MADISON SURGERY CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MADISON SURGERY CENTER INC (EIN 39-1940656)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-13
- IRS object ID
- 201233189349301463
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-13T10:02:55-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10000 INNOVATION DRIVE SUITE 250 | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 532264837 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391940656 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON SURGERY CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MADI | NameControl |
| Phone | 6088214883 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7974 UW HEALTH COURT | AddressLine1 |
| City | MIDDLETON | City |
| State | WI | State |
| ZIP Code | 53562 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PETER CHRISTMAN | Name |
| Title | PRESIDENT | Title |
| Phone | 6088214883 | Phone |
| Date Signed | 2012-11-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAY ADKISSON CPA | Name |
| PTIN | P01360892 | PTIN |
| Phone | 4144319300 | Phone |
| Date Prepared | 2012-11-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | PETER CHRISTMAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7974 UW HEALTH COURT | AddressLine1 |
| City | MIDDLETON | City |
| State | WI | State |
| ZIP Code | 53562 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 25634784 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MADISONSURGCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | THE CORPORATION'S GOAL IS TO PROVIDE QUALITY HEALTH CARE SERVICES, FACILITATE TRAINING OF MEDICAL STUDENTS, AND BE COMMITTED TO THE COMMUNITY IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 122 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23135830 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25634734 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 74 | InvestmentIncomePriorYear |
| Investment Income Current Year | 50 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23135904 | TotalRevenuePriorYear |
| Total Revenue Current Year | 25634784 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6825763 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6836174 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10787079 | OtherExpensePriorYear |
| Other Expenses Current Year | 11189281 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 17612842 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18025455 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5523062 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7609329 | RevenuesLessExpensesCY |
| Total Assets BOY | 12238773 | TotalAssetsBOY |
| Total Assets EOY | 12847751 | TotalAssetsEOY |
| Total Liabilities BOY | 1357769 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1332418 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10881004 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11515333 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE CORPORATION'S PURPOSES ARE TO: (A) PROVIDE SURGICAL SERVICES TO PATIENTS NOT REQUIRING HOSPITALIZATION IN FURTHERANCE OF THE NEEDS OF THE COMMUNITY; (B) CARRY ON EDUCATIONAL ACTIVITIES RELATED TO RENDERING HEALTH CARE SERVICES TO PATIENTS; (C) PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE AND ADVANCE THE GENERAL HEALTH AND WELFARE OF PERSONS IN THE COMMUNITY; AND (D) TO DO ALL OTHER THINGS NECESSARY OR CONVENIENT TO ACCOMPLISH ITS PURPOSES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17002510 | Expense |
| Revenue | 25634734 | Revenue |
| Description | HEALTH CARE SERVICES | Description |
| Total Program Service Expense | 17002510 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 14 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 122 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICK COCHEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6088214883 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7974 UW HEALTH COURT | AddressLine1 |
| City | MIDDLETON | City |
| State | WI | State |
| ZIP Code | 53562 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| PETER CHRISTMAN | ||||||
| PRESIDENT | 2.00 | X | X | 0 | 0 | 0 |
| KEVIN BOREDN | ||||||
| VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 |
| PAT GRUNWALD | ||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 |
| JAMES DECHENE | ||||||
| ASST. SECRETARY | 2.00 | X | X | 0 | 0 | 0 |
| RENEE RIZZO | ||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 |
| ROBERT PEARCE MD | ||||||
| BOARD OF GOVERNORS | 2.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| UNIVERSITY OF WISCONSIN MEDICAL FOUNDATI | |||||
| 7974 UW HEALTH COURT | MIDDLETON | WI | 53562 | MEDICAL SERVICES | 9451074 |
| MERITER HOSPITAL INC | |||||
| 202 S PARK STREET | MADISON | WI | 53715 | MEDICAL SERVICES | 1625834 |
| VANTAGE TECHNOLOGY | |||||
| PO BOX 428 | EFFINGHAM | IL | 62401 | MEDICAL SERVICES | 1422065 |
| BOARD OF REGENTS UW SYSTEM | |||||
| B6/319 CLINICAL SCIENCE CENTER 600 | MADISON | WI | 53792 | ANESTHESIOLOGY SERVICES | 438535 |
| TRI-NORTH BUILDERS | |||||
| 2625 RESEARCH PARK DR | FITCHBURG | WI | 53711 | BUILDING CONTRACTOR | 386240 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| AMBULATORY SURGERY CEN | 621910 | 25589265 | 25589265 |
| OTHER REVENUE | 621910 | 45469 | 45469 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25634734 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50 | TotalRevenueColumn |
| Exclusion | $50 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25634784 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25634734 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $50 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5019966 | Total |
| Program Services | 4560575 | ProgramServices |
| Management And General | 459391 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 423512 | Total |
| Program Services | 384755 | ProgramServices |
| Management And General | 38757 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1019896 | Total |
| Program Services | 926562 | ProgramServices |
| Management And General | 93334 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372800 | Total |
| Program Services | 338684 | ProgramServices |
| Management And General | 34116 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111685 | Total |
| Management And General | 111685 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16235 | Total |
| Management And General | 16235 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32389 | Total |
| Management And General | 32389 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202693 | Total |
| Program Services | 159455 | ProgramServices |
| Management And General | 43238 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69891 | Total |
| Management And General | 69891 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2184541 | Total |
| Program Services | 2119005 | ProgramServices |
| Management And General | 65536 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4427 | Total |
| Program Services | 4427 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8926 | Total |
| Program Services | 8926 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1117430 | Total |
| Program Services | 1092546 | ProgramServices |
| Management And General | 24884 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77130 | Total |
| Program Services | 76141 | ProgramServices |
| Management And General | 989 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | 5202891 | 5202891 | |
| STATE ASC ASSESSMENT | 1015871 | 1015871 | |
| PURCHASED SERVICES | 828318 | 797738 | 30580 |
| LAUNDRY SERVICES | 229034 | 229034 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87820 | Total |
| Program Services | 85900 | ProgramServices |
| Management And General | 1920 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18025455 | Total |
| Program Services | 17002510 | ProgramServices |
| Management And General | 1022945 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 978285 | BOY |
| EOY | 1143569 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 99816 | BOY |
| EOY | 99866 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4761207 | BOY |
| EOY | 5040686 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 950876 | BOY |
| EOY | 1169824 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110757 | BOY |
| EOY | 125967 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 13619132 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8351293 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5337832 | BOY |
| EOY | 5267839 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12238773 | BOY |
| EOY | 12847751 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 857340 | BOY |
| EOY | 816976 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500429 | BOY |
| EOY | 515442 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1357769 | BOY |
| EOY | 1332418 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10881004 | BOY |
| EOY | 11515333 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10881004 | BOY |
| EOY | 11515333 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12238773 | BOY |
| EOY | 12847751 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7609329 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -6975000 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 15838359 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20178914 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21279185 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23135830 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25634734 | CurrentTaxYear |
| Total | 106067022 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 15838359 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20178914 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21279185 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23135830 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25634734 | CurrentTaxYear |
| Total | 106067022 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 106067022 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 111626 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 49474 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 393 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 74 | CurrentTaxYearMinus1Year |
| Current Tax Year | 50 | CurrentTaxYear |
| Total | 161617 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 111626 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 49474 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 393 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 74 | CurrentTaxYearMinus1Year |
| Current Tax Year | 50 | CurrentTaxYear |
| Total | 161617 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 13606 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 188 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1836 | CurrentTaxYearMinus2Years |
| Total | 15630 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 15963591 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20228576 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21281414 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23135904 | CurrentTaxYearMinus1Year |
| Current Tax Year | 25634784 | CurrentTaxYear |
| Total | 106244269 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99830 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99770 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00150 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00210 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3190159 | OtherCostOrOtherBasis |
| Depreciation | 2849506 | Depreciation |
| Book Value | 340653 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10428973 | OtherCostOrOtherBasis |
| Depreciation | 5501787 | Depreciation |
| Book Value | 4927186 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5267839 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | STATE TAX ASSESSMENT PAYABLE | Description |
| Amount | $515,442 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 515442 | TotalOfAmounts |
| Total Revenue | 25634784 | TotalRevenue |
| Total Expenses | 18025455 | TotalExpenses |
| Excess Or Deficit For Year | 7609329 | ExcessOrDeficitForYear |
| Other | -$6,975,000 | OtherAmount |
| Total Adjustments | -6975000 | TotalAdjustments |
| Excess Or Deficit Per FS | 634329 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 25906327 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 271543 | OtherRevenues |
| Revenue Not Rptd F990 | 271543 | RevenueNotRptdF990 |
| Revenue Subtotal | 25634784 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 25634784 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 18296998 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 271543 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 271543 | ExpensesNotRptdF990 |
| Expenses Subtotal | 18025455 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 18025455 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE SURGERY CENTER IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SURGERY CENTER IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SURGERY CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINIATION 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 SURGERY CENTER RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2011 OR 2010 AS MANAGEMENT BELIEVES THE SURGERY CENTER HAS NO MATERIAL UNRECOGNIZED INCOME TAX POSITIONS. FEDERAL TAX RETURNS FOR TAX YEARS 2008 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | DISTRIBUTIONS TO MEMBERS -6,975,000. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 271,543. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 271,543. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION HAS ONE CLASS OF THREE VOTING MEMBERS WHICH HAVE IDENTIAL RIGHTS AND OBLIGATIONS WITH RESPECT TO VOTING, DISSOLUTION, REDEMPTION, TRANSFER AND OTHERWISE. MEMBERS WILL BE ADMITTED, SUSPENDED, EXPELLED OR TERMINATED PURSUANT TO BYLAWS OF THE CORPORATION. THE MEMBERS ARE UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION, INC., MERITER HOSPITAL, INC. AND UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY. | |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER APPOINTS TWO DIRECTORS. DIRECTORS WILL SERVE UNTIL HIS OR HER DEATH, RESIGNATION OR REMOVAL, OR UNTIL A SUCCESSOR HAS BEEN APPOINTED. UPON THE EXPIRATION OF A DIRECTOR'S TERM, THE MEMBER THAT APPOINTED SUCH DIRECTOR WILL APPOINT HIS OR HER SUCCESSOR. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE THE APPROVAL OF THE MEMBERS: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) AMENDMENT, RESTATEMENT, ALTERATION OR REPEAL OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION, OR THE ADOPTION OF NEW ARTICLES OF INCORPORATION OR BYLAWS; (C) A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; (D) THE CALL FOR ADDITIONAL CONTRIBUTIONS FROM MEMBERS TO THE CORPORATION OR ASSESSMENTS AGAINST THE MEMBERS; AND (3) ANY DISTRIBUTION OF ASSETS OF THE CORPORATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE SENIOR FINANCIAL ANALYST FOR UWMF REVIEWS THE FORM 990 BEFORE IT IS SIGNED BY THE VP OF FINANCE FOR THE MANAGING PARTNER. | |
| FORM 990, PART VI, SECTION B, LINE 12C | AT THE FIRST MEETINGS OF THE BOARD OF DIRECTORS AND THE OPERATIONS BOARD SUBSEQUENT TO THE ANNUAL MEETING OF THE SURGERY CENTER MEMBERS, EACH MEMBER OF THE BOARD OF DIRECTORS AND THE OPERATIONS BOARD SHALL SIGN A WRITTEN STATEMENT CERTIFYING TO ALL OF THE FOLLOWING: (I) HE OR SHE HAS RECEIVED A COPY OF THIS CONFLICT OF INTEREST POLICY; (II) HE OR SHE HAS READ AND UNDERSTANDS THIS CONFLICT OF INTEREST POLICY; (III) HE OR SHE AGREES TO COMPLY WITH THIS CONFLICT OF INTEREST POLICY; (IV) HE OR SHE UNDERSTANDS THAT THIS CONFLICT OF INTEREST POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND (V) HE OR SHE UNDERSTANDS THAT THE SURGERY CENTER IS A CHARITABLE ORGANIZATION, AND THAT, IN ORDER TO OBTAIN AND MAINTAIN THE TAX-EXEMPT STATUS OF THE SURGERY CENTER UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986 AS AMENDED, THE SURGERY CENTER MUST CONTINUALLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. ANY MEMBER OF THE BOARD OF DIRECTORS WHO REFUSES OR FAILS TO SIGN SUCH A STATEMENT SHALL BE PROHIBITED FROM PARTICIPATING IN DISCUSSION OR ACTION BY THE BOARD OF DIRECTORS OR THE OPERATIONS BOARD UNTIL SUCH STATEMENT IS SIGNED. IF IT IS DETERMINED AT ANY TIME THAT AN INTERESTED PERSON HAS NEGLIGENTLY OR INTENTIONALLY FAILED TO DISCLOSE A FINANCIAL INTEREST, THE PRESIDENT SHALL CONSIDER THE IMPOSITION OF SUCH SANCTIONS AS THE PRESIDENT, IN HIS OR HER EXCLUSIVE DISCRETION, MAY DEEM APPROPRIATE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | MADISON SURGERY CENTER MAKES THESE DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | DISTRIBUTIONS TO MEMBERS -6,975,000. TOTAL TO FORM 990, PART XI, LINE 5: -6,975,000. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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