2017-05-01T15:42:47-05:00 2016-06-30 391173131 SCHENCK SC 200 E WASHINGTON ST PO BOX 1739 APPLETON WI 549121739 990 2015-07-01 473298660 MOSAIC FAMILY HEALTH INC MOSA 9208322783 229 S MORRISON STREET APPLETON WI 54911 KRISTINA SMITH TREASURER 9208322783 2017-04-25 MIKE VANDEN HOGEN P00499282 9207318111 2015 2021-01-29 14:40:06Z LEE VOGEL MD 229 S MORRISON STREET APPLETON WI 54911 7274800 0 X WWW.MOSAICFAMILYHEALTH.ORG X 2015 WI OPERATE A MEDICAL CLINIC AND FAMILY MEDICINE RESIDENCY PROGRAM. 6 6 47 6 0 0 0 5091025 0 2183775 0 0 0 0 0 7274800 0 0 0 0 0 5067492 0 0 0 0 1616508 0 6684000 0 590800 0 916381 0 325581 0 590800 X CARING FOR PATIENTS, DISCOVERING KNOWLEDGE, TEACHING PHYSICIANS, AND SERVING THE COMMUNITY. 0 0 6074179 2183775 IN OUR FIRST YEAR OF MOSAIC FAMILY HEALTH WE MET MANY GOALS CENTERING AROUND OUR MISSION OF: CARING FOR PATIENTS, DISCOVERING KNOWLEDGE, TEACHING PHYSICIANS, AND SERVING THE COMMUNITY. WE CONTINUE TO HOUSE AND TRAIN 21 FAMILY MEDICINE RESIDENTS. WE GRADUATED 6 RESIDENTS IN JUNE 2016 AND ADDED 7 NEW ONES. WE PROVIDED 20,000 APPOINTMENTS TO PATIENTS BETWEEN PHYSICIAN, LAB, X-RAY, PSYCHOLOGY AND NURSING VISITS. WE CONTINUE TO SERVE SOME OF THE MOST VULNERABLE PATIENTS IN OUR COMMUNITY AND ARE ABLE TO HELP THEM MEET MANY OF THEIR BASIC NEEDS WITH ASSISTANCE FROM OUR IN-HOUSE CARE MANAGER. IN OCTOBER OF 2015 WE HIRED A SOCIAL WORKER WHO WAS TRAINED BY THE ROSALYNN CARTER INSTITUTE TO PROVIDE CASE MANAGEMENT FOR CAREGIVERS OF PEOPLE WITH DEMENTIA. THIS IS A 2 YEAR GRANT THAT WE HOPE WE WILL BE ABLE TO SUSTAIN TO HELP OUR AGING COMMUNITY. OUR FACULTY PHYSICIANS CONTINUE TO GROW IN THEIR KNOWLEDGE AND PRESENT AT MANY NATIONAL CONFERENCES THROUGHOUT THE YEAR PLUS CONTINUE TO DO LOCAL EVENTS. 6074179 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 47 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 X SHELLY WELHOUSE 9208322783 229 S MORRISON STREET APPLETON WI 54911 KRISTINA SMITH DIRECTOR, TREASURER 2.00 X X 0 0 0 KATIE BALL DIRECTOR 1.00 X 0 0 0 GREGORY LONG MD DIRECTOR 2.00 X 0 0 0 NORMA TURK MD DIRECTOR 1.00 X 0 0 0 LAWRENCE DONATELLE MD DIRECTOR 2.00 X 0 0 0 MONICA HILT DIRECTOR 1.00 X 0 0 0 LEE VOGEL MD EXECUTIVE DIRECTOR 65.00 X 92413 0 18483 ALLEN R LAST MD SECRETARY 55.00 X 92437 0 18487 184850 0 36970 0 0 0 0 MEDICAL COLLEGE OF WISCONSIN AFFILIATED 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 RESIDENT COMP. AND ASSESSMENTS 863682 MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 FACULTY COMP. AND ASSESSMENTS 660713 2 5051025 40000 242133 5091025 PATIENT SERVICES 621111 2078775 2078775 MEDICAL DIRECTOR & PRO 623110 105000 105000 2183775 7274800 2183775 0 0 152512 93997 58515 4083499 3957178 126321 167845 155469 12376 448211 431082 17129 215425 199541 15884 153660 153660 101847 101847 35394 35394 290339 131606 158733 73131 73131 92940 88315 4625 90881 90881 117320 111454 5866 34560 34560 51953 51953 114677 114677 MEDICAL SUPPLIES 221581 221581 MAINTENANCE AND REPAIRS 121576 121576 DUES AND SUBSCRIPTIONS 41480 41480 RECRUITMENT EXPENSES 32246 32246 42923 42923 6684000 6074179 609821 0 301310 40000 306445 36217 284362 51953 0 232409 0 916381 325581 0 325581 X 550800 40000 0 590800 0 916381 590800 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 267362 48970 218392 17000 2983 14017 232409 X COMPUTER EQUIPMENT 1 242133 0 0 0 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTIONS REPRESENTS THE NUMBER OF DONORS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS, TO APPROVE THE APPOINTMENT OF AND REMOVAL OF THE EXECUTIVE DIRECTOR, TO APPROVE AMENDMENTS TO THE ORGANIZATIONS GOVERNING DOCUMENTS, AND APPROVE OTHER ACTIONS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION HAS 2 CORPORATE MEMBERS. THE CORPORATE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE DIRECTORS AND DETERMINE THE NUMBER OF DIRECTORS, TO APPROVE THE APPOINTMENT OF AND REMOVAL OF THE EXECUTIVE DIRECTOR, TO APPROVE AMENDMENTS TO THE ORGANIZATIONS GOVERNING DOCUMENTS, AND APPROVE OTHER ACTIONS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED AND APPROVED BY THE TREASURER PRIOR TO FILING. A COPY OF THE 990 IS ALSO SENT TO EACH OF THE BOARD MEMBERS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS DISCLOSE POSSIBLE CONFLICTS OF INTERESTS AND THE BOARD OF DIRECTORS REVIEW TO DETERMINE IF AN ACTUAL CONFLICT OF INTEREST EXISTS. IF THERE IS A CONFLICT OF INTEREST, THAT INDIVIDUAL IS NOT PERMITTED TO VOTE IN REGARDS TO THE INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FOX VALLEY FAMILY PRACTICE RESIDENCY INC APPLETON 229 S MORRISON STREET APPLETON WI 54911 391327215 EQUIP AND MAINTAIN EDUCATIONAL FACILITY FOR LEASE TO RESIDENCY PROGRAM. WI 501(C)(3) LINE 11C, III-FI N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0