2014-05-13T10:50:02-05:00 2013-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 500 MIDLAND COURT PO BOX 8130 JANESVILLE WI 535478130 990 2012-07-01 237275336 MERCY FOUNDATION INC MERC 6087566000 PO BOX 5003 - 1000 MINERAL POINT JANESVILLE WI 535475003 JAVON BEA 6087566000 2014-05-07 1 WILLIAM T MURPHY CPA P00074580 6087525835 2014-05-07 2012 2015-11-30 17:44:51Z JAVON BEA PO BOX 5003 - 1000 MINERAL POINT JANESVILLE WI 535475003 835739 0 X N/A X 1972 WI TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. 3 1 0 75 0 0 264867 309732 120720 121500 35996 65610 -20230 -11031 401353 485811 0 0 0 0 94769 106018 0 0 132536 225702 295919 320471 401937 80882 83874 1617960 1616594 165567 16200 1452393 1600394 X TO SUPPORT MERCY HEALTH SYSTEM CORP, THE HOUSE OF MERCY & MERCY ASSISTED CARE HOSPICE PROGRAM. 0 0 154202 0 HOUSE OF MERCY, A HOMELESS SHELTER, PROVIDED 7,686 SHELTER NIGHTS. A TOTAL OF 305 INDIVIDUALS (154 ADULTS AND 151 CHILDREN) WERE SERVED. 33991 121500 MERCY FOUNDATION PROVIDES SUBSIDY FUNDING FOR THE MERCY HEALTH SYSTEM RESIDENCY PROGRAM. USE OF THESE DONATIONS ARE FOR EDUCATIONAL NECESSITIES OUTSIDE THE NORMAL OPERATING BUDGET OF THE MERCY RESIDENCY PROGRAM. EXPENSES IN FISCAL YEAR 2013 RELATED TO REIMBURSEMENT OF FY2012 MEDICAL MISSION TO HONDURAS IN CONJUCTIONS WITH THE SHOULDER TO SHOULDER, INC. ORGANIZATION. OTHER EXPENSES INCLUDED STIPENDS PAID TO PHYSICIANS FOR THEIR PRECEPTOR TIME AND THEIR TIME SPENT COORDINATING THE ROTATION OF THEIR STUDENTS. 14713 0 MERCY FOUNDATION PROVIDES SUBSIDY FUNDING FOR THE MERCY ASSISTED CARE HOSPICE PROGRAM. IN FY 2013, THE HOSPICE HOMECARE PROGRAM PROVIDED 5,681 VISITS TO PATIENTS NEEDING RNS, HEALTH AIDES, THERAPISTS, AND SOCIAL WORKERS DURING THE YEAR. FUNDING FROM THE FOUNDATION ALLOWED THIS PROGRAM TO CONTINUE TO PROVIDE HOSPICE CARE TO THE COMMUNITY. 35034 0 OTHER MISCELLANEOUS PROGRAM EXPENSES 35034 237940 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 3 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 0 0 0 WI X JOHN COOK 6087566642 1000 MINERAL POINT JANESVILLE WI 535475003 LARRY E SQUIRE 1.00 X X 0 0 0 MARK GOELZER 1.00 X X 0 474156 29991 JAVON R BEA 1.00 X X 0 5169487 34716 RICHARD GRUBER 1.00 X 0 162287 23142 BARB BORTNER 1.00 X 0 185153 35086 0 5991083 122935 0 0 1 0 0 150289 159443 309732 FAMILY PRACTICE RESIDE 900099 121500 121500 121500 37373 37373 266644 238407 28237 28237 28237 100490 150289 111521 -11031 -11031 485811 121500 0 54579 99406 99406 1541 1541 5071 5071 8600 8600 14524 14524 10719 983 6210 3526 2232 2232 HOUSE OF MERCY EXP (HOM 154202 154202 0 0 RESIDENCY PROGRAM EXPEN 33991 33991 0 0 OTHER FUNDDRAISING EXPE 20760 0 0 20760 HOSPICE PATIENT EXPENSE 14713 14713 0 0 36178 34051 2127 401937 237940 31461 132536 139732 101163 1390314 1515431 87914 0 1617960 1616594 165567 16200 165567 16200 X 1452393 1600394 1452393 1600394 1617960 1616594 83874 64127 0 X 0 1 X 1 0 X X 0 0 0 MERCY ASSISTED CARE INC 391035110 9 1 0 1 0 MERCY HEALTH SYSTEM CORPORATION 390816848 3 1 0 1 0 2 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 VARIOUS INVESTMENTS 1515431 F 1515431 DUE TO RELATED PARTY 16200 16200 CHARITY BALL 161647 103420 58227 7500 1500 1699 13030 3000 41632 JINGLE MINGLE 76006 46869 29137 5500 2000 900 7785 1131 15639 2 13126 0 13126 0 0 0 0 0 10205 250779 150289 100490 13000 3500 2599 20815 4131 67476 111521 -11031 0 0 0 0 0 0 0 0 0 MARK GOELZER 0 468860 0 0 0 5296 0 16548 0 13443 0 504147 0 0 JAVON R BEA 0 940949 0 755086 0 3473452 0 16548 0 18168 0 5204203 0 0 RICHARD GRUBER 0 135240 0 17245 0 9802 0 10039 0 13103 0 185429 0 0 BARB BORTNER 0 129477 0 51734 0 3942 0 12073 0 23013 0 220239 0 0 FORM 990, PART VI, SECTION B, LINE 11 NO REVIEW WAS OR WILL BE CONDUCTED FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REPORT ALL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR INVESTIGATING ALL CONFLICTS AND REPORTING TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. MERCY ALLIANCE INC 1000 MINERAL POINT JANESVILLE WI 535475003 391679859 MANAGEMENT OF HEALTHCARE ORGANIZATIONS WI 501(C)(3) 11A N/A 0 MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS 1000 MINERAL POINT JANESVILLE WI 535475003 390912682 TO SUPPORT MERCY HEALTH SYSTEM CORPORATION WI 501(C)(3) 11C MERCY HEALTH SYSTEM CORPORATION 0 MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT JANESVILLE WI 535475003 390816848 MEDICAL HEALTHCARE WI 501(C)(3) 3 MERCY ALLIANCE INC 0 MERCY ASSISTED CARE INC 901 MINERAL POINT JANESVILLE WI 535475003 391035110 HOME HEALTH CARE & SERVICES WI 501(C)(3) 9 MERCY ALLIANCE INC 0 MERCY HARVARD HOSPITAL INC 901 GRANT STREET HARVARD IL 60033 311551871 MEDICAL HEALTHCARE IL 501(C)(3) 3 MERCY ALLIANCE INC 0 HARVARD MEMORIAL HOSPITAL FOUNDATION 901 GRANT STREET HARVARD IL 60033 364308662 TO SUPPORT MERCY HARVARD HOSPITAL, INC. IL 501(C)(3) 11A MERCY HARVARD HOSPITAL INC 0 MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 1000 MINERAL POINT JANESVILLE WI 535475003 201673011 NONE IL 501(C)(3) 3 MERCY ALLIANCE INC 0 JANESVILLE MEDICAL CENTER INC 1000 MINERAL POINT JANESVILLE WI 535475003 391520130 MANAGEMENT ENTITY OF UNION EMPLOYEES WI MERCY HEALTH SYSTEM CORPORATION C 0 MERCYCARE INSURANCE COMPANY 3430 PALMER DRIVE JANESVILLE WI 53545 391768192 INSURANCE COMPANY WI MERCY HEALTH SYSTEM CORPORATION C 0 MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO 3430 PALMER DRIVE JANESVILLE WI 53545 201482553 INSURANCE COMPANY WI MERCY HEALTH SYSTEM CORPORATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0