PROHEALTH HOME CARE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PROHEALTH HOME CARE INC (EIN 20-0067392)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-11
- IRS object ID
- 202202239349300140
- Schema version
- 2020v4.2
- 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 | 2022-08-11T09:34:58-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 TOWN CENTER SUITE 100 | AddressLine1Txt |
| City | SOUTHFIELD | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48075 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200067392 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH HOME CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROH | BusinessNameControlTxt |
| Phone | 2629282981 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DR NO 130 | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53188 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW GUTIERREZ | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2629282981 | PhoneNum |
| Signature | 2022-07-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ANDREW | PersonFirstNm |
| Person Last | GUTIERREZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 2483522500 | PhoneNum |
| Preparation | 2022-07-18 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGELSGRACE HOSPICE | BusinessNameLine1Txt |
| Business Name Line2 | PROHEALTH HOME HOSPICE | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN EDWARDS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DR NO 130 | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53188 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,764,473 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | RENDERING HOSPICE AND HOME HEALTH CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 225 | TotalEmployeeCnt |
| Total Volunteers | 255 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $792,686 | PYContributionsGrantsAmt |
| CY Contributions Grants | $800,111 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,208,486 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,940,733 | CYProgramServiceRevenueAmt |
| PY Investment Income | $84 | PYInvestmentIncomeAmt |
| CY Investment Income | $208 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,958 | PYOtherRevenueAmt |
| CY Other Revenue | $23,421 | CYOtherRevenueAmt |
| PY Total Revenue | $17,026,214 | PYTotalRevenueAmt |
| CY Total Revenue | $18,764,473 | 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 | $11,591,021 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,078,614 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,844,673 | PYOtherExpensesAmt |
| CY Other Expenses | $4,290,166 | CYOtherExpensesAmt |
| PY Total Expenses | $15,435,694 | PYTotalExpensesAmt |
| CY Total Expenses | $17,368,780 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,590,520 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,395,693 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,594,807 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,299,123 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,911,328 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,619,951 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,683,479 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,679,172 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROHEALTH HOME CARE PROVIDES EXTRAORDINARY HOME CARE SERVICES IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,349,864 | ExpenseAmt |
| Revenue | $17,940,733 | RevenueAmt |
| Desc | THE CORPORATION HAS BEEN ORGANIZED TO CONDUCT PERPETUALLY A RESIDENTIAL HOSPICE, WHICH IS MAINTAINED AND OPERATED FOR THE CARE OF PERSONS SUFFERING FROM TERMINAL ILLNESSES. THE FACILITIES ARE MADE AVAILABLE ON AN EQUAL BASIS TO ALL PATIENTS REGARDLESS OF RACE, RELIGION, DISABILITY, COLOR, NATIONAL ORIGIN, AGE, SEX, SEXUAL ORIENTATION, FINANCIAL STATUS, OR PLACE OF RESIDENCE. THE RESIDENTIAL HOSPICE FACILITY, ANGELSGRACE, COMMENCED OPERATIONS ON 5/3/2004, AND DURING FY21 PROVIDED APPROXIMATELY 4,832 PATIENT DAYS OF SERVICE. THE CORPORATION ALSO PROVIDES SKILLED NURSING, THERAPY AND HOSPICE SERVICES IN PATIENTS' HOMES, AND CONDUCTS EDUCATIONAL ACTIVITIES RELATING TO RENDERING HOSPICE AND HOME HEALTH CARE. DURING FY21, THE CORPORATION PROVIDED 19,138 ROUTINE DAYS OF HOSPICE SERVICE, 24,796 NURSE VISITS, 2,241 SUPPORT CARE VISITS, AND 25,895 THERAPY VISITS. DURING FY21, $105,943 IN CHARITY CARE WAS PROVIDED. | Desc |
| Total Program Service Expenses | $15,349,864 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 225 | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW GUTIERREZ | PersonNm |
| Phone | 2629282453 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DR SUITE 130 | AddressLine1Txt |
| City | WAUKESHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53188 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | ||||||||
| PRESIDENT AND CEO - PHC | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $1,839,420 | $608,286 | |
| KENNETH PRICE | ||||||||
| CHIEF OPERATING OFFICER | 2.00 | 48.00 | Yes (X) | $0 | $736,930 | $480,274 | ||
| RONALD FARR | ||||||||
| CHIEF FINANCIAL OFFICER - PART YEAR | 2.00 | 50.00 | Yes (X) | $0 | $1,020,189 | $194,197 | ||
| JAYNE JERMIER | ||||||||
| PT CASE MGR, HOME HEALTH | 40.00 | 0.00 | $117,598 | $0 | $31,637 | Yes (X) | ||
| JACQUELINE SHANE | ||||||||
| RN CASE MANAGER | 40.00 | 0.00 | $138,556 | $0 | $8,159 | Yes (X) | ||
| LAURA DAUGHERTY | ||||||||
| CLINICAL NURSE II | 40.00 | 0.00 | $123,084 | $0 | $13,981 | Yes (X) | ||
| KATHLEEN O'BRIEN SORENSEN | ||||||||
| PT CASE MGR, HOME HEALTH | 40.00 | 0.00 | $113,707 | $0 | $21,477 | Yes (X) | ||
| KATHLEEN MULLEN | ||||||||
| MGR HOSPICE | 40.00 | 0.00 | $111,410 | $0 | $21,669 | Yes (X) | ||
| BETTY ARNDT | ||||||||
| SECRETARY | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAN MATOLA | ||||||||
| TREASURER | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEN RIESCH | ||||||||
| CHAIRPERSON | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE ERWIN | ||||||||
| VICE CHAIRPERSON | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JULIE SCHROEDER | ||||||||
| TREASURER - PART YEAR | 2.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID ROELKE | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| DAWN WITTAK | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| EMERY HARLAN | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| GARY BEYER | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM GANNON | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN HALLETT | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN WIMMER | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| JUDIE TAYLOR | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| SUE BELLEHUMEUR | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| TY TAYLOR | ||||||||
| DIRECTOR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK MOHR | ||||||||
| DIRECTOR - PART YEAR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| E JOHN RAASCH | ||||||||
| DIRECTOR - PART YEAR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| RALPH RAMIREZ | ||||||||
| DIRECTOR - PART YEAR | 2.00 | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BARR | ||||||||
| INTERIM CFO - STARTED AUG 2021 | 2.00 | 50.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $604,355 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,596,539 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,379,680 | 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 | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAFFENCY LLC | |||||
| 221 W COLLEGE AVE | APPLETON | WI | 54911 | PROFESSIONAL SERVICES | $185,702 |
| PIEPER POWER | |||||
| PO BOX 88601 | MILWAUKEE | WI | 53288 | PROFESSIONAL SERVICES | $124,076 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $784,204 | RelatedOrganizationsAmt |
| Government Grants | $15,907 | GovernmentGrantsAmt |
| Total Contributions | $800,111 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOME HEALTH SERVICES | 621610 | $9,949,770 | $9,949,770 |
| HOSPICE SERVICES | 623990 | $7,932,735 | $7,932,735 |
| NURSING HOME ROOM AND BOARD REIMB | 621610 | $58,228 | $58,228 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,940,733 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $208 | TotalRevenueColumnAmt |
| Exclusion | $208 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | VISITOR CAFE | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $23,421 | TotalRevenueColumnAmt |
| Exclusion | $23,421 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $23,421 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,764,473 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,940,733 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $23,629 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,967,013 | TotalAmt |
| Program Services | $8,854,690 | ProgramServicesAmt |
| Management And General | $1,112,323 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,274 | TotalAmt |
| Program Services | $296,143 | ProgramServicesAmt |
| Management And General | $30,131 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,073,059 | TotalAmt |
| Program Services | $1,845,329 | ProgramServicesAmt |
| Management And General | $227,730 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $712,268 | TotalAmt |
| Program Services | $630,703 | ProgramServicesAmt |
| Management And General | $81,565 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,156,970 | TotalAmt |
| Program Services | $1,958,595 | ProgramServicesAmt |
| Management And General | $198,375 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,010 | TotalAmt |
| Program Services | $126,002 | ProgramServicesAmt |
| Management And General | $86,008 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,207 | TotalAmt |
| Program Services | $69,395 | ProgramServicesAmt |
| Management And General | $108,812 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,213 | TotalAmt |
| Program Services | $390,126 | ProgramServicesAmt |
| Management And General | $1,087 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,866 | TotalAmt |
| Program Services | $1,783 | ProgramServicesAmt |
| Management And General | $83 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,997 | TotalAmt |
| Program Services | $51,723 | ProgramServicesAmt |
| Management And General | $141,274 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,632 | TotalAmt |
| Program Services | $225,688 | ProgramServicesAmt |
| Management And General | $20,944 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,834 | TotalAmt |
| Program Services | $7,834 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $436,703 | $436,703 |
| DRUGS AND PHARMACY | $235,892 | $235,892 |
| REPAIRS & MAINTENANCE | $167,768 | $167,768 |
| PROVISIONS | $48,062 | $48,062 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,012 | TotalAmt |
| Program Services | $3,428 | ProgramServicesAmt |
| Management And General | $10,584 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,368,780 | TotalAmt |
| Program Services | $15,349,864 | ProgramServicesAmt |
| Management And General | $2,018,916 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $659,492 | BOYAmt |
| EOY | $304,681 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,031,824 | BOYAmt |
| EOY | $2,216,647 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,238 | BOYAmt |
| EOY | $6,513 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,440 | BOYAmt |
| EOY | $26,826 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,502,949 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,976,843 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,668,305 | BOYAmt |
| EOY | $3,526,106 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $209,508 | BOYAmt |
| EOY | $218,350 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,594,807 | BOYAmt |
| EOY | $6,299,123 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,180,142 | BOYAmt |
| EOY | $2,397,000 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $641,285 | BOYAmt |
| EOY | $153,470 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,901 | BOYAmt |
| EOY | $69,481 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,911,328 | BOYAmt |
| EOY | $2,619,951 | 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 | $1,831,769 | BOYAmt |
| EOY | $2,045,036 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,851,710 | BOYAmt |
| EOY | $1,634,136 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,683,479 | BOYAmt |
| EOY | $3,679,172 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,594,807 | BOYAmt |
| EOY | $6,299,123 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,395,693 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,400,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $390,000 | OtherCostOrOtherBasisAmt |
| Book Value | $390,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,265,766 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,627,922 | DepreciationAmt |
| Book Value | $2,637,844 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $460,175 | OtherCostOrOtherBasisAmt |
| Depreciation | $287,887 | DepreciationAmt |
| Book Value | $172,288 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,361,643 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,061,034 | DepreciationAmt |
| Book Value | $300,609 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,365 | OtherCostOrOtherBasisAmt |
| Book Value | $25,365 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,526,106 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CURRENT OPERATING LEASE PAYABLE | $18,430 |
| LONG TERM OPERATING LEASE PAYABLE | $51,051 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $69,481 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN EDWARDS | ||||||||||||||
| PRESIDENT AND CEO - PHC | $0 | $1,120,244 | $0 | $719,176 | $0 | $0 | $0 | $575,234 | $0 | $33,052 | $0 | $2,447,706 | $0 | $0 |
| KENNETH PRICE | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $447,564 | $0 | $245,597 | $0 | $43,769 | $0 | $432,977 | $0 | $47,297 | $0 | $1,217,204 | $0 | $43,769 |
| RONALD FARR | ||||||||||||||
| CHIEF FINANCIAL OFFICER - PART YEAR | $0 | $560,882 | $0 | $339,110 | $0 | $120,197 | $0 | $139,309 | $0 | $54,888 | $0 | $1,214,386 | $0 | $120,197 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT |
| PART I, LINE 4B | PROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THIS SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THIS SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. SERP PAYMENTS DURING THE YEAR ARE AS FOLLOWS: RONALD FARR: $120,197 KENNETH PRICE: $43,769 SUSAN EDWARDS: $0 |
| PART I, LINE 6 | PROHEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | KEVIN BARR WAS COMPENSATED $120,832 DIRECTLY BY WARBIRD CONSULTING, A MANAGEMENT COMPANY FOR SERVICES AS INTERIM CFO FOR PROHEALTH CARE, INC. AND RELATED ORGANIZATIONS. SEPARATE COMPENSATION WAS PAID TO WARBIRD BY PROHEALTH CARE INC. FOR INTERIM CFO MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | PROHEALTH CARE, INC. IS THE SOLE CORPROATE MEMBER |
| FORM 990, PART VI, SECTION A, LINE 7A | ACCORDING TO THE GOVERNING DOCUMENTS, THE BOARD OF THE FILING ORGANIZATION IS THE SAME AS THE BOARD OF THE SOLE CORPORATE MEMBER, PROHEALTH CARE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | PROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING AND CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11B | AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITTEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, WHO THEN FORMALLY APPROVED THE FORM 990, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION. |
| FORM 990, PART VI, SECTION B, LINE 15 | AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO, SENIOR EXECUTIVE TEAM MEMBERS, AND VICE-PRESIDENTS. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | AGENCY STAFFING: PROGRAM SERVICE EXPENSES 694,162. MANAGEMENT AND GENERAL EXPENSES 198,375. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 892,537. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 482,628. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 482,628. OUTSIDE PATIENT SERVICES: PROGRAM SERVICE EXPENSES 432,679. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 432,679. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 349,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,126. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER TO RELATED ORG - PROHEALTH CARE, INC. -1,400,000. |
| FORM 990, PART XII, LINE 2C | THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC | |||||||||||
| 791 SUMMIT AVENUE | OCONOMOWOC | WI | 530663844 | 390794174 | HOSPITAL | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE FOUNDATION INC | |||||||||||
| 725 AMERICAN AVE | WAUKESHA | WI | 53188 | 391314542 | CHARITABLE SUPPORT | WI | 501(C)(3) | LINE 7 | PROHEALTH CARE INC | Yes (1) | |
| NATIONAL REGENCY OF NEW BERLIN INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 391077992 | HEALTHCARE | WI | 501(C)(3) | LINE 10 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC | |||||||||||
| 725 AMERICAN AVE | WAUKESHA | WI | 53188 | 390910727 | HOSPITAL | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
| PROHEALTH CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 531881131 | 391486873 | MANAGEMENT | WI | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| PROHEALTH MEDICAL GROUP INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 391083015 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | PROHEALTH CARE INC | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| PROHEALTH ALIGNED LLC (DBA PROHEALTH CARE MORELAND SURGERY CENTER) | |||||||||
| 1111 DELAFIELD STREET STE 1 | WAUKESHA | WI | 53188 | 263324572 | SURGERY CENTER | WI | N/A | 0 | 0 |
| REHABILITATION HOSPITAL OF WISCONSIN LLC | |||||||||
| 1625 COLDWATER CREEK DRIVE | WAUKESHA | WI | 53188 | 262332250 | INPATIENT REHABILITATION | WI | N/A | 0 | 0 |
| THE ORTHOPEDIC SURGERY CENTER LLC | |||||||||
| W238 N1610 BUSSE ROAD | WAUKESHA | WI | 53188 | 208356016 | ORTHOPEDIC SURGICAL SERVICES | WI | N/A | 0 | 0 |
| PROHEALTH SOLUTIONS LLC | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 273863494 | ACCOUNTABLE CARE ORGANIZATION | WI | N/A | 0 | 0 |
| LAKE COUNTRY ENDOSCOPY CENTER | |||||||||
| 1185 CORPORATE CENTER DR | OCONOMOWOC | WI | 53066 | 261572986 | ENDOSCOPY SERVICES | WI | N/A | 0 | 0 |
| WAUKESHA IMAGING LLC | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 392036860 | RADIOLOGY SERVICES | WI | N/A | 0 | 0 |
| PHCOAW CO-MANAGEMENT COMPANY LLC | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 811823911 | MANAGEMENT SERVICES | WI | N/A | 0 | 0 |
| GI SPECIALISTS LLC (DBA MORELAND ENDOSCOPY CENTER) | |||||||||
| 1111 DELAFIELD STREET STE 1 | WAUKESHA | WI | 53188 | 205269133 | ENDOSCOPY SERVICES | WI | N/A | 0 | 0 |
| SOUTHERN LAKES ENDOSCOPY CENTER | |||||||||
| 240 MAPLE AVENUE | MUKWONAGO | WI | 53149 | 824245460 | ENDOSCOPY SERVICES | WI | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| WAUKESHA HEALTH SYSTEM INC | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 391507910 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA PACIFIC INC | |||||||||
| 31416 AGOURA RD STE 180 | WESTLAKE VILLAGE | CA | 91361 | 953070501 | HEALTHCARE | CA | N/A | C | 0 |
| NATIONAL AVENUE DEVELOPMENT CORPORATION | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 391417226 | HEALTHCARE | WI | N/A | C | 0 |
| EMPATHIA INC | |||||||||
| N17 W24100 RIVERWOOD DR SUITE 130 | WAUKESHA | WI | 53188 | 391567366 | HEALTHCARE | WI | N/A | C | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROHEALTH CARE INC | ||
| R | $1,400,000 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE FOUNDATION INC | ||
| C | $784,204 | ACTUAL AMOUNT RECEIVED |
| PROHEALTH MEDICAL GROUP INC | ||
| P | $349,126 | ACTUAL COSTS INCURRED |
| PROHEALTH CARE INC | ||
| M | $192,998 | ACTUAL COSTS INCURRED |
| PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC | ||
| P | $159,561 | ACTUAL COSTS INCURRED |
| PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| P | $159,849 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH SYSTEM INC | ||
| M | $59,259 | ACTUAL COSTS INCURRED |
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