PROHEALTH CARE INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PROHEALTH CARE INC (EIN 39-1486873)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-09
- IRS object ID
- 201242229349301759
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-09T17:24:35-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391486873 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PROH | NameControl |
| Phone | 2629284740 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE NO 200 | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 531881131 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NANINE M NELSON | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 2629284740 | Phone |
| Date Signed | 2012-08-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUSAN MIENCIER | Name |
| Phone | 2483522500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SUSAN EDWARDS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE NO 200 | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 531881131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 107730864 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PROHEALTHCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND OTHER HEALTHCARE DELIVERY ENTITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 859 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 173658 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 19131000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 38024502 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 74489742 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 68569665 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 209963 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1136697 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 93830705 | TotalRevenuePriorYear |
| Total Revenue Current Year | 107730864 | 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 | 54981877 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 48069513 | 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 | 23777298 | OtherExpensePriorYear |
| Other Expenses Current Year | 21636850 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 78759175 | TotalExpensesPriorYear |
| Total Expenses Current Year | 69706363 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 15071530 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 38024501 | RevenuesLessExpensesCY |
| Total Assets BOY | 36553805 | TotalAssetsBOY |
| Total Assets EOY | 64495688 | TotalAssetsEOY |
| Total Liabilities BOY | 26433569 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 55554270 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10120236 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8941418 | NetAssetsOrFundBalancesEOY |
| Mission Description | CONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 61069745 | Expense |
| Revenue | 68396007 | Revenue |
| Description | PROHEALTH CARE PROVIDES SUPPORT TO WAUKESHA MEMORIAL AND OCONOMOWOC MEMORIAL, OUR HOSPITALS, IN ADDITION TO MEDICAL CENTERS, ASSISTED LIVING/LONG-TERM CARE, HOME HEALTH AND HOSPICE, FITNESS, AND OTHER HEALTHCARE SERVICES. AMONG THE SERVICES PROVIDED ARE ADMINISTRATION, FINANCIAL AND PATIENT ACCOUNTING, DECISION SUPPORT, INFORMATION SYSTEMS, PUBLIC RELATIONS, HUMAN RESOURCES, MATERIALS AND FACILITIES MANAGEMENT, AND EDUCATION. SEE ATTACHED COMMUNITY BENEFIT REPORT FOR AN ILLUSTRATION OF OUR SYSTEM'S ACCOMPLISHMENTS. | Description |
| Total Program Service Expense | 61069745 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| 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 | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 115 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 859 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NANINE NELSON | NamePerson |
| Telephone Number | 2629284740 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N17 W24100 RIVERWOOD DRIVE SUITE | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 531881131 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| JEAN CRUIKSHANK | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| TOM DALUM | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MAC DORN | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MARGARET FARROW | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| HELEN FORSTER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MIKE GALLAGHER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| MARIE KINGSBURY | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| RONALD FICKEL MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 267079 | 43392 | ||||
| THOMAS PACKEE | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| JANET SWANDBY | |||||||||
| VICE CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | X | |||
| SUSAN EDWARDS | |||||||||
| PRESIDENT/CEO (PARTIAL YR) | 40.00 | X | 187698 | 0 | 183487 | X | |||
| DAN D'ANGELO DDS | |||||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |||
| DIXON BENZ | |||||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | |||
| E JOHN RAASCH | |||||||||
| CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | X | |||
| REXFORD W TITUS III | |||||||||
| PRESIDENT/CEO (PARTIAL YR) | 40.00 | 881179 | 0 | 77290 | X | ||||
| NANINE M NELSON | |||||||||
| CFO (PARTIAL YEAR) | 40.00 | 322237 | 0 | 45418 | X | ||||
| ROBERT W MLYNAREK | |||||||||
| CFO (PARTIAL YEAR) | 40.00 | 415764 | 0 | 42806 | X | ||||
| JANET A SCHULZ | |||||||||
| CHIEF INTEGRATION OFFICER | 40.00 | 328654 | 0 | 52729 | X | ||||
| NADINE T GUIRL | |||||||||
| SENIOR VP - HUMAN RESOURCES | 40.00 | 242734 | 0 | 289687 | X | ||||
| PETER GEISS | |||||||||
| CHIEF MEDICAL OFFICER | 2.00 | 376158 | 0 | 44195 | X | ||||
| LORNA J GRANGER | |||||||||
| CHIEF LEGAL OFFICER | 40.00 | 330818 | 0 | 30737 | X | ||||
| JAMES E LYONS | |||||||||
| SENIOR VP | 2.00 | 309479 | 0 | 44551 | X | ||||
| CLYDE M CHUMBLEY | |||||||||
| PRESIDENT/CEO, PHCMA (PARTIAL YEAR) | 40.00 | 1187533 | 0 | 10406 | X | ||||
| GARY E BUERSTATTE | |||||||||
| SENIOR VP-STRATEGY PLANNING(PART YR) | 40.00 | 962015 | 0 | 44692 | X | ||||
| RODNEY C DYKEHOUSE | |||||||||
| VP-INFORMATION SERVICES | 40.00 | 277760 | 0 | 33115 | X | ||||
| MATT WADE | |||||||||
| VP-CONSTRUCTION & FACILITIES | 40.00 | 265788 | 0 | 43274 | X | ||||
| FREDERICK A MEIER | |||||||||
| VP-MATERIALS MANAGEMENT | 40.00 | 166174 | 0 | 18359 | X | ||||
| MICHAEL A MCCREA | |||||||||
| EXECUTIVE DIRECTOR | 40.00 | 264018 | 0 | 57230 | X | ||||
| GORICA OVERMOYER | |||||||||
| VP PERFORMANCE EXCELLENCE | 40.00 | 159996 | 0 | 28203 | X | ||||
| PAUL TODD | |||||||||
| FORMER DIRECTOR | 2.00 | 0 | 294097 | 37117 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 6678005 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 561176 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1126688 | TotalOtherCompensation |
| Number Individuals GT100 K | 40 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | 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 |
|---|---|---|---|---|---|
| R&R INSURANCE SERVICES INC | |||||
| PO BOX 1610 | WAUKESHA | WI | 53187 | INSURANCE SERVICES | 2338886 |
| STANDARD REGISTER | |||||
| PO BOX 91047 | CHICAGO | IL | 60693 | PRINTING SERVICES | 1320201 |
| BICK GROUP | |||||
| 12969 MANCHESTER ROAD | ST LOUIS | MO | 63131 | CONSTRUCTION SERVICES | 1166528 |
| WITI-TV | |||||
| 3609 SOLUTIONS CENTER | CHICAGO | IL | 60677 | MEDIA/ADVERTISING | 576381 |
| US TRANSCRIPTION INC | |||||
| 2728 ASBURY ROAD | DUBUQUE | IA | 52001 | TRANSCRIPTION SERVICES | 466703 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 32 | NumberOfContractorsGT100K |
| Related Organizations | 38024502 | RelatedOrganizations |
| Total Contributions | 38024502 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| SUPPORT SERVICES | 561000 | 68456879 | 68396007 | 60872 |
| TRANSPORTATION | 480000 | 112786 | 112786 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 68569665 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1136697 | TotalRevenueColumn |
| Exclusion | $1,136,697 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107730864 | TotalRevenueColumn |
| Related Or Exempt Function Income | 68396007 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 173658 | UnrelatedBusinessRevenue |
| Exclusion | $1,136,697 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5007746 | Total |
| Program Services | 4387286 | ProgramServices |
| Management And General | 620460 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33056283 | Total |
| Program Services | 28960610 | ProgramServices |
| Management And General | 4095673 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1601693 | Total |
| Program Services | 1403243 | ProgramServices |
| Management And General | 198450 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5890795 | Total |
| Program Services | 5160926 | ProgramServices |
| Management And General | 729869 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2512996 | Total |
| Program Services | 2201636 | ProgramServices |
| Management And General | 311360 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 678500 | Total |
| Program Services | 594434 | ProgramServices |
| Management And General | 84066 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3453 | Total |
| Program Services | 3025 | ProgramServices |
| Management And General | 428 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9145150 | Total |
| Program Services | 8012066 | ProgramServices |
| Management And General | 1133084 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1643882 | Total |
| Program Services | 1440205 | ProgramServices |
| Management And General | 203677 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2425591 | Total |
| Program Services | 2125060 | ProgramServices |
| Management And General | 300531 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1506500 | Total |
| Program Services | 1319845 | ProgramServices |
| Management And General | 186655 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316206 | Total |
| Program Services | 277028 | ProgramServices |
| Management And General | 39178 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 520831 | Total |
| Program Services | 456300 | ProgramServices |
| Management And General | 64531 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 526228 | Total |
| Program Services | 461028 | ProgramServices |
| Management And General | 65200 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75780 | Total |
| Program Services | 66391 | ProgramServices |
| Management And General | 9389 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BILLING & COLLECTION | 2386359 | 2090689 | 295670 |
| REPAIRS & MAINTENANCE | 2162879 | 1894898 | 267981 |
| DUES & SUBSCRIPTIONS | 245491 | 215075 | 30416 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69706363 | Total |
| Program Services | 61069745 | ProgramServices |
| Management And General | 8636618 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4459935 | BOY |
| EOY | 1907264 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8800097 | BOY |
| EOY | 7739863 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 498651 | BOY |
| EOY | 556669 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10691616 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3150873 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5700354 | BOY |
| EOY | 7540743 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11053768 | BOY |
| EOY | 5864936 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6041000 | BOY |
| EOY | 40886213 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36553805 | BOY |
| EOY | 64495688 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9311947 | BOY |
| EOY | 9119227 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 31400000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17121622 | BOY |
| EOY | 15035043 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26433569 | BOY |
| EOY | 55554270 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10120236 | BOY |
| EOY | 8941418 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10120236 | BOY |
| EOY | 8941418 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36553805 | BOY |
| EOY | 64495688 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 38024501 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -39203319 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (4 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| WAUKESHA MEMORIAL HOSPITAL INC | |||||
| 390910727 | 3 | 1 | 1 | 1 | $0 |
| OCONOMOWOC MEMORIAL HOSPITAL INC | |||||
| 390794174 | 3 | 1 | 1 | 1 | $0 |
| PROHEALTH HOME CARE INC | |||||
| 200067392 | 3 | 1 | 1 | 1 | $0 |
| NATIONAL REGENCY OF NEW BERLIN INC | |||||
| 391077992 | 9 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 4 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $3,453 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3453 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | A THIRD PARTY VENDOR PROVIDES ADVICE TO THE ORGANIZATION REGARDING ONGOING OPPORTUNITIES TO ADVANCE THE PROHEALTH CARE VALUE PROPOSITION MESSAGE WITH GOVERNMENT LEADERS OF INFLUENCE, BUSINESS LEADERS OF INFLUENCE AND BUSINESS ORGANIZATIONS. ADDITIONALLY, THE THIRD PARTY VENDOR PROVIDES CONSISTENT MONITORING OF STATE POLICY AND POLITICAL ENVIRONMENTS, COMMUNICATES WITH KEY LEGISLATORS AND AGENCIES AS NECESSARY, AND WORKS WITH STATE ASSOCIATIONS AS APPROPRIATE TO AID IN GOVERNMENT RELATIONS ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2732052 | OtherCostOrOtherBasis |
| Book Value | 2732052 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 323064 | OtherCostOrOtherBasis |
| Depreciation | 56056 | Depreciation |
| Book Value | 267008 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3924907 | OtherCostOrOtherBasis |
| Depreciation | 782598 | Depreciation |
| Book Value | 3142309 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3002130 | OtherCostOrOtherBasis |
| Depreciation | 2312219 | Depreciation |
| Book Value | 689911 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 709463 | OtherCostOrOtherBasis |
| Book Value | 709463 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7540743 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENT IN WHS/OCC/MA | 38407792 | C |
| INVESTMENT IN UM CSC | 200000 | C |
| INVESTMENT IN ACO | 2278421 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 40886213 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED MINIMUM PENSION | $7,953,037 |
| ACCRUED POSTRETIREMENT MEDICAL | $190,104 |
| DEFERRED COMPENSATION | $15,697 |
| ACCRUED MINIMUM SERP LIABILITY | $6,876,205 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15035043 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | FIN48 DISCLOSURE: FEDERAL INCOME TAX - PHC, WMH, OMH, NATIONAL REGENCY, AND PHHC ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. ALL OF THESE ENTITIES ARE, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. WHS IS A FOR-PROFIT STOCK CORPORATION AND IS SUBJECT TO INCOME TAXES. WHS ACCOUNTS FOR INCOME TAXES UNDER THE ASSET AND LIABILITY METHOD. UNDER THIS METHOD, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED RELATED TO THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE ACCOUNTING STANDARD THAT REFERS TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IS EFFECTIVE FOR FISCAL YEARS BEGINNING AFTER DECEMBER 15, 2006 FOR NONPUBLIC ENTITIES THAT HOLD PUBLIC DEBT. THE STANDARD ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED ON THE CONSOLIDATED FINANCIAL STATEMENT. COMPANIES MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE STANDARD ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. THE CORPORATION ADOPTED THIS STANDARD AS OF OCTOBER 1, 2007. THE ADOPTION DID NOT HAVE A MATERIAL IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO EXAMINATION BY TAXING AUTHORITIES; HOWEVER, NO EXAMINATIONS ARE IN PROGRESS. MANAGEMENT BELIEVES THE CORPORATION IS NOT SUBJECT TO TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RONALD FICKEL MD | |||||||||||||
| 0 | 180379 | 0 | 61386 | 0 | 25314 | 0 | 15627 | 0 | 27765 | 0 | 310471 | 0 | 0 |
| SUSAN EDWARDS | |||||||||||||
| 167371 | 0 | 0 | 0 | 20327 | 0 | 179245 | 0 | 4242 | 0 | 371185 | 0 | 0 | 0 |
| REXFORD W TITUS III | |||||||||||||
| 771901 | 0 | 0 | 0 | 109278 | 0 | 41307 | 0 | 35983 | 0 | 958469 | 0 | 0 | 0 |
| NANINE M NELSON | |||||||||||||
| 293983 | 0 | 0 | 0 | 28254 | 0 | 19160 | 0 | 26258 | 0 | 367655 | 0 | 0 | 0 |
| ROBERT W MLYNAREK | |||||||||||||
| 387382 | 0 | 0 | 0 | 28382 | 0 | 27211 | 0 | 15595 | 0 | 458570 | 0 | 0 | 0 |
| JANET A SCHULZ | |||||||||||||
| 297333 | 0 | 0 | 0 | 31321 | 0 | 19178 | 0 | 33551 | 0 | 381383 | 0 | 0 | 0 |
| NADINE T GUIRL | |||||||||||||
| 240715 | 0 | 0 | 0 | 2019 | 0 | 271626 | 0 | 18061 | 0 | 532421 | 0 | 0 | 0 |
| PETER GEISS | |||||||||||||
| 327241 | 0 | 0 | 0 | 48917 | 0 | 20719 | 0 | 23476 | 0 | 420353 | 0 | 0 | 0 |
| LORNA J GRANGER | |||||||||||||
| 305489 | 0 | 0 | 0 | 25329 | 0 | 7965 | 0 | 22772 | 0 | 361555 | 0 | 0 | 0 |
| JAMES E LYONS | |||||||||||||
| 299094 | 0 | 0 | 0 | 10385 | 0 | 31714 | 0 | 12837 | 0 | 354030 | 0 | 0 | 0 |
| CLYDE M CHUMBLEY | |||||||||||||
| 250161 | 0 | 0 | 0 | 937372 | 0 | 7258 | 0 | 3148 | 0 | 1197939 | 0 | 0 | 0 |
| GARY E BUERSTATTE | |||||||||||||
| 81202 | 0 | 0 | 0 | 880813 | 0 | 36974 | 0 | 7718 | 0 | 1006707 | 0 | 668787 | 0 |
| RODNEY C DYKEHOUSE | |||||||||||||
| 260056 | 0 | 0 | 0 | 17704 | 0 | 5869 | 0 | 27246 | 0 | 310875 | 0 | 0 | 0 |
| MATT WADE | |||||||||||||
| 223213 | 0 | 0 | 0 | 42575 | 0 | 15789 | 0 | 27485 | 0 | 309062 | 0 | 0 | 0 |
| FREDERICK A MEIER | |||||||||||||
| 155636 | 0 | 0 | 0 | 10538 | 0 | 4128 | 0 | 14231 | 0 | 184533 | 0 | 0 | 0 |
| MICHAEL A MCCREA | |||||||||||||
| 242918 | 0 | 0 | 0 | 21100 | 0 | 28992 | 0 | 28238 | 0 | 321248 | 0 | 0 | 0 |
| GORICA OVERMOYER | |||||||||||||
| 144343 | 0 | 0 | 0 | 15653 | 0 | 10888 | 0 | 17315 | 0 | 188199 | 0 | 0 | 0 |
| PAUL TODD | |||||||||||||
| 0 | 243912 | 0 | 37683 | 0 | 12502 | 0 | 17640 | 0 | 19477 | 0 | 331214 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | COUNTRY CLUB MEMBERSHIPS: REXFORD W TITUS III AND CLYDE CHUMBLEY - BENEFIT WAS NOT INCLUDED IN TAXABLE INCOME AS MEMBERSHIP IS FOR BUSINESS ONLY. |
| PART I, LINES 4A-B | LINE 4A: CLYDE CHUMBLEY: SEPARATION PAYMENTS WERE CALCULATED BASED A PERCENTAGE OF COMPENSATION FOR SERVICES PROVIDED IN A SENIOR LEADERSHIP ROLE PER THE DETAIL SPELLED OUT IN THE EXECUTIVE AND PHYSICIAN EMPLOYMENT AGREEMENT OF 1/4/2008 AND EMPLOYMENT SEPARATION OF 1/27/10. SEPARATION PAYMENTS WERE MADE IN TWO LUMP SUM AMOUNTS AS AGREED BETWEEN THE PARTIES IN A TERMINATION AGREEMENT EFFECTIVE, 3/15, 2010. GARY BUERSTATTE: EARLY RETIREMENT PAYMENTS WERE MADE AS APPROVED BY THE PHC BOARD OF DIRECTORS TO MADE AFTER 4/30/10. PAYMENTS WERE MADE IN BIWEEKLY INSTALLMENTS OVER AN 18 MONTH PERIOD PER AGREEMENT SIGNED BY THE PARTIES ON 12/23/09. LINE 4B: NAME PLAN REXFORD W TITUS III - SERP PLAN PARTICIPANT GARY BUERSTATTE - SERP PLAN PARTICIPANT NADINE GUIRL - SERP PLAN PARTICIPANT JAMES LYONS - SERP PLAN PARTICIPANT ROBERT MLYNAREK - SERP PLAN PARTICIPANT CLYDE CHUMBLEY - SERP PLAN PARTICIPANT SUSAN EDWARDS - SERP PLAN PARTICIPANT NANINE M NELSON - SERP PLAN PARTICIPANT JANET A SCHULZ - SERP PLAN PARTICIPANT PETER GEISS - SERP PLAN PARTICIPANT LORNA J GRANGER - SERP PLAN PARTICIPANT PROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION PERFORMED A REVIEW; THEN THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION. | |
| ALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING; DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS, NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS, AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION. | FORM 990, PART VI, SECTION B, LINE 12C | |
| AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO/PRESIDENT, OFFICER, EXECUTIVE DIRECTOR, VICE-PRESIDENT, AND SENIOR VICE-PRESIDENT. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2011. | FORM 990, PART VI, SECTION B, LINE 15 | |
| FINANCIAL STATEMENTS, GOVERNING DOCUMENTS & CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| FORM 990 PART VII: THE FOLLOWING OFFICERS AND DIRECTORS HAVE WORKED FOR RELATED ORGANIZATIONS. THESE INDIVIDUALS ARE AS FOLLOWS: OFFICERS/DIRECTORS AVG. HRS. / WEEK EMPLOYED BY RELATED ORGANIZATION ---------------------------------------------------------------------- RONALD FICKEL, MD GREATER THAN 40.00 WAUKESHA HEALTH CARE, INC. PAUL TODD, MD GREATER THAN 40.00 MEDICAL ASSOCIATES, INC. | ||
| CHANGES IN NET ASSETS OR FUND BALANCES: | EQUITY EARNINGS IN AFFILIATED ORGANIZATIONS 7,382,681. CAPITAL CONTRIBUTIONS TO RELATED ORGANIZATIONS -38,025,000. CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE -7,888,000. CHANGE IN SERP VALUATION -673,000. TOTAL TO FORM 990, PART XI, LINE 5: -39,203,319. | FORM 990, PART XI, LINE 5: |
| THE AUDIT PROCESS HAS NOT CHANGED IN THE CURRENT YEAR. | FORM 990, PART XII, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OCONOMOWOC MEMORIAL HOSPITAL INC | |||||||||||
| 791 SUMMIT AVENUE | OCONOMOWOC | WI | 53066 | 390794174 | HOSPITAL | WI | 501(C)(3) | LINE 3 | N/A | 1 | |
| WAUKESHA MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | 391314542 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 1 | WAUKESHA MEMORIAL HOSPITAL INC | |
| PROHEALTH HOME CARE INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 200067392 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | N/A | 1 | |
| NATIONAL REGENCY OF NEW BERLIN INC | |||||||||||
| N17 W24100 RIVERWOOD DR SUITE 200 | WAUKESHA | WI | 53188 | 391077992 | HEALTHCARE | WI | 501(C)(3) | LINE 9 | N/A | 1 | |
| WAUKESHA MEMORIAL HOSPITAL INC | |||||||||||
| 725 AMERICAN AVENUE | WAUKESHA | WI | 53188 | 390910727 | HOSPITAL | WI | 501(C)(3) | LINE 3 | N/A | 1 | |
| OCONOMOWOC MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 791 SUMMIT AVENUE | OCONOMOWOC | WI | 53066 | 391271647 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 1 | OCONOMOWOC MEMORIAL HOSPITAL INC | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROHEALTH ALIGNED LLC (DBA MSC) | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 DELAFIELD STREET STE 1 | AddressLine1 |
| City | WAUKESHA | City |
| State | WI | State |
| ZIP Code | 53188 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263324572 | EIN |
| Primary Activity | SURGERY CENTER | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WAUKESHA HEALTH SYSTEM INC | ||||||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391507910 | HEALTHCARE | WI | N/A | C | -2423367 | 32221236 | 1.00000 | |
| EMPATHIA PACIFIC INC | ||||||||||||
| 31416 AGOURA RD STE 180 | WESTLAKE VILLAGE | CA | 91361 | 953070501 | HEALTHCARE | CA | C | 26360 | 918413 | 1.00000 | EMPATHIA INC | |
| MEDICAL ASSOCIATES INC | ||||||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391083015 | HEALTHCARE | WI | C | -26419493 | 100128793 | 1.00000 | WAUKESHA HEALTH SYSTEM INC | |
| NATIONAL AVENUE DEVELOPMENT CORPORATION | ||||||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391417226 | HEALTHCARE | WI | C | 45046 | 1280916 | 1.00000 | WAUKESHA HEALTH SYSTEM INC | |
| WAUKESHA HEALTH CARE INC | ||||||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391773598 | HEALTHCARE | WI | C | -4968757 | 1.00000 | WAUKESHA HEALTH SYSTEM INC | ||
| EMPATHIA INC | ||||||||||||
| N17 W24100 RIVERWOOD DRIVE STE 200 | WAUKESHA | WI | 53188 | 391567366 | HEALTHCARE | WI | C | 1354523 | 19111153 | 1.00000 | WAUKESHA HEALTH SYSTEM INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (21 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| C | 35077002 | ACTUAL AMOUNT RECEIVED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| C | 2947500 | ACTUAL AMOUNT RECEIVED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| J | 116985 | ACTUAL COSTS INCURRED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| K | 10032599 | ACTUAL COSTS INCURRED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| K | 51743328 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH CARE INC | ||
| K | 1332336 | ACTUAL COSTS INCURRED |
| MEDICAL ASSOCIATES INC | ||
| K | 3881380 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH SYSTEM INC | ||
| O | 1800594 | ACTUAL COSTS INCURRED |
| NATIONAL REGENCY OF NEW BERLIN INC | ||
| O | 372250 | ACTUAL COSTS INCURRED |
| EMPATHIA PACIFIC INC | ||
| O | 236936 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH CARE INC | ||
| O | 358569 | ACTUAL COSTS INCURRED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| O | 6947154 | ACTUAL COSTS INCURRED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| O | 1158729 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH SYSTEM INC | ||
| P | 483257 | ACTUAL COSTS INCURRED |
| EMPATHIA PACIFIC INC | ||
| P | 158332 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH CARE INC | ||
| P | 6203291 | ACTUAL COSTS INCURRED |
| WAUKESHA MEMORIAL HOSPITAL INC | ||
| P | 175429 | ACTUAL COSTS INCURRED |
| OCONOMOWOC MEMORIAL HOSPITAL INC | ||
| P | 1059100 | ACTUAL COSTS INCURRED |
| PROHEALTH HOME CARE INC | ||
| P | 95387 | ACTUAL COSTS INCURRED |
| MEDICAL ASSOCIATES INC | ||
| B | 27014502 | ACTUAL COSTS INCURRED |
| WAUKESHA HEALTH CARE INC | ||
| B | 9010000 | ACTUAL COSTS INCURRED |
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