AFFINITY HEALTH SYSTEM: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- AFFINITY HEALTH SYSTEM (EIN 39-1568866)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-11
- IRS object ID
- 201831319349302373
- Schema version
- 2016v3.0
- 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 | 2018-05-11T12:01:28-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391568866 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Affinity Health System | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AFFI | BusinessNameControlTxt |
| Phone | 3147338000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 S ONEIDA STREET | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54915 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tonya Mershon | PersonNm |
| Person Title | Tax Officer | PersonTitleTxt |
| Signature | 2017-10-24 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bernard Sherry | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 W River Woods Parkway | AddressLine1Txt |
| City | Glendale | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,437,383 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.affinityhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 165 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $130 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,711,636 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,186,825 | CYProgramServiceRevenueAmt |
| PY Investment Income | $311,247 | PYInvestmentIncomeAmt |
| CY Investment Income | $183,561 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,173 | PYOtherRevenueAmt |
| CY Other Revenue | $3,556 | CYOtherRevenueAmt |
| PY Total Revenue | $18,024,186 | PYTotalRevenueAmt |
| CY Total Revenue | $9,373,942 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,501,179 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,516,653 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,411,660 | PYOtherExpensesAmt |
| CY Other Expenses | $7,678,188 | CYOtherExpensesAmt |
| PY Total Expenses | $17,912,839 | PYTotalExpensesAmt |
| CY Total Expenses | $9,194,841 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $111,347 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $179,101 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,295,873 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,577,427 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,660,099 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $243,635 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,635,774 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,333,792 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $109,524 | ExpenseAmt |
| Revenue | $9,190,381 | RevenueAmt |
| Desc | THE ENTITY BELIEVES IN MEETING THE HEALTHCARE NEEDS OF THE POOR, INDIGENT, AND UNDERSERVED. CARE IS PROVIDED TO THE PATIENTS WITHOUT REGARDS FOR ABILITY TO PAY. THE ENTITY PROVIDES ADMINISTRATIVE SUPPORT TO THREE HOSPITALS, AND 26 CLINIC LOCATIONS. THE ENTITY ALSO PROVIDES: FREE NEWSLETTERS FOCUSING ON WOMEN'S HEALTH ISSUES, CHILDREN'S HEALTH, AND SAFETY ISSUES HEALTH; INFORMATION SPOTS ON TELEVISION AND RADIO CLASSES ON A VARIETY OF HEALTH RELATED TOPICS INCLUDING PREGNANCY AND CHILD REARING. | Desc |
| Total Program Service Expenses | $109,524 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 165 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Mannes | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4144654571 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 W River Woods Parkway | AddressLine1Txt |
| City | Glendale | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| JOHN RUSSO | ||||||||||
| CHAIRMAN | 0.4 | 1.4 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| WAYNE WIETING | ||||||||||
| VICE-CHAIRMAN | 0.4 | 1.4 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARK W FAUSTICH MD | ||||||||||
| SECRETARY | 0.4 | 41.0 | Yes (X) | Yes (X) | $0 | $464,782 | $33,026 | |||
| BRIAN WALLACE | ||||||||||
| TREASURER | 0.4 | 1.4 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LANE EARNS | ||||||||||
| BOARD MEMBER | 0.4 | 1.4 | Yes (X) | $0 | $0 | $0 | ||||
| MARLIN GREENFIELD | ||||||||||
| BOARD MEMBER | 0.4 | 1.4 | Yes (X) | $0 | $0 | $0 | ||||
| MARK KEHRBERG MD | ||||||||||
| BOARD MEMBER | 0.4 | 1.6 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN RALOFSKY | ||||||||||
| BOARD MEMBER | 0.4 | 1.1 | Yes (X) | $0 | $0 | $0 | ||||
| KATHRYN SIEMAN | ||||||||||
| BOARD MEMBER | 0.4 | 1.4 | Yes (X) | $0 | $0 | $0 | ||||
| SUDEEP S SODHI MD | ||||||||||
| BOARD MEMBER | 0.4 | 41.0 | Yes (X) | $0 | $969,587 | $48,890 | ||||
| MONICA VOMASTIC | ||||||||||
| BOARD MEMBER | 0.4 | 1.4 | Yes (X) | $0 | $0 | $0 | ||||
| WENDY SCHROEDER DO | ||||||||||
| BOARD MEMBER | 0.4 | 41.0 | Yes (X) | $0 | $331,895 | $49,240 | ||||
| DANIEL E NEUFELDER | ||||||||||
| SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) | 0.4 | 39.1 | Yes (X) | $0 | $1,825,757 | $28,416 | ||||
| GARY KUSNIERZ | ||||||||||
| VP PERFORMANCE EXCELLENCE | 40.0 | 0.3 | $0 | $264,324 | $30,426 | Yes (X) | ||||
| JESSICA F CZAJA | ||||||||||
| Dir Finance | 40.0 | 0 | $110,246 | $0 | $27,469 | Yes (X) | ||||
| MIKE C PERRY | ||||||||||
| Manager, Value Stream | 40.0 | 0 | $114,501 | $0 | $12,426 | Yes (X) | ||||
| KAREN I SCHAEFER | ||||||||||
| Lean Education Dir | 40.0 | 0 | $119,676 | $0 | $12,775 | Yes (X) | ||||
| RUSSELL D SESTO | ||||||||||
| Physician Relations System Dir | 40.0 | 0 | $122,705 | $0 | $20,245 | Yes (X) | ||||
| JOSEPH D VANEVANHOVEN | ||||||||||
| Manager, Value Stream | 40.0 | 0 | $124,354 | $0 | $37,621 | Yes (X) | ||||
| NICHOLAS DESIEN | ||||||||||
| FORMER OFFICER (END 12/2015) | 0.0 | 0.0 | $0 | $2,710,823 | $443 | Yes (X) | ||||
| JEFFREY FRANCIS | ||||||||||
| FORMER OFFICER (END 9/2015) | 0.0 | 0.0 | $0 | $225,000 | $0 | Yes (X) | ||||
| MONICA A HILT | ||||||||||
| FORMER OFFICER (END 12/2015) | 0.0 | 40.0 | $0 | $732,037 | $40,775 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $591,482 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,524,205 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $341,752 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Services to Affiliates | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $9,186,825 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,186,825 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,186,825 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $246,692 | TotalRevenueColumnAmt |
| Exclusion | $246,692 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $310 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $63,441 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$63,131 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$63,131 | TotalRevenueColumnAmt |
| Exclusion | -$63,131 | ExclusionAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Exclusion | $0 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous Revenue | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $3,556 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,556 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,556 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,373,942 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,190,381 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $183,561 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,635,431 | TotalAmt |
| Program Services | $75,734 | ProgramServicesAmt |
| Management And General | $1,559,697 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$615,904 | TotalAmt |
| Program Services | -$28,521 | ProgramServicesAmt |
| Management And General | -$587,383 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,426 | TotalAmt |
| Program Services | $17,478 | ProgramServicesAmt |
| Management And General | $359,948 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,700 | TotalAmt |
| Program Services | $5,543 | ProgramServicesAmt |
| Management And General | $114,157 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,650 | TotalAmt |
| Management And General | $1,650 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $424,726 | TotalAmt |
| Program Services | $2,278 | ProgramServicesAmt |
| Management And General | $422,448 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,463 | TotalAmt |
| Program Services | $3,070 | ProgramServicesAmt |
| Management And General | $11,393 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89 | TotalAmt |
| Management And General | $89 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,047,210 | TotalAmt |
| Program Services | $19,492 | ProgramServicesAmt |
| Management And General | $7,027,718 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Non Recurring Expenses | $169,192 | $169,192 | |
| Medical Supplies | $13,251 | $13,251 | |
| Purchased Services | $6,295 | $5,607 | $688 |
| Miscellaneous Expenses | $1,312 | $801 | $511 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,194,841 | TotalAmt |
| Program Services | $109,524 | ProgramServicesAmt |
| Management And General | $9,085,317 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100 | BOYAmt |
| EOY | $1,009 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,091,958 | BOYAmt |
| EOY | $4,946,473 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,462,555 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $748 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,661,295 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,929,580 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,559,968 | BOYAmt |
| EOY | $2,731,715 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,910,520 | BOYAmt |
| EOY | $599,807 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,270,772 | BOYAmt |
| EOY | $297,675 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,295,873 | BOYAmt |
| EOY | $8,577,427 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $982,565 | BOYAmt |
| EOY | $38,305 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,677,534 | BOYAmt |
| EOY | $205,330 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,660,099 | BOYAmt |
| EOY | $243,635 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,635,774 | BOYAmt |
| EOY | $8,333,792 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,635,774 | BOYAmt |
| EOY | $8,333,792 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,295,873 | BOYAmt |
| EOY | $8,577,427 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $179,101 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $10,238,831 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$14,719,914 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 6 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (6 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||||
| 390806268 | 3 | Yes (true) | $0 | $0 |
| MERCY HEALTH FOUNDATION INC | ||||
| 237140261 | 9 | Yes (true) | $0 | $0 |
| ST ELIZABETH HOSPITAL INC | ||||
| 390816818 | 3 | Yes (true) | $0 | $0 |
| ST ELIZABETH HOSPITAL FOUNDATION INC | ||||
| 391256677 | 7 | Yes (true) | $0 | $0 |
| NETWORK HEALTH SYSTEM INC | ||||
| 391127163 | 3 | Yes (true) | $0 | $0 |
| ASCENSION CALUMET HOSPITAL INC | ||||
| 390905385 | 3 | Yes (true) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 6 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | false | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 30 MONETARY SUPPORT PROVIDED TO SUPPORTED ORGANIZATIONS | AFFINITY HEALTH SYSTEM, INC. SUPPORTS THE PROVISION OF HEALTHCARE SERVICES AT THE CORPORATIONS TO WHICH IT IS A MEMBER THROUGH THE PROVISION OF CENTRALIZED ADMINISTRATIVE SUPPORT INCLUDING REVENUE CYCLE, ADMINISTRATIVE COSTS, COMPLIANCE/CORPORATE INTEGRITY, TELECOMMUNICATIONS, BUSINESS SERVICES, HUMAN RESOURCES AND MARKETING. COSTS OF CERTAIN OF THESE DEPARTMENTS ARE CHARGED TO THE MEMBERS THROUGH A MANAGEMENT FEE. TRANSACTIONS WITH EACH MEMBER ARE DELINEATED ON SCHEDULE R. |
| Schedule A, Part IV, Section C, Line 1 Majority director detail | ALL OF THE ORGANIZATION'S DIRECTORS OR TRUSTEES ARE APPOINTED BY ASCENSION HEALTH. ASCENSION HEALTH IS ORGANIZED AND AT ALL TIMES SHALL BE OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL IN THE UNITED STATES, ST. LOUISE PROVINCE, THE CONGREGATION OF ST. JOSEPH, THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET, THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE - AMERICAN PROVINCE AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE BY AND THROUGH ASCENSION SPONSOR. ASCENSION SPONSOR IS THE CANONICAL SPONSOR WHICH WAS FORMED BY THE FOUNDING SPONSORS AND WHICH HAS BEEN CONFERRED PUBLIC JURIDIC PERSONALITY BY DECREE OF THE CONGREGATION FOR INSTITUTES OF CONSECRATED LIFE AND SOCIETIES OF APOSTOLIC LIFE OF THE ROMAN CATHOLIC CHURCH. DUE TO THE FACT THAT BOTH THE SUPPORTED ORGANIZATION(S) AND THE SUPPORTING ORGANIZATION ARE UNDER THE CONTROL OF ASCENSION HEALTH, THE CONTROL AND MANAGEMENT OF THE SUPPORTING ORGANIZATION WAS VESTED IN THE SAME PERSONS THAT CONTROLLED OR MANAGED THE SUPPORTED ORGANIZATON(S). |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,583,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $782,191 | DepreciationAmt |
| Book Value | $801,240 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,077,864 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,147,389 | DepreciationAmt |
| Book Value | $1,930,475 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,731,715 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| 457B Plan Liability | |
| AH Savings Plan | |
| Payable to Affiliates | |
| Other Misc Liabilities | |
| Due to Affiliates | $205,420 |
| Savings Plan Liability | -$90 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $205,330 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK W FAUSTICH MD | ||||||||||||||
| SECRETARY | $0 | $452,697 | $0 | $5,000 | $0 | $7,085 | $0 | $17,225 | $0 | $15,801 | $0 | $497,808 | $0 | $0 |
| SUDEEP S SODHI MD | ||||||||||||||
| BOARD MEMBER | $0 | $961,795 | $0 | $0 | $0 | $7,792 | $0 | $17,225 | $0 | $31,665 | $0 | $1,018,477 | $0 | $0 |
| WENDY SCHROEDER DO | ||||||||||||||
| BOARD MEMBER | $0 | $328,887 | $0 | $2,000 | $0 | $1,008 | $0 | $14,575 | $0 | $34,665 | $0 | $381,135 | $0 | $0 |
| NICHOLAS DESIEN | ||||||||||||||
| FORMER OFFICER (END 12/2015) | $0 | $190,823 | $0 | $0 | $0 | $2,520,000 | $0 | $443 | $0 | $0 | $0 | $2,711,266 | $0 | $0 |
| JEFFREY FRANCIS | ||||||||||||||
| FORMER OFFICER (END 9/2015) | $0 | $0 | $0 | $0 | $0 | $225,000 | $0 | $0 | $0 | $0 | $0 | $225,000 | $0 | $0 |
| MONICA A HILT | ||||||||||||||
| FORMER OFFICER (END 12/2015) | $0 | $493,948 | $0 | $231,779 | $0 | $6,310 | $0 | $17,225 | $0 | $23,550 | $0 | $772,812 | $0 | $0 |
| DANIEL E NEUFELDER | ||||||||||||||
| SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) | $0 | $861,918 | $0 | $713,099 | $0 | $250,740 | $0 | $15,900 | $0 | $12,516 | $0 | $1,854,173 | $0 | $0 |
| GARY KUSNIERZ | ||||||||||||||
| VP PERFORMANCE EXCELLENCE | $0 | $218,417 | $0 | $41,677 | $0 | $4,230 | $0 | $15,720 | $0 | $14,706 | $0 | $294,750 | $0 | $0 |
| JOSEPH D VANEVANHOVEN | ||||||||||||||
| Manager, Value Stream | $113,891 | $0 | $0 | $0 | $10,463 | $0 | $6,847 | $0 | $30,774 | $0 | $161,975 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Travel for companions | Business travel expenses for spouses of executives and golf club memberships for executives are reimbursed as part of their executive flex credit account. Receipts are provided to the Sr. Administrative Assistant in HR who reviews for accuracy and completes a reimbursement form with substantiation to payroll for reimbursement. These reimbursements are taxable, and when added to the compensation package taken as a whole have been included when compared to the compensation studies. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF AFFINITY HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individual(s) received severance payments from the organization or a related organization: Nicholas Desien - $2,520,000 Jeffrey Francis - $225,000 Daniel Neufelder - $234,000 Karen Schaefer - $53,750 Russell Sesto - $34,208 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No individuals received current year distributions. |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | CASH ACCOUNT TRANSFERRED TO PARENT'S BALANCE SHEET | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2017-06-30 | DistributionDt |
| Fair Market Value Of Asset | $5,351,179 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | FMV | MethodOfFMVDeterminationTxt |
| EIN | 453358926 | EIN |
| Person | ASCENSION HEALTH ALLIANCE | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 45998 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63145 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | false | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | false | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule N, Part II CASH TRANSFER | FormAndLineReferenceDesc |
| Explanation | AFFINITY HEALTH SYSTEM, INC. TRANSFERRED ITS CASH BALANCE TO ASCENSION HEALTH ALLIANCE (45-3358926) DURING FISCAL YEAR ENDED 6/30/2017. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF AFFINITY HEALTH SYSTEM. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES | THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF AFFINITY HEALTH SYSTEM. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Affinity Health System, Inc. has a single corporate member, Ministry Health Care, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Affinity Health System, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Affinity Health System, Inc. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to Affinity Health System, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Line 19 Required documents available to the public | The Organization will provide any documents open to public inspection upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Transfer with Affliates - -9368735; Net Transfer to/from Alpha - -5351179; |
| Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS | The activity of AFFINITY HEALTH SYSTEM, INC. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of AFFINITY HEALTH SYSTEM, INC. is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of AFFINITY HEALTH SYSTEM, INC. |
| Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant | AFFINITY HEALTH SYSTEM, INC. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (52 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 | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH | MO | 501(c)(3) | Type I | NA | false | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH | MO | 501(c)(3) | Type I | ASCENSION HEALTH ALLIANCE | false | |
| COLUMBIA ST MARY'S INC | |||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | GLENDALE | WI | 53212 | 391834639 | PARENT CORPORATION | WI | 501(c)(3) | Type I | ASCENSION HEALTH | false | |
| MINISTRY HEALTH CARE INC | |||||||||||
| 10925 W LAKE PARK DR STE 100 | MILWAUKEE | WI | 53224 | 391490371 | PARENT CORPORATION | WI | 501(c)(3) | Type II | ASCENSION HEALTH | false | |
| WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | |||||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391568865 | PARENT CORPORATION | IL | 501(c)(3) | Type III-FI | ASCENSION HEALTH | false | |
| COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | |||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | GLENDALE | WI | 53212 | 390806315 | HOSPITAL | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | Yes (true) | |
| COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC | |||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | GLENDALE | WI | 53212 | 390807063 | HOSPITAL | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | Yes (true) | |
| SACRED HEART REHABILITATION INSTITUTE INC | |||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | GLENDALE | WI | 53212 | 390902199 | REHAB SERVICES | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | Yes (true) | |
| AGAPE COMMUNITY CENTER OF MILWAUKEE INC | |||||||||||
| 6100 NORTH 42ND STREET | MILWAUKEE | WI | 53209 | 391461846 | COMMUNITY CENTER | WI | 501(c)(3) | 7 | MINISTRY HEALTH CARE INC | Yes (true) | |
| ASCENSION EAGLE RIVER MEMORIAL HOSPITAL INC FKA EAGLE RIVER MEMORIAL HOSPIT | |||||||||||
| 201 HOSPITAL ROAD | EAGLE RIVER | WI | 54521 | 390985690 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | AL INC |
| ASCENSION GOOD SAMARITAN HOSPITAL INC FKA GOOD SAMARITAN HEALTH CENTER OF M | |||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 390808503 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | ERRILL WI INC |
| ASCENSION OUR LADY OF VICTORY HOSPITAL INC FKA OUR LADY OF VICTORY HOSPITAL | |||||||||||
| 1120 PINE STREET | STANLEY | WI | 54768 | 390807065 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | INC |
| ASCENSION SACRED HEART-STMARY'S HOSPITALS INC FKA SACRED HEART-SAINT MARY'S | |||||||||||
| PO BOX 347 | STEVENS POINT | WI | 54481 | 391390638 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | HOSPITALS INC |
| ASCENSION ST CLARE'S HOSPITAL INC FKA SAINT CLARE'S HOSPITAL OF WESTON INC | |||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 721531917 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| ASCENSION ST MICHAEL'S HOSPITAL INC FKA SAINT MICHAEL'S HOSPITAL OF STEVENS | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 390808443 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | POINT INC |
| HOWARD YOUNG HEALTH CARE INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391499115 | HOME OFFICE | WI | 501(c)(3) | Type II | MINISTRY HEALTH CARE INC | Yes (true) | |
| MERCY MEDICAL CENTER OF OSHKOSH INC | |||||||||||
| 500 S OAKWOOD ROAD | OSHKOSH | WI | 54904 | 390806268 | HOSPITAL | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| MINISTRY MEDICAL GROUP INC | |||||||||||
| 824 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391965593 | MEDICAL GROUP | WI | 501(c)(3) | Type III-FI | MINISTRY HEALTH CARE INC | Yes (true) | |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA INC | |||||||||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | 410693877 | MEDICAL GROUP | MN | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | |||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391847631 | MEDICAL GROUP | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| ST ELIZABETH HOSPITAL INC | |||||||||||
| 1506 S ONEIDA STREET | APPLETON | WI | 54915 | 390816818 | MEDICAL GROUP | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| THE HOWARD YOUNG MEDICAL CENTER INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 390873606 | MEDICAL GROUP | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| DOOR COUNTY MEMORIAL HOSPITAL INC | |||||||||||
| 323 SOUTH 18TH AVENUE | STURGEON BAY | WI | 54235 | 390806324 | MEDICAL GROUP | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| ASCENSION CALUMET HOSPITAL INC FKA CALUMET MEDICAL CENTER INC | |||||||||||
| 614 MEMORIAL DRIVE | CHILTON | WI | 53014 | 390905385 | MEDICAL GROUP | WI | 501(c)(3) | 3 | MINISTRY HEALTH CARE INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC | |||||||||||
| 3801 SPRING STREET | RACINE | WI | 53405 | 391264986 | MEDICAL GROUP | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC | |||||||||||
| 10101 SOUTH 27TH STREET | FRANKLIN | WI | 53132 | 562592868 | MEDICAL GROUP | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - PHARMACY ENTERPRISES & FRANCISCAN WOODS INC | |||||||||||
| 19525 WEST NORTH AVENUE | BROOKFIELD | WI | 53005 | 391613624 | MEDICAL GROUP | WI | 501(c)(3) | 10 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS INC | |||||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 390907740 | MEDICAL GROUP | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN LABORATORIES INC | |||||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 391701402 | MEDICAL GROUP | WI | 501(c)(3) | 10 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN MEDICAL GROUP INC | |||||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391791586 | MEDICAL GROUP | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN INC | |||||||||||
| 5000 WEST CHAMBERS STREET | MILWAUKEE | WI | 53210 | 390816857 | HOSPITAL | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| WHEATON FRANCISCAN HOME HEALTH & HOSPICE INC | |||||||||||
| 3070 North 51st Street Suite 406 | MILWAUKEE | WI | 53210 | 391559428 | HOME HEALTH | WI | 501(c)(3) | 10 | WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC | Yes (true) | |
| CATALPA HEALTH INC | |||||||||||
| N4642 COUNTY N | APPLETON | WI | 54914 | 454681563 | BEHAVIORAL HEALTH SERVICES | WI | 501(c)(3) | 3 | AFFINITY HEALTH SYSTEM | Yes (true) | |
| MERCY HEALTH FOUNDATION INC | |||||||||||
| PO BOX 3370 | OSHKOSH | WI | 54903 | 237140261 | FOUNDATION | WI | 501(c)(3) | 10 | AFFINITY HEALTH SYSTEM | Yes (true) | |
| NETWORK HEALTH SYSTEM INC | |||||||||||
| 1570 APPLETON RD | MENASHA | WI | 54952 | 391127163 | CLINICAL HEALTHCARE SERVICES | WI | 501(c)(3) | 3 | AFFINITY HEALTH SYSTEM | Yes (true) | |
| ST ELIZABETH HOSPITAL FOUNDATION INC | |||||||||||
| 1506 S ONEIDA STREET | APPLETON | WI | 54915 | 391256677 | FOUNDATION | WI | 501(c)(3) | 7 | AFFINITY HEALTH SYSTEM | Yes (true) | |
| GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC | |||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 391627755 | FOUNDATION | WI | 501(c)(3) | Type I | ASCENSION GOOD SAMARITAN HOSPITAL INC | Yes (true) | |
| MINISTRY WEIGHT MANAGEMENT INC | |||||||||||
| 2251 NORTH SHORE DRIVE | RHINELANDER | WI | 54501 | 391829015 | SPECIALTY HEALTH SERVICES | WI | 501(c)(3) | 3 | ASCENSION SACRED HEART - STMARY'S HOSPITALS INC | Yes (true) | |
| FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC | |||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 753193633 | FOUNDATION | WI | 501(c)(3) | Type I | ASCENSION ST CLARE'S HOSPITAL INC | Yes (true) | |
| SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391657410 | Foundation | WI | 501(c)(3) | Type I | ASCENSION ST MICHAEL'S HOSPITAL INC | Yes (true) | |
| COLUMBIA COLLEGE OF NURSING INC | |||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | GLENDALE | WI | 53212 | 391596986 | COLLEGE | WI | 501(c)(3) | 2 | COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | Yes (true) | |
| DR KATE NEWCOMB CONVALESCENT CENTER INC | |||||||||||
| PO BOX 829 | WOODRUFF | WI | 54568 | 391357365 | NURSING/ASSISTED LIVING SERVICES | WI | 501(c)(3) | 10 | HOWARD YOUNG HEALTH CARE INC | Yes (true) | |
| FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | |||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391684957 | FOUNDATION | WI | 501(c)(3) | Type I | SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | Yes (true) | |
| VOLUNTEERS IN PARTNERSHIP WITH WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS I | |||||||||||
| 3807 SPRING STREET | RACINE | WI | 53405 | 930838390 | FOUNDATION | WI | 501(c)(3) | 10 | WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC | Yes (true) | NC |
| WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS FOUNDATION INC | |||||||||||
| 3805B SPRING STREET | RACINE | WI | 53405 | 391570877 | FOUNDATION | WI | 501(c)(3) | 7 | WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - CIRCLE OF LIFE FOUNDATION INC | |||||||||||
| 4300 WEST BROWN DEER RD STE 2 | BROWN DEER | WI | 53223 | 562426294 | FOUNDATION | WI | 501(c)(3) | Type I | WHEATON FRANCISCAN HEALTHCARE - PHARMACY ENTERPRISES & FRANCISCAN WOODS INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - FOUNDATION FOR ST FRANCIS AND FRANKLIN INC | |||||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 320135258 | FOUNDATION | WI | 501(c)(3) | Type I | WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS INC | Yes (true) | |
| METRO PHYSICIANS INC | |||||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 943436893 | MEDICAL GROUP | WI | 501(c)(3) | 3 | WHEATON FRANCISCAN MEDICAL GROUP | Yes (true) | |
| WHEATON FRANCISCAN - ELMBROOK MEMORIAL FOUNDATION INC | |||||||||||
| 3237 SOUTH 16TH STREET | MILWAUKEE | WI | 53215 | 392028808 | FOUNDATION | WI | 501(c)(3) | Type I | WHEATON FRANCISCANL INC | Yes (true) | |
| WHEATON FRANCISCAN - ST JOSEPH FOUNDATION INC | |||||||||||
| 5000 WEST CHAMBERS STREET | MILWAUKEE | WI | 53210 | 391636804 | FOUNDATION | WI | 501(c)(3) | Type I | WHEATON FRANCISCANL INC | Yes (true) | |
| WHEATON FRANCISCAN HEALTHCARE - ELMBROOK MEMORIAL AUXILIARY | |||||||||||
| 19333 WEST NORTH AVENUE | BROOKFIELD | WI | 53045 | 396068950 | AUXILIARY | WI | 501(c)(3) | Type III-FI | WHEATON FRANCISCANL INC | Yes (true) | |
| HORIZON HOME CARE & HOSPICE INC | |||||||||||
| 8949 N DEERBROOK TRL | BROWN DEER | WI | 53223 | 391171298 | HOME CARE / HOSPICE | WI | 501(c)(3) | 3 | NA | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TWINMED LLP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 W COLLEGE AVE SUITE 3B | AddressLine1Txt |
| City | APPLETON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54911 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391180341 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| PROSPECT MEDICAL COMMONS CONDOMINIUM ASSOCIATION INC | |||||||||
| 4425 N PORT WASHINGTON RD | GLENDALE | WI | 53212 | 208042108 | CONDO ASSOCIATION | WI | NA | C Corporation | Yes (true) |
| FRANKLIN MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 341983857 | CONDO ASSOCIATION | WI | NA | C Corporation | Yes (true) |
| WHEATON FRANCISCAN HOLDINGS INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391836357 | HOLDING CO | WI | NA | C Corporation | Yes (true) |
| WHEATON FRANCISCAN PROVIDER NETWORK INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391952140 | PROVIDER CONTRACT | WI | NA | C Corporation | Yes (true) |
| MADISON MEDICAL AFFILIATES INC | |||||||||
| 4425 N PORT WASHINGTON RD | GLENDALE | WI | 53212 | 391855720 | HEALTHCARE | WI | NA | C Corporation | Yes (true) |
| WHEATON WAY CONDOMINIUM OWNERS ASSOCIATION INC | |||||||||
| 10101 SOUTH 27TH STREET | FRANKLIN | WI | 53123 | 300659830 | CONDO ASSOCIATION | WI | NA | C Corporation | Yes (true) |
| WHEATON FRANCISCAN ENTERPRISES INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391985204 | HOLDING CO | WI | NA | C Corporation | Yes (true) |
| WHEATON FRANCISCAN MEDICAL GROUP - SUSSEX INC | |||||||||
| 400 WEST RIVER WOODS PARKWAY | GLENDALE | WI | 53212 | 391361100 | HEALTHCARE | WI | NA | C Corporation | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASCENSION ST CLARE'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $67,926 | InvolvedAmt |
| Method Of Amount Determination | FAIR MARKET VALUE | MethodOfAmountDeterminationTxt |
Comments