2012-09-12T11:15:12-05:00 2011-12-31 420714325 MCGLADREY LLP PO BOX 5946 MADISON WI 537050946 990 2011-01-01 391264667 COMMUNITY CARE INC COMM 4143856610 1555 S LAYTON BLVD MILWAUKEE WI 53215 KIRBY G SHOAF 4143856610 2012-09-06 1 JAMES G GRAHAM P00006111 6088332612 2011 2016-02-24 21:20:13Z KIRBY G SHOAF 1555 S LAYTON BLVD MILWAUKEE WI 53215 325224943 0 X WWW.COMMUNITYCAREINC.ORG X 1977 WI COMMUNITY CARE'S MISSION IS TO DEVELOP AND DEMONSTRATE INNOVATIVE, FLEXIBLE, COMMUNITY-BASED APPROACHES TO CARE FOR AT-RISK ADULTS, IN ORDER TO OPTIMIZE THEIR QUALITY OF LIFE AND OPTIMIZE THE ALLOCATION OF COMMUNITY RESOURCES. 16 16 1180 44 0 0 464954 117153 259122086 322164906 139134 236905 12306 2955 259738480 322521919 0 0 233020334 275401473 23163267 27690871 0 0 0 7690205 8349591 263873806 311441935 -4135326 11079984 146694152 74313428 127638942 41567726 19055210 32745702 X COMMUNITY CARE DEMONSTRATES AND MANAGES INNOVATIVE, FLEXIBLE COMMUNITY-BASED PROGRAMS TO CARE FOR AT-RISK ADULTS IN ORDER TO ENHANCE THEIR QUALITY OF LIFE AND OPTIMIZE THE ALLOCATION OF COMMUNITY RESOURCES. 0 0 300045605 322032335 FAMILY CARE: PROVIDES INTEGRATED TECHNICAL CONSULTING AND ADDITIONAL LONG-TERM CARE SERVICES TO SENIORS AND ADULTS WITH PHYSICAL OR DEVELOPMENTAL DISABILITIES. THE OBJECTIVE IS TO HELP MEMBERS COORDINATE VARIOUS INDEPENDENT SPECIAL SERVICES RELATING TO THEIR NEEDS WITH FAMILY CARE SERVICES ENABLING MEMBERS TO RECEIVE THESE SERVICES IN THEIR PERSONAL RESIDENCES. 171608 82795 AFH CERTIFICATION - THIS PROGRAM MAKE SURE THAT THE ADULT FAMILY HOME(AFH) THAT CCI PLACES MEMBER IN COMPLIES WITH STATE AND FEDERAL REGULATIONS. 86530 49776 TECHNICAL ASSISTANCE - THE PROGRAM PROVIDE TECHNICAL SUPPORT TO NEW AND/OR START UP PACE PROGRAMS. 167374 2955 OTHER PROGRAM SERVICES INCLUDE: 1) SIOUXLAND PACE, 2) BUSINESS DEVELOPMENT AND 3) PATHWAYS TO INDEPENDENCE.SIOUXLAND PACE IS AN OPERATING PACE PROGRAM IN SIOUX CITY, IA, THAT IS CONDUCTED AS A JOINT EQUITY PARTNERSHIP WITH ST. LUKE'S HEALTH SYSTEM. BUSINESS DEVELOPMENT IS A PROGRAM THAT SEARCHES FOR OTHER OPPORTUNITIES TO FURTHER THE ORGANIZATION'S MISSION. EXAMPLES INCLUDE GRANT-FUNDED OPPORTUNITIES THROUGH THE ACA AND DEVELOPMENT OF CO-SPONSOR MODELS FOR NEW PACE PROGRAMS IN OTHER MARKETS. PATHWAYS TO INDEPENDENCE WAS A PROGRAM OPERATED FROM A SMALL GRANT PROVIDED BY THE WISCONSIN DEPARTMENT OF HEALTH SERVICES TO ASSIST THE ORGANIZATION WITH DEVELOPMENT OF THE NECESSARY INFRASTRUCTURE WITHIN ITS MANAGED CARE ORGANIZATION TO EFFECTIVELY ASSIST MEMBERS WITH PHYSICAL AND DEVELOPMENTAL DISABILITIES WHO WISH TO PURSUE INTEGRATED EMPLOYMENT. THE PROGRAM ENDED SEPTEMBER 30, 2011. 167374 2955 300471117 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1053 0 1 1180 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X LAWRENCE PAPLHAM 4149022370 1555 S LAYTON BLVD MILWAUKEE WI 53215 VIRGINIA THOMAS 1.00 X X 0 0 0 DORIS CHORTEK 1.00 X 0 0 0 ED CORRIGAN 1.00 X 0 0 0 EDMUND DUTHIE 1.00 X 0 0 0 STEVEN M DZIEDZIC 1.00 X 0 0 0 ROBERT GOLDSTEIN 1.00 X X 0 0 0 ROBERT HARRIS 1.00 X X 0 0 0 BEN GREENEBAUM 1.00 X 0 0 0 ANNE KIEKHOFER 1.00 X 0 0 0 JOHN PLANT 1.00 X 0 0 0 CONRAD SOBCZAK 1.00 X 0 0 0 ROBERT SPEER 1.00 X X 0 0 0 RICHARD THEADO 1.00 X 0 0 0 STEPHEN C VANDERBLOEMEN 1.00 X 0 0 0 RENEE SARTIN KIRBY 1.00 X 0 0 0 PATRICIA SCHROEDER 1.00 X 0 0 0 KIRBY SHOAF 40.00 X 258475 95601 20072 LAWRENCE PAPLHAM 40.00 X 176607 65320 7986 MARY GAVINSKI 40.00 X 286017 0 7700 ED KOHL 40.00 X 164628 0 17985 MARILYN SINCABAN 40.00 X 214747 0 6762 GREGORY NIERENGARTEN 40.00 X 191079 0 18917 ALICIA MODJESKA 40.00 X 168248 0 10122 1459801 160921 89544 29 0 1 0 HOMES FOR INDEPENDENT LIVING OF WI LLC PO BOX 3090 MILWAUKEE WI 532013090 RESIDENTIAL SERVICES 13788113 SOCIETYS ASSETS INC 5200 WASHINGTON AVENUE SUITE 225 RACINE WI 53406 IN-HOME CARE 9442419 MILWAUKEE CENTER FOR INDEPENDENCE 2020 WEST WELLS STREET MILWAUKEE WI 53233 IN-HOME CARE 6477035 ALPHA HOMES OF WISCONSIN INC 6216 WASHINGTON AVENUE SUITE D RACINE WI 53406 RESIDENTIAL SERVICES 6346769 INNOVATIVE SERVICES 445 S MADISON AVENUE GREEN BAY WI 54301 RESIDENTIAL SERVICES 5347832 412 19992 97161 117153 CAPITATION REVENUE 524114 290387345 290387345 PATIENT SERVICES 524114 31847704 31847704 CONTRACT REVENUE 524114 132572 132572 RISK-SHARING REVENUE 524114 -202715 -202715 322164906 275438 275438 2337400 327091 2342009 361015 -4609 -33924 -38533 -38533 OTHER REVENUE 900099 2955 2955 2955 322521919 322167861 0 236905 275401473 275401473 1459801 1459801 21114569 15565039 5549530 389423 264471 124952 2987517 2279683 707834 1739561 1326268 413293 22188 22188 131468 78870 52598 50950 50950 11090 11090 1444111 276387 1167724 95521 1761 93760 277165 152957 124208 466237 143861 322376 628180 589072 39108 41398 16978 24420 87500 2287 85213 917531 103438 814093 114672 5846 108826 ALLOCATED EXPENSE 1712659 1712659 EQUIPMENT RENTAL 1038021 404787 633234 BAD DEBT EXPENSE 598737 598852 -115 SUPPLIES 418201 68054 350147 293962 18573 275389 311441935 300471117 10970818 0 101961545 29891530 11449218 9326334 166122 216134 1055055 1658030 24121294 12587045 12806254 11534249 19255958 21687151 146694152 74313428 7172383 8868346 85516764 4670000 4545000 30279795 28154380 127638942 41567726 X 19055210 32745702 19055210 32745702 146694152 74313428 X 11079984 2610508 X X 0 1 1 X 1 1 X 2831514 2637083 1243047 464954 117153 7293751 37287279 104494034 161478003 259122086 322164906 884546308 40118793 107131117 162721050 259587040 322282059 891840059 0 0 0 891840059 173592 651784 101246 150401 275438 1352461 173592 651784 101246 150401 275438 1352461 12306 2955 15261 40292385 107782901 162822296 259749747 322560452 893207781 0.99850 0.99780 0.00150 0.00220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 50950 0 0 50950 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: COMMUNITY CARE, INC HIRES THIRD PARTIES, BLUMENFELD & ASSOCIATES, LLC AND GIELOW ASSOCIATES, TO LOBBY ON ITS BEHALF. MANAGEMENT ALSO HAS DIRECT CONTACT WITH LEGISLATORS AND ITS STAFF. 685309 685309 13239768 5232635 8007133 10009609 7332106 2677503 186608 22304 164304 11534249 OTHER ASSETS 161923 RESERVE FUND 5314656 DUE FROM CCHP 71696 INVESTMENT IN CCHP 16138876 21687151 IBNR FUND 27736569 UNPAID CLAIMS 417811 28154380 322521919 311441935 11079984 -12486 2622994 2610508 13690492 322282059 -12486 -12486 322294545 11090 216284 227374 322521919 311430845 0 311430845 11090 11090 311441935 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION FOLLOWS THE PROVISIONS OF ASC 740, INCOME TAXES. AS REQUIRED BY THE UNCERTAIN TAX POSITION GUIDANCE IN ASC 740, THE ORGANIZATION RECOGNIZES THE FINANCIAL STATEMENT BENEFIT OF A TAX POSITION ONLY AFTER DETERMINING THAT THE RELEVANT TAX AUTHORITY WOULD MORE LIKELY THAN NOT SUSTAIN THE POSITION FOLLOWING AN AUDIT. FOR POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT THRESHOLD, THE AMOUNT RECOGNIZED IN THE FINANCIAL STATEMENTS IS THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH THE RELEVANT TAX AUTHORITY. THERE WERE NO SIGNIFICANT MATTERS DETERMINED BY MANAGEMENT TO BE UNRECOGNIZED TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN THAT HAVE BEEN RECORDED ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010. TAX YEARS OPEN UNDER THE FEDERAL STATUTE OF LIMITATIONS INCLUDE 2008 THROUGH 2011. TAX YEARS OPEN UNDER THE STATE OF WISCONSIN STATUTE INCLUDE 2007 THROUGH 2011. PART XI, LINE 8 - OTHER ADJUSTMENTS: INVESTMENT IN CURRENT YEAR EARNINGS OF CCHP 2,259,565. REVERSAL OF PREMIUM DEFICIENCY RESERVE 363,429. TOTAL TO SCHEDULE D, PART XI, LINE 8: 2,622,994. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 247,253. OTHER REVENUE -30,969. X X X X 0 0 0 0 0 0 0 0 0 KIRBY SHOAF 258475 95601 0 0 0 0 5366 1984 9287 3435 273128 101020 0 0 LAWRENCE PAPLHAM 176607 65320 0 0 0 0 5354 1980 476 176 182437 67476 0 0 MARY GAVINSKI 286017 0 0 0 0 0 7350 0 350 0 293717 0 0 0 ED KOHL 164628 0 0 0 0 0 5062 0 12923 0 182613 0 0 0 MARILYN SINCABAN 214747 0 0 0 0 0 6412 0 350 0 221509 0 0 0 GREGORY NIERENGARTEN 191079 0 0 0 0 0 5993 0 12924 0 209996 0 0 0 ALICIA MODJESKA 168248 0 0 0 0 0 0 0 10122 0 178370 0 0 0 WI HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 97710V4R6 2007-09-01 5000000 IMPROVEMENT OF FACILITIES 0 0 0 455000 5000000 144674 4855326 2007 0 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 1 1 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND FINANCE COMMITTEE COMPLETE A DETAIL REVIEW OF FORM 990. A COPY OF FORM 990 IS MAILED TO THE ENTIRE BOARD BEFORE IT IS FILED ELECTRONICALLY. FORM 990, PART VI, SECTION B, LINE 12C COMMUNITY CARE REQUIRES THE MEMBERS OF THE BOARD OF DIRECTORS TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ANNUALLY AND WHENEVER A NEW ISSUE ARISES. SHOULD THE ORGANIZATION BECOME AWARE OF ANY UNREPORTED POTENTIAL CONFLICTS, THE CONCERNS ARE RAISED WITH THE INDIVIDUAL TO DETERMINE THE EXISTENCE OF ANY SUCH ISSUE. THE DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER AND THE BOARD CHAIRPERSON TO DETERMINE IF ANY MITIGATION IS REQUIRED. THE BOARD OF DIRECTORS IS PROVIDED WITH A SUMMARY OF MEMBER-DISCLOSED CONFLICTS OF INTEREST ANNUALLY AND ANY TIME THE INFORMATION IS CHANGED. ADDITIONALLY, THE COMPLIANCE OFFICER IS AWARE OF THE MEETING AGENDAS AND ENSURES THAT ANY POTENTIAL CONFLICTS OF INTEREST ARE KNOWN AND ADDRESSED PRIOR TO ANY MEETING. SHOULD A CONFLICT BE DISCLOSED OR IDENTIFIED DURING A MEETING THE BOARD CHAIRPERSON OR COMPLIANCE OFFICER WILL IMPLEMENT THE NECESSARY MEASURES TO MITIGATE THE CONCERN. MANAGEMENT AND INDIVIDUALS WITH SPENDING AUTHORITY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ANNUALLY AND WHENEVER NEW ISSUES ARE IDENTIFIED. SHOULD THE ORGANIZATION BECOME AWARE OF ANY UNREPORTED POTENTIAL CONFLICTS, THE CONCERNS ARE RAISED WITH THE INDIVIDUAL TO DETERMINE THE EXISTENCE OF ANY SUCH ISSUE. THESE DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER AND THE CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE FOLLOWING DESCRIBES HOW COMMUNITY CARE INC. DETERMINES ITS SALARY AND WAGES. COMMUNITY CARE, INC. ENGAGED THE SERVICES OF THE MANAGEMENT CONSULTING FIRM MCGLADREY LLP TO PROVIDE SALARY RANGE SUGGESTIONS FOR TOP PERSONNEL AND FOR MANAGERS IN THE HUMAN RESOURCES DEPARTMENT. IN 2009, MCGLADREY LLP ANALYZED 34 SUCH POSITIONS BASED ON SCOPE (USING OPERATING REVENUE PROJECTIONS) AND CLOSE SCRUTINY OF THE POSITION DESCRIPTIONS FOR THOSE POSITIONS. INITIAL COMPENSATION IS BASED ON TOTAL YEARS OF RELEVANT EXPERIENCE; ANNUAL MERIT INCREASES ARE GIVEN BASED ON THE INDIVIDUAL'S PERFORMANCE EVALUATION. THE DIRECTOR OF HUMAN RESOURCES REVIEWS THE PERFORMANCE EVALUATION FOR ACCURACY AND CONSISTENCY, AND ASSIGNS A PERCENTAGE INCREASE BASED ON THE TOTAL "POINTS" EARNED BY THE EMPLOYEE ON THE PERFORMANCE EVALUATION. EACH PERFORMANCE EVALUATION IS FIRST SIGNED OFF ON BY THE EXECUTIVE OVERSEEING THE ADMINISTRATOR/DIRECTOR GIVING THE EVALUATION. MANAGERS IN THE HUMAN RESOURCES DEPARTMENT ARE INCLUDED IN THE MCGLADREY LLP STUDY TO AVOID THE PERCEPTION OF CONFLICT OF INTEREST, AS THE DEPARTMENT SETS THE RANGES FOR ALL OTHER POSITIONS IN THE AGENCY. FORM 990, PART VI, SECTION C, LINE 19 RECORDS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST BY MAILING TO: COMMUNITY CARE INC, C/O LAWRENCE PAPLHAM, 1555 S. LAYTON BLVD. MILWAUKEE, WI 53215. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -12,486. INVESTMENT IN CURRENT YEAR EARNINGS OF CCHP 2,259,565. REVERSAL OF PREMIUM DEFICIENCY RESERVE 363,429. TOTAL TO FORM 990, PART XI, LINE 5: 2,610,508. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR. COMMUNITY CARE HEALTH PLAN INC 1555 S LAYTON BLVD MILWAUKEE WI 53215 320124346 HMO WI 501(C)(4) COMMUNITY CARE INC 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 COMMUNITY CARE HEALTH PLAN M 12921586 ALLOCATED EXPENSE COMMUNITY CARE HEALTH PLAN N 22982816 DIRECT EMPLOYEE EXPENSE COMMUNITY CARE HEALTH PLAN P 35904402 AMOUNT INVOICED