
| WFH-THE WISCONSIN HEART HOSPITAL INC (3) | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391220690 | FOUNDATION | WI | 501(c)(3) | 11 - I | WFH-SE WI |
| WFH-FNDN FOR ST FRANCIS AND FRANKLIN INC | |||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 320135258 | FOUNDATION | WI | 501(c)(3) | 11 - I | WFH-SFH |
| WFH - TERRACE AT ST FRANCIS INC | |||||||||
| 3200 SOUTH 20TH STREET | MILWAUKEE | WI | 53215 | 391486775 | NURSING HOME | WI | 501(c)(3) | 9 | WFH-SE WI |
| WFH - FRANKLIN INC | |||||||||
| 10101 SOUTH 27TH STREET | FRANKLIN | WI | 53132 | 562592868 | HOSPITAL | WI | 501(c)(3) | 3 | WFH-SE WI |
| WHEATON WAY CONDO OWNERS ASSCN INC | |||||||||
| 10101 SOUTH 27TH STREET | FRANKLIN | WI | 53132 | 300659830 | CONDO ASSCN | WI | N/A | N/A | WFH-FRKLN |
| METRO PHYSICIANS INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 943436893 | MED GROUP | WI | 501(c)(3) | 3 | WFMG |
| MARIANJOY INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 363483589 | HOLDING CO | IL | 501(c)(3) | 11 - III-FI | WFSI |
| MARIANJOY FOUNDATION INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 352165613 | FOUNDATION | IL | 501(c)(3) | 7 | MJ HOSP |
| MARIANJOY REHAB CENTER AUXILIARY INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 363896976 | AUXILIARY | IL | 501(c)(3) | 11 - I | MJ HOSP |
| MARIANJOY REHAB HOSPITAL & CLINICS INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 362680776 | REHAB HOSPITA | IL | 501(c)(3) | 3 | MARIANJOY |
| REHABILITATION MEDICINE CLINIC INC | |||||||||
| 26 W 171 ROOSEVELT RD | WHEATON | IL | 60187 | 363236791 | MEDICAL GRP | IL | 501(c)(3) | 3 | MARIANJOY |
| OSF SERVICES INC | |||||||||
| PO Box 667 | WHEATON | IL | 601870667 | 391471463 | HOLDING CO | WI | 501(c)(3) | 11 - III-FI | WFSI |
| CANTICLE MINISTRIES INC | |||||||||
| PO Box 667 | WHEATON | IL | 601870667 | 364091836 | HOUSING/ADVCY | IL | 501(c)(3) | 7 | OSF SVCS INC |
| CLARA PFAENDER FUND INC | |||||||||
| PO Box 667 | WHEATON | IL | 601870667 | 363353311 | SPONSORSHIP | IL | 501(c)(3) | 11 - III-O | OSF SVCS INC |
| FRANCISCAN SISTERS CHARITABLE FUND OF CO | |||||||||
| 2626 OSCEOLA STREET | DENVER | CO | 80212 | 840733072 | AUXILIARY | CO | 501(c)(3) | 7 | OSF SVCS INC |
| RUSH OAK PARK HOSPITAL INC | |||||||||
| 520 SOUTH MAPLE AVENUE | OAK PARK | IL | 60304 | 362183812 | HOSPITAL | IL | 501(c)(3) | 3 | OSF SVCS INC |
| SET MINISTRY INC | |||||||||
| 2977 NORTH 50TH STREET | MILWAUKEE | WI | 53210 | 391618277 | SOCIAL WORK | WI | 501(c)(3) | 9 | OSF SVCS INC |
| ST CATHERINE'S HOSPITAL INC | |||||||||
| 9555 76TH STREET | PLEASANT PRAIRIE | WI | 53158 | 390855075 | HOSPITAL | WI | 501(c)(3) | 3 | OSF SVCS INC |
| SYNERGON HEALTH SYSTEM INC (5) | |||||||||
| 520 SOUTH MAPLE AVENUE | OAK PARK | IL | 60304 | 363739067 | HOSPITAL | IL | 501(c)(3) | 3 | NONE |
| UHS INC (6) | |||||||||
| 6308 EIGHTH AVENUE | KENOSHA | WI | 53143 | 391956749 | HOSPITAL | WI | 501(c)(3) | 3 | NONE |
| WFH - IOWA INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421177001 | HOLDING CO | IA | 501(c)(3) | 11 - III-FI | WFSI |
| COVENANT FOUNDATION INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421295784 | FOUNDATION | IA | 501(c)(3) | 9 | COV MED CTR |
| MERCY HOSPITAL OF FRANCISCAN SISTERS INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421178403 | HOSPITAL | IA | 501(c)(3) | 3 | WFH-IOWA |
| NE IOWA REAL ESTATE INVESTMENTS LTD | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421207432 | HOLDING CO | IA | 501(c)(2) | N/A | WFH-IOWA |
| SCHOITZ HEALTH RESOURCES INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421232935 | PROMOTE HLTH | IA | 501(c)(3) | 11 - II | NA |
| SCHOITZ MEDICAL CENTER INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 420718472 | OP ROOM SVCS | IA | 501(c)(3) | 3 | SCHOITZ HR |
| SARTORI HEALTH CARE FOUNDATION INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421240996 | FOUNDATION | IA | 501(c)(3) | 11 - I | SARTORI HOSP |
| SARTORI MEMORIAL HOSPITAL INC | |||||||||
| 515 COLLEGE STREET | CEDAR FALLS | IA | 50613 | 420758901 | HOSPITAL | IA | 501(c)(3) | 3 | WFH-IOWA |
| FRANCISCAN MINISTRIES INC | |||||||||
| 26W171 ROOSEVELT ROAD | WHEATON | IL | 601870667 | 363259684 | HOLDING CO | IL | 501(c)(3) | 11 - III-FI | WFSI |
| ASSISI HOMES - BATAVIA APARTMENTS INC | |||||||||
| 1259 EAST WILSON STREET | BATAVIA | IL | 60510 | 363914084 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| ASSISI HOMES - COLONY PARK INC | |||||||||
| 550 EAST THORNHILL DRIVE | CAROL STREAM | IL | 60188 | 364039278 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| ASSISI HOMES - CONSTITUTION HOUSE INC | |||||||||
| 401 NORTH CONSTITUTION DRIVE | AURORA | IL | 60506 | 364049150 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| ASSISI HOMES - JEFFERSON COURT INC | |||||||||
| 415 EAST KNAPP STREET | MILWAUKEE | WI | 53202 | 391771526 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| ASSISI HOMES - KENOSHA INC | |||||||||
| 1860 27TH AVENUE | KENOSHA | WI | 53140 | 391814815 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| ASSISI HOMES - SAXONY INC | |||||||||
| 1876 22ND AVENUE | KENOSHA | WI | 53140 | 391790498 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| ASSISI HOMES OF GURNEE INC | |||||||||
| 3495 WEST GRAND AVENUE | GURNEE | IL | 60031 | 363942336 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| ASSISI HOMES OF ILLINOIS INC | |||||||||
| 2126 WEST ROOSEVELT ROAD | WHEATON | IL | 60187 | 363803443 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| Assisi HOMES OF NEENAH INC | |||||||||
| 210 BYRD AVENUE | NEENAH | WI | 54946 | 363767250 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| CANTICLE PLACE INC | |||||||||
| 26W171 ROOSEVELT ROAD | WHEATON | IL | 601870667 | 363957850 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| CATHERINE MARIAN HOUSING INC | |||||||||
| 806 SOUTH WISCONSIN AVENUE | RACINE | WI | 53403 | 391657098 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| CLARE GARDENS INC | |||||||||
| 2626 OSCEOLA STREET | DENVER | CO | 80212 | 237200039 | HOUSING | CO | 501(c)(3) | 9 | FMI |
| CLARE OF ASSISI HOMES-WESTMINSTER INC | |||||||||
| 2451 WEST 82ND PLACE | WESTMINSTER | CO | 80031 | 742740978 | HOUSING | CO | 501(c)(3) | 9 | FMI |
| DAYSPRING VILLA INC | |||||||||
| 3777 WEST 26TH AVENUE | DENVER | CO | 80211 | 363933908 | HOUSING | CO | 501(c)(3) | 9 | FMI |
| FRANCIS HEIGHTS INC | |||||||||
| 2626 OSCEOLA STREET | DENVER | CO | 80212 | 840626174 | HOUSING | CO | 501(c)(3) | 9 | FMI |
| FRANCISCAN MINISTRIES COMMUNITY FNDN INC | |||||||||
| 26W171 ROOSEVELT ROAD | WHEATON | IL | 601870667 | 364456204 | FOUNDATION | IL | 501(c)(3) | 11 - II | FMI |
| FRANCISCAN SENIORS KENOSHA INC | |||||||||
| 1920 27TH AVENUE | KENOSHA | WI | 53140 | 391821568 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| MARIAN HOUSING CENTER INC | |||||||||
| 4105 SPRING STREET | RACINE | WI | 53405 | 391515867 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| MARIAN PARK INC | |||||||||
| 2126 WEST ROOSEVELT ROAD | WHEATON | IL | 60187 | 362750105 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| RIDGEWAY PLACE INC | |||||||||
| 155 EAST RIDGEWAY AVENUE | WATERLOO | IA | 50702 | 421416064 | HOUSING | IA | 501(c)(3) | 9 | FMI |
| STARVED ROCK-LASALLE MANOR INC | |||||||||
| 1135 10TH STREET | LASALLE | IL | 61301 | 363796933 | HOUSING | IL | 501(c)(3) | 9 | FMI |
| VILLA MARIA INC | |||||||||
| 2461 WEST 82ND PLACE | WESTMINSTER | CO | 80031 | 841347868 | HOUSING | CO | 501(c)(3) | 9 | FMI |
| VILLA ST CLARE INC | |||||||||
| 130 BYRD AVENUE | NEENAH | WI | 54946 | 391769395 | HOUSING | WI | 501(c)(3) | 9 | FMI |
| ASSISI HOMES LASALLE MANOR INC (4) | |||||||||
| 26W171 ROOSEVELT ROAD | WHEATON | IL | 601890795 | 800623447 | HOUSING | IL | 501(c)(3) | 9 | FMI |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Code VCodeVAmount |
|---|---|---|---|---|---|---|---|---|
| KENOSHA SNR | ||||||||
| PO BOX 667 | WHEATON | IL | 60187 | 391801541 | HOUSING | WI | FR SNRS | $0 |
| STARVED ROCK | ||||||||
| PO BOX 667 | WHEATON | IL | 60187 | 363811835 | HOUSING | IL | SRLM INC | $0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|
| NETWORK HEALTH INSURANCE CORPORATION | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54942 | 392020474 | INSURANCE CO | WI | NETWK HLTH SY | C CORP | |
| NETWORK HEALTH PLAN | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54942 | 391442058 | HLTH MAINT ORG | WI | NETWK HLTH SY | C CORP | |
| WHEATON FRANCISCAN ENTERPRISES INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391985204 | HOLDING CO | WI | WF HOLD INC | C CORP | |
| WHEATON FRANCISCAN HOLDINGS INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391836357 | HOLDING CO | WI | WFH-SE WI | C CORP | |
| WHEATON FRANCISCAN MED GRP-SUSSEX INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391361100 | MED GROUP | WI | WF HOLD INC | C CORP | |
| WHEATON FRANCISCAN PROVIDER NETWORK INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391952140 | ADMIN SUPPORT | WI | WFH-SE WI | C CORP | |
| COVENANT REGIONAL SERVICES INC | |||||||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | 421189805 | PHARMACY | IA | WFH-IOWA | C CORP | |
| WHEATON FRANCISCAN INSURANCE COMPANY | |||||||||
| 980691609 | FINANCIAL | WFSI | UK | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | true | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Covenant Foundation Inc | |
| C | 1917345 |
| Covenant Foundation Inc | |
| B | 15000 |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule R Disclosures | Identifier |
| Return Reference | Part II | ReturnReference |
| Explanation | (1) Wheaton Franciscan Healthcare - Elmbrook Memorial Foundation, Inc. changed its legal name to Wheaton Franciscan - Elmbrook Memorial Foundation, Inc. effective July 1, 2011. (2) On July 1, 2011, Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. (FEIN #39-0853528) was merged into Wheaton Franciscan, Inc. (FEIN 39-0816857). As a result of this merger, Wheaton Franciscan, Inc. f/k/a Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. (FEIN #39-0853528) ceased to exist and will file its final IRS Form 990 for the fiscal year ending June 30, 2011. (3) Wheaton Franciscan Healthcare - The Wisconsin Heart Hospital, Inc. f/k/a St Michael Hospital Community Foundation, Inc. (FEIN #39-1220690) was dissolved effective December 21, 2010 and as such, will file its final IRS Form 990 for tax year 2010. (4) Assisi Homes - LaSalle Manor, Inc. was formed on July 8, 2010 and was granted tax exempt status on February 14, 2011 retroactive to July 8th. (5) Synergon Health System Inc is listed with no direct controlling entity because of the two organizations with an interest, Rush Presbyterian and OSF Services Inc, neither can appoint a majority of the board, therefore neither organization "controls". (6) UHS, Inc. is listed without a direct controlling entity because of the two organizations with an interest, KHMC Community Board and OSF Services Inc, neither can appoint a majority of the board, and since KHMC is not an entity (it is a community board), neither body "controls". | Explanation |