SAN CAMILLO INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SAN CAMILLO INC (EIN 39-1487306)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-08
IRS object ID
201442209349301059
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-08-08T13:27:46-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391487306EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAN CAMILLO INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSANCNameControl
Phone4142598320Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110200 W BLUEMOUND ROADAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN SCHWABName
TitleCHIEF FINANCIAL OFFICERTitle
Phone4142581814Phone
Date Signed2014-08-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
PTINP01360892PTIN
Phone4144319300Phone
Date Prepared2014-08-07DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN SCHWABNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110200 W BLUEMOUND ROADAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14934909GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STCAM.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1923YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionBY 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4117ContributionsGrantsPriorYear
Contributions Grants Current Year441168ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13158624ProgramServiceRevenuePriorYear
Program Service Revenue CY14459099ProgramServiceRevenueCY
Investment Income Prior Year3345InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year21830OtherRevenuePriorYear
Other Revenue Current Year34642OtherRevenueCurrentYear
Total Revenue Prior Year13187916TotalRevenuePriorYear
Total Revenue Current Year14934909TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3322028SalariesEtcPriorYear
Salaries Etc Current Year2848902SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7385119OtherExpensePriorYear
Other Expenses Current Year9677445OtherExpensesCurrentYear
Total Expenses Prior Year10707147TotalExpensesPriorYear
Total Expenses Current Year12526347TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2480769RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2408562RevenuesLessExpensesCY
Total Assets BOY52381305TotalAssetsBOY
Total Assets EOY55075011TotalAssetsEOY
Total Liabilities BOY37741562TotalLiabilitiesBOY
Total Liabilities EOY37803555TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14639743NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17271456NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionBY 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7183845Expense
Revenue8872103Revenue
DescriptionOPERATES A 288 UNIT INDEPENDENT LIVING FACILITY FOR SENIOR RESIDENTSDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4523856Expense
Revenue5586996Revenue
DescriptionOPERATES A 109 UNIT ASSISTED LIVING FACILITY PROVIDING HEALTHCARE AND OTHER SERVICES TO THE FRAIL ELDERLYDescription
FieldValueIRS element (for citing)
Total Program Service Expense11707701TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SAN CAMILLO INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4142581814TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110200 W BLUEMOUND ROADAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
HARRY W WHELPLEY
CHAIRPERSON2.00XX000
FR RICHARD O'DONNELL MI
VICE CHAIRPERSON20.00XX000
FR LEANDRO BLANCO MI
TREASURER20.00XX000
FR PEDRO TRAMONTIN MI
BOARD MEMBER2.00X000
BR MARIO CRIVELLO MI
BOARD MEMBER2.00X000
FREDERICK A MUTH JR
BOARD MEMBER2.00X000
MARK E SLESAR
BOARD MEMBER2.00X000
ROSEMARIE MATHEUS
BOARD MEMBER2.00X000
NICK LAUBUSCH
BOARD MEMBER2.00X000
JIM WESSON
BOARD MEMBER2.00X000
RICK L JOHNSON
PRESIDENT & CEO40.00X024278818368
KEVIN SCHWAB
CHIEF FINANCIAL OFFICER40.00X017665612899
MARIE D'AMICO
SECRETARY & VICE PRESIDENT40.00X01224486885
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs541892TotalReportableCompFrmRltdOrgs
Total Other Compensation38152TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MORRISON MANAGEMENT SPECIALISTS INC
PO BOX 102289ATLANTAGA30368FOOD SERVICE2675421
KBS CONSTRUCTION INC
3841 KIPP STREETMADISONWI53718CONSTRUCTION441874
STEIGERWALD CONSTRUCTION INC
5310 W STATE STMILWAUKEEWI53208CONSTRUCTION435653
CARPETLAND USA
11316 W ROGERS STWEST ALLISWI53227SUPPLIER185430
VERHALEN INC
500 PILGRIM WAYGREEN BAYWI53288SUPPLIER164721
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Related Organizations441168RelatedOrganizations
Total Contributions441168TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MONTHLY SERVICE FEES9000991159548711595487
AMORTIZATION REVENUE90009914126231412623
SUPPORTING SERVICES900099961784961784
RESIDENT SERVICES900099489205489205
FieldValueIRS element (for citing)
Total Program Service Revenue14459099TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real34642Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real34642Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column34642TotalRevenueColumn
Exclusion$34,642ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14934909TotalRevenueColumn
Related Or Exempt Function Income14459099RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$34,642ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2344927Total
Program Services2227681ProgramServices
Management And General117246ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total379962Total
Program Services360964ProgramServices
Management And General18998ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total124013Total
Program Services117812ProgramServices
Management And General6201ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2342465Total
Program Services2225342ProgramServices
Management And General117123ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total58388Total
Program Services10510ProgramServices
Management And General47878ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total191389Total
Program Services34450ProgramServices
Management And General156939ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1763337Total
Program Services1675170ProgramServices
Management And General88167ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total368936Total
Program Services350489ProgramServices
Management And General18447ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total803740Total
Program Services763553ProgramServices
Management And General40187ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total125365Total
Program Services119097ProgramServices
Management And General6268ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1297645Total
Program Services1232763ProgramServices
Management And General64882ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1374Total
Program Services1305ProgramServices
Management And General69ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total729Total
Program Services693ProgramServices
Management And General36ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total264566Total
Program Services251338ProgramServices
Management And General13228ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1147186Total
Program Services1089827ProgramServices
Management And General57359ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total80308Total
Program Services76293ProgramServices
Management And General4015ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
RAW FOOD / GROCERIES99168494210049584
MAINTENANCE1491281416727456
CATERING1680615966840
BAD DEBT EXPENSE39372

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total74360Total
Program Services70639ProgramServices
Management And General3721ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12526347Total
Program Services11707701ProgramServices
Management And General818646ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY850BOY
EOY2154460EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY62462BOY
EOY312196EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY36501BOY
EOY28160EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY33396BOY
EOY29133EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis44270459LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec28239793LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14964270BOY
EOY16030666EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2553795BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY34730031BOY
EOY36520396EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY52381305BOY
EOY55075011EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY359046BOY
EOY377121EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY864651BOY
EOY930711EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5055000BOY
EOY4505000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY31462865BOY
EOY31990723EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY37741562BOY
EOY37803555EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14639743BOY
EOY17271456EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14639743BOY
EOY17271456EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52381305BOY
EOY55075011EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2408562ReconcilationRevenueExpenses
Reconcilation Other Changes223151ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2200CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2591CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1375CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4117CurrentTaxYearMinus1Year
Current Tax Year441168CurrentTaxYear
Total451451Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12072305CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12349255CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12417849CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13243427CurrentTaxYearMinus1Year
Current Tax Year14459099CurrentTaxYear
Total64541935Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12074505CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12351846CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12419224CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13247544CurrentTaxYearMinus1Year
Current Tax Year14900267CurrentTaxYear
Total64993386Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50964993386PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years84577CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years32071CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29311CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25175CurrentTaxYearMinus1Year
Current Tax Year34642CurrentTaxYear
Total205776Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years84577CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years32071CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29311CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25175CurrentTaxYearMinus1Year
Current Tax Year34642CurrentTaxYear
Total205776Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12159082CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12383917CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12448535CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13272719CurrentTaxYearMinus1Year
Current Tax Year14934909CurrentTaxYear
Total65199162Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99680PublicSupportPercentage509
Prior Year Support Percentage0.99590PriorYearSupportPercentage
Investment Income Percentage0.00320InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00410PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1037314OtherCostOrOtherBasis
Book Value1037314BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis30293887OtherCostOrOtherBasis
Depreciation18876881Depreciation
Book Value11417006BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis920850OtherCostOrOtherBasis
Depreciation812922Depreciation
Book Value107928BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis11385233OtherCostOrOtherBasis
Depreciation8206588Depreciation
Book Value3178645BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis633175OtherCostOrOtherBasis
Depreciation343402Depreciation
Book Value289773BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16030666TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM RELATED PARTYDescription
Book Value36520396BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets36520396TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ENTRANCE FEES$22,885,540
RESIDENT FUNDS HELD FOR SAFE KEEPING$1,044
DUE TO RELATED PARTY$9,104,139
FieldValueIRS element (for citing)
Total Of Amounts31990723TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt14716892TotRevenueEtcAuditedFinclStmt
Other Revenues223151OtherRevenues
Revenue Not Rptd F990223151RevenueNotRptdF990
Revenue Subtotal14493741RevenueSubtotal
Other Revenues Not Included441168OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt441168RevenueNotRptdOnFinStmt
Total Revenue Per Form99014934909TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12526347TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal12526347ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012526347TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM AND ITS CONSOLIDATED AFFILIATES DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE SYSTEM AND ITS CONSOLIDATED AFFILIATES RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2013 OR 2012. FEDERAL TAX RETURNS FOR TAX YEARS 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE ORGANIZATION HAS CERTAIN ACTIVITIES WHICH ARE CONSIDERED UNRELATED TO THEIR EXEMPT PURPOSE AND, ACCORDINGLY, ARE TAXABLE IN ACCORDANCE WITH THE CODE. THESE ACTIVITIES ARE NOT SIGNIFICANT AND NO PROVISION FOR TAXES HAS BEEN RECORDED.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS 221,834. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 1,317.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS FROM RELATED ORGANIZATIONS 441,168.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICK L JOHNSON
PRESIDENT & CEO02070590267480898101100007368026115600
KEVIN SCHWAB
CHIEF FINANCIAL OFFICER0140655031500045010733205567018955500

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Date Issued2012-02-29DateIssued
Issue Price5580000IssuePrice
Description Of PurposeREFINANCE 1995 BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired1075000AmountRetired
Total Proceeds5580000TotalProceeds
Issuance Costs From Proceeds35883IssuanceCostsFromProceeds
Other Spent Proceeds5546117OtherSpentProceeds
Year Of Subst Completion2012YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind0AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop1ChangeInUseBondFinancedProp
Prcntge Bond Financed Prop0.00000PrcntgeBondFinancedProp
Remedial Action Taken0RemedialActionTaken
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed1Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1US BANKBusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE 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 7ATHE SOLE MEMBER ST. CAMILLUS HEALTH SYSTEM, INC., ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE 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 11THE 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 12CTHE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE 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 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,675,170. MANAGEMENT AND GENERAL EXPENSES 88,167. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,763,337.OTHER FEES
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 221,834. NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 1,317.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ST CAMILLUS HEALTH SYSTEM INC
10101 W WISCONSIN AVENUEWAUWATOSAWI53226390806167ADMINISTRATIVE AND MANAGEMENT SERVICESWI501(C)(3)11(B)N/A0
ST CAMILLUS COMMUNITIES INC
10101 W WISCONSIN AVENUEWAUWATOSAWI53226391843041RESIDENTIAL FACILITIESWI501(C)(3)11(B)0ST CAMILLUS HEALTH SYSTEM INC
ORDER OF ST CAMILLUS FOUNDATION INC
10200 W BLUEMOUND ROADWAUWATOSAWI53226391925879FUND-RAISING SUPPORTWI501(C)(3)11(B)0ST CAMILLUS HEALTH SYSTEM INC
ST CAMILLUS HEALTH CENTER INC
10101 W WISCONSIN AVENUEWAUWATOSAWI53226391079224HEALTH SERVICESWI501(C)(3)90ST CAMILLUS HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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