SAN CAMILLO INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAN CAMILLO INC (EIN 39-1487306)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-11
- IRS object ID
- 202322239349301847
- Schema version
- 2021v4.2
- 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 | 2023-08-11T16:24:53-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 N RADNOR-CHESTER RD SUITE 200 | AddressLine1Txt |
| City | RADNOR | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391487306 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN CAMILLO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SANC | BusinessNameControlTxt |
| Phone | 4142581814 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10200 W BLUEMOUND ROAD | AddressLine1Txt |
| City | WAUWATOSA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTOPHER CHERNEY | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 4142581814 | PhoneNum |
| Signature | 2023-08-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CHRISTOPHER | PersonFirstNm |
| Person Last | CHERNEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SOLOMON MARDAKHAEV | PreparerPersonNm |
| PTIN | P01806552 | PTIN |
| Phone | 6105653930 | PhoneNum |
| Preparation | 2023-08-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHANNON ANGELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10200 W BLUEMOUND ROAD | AddressLine1Txt |
| City | WAUWATOSA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,861,615 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STCAM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $27,589 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,718,954 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,769,359 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$15,139 | PYInvestmentIncomeAmt |
| CY Investment Income | -$14,711 | CYInvestmentIncomeAmt |
| PY Other Revenue | $42,230 | PYOtherRevenueAmt |
| CY Other Revenue | $64,325 | CYOtherRevenueAmt |
| PY Total Revenue | $12,746,045 | PYTotalRevenueAmt |
| CY Total Revenue | $14,846,562 | 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 | $3,692,265 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,240,629 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,693,487 | PYOtherExpensesAmt |
| CY Other Expenses | $12,543,066 | CYOtherExpensesAmt |
| PY Total Expenses | $11,385,752 | PYTotalExpensesAmt |
| CY Total Expenses | $16,783,695 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,360,293 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,937,133 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $78,721,185 | TotalAssetsBOYAmt |
| Total Assets EOY | $155,042,559 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $71,761,561 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $150,020,068 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,959,624 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,022,491 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,832,818 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,043,164 | RevenueAmt |
| Desc | OPERATES A 446 UNIT INDEPENDENT LIVING FACILITY FOR SENIOR RESIDENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,097,797 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,726,195 | RevenueAmt |
| Desc | OPERATES A 49 UNIT RELIGIOUS ASSISTED LIVING FACILITY PROVIDING HEALTHCARE AND OTHER SERVICES TO PRIESTS AND BROTHERS FROM THE JESUIT ORDER. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $15,930,615 | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTOPHER CHERNEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4142581814 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10200 W BLUEMOUND ROAD | AddressLine1Txt |
| City | WAUWATOSA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| JUSTIN MUNZEL | |||||||||
| CHIEF FINANCIAL OFFICER (THRU JUNE 2022) | 1.00 | 43.00 | Yes (X) | $0 | $215,414 | $17,469 | |||
| KEVIN SCHWAB | |||||||||
| FORMER CHIEF EXECUTIVE OFFICER | 0.00 | 0.00 | $0 | $208,036 | $23,250 | Yes (X) | |||
| SHANNON ANGELL | |||||||||
| CHIEF EXECUTIVE OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $208,969 | $8,198 | |||
| JULIANNE LEVERITT | |||||||||
| ADMINISTRATOR OF INDEPENDENT LIVING | 30.00 | 10.00 | $0 | $141,849 | $6,302 | Yes (X) | |||
| PAMELA LOVELESS | |||||||||
| DIRECTOR ORGANIZATIONAL & PROFESSIONAL DEVELOPMENT | 1.00 | 41.00 | $0 | $119,915 | $9,284 | Yes (X) | |||
| GESA HEGEMAN | |||||||||
| DIRECTOR OF HUMAN RESOURCES | 1.00 | 41.00 | $0 | $122,396 | $3,126 | Yes (X) | |||
| MELISSA CURRAN | |||||||||
| CONTROLLER | 1.00 | 43.00 | $0 | $109,731 | $9,443 | Yes (X) | |||
| THOMAS O'BRIEN | |||||||||
| CHIEF FINANCIAL OFFICER (FROM JULY 2022) | 1.00 | 43.00 | Yes (X) | $0 | $0 | $0 | |||
| FR PEDRO TRAMONTIN MI | |||||||||
| VICE CHAIR OF THE BOARD | 1.00 | 43.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| FR LEANDRO BLANCO MI | |||||||||
| TREASURER | 1.00 | 43.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| STACY BARNES | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| MARGO FRANKLIN | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| KELLY GAGLIONE | |||||||||
| DIRECTOR (THRU NOV 2021) | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| NICK LAUBUSCH | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| DR RAUL MATEO | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| FR AGUSTIN OROSA | |||||||||
| DIRECTOR | 1.00 | 43.00 | $0 | $0 | $0 | Yes (X) | |||
| JUDIE TAYLOR | |||||||||
| DIRECTOR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,126,310 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $77,072 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEINGARTH PAINTING LLC | |||||
| 714 EAST LOCUST STREET | MILWAUKEE | WI | 53212 | ENV ENVIRONMENTAL SERVICES | $250,440 |
| ROMAN ELECTRIC CO INC | |||||
| PO BOX 14396 | MILWAUKEE | WI | 53214 | ELECTRICAL SERVICES | $241,275 |
| BAY TOWEL INC | |||||
| P O BOX 12115 | GREEN BAY | WI | 54307 | LNDR LAUNDRY | $219,925 |
| HGA | |||||
| SDS 12-1861 PO BOX 86 | MINNEAPOLIS | MN | 55486 | CONSULTING SERVICES | $201,137 |
| KELMANN RESTORATION CORPORATION | |||||
| 12001 WEST DEARBOURN AVENUE | WAUWATOSA | WI | 53226 | RESTORATION SERVICES | $182,547 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $27,589 | RelatedOrganizationsAmt |
| Total Contributions | $27,589 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MONTHLY SERVICE FEE REVENUE | 623000 | $11,797,005 | $11,797,005 |
| SUPPORT SERVICE REVENUE | 623990 | $2,239,725 | $2,239,725 |
| RESIDENT SERVICE REVENUE | 623000 | $732,629 | $732,629 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,769,359 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $342 | TotalRevenueColumnAmt |
| Exclusion | $342 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $64,325 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $64,325 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,325 | TotalRevenueColumnAmt |
| Exclusion | $64,325 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,053 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$15,053 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$15,053 | TotalRevenueColumnAmt |
| Exclusion | -$15,053 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,846,562 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,769,359 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $49,614 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,581,298 | TotalAmt |
| Program Services | $3,402,233 | ProgramServicesAmt |
| Management And General | $179,065 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $403,154 | TotalAmt |
| Program Services | $382,996 | ProgramServicesAmt |
| Management And General | $20,158 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256,177 | TotalAmt |
| Program Services | $243,368 | ProgramServicesAmt |
| Management And General | $12,809 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,189,656 | TotalAmt |
| Program Services | $3,030,173 | ProgramServicesAmt |
| Management And General | $159,483 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,650 | TotalAmt |
| Program Services | $3,177 | ProgramServicesAmt |
| Management And General | $14,473 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,139 | TotalAmt |
| Program Services | $279,432 | ProgramServicesAmt |
| Management And General | $14,707 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,751 | TotalAmt |
| Program Services | $2,613 | ProgramServicesAmt |
| Management And General | $138 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,357 | TotalAmt |
| Program Services | $721,389 | ProgramServicesAmt |
| Management And General | $37,968 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,338,724 | TotalAmt |
| Program Services | $3,171,788 | ProgramServicesAmt |
| Management And General | $166,936 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $421 | TotalAmt |
| Program Services | $400 | ProgramServicesAmt |
| Management And General | $21 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,831 | TotalAmt |
| Program Services | $1,739 | ProgramServicesAmt |
| Management And General | $92 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125 | TotalAmt |
| Program Services | $119 | ProgramServicesAmt |
| Management And General | $6 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,642,465 | TotalAmt |
| Program Services | $3,460,342 | ProgramServicesAmt |
| Management And General | $182,123 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,325 | TotalAmt |
| Program Services | $87,709 | ProgramServicesAmt |
| Management And General | $4,616 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RAW FOOD & GROCERIES | $1,001,993 | $951,893 | $50,100 |
| MISCELLANEOUS | $88,295 | $83,880 | $4,415 |
| REPAIRS & MAINTENANCE | $70,540 | $67,013 | $3,527 |
| CATERING EXPENSE | $25,408 | $24,138 | $1,270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,386 | TotalAmt |
| Program Services | $16,213 | ProgramServicesAmt |
| Management And General | $1,173 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,783,695 | TotalAmt |
| Program Services | $15,930,615 | ProgramServicesAmt |
| Management And General | $853,080 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $330 | BOYAmt |
| EOY | $750 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,048 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,180 | BOYAmt |
| EOY | $36,187 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $195,443,863 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $40,438,241 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,178,381 | BOYAmt |
| EOY | $155,005,622 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,493,246 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,721,185 | BOYAmt |
| EOY | $155,042,559 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,307 | BOYAmt |
| EOY | $810,064 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,587,426 | BOYAmt |
| EOY | $11,795,133 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,786,828 | BOYAmt |
| EOY | $137,414,871 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,761,561 | BOYAmt |
| EOY | $150,020,068 | 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 | $6,959,624 | BOYAmt |
| EOY | $5,022,491 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,959,624 | BOYAmt |
| EOY | $5,022,491 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,721,185 | BOYAmt |
| EOY | $155,042,559 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,937,133 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,006 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $206 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $72,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $27,589 | CurrentTaxYearAmt |
| Total | $100,801 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,182,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,398,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,529,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,718,954 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,769,359 | CurrentTaxYearAmt |
| Total | $65,597,623 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,183,011 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,398,420 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,601,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,718,954 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,796,948 | CurrentTaxYearAmt |
| Total | $65,698,424 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $65,698,424 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,342 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,731 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,572 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,230 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $64,667 | CurrentTaxYearAmt |
| Total | $256,542 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,342 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,731 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,572 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,230 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $64,667 | CurrentTaxYearAmt |
| Total | $256,542 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,237,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,449,151 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,645,663 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,761,184 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,861,615 | CurrentTaxYearAmt |
| Total | $65,954,966 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99610 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99620 | PublicSupportPY509Pct |
| Investment Income CY | 0.00390 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00380 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,037,314 | OtherCostOrOtherBasisAmt |
| Book Value | $1,037,314 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $172,096,149 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,647,876 | DepreciationAmt |
| Book Value | $144,448,273 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,548,678 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,790,365 | DepreciationAmt |
| Book Value | $6,758,313 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,761,722 | OtherCostOrOtherBasisAmt |
| Book Value | $2,761,722 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $155,005,622 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| REFUNDABLE ENTRANCE FEES | $88,585,191 |
| DUE TO RELATED PARTY | $48,829,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $137,414,871 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $14,846,562 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,846,562 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,846,562 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,811,284 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $27,589 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $27,589 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,783,695 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,783,695 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART XII, LINE 2D - OTHER ADJUSTMENTS: | FormAndLineReferenceDesc |
| Explanation | DISTRIBUTIONS 27,589. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUSTIN MUNZEL | ||||||||||||||
| CHIEF FINANCIAL OFFICER (THRU JUNE 2 | $0 | $208,824 | $0 | $6,590 | $0 | $0 | $0 | $9,750 | $0 | $7,719 | $0 | $232,883 | $0 | $0 |
| KEVIN SCHWAB | ||||||||||||||
| FORMER CHIEF EXECUTIVE OFFICER | $0 | $208,036 | $0 | $0 | $0 | $0 | $0 | $19,142 | $0 | $4,108 | $0 | $231,286 | $0 | $0 |
| SHANNON ANGELL | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $197,235 | $0 | $11,734 | $0 | $0 | $0 | $4,258 | $0 | $3,940 | $0 | $217,167 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE TOP MANAGEMENT OFFICIAL IS COMPENSATED BY ST. CAMILLUS HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF SAN CAMILLO, INC. ST. CAMILLUS HEALTH SYSTEM, INC. ESTABLISHED THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL USING COMPENSATION COMMITTEE, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND THE APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE METHOD. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION HAS A SINGLE CLASS OF MEMBERS AND THE SOLE MEMBER OF THAT CLASS IS ST. CAMILLUS HEALTH SYSTEM, INC., A WISCONSIN NONSTOCK CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS SHALL NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE MEMBER: TO DEFINE THE PHILOSOPHY, MISSION AND PURPOSE OF THE CORPORATION AND TO ADOPT, AMEND OR REPEAL ANY STATEMENTS OF MISSION OR PHILOSOPHY FOR THE CORPORATION; TO ADOPT, APPROVE, RESTATE, REVISE, OR AMEND THESE AMENDED AND RESTATED ARTICLES OF INCORPORATION AND THE BY-LAWS OF THE CORPORATION; TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION AND DETERMINE THE NUMBER (WHICH MAY NOT BE LESS THAN THREE) OF SUCH DIRECTORS; TO AUTHORIZE OR MAKE OTHER DECISIONS RELATING TO THE TRANSFER OR SALE OF OR CREATION OF AN ENCUMBRANCE (E.G. MORTGAGE, PLEDGE OR GRANT OF SECURITY INTEREST) UPON FIXED ASSETS OF THE CORPORATION WITH A VALUE IN EXCESS OF $500,000; TO AUTHORIZE THE INCURRENCE BY THE CORPORATION OF DEBT FOR MONEY BORROWED IN AMOUNTS IN EXCESS OF $500,000; TO ADOPT AMEND OR REPEAL ANY PLAN OF DISSOLUTION, CONSOLIDATION OR MERGER OF THE CORPORATION, ANY CONTRACT OR AGREEMENT FOR THE MANAGEMENT OF THE CORPORATION OR ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; TO CREATE, ACQUIRE, SELL, PURCHASE, DISSOLVE OR MAKE OTHER DISPOSITION OF ANY ENTITY OWNED OR CONTROLLED OR TO BE OWNED OR CONTROLLED BY THE CORPORATION OR ANY OWNERSHIP INTEREST IN ANY SUCH ENTITY; TO APPROVE ANY ACTIONS OR EXERCISE ANY POWER RESERVED TO THE CORPORATION AS A MEMBER OR SHAREHOLDER OF ANOTHER ENTITY; TO APPROVE THE INITIAL ELECTION BY THE BOARD OF DIRECTORS OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION (BUT NOT SUBSEQUENT RE-ELECTIONS OF THOSE PERSONS TO SERVE CONSECUTIVE TERMS IN SUCH RESPECTIVE OFFICES) AND TO REMOVE THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION WHETHER OR NOT SUCH REMOVAL IS APPROVED BY THE BOARD OF DIRECTORS; AND TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AND TO DETERMINE THE TERM OF THE PRESIDENT'S APPOINTMENT, SUCH TERM NOT TO EXCEED THREE YEARS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CONTROLLER REVIEW THE FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. A COPY IS KEPT ON HAND FOR PUBLIC VIEWING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY. NO CONTRACT OR OTHER TRANSACTION BETWEEN THIS CORPORATION AND ONE OR MORE OF ITS DIRECTORS OR ANY OTHER CORPORATION, FIRM, ASSOCIATION, OR ENTITY IN WHICH ONE OR MORE OF ITS DIRECTORS ARE DIRECTORS OR OFFICERS OR HAS A MATERIAL FINANCIAL INTEREST, SHALL BE EITHER VOID OR VOIDABLE BECAUSE OF SUCH RELATIONSHIP OR INTEREST OR BECAUSE SUCH DIRECTOR OR DIRECTORS ARE PRESENT AT THE MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF WHICH AUTHORIZES, APPROVES OR RATIFIES SUCH CONTRACT OR TRANSACTION OR BECAUSE HIS OR THEIR VOTES ARE COUNTED FOR SUCH PURPOSE, IF ( 1) THE FACT OF SUCH RELATIONSHIP OR INTEREST IS DISCLOSED OR KNOWN TO THE BOARD OF DIRECTORS OR COMMITTEE WHICH AUTHORIZES, APPROVES OR RATIFIES THE CONTRACT OR TRANSACTION BY A VOTE OR CONSENT SUFFICIENT FOR THE PURPOSE WITHOUT COUNTING THE VOTES OR CONSENTS OF SUCH INTERESTED DIRECTORS; OR (2) THE FACT OF SUCH RELATIONSHIP OR INTEREST IS DISCLOSED OR KNOWN TO THE MEMBERS ENTITLED TO VOTE AND THEY AUTHORIZE, APPROVE OR RATIFY SUCH CONTRACT OR TRANSACTION BY VOTE OR WRITTEN CONSENT; OR (3) THE CONTRACT OR TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION. COMMON OR INTERESTED DIRECTORS MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM AT A MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF WHICH AUTHORIZES, APPROVES OR RATIFIES SUCH CONTRACT OR TRANSACTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. AUDITED FINANCIAL STATEMENTS ARE PUT IN THE RESIDENT LIBRARY AND AVAILABLE TO PROSPECTIVE RESIDENTS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST CAMILLUS HEALTH SYSTEM INC | |||||||||||
| 10101 W WISCONSIN AVENUE | WAUWATOSA | WI | 53226 | 390806167 | ADMINISTRATIVE AND MANAGEMENT SERVICES | WI | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| ST CAMILLUS COMMUNITIES INC | |||||||||||
| 10101 W WISCONSIN AVENUE | WAUWATOSA | WI | 53226 | 391843041 | RESIDENTIAL FACILITIES | WI | 501(C)(3) | LINE 12B, II | 0 | ST CAMILLUS HEALTH SYSTEM INC | |
| ORDER OF ST CAMILLUS FOUNDATION INC | |||||||||||
| 10200 W BLUEMOUND ROAD | WAUWATOSA | WI | 53226 | 391925879 | FUND-RAISING SUPPORT | WI | 501(C)(3) | LINE 12B, II | 0 | ST CAMILLUS HEALTH SYSTEM INC | |
| ST CAMILLUS HEALTH CENTER INC | |||||||||||
| 10101 W WISCONSIN AVENUE | WAUWATOSA | WI | 53226 | 391079224 | HEALTH SERVICES | WI | 501(C)(3) | LINE 10 | 0 | ST CAMILLUS HEALTH SYSTEM INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | 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 |
Comments