2016-08-09T13:27:49-05:00 2015-09-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2014-10-01 391487306 SAN CAMILLO INC SANC 4142581814 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 JUSTIN MUNZEL CHIEF FINANCIAL OFFICER 4142598355 2016-08-08 1 PAUL DALY CPA P00277674 4144319300 2016-08-03 2014 2016-12-15 16:53:06Z KEVIN SCHWAB 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 14219633 0 0928 X WWW.STCAM.COM X 1923 WI BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 12 12 0 12 0 0 10219 71021 13695533 14107630 1274 1990 38992 38992 13746018 14219633 0 0 0 0 3859026 4427722 0 0 0 9083989 8883880 12943015 13311602 803003 908031 57150879 58617231 59448636 59944728 -2297757 -1327497 X BY PROVIDING SERVICES TO THE POOR, THE SICK AND THE ELDERLY WITH A SENSE OF COMPASSION AND LOVE, ST. CAMILLUS OFFERS HOPE AND MEANING TO THOSE WHO ARE SUFFERING, COMFORT AND SECURITY TO THOSE WHO ARE AGING, AND SERENITY TO THOSE WHO ARE DYING, TAKING INTO ACCOUNT EACH PERSON'S INNATE DIGNITY, UNIQUE NEEDS, AND GOD-GIVEN RIGHTS. 0 0 7585954 8605654 OPERATES A 288 UNIT INDEPENDENT LIVING FACILITY FOR SENIOR RESIDENTS 4850036 5501976 OPERATES A 109 UNIT ASSISTED LIVING FACILITY PROVIDING HEALTHCARE AND OTHER SERVICES TO THE FRAIL ELDERLY 12435990 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X SAN CAMILLO INC 4142581814 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 BR MARIO CRIVELLO MI BOARD MEMBER 40.00 X 0 0 0 DAVID NILES BOARD MEMBER 1.00 X 0 0 0 FR LEANDRO BLANCO MI TREASURER 40.00 X X 0 0 0 FR PEDRO TRAMONTIN MI VICE CHAIR 40.00 X 0 0 0 FR RICHARD O'DONNELL MI BOARD MEMBER 20.00 X X 0 0 0 FRANCIS WIESNER CHAIRPERSON 1.00 X X 0 0 0 MARK E SLESAR FINANCE COMMITTEE CHAIR 1.00 X 0 0 0 NICK LAUBUSCH BOARD MEMBER 1.00 X 0 0 0 ROSEMARIE MATHEUS BOARD MEMBER 1.00 X 0 0 0 TOM DEISINGER BOARD MEMBER 1.00 X 0 0 0 JUDIE TAYLOR BOARD MEMBER 1.00 X 0 0 0 COREEN DICUS-JOHNSON BOARD MEMBER 1.00 X 0 0 0 KEVIN SCHWAB CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 174440 24079 MARIE D'AMICO SECRETARY & VICE PRESIDENT 40.00 X 128227 0 21585 RICK L JOHNSON PRESIDENT & CEO 1.00 40.00 X 0 249019 26701 DAVID TANCK ADMINISTRATOR-AL & SKILLED NURSING 1.00 40.00 X 0 105274 20266 RICHARD SENK DIRECTOR OF ENVIRONMENTAL SERVICES 1.00 40.00 X 0 114718 21314 128227 643451 113945 1 0 1 0 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 339911 DIERKS WAUKESHA PB BOX 0469 WAUKESHA WI 53187 FOOD SERVICE 280536 CARPETLAND USA 11316 W ROGERS ST WEST ALLIS WI 53227 FLOORING 199582 REINHART FOODSERVICE LLC 9950 S REINHART DRIVE OAK CREEK WI 531540395 FOOD SERVICE 148619 4 71021 71021 MONTHLY SERVICE FEES 900099 12543231 12543231 SUPPORTING SERVICES 900099 931185 931185 RESIDENT SERVICES 900099 542110 542110 AMORTIZATION REVENUE 900099 91104 91104 14107630 1990 1990 38992 0 38992 38992 38992 14219633 14107630 0 40982 3840529 3648503 192026 360841 342799 18042 226352 215034 11318 2698446 2563524 134922 49681 8943 40738 223089 40156 182933 298468 283545 14923 373345 354678 18667 717438 681566 35872 175620 166839 8781 1343686 1276502 67184 2567 2439 128 427 406 21 209433 198961 10472 1435991 1364191 71800 88192 83782 4410 RAW FOOD / GROCERIES 966191 917881 48310 MAINTENANCE 267105 253750 13355 MISCELLANEOUS 34201 32491 1710 13311602 12435990 875612 0 2254418 2254418 114384 119934 37101 37865 24869 20606 46524599 30946311 15544044 15578288 39176063 40606120 57150879 58617231 506142 510198 4595359 1115479 3935000 3340000 50412135 54979051 59448636 59944728 X -2297757 -1327497 -2297757 -1327497 57150879 58617231 X 908031 62229 X 0 1 X 1 0 X 1375 4117 441168 10219 71021 527900 12417849 13243427 14459099 13695533 14107630 67923538 12419224 13247544 14900267 13705752 14178651 68451438 0 0 0 68451438 29311 25175 34642 40266 40982 170376 29311 25175 34642 40266 40982 170376 12448535 13272719 14934909 13746018 14219633 68621814 0.99750 0.99760 0.00250 0.00240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1037314 1037314 30493680 20291936 10201744 1064440 863060 201380 13318346 9434536 3883810 610819 356779 254040 15578288 DUE FROM RELATED PARTY 40606120 40606120 REFUNDABLE ENTRANCE FEES 45088812 RESIDENT FUNDS HELD FOR SAFE KEEPING 1285 DUE TO RELATED PARTY 9888954 54979051 X X X X X 0 0 0 0 0 0 0 0 0 KEVIN SCHWAB CHIEF FINANCIAL OFFICER 0 157342 0 17025 0 73 0 8750 0 15329 0 198519 0 0 RICK L JOHNSON PRESIDENT & CEO 0 226543 0 22000 0 476 0 11423 0 15278 0 275720 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 2012-02-29 5580000 REFINANCE 1995 BONDS 0 0 0 A 2240000 5580000 35883 5544117 2012 1 0 0 0 A 0 0 0 0 0 0 0 A 1 1 1 US BANK 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS A SINGLE CLASS OF MEMBERS AND THE SOLE MEMBER OF THAT CLASS IS ST. CAMILLUS HEALTH SYSTEM, INC., A WISCONSIN NONSTOCK CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS SHALL NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE MEMBER: TO DEFINE THE PHILOSOPHY, MISSION AND PURPOSE OF THE CORPORATION AND TO ADOPT, AMEND OR REPEAL ANY STATEMENTS OF MISSION OR PHILOSOPHY FOR THE CORPORATION; TO ADOPT, APPROVE, RESTATE, REVISE, OR AMEND THESE AMENDED AND RESTATED ARTICLES OF INCORPORATION AND THE BY-LAWS OF THE CORPORATION; TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION AND DETERMINE THE NUMBER (WHICH MAY NOT BE LESS THAN THREE) OF SUCH DIRECTORS; TO AUTHORIZE OR MAKE OTHER DECISIONS RELATING TO THE TRANSFER OR SALE OF OR CREATION OF AN ENCUMBRANCE (E.G. MORTGAGE, PLEDGE OR GRANT OF SECURITY INTEREST) UPON FIXED ASSETS OF THE CORPORATION WITH A VALUE IN EXCESS OF $500,000; TO AUTHORIZE THE INCURRENCE BY THE CORPORATION OF DEBT FOR MONEY BORROWED IN AMOUNTS IN EXCESS OF $500,000; TO ADOPT AMEND OR REPEAL ANY PLAN OF DISSOLUTION, CONSOLIDATION OR MERGER OF THE CORPORATION, ANY CONTRACT OR AGREEMENT FOR THE MANAGEMENT OF THE CORPORATION OR ANY SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; TO CREATE, ACQUIRE, SELL, PURCHASE, DISSOLVE OR MAKE OTHER DISPOSITION OF ANY ENTITY OWNED OR CONTROLLED OR TO BE OWNED OR CONTROLLED BY THE CORPORATION OR ANY OWNERSHIP INTEREST IN ANY SUCH ENTITY; TO APPROVE ANY ACTIONS OR EXERCISE ANY POWER RESERVED TO THE CORPORATION AS A MEMBER OR SHAREHOLDER OF ANOTHER ENTITY; TO APPROVE THE INITIAL ELECTION BY THE BOARD OF DIRECTORS OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION (BUT NOT SUBSEQUENT RE-ELECTIONS OF THOSE PERSONS TO SERVE CONSECUTIVE TERMS IN SUCH RESPECTIVE OFFICES) AND TO REMOVE THE CHIEF EXECUTIVE OFFICER AND THE CHIEF OPERATING OFFICER OF THE CORPORATION WHETHER OR NOT SUCH REMOVAL IS APPROVED BY THE BOARD OF DIRECTORS; AND TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AND TO DETERMINE THE TERM OF THE PRESIDENT'S APPOINTMENT, SUCH TERM NOT TO EXCEED THREE YEARS. FORM 990, PART VI, SECTION B, LINE 11 THE CEO, CFO AND CONTROLLER REVIEW THE 990 BEFORE IT IS FILED WITH THE IRS. A COPY IS KEPT ON HAND FOR PUBLIC VIEWING. FORM 990, PART VI, SECTION B, LINE 12C THE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS SALARIES WHICH ARE THEN COMPARED TO MANAGEMENT RESOURCE ASSOCIATION DATA. THE ORGANIZATION ALSO COMPARES THEIR SALARIES TO OTHER COMPANIES THAT ARE SIMILAR IN NATURE VIA 990'S. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 62,229. ST CAMILLUS HEALTH SYSTEM INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 390806167 ADMINISTRATIVE AND MANAGEMENT SERVICES WI 501(C)(3) 11(B) N/A 0 ST CAMILLUS COMMUNITIES INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391843041 RESIDENTIAL FACILITIES WI 501(C)(3) 11(B) ST CAMILLUS HEALTH SYSTEM INC 0 ORDER OF ST CAMILLUS FOUNDATION INC 10200 W BLUEMOUND ROAD WAUWATOSA WI 53226 391925879 FUND-RAISING SUPPORT WI 501(C)(3) 11(B) ST CAMILLUS HEALTH SYSTEM INC 0 ST CAMILLUS HEALTH CENTER INC 10101 W WISCONSIN AVENUE WAUWATOSA WI 53226 391079224 HEALTH SERVICES WI 501(C)(3) 9 ST CAMILLUS HEALTH SYSTEM INC 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1