2025-05-12T17:21:32-05:00 2024-06-30 410746749 CLIFTONLARSONALLEN LLP 200 EAST WASHINGTON STREET APPLETON WI 549115481 990 2023-07-01 473298660 MOSAIC FAMILY HEALTH INC MOSA 9208322783 100 N ONEIDA STREET APPLETON WI 54911 LEE VOGEL MD PRESIDENT 9208322783 2025-05-12 1 0 MICHAEL VANDENHOGEN P00499282 9207318111 2025-05-12 2023 2025-03-06 01:10:19Z X LEE VOGEL MD 100 N ONEIDA STREET APPLETON WI 54911 15975631 0 X WWW.MOSAICFAMILYHEALTH.ORG X 2015 WI OPERATE A MEDICAL CLINIC AND FAMILY MEDICINE RESIDENCY PROGRAM. 6 6 50 6 0 0 5961023 13305277 2440441 2571949 13112 87076 180000 11329 8594576 15975631 10310 0 0 0 6505576 6188055 0 0 7752 1763609 1882094 8279495 8070149 315081 7905482 2840466 13756449 401061 3411562 2439405 10344887 TO PROVIDE FULL-SCOPE FAMILY MEDICINE SERVICES WHILE TRAINING FUTURE PHYSICIANS AND IMPROVING THE OVERALL HEALTH OF THE FOX CITIES. 0 0 7358852 2583278 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 FULL SCOPE OF PRACTICE SKILLS TO SERVE IN CRITICAL ACCESS HOSPITALS. 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." 7358852 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 50 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 WI X JILLIAN WILSON 9205607160 100 N ONEIDA STREET APPLETON WI 54911 KRISTINA SMITH DIRECTOR, TREASURER 2.00 X X 0 0 0 KATIE BALL DIRECTOR 1.00 X 0 0 0 SARA MARQUARDT DIRECTOR 2.00 X 0 0 0 PETER ROLOFF MD DIRECTOR (LEFT DEC 2023) 1.00 X 0 0 0 MIKE BERGMANN DIRECTOR 1.00 X 0 0 0 MBONU IKEZUAGU MD DIRECTOR 1.00 X 0 0 0 SONAL CHANDRATRE DIRECTOR (AS OF FEB 2024) 1.00 X 0 0 0 LEE VOGEL MD PRESIDENT/EXECUTIVE DIRECTOR 65.00 X 254244 0 57968 ELIZABETH MENZEL MD SECRETARY/PROGRAM DIRECTOR 55.00 X 260317 0 59352 MEGAN EVERSON MD ASSISTANT PROFESSOR 55.00 X 233793 0 53305 ALLEN R LAST MD ASSISTANT PROFESSOR 55.00 X 233793 0 53305 KATHRYN JACOBE MD ASSISTANT PROFESSOR 55.00 X 231815 0 52854 DEBORAH SCHULTZ MD ASSOCIATE PROFESSOR 55.00 X 233629 0 53267 LAURA VERHAGEN DO ASSISTANT PROFESSOR 55.00 X 214512 0 48909 1662103 0 378960 10 0 1 1 MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 FACULTY COMP. AND ASSESSMENTS 2224205 WINC GME CONSORTIUM 425 WIND RIDGE DR WAUSAU WI 54401 RESIDENT WAGES 1069454 EDGEMED HEALTHCARE LLC 4800 T-REX AVENUE 2ND FLOOR BOCA RATON FL 33431 MEDICAL BILLING & PRACTICE MGMT. 127265 THEDACARE 1818 N MEADE ST APPLETON WI 54911 INFORMATION TECHNOLOGY SUPPORT 109142 4 5237901 3320115 4747261 13305277 PATIENT SERVICES 621110 2397532 2397532 MEDICAL DIRECTOR & PROFESSIONAL S 623000 124992 124992 INSURANCE INCENTIVES 621110 49425 49425 2571949 87076 87076 OTHER REVENUE 621110 11329 11329 11329 15975631 2583278 0 87076 323517 189720 126045 7752 4734840 4618930 115910 45593 42927 2666 933406 922089 11317 150699 141886 8813 294615 294615 35361 35361 324349 324349 122448 122448 47454 47454 134686 110192 24494 99324 99324 142725 135589 7136 36831 36831 18811 18811 62674 62674 MEDICAL SUPPLIES 341883 341883 MAINTENANCE & REPAIRS 161818 161818 DUES AND SUBSCRIPTIONS 42315 42315 RECRUITMENT EXPENSES 16800 16800 8070149 7358852 703545 7752 997529 1704651 1245214 6036483 367428 150255 182727 255494 1301 47764 5884457 322655 46267 5561802 2840466 13756449 284679 572891 111382 2838671 5000 401061 3411562 X 2239108 2530112 200297 7814775 2439405 10344887 2840466 13756449 7905482 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10471 2853 7618 342779 319802 22977 5531207 5531207 5561802 16963135 987504 987504 15975631 0 15975631 9057653 987504 987504 8070149 0 8070149 X 0 0 0 0 0 0 0 0 0 ELIZABETH MENZEL MD SECRETARY/PROGRAM DIRECTOR 260317 0 0 0 0 0 0 0 59352 0 319669 0 0 0 LEE VOGEL MD PRESIDENT/EXECUTIVE DIRECTOR 254244 0 0 0 0 0 0 0 57968 0 312212 0 0 0 MEGAN EVERSON MD ASSISTANT PROFESSOR 233793 0 0 0 0 0 0 0 53305 0 287098 0 0 0 ALLEN R LAST MD ASSISTANT PROFESSOR 233793 0 0 0 0 0 0 0 53305 0 287098 0 0 0 DEBORAH SCHULTZ MD ASSOCIATE PROFESSOR 233629 0 0 0 0 0 0 0 53267 0 286896 0 0 0 KATHRYN JACOBE MD ASSISTANT PROFESSOR 231815 0 0 0 0 0 0 0 52854 0 284669 0 0 0 LAURA VERHAGEN DO ASSISTANT PROFESSOR 214512 0 0 0 0 0 0 0 48909 0 263421 0 0 0 FORM 990, PART VII, LINE 5 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. FORM 990, PART VI, SECTION A, LINE 2 KRISTINA SMITH, PETER ROLOFF, SONAL CHANDRATRE, AND MIKE BERGMANN 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, THE CEO 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. 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 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0