ST CAMILLUS HEALTH CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ST CAMILLUS HEALTH CENTER INC (EIN 39-1079224)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201212289349303381
Schema version
2010v3.4
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)
Timestamp2012-08-15T14:57:20-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391079224EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CAMILLUS HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTCANameControl
Phone4142581814Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVENUEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN SCHWABName
TitleCHIEF FINANCIAL OFFICERTitle
Phone4142581814Phone
Date Signed2012-08-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
Phone4144319300Phone
Date Prepared2012-08-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14801442GrossReceipts
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 Volunteers15TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year94581ContributionsGrantsPriorYear
Contributions Grants Current Year18173ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12802856ProgramServiceRevenuePriorYear
Program Service Revenue CY14781188ProgramServiceRevenueCY
Investment Income Prior Year21813InvestmentIncomePriorYear
Investment Income Current Year2081InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year12919250TotalRevenuePriorYear
Total Revenue Current Year14801442TotalRevenueCurrentYear
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 Year7600897SalariesEtcPriorYear
Salaries Etc Current Year8492471SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7235588OtherExpensePriorYear
Other Expenses Current Year7480698OtherExpensesCurrentYear
Total Expenses Prior Year14836485TotalExpensesPriorYear
Total Expenses Current Year15973169TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1917235RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1171727RevenuesLessExpensesCY
Total Assets BOY24578893TotalAssetsBOY
Total Assets EOY23585439TotalAssetsEOY
Total Liabilities BOY33819099TotalLiabilitiesBOY
Total Liabilities EOY34099652TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-9240206NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-10514213NetAssetsOrFundBalancesEOY
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
Expense8124017Expense
Revenue8741594Revenue
DescriptionSKILLED NURSING FACILITIES - ST. CAMILLUS HEALTH CENTER PROVIDES IN-HOUSE NURSING SERVICES TO ITS RESIDENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1873717Expense
Revenue2016154Revenue
DescriptionHOME HEALTH CARE AGENCY - ST. CAMILLUS HEALTH CENTER OFFERS NURSING SERVICES TO THE RESIDENTS OF THE INDEPENDENT LIVING FACILITY, ASSISTED LIVING FACILITY AND TO OTHER COMMUNITY RESIDENTS IN NEED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3739191Expense
Revenue4023440Revenue
DescriptionASSISTED LIVING FACILITY - A 76-UNIT ASSISTED LIVING FACILITY PROVIDING ASSISTANCE WITH DAILY LIVING ACTIVITIES AND OTHER HEALTH RELATED SERVICES TO SENIOR RESIDENTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense13736925TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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
Transaction Related Entity0TransactionRelatedEntity
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
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
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 Line1ST CAMILLUS HEALTH CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4142581814TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line110101 W WISCONSIN AVEAddressLine1
CityWAUWATOSACity
StateWIState
ZIP Code53226ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
FR RICHARD O'DONNELL MI
VICE CHAIRPERSON2.00X000
FR LOUIS LUSSIER MIMD PHD
BOARD OF DIRECTOR2.00X000
PAULA HOGAN
BOARD OF DIRECTOR2.00X000
FR PEDRO TRAMONTIN MI
BOARD OF DIRECTOR2.00X000
BR MARIO CRIVELLO OS CAM
BOARD OF DIRECTOR2.00X000
FR EUGENE DUTKIEWICZ SJ
TREASURER2.00X000
ATTY FREDERICK A MUTH JR
BOARD OF DIRECTOR2.00X000
MARK E SLESAR
BOARD OF DIRECTOR2.00X000
HARRY W WHELPLEY
CHAIRPERSON2.00X000
NICK LAUBUSCH
BOARD OF DIRECTOR2.00X000
ROSEMARIE MATHEUS RN MSN
BOARD OF DIRECTOR2.00X000
JIM WESSON
BOARD OF DIRECTOR2.00X000
DAN MATTES
BOARD OF DIRECTOR2.00X000
RICK L JOHNSON
PRESIDENT40.0002640038496X
MARIE D'AMICO
VICE PRESIDENT & SECRETARY40.0001278153037X
KEVIN SCHWAB
CFO40.0001557106957X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs547528TotalReportableCompFrmRltdOrgs
Total Other Compensation18490TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1STAFFING PARTNERSBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BOX 88247AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53288ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesSTAFF SERVICESDescriptionOfServices
Compensation202702Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations18173RelatedOrganizations
Total Contributions18173TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES6230001240121112401211
OTHER SUPPORT SERVICES62300013755001375500
MONTHLY SERVICE FEES62300010044771004477
FieldValueIRS element (for citing)
Total Program Service Revenue14781188TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2081TotalRevenueColumn
Exclusion$2,081ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14801442TotalRevenueColumn
Related Or Exempt Function Income14781188RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,081ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7061992Total
Program Services6073313ProgramServices
Management And General988679ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total906953Total
Program Services779980ProgramServices
Management And General126973ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total523526Total
Program Services450232ProgramServices
Management And General73294ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2110087Total
Program Services1814675ProgramServices
Management And General295412ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total7250Total
Program Services6235ProgramServices
Management And General1015ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11192Total
Program Services9625ProgramServices
Management And General1567ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total855934Total
Program Services736103ProgramServices
Management And General119831ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1089533Total
Program Services936998ProgramServices
Management And General152535ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total8087Total
Program Services6955ProgramServices
Management And General1132ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total703221Total
Program Services604770ProgramServices
Management And General98451ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total943814Total
Program Services811680ProgramServices
Management And General132134ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total134613Total
Program Services115767ProgramServices
Management And General18846ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES742975638958104017
RAW FOOOD / GROCERIES53852146312875393
MAINTENANCE15613913428021859
MISCELLANEOUS936508053913111
BAD DEBT EXPENSE856827368711995

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15973169Total
Program Services13736925ProgramServices
Management And General2236244ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10428BOY
EOY500EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY922664BOY
EOY1117977EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY30779BOY
EOY28226EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY316262BOY
EOY294078EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis32370668LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12597520LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY20452552BOY
EOY19773148EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY880726BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1965482BOY
EOY2371510EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24578893BOY
EOY23585439EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY549565BOY
EOY553971EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16560000BOY
EOY12565000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16709534BOY
EOY20980681EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY33819099BOY
EOY34099652EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-9240206BOY
EOY-10514213EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-9240206BOY
EOY-10514213EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24578893BOY
EOY23585439EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1171727ReconcilationRevenueExpenses
Reconcilation Other Changes-102280ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years16513CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12511CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2124CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year94581CurrentTaxYearMinus1Year
Current Tax Year18173CurrentTaxYear
Total143902Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11369638CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11727489CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12133358CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12802856CurrentTaxYearMinus1Year
Current Tax Year14781188CurrentTaxYear
Total62814529Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11386151CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11740000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12135482CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12897437CurrentTaxYearMinus1Year
Current Tax Year14799361CurrentTaxYear
Total62958431Total

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 Total50962958431PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years32592CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years41778CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13791CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21813CurrentTaxYearMinus1Year
Current Tax Year2081CurrentTaxYear
Total112055Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years32592CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years41778CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13791CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21813CurrentTaxYearMinus1Year
Current Tax Year2081CurrentTaxYear
Total112055Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11418743CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11781778CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12149273CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12919250CurrentTaxYearMinus1Year
Current Tax Year14801442CurrentTaxYear
Total63070486Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99820PublicSupportPercentage509
Prior Year Support Percentage0.99770PriorYearSupportPercentage
Investment Income Percentage0.00180InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00230PriorYrInvestIncomePercentage
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 Basis61277OtherCostOrOtherBasis
Book Value61277BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis25842734OtherCostOrOtherBasis
Depreciation6858218Depreciation
Book Value18984516BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis20218OtherCostOrOtherBasis
Depreciation14738Depreciation
Book Value5480BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6073544OtherCostOrOtherBasis
Depreciation5434722Depreciation
Book Value638822BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis372895OtherCostOrOtherBasis
Depreciation289842Depreciation
Book Value83053BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19773148TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESIDENT FUNDS HELD FOR SAFE KEEPING5729
DUE FROM RELATED PARTY2365781
FieldValueIRS element (for citing)
Total Book Value Other Assets2371510TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
RESIDENT FUNDS HELD FOR SAFE KEEPING$4,638
DUE TO RELATED PARTY$19,407,959
INTEREST RATE SWAP$1,382,367
REFUNDABLE ENTRANCE FEES$185,717
FieldValueIRS element (for citing)
Total Of Amounts20980681TotalOfAmounts
Total Revenue14801442TotalRevenue
Total Expenses15973169TotalExpenses
Excess Or Deficit For Year-1171727ExcessOrDeficitForYear
Net Unrealized GL On Investments-195NetUnrealizedGLOnInvestments
Other-$102,085OtherAmount
Total Adjustments-102280TotalAdjustments
Excess Or Deficit Per FS-1274007ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14783269TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal14783269RevenueSubtotal
Other Revenues Not Included18173OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt18173RevenueNotRptdOnFinStmt
Total Revenue Per Form99014801442TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16075254TotExpensesEtcAuditedFinclStmt
Other Expenses Included102085OtherExpensesIncluded
Expenses Not Rptd F990102085ExpensesNotRptdF990
Expenses Subtotal15973169ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99015973169TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM AND ITS COMBINED 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 COMBINED AFFILIATES RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2010 OR 2009. FEDERAL RETURNS FOR THE YEARS ENDED SEPTEMBER 30, 2009, 2008, AND 2007, REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -102,085.
PART XII, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS FROM RELATED ORGANIZATIONS 18,173.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 102,085.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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)

Base 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
0207381048786078360849600027249900
KEVIN SCHWAB
0137369016000023410695700016266700

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

CUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
NONEAVAIL2003-06-197415000REFINANCE 1998 ISSUE000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
NONEAVAIL2005-02-248200000REMODEL OF SKILLED NURSING FACILITY000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
22900007415000109150730585020031011
7600008200000211399798860120051011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000011
000011

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
US BANK
0117.00000000000000000
US BANK
01110.00000000000000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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.
THE PARTIES THAT ARE INVOLVED ARE ASKED TO DISCLOSE ANY CHANGES THAT WOULD IMPACT THE POLICY.FORM 990, PART VI, SECTION B, LINE 12C
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 B, LINE 15
THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED LOSSES ON INVESTMENTS: -195. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -102,085. TOTAL TO FORM 990, PART XI, LINE 5: -102,280.FORM 990, PART XI, LINE 5:

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 OrgControlledOrg
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)N/A0
SAN CAMILLO INC
10200 W BLUEMOUND ROADWAUWATOSAWI53226391487306ASSISTED LIVINGWI501(C)(3)9N/A0
ORDER OF ST CAMILLUS FOUNDATION INC
10200 W BLUEMOUND ROADWAUWATOSAWI53226391925879FUND-RAISING SUPPORTWI501(C)(3)11(B)N/A0
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 Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
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

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.