2019-08-12T12:52:30-05:00 2018-09-30 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2017-10-01 391083015 PROHEALTH CARE MEDICAL ASSOCIATES INC PROH 2629284740 N17 W24100 RIVERWOOD DRIVE NO 200 WAUKESHA WI 53188 RONALD J FARR CHIEF FINANCIAL/ADMIN OFFICER 2629284740 2019-07-31 1 DAVID LOWENTHAL P00378651 2483522500 2019-07-31 67.59.56.30 2019-07-31 16:02:03 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EBB51160BF2136090E0706D858221EDFD566B897 2017 2019-02-21 02:37:17Z PROHEALTH MEDICAL GROUP SUSAN EDWARDS N17 W24100 RIVERWOOD DRIVE NO 200 WAUKESHA WI 53188 158570127 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. 13 11 1188 12 435769 178137 0 33200 139011920 153931687 485488 944736 572529 790141 140069937 155699764 0 0 0 0 108427210 116511239 0 0 0 48730501 52796213 157157711 169307452 -17087774 -13607688 90786769 128060438 71909204 79636015 18877565 48424423 CONTINOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. 0 0 158572142 153495918 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 434,936 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. 158572142 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 1 0 0 0 0 0 1 1 1 0 0 1 53 0 1 1188 1 1 1 0 0 0 0 0 0 0 0 0 X 13 11 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 1424072 861913 MARK MOHR 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 MIKE ERWIN VICE CHAIRPERSON 2.00 8.00 X X 0 0 0 E JOHN RAASCH 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 JIM GANNON DIRECTOR 2.00 8.00 X 0 0 0 SUE BELLEHUMEUR DIRECTOR 2.00 8.00 X 0 0 0 KEN RIESCH DIRECTOR 2.00 8.00 X 0 0 0 GARY BEYER DIRECTOR 2.00 8.00 X 0 0 0 JOHN HALLET DIRECTOR 2.00 8.00 X 0 0 0 DOUG HASTAD DIRECTOR - PART YEAR 2.00 8.00 X 0 0 0 RONALD FARR CHIEF FINANCIAL/ADMIN OFFICER 2.00 50.00 X 0 849926 82601 KENNETH PRICE CHIEF OPERATING OFFICER 2.00 50.00 X 0 486922 63838 JOHN DYER MEDICAL DIRECTOR - PART YEAR 40.00 0.00 X 325986 0 18548 JEREMY PRICE VP MED GROUP OPERATIONS-PART YR 40.00 0.00 X 271776 0 20236 JOHN ROBERTSTAD CHIEF COMMUNITY LIAISON 2.00 46.00 X 0 684446 62804 DAVID NIENHUIS PHYSICIAN 40.00 0.00 X 731920 0 43619 MARK STOUT PHYSICIAN 40.00 0.00 X 610000 0 43608 MATTHEW WEINBURG PHYSICIAN 40.00 0.00 X 976987 0 44431 KOOROUSH SAEIAN PHYSICIAN 40.00 0.00 X 961063 0 54557 LISA SCHMITZ PHYSICIAN 40.00 0.00 X 794508 0 42590 4672240 3445366 1338745 227 0 1 0 IRGENS 833 E MICHIGAN STREET SUITE 400 MILWAUKEE WI 53202 REAL ESTATE MGMT 2841131 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 022417844 PROFESSIONAL SERVICES 1503499 ENVIRONMENT CONTROL OF WI 2902 AGRICULTURE DRIVE MADISON WI 537186876 CLEANING SERVICES 412772 GN RESOUND PO BOX 200217 PITTSBURGH PA 152510217 AUDIOLOGY SERVICES 300400 PITZKA WRECKING INC 1007 N BEL AYR DR WAUKESHA WI 53188 DEMOILTION SERVICES 245000 15 33200 33200 PATIENT SERVICES 621400 123029460 122593691 435769 PHYSICIAN SUBSIDIES 621110 21017245 21017245 PHS DISTRIBUTION REVENUE 621110 6745964 6745964 LEASED PHYSICIANS 621110 2001462 2001462 RENTAL REV-AFFILIATES 532000 933047 933047 204509 204509 153931687 56630 56630 1240597 450456 790141 790141 790141 3308013 2419907 888106 888106 888106 155699764 153495918 435769 1734877 304720 304720 96315060 94640488 1674572 2605637 2605637 12157760 12156646 1114 5128062 4996088 131974 10160178 7333427 2826751 3596 3567 29 660748 637460 23288 2049144 131 2049013 5374082 5191262 182820 76505 76505 776288 713184 63104 2603521 1552227 1051294 13814134 11869104 1945030 4598427 4427408 171019 416272 244285 171987 DRUGS 5595188 5595188 BAD DEBT 3438202 3438202 MEDICAL SUPPLIES 1278307 1270767 7540 TAXES RELATED TO UBI 32789 32789 1918832 1820566 98266 169307452 158572142 10735310 0 1068099 973647 7496309 7593625 535017 0 654687 2082905 89231768 27863620 44046244 61368148 5748858 6480608 31237555 49561505 90786769 128060438 13642224 14795992 3643989 3158916 20442605 15835097 34180386 45846010 71909204 79636015 X 18877565 48424423 18877565 48424423 90786769 128060438 X -13607688 43154546 X X 0 1 X 1 0 X 7285045 7285045 59577975 17324630 42253345 9286105 2520054 6766051 11519847 6860741 4659106 1562796 1158195 404601 61368148 DEFERRED COMPENSATION/VALUATION 22357040 OTHER ASSETS 1569470 DUE FROM AFFILIATES 25634995 49561505 DEFERRED COMPENSATION 22357040 DUE TO AFFILIATES 23488970 45846010 X X X X 1 1 0 0 0 1 1 0 0 SUSAN EDWARDS PRESIDENT & CEO - PHC 0 922454 0 501618 0 0 0 834859 0 27054 0 2285985 0 0 RONALD FARR CHIEF FINANCIAL/ADMIN OFFICER 0 611653 0 238273 0 0 0 38627 0 43974 0 932527 0 129513 KENNETH PRICE CHIEF OPERATING OFFICER 0 326049 0 160873 0 0 0 28188 0 35650 0 550760 0 0 JOHN DYER MEDICAL DIRECTOR - PART YEAR 195755 0 0 0 130231 0 0 0 18548 0 344534 0 0 0 JEREMY PRICE VP MED GROUP OPERATIONS-PART YR 153176 0 0 0 118600 0 0 0 20236 0 292012 0 0 0 JOHN ROBERTSTAD CHIEF COMMUNITY LIAISON 0 479048 0 205398 0 0 0 21764 0 41040 0 747250 0 0 DAVID NIENHUIS PHYSICIAN 727028 0 4892 0 0 0 12000 0 31619 0 775539 0 0 0 MARK STOUT PHYSICIAN 610000 0 0 0 0 0 12000 0 31608 0 653608 0 0 0 MATTHEW WEINBURG PHYSICIAN 726018 0 250969 0 0 0 9000 0 35431 0 1021418 0 0 0 KOOROUSH SAEIAN PHYSICIAN 715482 0 245581 0 0 0 12000 0 42557 0 1015620 0 0 0 LISA SCHMITZ PHYSICIAN 674187 0 120321 0 0 0 9000 0 33590 0 837098 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: JOHN DYER RECEIVED SEVERENCE PAYMENTS TOTALING $123,528.00 DURING THE TAX YEAR. PAYMENTS ARE MADE IN BIWEEKLY INSTALLMENTS OVER A TWENTY WEEK PERIOD PER THE AGREEMENT SIGNED BY THE PARTIES ON AUGUST 21, 2017. JEREMY PRICE RECEIVED SEVERENCE PAYMENTS TOTALING $108,136.96 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: $129,513 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. MIKEY LIKES IT LLC KEN RIESCH, BOARD MEMBER, IS A >35% OWNER OF MIKEY LIKES IT, LLC 2900000 REAL ESTATE SALE 0 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 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/PRESIDENT, EXECUTIVE DIRECTOR, VICE-PRESIDENT, SENIOR VICE-PRESIDENT AND ABOVE. 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 2018. 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 33,400,000. CHANGE IN MINIMUM PENSION LIABILITY 2,064,546. TRANSFER FROM AFFILIATE FOR CENTRALLY MANAGED INVESTMENTS 7,690,000. FORM 990, PART XII, LINE 2C THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. OCONOMOWOC MEMORIAL HOSPITAL INC 791 SUMMIT AVENUE OCONOMOWOC WI 53066 390794174 HOSPITAL WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 PROHEALTH HOME CARE INC N17 W24100 RIVERWOOD DR SUITE 200 WAUKESHA WI 53188 200067392 HEALTHCARE WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 NATIONAL REGENCY OF NEW BERLIN INC N17 W24100 RIVERWOOD DR SUITE 200 WAUKESHA WI 53188 391077992 HEALTHCARE WI 501(C)(3) LINE 10 PROHEALTH CARE INC 1 WAUKESHA MEMORIAL HOSPITAL INC 725 AMERICAN AVENUE WAUKESHA WI 53188 390910727 HOSPITAL WI 501(C)(3) LINE 3 PROHEALTH CARE INC 1 PROHEALTH CARE FOUNDATION INC 725 AMERICAN AVENUE WAUKESHA WI 53188 391314542 CHARITABLE SUPPORT WI 501(C)(3) LINE 7 PROHEALTH CARE INC 1 PROHEALTH CARE INC N17 W24100 RIVERWOOD DR SUITE 200 WAUKESHA WI 53188 391486873 MANAGEMENT WI 501(C)(3) LINE 12B, II N/A 0 PROHEALTH ALIGNED LLC (DBA PROHEALTH CARE MORELAND SURGERY CENTER) 1111 DELAFIELD STREET STE 1 WAUKESHA WI 53188 263324572 SURGERY CENTER WI N/A REHABILITATION HOSPITAL OF WISCONSIN LLC 1625 COLDWATER CREEK DRIVE WAUKESHA WI 53188 262332250 INPATIENT REHABILITATION WI N/A THE ORTHOPEDIC SURGERY CENTER LLC W238 N1610 BUSSE ROAD WAUKESHA WI 53188 208356016 ORTHOPEDIC SURGICAL SERVICES WI N/A PROHEALTH SOLUTIONS LLC 2000 PEWAUKEE RD SUITE C WAUKESHA WI 53188 273863494 ACCOUNTABLE CARE ORGANIZATION WI N/A LAKE COUNTRY ENDOSCOPY CENTER 1185 CORPORATE CENTER DR OCONOMOWOC WI 53066 261572986 ENDOSCOPY SERVICES WI N/A WAUKESHA IMAGING LLC N17 W24100 RIVERWOOD DR STE 200 WAUKESHA WI 53188 392036860 RADIOLOGY SERVICES WI N/A PHCOAW CO-MANAGEMENT COMPANY LLC N17 W24100 RIVERWOOD DR STE 200 WAUKESHA WI 53188 811823911 MANAGEMENT SERVICES WI N/A GI SPECIALISTS LLC (DBA MORELAND ENDOSCOPY CENTER) 1111 DELAFIELD STREET STE 1 WAUKESHA WI 53188 205269133 ENDOSCOPY SERVICES WI N/A SOUTHERN LAKES ENDOSCOPY CENTER 240 MAPLE AVENUE MUKWONAGO WI 53149 824245460 ENDOSCOPY SERVICES WI N/A WAUKESHA HEALTH SYSTEM INC N17 W24100 RIVERWOOD DRIVE STE 200 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 DRIVE STE 200 WAUKESHA WI 53188 391417226 HEALTHCARE WI N/A C 0 EMPATHIA INC N17 W24100 RIVERWOOD DRIVE STE 200 WAUKESHA WI 53188 391567366 HEALTHCARE WI N/A C 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 WAUKESHA MEMORIAL HOSPITAL INC A 569589 ACTUAL AMOUNT RECEIVED WAUKESHA MEMORIAL HOSPITAL INC K 2082071 ACTUAL COSTS INCURRED OCONOMOWOC MEMORIAL HOSPITAL INC K 59447 ACTUAL COSTS INCURRED WAUKESHA HEALTH SYSTEM INC K 237913 ACTUAL COSTS INCURRED NATIONAL REGENCY OF NEW BERLIN INC K 504204 ACTUAL COSTS INCURRED PROHEALTH CARE INC M 11438057 ACTUAL COSTS INCURRED PROHEALTH SOLUTIONS LLC M 529202 ACTUAL COSTS INCURRED WAUKESHA MEMORIAL HOSPITAL INC P 4839118 ACTUAL COSTS INCURRED WAUKESHA MEMORIAL HOSPITAL INC Q 17932154 ACTUAL AMOUNT RECEIVED OCONOMOWOC MEMORIAL HOSPITAL INC Q 3147001 ACTUAL AMOUNT RECEIVED WAUKESHA HEALTH SYSTEM INC Q 82715 ACTUAL AMOUNT RECEIVED PROHEALTH HOME CARE INC Q 202829 ACTUAL AMOUNT RECEIVED PROHEALTH CARE INC P 114972 ACTUAL COSTS INCURRED PROHEALTH SOLUTIONS LLC L 6745964 ACTUAL AMOUNT RECEIVED PROHEALTH CARE INC S 28140000 ACTUAL AMOUNT RECEIVED OCONOMOWOC MEMORIAL HOSPITAL INC A 355661 ACTUAL AMOUNT RECEIVED LAKE COUNTRY ENDOSCOPY CENTER A 54225 ACTUAL AMOUNT RECEIVED WAUKESHA HEALTH SYSTEM INC A 16715 ACTUAL AMOUNT RECEIVED