2020-08-13T09:59:37-05:00 2019-09-30 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2018-10-01 391083015 PROHEALTH MEDICAL GROUP INC PROH 2629284740 N17 W24100 RIVERWOOD DRIVE NO 200 WAUKESHA WI 53188 RONALD J FARR CHIEF FINANCIAL OFFICER 2629284740 2020-07-28 1 DAVID LOWENTHAL P00378651 2483522500 2020-07-28 174.230.2.33 2020-07-28 08:36:49 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 852ED58CBC9AA6807749D456DA873D43AD1BF2F7 2018 2020-09-22 18:59:49Z PROHEALTH MEDICAL GROUP SUSAN EDWARDS N17 W24100 RIVERWOOD DRIVE NO 200 WAUKESHA WI 53188 150950178 0 X WWW.PROHEALTHCARE.ORG X 1965 WI SERVE THE HEALTH CARE AND HUMAN SERVICE NEEDS OF PERSONS RESIDING IN SOUTHEAST WISCONSIN AND SURROUNDING AREAS. 15 13 1147 14 431341 135760 33200 96670 153931687 146464966 944736 1667973 790141 877863 155699764 149107472 0 0 0 0 116511239 121507184 0 0 0 52796213 53531725 169307452 175038909 -13607688 -25931437 128060438 102675648 79636015 55695148 48424423 46980500 CONTINOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. 0 0 161885507 146033625 PHCMA OPERATES VARIOUS CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PHCMA FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PHCMA PROVIDED 461,401 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. 161885507 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 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 1 1 0 0 1 69 0 1 1147 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X RONALD FARR 2629284740 N17 W24100 RIVERWOOD DRIVE SUITE WAUKESHA WI 53188 SUSAN EDWARDS PRESIDENT & CEO - PHC 2.00 50.00 X X 0 8750430 41015 E JOHN RAASCH CHAIRPERSON 2.00 8.00 X X 0 0 0 MIKE ERWIN VICE CHAIRPERSON 2.00 8.00 X X 0 0 0 BETTY ARNDT SECRETARY 2.00 8.00 X X 0 0 0 JULIE SCHROEDER TREASURER 2.00 8.00 X X 0 0 0 MARK MOHR DIRECTOR 2.00 8.00 X 0 0 0 DAN MATOLA DIRECTOR 2.00 8.00 X 0 0 0 SUE BELLEHUMEUR DIRECTOR 2.00 8.00 X 0 0 0 GARY BEYER DIRECTOR 2.00 8.00 X 0 0 0 KEN RIESCH DIRECTOR 2.00 8.00 X 0 0 0 JIM GANNON DIRECTOR 2.00 8.00 X 0 0 0 RALPH RAMIREZ DIRECTOR 2.00 8.00 X 0 0 0 DAVID ROELKE DIRECTOR 2.00 8.00 X 0 0 0 JOHN HALLET DIRECTOR 2.00 8.00 X 0 0 0 EMERY HARLAN DIRECTOR 2.00 8.00 X 0 0 0 RONALD FARR CHIEF FINANCIAL OFFICER 2.00 50.00 X 0 1173201 174576 JOHN ROBERTSTAD CHIEF COMMUNITY LIAISON 2.00 46.00 X 0 703259 57803 KENNETH PRICE CHIEF OPERATING OFFICER 2.00 48.00 X 0 842770 94746 MATTHEW WEINBURG PHYSICIAN 50.00 0.00 X 916453 0 44681 KOOROUSH SAEIAN PHYSICIAN 50.00 0.00 X 823845 0 54807 MARK STOUT PHYSICIAN 50.00 0.00 X 928407 0 43858 ARTHUR COFFEY PHYSICIAN 25.00 25.00 X 592756 478219 39709 AFROZ HAI PHYSICIAN 50.00 0.00 X 779701 0 40099 JEREMY PRICE FORMER VP MED GROUP OPERATIONS 0.00 0.00 X 169798 0 0 4210960 11947879 591294 249 1 1 0 APOGEE MEDICAL MANAGEMENT 15059 N SCOTTSDALE RD STE 600 SCOTTSDALE AZ 85254 PROFESSIONAL SERVICES 5214871 GOODMAN CAMPBELL BRAIN & SP 13345 ILLINOIS STREET CARMEL IN 46032 PROFESSIONAL SERVICES 1622378 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 022417844 PROFESSIONAL SERVICES 852735 QUALINOVA CARE 700 RITTENHOUSE STREET HYATTSVILLE MD 20783 PROFESSIONAL SERVICES 671239 JOHNSON & SONS PAVING LLC PO BOX 78696 MILWAUKEE WI 532788696 CONSTRUCTION SERVICES 409634 13 96670 96670 PATIENT SERVICES 621400 136185521 135754180 431341 PHYSICIAN SUBSIDIES 621110 5292665 5292665 PHS DISTRIBUTION REVENUE 621110 2290829 2290829 RENTAL REV-AFFILIATES 532000 1620268 1620268 MEDICARE NET GEN INCENTIVE PAYMEN 621110 586484 586484 489199 489199 146464966 83382 83382 1919722 1041859 877863 877863 877863 2385438 800847 1584591 1584591 1584591 149107472 146033625 431341 2545836 100611346 97739158 2872188 3128724 3128724 12366211 12331090 35121 5400903 5228079 172824 9014888 8586228 428660 1771 925 846 681377 646852 34525 2140105 2140105 6367675 6147410 220265 88954 78429 10525 629214 565531 63683 2797774 2797774 11131908 2359965 8771943 5444238 4980478 463760 497788 497788 DRUGS 6025720 6025720 BAD DEBT 3795585 3795585 MEDICAL SUPPLIES 3613639 3613639 TAXES RELATED TO UBI 15000 0 15000 1286089 1222027 64062 175038909 161885507 13153402 0 973647 435479 7593625 9581983 2082905 1930632 90015667 32535292 61368148 57480375 6480608 6443538 49561505 26803641 128060438 102675648 14795992 18959214 3158916 2703145 15835097 0 45846010 34032789 79636015 55695148 X 48424423 46980500 48424423 46980500 128060438 102675648 X -25931437 24487514 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6152045 6152045 59656606 20169407 39487199 9543139 3338929 6204210 12387659 7811727 4575932 2276218 1215229 1060989 57480375 DEFERRED COMPENSATION/VALUATION 19610209 OTHER ASSETS 1385070 DUE FROM AFFILIATES 5808362 26803641 DEFERRED COMPENSATION 19610209 LEASE PAYABLE 14422580 34032789 X X X X 1 1 0 0 0 1 1 0 0 SUSAN EDWARDS PRESIDENT & CEO - PHC 0 968387 0 1135064 0 6646979 0 12250 0 28765 0 8791445 0 6646979 RONALD FARR CHIEF FINANCIAL OFFICER 0 504384 0 562659 0 106158 0 127432 0 47144 0 1347777 0 106158 JOHN ROBERTSTAD CHIEF COMMUNITY LIAISON 0 477369 0 225890 0 0 0 15320 0 42483 0 761062 0 0 KENNETH PRICE CHIEF OPERATING OFFICER 0 376345 0 428979 0 37446 0 55933 0 38813 0 937516 0 37446 MATTHEW WEINBURG PHYSICIAN 796918 0 119535 0 0 0 9250 0 35431 0 961134 0 0 0 KOOROUSH SAEIAN PHYSICIAN 763810 0 60035 0 0 0 12250 0 42557 0 878652 0 0 0 MARK STOUT PHYSICIAN 865907 0 62500 0 0 0 12250 0 31608 0 972265 0 0 0 ARTHUR COFFEY PHYSICIAN 592756 303015 0 151384 0 23820 0 0 1268 38441 594024 516660 0 0 AFROZ HAI PHYSICIAN 594844 0 184857 0 0 0 7849 0 32250 0 819800 0 0 0 JEREMY PRICE FORMER VP MED GROUP OPERATIONS 0 0 0 0 169798 0 0 0 0 0 169798 0 0 0 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, LINES 4A-B PART I LINE 4A: JEREMY PRICE RECEIVED SEVERENCE PAYMENTS TOTALING $169,798 DURING THE TAX YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER A FIFTY-TWO WEEK PERIOD PER THE AGREEMENT SIGNED BY THE PARTIES ON AUGUST 2, 2017. PART I LINE 4B: PROHEALTH CARE INC. (PHC) MAINTAINS TWO SUPPLEMENTAL RETIREMENT PLANS (SERPS) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THESE SERPS ARE UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLANS THAT ARE INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THESE SERPS ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. SERP PAYMENTS DURING THE YEAR ARE AS FOLLOWS: RONALD FARR: $106,158 KENNETH PRICE: $37,446 SUSAN EDWARDS' DEFERRED COMPENSATION FROM THE DB SERP PLAN HAS BEEN ACCRUED AND REPORTED PROPORTIONATELY OVER THE PAST EIGHT YEARS IN COLUMN C OF SCHEDULE J, PART II. IN THE CURRENT FISCAL 2019 PERIOD, THE DB SERP PLAN BENEFIT VESTED AND WAS PAID OUT IN CALENDAR 2018 WAGES. ACCORDINGLY, THE FEBRUARY 2018 PAYMENT OF $6,646,979 IS REPORTED IN SCHEDULE J, PART II, COLUMN B(III) AND IN COLUMN F. 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. FORM 990, PART VI, SECTION A, LINE 6 PROHEALTH CARE, INC. IS THE SOLE CORPORATE 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 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 2019. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATES 25,780,000. CHANGE IN MINIMUM PENSION LIABILITY -292,486. TRANSFER FROM AFFILIATE FOR CENTRALLY MANAGED INVESTMENTS -1,000,000. FORM 990, PART XII, LINE 2C THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. 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