MOSAIC FAMILY HEALTH INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- MOSAIC FAMILY HEALTH INC (EIN 47-3298660)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-11
- IRS object ID
- 202631319349304678
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-11T15:20:21-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 W LAWRENCE STREET SUITE 500 | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54911 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473298660 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSAIC FAMILY HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOSA | BusinessNameControlTxt |
| Phone | 9208322783 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N ONEIDA STREET | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54911 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MIKE BERGMANN | PersonNm |
| Person Title | BOARD CHAIR | PersonTitleTxt |
| Phone | 9208322783 | PhoneNum |
| Signature | 2026-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL VANDENHOGEN | PreparerPersonNm |
| PTIN | P00499282 | PTIN |
| Phone | 9207318111 | PhoneNum |
| Preparation | 2026-05-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LEIF ELSMO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N ONEIDA STREET | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54911 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,384,302 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MOSAICFAMILYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | OPERATE A MEDICAL CLINIC AND FAMILY MEDICINE RESIDENCY PROGRAM. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 87 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $13,305,277 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,693,137 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,571,949 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,618,123 | CYProgramServiceRevenueAmt |
| PY Investment Income | $87,076 | PYInvestmentIncomeAmt |
| CY Investment Income | $38,092 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,329 | PYOtherRevenueAmt |
| CY Other Revenue | $21,287 | CYOtherRevenueAmt |
| PY Total Revenue | $15,975,631 | PYTotalRevenueAmt |
| CY Total Revenue | $16,370,639 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,188,055 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,231,334 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $7,752 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,882,094 | PYOtherExpensesAmt |
| CY Other Expenses | $2,584,892 | CYOtherExpensesAmt |
| PY Total Expenses | $8,070,149 | PYTotalExpensesAmt |
| CY Total Expenses | $8,816,226 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,905,482 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,554,413 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,756,449 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,368,289 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,411,562 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,468,989 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,344,887 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,899,300 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE FULL-SCOPE FAMILY MEDICINE SERVICES WHILE TRAINING FUTURE PHYSICIANS AND IMPROVING THE OVERALL HEALTH OF THE FOX CITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,018,065 | ExpenseAmt |
| Revenue | $2,639,410 | RevenueAmt |
| Desc | MOSAIC FAMILY HEALTH IS THE MEDICAL HOME OF THE FOX VALLEY FAMILY MEDICINE RESIDENCY PROGRAM - A 21 RESIDENT TRAINING PROGRAM AFFILIATED WITH THE MEDICAL COLLEGE OF WISCONSIN. WE TRAIN FAMILY PHYSICIANS FOR THE FOX VALLEY COMMUNITY AND NORTH EAST WISCONSIN, SPECIALIZING IN PROVIDING PHYSICIANS WITH A FULL SCOPE OF PRACTICE SKILLS TO SERVE IN CRITICAL ACCESS HOSPITALS. WE HAVE GRADUATED 261 RESIDENTS, AND WITH APPROXIMATELY 70% PRACTICING IN WISCONSIN, WE HAVE CREATED PHYSICIANS WHO HAVE CARED FOR APPROXIMATELY 325,000 WISCONSIN CITIZENS OVER THE YEARS IN A MULTITUDE OF VISITS AND SETTINGS, INCLUDING CLINICS, HOSPITALS, NURSING HOMES AND HOMES. OUR CARE SERVICES CONTINUE TO EXPAND AND INCLUDE AMBULATORY PRIMARY CARE FOR ALL AGES, INCLUDING MATERNAL AND INFANT CARE, INTEGRATED BEHAVIORAL HEALTH, MEDICATION ASSISTED ADDICTION TREATMENT, CARE IN SKILLED NURSING FACILITIES. A SPECIAL FOCUS IS CARE FOR THE VULNERABLE AND MARGINALIZED COMMUNITIES. WE SEEK FOR ALL PATIENTS, TO FLOURISH AND ARE INTENTIONALLY BUILDING A "HEALTH EQUITY HUB." MOSAIC HAS BECOME A CRITICAL COMPONENT OF THE HEALTHCARE FABRIC OF THE FOX VALLEY COMMUNITY. WITH 30% MEDICAID AND 30% MEDICARE PATIENT POPULATION (OF APPROXIMATELY 6,000 PATIENTS) WE ARE AN ESSENTIAL SAFETY NET CLINIC, AND CONTINUOUSLY IN NEED OF DONOR AND COMMUNITY SUPPORT TO MEET OUR MISSIONS. | Desc |
| Total Program Service Expenses | $8,018,065 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 87 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JILLIAN WILSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9205607160 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N ONEIDA STREET | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54911 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| KRISTINA SMITH | |||||||
| DIRECTOR, TREASURER (LEFT JAN 2025) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KATIE BALL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SARA MARQUARDT | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE BERGMANN | |||||||
| DIRECTOR (LEFT NOV 2024) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MBONU IKEZUAGU MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SONAL CHANDRATRE | |||||||
| DIRECTOR (LEFT NOV 2024) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GRETCHEN WAGNER MD | |||||||
| DIRECTOR (AS OF JUNE 2025) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SRIRAM DARISETTY MD | |||||||
| DIRECTOR (AS OF NOV 2024) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACQUELINE FOWLER | |||||||
| DIRECTOR (AS OF FEB 2025) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELSEY KIERNERT | |||||||
| DIRECTOR (FEB-JUNE 2025) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEE VOGEL MD | |||||||
| PRESIDENT/EXECUTIVE DIRECTOR | 65.00 | Yes (X) | $254,244 | $0 | $57,968 | ||
| ELIZABETH MENZEL MD | |||||||
| SECRETARY/PROGRAM DIRECTOR | 55.00 | Yes (X) | $268,223 | $0 | $61,155 | ||
| MEGAN EVERSON MD | |||||||
| ASSISTANT PROFESSOR | 55.00 | $234,386 | $0 | $53,440 | Yes (X) | ||
| ALLEN R LAST MD | |||||||
| ASSISTANT PROFESSOR | 55.00 | $234,857 | $0 | $53,547 | Yes (X) | ||
| KATHRYN JACOBE MD | |||||||
| ASSISTANT PROFESSOR | 55.00 | $240,573 | $0 | $54,851 | Yes (X) | ||
| DEBORAH SCHULTZ MD | |||||||
| ASSOCIATE PROFESSOR | 55.00 | $233,630 | $0 | $53,268 | Yes (X) | ||
| ALICE BOSHOVEN MD | |||||||
| ASSISTANT PROFESSOR | 55.00 | $230,142 | $0 | $52,472 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,696,055 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $386,701 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THE BOLDT COMPANY | |||||
| 2525 N ROEMER RD | APPLETON | WI | 54911 | CONSTRUCTION SERVICES | $8,268,022 |
| MEDICAL COLLEGE OF WISCONSIN | |||||
| 8701 WATERTOWN PLANK ROAD | MILWAUKEE | WI | 53226 | FACULTY COMP. AND ASSESSMENTS | $2,008,075 |
| WINC GME CONSORTIUM | |||||
| 425 WIND RIDGE DR | WAUSAU | WI | 54401 | RESIDENT WAGES | $1,474,137 |
| CLIFTONLARSONALLEN LLP | |||||
| 100 W LAWENCE ST SUITE 500 | APPLETON | WI | 54911 | ACCOUNTING SERVICES | $152,730 |
| MEDUSIND | |||||
| 6100 WATERFORD DISTRICT DRIVE | MIAMI | FL | 33126 | MEDICAL BILLING & PRACTICE MANAGEMENT | $148,454 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $5,458,399 | MembershipDuesAmt |
| Related Organizations | $1,208,426 | RelatedOrganizationsAmt |
| Government Grants | $6,094,059 | GovernmentGrantsAmt |
| All Other Contributions | $932,253 | AllOtherContributionsAmt |
| Noncash Contributions | $1,208,426 | NoncashContributionsAmt |
| Total Contributions | $13,693,137 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621110 | $2,456,281 | $2,456,281 |
| MEDICAL DIRECTOR & PROFESSIONAL S | 623000 | $124,992 | $124,992 |
| INSURANCE INCENTIVES | 621110 | $36,850 | $36,850 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,618,123 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,755 | TotalRevenueColumnAmt |
| Exclusion | $51,755 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $13,663 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$13,663 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$13,663 | TotalRevenueColumnAmt |
| Exclusion | -$13,663 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,287 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,287 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,287 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,370,639 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,639,410 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,092 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,136 | TotalAmt |
| Program Services | $191,946 | ProgramServicesAmt |
| Management And General | $126,438 | ManagementAndGeneralAmt |
| Fundraising | $7,752 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,649,913 | TotalAmt |
| Program Services | $4,473,517 | ProgramServicesAmt |
| Management And General | $176,396 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,556 | TotalAmt |
| Program Services | $39,893 | ProgramServicesAmt |
| Management And General | $3,663 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $940,505 | TotalAmt |
| Program Services | $928,892 | ProgramServicesAmt |
| Management And General | $11,613 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,224 | TotalAmt |
| Program Services | $257,956 | ProgramServicesAmt |
| Management And General | $13,268 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,756 | TotalAmt |
| Program Services | $346,756 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,408 | TotalAmt |
| Management And General | $32,408 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,644 | TotalAmt |
| Management And General | $339,644 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,108 | TotalAmt |
| Program Services | $168,108 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,698 | TotalAmt |
| Management And General | $27,698 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,227 | TotalAmt |
| Program Services | $141,195 | ProgramServicesAmt |
| Management And General | $26,032 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,841 | TotalAmt |
| Program Services | $92,841 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,014 | TotalAmt |
| Program Services | $167,213 | ProgramServicesAmt |
| Management And General | $8,801 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,984 | TotalAmt |
| Program Services | $22,984 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $342,302 | TotalAmt |
| Program Services | $327,251 | ProgramServicesAmt |
| Management And General | $15,051 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,539 | TotalAmt |
| Program Services | $67,539 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $536,287 | $536,287 | |
| MAINTENANCE & REPAIRS | $187,946 | $178,549 | $9,397 |
| DUES AND SUBSCRIPTIONS | $50,329 | $50,329 | |
| RECRUITMENT EXPENSES | $26,809 | $26,809 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,816,226 | TotalAmt |
| Program Services | $8,018,065 | ProgramServicesAmt |
| Management And General | $790,409 | ManagementAndGeneralAmt |
| Fundraising | $7,752 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,704,651 | BOYAmt |
| EOY | $1,747,118 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,036,483 | BOYAmt |
| EOY | $1,252,824 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,255 | BOYAmt |
| EOY | $1,798,108 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,494 | BOYAmt |
| EOY | $204,502 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,764 | BOYAmt |
| EOY | $41,659 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,722,780 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $398,702 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,561,802 | BOYAmt |
| EOY | $14,324,078 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,756,449 | BOYAmt |
| EOY | $19,368,289 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,891 | BOYAmt |
| EOY | $1,468,989 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,838,671 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,411,562 | BOYAmt |
| EOY | $1,468,989 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,530,112 | BOYAmt |
| EOY | $16,222,902 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,814,775 | BOYAmt |
| EOY | $1,676,398 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,344,887 | BOYAmt |
| EOY | $17,899,300 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,756,449 | BOYAmt |
| EOY | $19,368,289 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,554,413 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,307,778 | OtherCostOrOtherBasisAmt |
| Depreciation | $190,495 | DepreciationAmt |
| Book Value | $13,117,283 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,415,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $208,207 | DepreciationAmt |
| Book Value | $1,206,795 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,324,078 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $17,073,767 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $703,127 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $1 | OtherRevenueAmt |
| Revenue Not Reported | $703,128 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,370,639 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,370,639 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,519,353 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $703,127 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $703,127 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,816,226 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,816,226 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART XI, LINE 2D - OTHER ADJUSTMENTS: | FormAndLineReferenceDesc |
| Explanation | ROUNDING 1. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH MENZEL MD | ||||||||||||||
| SECRETARY/PROGRAM DIRECTOR | $268,223 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $61,155 | $0 | $329,378 | $0 | $0 | $0 |
| LEE VOGEL MD | ||||||||||||||
| PRESIDENT/EXECUTIVE DIRECTOR | $254,244 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $57,968 | $0 | $312,212 | $0 | $0 | $0 |
| KATHRYN JACOBE MD | ||||||||||||||
| ASSISTANT PROFESSOR | $240,573 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $54,851 | $0 | $295,424 | $0 | $0 | $0 |
| ALLEN R LAST MD | ||||||||||||||
| ASSISTANT PROFESSOR | $234,857 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $53,547 | $0 | $288,404 | $0 | $0 | $0 |
| MEGAN EVERSON MD | ||||||||||||||
| ASSISTANT PROFESSOR | $234,386 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $53,440 | $0 | $287,826 | $0 | $0 | $0 |
| DEBORAH SCHULTZ MD | ||||||||||||||
| ASSOCIATE PROFESSOR | $233,630 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $53,268 | $0 | $286,898 | $0 | $0 | $0 |
| ALICE BOSHOVEN MD | ||||||||||||||
| ASSISTANT PROFESSOR | $230,142 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $52,472 | $0 | $282,614 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII, LINE 5 | FormAndLineReferenceDesc |
| Explanation | THE INDIVIDUALS LISTED ON SCHEDULE J ARE PAID BY MEDICAL COLLEGE OF WISCONSIN, AN UNRELATED ORGANIZATION. THE ORGANIZATION MAKES PAYMENTS TO MEDICAL COLLEGE OF WISCONSIN FOR WAGES, BENEFITS, AND OTHER ASSESSMENTS. | ExplanationTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PROPERTY & EQUIPMENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,208,426 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV AT DONATION | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | REPRESENTS THE NUMBER OF CONTRIBUTIONS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 2A: | THE ORGANIZATION DIRECTLY EMPLOYED 51 EMPLOYEES WHO WERE REPORTED ON ITS 2024 FORM W-3. IN ADDITION, THE ORGANIZATION'S CEO AND FACULTY TOTALING 8 FOR 2024 WERE REPORTED AS EMPLOYEES OF MEDICAL COLLEGE OF WISCONSIN UNDER FEIN 39-0806261. THE ORGANIZATION'S RESIDENTS TOTALING 28 FOR 2024 WERE REPORTED AS EMPLOYEES OF WINC GME CONSORTIUM UNDER FEIN 85-0632686. THE COMPENSATION PAID MEDICAL COLLEGE OF WISCONSIN AND WINC GME CONSORTIUM FOR THESE EMPLOYEES IS INCLUDED IN THE FORM 990, PART VII SECTION B. |
| FORM 990, PART VI, SECTION A, LINE 2 | KRISTINA SMITH, SONAL CHANDRATRE, KELSEY KIENERT, GRETCHEN WAGNER, MIKE BERGMANN, SRIRAM DARISETTY AND JACQUELINE FOWLER HAVE A BUSINESS RELATIONSHIP AS THEY ARE OFFICERS/EMPLOYEES OF THE SAME MEMBER ORGANIZATION. KATIE BALL, SARA MARQUARDT, AND MBONU IKEZUAGU HAVE A BUSINESS RELATIONSHIP AS THEY ARE OFFICERS/EMPLOYEES OF THE SAME MEMBER ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS, TO APPROVE THE APPOINTMENT OF AND REMOVAL OF THE CEO, TO APPROVE AMENDMENTS TO THE ORGANIZATIONS GOVERNING DOCUMENTS, AND APPROVE OTHER ACTIONS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS, TO APPROVE THE APPOINTMENT OF AND REMOVAL OF THE CEO, TO APPROVE AMENDMENTS TO THE ORGANIZATIONS GOVERNING DOCUMENTS, AND APPROVE OTHER ACTIONS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS FIRST REVIEWED BY THE CEO AND OTHER MEMBERS OF THE FINANCE COMMITTEE. AFTER THEIR REVIEW AND APPROVAL, A COPY OF THE 990 IS SENT TO EACH BOARD MEMBER. THE BOARD THEN VOTES TO APPROVE THE 990. WITH BOARD APPROVAL, AN OFFICER SIGNS THE RETURN AND A COPY IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE BOARD OF DIRECTORS COMPLETES AND SIGNS A CONFLICT OF INTEREST QUESTIONNAIRE. DURING THE YEAR, DIRECTORS AND OFFICERS DISCLOSE POSSIBLE CONFLICTS OF INTERESTS TO THE BOARD AND THE BOARD REVIEWS THE ISSUES TO DETERMINE IF AN ACTUAL CONFLICT OF INTEREST EXISTS. IF THERE IS A CONFLICT OF INTEREST, THAT INDIVIDUAL IS NOT PERMITTED TO VOTE IN REGARDS TO THE ITEM OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND FACULTY ARE EMPLOYED BY MEDICAL COLLEGE OF WISCONSIN (MCW) AND THEIR COMPENSATION IS CONSISTENT WITH MCW DEPARTMENT OF FAMILY MEDICINE FACULTY AND LEADERSHIP COMPENSATION. FACULTY AND LEADERSHIP COMPENSATION CORRIDORS ARE DETERMINED BY MCW / DEPARTMENT LEADERSHIP AND COMPENSATION COMMITTEE, USING COMPENSATION SURVEYS BY INDEPENDENT CONSULTANTS ENGAGED BY MCW, AS WELL AS BY MOSAIC'S ACCOUNTING FIRM, CLA TO ENSURE INPUT FROM INDEPENDENT ANALYSIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| FOX VALLEY FAMILY PRACTICE RESIDENCY INC APPLETON | ||||||||||
| 100 N ONEIDA STREET | APPLETON | WI | 54911 | 391327215 | EQUIP AND MAINTAIN EDUCATIONAL FACILITY FOR LEASE TO RESIDENCY PROGRAM. | WI | 501(C)(3) | LINE 12C, III-FI | N/A | 0 |
| GOLD CROSS AMBULANCE SERVICES INC | ||||||||||
| 1055 WITTMANN DRIVE | MENASHA | WI | 54952 | 391702433 | AMBULANCE SERVICES | WI | 501(C)(3) | LINE 10 | N/A | 0 |
| CATALPA HEALTH INC | ||||||||||
| 4635 W COLLEGE AVENUE | APPLETON | WI | 54914 | 454681563 | CHILDREN'S MENTAL HEALTH | WI | 501(C)(3) | LINE 3 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |