2017-05-12T12:34:46-05:00 2016-06-30 420714325 RSM US LLP 1 S Wacker Drive Chicago IL 60606 990 2015-07-01 391824445 University of Wisconsin Medical Foundation Inc UNIV 6082657131 7974 UW Health Court Middleton WI 53562 Robert W Flannery SVP/CFO 6082657131 2017-05-11 1 Wayne Harder P00294296 3126343400 2015 2021-01-29 14:40:06Z Alan Kaplan MD 7974 UW Health Court Middleton WI 53562 821585709 0 X www.uwhealth.org X 1996 WI University of Wisconsin Medical Foundation (UWMF) supports the teaching, research and service missions of the University of Wisconsin School of Medicine and Public Health by promoting the delivery of excellent and innovative patient care by faculty and staff who serve local, regional, national and international populations. 15 4 4804 0 5132971 -290492 57193313 78422871 699550184 736537759 5944790 1090241 3443609 2920609 766131896 818971480 81811331 162984767 0 0 459049660 499078221 0 0 0 199055292 219769633 739916283 881832621 26215613 -62861141 727132485 529863634 205329976 255537577 521802509 274326057 X University of Wisconsin Medical Foundation (UWMF) supports the teaching, research and service missions of the University of Wisconsin School of Medicine and Public Health by promoting the delivery of excellent and innovative patient care by faculty and staff who serve local, regional, national and international populations. 0 0 199042179 124114000 Funding allocated to provide medical education for the benefit of, and in support of, the purpose of the UW Medical School and Public Health. 28563111 28563111 Funding allocated to provide medical research for the benefit of, and in support of, the purpose of the UW Medical School and Public Health. 631990887 8815093 736537759 Funding allocated to provide healthcare for the benefit of, and in support of, the purpose of the UW Medical School and Public Health. 1492563 1492563 Other Program Revenue and Expenses allocated to provide medical education for the benefit of and in support of the purpose of the UW Medical School and Public Health. 1492563 1492563 861088740 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 318 0 1 4804 1 1 1 0 0 0 0 0 0 0 0 0 X 15 4 0 0 1 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IL WI X Robert W Flannery SVPCFO 6082657131 7974 UW Health Court Middleton WI 53562 Jennifer Alexander Director 1.00 X 0 0 0 Ronald Anderson Director 1.00 X 0 0 0 Patricia Brady Director 1.00 X 0 0 0 Frederick Wenzel Director 1.00 X 0 0 0 Terri Young MD Director (as of January 2016) 1.00 39.00 X 349973 181247 54577 Ben Graf MD Director 1.00 39.00 X 542736 70863 39840 Nizar Jarjour MD President of the Foundation 1.00 39.00 X 253633 211224 53090 Jon Matsumura MD Director 1.00 39.00 X 596790 98073 54463 Stephen Nakada MD Director 1.00 39.00 X 424709 190437 54463 Richard Page MD Director 1.00 39.00 X 403334 210262 55663 Laurel Rice MD Director 1.00 39.00 X 379704 172014 54463 William Schwab MD Director 1.00 39.00 X 137478 96364 37584 Alan Kaplan UWH CEO (as of April 2016) 40.00 0.00 X X 0 0 0 K Craig Kent MD Director (left August 2016) 1.00 39.00 X 499130 178208 53060 Peter Christman COO (left October 2015) 40.00 X 748979 0 63178 Robert Flannery CAO & CFO 40.00 X 472819 0 63383 Kelsie Doty Treasurer (as of July 2015) 40.00 X 162779 0 35159 Peter Newcomer Medical Director 1.00 39.00 X 376407 70282 54463 Jonathan Jaffery MD Medical Director 1.00 39.00 X 218766 115330 53090 Steven Means VP of Legal Services & Compliance 40.00 X 365899 0 62992 Jeffrey Grossman MD President & CEO 39.00 1.00 X 2158323 546857 91466 Geoffrey S Baer MD PhD Physician 39.00 1.00 X 948033 50841 53090 Nilto C De Oliveira MD Physician 39.00 1.00 X 791963 32769 53090 Robert J Dempsey MD Physician 39.00 1.00 X 846519 163560 53090 Matthew W Squire MD Physician 39.00 1.00 X 799168 56795 90 11477142 2445126 1040294 1253 0 1 0 Epic Systems Corp PO Box 88314 Milwaukee WI 53288 Health Record Consulting 2237647 Weatherby Locums INC 6451 North Federal Highway suite 8 Fort Lauderdale FL 33308 Locum Physicians 972741 Environmental Control Group of Wisconsin 2902 Agriculture Drive Madison WI 53718 Custodial Services 964767 Shine United 202 N Henry St Madison WI 53703 Advertising 924386 State Collection Service Inc 2509 South Stoughton Rd Ste 100 Madison WI 53716 Collection Services 618976 55 78422871 78422871 Patient Services 621111 500020875 500020875 Premium Revenue 900099 199148017 199148017 37368867 32246082 5122785 736537759 3694100 3694100 2664334 10370 2653964 2653964 10186 2643778 2603859 -2603859 -2603859 -2603859 266645 266645 266645 818971480 731414974 5132971 4000664 162984767 162984767 8287458 3766311 4521147 430030082 416474202 13555880 11740644 11740644 29105865 29105865 19914172 19914172 21927102 21268232 658870 734890 734890 133915 133915 226759 226759 1112068 1112068 4777859 4777859 7416786 7416786 20506602 20506602 592277 592277 5688926 5688926 912420 912420 7245892 7245892 1441952 1441952 Reimb. of Med School Ex 90384957 90384957 Drugs and Patient Care 37476886 37476886 Bad Debt Expense 7095465 7095465 12094877 12094877 881832621 861088740 20743881 0 176993704 149442752 61340250 67292866 4574698 5287274 19626431 24460108 142689850 76540752 58994657 66149098 175906285 164134844 229110418 52994212 108224 102480 477818 0 727132485 529863634 148832724 204119215 40070000 36960000 16427252 14458362 205329976 255537577 X 521802509 274326057 521802509 274326057 727132485 529863634 X -62861141 -2638972 -181976339 X 0 1 X 1 0 X 37593827 48104050 54241924 57193313 78422871 275555985 606732366 622980230 658892013 700536394 713369590 3302510593 644326193 671084280 713133937 757729707 791792461 3578066578 0 0 0 3578066578 6393597 7894444 10221619 6735997 6358434 37604091 6393597 7894444 10221619 6735997 6358434 37604091 152449 98351 337265 588065 740900 224253 181069 138579 266645 1551446 651613139 679301328 723873890 764604283 798417540 3617810180 0.98900 0.98850 0.01040 0.01080 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 142908 1 83851 0 0 226759 0 Part II-B, Line 1: Amounts in support of lobbying are for Venn Strategies, LLC of $83,851. Dues were paid to State and National Medical Societies totaling $142,908. 7959113 7959113 56326300 25684135 30642165 22203465 6642366 15561099 56200972 44214251 11986721 66149098 Wisconsin Sleep, Inc. 1891594 C Generations Fertility Care, Inc. 291787 C Madison Medical Center 5075615 C Madison Surgery Center 3929344 C Meriter Physician Contracting 24844 C Wisconsin Dialysis, Inc. 1136353 C Transformation Surgery Center, Inc. 801477 C University Health Care, Inc. 35763090 C Chartwell Wisconsin Enterprises, LLC 3947122 C UW Health Accountable Care Org. 132986 C 52994212 Due to Med. School Dev. Fund 8203499 Due to Research & Dev. Fund 254863 Due to Carbone Cancer Center 6000000 14458362 X 708018822 -2638972 -6732946 -9371918 717390740 101580740 101580740 818971480 773881454 10370 10370 773871084 107961537 107961537 881832621 Part X, Line 2: The Foundation has been determined to qualify as exempt from federal income tax under Internal Revenue Code Section 501(a) as an organization described in Section 501(c)(3) of the Code. The Foundation follows the Financial Accounting Standards Board (FASB) guidance on income taxes, Accounting for Uncertainty in Income Taxes, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under this guidance, the Foundation may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. Examples of tax positions include the tax-exempt status of the Foundation and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement. Most of the income earned by the Foundation is exempt from taxation as income related to the mission of the organization. However, the Foundation does earn an immaterial amount of unrelated business income and recognized income tax expense of approximately $0 and $130,000 for the years ended June 30, 2016 and 2015, respectively, within order, net in the statements of operations and changes in net assets. With few exceptions, the Foundation is no longer subject to examination by the Internal Revenue Service for the years 2012 and earlier. Part XI, Line 2d - Other Adjustments: Bad debt expense -7,095,465. Equity in earnings of joint ventures 362,519. Part XI, Line 4b - Other Adjustments: Rental Expense -10,370. Contributed Revenue Presented Net of Expense 78,422,941. Program Service Revenue Presented Net of Expense 22,443,201. FASB to GASB Conversion 724,968. Part XII, Line 2d - Other Adjustments: Reclassification of Rent Expenses 10,370. Part XII, Line 4b - Other Adjustments: Reclassification of Bad Debt Expenses 7,095,465. Contributed Revenue Presented Net of Expense 78,422,871. Program Service Revenue Presented Net of Expense 22,443,201. 1 University of Wisconsin Foundation 1848 University Avenue Madison WI 53708 390743975 501(c)(3) 90062500 Academic Support University of Wisconsin Foundation 1848 University Avenue Madison WI 53708 390743975 501(c)(3) 28563111 Research Support UW School of Medicine and Public Health 750 Highland Avenue Madison WI 53705 396006492 GOVT 34114000 Support Functions of the Medical School University Health Care Inc 301 S Westfield Road Ste 350 Milwaukee WI 53717 391446049 501(c)(3) 4916841 Support for Contract Management Madison Community Health Center Inc DBA Access Community Health Centers 2202 Park Street Madison WI 53713 391391134 501(c)(3) 723888 Support Functions of the Organization United Way of Dane County Inc 2059 Atwood Avenue Madison WI 53707 390817532 501(c)(3) 687905 Support Functions of the Organization The Center for Patient Partnerships 975 Bascom Mall Suite 4311 Madison WI 53706 Govt 321666 Support Functions of the Organization University of Wisconsin Hospital and Clinics Authority 301 S Westfield Road Ste 350 Madison WI 53717 391835630 GOVT 180000 Support Functions of the Organization Friends of University of Wisconsin Hospitals and Clinics 301 S Westfield Road Ste 250 Madison WI 53717 510137187 501(c)(3) 41520 Support Functions of the Organization American Family Childrens Hospital 600 Highland Avenue Madison WI 53792 391835630 501(c)(3) 24250 Support Functions of the Organization Vision Event Management 16851 Southpark Drive suite 100 South Holland IL 60473 225564131 S-corp 17000 Support Functions of the Organization Community Shares of Wisconsin 612 W Main Street Ste 200 Madison WI 53703 391172378 501(c)(3) 12000 Support Functions of the Organization Agrace Hospicecare Inc 5395 E Cheryl Parkway Fitchburg WI 53711 300001703 501(c)(3) 10000 Support Functions of the Organization University of New Mexico Children's Hospital 2211 Lomas Blvd Albuquerque NM 87106 856000642 GOVT 10000 Support Functions of the Organization National Alliance on Mental Illness Dane County 3803 N Fairfax Drive Ste 100 Arlington VA 22203 431201653 501(c)(3) 5000 Support Functions of the Organization UW Carbone Cancer Center 600 Highland Avenue Madison WI 53792 391805963 501(c)(3) 5000 Support Functions of the Organization Urology Care Foundation Inc co North Central Section 1000 Corporate Blvd Linthicum MD 21090 203210212 501(c)(3) 5000 Support Functions of the Organization 15 1 Part I, Line 2: The Grant Schedule for UW School of Medicine is based on a 3 year agreement at a fixed amount. UWMF makes a contribution to UW Foundation for R&D of 2.5% of professional revenues which is part of its bylaws. University Healthcare Inc. support is based on their annual budget. A monthly reconciliation is performed by reviewing the professional revenues and performing the calculation for R&D. The discrepancies are given to the departments for review and funds are adjusted on the following month's transfer. The fixed amounts are reviewed monthly to confirm transfers to contracts and budget. Any discrepancies are adjusted in the following month. X 1 1 X X X 1 0 0 0 0 0 0 0 0 Terri Young MD Director (as of January 2016) 349973 181247 0 0 0 0 53000 0 1577 0 404550 181247 0 0 Ben Graf MD Director 542736 70863 0 0 0 0 39750 0 90 0 582576 70863 0 0 Nizar Jarjour MD President of the Foundation 253633 211224 0 0 0 0 53000 0 90 0 306723 211224 0 0 Jon Matsumura MD Director 596790 98073 0 0 0 0 53000 0 1463 0 651253 98073 0 0 Stephen Nakada MD Director 424709 190437 0 0 0 0 53000 0 1463 0 479172 190437 0 0 Richard Page MD Director 403334 210262 0 0 0 0 53000 0 2663 0 458997 210262 0 0 Laurel Rice MD Director 379704 172014 0 0 0 0 53000 0 1463 0 434167 172014 0 0 William Schwab MD Director 137478 96364 0 0 0 0 34994 0 2590 0 175062 96364 0 0 K Craig Kent MD Director (left August 2016) 406286 178208 91512 0 1332 0 53000 0 60 0 552190 178208 0 0 Peter Christman COO (left October 2015) 554930 0 48445 0 145604 0 34850 0 28328 0 812157 0 0 0 Robert Flannery CAO & CFO 433228 0 33374 0 6217 0 34850 0 28533 0 536202 0 0 0 Kelsie Doty Treasurer (as of July 2015) 155552 0 6923 0 304 0 19067 0 16092 0 197938 0 0 0 Peter Newcomer Medical Director 376407 70282 0 0 0 0 53000 0 1463 0 430870 70282 0 0 Jonathan Jaffery MD Medical Director 218766 115330 0 0 0 0 53000 0 90 0 271856 115330 0 0 Steven Means VP of Legal Services & Compliance 336876 0 26366 0 2657 0 34850 0 28142 0 428891 0 0 0 Jeffrey Grossman MD President & CEO 439096 546857 0 0 1719227 0 75882 0 15584 0 2249789 546857 0 0 Geoffrey S Baer MD PhD Physician 948033 50841 0 0 0 0 53000 0 90 0 1001123 50841 0 0 Nilto C De Oliveira MD Physician 791963 32769 0 0 0 0 53000 0 90 0 845053 32769 0 0 Robert J Dempsey MD Physician 846519 163560 0 0 0 0 53000 0 90 0 899609 163560 0 0 Matthew W Squire MD Physician 799168 56795 0 0 0 0 0 0 90 0 799258 56795 0 0 Part I, Line 1a UWMF reimburses Chairs and the Dean of the Medical School for the business use of their social club dues. As a business expense, amounts are not taxable. Part I, Line 4a Peter Christman and Jeffrey Grossman received severance payments during the 2015 calendar year, included as other taxable compensation per Schedule J, Part II, column b(iii). Christman received $137,594 and Grossman received $1,713,420 in severance. Form 990, Part VI, Section A, line 4 The Bylaws of the Organization were amended as part of the UW Health system integration whereby the University of Wisconsin Hospitals and Clinics Authority shall be the sole member of the Organization Form 990, Part VI, Section A, line 6 The sole member of the Organization is the University of Wisconsin Hospitals and Clinics Authority. Form 990, Part VI, Section A, line 7b The sole member of the Organization has the overall rights to govern, direct, and oversee the property, funds, business, and affairs of the Organization except when reserved to the Board of Directors. Form 990, Part VI, Section B, line 11 Form 990 is completed by the organization's external accounting firm. Upon completion, the manager of financial accounting reviews the return and workpapers. Once that is complete, the return is then forwarded to the Chief Financial Officer for review. When all reviewers have determined that Form 990 is complete and accurate, the return is provided to the members of the Board of Directors. After they have had time to review, the return is submitted for filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The Compliance and Legal Department reviews conflict of interest forms. If potential conflicts are found, there is a discussion between legal services, the CFO, and the individual. The Compliance Department issues questionnaires annually and there is 100% compliance in responding. If there is a conflict, the fix is to recuse oneself from any vote. If it is a sensitive matter, the fix is to recuse oneself from the discussion and the vote. The conflict of interest policy provides a process for both voluntary and involuntary recusal. Form 990, Part VI, Section B, line 15 A compensation review committee (CRC) has been established. The committee shall consist exclusively of the public directors. The CRC shall act in accordance with the foundation's compensation principles and policy. The committee shall make final decisions on such matters after satisfying itself that the standards set in the foundation's compensation principles and policy have been met. The committee may request additional data or information prior to approving matters within its jurisdiction. The CRC shall take final action to approve or disapprove all foundation and departmental compensation formulae and policy. The Committee engages an Independent Compensation Consultant to review physician compensation. Outliers identified are substantiated. A presentation is made to the CRC for approval. Executive compensation is based on comparative data with like positions within the market. The compensation for President, CAO, and all Vice Presidents is presented to the compensation committee annually. This committee is comprised of the UWMF's public board members. Form 990, Part VI, Section C, line 19 The financial statements, bylaws, articles, conflict of interest policies, tax returns, and Form 1023 are available upon request from the corporate office for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part XI, line 9: Revenue from Unconsolidated Entities -362,521. FASB to GASB Conversion -181,613,818. University of Wisconsin 1220 Linden Drive Madison WI 53706 396006492 Education WI 115 N/A N/A 0 Regional Division Inc 301 South Westfield Road Suite 320 Madison WI 53717 391446049 Regional Parent Corporation to manage and direct activities of entities WI 501(c)(2) Line 11a University of WI Hospital and Clinics 1 University Health Care Inc 301 South Westfield Road Suite 320 Madison WI 53717 391446049 Support Organization WI 501(c)(3) Line 11a University of WI Hospital and Clinics 1 Generations Fertility Care 2365 Deming Way Middleton WI 53562 273496527 Reproductive Endocrinology and Infertility Services WI 501(c)(3) Line 9 N/A 0 Wisconsin Dialysis 3034 Fish Hatchery Road Fitchburg WI 53713 300072647 Dialysis Services WI 501(c)(3) Line 11c N/A 0 Madison Surgery Center 7974 UW Health Court Middleton WI 53562 391940656 Health Care Services and Training WI 501(c)(3) Line 9 N/A 0 SwedishAmerican Health System Corporation 1401 East State Street Rockford IL 61104 363241458 Parent Corporation to manage and direct activites of entities IL 501(c)(3) Line 11a University Health Care Inc 1 SwedishAmerican Hospital 1401 East State Street Rockford IL 61104 362222696 Hospital IL 501(c)(3) Line 3 SwedishAmerican Health System Corporation 1 SwedishAmerican Foundation 1401 East State Street Rockford IL 61104 363097493 Supporting Organization for SwedishAmerican Hospital fundraising IL 501(c)(3) Line 7 SwedishAmerican Hospital 1 SwedishAmerican Realty Corporation 1313 East State Street Rockford IL 61104 363248013 Title Holding Company IL 501(c)(2) SwedishAmerican Health System Corporation 1 SwedishAmerican Hospital Self Insurance Trust 1401 East State Street Rockford IL 61104 366652702 Hospital Malpractice Trust VT 501(c)(3) Line 11a SwedishAmerican Hospital 1 Three Rivers Partners LLC 1313 East State Street Rockford IL 61104 262231757 Information Technology Services IL N/A N/A 0 0 Northern Illinois Vein Clinic 2550 Charles Street Rockford IL 61108 201642329 Outpateint Health Services IL N/A N/A 0 0 SARI Insurance Company 76 St Paul Street Suite 500 Burlington VT 054014477 030308753 Captive Insurance Company VT SAHS Corporation C 1 LSG Building Corporation 1313 East State Street Rockford IL 61104 363033985 Real Estate IL SAHS Corporation S 1 State & Charles Inc 1313 East State Street Rockford IL 61104 363321193 Holding Company IL SAHS Corporation C 1 SwedishAmerican Health Management Corp 1313 East State Street Rockford IL 61104 363246511 Management Services IL State & Charles Inc C 1 Unity Health Insurance 840 Carolina Street Sauk City WI 53583 391450766 Health Maintenance Organization WI University Health Care Inc C 1 Health Professionals of Wisconsin 301 South Westfield Road Madison WI 53717 391806711 Real Estate WI University Health Care Inc C 1 Physician's Care Network 1313 East State Street Rockford IL 61104 363455791 Health Services IL State & Charles Inc C 0 1 1 1 0 0 0 0 0 0 1 1 1 0 1 1 1 1 0 0 Wisconsin Dialysis C 200000 FMV Univeristy Health Care Inc B 8580000 FMV Madison Surgery Center A 1538725 FMV Madison Surgery Center C 2800000 FMV Madison Surgery Center L 1734758 FMV Madison Surgery Center O 6763188 FMV Madison Surgery Center P 806451 FMV Generations Fertility Care Inc B 300000 FMV Generations Fertility Care Inc J 543981 FMV Generations Fertility Care Inc L 473711 FMV Generations Fertility Care Inc O 1854484 FMV