Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3421 West Ninth Street
 
Room/suite
City or town, state or country, and ZIP + 4
Waterloo, IA507025499
D Employer identification number

42-1177001
E Telephone number

G Gross receipts $ 12,218,925
F Name and address of principal officer:
Jack Dusenbery
3421 West Ninth Street
Waterloo,IA507025499
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.wheatoniowa.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1982
M State of legal domicile: IA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Wheaton Franciscan Healthcare-Iowa, Inc. is a regional holding company that exists to support the programs and activities of it's supported orgs which in turn help them achieve their exempt purposes.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 8
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,287,080 0
9 Program service revenue (Part VIII, line 2g) ......... 11,940,783 12,112,337
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,744 -57
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 122,784 106,588
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 17,364,391 12,218,868
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 189,198 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 14,467,372 13,981,250
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 14,656,570 13,981,250
19 Revenue less expenses. Subtract line 18 from line 12...... 2,707,821 -1,762,382
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 18,715,953 15,371,885
21 Total liabilities (Part X, line 26)............ 18,064,295 16,154,712
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 651,658 -782,827
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: AS A MEMBER OF WHEATON FRANCISCAN HEALTHCARE, OUR AFFILIATES STRIVE TO LIVE OUT THE HEALING MINISTRY OF THE JUDEO-CHRISTIAN TRADITION WHILE PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTE THE DIGNITY AND WELL BEING OF THE PATIENTS AND COMMUNITIES WE SERVE. OUR VISION IS TO BE RECOGNIZED FOR SUPERIOR HEALTHCARE SERVICE, CLINICAL EXCELLENCE, AS THE HEALTHCARE EMPLOYER OF CHOICE, AND THE PREFERRED PARTNER OF PHYSICIANS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 7,357,348 including grants of $   ) (Revenue $ 11,163,231 )
WHEATON FRANCISCAN SERVICES, INC. (WFSI) is a Catholic, not-for-profit health care and housing organization serving at sites in Wisconsin, Iowa, Illinois, and Colorado. The System includes 18 hospital sites, three transitional and extended-care facilities, two home health agencies, nearly 3,500 physicians, more than 70 clinic sites with 770 employed physicians, and approximately 2,800 units of assisted living and other housing, and the corporate services offices in Wheaton, Illinois, and Glendale, Wisconsin. Started more than 125 years ago and formally incorporated in 1983, WFSI is committed to living out the Mission and Values of its Sponsors, the Wheaton Franciscan Sisters, by providing excellent and compassionate health care and housing services to all, regardless of their ability to pay. WFSI was incorporated in 1983 to preserve and strengthen Judeo-Christian values, provide a framework for lay expertise and involvement, respond to an increasingly complex environment, ensure continuity of Franciscan sponsorship, and assure viability and excellence throughout the organization. As a not-for-profit organization, WFSI reinvests all net income into the communities it serves. Its multiple entities are dedicated to delivering quality health care to patients and residents through highly-trained staff, advanced technology, and superior and compassionate service; caring for each person's body, mind, and spirit with respect and dignity; working to improve the health of the communities; and ensuring health care access for everyone. WFSI is organized into market-based regional holding companies organized in the Southeast, Wisconsin region, the Fox Valley, Wisconsin region, as well as other regional holding companies conducting services in Illinois, Iowa, and Colorado. The System's housing and spiritual development services are organized under the holding company name of Franciscan Ministries, Inc. Since 2006, the "doing business as" name for WFSI's health care ministry has been Wheaton Franciscan Healthcare (WFH). In 2011 Wheaton Franciscan Healthcare in Southeast Wisconsin was recognized as one of the nation's top 25 most efficient, best-performing health care networks by SDI, the nation's premier integrated health network evaluation system. Wheaton Franciscan Healthcare ranked as the top integrated system in Southeast Wisconsin, is among the top 10 in the Midwest, and ranked 23 nationally. Other national recognitions include being named one of the best performing 50 systems in Thompson Reuters' 100 Top Hospitals: Health Systems Quality/Efficiency Study in 2009. Wheaton Franciscan Healthcare also received a 2009 VIP Award from McKesson Technology Solutions for its success in using information technology to enhance patient safety across nine hospital sites and more than 100 physician offices. The VIP Awards are presented annually to organizations that demonstrate vision, innovation and performance in the use of healthcare IT. Wheaton Franciscan Healthcare was one of five health care organizations selected by a panel of experts in the field of health care IT use to receive the award. Please see our full 2011 Annual Report online at: http://www.wfhealthcare.org/Wheaton/Documents/2011AnnualReport.pdf CORPORATE STRUCTURE: Parent Company: Wheaton Franciscan Services, Inc. DBA Wheaton Franciscan Healthcare Health care ministry: Wheaton Franciscan Healthcare Housing ministry: Franciscan Ministries, Inc. Health Care Mission: Wheaton Franciscan Healthcare is committed to living out the healing ministry of Jesus by providing exceptional and compassionate health care service that promotes the dignity and well being of the people we serve. Health Care Vision: Our health ministries will be recognized in each community we serve for superior and compassionate patient service, clinical excellence, as the health care employer of choice, and the preferred partner of physicians. Housing Mission: Franciscan Ministries is committed to providing quality and affordable housing in a compassionate environment that promotes wholeness of life within ourselves and the communities we serve. Housing Vision: Our housing ministries will be recognized for excellence in property management and a well-integrated network of support services that provide hope, growth, and opportunity. Values: Our common Values, which flow from our Mission and Catholic tradition, must have meaning for every one of us. Through them we put the healing ministry of Jesus into practice throughout the Wheaton Franciscan System. Respect: We value each person as sacred, created in the image and likeness of God, which gives worth and meaning to each person's life. Integrity: We value honesty and words and actions that build trust. Development: We value personal and professional growth that combines the physical, emotional, spiritual and relational aspects of life and work. Excellence: We value superior performance in our work and service. Stewardship: We value our responsibility to use human, financial, and natural resources entrusted to us for the common good, with special concern for those who are poor. WHEATON FRANCISCAN HEALTHCARE Wheaton Franciscan Services, Inc.'s health care division, doing business as Wheaton Franciscan Healthcare (WFH), consists of facilities in Illinois, Iowa, and Wisconsin. SYSTEM STATISTICS Hospital Sites: 18 Staffed Hospital beds: 2,114 Long-term Care Facilities: 3 Home Health Agencies: 2 Units of Housing: 2,681 Associates: 21,005 Affiliated Physicians: 2,710 Employed Physicians: 770 Emergency Room Visits: 374,436 Newborns: 10,519 Hospital Admissions: 84,924 Hospital Patient Days: 403,808 Skilled Nursing Unit Patient Days: 24,120 Long-term Care Facility Patient Days: 82,110 Hospital Outpatient Visits: 1,972,764 Hospice Days: 19,860 Home Health Visits: 115,253 Medical Group Physician Visits: 2,000,423 WFH ORGANIZATIONS Iowa Covenant Medical Center, Inc. Mercy Hospital of Franciscan Sisters, Inc. Sartori Memorial Hospital, Inc. Covenant Clinic Covenant Foundation, Inc. Sartori Health Care Foundation, Inc. Covenant Regional Services, Inc. Illinois Marianjoy Rehabilitation Hospital and Clinics Marianjoy Medical Group Marianjoy Foundation RUSH OAK PARK HOSPITAL, Inc. OSF Services Canticle Ministries Clara Pfaender Fund Wisconsin Wheaton Franciscan - St. Joseph and The Wisconsin Heart Hospital Campuses All Saints Elmbrook Memorial St. Francis Franklin Franciscan Woods The Terrace at St. Francis Wheaton Franciscan Home Health Wheaton Franciscan Hospice Wheaton Franciscan Laboratories Wheaton Franciscan Medical Group All Saints Foundation Volunteers in Partnership with Wheaton Franciscan Healthcare-All Saints St. Joseph Foundation Elmbrook Memorial Foundation Circle of Life Foundation The Foundation for St. Francis and Franklin AFFILIATIONS INCLUDE: Midwest Orthopedic Specialty Hospital - Franklin, WI Affinity Health System - Menasha, Wisconsin St. Elizabeth Hospital Mercy Medical Center of Oshkosh Calumet Medical Center Network Health Plan of Wisconsin Affinity Medical Group St. Elizabeth Hospital Foundation Mercy Health Foundation United Hospital System - Kenosha, Wisconsin St. Catherine's Medical Center and Kenosha Medical Center Campuses WHEATON FRANCISCAN HEALTHCARE COMMUNITY IMPACT FOR SYSTEM / 2011 Charity Care: $29,311,248. Charity Care is defined as free or discounted health services provided to those who cannot afford to pay and who meet all criteria for financial assistance. Charity care is based on actual costs, not charges, and does not include bad debt. Unreimbursed cost of public programs: $89,193,180. Unreimbursed cost of public programs is defined as the shortfall experienced when payments received are below the cost of treating public beneficiaries through Medicaid and other local public programs. Community Health Improvement Services: $2,921,540. Community Health Improvement Services are defined as clinical and non-clinical services designed to improve community health, which are provided to the community for free or for fees that did not cover costs. Financial contributions: $3,461,030. Financial contributions are defined as contributions, including cash, non-cash items such as food, furniture, equipment, supplies, and loaned staff for volunteer and charitable purposes, made to individuals, community groups, or nonprofit organizations for charitable purposes. Health professions education: $8,788,076. Health professions education is defined as direct costs incurred for accredited training and education programs for physicians, nurses, allied health professionals and technicians (does not include ongoing education for staff). Community building activities: $820,333. Community building activities are defined as programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental issues. Costs for these activities include cash and in-kind donations. Communit
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 7,357,348
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
16
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
Yes
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
TIMOTHY HUBER
3421 WEST NINTH STREET
WATERLOO,IA507025499
(319) 272-7607
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Cynthia Goro
Director
 1.0 X                
(2) Sandie Graf
Director
 1.0 X                
(3) Jerry Harris
Director
 1.0 X                
(4) Eric Locke
Director
 1.0 X                
(5) Michael Mallaro
Director
 1.0 X                
(6) Wallace Rundle
Director
 1.0 X                
(7) Gregory Schmitz
Director
 1.0 X                
(8) Frank Seng
Director
 1.0 X                
(9) Edward Stachovic
Director
 1.0 X                
(10) Douglas Stanford MD
Director
 1.0 X                
(11) Ron Van Veldhuizen
Director
 1.0 X                
(12) Camille Hogan
Chair/Vice Chair - Director
 1.0 X   X            
(13) Becky Mudd
ViceChair - Director
 1.0 X   X            
(14) Jack Dusenbery
President - Director
 40.0 X   X       0 568,344 67,280
(15) Peter Hohnstein MD
Director
 40.0 X           0 431,302 43,796
(16) John Oliverio
Secretary/Treasurer - Director
 40.0 X   X       0 1,813,218 157,725
(17) James Peterson MD
Director
 40.0 X           0 305,586 42,828
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Brian Sims DO
Director
 40.0 X           0 585,658 41,034
(19) Michael Slavin DO
Director
 40.0 X           0 533,234 34,750
(20) Michele Panicucci
Asst. Treas.
 40.0     X       0 383,842 62,871
(21) Nancy Schaefer
Asst. Secy
 40.0     X       0 49,111 6,632
(22) Rose Fowler
VP Operations / Site Administr
 40.0       X     0 181,806 41,961
(23) Paul Franke MD
VP Medical Affairs
 40.0       X     0 380,259 29,685
(24) Jeffrey Halverson
VP Physician Networking
 40.0       X     0 295,468 56,283
(25) Christopher Hyers
VP Business Development
 40.0       X     0 236,411 43,958
(26) Wayne Frangesch
SVP-SYSTEM HUMAN RESOURCES/OD
 40.0           X 0 358,370 60,311
(27) Jon Wachs
Sr VP and Chief Operating Offi
 40.0           X 0 804,963 309,576






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 6,927,572 998,690
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
AHC Inc
13575 Heathcote Boulevard Suite 30
GAINSVILLE,VA20155 		Collection Services 1,006,467
Credit Bureau Accounts Inc
PO Box 1289
PEORIA,IL61654 		Collection Services 132,907
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet2
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 0
Program Service Revenue Business Code
2a INTEREST INCOME 900,099 954,842     954,842
b SUPPORT SERVICE TO AFFILIATES 900,099 11,157,495 11,157,495    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 12,112,337
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 0      
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   57
c Gain or (loss)   -57
d Net gain or (loss)..........MediumBullet -57     -57
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a HEALTH INFORMATION MANAGEMENT 900,099 17,240     17,240
b CLINICAL DEVELOPMENT 900,099 14,521     14,521
c QUALITY SERVICES 900,099 61,646     61,646
d All other revenue .... 13,181 5,736   7,445
e Total. Add lines 11a–11d ......MediumBullet 106,588
12 Total revenue. See Instructions....MediumBullet 12,218,868 11,163,231   1,055,637
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 0      
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 2,989,312 1,494,656 1,494,656  
12 Advertising and promotion .... 825,584 412,792 412,792  
13 Office expenses ....... 354,232 177,116 177,116  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 123,256 61,628 61,628  
17 Travel ............ 9,206 4,603 4,603  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 3,066 1,533 1,533  
20 Interest ........... 991,889   991,889  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 34,541 17,271 17,270  
23 Insurance .............. 0      
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a SALARY ALLOCATION 6,726,540 3,363,270 3,363,270  
b REALIZED LOSSES 1,725,335 1,725,335    
c DUES & SUBSCRIPTIONS 107,396 53,698 53,698  
d PROPERTY TAXES 46,386 23,193 23,193  
e MISCELLANEOUS EXPENSE 20,035 10,017 10,018  
f All other expenses 24,472 12,236 12,236  
25 Total functional expenses. Add lines 1 through 24f 13,981,250 7,357,348 6,623,902 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 15,232,903 7 12,945,010
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,544,041
b Less: accumulated depreciation. ..... 10b 1,473,413 105,226 10c 70,628
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 1,226,476 12 68,353
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 2,151,348 15 2,287,894
16 Total assets. Add lines 1 through 15 (must equal line 34)... 18,715,953 16 15,371,885
Liabilities 17 Accounts payable and accrued expenses . 203,266 17 329,088
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 17,861,029 23 15,825,624
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D.....   25  
26 Total liabilities. Add lines 17 through 25..... 18,064,295 26 16,154,712
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 651,658 27 -782,827
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 651,658 33 -782,827
34 Total liabilities and net assets/fund balances ..... 18,715,953 34 15,371,885
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
12,218,868
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
13,981,250
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-1,762,382
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
651,658
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
327,897
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
-782,827
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
(1) COVENANT MEDICAL CENTER INC
  		421264647 03   No Yes   Yes   8,943,912
(2) MERCY HOSPITAL OF FRANCISCAN SISTERS INC
  		421178403 03   No Yes   Yes   602,346
(3) NE IOWA REAL ESTATE INVESTMENTS LTD 501(C)(2)
  		421207432 0   No Yes   Yes   0
(4) SARTORI MEMORIAL HOSPITAL INC
  		420758901 03   No Yes   Yes   1,520,387
Total                 11,066,645

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
3,746
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
0
j
Total. lines 1c through 1i ...................................
3,746
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C Disclosures Part II-B Line 1i Wheaton Franciscan Healthcare and Franciscan Ministries are part of a controlled group of healthcare and housing organizations that are related through a common parent organization. Certain entities within this controlled group engage in limited lobbying activities that benefit each organization collectively. Wheaton Franciscan Healthcare employs one full time Vice President of Strategic Planning and Government Relations whose duties include a portion of lobbying activities. These lobbying activities approximate 20% of total annual salary. A benefits factor of 25% is added, and the total is allocated amongst the organizations receiving the benefit of these services. The lobbying activities include such things as preservation of Medicare and Medicaid funding; monitoring federal legislation that may impact the organization; participating in and coordinating visits with elected officials; coordinating advocacy activities in conjunction with relevant trade associations; and providing awareness on specific state related legislative issues when the need arises (e.g.: state hospital assessment legislation in Wisconsin). The portion of direct expenses related to annual employee business travel to Washington DC or other locations, in order to lobby for issues important to healthcare providers and patients, have been included if applicable. Finally, any trade association dues containing a percentage portion allocable to lobbying activities, has been added or estimated, as appropriate. Lobbying expenses incurred by each organization directly, are reflected on their respective IRS Form 990, and can be summarized as follows: Wheaton Franciscan Services, Inc. #36-3262111 $72,014 Wheaton Franciscan Healthcare - Southeast Wisconsin, Inc. #39-1566865 $32,020 Wheaton Franciscan, Inc. (formerly Wheaton Franciscan Healthcare - St. Joseph, Inc. and The Wisconsin Heart Hospital, Inc.) #39-0816857 $10,381 Wheaton Franciscan Healthcare - St. Francis, Inc. #39-0907740 $7,924 Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. #39-0853528 $4,012 Wheaton Franciscan Healthcare - All Saints, Inc. #39-1264986 $8,234 Wheaton Franciscan Healthcare - Franklin, Inc. #56-2592868 $1,516 Wheaton Franciscan Home Health and Hospice, Inc. #39-1559428 $ 962 Marianjoy, Inc. #36-3483589 $3,746 Marianjoy Rehabilitation Hospitals and Clinics, Inc. #36-2680776 $11,814 Wheaton Franciscan Healthcare - Iowa, Inc. #42-1177001 $3,746 Covenant Medical Center, Inc. #42-1264647 $27,090 Sartori Hospital, Inc. #42-0758901 $5,146 Mercy Hospital, Inc. #42-1178403 $2,400 TOTAL LOBBYING EXPENSES: $191,005
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................   11,272 6,199 5,073
c Leasehold improvements ............        
d Equipment ................   1,527,966 1,464,455 63,511
e Other .................   4,803 2,759 2,044
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 70,628
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM AFFILIATE 2,287,894








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,287,894
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet  
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Jack Dusenbery (i)
(ii)		 0
371,426 		 
185,400 		 
11,518 		 
44,333 		 
22,947 		0
635,624 		 
 
(2) Rose Fowler (i)
(ii)		 0
159,860 		 
20,816 		 
1,130 		 
19,226 		 
22,735 		0
223,767 		 
 
(3) Wayne Frangesch (i)
(ii)		 0
263,298 		 
80,700 		 
14,372 		 
32,282 		 
28,029 		0
418,681 		 
 
(4) Paul Franke MD (i)
(ii)		 0
290,760 		 
87,900 		 
1,599 		 
13,198 		 
16,487 		0
409,944 		 
 
(5) Jeffrey Halverson (i)
(ii)		 0
203,558 		 
76,400 		 
15,510 		 
35,437 		 
20,846 		0
351,751 		 
 
(6) Peter Hohnstein MD (i)
(ii)		 0
428,782 		 
  		 
2,520 		 
21,228 		 
22,568 		0
475,098 		 
 
(7) Christopher Hyers (i)
(ii)		 0
171,433 		 
61,300 		 
3,678 		 
17,481 		 
26,477 		0
280,369 		 
 
(8) John Oliverio (i)
(ii)		 0
918,033 		 
527,500 		 
367,685 		 
92,775 		 
64,950 		0
1,970,943 		 
350,448
(9) Michele Panicucci (i)
(ii)		 0
239,550 		 
128,700 		 
15,592 		 
43,096 		 
19,775 		0
446,713 		 
 
(10) James Peterson MD (i)
(ii)		 0
301,123 		 
  		 
4,463 		 
21,311 		 
21,517 		0
348,414 		 
 
(11) Brian Sims DO (i)
(ii)		 0
584,366 		 
  		 
1,292 		 
18,031 		 
23,003 		0
626,692 		 
 
(12) Michael Slavin DO (i)
(ii)		 0
517,648 		 
  		 
15,586 		 
21,230 		 
13,520 		0
567,984 		 
 
(13) Jon Wachs (i)
(ii)		 0
527,805 		 
147,700 		 
129,458 		 
257,089 		 
52,487 		0
1,114,539 		 
98,329



Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J Disclosures Various - See the following references Schedule J Part 1 Line 3 The compensation of the filing organization's CEO and/or the Executive Director is determined at the parent organization level, using the process described in Schedule O related to Part VI Section B Line 15. The parent organization, Wheaton Franciscan Services, Inc. (FEIN: 36-3262111) uses a compensation committee, independent compensation consultants, and compensation surveys and studies to determine appropriate levels of compensation that are reflective of fair market value. All compensation is approved by the board and/or compensation committee. Schedule J Part 1 Line 4b John Oliverio received a 2010 taxable payout of $350,448 related to a supplemental nonqualified retirement plan known as the Wheaton Franciscan Services Benefit Restoration Plan. Jon Wachs received a 2010 taxable payout of $98,329 related to a supplemental nonqualified retirement plan known as the Wheaton Franciscan Services Benefit Restoration Plan.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Identifier Return Reference Explanation
Schedule O Disclosures Various - See the following references IRS Form 990 Part VI Section A Line 2 Board Directors Mike Mallaro and Frank Seng have a business relationship at VGM Group, an unrelated organization, where they both serve as co-trustees of the companies ESOP Plan. IRS Form 990 Part VI Section A Lines 6-7b Wheaton Franciscan Healthcare-Iowa, Inc. has two members, a corporate member and a Managing Member; both of which hold several reserved powers over Wheaton Franciscan Healthcare-Iowa, Inc.. These reserved powers include, but are not limited to, the election of members of the governing body and election of officers, approval of certain financial expenditures in accordance with policy, and approval of budgets and strategic plans; these approvals are based on recommendations from the governing body. IRS Form 990 Part VI Section B Line 10 Wheaton Franciscan Healthcare and Franciscan Ministries are part of a controlled group of health care and housing providers, controlled under a common parent organization Wheaton Franciscan Services, Inc. Some of these organizations are exempt through the Catholic Group Ruling and other organizations have a stand alone exemption (IRS determination) letter. As such, these related affiliates have certain policies and procedures that were adopted at the parent level, but are applicable to the entire controlled group of organizations. All policy and procedure matters are handled in a manner to ensure that all activities are consistent with the organization's overall exempt purposes. Please see Schedule R for a full listing of all related affiliate organizations. IRS Form 990 Part VI Section B Line 11 Affiliates of Wheaton Franciscan Healthcare use a multiple-level review process on all Federal and State information and tax returns to ensure accurate and timely filing for all organizations. Under the direction of the Tax Manager, the Accounting Department prepares Forms 990, 990-T, and associated state filings. When complete, the return is first reviewed by the Controller, who focuses on the income statement and balance sheet items, and all schedules where transactions of this type might be reported. If discrepancies are found, the item will be corrected prior to the next step in the review process. Once cleared through Accounting, the return is provided to the Tax Department, where the Tax Manager and Vice President of Treasury and Risk Management focus their review on consistency of reporting between all returns, accuracy of tax related information, and explanation and understanding of any outliers. Again, any problems or questions are investigated and corrected. Depending on the level of complexity of the year in question, as well as the individual issues specific to that filing, certain returns may be selected for outside review by a public accounting firm. This decision will vary from year to year based on many factors, and sometimes outside review is not utilized at all. Also, certain schedules, such as Schedule K, Schedule H, and Schedule J, may be selected for review by outside bond counsel, a community benefit associate, and/or the compensation committee respectfully and as needed. This decision will vary from year to year, again based on many factors. The Accounting Department, upon completion of all levels of review, will schedule an appointment with the Senior Vice President and CFO, who will perform a review prior to signing the return. Once signed, the return is cleared to provide to members of the Board of Directors. The parent organization, Wheaton Franciscan Services, Inc. has designated that the Audit Committee review the parent return in certain years. This is a cursory review, where the 990 is explained at a high level by management representatives, and any questions or concerns that the board has can be addressed. At a later date and prior to efiling, the full board is provided access to all 990's and 990-T's throughout the system via an online portal. A similar process exists at the regional holding company levels - a 990 is selected for review in certain years by the Finance and Operations Committee. Similarly, the 990 (and accompanying 990-T if any) is explained at a high level, and board questions or concerns are addressed. Members of the full board are provided access to all 990's and 990-T's within that region prior to efiling via an online portal. IRS Form 990 Part VI Section B Line 12 As part of an annual process, conflict of interest questions are sent out to all Officers, Directors, and other individuals in key positions using software designed to capture this information. The responses are analyzed in order to determine information on potential conflicts, as well as information on business and family relationships for purposes of answering certain questions on IRS Form 990. Responses to these questions are reviewed by the Vice President of Compliance and the Manager of Tax Compliance, and follow up action, if any, are documented within the software. After an approximate 3 and again at 6 weeks, names of all non responders are compiled, and these individuals receive either an email or letter reminding them to complete the information. Responses to questions continue to be reviewed and documented throughout this time period. Approximately 1 month prior to the filing deadline of IRS Form 990, responses to date are compiled. Any response requiring disclosure is entered into the information return. Also at this date, the remaining non responder names are determined, and a letter, along with the actual Conflict of Interest Policy, is sent to the Chairperson of each board. The letter outlines the current non responders, as well as any Officer or Board member that has disclosed a financial interest that might pose a potential conflict of interest. Depending upon the nature of the financial interest and work done by the board, several actions may be considered - the board member with a financial interest would need to voluntarily excuse him or herself from the deliberations and/or voting on such a matter; or, if necessary, the board would determine that the subject's financial interest was an actual conflict of interest, in which case the board member would be informed by the board Chairperson that he or she would not be allowed to vote in any such matters due to this real or perceived conflict of interest. Minutes of the board meeting would document this decision process, and reflect whatever action(s) are ultimately taken. The board chairperson is also required to discuss with non responders the repercussions of not responding after two attempts, and require the board member to complete the annual conflict of interest disclosure questions before being allowed to continue in any board matters. If the board member refuses, the Chairperson has the authority to determine the appropriate action, including, but not limited to prohibiting them from participating in deliberations, preventing them from voting, and/or removing them as a board member. IRS Form 990 Part VI Section B Line 15 The compensation of the CEO of Wheaton Franciscan Services Inc. (WFSI) and other officers and key employees of the filing organization is reviewed and approved on an annual basis by the Executive Committee of the WFSI Board of Directors, an independent board, acting in a manner consistent with its conflicts of interest policy. The board's decision is informed by an opinion on market comparable compensation data provided to the board by an independent compensation expert. The organization maintains contemporaneous documentation of the substantiation of the deliberation and decision by the board. Compensation for the organization's President and other officers and key management employees, is reviewed and approved, as part of the Wheaton Franciscan Services, Inc. Executive Compensation Plan, on an annual basis by the Executive Committee of the Wheaton Franciscan Services, Inc. Board of Directors (the "Executive Committee of the WFSI Board"), an independent board, acting in a manner consistent with its conflicts of interest policy. The Executive Committee of the WFSI Board's decision is informed by an opinion on market comparable compensation data provided to the board committee by an independent compensation expert. The Executive Committee of the WFSI Board maintains contemporaneous documentation of the substantiation of the deliberation and decisions it makes. For those officers and key employees that are paid for their services other than pursuant to the WFSI Executive Compensation Plan, the compensation terms are approved by the President of Covenant Medical Center, Inc. and Wheaton Franciscan Services - Iowa, Inc. In such case, decisions are made in accordance with the organization's conflict of interest requirements. Also, in such case, the compensation paid pursuant to a contract is determined with reference to market comparable information. Organizational policy requires that contemporaneous documentation of the same be maintained.
Schedule O Disclosures Continued Various - See the following references IRS Form 990 Part VI Section B Line 16 Wheaton Franciscan Healthcare-Iowa, Inc. participated in one or more joint ventures in furtherance of its exempt activities during FY 2011. Wheaton Franciscan Healthcare has several policies that govern entering into joint venture relationships and all governing documents of such joint ventures do include one or more safeguards to protect the tax-exempt status of Wheaton Franciscan Healthcare-Iowa, Inc. IRS Form 990 Part VI Section C Line 19 Affiliates of Wheaton Franciscan Healthcare and Franciscan Ministries provide upon request certain documents including our financial statements, conflict of interest policy, and governing documents that support our tax exempt status, including, but not limited to, articles of incorporation and bylaws. Requests for information are considered on a case-by-case basis, and this process is outlined in our Public Disclosure Policy. As part of the requirements for tax exempt bond financing, the consolidated financial statements of Wheaton Franciscan Services, Inc. (#36-3262111), the parent corporation of Wheaton Franciscan Healthcare and Franciscan Ministries affiliates are required to be provided each quarter to the Municipal Securities Rule Making Board (MSRB). The vehicle used to accomplish this is through an external website (http://emma.msrb.org/) referred to as "EMMA" (Electronic Municipal Market Access System). The financial statements are uploaded each quarter to the website, and along with other information provided at the bond's inception, are available for viewing by the general public. IRS Form 990 Part VII Column B Wheaton Franciscan Healthcare and Franciscan Ministries are a controlled group of related healthcare and housing organizations. As such, many employees who are at the Vice President level or above, or who are Officers and/or Directors of organizations where Wheaton has common boards and other overlaps, spend significant time devoted to tasks not only for the filing organization, but also for related organizations. While there is no official time study tracking that is done, it is estimated that for each employee, tasks devoted to related organizations could approximate up to 80% of total hours. IRS Form 990 Part XI Line 5 Certain related organizations utilize receivable/payable accounts throughout the year. These intercompany balances are settled through the equity account at the end of each fiscal year to bring the receivable/payable balances to zero. DISCLOSURE STATEMENT RELATED TO FORMS 5471 INFO RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: WHEATON FRANCISCAN SERVICES, INC. ADDRESS: 26 W171 ROOSEVELT ROAD, WHEATON, IL 60187 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 36-3262111 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare-Iowa Inc
 
Employer identification number

42-1177001
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) Cedar Valley Comm Hlthcr-Wheaton IA LLC
3421 West Ninth Street
Waterloo,IA50702
26-4634545 		Health Plan IA -80,399 51,266 WFH-IOWA INC
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) WHEATON FRANCISCAN SERVICES INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
36-3262111 		PARENT CORP IL 501(c)(3) 11 - III-FI NA
 
 
 
(2) AFFINITY HEALTH SYSTEM

1570 MIDWAY PLACE

MENASHA,WI54942
39-1638765 		HOLDING CO IL 501(c)(3) 11 - I WFSIMHC
 
 
 
(3) AUXILIARY OF ST ELIZABETH HOSPITAL INC

1506 SOUTH ONEIDA STREET

APPLETON,WI54915
39-6077331 		AUXILIARY WI 501(c)(3) 11 - III-O ST ELIZ HOSP
 
 
 
(4) CALUMET MEDICAL CENTER INC

614 MEMORIAL DRIVE

CHILTON,WI53014
39-0905385 		HOSPITAL WI 501(c)(3) 3 AFF HLTH SYS
 
 
 
(5) MERCY MEDICAL CENTER OF OSHKOSH INC

500 SOUTH OAKWOOD ROAD

OSHKOSH,WI54904
39-0806268 		HOSPITAL WI 501(c)(3) 3 AFF HLTH SYS
 
 
 
(6) NETWORK HEALTH SYSTEM INC

1570 MIDWAY PLACE

MENASHA,WI54942
39-1127163 		MED GROUP WI 501(c)(3) 3 AFF HLTH SYS
 
 
 
(7) ST ELIZABETH HOSPITAL COMMUNITY FNDN INC

1506 SOUTH ONEIDA STREET

APPLETON,WI54915
39-1256677 		FOUNDATION WI 501(c)(3) 11 - I AFF HLTH SYS
 
 
 
(8) ST ELIZABETH HOSPITAL INC

1506 SOUTH ONEIDA STREET

APPLETON,WI54915
39-0816818 		HOSPITAL WI 501(c)(3) 3 AFF HLTH SYS
 
 
 
(9) WFH - SOUTHEAST WISCONSIN INC

400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
39-1568865 		HOLDING CO IL 501(c)(3) 11 - III-FI WFSI
 
 
 
(10) WFH - ALL SAINTS INC

3801 SPRING STREET

RACINE,WI53405
39-1264986 		HOSPITAL WI 501(c)(3) 3 WFH-SE WI
 
 
 
(11) WFH - ALL SAINTS FOUNDATION INC

1320 WISCONSIN AVENUE

RACINE,WI53403
39-1570877 		FOUNDATION WI 501(c)(3) 11 - I WFH-AS INC
 
 
 
(12) VOLUNTEERS IN PTNRSHIP WITH WFH-AS INC

3801 SPRING STREET

RACINE,WI53405
93-0838390 		FOUNDATION WI 501(c)(3) 11 - III-O WFH-AS INC
 
 
 
(13) WFH - CIRCLE OF LIFE FOUNDATION INC

13950 WEST CAPITOL DRIVE

BROOKFIELD,WI53005
56-2426294 		FOUNDATION WI 501(c)(3) 11 - I WFH-PE
 
 
 
(14) WHEATON FRAN HOME HEALTH & HOSPICE INC

3070 NORTH 51ST STREET STE 406

MILWAUKEE,WI53210
39-1559428 		HOME HLTH WI 501(c)(3) 3 WFH-SE WI
 
 
 
(15) WHEATON FRANCISCAN MEDICAL GROUP INC

400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
39-1791586 		MED GROUP WI 501(c)(3) 3 WFH-SE WI
 
 
 
(16) WHEATON FRANCISCAN -ELMBROOK FNDN (1)

19333 WEST NORTH AVENUE

BROOKFIELD,WI53045
39-2028808 		FOUNDATION WI 501(c)(3) 11 - I WF INC
 
 
 
(17) WHEATON FRANCISCAN INC (2)

19333 WEST NORTH AVENUE

BROOKFIELD,WI53045
39-0853528 		HOSPITAL WI 501(c)(3) 3 WFH-SE WI
 
 
 
(18) WHEATON FRANCISCAN LABORATORIES INC

11020 WEST PLANK COURT

WAUWATOSA,WI53226
39-1701402 		LABORATORY WI 501(c)(3) 9 WFH-SE WI
 
 
 
(19) WFH PHARMACY ENT AND FRAN WOODS INC

13950 WEST CAPITOL DRIVE

BROOKFIELD,WI53005
39-1613624 		PHARMACY WI 501(c)(3) 9 WFH-SE WI
 
 
 
(20) WFH - ST FRANCIS INC

3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
39-0907740 		HOSPITAL WI 501(c)(3) 3 WFH-SE WI
 
 
 
(21) WF - ST JOSEPH FOUNDATION INC

5000 WEST CHAMBERS STREET

MILWAUKEE,WI53210
39-1636804 		FOUNDATION WI 501(c)(3) 11 - I WF INC
 
 
 
(22) WHEATON FRANCISCAN INC

5000 WEST CHAMBERS STREET

MILWAUKEE,WI53210
39-0816857 		HOSPITAL WI 501(c)(3) 3 WFH-SE WI
 
 
 
(23) WFH-THE WISCONSIN HEART HOSPITAL INC (3)

400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
39-1220690 		FOUNDATION WI 501(c)(3) 11 - I WFH-SE WI
 
 
 
(24) WFH-FNDN FOR ST FRANCIS AND FRANKLIN INC

3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
32-0135258 		FOUNDATION WI 501(c)(3) 11 - I WFH-SFH
 
 
 
(25) WFH - TERRACE AT ST FRANCIS INC

3200 SOUTH 20TH STREET

MILWAUKEE,WI53215
39-1486775 		NURSING HOME WI 501(c)(3) 9 WFH-SE WI
 
 
 
(26) WFH - FRANKLIN INC

10101 SOUTH 27TH STREET

FRANKLIN,WI53132
56-2592868 		HOSPITAL WI 501(c)(3) 3 WFH-SE WI
 
 
 
(27) WHEATON WAY CONDO OWNERS ASSCN INC

10101 SOUTH 27TH STREET

FRANKLIN,WI53132
30-0659830 		CONDO ASSCN WI N/A N/A WFH-FRKLN
 
 
 
(28) METRO PHYSICIANS INC

400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
94-3436893 		MED GROUP WI 501(c)(3) 3 WFMG
 
 
 
(29) MARIANJOY INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
36-3483589 		HOLDING CO IL 501(c)(3) 11 - III-FI WFSI
 
 
 
(30) MARIANJOY FOUNDATION INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
35-2165613 		FOUNDATION IL 501(c)(3) 7 MJ HOSP
 
 
 
(31) MARIANJOY REHAB CENTER AUXILIARY INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
36-3896976 		AUXILIARY IL 501(c)(3) 11 - I MJ HOSP
 
 
 
(32) MARIANJOY REHAB HOSPITAL & CLINICS INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
36-2680776 		REHAB HOSPITA IL 501(c)(3) 3 MARIANJOY
 
 
 
(33) REHABILITATION MEDICINE CLINIC INC

26 W 171 ROOSEVELT RD

WHEATON,IL60187
36-3236791 		MEDICAL GRP IL 501(c)(3) 3 MARIANJOY
 
 
 
(34) OSF SERVICES INC

PO Box 667

WHEATON,IL601870667
39-1471463 		HOLDING CO WI 501(c)(3) 11 - III-FI WFSI
 
 
 
(35) CANTICLE MINISTRIES INC

PO Box 667

WHEATON,IL601870667
36-4091836 		HOUSING/ADVCY IL 501(c)(3) 7 OSF SVCS INC
 
 
 
(36) CLARA PFAENDER FUND INC

PO Box 667

WHEATON,IL601870667
36-3353311 		SPONSORSHIP IL 501(c)(3) 11 - III-O OSF SVCS INC
 
 
 
(37) FRANCISCAN SISTERS CHARITABLE FUND OF CO

2626 OSCEOLA STREET

DENVER,CO80212
84-0733072 		AUXILIARY CO 501(c)(3) 7 OSF SVCS INC
 
 
 
(38) RUSH OAK PARK HOSPITAL INC

520 SOUTH MAPLE AVENUE

OAK PARK,IL60304
36-2183812 		HOSPITAL IL 501(c)(3) 3 OSF SVCS INC
 
 
 
(39) SET MINISTRY INC

2977 NORTH 50TH STREET

MILWAUKEE,WI53210
39-1618277 		SOCIAL WORK WI 501(c)(3) 9 OSF SVCS INC
 
 
 
(40) ST CATHERINE'S HOSPITAL INC

9555 76TH STREET

PLEASANT PRAIRIE,WI53158
39-0855075 		HOSPITAL WI 501(c)(3) 3 OSF SVCS INC
 
 
 
(41) SYNERGON HEALTH SYSTEM INC (5)

520 SOUTH MAPLE AVENUE

OAK PARK,IL60304
36-3739067 		HOSPITAL IL 501(c)(3) 3 NONE
 
 
 
(42) UHS INC (6)

6308 EIGHTH AVENUE

KENOSHA,WI53143
39-1956749 		HOSPITAL WI 501(c)(3) 3 NONE
 
 
 
(43) COVENANT FOUNDATION INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1295784 		FOUNDATION IA 501(c)(3) 9 COV MED CTR
 
 
 
(44) COVENANT MEDICAL CENTER INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1264647 		HOSPITAL IA 501(c)(3) 3 WFH-IOWA
 
 
 
(45) MERCY HOSPITAL OF FRANCISCAN SISTERS INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1178403 		HOSPITAL IA 501(c)(3) 3 WFH-IOWA
 
 
 
(46) NE IOWA REAL ESTATE INVESTMENTS LTD

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1207432 		HOLDING CO IA 501(c)(2) N/A WFH-IOWA
 
 
 
(47) SCHOITZ HEALTH RESOURCES INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1232935 		PROMOTE HLTH IA 501(c)(3) 11 - II NA
 
 
 
(48) SCHOITZ MEDICAL CENTER INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-0718472 		OP ROOM SVCS IA 501(c)(3) 3 SCHOITZ HR
 
 
 
(49) SARTORI HEALTH CARE FOUNDATION INC

3421 WEST NINTH STREET

WATERLOO,IA50702
42-1240996 		FOUNDATION IA 501(c)(3) 11 - I SARTORI HOSP
 
 
 
(50) SARTORI MEMORIAL HOSPITAL INC

515 COLLEGE STREET

CEDAR FALLS,IA50613
42-0758901 		HOSPITAL IA 501(c)(3) 3 WFH-IOWA
 
 
 
(51) FRANCISCAN MINISTRIES INC

26W171 ROOSEVELT ROAD

WHEATON,IL601870667
36-3259684 		HOLDING CO IL 501(c)(3) 11 - III-FI WFSI
 
 
 
(52) ASSISI HOMES - BATAVIA APARTMENTS INC

1259 EAST WILSON STREET

BATAVIA,IL60510
36-3914084 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(53) ASSISI HOMES - COLONY PARK INC

550 EAST THORNHILL DRIVE

CAROL STREAM,IL60188
36-4039278 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(54) ASSISI HOMES - CONSTITUTION HOUSE INC

401 NORTH CONSTITUTION DRIVE

AURORA,IL60506
36-4049150 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(55) ASSISI HOMES - JEFFERSON COURT INC

415 EAST KNAPP STREET

MILWAUKEE,WI53202
39-1771526 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(56) ASSISI HOMES - KENOSHA INC

1860 27TH AVENUE

KENOSHA,WI53140
39-1814815 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(57) ASSISI HOMES - SAXONY INC

1876 22ND AVENUE

KENOSHA,WI53140
39-1790498 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(58) ASSISI HOMES OF GURNEE INC

3495 WEST GRAND AVENUE

GURNEE,IL60031
36-3942336 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(59) ASSISI HOMES OF ILLINOIS INC

2126 WEST ROOSEVELT ROAD

WHEATON,IL60187
36-3803443 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(60) Assisi HOMES OF NEENAH INC

210 BYRD AVENUE

NEENAH,WI54946
36-3767250 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(61) CANTICLE PLACE INC

26W171 ROOSEVELT ROAD

WHEATON,IL601870667
36-3957850 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(62) CATHERINE MARIAN HOUSING INC

806 SOUTH WISCONSIN AVENUE

RACINE,WI53403
39-1657098 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(63) CLARE GARDENS INC

2626 OSCEOLA STREET

DENVER,CO80212
23-7200039 		HOUSING CO 501(c)(3) 9 FMI
 
 
 
(64) CLARE OF ASSISI HOMES-WESTMINSTER INC

2451 WEST 82ND PLACE

WESTMINSTER,CO80031
74-2740978 		HOUSING CO 501(c)(3) 9 FMI
 
 
 
(65) DAYSPRING VILLA INC

3777 WEST 26TH AVENUE

DENVER,CO80211
36-3933908 		HOUSING CO 501(c)(3) 9 FMI
 
 
 
(66) FRANCIS HEIGHTS INC

2626 OSCEOLA STREET

DENVER,CO80212
84-0626174 		HOUSING CO 501(c)(3) 9 FMI
 
 
 
(67) FRANCISCAN MINISTRIES COMMUNITY FNDN INC

26W171 ROOSEVELT ROAD

WHEATON,IL601870667
36-4456204 		FOUNDATION IL 501(c)(3) 11 - II FMI
 
 
 
(68) FRANCISCAN SENIORS KENOSHA INC

1920 27TH AVENUE

KENOSHA,WI53140
39-1821568 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(69) MARIAN HOUSING CENTER INC

4105 SPRING STREET

RACINE,WI53405
39-1515867 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(70) MARIAN PARK INC

2126 WEST ROOSEVELT ROAD

WHEATON,IL60187
36-2750105 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(71) RIDGEWAY PLACE INC

155 EAST RIDGEWAY AVENUE

WATERLOO,IA50702
42-1416064 		HOUSING IA 501(c)(3) 9 FMI
 
 
 
(72) STARVED ROCK-LASALLE MANOR INC

1135 10TH STREET

LASALLE,IL61301
36-3796933 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
(73) VILLA MARIA INC

2461 WEST 82ND PLACE

WESTMINSTER,CO80031
84-1347868 		HOUSING CO 501(c)(3) 9 FMI
 
 
 
(74) VILLA ST CLARE INC

130 BYRD AVENUE

NEENAH,WI54946
39-1769395 		HOUSING WI 501(c)(3) 9 FMI
 
 
 
(75) ASSISI HOMES LASALLE MANOR INC (4)

26W171 ROOSEVELT ROAD

WHEATON,IL601890795
80-0623447 		HOUSING IL 501(c)(3) 9 FMI
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) KENOSHA SNR

PO BOX 667
WHEATON,IL60187
39-1801541 		HOUSING WI FR SNRS
  		          0      
(2) STARVED ROCK

PO BOX 667
WHEATON,IL60187
36-3811835 		HOUSING IL SRLM INC
  		          0      










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) NETWORK HEALTH INSURANCE CORPORATION
1570 MIDWAY PLACE
MENASHA,WI54942
39-2020474 		INSURANCE CO WI NETWK HLTH SY
  		C CORP      
(2) NETWORK HEALTH PLAN
1570 MIDWAY PLACE
MENASHA,WI54942
39-1442058 		HLTH MAINT ORG WI NETWK HLTH SY
  		C CORP      
(3) WHEATON FRANCISCAN ENTERPRISES INC
400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1985204 		HOLDING CO WI WF HOLD INC
  		C CORP      
(4) WHEATON FRANCISCAN HOLDINGS INC
400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1836357 		HOLDING CO WI WFH-SE WI
  		C CORP      
(5) WHEATON FRANCISCAN MED GRP-SUSSEX INC
400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1361100 		MED GROUP WI WF HOLD INC
  		C CORP      
(6) WHEATON FRANCISCAN PROVIDER NETWORK INC
400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1952140 		ADMIN SUPPORT WI WFH-SE WI
  		C CORP      
(7) COVENANT REGIONAL SERVICES INC
3421 WEST NINTH STREET
WATERLOO,IA50702
42-1189805 		PHARMACY IA WFH-IOWA
  		C CORP 2,872,247 0 100.000 %
(8) WHEATON FRANCISCAN INSURANCE COMPANY
 
 
98-0691609 		FINANCIAL UK WFSI
  		       
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Cedar Valley Comm Healthcare-Wheaton Iowa LLC

 Q 80,399  
(2) Covenant Regional Services Inc

 Q 1,618,134  
(3) Covenant Medical Center Inc

 A 867,841  
(4) Mercy Hospital of Franciscan Sisters Inc

 A 87,001  
(5) Covenant Medical Center Inc

 D 1,702,582  
(6) Mercy Hospital of Franciscan Sisters Inc

 D 448,765  
(7) Covenant Medical Center Inc

 P 9,007,527  
(8) Sartori Memorial Hospital Inc

 P 1,520,387  
(9) Mercy Hospital of Franciscan Sisters Inc

 P 602,346  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Schedule R Disclosures Part II (1) Wheaton Franciscan Healthcare - Elmbrook Memorial Foundation, Inc. changed its legal name to Wheaton Franciscan - Elmbrook Memorial Foundation, Inc. effective July 1, 2011. (2) On July 1, 2011, Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. (FEIN #39-0853528) was merged into Wheaton Franciscan, Inc. (FEIN 39-0816857). As a result of this merger, Wheaton Franciscan, Inc. f/k/a Wheaton Franciscan Healthcare - Elmbrook Memorial, Inc. (FEIN #39-0853528) ceased to exist and will file its final IRS Form 990 for the fiscal year ending June 30, 2011. (3) Wheaton Franciscan Healthcare - The Wisconsin Heart Hospital, Inc. f/k/a St Michael Hospital Community Foundation, Inc. (FEIN #39-1220690) was dissolved effective December 21, 2010 and as such, will file its final IRS Form 990 for tax year 2010. (4) Assisi Homes - LaSalle Manor, Inc. was formed on July 8, 2010 and was granted tax exempt status on February 14, 2011 retroactive to July 8th. (5) Synergon Health System Inc is listed with no direct controlling entity because of the two organizations with an interest, Rush Presbyterian and OSF Services Inc, neither can appoint a majority of the board, therefore neither organization "controls". (6) UHS, Inc. is listed without a direct controlling entity because of the two organizations with an interest, KHMC Community Board and OSF Services Inc, neither can appoint a majority of the board, and since KHMC is not an entity (it is a community board), neither body "controls".
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