2021-11-05T10:42:44-05:00 2020-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2020-01-01 391500075 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC CHIL 4142665420 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2021-11-04 1 MARC CADIEUX 999009999 JILL M BOYLE CPA P01246734 2627549400 2021-11-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHILDREN'S WISCONSIN MEG BRZYSKI NELSON PO BOX 1997 MS 900 MILWAUKEE WI 532011997 502574038 0 X WWW.CHILDRENSWI.ORG X 1984 WI SECURE FINANCIAL SUPPORT FOR CHILDREN'S HOSPITAL AND HEALTH SYSTEM AND ITS TAX EXEMPT AFFILIATES. 35 33 50 410 0 0 48392690 34692358 0 0 31106715 60029263 -618012 -277437 78881393 94444184 17794013 22072690 0 0 5062652 5470553 300346 292276 6121969 5362381 5518594 28519392 33354113 50362001 61090071 1035129694 1206475471 33649843 32461527 1001479851 1174013944 X CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. IS A 501(C)(3) ORGANIZATION THAT EXISTS TO FUNDRAISE FOR CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. AND ITS NOT-FOR-PROFIT AFFILIATES INCLUDING CHILDREN'S HOSPITAL OF WISCONSIN, INC., CHILDREN'S MEDICAL GROUP, INC., AND CHILDREN'S SERVICE SOCIETY OF WISCONSIN. 0 0 7024040 7024040 IN COLLABORATION WITH CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW OR "THE HOSPITAL") AND ITS AFFILIATES, CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. ("CHWF OR "THE FOUNDATION") RAISES FUNDS TO SUPPORT FREE OR BELOW-COST COMMUNITY PROGRAMS SUCH AS HEALTH EDUCATION, CHILD ABUSE PREVENTION, PARENTING EDUCATION AND INJURY PREVENTION PROGRAMS. FUNDING ALSO SUPPORTS SCHOOL BASED HEALTH CENTERS IN MILWAUKEE SCHOOLS, PRIMARY CARE CLINICS IN UNDERSERVED AREAS, AND SUPPORTS SOCIAL SERVICES PROVIDED TO WISCONSIN CHILDREN AND FAMILIES BY CHILDREN'S SERVICE SOCIETY OF WISCONSIN. 9501461 9447961 THE FOUNDATION PROVIDES RESOURCES ESSENTIAL TO SUPPORT THE OPERATIONS OF CHW. 4218999 4218999 IN COLLABORATION WITH CHW AND ITS AFFILIATES, THE FOUNDATION RAISES FUNDS TO SUPPORT INNOVATIVE NEW BIOMEDICAL, CLINICAL AND TRANSLATIONAL RESEARCH. 1381690 1381690 PHILANTHROPIC SUPPORT RECEIVED BY THE FOUNDATION SUPPORTS CAPITAL EXPENDITURES SUCH AS FACILITIES EXPANSION, RENOVATION AND EQUIPMENT. 1381690 1381690 22126190 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 X 0 0 50 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 35 33 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI FL MN OH X MS SARAH KAFKA 4142661887 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0.00 40.00 X 0 1977316 57166 MARC CADIEUX TREASURER 0.00 40.00 X 0 839342 94857 MICHELLE METTNER SECRETARY 0.00 40.00 X 0 648967 106666 MARGARET NELSON DIRECTOR/CDO & PRESIDENT FOUNDATION 0.00 40.00 X X 0 597593 107376 JEFF STEWART COO FOUNDATION 40.00 0.00 X 311742 0 51925 JAY RABIDEAUX VP DEVELOPMENT 40.00 0.00 X 294201 0 47949 MARYANNE KESSEL EXECUTIVE DEVELOPMENT DIR, HHI 40.00 0.00 X 282456 0 40842 CHRISTINE BARANOUCKY VP ENGAGEMENT & STEWARDSHIP 40.00 0.00 X 220674 0 26044 KELLY SACHSE SENIOR DIR, PLANNED GIVING 40.00 0.00 X 192778 0 45857 HEATHER NELSON EXEC DIR PHILANTHROPY 40.00 0.00 X 186326 0 39738 DAVID WERNER DIRECTOR/CHAIR 1.00 0.00 X X 0 0 0 KELLY J CLEARY-REBHOLZ DIRECTOR/VICE CHAIR 1.00 0.00 X X 0 0 0 THOMAS E ARENBERG DIRECTOR 1.00 0.00 X 0 0 0 MARK BLUTSTEIN DIRECTOR 1.00 0.00 X 0 0 0 BETSY BRENNER DIRECTOR 1.00 0.00 X 0 0 0 DAN BUEHRLE DIRECTOR 1.00 0.00 X 0 0 0 GARTH CHAMBERS DIRECTOR 1.00 0.00 X 0 0 0 BARRI DRURY DIRECTOR 1.00 0.00 X 0 0 0 KRISTY ELMORE DIRECTOR 1.00 0.00 X 0 0 0 RAQUEL FILMANOWICZ DIRECTOR 1.00 0.00 X 0 0 0 RICHARD FLORSHEIM DIRECTOR 1.00 0.00 X 0 0 0 KELLY GREBE DIRECTOR 1.00 0.00 X 0 0 0 MARY M HOSMER DIRECTOR 1.00 0.00 X 0 0 0 JERRY JENDUSA DIRECTOR 1.00 0.00 X 0 0 0 CHRISTOPHER KALTENBACH DIRECTOR 1.00 0.00 X 0 0 0 TED D KELLNER DIRECTOR 1.00 0.00 X 0 0 0 BERNARD S KUBALE DIRECTOR 1.00 0.00 X 0 0 0 DAVE LUCZAK DIRECTOR 1.00 0.00 X 0 0 0 KARIM J MACLEOD DIRECTOR 1.00 0.00 X 0 0 0 DAVE MARGOLIS MD DIRECTOR 1.00 0.00 X 0 0 0 JOHN MILLER DIRECTOR 1.00 0.00 X 0 0 0 CHAD NOEL DIRECTOR 1.00 0.00 X 0 0 0 JOHN M NOEL DIRECTOR 1.00 0.00 X 0 0 0 UGO NWAGBARAOCHA DIRECTOR 1.00 0.00 X 0 0 0 JIM OSTROM DIRECTOR 1.00 0.00 X 0 0 0 GREG W RENZ DIRECTOR 1.00 0.00 X 0 0 0 MARY ELLEN B STANEK DIRECTOR 1.00 0.00 X 0 0 0 SHELLY STAYER DIRECTOR 1.00 0.00 X 0 0 0 MARK THEINE DIRECTOR 1.00 0.00 X 0 0 0 STACEY WALTHERS NAFFAH DIRECTOR 1.00 0.00 X 0 0 0 TEDDY WERNER DIRECTOR 1.00 0.00 X 0 0 0 MARK WITT DIRECTOR 1.00 0.00 X 0 0 0 PORTIA YOUNG DIRECTOR 1.00 0.00 X 0 0 0 1488177 4063218 618420 15 0 1 0 NORTHERN TRUST 50 S LASALLE M11 CHICAGO IL 60603 INVESTMENT FEES 387568 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 HOSPITAL AWARENESS NETWORK 382121 CAMBRIDGE ASSOCIATES LLC 125 HIGH STREET BOSTON MA 02110 INVESTMENT FEES 356675 RUANE CUNNIFF & GOLDFARB LP 9 WEST 57TH STREET SUITE 5000 NEW YORK NY 10019 INVESTMENT FEES 297484 SCHULTZ & WILLIAMS INC 1617 JFK BOULEVARD 1700 PHILADELPHIA PA 19103 CONSULTING 237998 13 294203 1697269 32700886 1106721 34692358 16431681 16431681 451232016 407634176 258 43597840 -258 43597582 43597582 217983 1697269 495420 -277437 -277437 94444184 0 0 59751826 22072690 22072690 363667 363667 4171445 734921 3436524 234940 36718 198222 412157 103159 308998 288344 68063 220281 893852 893852 292276 292276 2362614 2362614 861152 32168 828984 61983 61983 278372 272860 5512 30752 30752 19598 19598 588 92 496 120954 120954 OTHER EXPENSES 888729 53500 86134 749095 33354113 22126190 5105954 6121969 147911 200 2832687 1238921 184428 94997 428146 414267 1094209 424593 790828 669616 747937766 887051189 282807928 317006281 1035129694 1206475471 2268679 2106814 31381164 30354713 33649843 32461527 X 718718759 857087227 282761092 316926717 1001479851 1174013944 1035129694 1206475471 X 61090071 112010473 -566451 X 0 1 X 1 0 X 20709458 29167543 23637591 48392690 34692358 156599640 20709458 29167543 23637591 48392690 34692358 156599640 19723612 136876028 13766915 13416269 15838741 18929945 16431681 78383551 234983191 0.58250 0.57200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 807628630 27146139 123060013 22072690 1609777 934152315 636588049 66390715 124194019 17794013 1750140 807628630 642119355 41526559 -28325485 17027970 1704410 636588049 462655398 131211131 69065559 19121641 1691092 642119355 436220272 39117093 11368135 22396845 1653257 462655398 0.66100 0.24500 0.09400 0 0 602693 219639 383054 491516 204954 286562 669616 INVESTMENTS, PLEDGES, TRUSTS, & BEQUESTS DESIGNATED FOR RESTRICTED PURPOSES 316926718 457 PLAN ASSETS 79563 317006281 PAYABLE TO AFFILIATES 30275150 457 PLAN LIABILITY 79563 30354713 X PART V, LINE 4: CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION HOLDS ENDOWMENT FUNDS ON BEHALF OF CHILDREN'S HOSPITAL OF WISCONSIN AND RELATED ENTITIES. INTENDED USES OF THE FUNDS INCLUDE VARIOUS HEALTH-RELATED SERVICES, EDUCATION, CAPITAL PROJECTS, RESEARCH, AND SOCIAL SERVICES TO CHILDREN AND FAMILIES. PART X, LINE 2: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENT 20121896 0 0 0 0 0 0 20121896 0 20121896 1 0 0 0 1 0 PART III ACCOUNTING METHOD: X X X X X X 1 SCHULTZ & WILLIAMS INC 1617 JOHN F KENNEDY BLVD STE 1700 PHILADELPHIA PA 19103 CONSULTING, FEASIBILITY STUDY, PHILANTHROPIC BENCHMARKING 0 761458 237998 -237998 BENTZ WHALEY FLESSNER 7251 OHMS LANE MINNEAPOLIS MN 55439 CONSULTING, FEASIBILITY STUDY, PHILANTHROPIC BENCHMARKING 0 0 54278 -54278 761458 292276 -292276 WI FL AZ MN OH BRIGG'S & AL'S RUN AND WALK 315101 260678 54423 27450 131661 MIRACLE MARATHON 744700 737030 7670 33824 622 47517 7 855451 699561 155890 97195 2085 80 154986 1915252 1697269 217983 158469 2085 702 334164 495420 -277437 SCHEDULE G, PART I, LINE 2B, COLUMN III, CUSTODY/CONTROL OF CONTRIBUTIONS: BENTZ WHALEY FLESSNER AND SCHULTZ & WILLIAMS, INC. DOES NOT ACCEPT OR PROCESS DONATIONS ON BEHALF OF CHF. ALL CONTRIBUTIONS ARE DIRECTED TO AND RECEIVED BY CHF. DURING 2020, THE ORGANIZATION PAID BENTZ WHALEY FLESSNER $54,278 FOR SERVICES AND PAID SCHULTZ & WILLIAMS, INC. $237,998 FOR SERVICES. SCHEDULE G, PART I, LINE 2B, COLUMN IV, GROSS RECEIPTS: BENTZ WHALEY FLESSNER PROVIDED CONSULTING FOR PHILANTHROPIC BENCHMARKING AND FEASIBILITY TO CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. THE ORGANIZATION DOES NOT ANTICIPATE RECEIVING ANY GROSS RECEIPTS FOR ACTIVITY DUE TO THE NATURE OF CONSULTING. BENTZ WHALEY FLESSNER WAS INCLUDED ON SCHEDULE G DUE TO DEFINITION OF FUNDRAISING ACTIVITIES IN INSTRUCTIONS. 1 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390812532 501(C)(3) 10625082 OPERATION & CAPITAL SUPPORT CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 501(C)(3) 7719360 MEDICAL RESEARCH, CHILD ABUSE PREVENTION, HEALTH EDUCATION, SCHOOL BASED CLINICS, COMMUNITY SERVICE & CAPITAL SUPPORT CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 501(C)(3) 2983199 CHILD WELLBEING SERVICES & CAPITAL SUPPORT CHILDREN'S MEDICAL GROUP INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391789197 501(C)(3) 745049 COMMUNITY-BASED PRIMARY CARE CLINICS 4 0 PART I, LINE 2: CHWF AWARDS GRANTS TO ITS TAX-EXEMPT AFFILIATES. GRANTS ARE AWARDED BASED ON THE STRATEGIC INITIATIVES OF THE HEALTH SYSTEM, THE NEEDS OF THE AFFILIATES, AND ANY PURPOSE RESTRICTIONS SET BY THE DONORS. THE NEEDS OF THE AFFILIATES ARE EVALUATED IN THE ANNUAL BUDGET PROCESS. FINAL BUDGETS REQUIRE APPROVAL FROM MANAGEMENT, THE ENTITY'S BOARD OF DIRECTORS AND THE CHHS BOARD OF DIRECTORS AND SENIOR MANAGEMENT. IN ADDITION, THE OPERATIONS OF ALL AFFILIATES ARE SUBJECT TO SYSTEM CONTROLS, POLICIES AND PROCEDURES, AND ARE REFLECTED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF CHHS AND ITS AFFILIATES. 0 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0 1060734 0 529018 0 387564 0 21150 0 36016 0 2034482 0 0 MARC CADIEUX TREASURER 0 595303 0 187603 0 56436 0 91485 0 3372 0 934199 0 31926 MICHELLE METTNER SECRETARY 0 452620 0 141900 0 54447 0 78146 0 28520 0 755633 0 8095 MARGARET NELSON DIRECTOR/CDO & PRESIDENT FOUNDATION 0 423797 0 127690 0 46106 0 70014 0 37362 0 704969 0 27285 JEFF STEWART COO FOUNDATION 233127 0 56057 0 22558 0 24000 0 27925 0 363667 0 0 0 JAY RABIDEAUX VP DEVELOPMENT 238268 0 55428 0 505 0 15450 0 32499 0 342150 0 0 0 MARYANNE KESSEL EXECUTIVE DEVELOPMENT DIR, HHI 238908 0 36193 0 7355 0 23799 0 17043 0 323298 0 0 0 CHRISTINE BARANOUCKY VP ENGAGEMENT & STEWARDSHIP 173953 0 36971 0 9750 0 13362 0 12682 0 246718 0 0 0 KELLY SACHSE SENIOR DIR, PLANNED GIVING 161900 0 21353 0 9525 0 16042 0 29815 0 238635 0 0 0 HEATHER NELSON EXEC DIR PHILANTHROPY 164895 0 21083 0 348 0 7752 0 31986 0 226064 0 0 0 PART I, LINE 3 THE FOUNDATION RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF THE FOUNDATION, TO ESTABLISH THE COMPENSATION OF THE FOUNDATION'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION. PART I, LINE 4B IN 2020, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F)). THE ORGANIZATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2020 WERE AS FOLLOWS: M. BRZYSKI NELSON, $51,714; M. CADIEUX, $70,335; AND M. METTNER, $56,996. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2020 WERE: M. BRZYSKI NELSON, $27,285, M. CADIEUX, $31,926, AND M. METTNER, $8,095. PART I, LINE 7 CERTAIN EXECUTIVES PARTICIPATE IN AN ANNUAL BONUS PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. BONUS CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND EXECUTIVE SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS 1. MARGARET TROY, DIRECTOR OF CHWF AND PRESIDENT & CEO OF CHHS, MARGARET BRZYSKI NELSON, DIRECTOR, CHIEF DEVELOPMENT OFFICER, AND PRESIDENT OF CHWF, MARC CADIEUX, TREASURER OF CHWF AND TREASURER & CFO OF CHHS, AND MICHELLE METTNER, SECRETARY OF CHWF AND CORP VP GOV & LEGAL AFFAIRS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY AND MS. NELSON AS MEMBERS OF THE BOARD OF DIRECTORS OF CHWF WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS X 15 345293 SELLING PRICE X TOYS / BLANKETS / OTHER 461 553424 FMV X NONCASH PRIZES 315 173204 FMV X OTHER DONATED GOODS 5 33020 FMV X FOOD / BEVERAGES 4 1780 FMV 0 1 1 PART I, LINE 32B: THE ORGANIZATION USES VARIOUS BROKERAGE FIRMS TO SELL DONATED SECURITIES. FORM 990, PART V, LINE 1A THE ORGANIZATION DID NOT FILE ANY FORMS 1099 DURING THE TAXABLE YEAR. ALTHOUGH THE ORGANIZATION DID RETAIN INDEPENDENT CONTRACTORS, THE COMPENSATION AMOUNTS OWED TO SUCH CONTRACTORS WERE PROCESSED AND PAID BY A RELATED ENTITY, CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW"), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHW. THE FORMS 1099 FOR SUCH PAYMENTS WERE ISSUED BY CHW, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: BRENNER AND MARGOLIS, KELLNER AND MARGOLIS, TROY AND MARGOLIS, AND STANEK AND MARGOLIS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHHS. FORM 990, PART VI, SECTION A, LINE 7A CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 OF CHWF WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF CHHS AND PRIOR TO FILING, A COPY WAS PROVDED TO ALL DIRECTORS OF CHWF. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE DIRECTOR OF CORPORATE COMPLIANCE. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, TREASURER, AND SECRETARY WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS (THE ORGANIZATION'S CORPORATE MEMBER). WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE KEY EMPLOYEE WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CHWF ARE AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST TO THE CHHS PUBLIC RELATIONS DEPARTMENT. FORM 990, PART XI, LINE 9: WRITE-OFF OF UNCOLLECTIBLE PLEDGES -566,451. FORM 990, SCHEDULE R, PART V, LINE 1D PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED DECEMBER 1, 2017, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEES CERTAIN DEBT ISSUED BY A MEMBER OF THE OBLIGATED GROUP THROUGH THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PAYMENT OF SCHEDULED PRINCIPAL AND INTEREST IS SECURED BY A PLEDGE OF THE HOSPITAL'S AND FOUNDATION'S GROSS UNRESTRICTED RECEIPTS. FORM 8865, KPS SPECIAL SITUATIONS FUND V (A), LP EIN: 98-1509288 KPS SPECIAL SITUATIONS FUND V (A), LP EIN: 98-1509288 THE FOLLOWING OBLIGATIONS WILL BE SATISFIED BY CA RESOURCES FUND (U.S. TAX-EXEMPT), L.P. - SERIES KPS SPECIAL SITUATIONS FUNDS V (A). THE FUND WILL ATTACH FORM 8865 TO ITS FORM 1065 WHICH WILL BE FILED WITH THE INTERNAL REVENUE SERVICE CENTER IN OGDEN, UT 84201-0011. CA RESOURCES FUND (U.S. TAX-EXEMPT), L.P. - SERIES KPS SPECIAL SITUATIONS FUNDS V (A), LP'S TAX IDENTIFICATION NUMBER IS 84-3054793 AND ITS ADDRESS IS: 125 HIGH STREET BOSTON, MA 02110 CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S MEDICAL GROUP INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S PHYSICIAN GROUP PC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 364303682 PEDIATRIC PHYSICIAN SERVICES IL 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 CHILD WELLBEING SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S COMMUNITY HEALTH PLAN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 271494977 WISCONSIN MEDICAID HMO WI 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SPECIALTY GROUP INC 999 N 92ND ST SUITE C740 MILWAUKEE WI 53226 391990012 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 12A, I N/A 0 WEST ALLIS PRESCRIPTION CENTER INC 6737 W WASHINGTON ST STE 1100 WEST ALLIS WI 53214 463421597 PHARMACY WI N/A C 0 WAUWATOSA PRESCRIPTION CENTER INC SKYWALK PHARMACY 9000 W WISCONSIN AVE WAUWATOSA WI 53226 061654484 PHARMACY WI N/A C 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 SCHEDULE R, PART V, LINE 1D PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED DECEMBER 1, 2017, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEES CERTAIN DEBT ISSUED BY A MEMBER OF THE OBLIGATED GROUP THROUGH THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PAYMENT OF SCHEDULED PRINCIPAL AND INTEREST IS SECURED BY A PLEDGE OF THE HOSPITAL'S AND FOUNDATION'S GROSS UNRESTRICTED RECEIPTS.