2016-11-09T14:12:27-06:00 2015-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2015-01-01 391500075 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC CHIL 4142665420 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2016-10-25 1 BRYAN L PAUTSCH CPA P00034913 2627549400 2016-10-17 2015 2017-02-10 21:41:12Z MEG BRZYSKI NELSON PO BOX 1997 MS 900 MILWAUKEE WI 532011997 167032998 0 X WWW.CHW.ORG X 1984 WI SECURE FINANCIAL SUPPORT FOR CHILDREN'S HOSPITAL AND HEALTH SYSTEM AND ITS TAX EXEMPT AFFILIATES. 32 21 45 1006 0 -1709 28116969 21254146 0 0 25150402 21267728 -302647 -281139 52964724 42240735 18334469 19815670 0 0 4018692 4187217 19401 17296 4288011 3158897 3486577 25531459 27506760 27433265 14733975 638432093 625234438 23955960 25363634 614476133 599870804 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 5598892 5598892 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, AND SUPPORTS SOCIAL SERVICES PROVIDED TO WISCONSIN CHILDREN AND FAMILIES BY CHILDREN'S SERVICE SOCIETY OF WISCONSIN. 6200442 6200442 THE FOUNDATION PROVIDES RESOURCES ESSENTIAL TO SUPPORT THE OPERATIONS OF CHW. 3206671 3206671 IN COLLABORATION WITH CHW AND ITS AFFILIATES, THE FOUNDATION RAISES FUNDS TO SUPPORT INNOVATIVE NEW BIOMEDICAL, CLINICAL AND TRANSLATIONAL RESEARCH. 4809665 4809665 PHILANTHROPIC SUPPORT RECEIVED BY THE FOUNDATION SUPPORTS CAPITAL EXPENDITURES SUCH AS FACILITIES EXPANSION, RENOVATION AND EQUIPMENT. 4809665 4809665 19815670 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 X 0 0 45 1 1 1 0 0 0 0 1 1 0 0 0 0 X 32 21 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI MN FL X MS SARAH KAFKA 4142661887 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 JASON ALLEN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS E ARENBERG DIRECTOR/CHAIR 1.00 0.00 X X 0 0 0 RICK BOELTER DIRECTOR 1.00 0.00 X 0 0 0 KELLY J CLEARY-REBHOLZ DIRECTOR 1.00 0.00 X 0 0 0 MITCHELL COX DIRECTOR 1.00 0.00 X 0 0 0 BARRI DRURY DIRECTOR 1.00 0.00 X 0 0 0 RAQUEL FILMANOWICZ DIRECTOR 1.00 0.00 X 0 0 0 MARC H GORELICK MD DIRECTOR 1.00 0.00 X 0 632707 92151 KELLY GREBE DIRECTOR 1.00 0.00 X 0 0 0 SCOTT R HAAG DIRECTOR (THROUGH FEB. 2015) 1.00 0.00 X 0 0 0 SCOTT HAPP DIRECTOR 1.00 0.00 X 0 0 0 JACQUELINE HERD-BARBER DIRECTOR 1.00 0.00 X 0 0 0 MARY M HOSMER DIRECTOR 1.00 0.00 X 0 0 0 CHRISTOPHER KALTENBACH DIRECTOR/VICE CHAIR 1.00 0.00 X 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 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 M NOEL DIRECTOR 1.00 0.00 X 0 0 0 UGO NWAGBARAOCHA DIRECTOR 1.00 0.00 X 0 0 0 LARRY J POLACHECK MD DIRECTOR 1.00 0.00 X 0 0 0 TODD M REARDON DIRECTOR (THROUGH MID-DEC. 2015) 1.00 0.00 X 0 0 0 GREG W RENZ DIRECTOR 1.00 0.00 X 0 0 0 MARY ANN RENZ DIRECTOR 1.00 0.00 X 0 0 0 JAY O ROTHMAN DIRECTOR 1.00 0.00 X 0 0 0 JOHN S SHIELY DIRECTOR 1.00 0.00 X 0 0 0 THELMA A SIAS DIRECTOR 1.00 0.00 X 0 0 0 MARY ELLEN B STANEK DIRECTOR 1.00 0.00 X 0 0 0 JOHN W STEINER DIRECTOR (THROUGH SEPT. 2015) 1.00 0.00 X 0 0 0 CURT B TRAU DIRECTOR 1.00 0.00 X 0 0 0 JAMES S TWEDDELL MD DIRECTOR (THROUGH JUNE 2015) 1.00 0.00 X 0 0 0 LES J WEIL DIRECTOR 1.00 0.00 X 0 0 0 DAVID WERNER DIRECTOR 1.00 0.00 X 0 0 0 TEDDY WERNER DIRECTOR 1.00 0.00 X 0 0 0 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0.00 40.00 X 0 1376051 280989 MEG BRYSKI NELSON DIRECTOR/CDO & PRESIDENT FOUNDATION 40.00 0.00 X X 254029 0 66302 WELDON GAGE TREASURER (THROUGH JAN. 2015) 0.00 40.00 X 0 181445 951 SHEILA REYNOLDS SECRETARY 0.00 40.00 X 0 437468 87457 MARC CADIEUX TREASURER 0.00 40.00 X 0 443414 52167 JEFFREY STEWART COO FOUNDATION 40.00 0.00 X 257042 0 47903 MARTIN VOGEL VP PRINCIPAL GIFTS 40.00 0.00 X 291104 0 48717 KELLY SACHSE SENIOR DIR, PLANNED GIVING 40.00 0.00 X 168176 0 34324 CHAD HERSHNER SR DIRECTOR REG PHILANTHROPY 40.00 0.00 X 133161 0 28511 JAY BLANKENSHIP DIR, DEVELOPMENT 40.00 0.00 X 111827 0 14933 ELIZABETH DOLAN DIR, DEVELOPMENT 40.00 0.00 X 106519 0 29233 1321858 3071085 783638 7 0 1 0 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 HOSPITAL AWARENESS NETWORK 365809 MACKAY SHIELDS LLC 1345 AVENUE OF THE AMERICAS NEW YORK NY 10105 INVESTMENT FEES 206942 BLACKBAUD PO BOX 930256 ATLANTA GA 31193 SOFTWARE LICENSING AND MAINTENANCE FEES 205098 HEARTLAND ADVISORS INC 789 N WATER STREET MILWAUKEE WI 53202 INVESTMENT FEES 179403 ROBERT W BAIRD & CO INC 777 EAST WISCONSIN AVENUE MILWAUKEE WI 53202 INVESTMENT FEES 149408 7 291595 2585317 18377234 428047 21254146 13146821 13146821 132050009 123929102 8120907 8120907 8120907 576372 2585317 862564 -286192 -286192 5650 597 5053 5053 42240735 0 0 20986589 19815670 19815670 1591782 625276 966506 1666761 359639 1307122 208255 61244 147011 522314 153373 368941 198105 47887 150218 750000 750000 54 54 17296 17296 1003830 1003830 931548 54029 877519 2740 2740 190136 189534 602 30077 30077 71187 12424 58763 8698 929 7769 72360 57642 14718 OTHER EXPENSES 425947 87272 338675 27506760 19815670 3403079 4288011 6609439 3133259 243238 376318 287150 259369 846366 133474 735055 712892 409611027 409073122 220946184 211679478 638432093 625234438 2651936 1720761 21304024 23642873 23955960 25363634 X 393529948 388191326 70652967 65432964 150293218 146246514 614476133 599870804 638432093 625234438 X 14733975 -29187748 -151556 X 0 1 X 1 0 X 13591720 18935100 32901457 28116969 21254146 114799392 13591720 18935100 32901457 28116969 21254146 114799392 6535732 108263660 9266580 9851922 9765660 12112437 13146821 54143420 168942812 3361904 0.64080 0.65660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 444949513 14759398 -2123993 19815670 1548976 436220272 383436027 72138704 9159320 18334470 1450068 444949513 346169361 28704965 21244124 11508199 1174224 383436027 328402888 15733025 13775225 10644366 1097411 346169361 329141297 10288629 552574 10661369 918243 328402888 0.51500 0.33500 0.15000 0 0 457379 38115 419264 66688 22637 44051 322299 72722 249577 712892 INVESTMENTS, PLEDGES, TRUSTS, & BEQUESTS DESIGNATED FOR RESTRICTED PURPOSES 211679478 211679478 PAYABLE TO AFFILIATES 23642873 23642873 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: FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. X X X X X X 1 FIRST EDGE SOLUTIONS 4230 N OAKLAND MILWAUKEE WI 53211 DIRECT MAIL 0 0 17296 -17296 17296 -17296 WI FL MN AL'S RUN AND WALK 899609 592091 307518 17871 42139 14466 17350 251999 MIRACLE MARATHON 1134332 1102977 31355 21671 615 209819 10 1127748 890249 237499 100834 88308 2500 94992 3161689 2585317 576372 140376 42139 103389 19850 556810 862564 -286192 SCHEDULE G, PART I, LINE 2B, COLUMN III, CUSTODY/CONTROL OF CONTRIBUTIONS: FIRST EDGE SOLUTIONS DOES NOT ACCEPT OR PROCESS DONATIONS ON BEHALF OF CHF. ALL CONTRIBUTIONS ARE DIRECTED TO AND RECEIVED BY CHF. DURING 2015, THE ORGANIZATION PAID FIRST EDGE SOLUTIONS $14,802 FOR SERVICES AND $2,494 FOR DIRECT EXPENSES, FOR A TOTAL OF $17,296. SCHEDULE G, PART I: IN 2015, FIRST EDGE SOLUTIONS WAS PAID $17,296 FOR 2014 SERVICES. IN 2014, CHILDREN'S HOSPITAL OF WISCONSIN RECEIVED $69,024 OF CONTRIBUTIONS FOR SERVICES PROVIDED BY FIRST EDGE SOLUTIONS. 1 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390812532 501(C)(3) 11010107 OPERATION & CAPITAL SUPPORT CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 501(C)(3) 5659791 MEDICAL RESEARCH, CHILD ABUSE PREVENTION, HEALTH EDUCATION, SCHOOL BASED CLINICS, COMMUNITY SERVICE CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 501(C)(3) 2686140 CHILD WELLBEING SERVICES CHILDREN'S MEDICAL GROUP INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391789197 501(C)(3) 459632 COMMUNITY-BASED PRIMARY CARE CLINICS 4 0 PART I, LINE 2: IN COLLABORATION WITH CHW, 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 MARC H GORELICK MD DIRECTOR 0 457436 0 169578 0 5693 0 55200 0 36951 0 724858 0 0 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0 813770 0 446931 0 115350 0 232659 0 48330 0 1657040 0 0 MEG BRYSKI NELSON DIRECTOR/CDO & PRESIDENT FOUNDATION 252134 0 0 0 1895 0 33374 0 32928 0 320331 0 0 0 WELDON GAGE TREASURER (THROUGH JAN. 2015) 0 53541 0 127883 0 21 0 0 0 951 0 182396 0 0 SHEILA REYNOLDS SECRETARY 0 287272 0 93546 0 56650 0 51224 0 36233 0 524925 0 35371 MARC CADIEUX TREASURER 0 273307 0 95252 0 74855 0 47350 0 4817 0 495581 0 0 JEFFREY STEWART COO FOUNDATION 187617 0 59206 0 10219 0 20335 0 27568 0 304945 0 0 0 MARTIN VOGEL VP PRINCIPAL GIFTS 218114 0 66516 0 6474 0 19600 0 29117 0 339821 0 5373 0 KELLY SACHSE SENIOR DIR, PLANNED GIVING 151822 0 15038 0 1316 0 13541 0 20783 0 202500 0 0 0 CHAD HERSHNER SR DIRECTOR REG PHILANTHROPY 123921 0 8992 0 248 0 5850 0 22661 0 161672 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 PART I, LINE 4B: IN 2015, 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 2015 WERE AS FOLLOWS: M. BRZYSKI NELSON, $26,145; M. CADIEUX, $27,750; AND S. REYNOLDS, $31,624. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2015 WERE: S. REYNOLDS, $35,371. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT AND CEO. THE AMOUNT SET ASIDE IN 2015 WAS $274,540 AND OF THAT, $58,831 WAS PAID AS A VESTED DISTRIBUTION UNDER THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN) MENTIONED ABOVE AND IS INCLUDED IN PART II, COLUMN (B)(III). 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, MARC CADIEUX, TREASURER OF CHWF AND TREASURER & CFO OF CHHS, WELDON GAGE, TREASURER OF CHWF (THROUGH JANUARY 2015) AND TREASURER & CFO OF CHHS (THROUGH JANUARY 2015), AND SHEILA REYNOLDS, SECRETARY OF CHWF AND CORPORATE VICE PRESIDENT & GENERAL COUNSEL OF CHHS - 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 AS A MEMBER OF THE BOARD OF DIRECTORS OF CHWF WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 2. MARC GORELICK, M.D., DIRECTOR OF CHWF AND COO CHW & EVP CHHS - 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 CHW AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY DR. GORELICK AS A MEMBER OF THE BOARD OF DIRECTORS OF CHWF WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. FIDUCIARY MANAGEMENT INC DIRECTOR (KELLNER) 270461 MR. KELLNER IS EXECUTIVE CHAIRMAN OF FIDUCIARY MANAGEMENT, INC. THE ORGANIZATION PAID $270,461 TO FIDUCIARY MANAGEMENT, INC. FOR INVESTMENT SERVICES. 0 BAIRD ADVISORS DIRECTOR (STANEK) 149752 MS. STANEK IS CHIEF INVESTMENT OFFICER OF BAIRD ADVISORS. THE ORGANIZATION PAID $149,752 TO BAIRD ADVISORS FOR INVESTMENT SERVICES. 0 X 23 181432 SELLING PRICE X NONCASH PRIZES 420 215683 FMV X FOOD / BEVERAGES 46 17969 FMV X OTHER DONATED GOODS 13 12963 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: ROTHMAN AND ALLEN, SHIELY AND FILMANOWICZ, STANEK AND TWEDDELL, KELLNER AND TWEDDELL, HERD-BARBER AND TWEDDELL, AND STANEK AND SIAS. FAMILY RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: G. RENZ AND M.A. RENZ. 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 11 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 CORPORATE VICE PRESIDENT AND GENERAL COUNSEL OF CHHS. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE AT EACH BOARD AND COMMITTEE MEETING. 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 EMPLOYEES 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 THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. FORM 990, PART XI, LINE 9: WRITE-OFF OF UNCOLLECTIBLE PLEDGES -151,556. FORM 990, SCHEDULE R, PART V, LINE 1D PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED MAY 1, 2004, CHW AND CHWF 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. CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 OPERATIONAL SUPPORT SERVICES 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 9 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 9 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 VIRTUAL PICU SYSTEMS LLC 401 WYTHE STREET SUITE 101 ALEXANDRIA VA 22314 201414664 QUALITY/OUTCOMES ANALYSIS DE CHILDREN'S HOSPITAL & HEALTH SYSTEM RELATED 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0