MERCY HEALTH SYSTEM CORPORATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MERCY HEALTH SYSTEM CORPORATION (EIN 39-0816848)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-11
IRS object ID
201101319349301795
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-11T14:45:54-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly Virchow Krause LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 Midland Court PO Box 8130AddressLine1
CityJanesvilleCity
StateWIState
ZIP Code535478130ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390816848EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY HEALTH SYSTEM CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone6087566000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 - 1000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAVON BEAName
TitleCEOTitle
Phone6087566000Phone
Date Signed2011-05-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam T Murphy CPAName
Phone6087525835Phone
Date Prepared2011-05-10DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAVON BEANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 5003 - 1000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode
FieldValueIRS element (for citing)
Gross Receipts432050482GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.mercyhealthsystem.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionThe mission of Mercy Health System is to provide exceptional health care services resulting in healing in the broadest sense.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees3580TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI7537717TotalGrossUBI
Net Unrelated Business Txbl Income-17434NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year236056ContributionsGrantsPriorYear
Contributions Grants Current Year239288ContributionsGrantsCurrentYear
Program Service Revenue Prior Year420506408ProgramServiceRevenuePriorYear
Program Service Revenue CY419084944ProgramServiceRevenueCY
Investment Income Prior Year-715230InvestmentIncomePriorYear
Investment Income Current Year658102InvestmentIncomeCurrentYear
Other Revenue Prior Year115470OtherRevenuePriorYear
Other Revenue Current Year1891518OtherRevenueCurrentYear
Total Revenue Prior Year420142704TotalRevenuePriorYear
Total Revenue Current Year421873852TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year249137GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year247006590SalariesEtcPriorYear
Salaries Etc Current Year254680596SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year156291265OtherExpensePriorYear
Other Expenses Current Year150038775OtherExpensesCurrentYear
Total Expenses Prior Year403546992TotalExpensesPriorYear
Total Expenses Current Year404719371TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16595712RevenuesLessExpensesPriorYear
Revenues Less Expenses CY17154481RevenuesLessExpensesCY
Total Assets BOY328015658TotalAssetsBOY
Total Assets EOY342696939TotalAssetsEOY
Total Liabilities BOY212194382TotalLiabilitiesBOY
Total Liabilities EOY243539510TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY115821276NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY99157429NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of Mercy Health System is to provide exceptional health care services resulting in healing in the broadest sense.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense331025130Expense
Revenue410684713Revenue
DescriptionHOSPITAL ADMISSIONS 10,202, NURSING HOME ADMISSIONS 297, BIRTHS 1,091, OUTPATIENT VISITS 1,117,017Description
Total Program Service Expense331025130TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096242NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3580NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN COOKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6087566642TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 MINERAL POINTAddressLine1
CityJANESVILLECity
StateWIState
ZIP Code535475003ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ROWLAND MCCLELLAN
ChAIRPERSON & DIRECTOR1.00X74700
ThOMAS POOL
VICE-CHAIRPERSON & DIRECTO1.00X1500000
LARRY SQUIRE
TREASURER & DIRECTOR1.00X393400
SIMA WEXLER
SECRETARY & DIRECTOR1.00X000
DAVE SYVERSON
DIRECTOR1.00X1350000
MARK GOELZER MD
DIRECTOR1.00X000
ROBERT CONSIGNY
DIRECTOR1.00X000
STEVE VAN GALDER
DIRECTOR1.00X34400
Katherine Schack
DiRECTOR1.00X000
BARB BORTNER
VICE-PRESIDENT55.00178564021245X
DAN COLBY
VICE-PRESIDENT55.00253685040031X
DAVID KURTZ
VICE-PRESIDENT55.00185907025055X
JOHN COOK
VICE-PRESIDENT55.00275733019902X
JOSEPH NEMETH
VICE-PRESIDENT55.00267232041707X
KATHY HARRIS
VICE-PRESIDENT55.00125328013402X
RUTH YARBROUGH
VICE-PRESIDENT55.00217437039935X
RICHARD GRUBER
VICE-PRESIDENT55.00188532013195X
RALPH TOPINKA
VICE-PRESIDENT55.00337589039800X
SUE RIPSCH
VICE-PRESIDENT55.00304462029435X
JAVON BEA
PRESIDENT & DIRECTOR55.00X197902301660001X
Bradley Fideler
Physician40.0013850660311318X
Vikram Khanna
Physician40.001002362051413X
Christopher Sturm
Physician40.00940840049243X
John Bussa
physician40.00859424072757X
Francis Kaveggia
physician40.00866191054410X
FieldValueIRS element (for citing)
Total Reportable Comp From Org9400900TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation2482849TotalOtherCompensation
Number Individuals GT100 K352NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Findorff Inc
300 S Bedford StMadisonWI53703ConSTRUCTION4803718
Mckesson Information Solutions
PO Box 98347ChicagoIL606938347Patient Stmt Processing/Maintenance3276446
Hammel Green & Abrahamson
PO BOX 86MinneapolisMN554861861Architectual Services1569565
MAGILL CONSTRUCTION COMPANY
977 KOOPMAN LANEELKHORNWI53121CONSTRUCTION1463772
Quest Diagnostics
1355 Mittel BlvdWoodaleIL60191Lab Services1185074
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K
Government Grants85299GovernmentGrants
All Other Contributions153989AllOtherContributions
Total Contributions239288TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PATIENT SERVICE REVENU621110410684713410684713
UNRELATED BUSINESS INC56100075377177537717
CAFETERIA722210862514$862,514
FieldValueIRS element (for citing)
Total Program Service Revenue419084944TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column630875TotalRevenueColumn
Exclusion$630,875ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10193657Securities
Other10200Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10030200Securities
Other146430Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities163457Securities
Other-136230Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column27227TotalRevenueColumn
Exclusion$27,227ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER INVESTMENTS9000991635183$1,635,183
MISCELLANEOUS900099256335$256,335
FieldValueIRS element (for citing)
Total Other Revenue1891518TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column421873852TotalRevenueColumn
Related Or Exempt Function Income410684713RelatedOrExemptFunctionIncome
Unrelated Business Revenue7537717UnrelatedBusinessRevenue
Exclusion$3,412,134ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6290725Total
Management And General6290725ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total201581651Total
Program Services166722406ProgramServices
Management And General34859245ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8710503Total
Program Services6471754ProgramServices
Management And General2238749ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total25947316Total
Program Services18903940ProgramServices
Management And General7043376ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12150401Total
Program Services9266758ProgramServices
Management And General2883643ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total278406Total
Management And General278406ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48300Total
Management And General48300ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total72296Total
Management And General72296ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19194616Total
Program Services10552592ProgramServices
Management And General8642024ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2926964Total
Program Services64061ProgramServices
Management And General2862903ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total68658238Total
Program Services64870872ProgramServices
Management And General3787366ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total934940Total
Program Services444978ProgramServices
Management And General489962ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6995882Total
Program Services6261314ProgramServices
Management And General734568ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total758346Total
Program Services283877ProgramServices
Management And General474469ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1306457Total
Program Services915606ProgramServices
Management And General390851ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5191460Total
Program Services4646357ProgramServices
Management And General545103ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17965441Total
Program Services16061847ProgramServices
Management And General1903594ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6535620Total
Program Services5487047ProgramServices
Management And General1048573ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBTS118398371183983700
WI MEDICAID & OTHER TAX6072326607232600
EQUIPMENT REPAIRS & MAI5303587368231416212730
SPECIAL PROJECT FUND1633754016337540
INTER-ENTITY TRANSACTIO-8929639-2269571-66600680

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3251944Total
Program Services746815ProgramServices
Management And General2505129ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total404719371Total
Program Services331025130ProgramServices
Management And General73694241ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16365BOY
EOY16320EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY17302367BOY
EOY13332054EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY77923407BOY
EOY67615922EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7765991BOY
EOY9501828EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3797071BOY
EOY4648927EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis331174508LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec157799472LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY171405846BOY
EOY173375036EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY39951670BOY
EOY66794118EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9852941BOY
EOY7412734EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY328015658BOY
EOY342696939EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY63062543BOY
EOY69162408EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY55208692BOY
EOY37224761EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY93923147BOY
EOY137152341EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY212194382BOY
EOY243539510EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY115821276BOY
EOY99157429EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY115821276BOY
EOY99157429EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY328015658BOY
EOY342696939EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis26450912OtherCostOrOtherBasis
Book Value26450912BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis160628997OtherCostOrOtherBasis
Depreciation70327267Depreciation
Book Value90301730BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5207960OtherCostOrOtherBasis
Depreciation3026448Depreciation
Book Value2181512BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis119092628OtherCostOrOtherBasis
Depreciation80341504Depreciation
Book Value38751124BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis19794011OtherCostOrOtherBasis
Depreciation4104253Depreciation
Book Value15689758BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings173375036TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVEST. - FUTURE REPLACE OF PROP, PLANT & EQUIPMENT18142226F
ASSETS UNDER BOND INDENTURE AGREEMENT9183827F
DEFERRED COMPENSATION13004193F
INVESTMENT IN MERCYCARE14182986F
INVESTMENTS - OTHER4280886F
BOND PROJECT FUND8000000F
FieldValueIRS element (for citing)
Total Of Book Value Securities66794118TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$13,004,193
PENSION LIABILITY$35,515,000
CAPITAL LEASES PAYABLE$49,929
DUE TO RELATED PARTY$88,583,219
FieldValueIRS element (for citing)
Total Of Amounts137152341TotalOfAmounts
Total Revenue421873852TotalRevenue
Total Expenses404719371TotalExpenses
Excess Or Deficit For Year17154481ExcessOrDeficitForYear
Net Unrealized GL On Investments431672NetUnrealizedGLOnInvestments
Other-$34,250,000OtherAmount
Total Adjustments-33818328TotalAdjustments
Excess Or Deficit Per FS-16663847ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt421873852TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal421873852RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990421873852TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt404719371TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal404719371ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990404719371TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8 - Other Adjustments:Identifier
ExplanationCHANGES IN PENSION OBLIGATIONS: -6950000. TRANSFER TO MERCY ALLIANCE, INC.: -27300000.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8150970TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense8150970NetCommunityBenefitExpense
Percent Of Total Expense0.02070PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense55468313TotalCommunityBenefitExpense
Direct Offsetting Revenue35764790DirectOffsettingRevenue
Net Community Benefit Expense19703523NetCommunityBenefitExpense
Percent Of Total Expense0.05020PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense4347852TotalCommunityBenefitExpense
Direct Offsetting Revenue2689330DirectOffsettingRevenue
Net Community Benefit Expense1658522NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense67967135TotalCommunityBenefitExpense
Direct Offsetting Revenue38454120DirectOffsettingRevenue
Net Community Benefit Expense29513015NetCommunityBenefitExpense
Percent Of Total Expense0.07510PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1502353TotalCommunityBenefitExpense
Direct Offsetting Revenue173394DirectOffsettingRevenue
Net Community Benefit Expense1328959NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4067438TotalCommunityBenefitExpense
Direct Offsetting Revenue3034317DirectOffsettingRevenue
Net Community Benefit Expense1033121NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense11259427TotalCommunityBenefitExpense
Direct Offsetting Revenue7412629DirectOffsettingRevenue
Net Community Benefit Expense3846798NetCommunityBenefitExpense
Percent Of Total Expense0.00980PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense267947TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense267947NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17097165TotalCommunityBenefitExpense
Direct Offsetting Revenue10620340DirectOffsettingRevenue
Net Community Benefit Expense6476825NetCommunityBenefitExpense
Percent Of Total Expense0.01650PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense85064300TotalCommunityBenefitExpense
Direct Offsetting Revenue49074460DirectOffsettingRevenue
Net Community Benefit Expense35989840NetCommunityBenefitExpense
Percent Of Total Expense0.09160PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense125000TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense125000NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense125000TotalCommunityBuildingExpense
Net Community Building Expense125000NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,339,764BadDebtExpenseAmount
Amount Attributable To683490AmountAttributableTo
Amount Reimbursed By Medicare41606131AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare91320773CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-49714642MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (48 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursCritical Access HospitalCriticalAccessHospitalOtherOther
Mercy Hospital
1000 Mineral Point AvenueJanesvilleWI53548XXXX
Mercy Walworth Hospital and Medical Cent
N2950 State Road 67Lake GenevaWI53147XXXX
Mercy Manor Transition Center
1000 Mineral Point AvenueJanesvilleWI53548Skilled Nursing/Sub-Acute Care Facility
Mercy Regional Cancer Center
1000 Mineral Point AvenueJanesvilleWI53548Radiation Oncology Clinic/Radiation Therapy Facility
House of Mercy Homeless Shelter
320 Lincoln StreetJanesvilleWI53548Homeless Center
Mercy Algonquin Medical Center
2401 Harnish Drive Suite 101AlgonquinIL60102Outpatient Physician Clinic
Mercy Bariatric Wellness Center
250 E Center Drive Suite 201Vernon HillsIL60061Outpatient Physician Clinic
Mercy Barrington Medical Center
500 West Highway 22BarringtonIL60010Outpatient Physician Clinic
Mercy Beloit Medical Center
2825 Prairie AvenueBeloitWI53511Outpatient Physician Clinic/Urgent Care Facility
Mercy Brodhead Medical Center
2310 First Center AvenueBrodheadWI53520Outpatient Physician Clinic
Mercy Center for Corrective Eye Surgery
5400 W Elm Street Suite 120McHenryIL60050Outpatient Physician Clinic
Mercy Center for Corrective Eye Surgery
8780 W Golf Road Ste 304NilesIL60714Outpatient Physician Clinic
Mercy Clinic East
3524 East Milwaukee StreetJanesvilleWI53546Outpatient Physician Clinic/Urgent Care Facility
Mercy Clinic East Pharmacy
3524 East Milwaukee StreetJanesvilleWI53546Retail Pharmacy
Mercy Clinic South
849 Kellogg AvenueJanesvilleWI53546Residency Program / Outpatient Physician Clinic
Mercy Clinic West
1000 Mineral Point AvenueJanesvilleWI53548Outpatient Physician Clinic & Medical Oncology
Mercy Clinic West Pharmacy
1000 Mineral Point AvenueJanesvilleWI53548Retail Pharmacy
Mercy Crystal Lake Chiropractic and Reha
330 W Terra Cotta Road Rte 176Crystal LakeIL60014Chiropractor
Mercy Crystal Lake Medical Center East
390 Congress ParkwayCrystal LakeIL60014Outpatient Physician Clinic
Mercy Crystal Lake Medical Center West
350 Congress ParkwayCrystal LakeIL60014Outpatient Physician Clinic
Mercy Crystal Lake OBGYN
750 E Terra Cotta Ste BCrystal LakeIL60014Outpatient Physician Clinic
Mercy Crystal Lake Medical Center South
415-A Congress ParkwayCrystal LakeIL60014Outpatient Physician Clinic
Mercy Delavan Medical Center
1038 E Geneva StDelavanWI53115Outpatient Physician Clinic
Mercy Edgerton Medical Center
217 N Main StreetEdgertonWI53534Outpatient Physician Clinic
Mercy Evansville Medical Center
300 Union StreetEvansvilleWI53536Outpatient Physician Clinic
Mercy Harvard Clinic South
348 S DivisionHarvardIL60033outpatient Physician Clinic
Mercy Health Mall
1010 North WashingtonJanesvilleWI53548Outpatient Physician Clinic/Urgent Care Facility
Mercy Health Mall Pharmacy
1010 North WashingtonJanesvilleWI53548Retail Pharmacy
Mercy Lake Geneva Medical Center
350 Peller RoadLake GenevaWI53147outpatient Physician Clinic
Mercy Lakeside Orthopaedics
352 Peller RoadLake GenevaWI53147Outpatient Physician Clinic
Mercy McHenry Internal Medicine Center
633 Ridgeview DriveMcHenryIL60050Outpatient Physician Clinic
Mercy McHenry Medical Center
3922 Mercy DriveMCHenryIL60050Outpatient Physician Clinic
Mercy Milton Medical Center
725 South Janesville StreetMiltonWI53563Outpatient Physician Clinic
Mercy Milton Pharmacy
725 South Janesville StreetMiltonWI53563Retail Pharmacy
Mercy Northwest Women's Group
47 West Acorn LaneLake in the HillsIL601564804Outpatient Physician Clinic
Mercy Options-Cooperative Childcare Inst
20 East Court StreetJanesvilleWI53548Treatment Facility for Adolescents
Mercy Options-Janesville
903 Mineral Point AvenueJanesvilleWI53548Physician & Therapist Services: Mental Health & Addiction Treatment
Mercy Regional Dialysis Center
903 Mineral Point AvenueJanesvilleWI53548Dialysis Center
Mercy Regional Lung Center
903 Mineral Point AvenueJanesvilleWI53548Physicians Clinic & Sleep Disorder Center
Mercy Richmond Medical Center
9715 Prairie RidgeRichmondIL60071Outpatient Physician Clinic
Mercy Sharon Medical Center
118 Plain StreetSharonWI53585Outpatient Physician Clinic
Mercy Sports Medicine and Rehabilitation
557 North WashingtonJanesvilleWI53548Outpatient Physician Clinic and Rehabilitation Facility
Mercy Terrace
510 N Terrace StreetJanesvilleWI53548Outpatient Physician Clinic
Mercy Walworth Pharmacy
N2950 State Road 67Lake GenevaWI53147Retail Pharmacy
Mercy Whitewater Medical Center
507 West Main StreetWhitewaterWI53190Outpatient Physician Clinic
Mercy Whitewater Sports Medicine & Rehab
519 West Main StreetWhitewaterWI53190Outpatient Physician Clinic and Rehabilitation Facility
Mercy Woodstock Medical Center
2000 Lake AvenueWoodstockIL60098Outpatient Physician Clinic/Urgent Care Facility
Mercy Woodstock Pharmacy
2000 Lake AvenueWoodstockIL60098Retail Pharmacy

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnPart I, Line 6a: Mercy Health System, Corp. (MHS) submits an annual Community Benefit Statement to the Wisconsin Hospital Association. Periodically, it publishes a pamphlet explaining the Community Benefits that Mercy Health System Corp, and the related organizations of MHS provide to the communities they serve. MHS has supplied supplemental community benefit statement information with its 990 tax return since fiscal year 2006 (tax form 2005).AnnualCommunityBenefitExpln
Costing Method UsedPart I, Line 7: A cost-to-charge ratio methodology was used to determine costs associated with Charity Care, Unreimbursed Medicaid, and Other Means Tested Government Programs. The cost-to-charge ratio was derived from IRS worksheet 2 Ratio of Patient Care Cost-to-Charge. The cost of the Other Benefits referenced in the table of line 7 (community health improvement services and community benefit operations; health professions education; subsidized health services; cash and in-kind contributions) were determined using actual department/service specific data and/or cost accounting derived data.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g: The subsidized health care line includes $2,144,082 of expenses (column c) and $1,292,916 of net expenses (column e) attributable to the costs of Trauma Surgeons. These Surgeons staff the Level II Trauma program of Mercy Health System Corporation 24/7. Also included is $507,008 of expenses (column c) and $8,419 of net expenses (column e) of a clinic based diabetic center that is run in conjunction to the hospital based Nutrition/Wellness Program.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: Bad Debt Expense of $11,839,837 included on Form 990, Part IX, line 25, was excluded from expenses when calculating the percentage in this column.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: Bad debt expense is accounted for in the following manner (as detailed in Note 1 of the audited financial statements of Mercy Health System Corporation and Subsidiaries). The carrying amounts of accounts receivable are reduced by allowances that reflect management's best estimate of the amounts that will not be collected. . . .management provides for probable uncollectible amounts, primarily uninsured patients and amounts patients are personally responsible for, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to patient accounts receivable. The cost of bad debt on line 2 Part III was determined by applying the cost to charge ratio to those charges estimated and expensed as uncollectible. The estimate of bad debt dollars that may have been covered through Mercy's financial assistance/charity care policy (had the proper paper work been completed by the individual needing assistance) is estimated at 12.8%. This figure was based on the percent of Bad Debt account dollars that are reclassified for Charity and/or Bankruptcy purposes.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: Data for lines 5 & 6 of Part III and the Medicare Shortfall is based on Mercy's two hospitals' Medicare cost reports.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: Patients who are self-pay, regardless of whether they qualify for Mercy's Community Care Program, will receive a 20% discount from Mercy's standard fee schedule. All self-pay patients meet with patient financial counselors and discuss payment options including Mercy's Community Care Program. Patients must apply for Community Care and supply Mercy with the necessary financial and other information required. Patients who qualify for Community Care benefits will receive a reduction in the balance owed, extended payment terms, or both. The amount of the Community Care benefit will be based on the patient's ability to pay and the size of the outstanding balance.DebtCollectionPolicy
Number Of Facility Type ExplnPart V: Hospital & Regional Trauma Center 1Critical Access Hospital 1Sub-Acute/skilled nursing facility 1Radiation Oncology Clinic 1Residency Program/Outpatient Physician Clinic 1Mental Health Clinic 1Residential Treatment Center for children ages 6-17: 1Dialysis Center 1Other Outpatient Physicians Clinics 34Homeless Shelter 1Retail Pharmacies 6NumberOfFacilityTypeExpln
Needs AssessmentPart VI, Line 2: Mercy Health System Corporation does community needs assessments in conjunction with the Public Health Departments of Walworth (WI), Rock (WI), and McHenry (IL) counties every 18 months. Mercy has dedicated staff that works with various agencies/programs of nearby communities to assess health needs. Collaborative examples of Mercy and Mercy's related entities include: i) The Community Health Center at Mercy Clinic South: Partnership with the Community Health Center, Inc. of Beloit, WI In 2006, Mercy partnered with Community Health Center, Inc. to open this clinic in Janesville. It provides free and low-cost care to low-income, uninsured and underinsured patients. This first-of-its-kind partnership is the result of years of work with local partners and the federal government to design and debut a new model of care for the underserved. The clinic sees over 200 new patients each month, has significantly improved patient outcomes, and has saved millions in unnecessary emergency department costs. ii) HealthNet free clinic in Janesville: Mercy physicians volunteer their services. Mercy also donates lab, radiology and other ancillary services to patients. iii) Cooperative Child Care Institute: Collaboration with Janesville Public School District and Rock County Human Services to serve emotionally challenged children. iv) Family Health Partnership Clinic and Well Child Clinic in Woodstock, IL and Harvard Free Clinic in McHenry County, IL: Mercy physicians volunteer their services. v) Family Health Partnership Clinic: McHenry County Department of Health collaboration to provide mammograms at Mercy facilities for women who cannot otherwise afford the service. vi) Rock County Health Department: Bioterrorism readiness project. vii) Red Cross: Blood drive and cooperative volunteer efforts. viii) United Way: Fund raising campaign and Rock County Needs Assessment Survey contributor ix) Area Police and Fire Departments: Provide portable defibrillators for police vehicles and free or reduced-cost paramedic/EMT educational opportunities. x) Community Action, Inc.: Mercy leadership serves on strategic planning committee and Community Action Development Board.NeedsAssessment
Patient Education AssistancePart VI, Line 3: All uninsured patients are notified of Mercy's financial aide policy upon registration. Information is also available at the health system's website, in our emergency rooms, Financial Services Offices, and with the patient financial counselors. Appropriate personnel have been trained on how to interact with patients about financial aid availability, and how to direct patients to appropriate financial aid staff. The hospitals have translation services available as needed.PatientEducationAssistance
Community InformationPart VI, Line 4: One hospital of Mercy Health System Corporation is located in Janesville, WI. It is currently the only general acute care hospital located in Janesville, WI, and is the largest of six hospitals within a 30-mile radius. It is licensed for 240 beds and is located in Rock County, WI, where approximately 11% of the population is below the poverty level. Median household income in Rock Co. is below the State's average. Rock County's unemployment rate as of February, 2010 was at 12.7%; due in large part to the closing of General Motors assemble plant in December 2008. General Motors used to be the largest employer in the area. Mercy Health System's second hospital is in Walworth County. It is designated as a critical access 6 bed hospital. Walworth County is also estimated to have approximately 11% of the population below the poverty level. Walworth's unemployment rate as of February, 2010 was at 10.7%. The two hospitals' payor demographics included 37.6% Medicare, and 15.1% Medicaid for the fiscal year of July 1, 2009 - June 30, 2010 (as determined by charges billed).CommunityInformation
Community Building ActivitiesPart VI, Line 5: Mercy's many health improvement and benefit services/operations were the result of Mercy filling a community need. Mercy's collaborative efforts and the efforts of its related entities have brought assistance to the area's underserved (as detailed in #2 above).CommunityBuildingActivities
Other InformationPart VI, Line 6: The hospitals of Mercy Health System have an open medical staff with privileges available to all qualified physicians in the area. Mercy Health System has a governing body in which independent persons representative of the community comprise a majority.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: Mercy Health System Corporation operates two hospitals and has community clinics located throughout six counties of Wisconsin and Illinois. It is part of a larger integrated health system and affiliated with other separately reported organizations. Mercy Alliance Inc. is the parent company of Mercy Health System Corporation, Mercy Assisted Care Inc, and Mercy Harvard Hospital Inc. Mercy Assisted Care provides Home Health Services and DME (durable medical equipment) services; thus providing continuation of care to Mercy Health System patients and the community as a whole. Mercy Harvard Hospital provides acute care services in McHenry County Illinois. Mercy Health System Corp. works with the Mercy Foundation, Inc. to operate a Homeless Shelter in Janesville, WI.: The House of Mercy Homeless Center provides shelter, support, and training to women, children, and families to help fight homelessness. It sheltered over 4,700 individuals since it opened in 1996. Mercy Hospital Association of Volunteers, Inc. is the organization/tax entity of Mercy's volunteers. Volunteers numbered 1,209 in Calendar Year 2009. This organization not only supports Mercy's services, but provides benefits to the community as a whole. In conjunction with Mercy Health System's meal preparation, the volunteers participate in and oversee a Meals on Wheels program: participant/nutrition specific meals are prepared and delivered to the elderly needing assistance in Janesville. The Volunteer Association runs a Hospitality House in which family members of patients are offered free housing during their loved ones extended hospital stay and rehabilitation.AffiliatedHealthCareSystem
Reports Filed With StatesWIReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Payments For Use Of ResidenceXPaymentsForUseOfResidence
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BARB BORTNER
13062004555402390000212450199809000
DAN COLBY
178849063435011401000400310293716000
DAVID KURTZ
13062004588309404000250550210962000
JOHN COOK
21240605625007077000199020295635000
JOSEPH NEMETH
17918208039207658000417070308939000
RUTH YARBROUGH
152725054028010684000399350257372000
RICHARD GRUBER
13924504588303404000131950201727000
RALPH TOPINKA
24619208725004147000398000377389000
SUE RIPSCH
22012708202202313000294350333897000
JAVON BEA
810298066179405069310161925704074403639024000
Bradley Fideler
11535000215066016500028017503114301696384000
Vikram Khanna
485800050006201650002017503123801053775000
Christopher Sturm
62714502971950165000201750290680990083000
John Bussa
36270004747240220000481750245820932181000
Francis Kaveggia
36210004553100487810201750342350920601000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 1aReturnReference
ExplanationResidence for personal use - The CEO is provided with a residence. The cost of renting the residence is treated as taxable compensation. Payments for business use of personal residence - The CEO is reimbursed for internet access and communication costs used for business purposes at his personal residence. The reimbursement is treated as taxable compensation. Health Club Dues - The CEO is reimbursed for Health Club Dues. This is treated as taxable compensation. Personal Services - The CEO is reimbursed for income tax preparation services. This is treated as taxable compensation.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
James Nemeth
Family Member of Joseph Nemeth, Officer114161Employment - Finance Manager0
Jamie Kurtz
Family Member of David Kurtz, Officer33432Employment - Patient Account Representative0
Kristen Goelzer
Family Member of Mark Goelzer, Director292124Employment - Physician0
JOANNA BEA
Family Member of Javon Bea, President & Director66498Employment - Manager Architectural & Interior Design0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section B, line 11NO REVIEW WAS OR WILL BE CONDUCTED
Form 990, Part VI, Section B, line 12cOfficers, directors, and key employees are required to report all conflicts of interest. The compliance officer is responsible for investigating all conflicts and reporting to the board.
Form 990, Part VI, Section B, line 15The Mercy Alliance Compensation Committee is comprised of the Board Chairperson, Secretary, and the Treasurer. The Compensation Committee is assisted by independent legal council and an independent compensation consultant. The compensation Committee, legal council, and the compensation consultant meet throughout the year and report directly to the Board of Directors annually. This process was completed for 2010.
Form 990, Part VI, Section C, line 19Governing Documents, Conflict of Interest Policy & Financial Statements are available upon request.
FORM 990, PART I, LINE 6MERCY HEALTH SYSTEM CORPORATION HAS REPORTED ZERO FOR THE TOTAL NUMBER OF VOLUNTEERS. THIS IS DUE TO THE FACT THAT ALL 1,209 VOLUNTEERS FOR THE MERCY HEALTH SYSTEM CORPORATION ARE TECHNICALLY VOLUNTEERS OF THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS AND AS SUCH HAVE BEEN REPORTED ON THEIR TAX RETURN. PLEASE SEE THE MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS TAX RETURN FOR MORE INFORMATION ON MERCY VOLUNTEER ACTIVITIES.TOTAL NUMBER OF VOLUNTEERS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
MERCY ALLIANCE INC
1000 MINERAL POINTJANESVILLEWI535475003391679859MANAGEMENT OF HEALTHCARE ORGANIZATIONSWI501(C)(3)11AN/A
MERCY FOUNDATION INC
1000 MINERAL POINTJANESVILLEWI535475003237275336TO SUPPORT MERCY HEALTH SYSTEM & THE HOUSE OF MERCYWI501(C)(3)11AMERCY HEALTH SYSTEM CORPORATION
MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS
1000 MINERAL POINTJANESVILLEWI535475003390912682TO SUPPORT MERCY HEALTH SYSTEM CORPORATIONWI501(C)(3)11CMERCY HEALTH SYSTEM CORPORATION
MERCY ASSISTED CARE INC
901 MINERAL POINTJANESVILLEWI535475003391035110HOME HEALTH CARE & SERVICESWI501(C)(3)9MERCY ALLIANCE INC
MERCY ALLIANCE INC
901 GRANT STREETHARVARDIL60033311551871MEDICAL HEALTHCAREIL501(C)(3)3MERCY ALLIANCE INC
HARVARD MEMORIAL HOSPITAL FOUNDATION
901 GRANT STREETHARVARDIL60033364308662TO SUPPORT MERCY HARVARD HOSPITAL, INC.IL501(C)(3)11AMERCY HARVARD HOSPITAL INC
MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER
1000 MINERAL POINTJANESVILLEWI535475003201673011NONEIL501(C)(3)3MERCY ALLIANCE INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncome
JANESVILLE MEDICAL CENTER INC
1000 MINERAL POINTJANESVILLEWI535475003391520130MANAGEMENT ENTITY OF UNION EMPLOYEESWIMERCY HEALTH SYSTEM CORPORATIONC109691.00000
MERCYCARE INSURANCE COMPANY
3430 PALMER DRIVEJANESVILLEWI53545391768192INSURANCE COMPANYWImERCY HEALTH SYSTEM CORPORATIONC393031141.00000-248491
MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO
3430 PALMER DRIVEJANESVILLEWI53545201482553INSURANCE COMPANYWImERCY HEALTH SYSTEM CORPORATIONC1.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1MERCYCARE INSURANCE COMPANYBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved5228911AmountInvolved

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