2015-11-13T12:35:35-06:00 2014-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2014-01-01 391500074 CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC CHIL 4142665420 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 MARC A CADIEUX TREASURER 4142665420 2015-10-30 1 BRYAN L PAUTSCH CPA P00034913 2627549400 2015-10-01 2014 2016-04-25 22:37:26Z SEE SCHEDULE O MARGARET TROY 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 128916761 0 X WWW.CHW.ORG X 1985 WI INTEGRATED AND COORDINATED HEALTH SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS. 24 16 946 3000 0 0 15096540 14120246 104646476 112745702 521962 1027623 975497 982739 121240475 128876310 492765 252215 0 6519328 64610047 67189456 0 0 0 60263464 59576529 125366276 133537528 -4125801 -4661218 70572534 96123178 40073827 67264161 30498707 28859017 X CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS") IS COMMITTED TO ENSURING A HEALTHIER FUTURE FOR CHILDREN BY PROVIDING AN INTEGRATED AND COORDINATED HEALTH AND SOCIAL SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS. 1 0 84543435 91270059 CHHS IS THE PARENT ORGANIZATION OF AN INTEGRATED SYSTEM OF ENTITIES PROVIDING COMPREHENSIVE MEDICAL CARE AND SOCIAL SERVICES TO CHILDREN FROM WISCONSIN AND THROUGHOUT THE COUNTRY. THE SYSTEM INCLUDES WISCONSIN'S ONLY FREESTANDING HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN, AS WELL AS VARIOUS OTHER FACILITIES PROVIDING INPATIENT AND OUTPATIENT CARE FOR CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE SYSTEM ALSO INCLUDES EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS. ON AN AGGREGATE BASIS, THE ENTITIES WITHIN THE SYSTEM PROVIDED COMMUNITY BENEFITS OF OVER $102 MILLION.CHHS OVERSEES AND COORDINATES THE ACTIVITIES OF THE VARIOUS OPERATING ENTITIES WITHIN THE INTEGRATED SYSTEM, THROUGH THE PROVISION OF SUPPORTIVE AND ADMINISTRATIVE SERVICES ON A CONSOLIDATED, CENTRALIZED BASIS 11559547 1333411 CHILDREN'S RESEARCH INSTITUTE ("CRI") IS A PROGRAM OF CHHS THAT ADVANCES PEDIATRIC MEDICAL RESEARCH IN WISCONSIN AND BEYOND. WITH A FOCUS ON TRANSLATIONAL RESEARCH, CRI IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES AT PATIENTS' BEDSIDES.RESEARCHERS AT CRI CONTINUE TO INVESTIGATE WAYS TO IMPROVE CARE FOR HEART TRANSPLANT PATIENTS, INCLUDING THE DEVELOPMENT OF A NEW METHOD TO MONITOR PEDIATRIC HEART TRANSPLANT RECIPIENTS AND IDENTIFY EARLY SIGNS OF TRANSPLANT REJECTION. CRI RESEARCHERS CONTINUE TO MAKE PROGRESS ON THE $3.3 MILLION, FIVE-YEAR GRANT RECEIVED IN 2013 FROM THE NATIONAL INSTITUTE OF HEALTH'S NATIONAL HEART, LUNG AND BLOOD INSTITUTE TO COMPLETE A SIX-CENTER CLINICAL STUDY OF THE NONINVASIVE APPROACH. TYPICALLY, HEART TRANSPLANT PATIENTS MUST UNDERGO A SERIES OF EIGHT TO TWELVE BIOPSIES PER YEAR TO MONITOR FOR TRANSPLANT REJECTION. THIS INVASIVE APPROACH POSES CERTAIN RISKS, AND CAN BE DIFFICULT FOR CHILDREN WHO HAVE ALREADY SPENT A CONSIDERABLE AMOUNT OF TIME HOSPITALIZED. THE RESEARCHERS HAVE DESIGNED A NONINVASIVE APPROACH THAT INVOLVES A SIMPLE BLOOD DRAW. THE LEVEL OF DONOR DNA IN THE BLOOD SERVES AS A BAROMETER OF HEART HEALTH; MORE THAN ONE-PERCENT OF DONOR DNA IN THE BLOOD INDICATES REJECTION. IN A PILOT STUDY, THIS METHOD SHOWED 100% SENSITIVITY.CRI ALSO CONTINUES TO FOCUS EFFORTS ON CHILDHOOD CANCER RESEARCH, INCLUDING IMPROVING SURVIVORSHIP AND QUALITY OF LIFE FOR CHILDREN BATTLING SOME OF THE TOUGHEST FORMS OF THE DISEASE. IN 2013, CHILDREN'S HOSPITAL OF WISCONSIN ("CHW") WAS AWARDED A 10-YEAR $10 MILLION GIFT FROM THE MACC FUND (MIDWEST ATHLETES AGAINST CHILDHOOD CANCER). THIS GIFT CONTINUES TO BE USED TO FURTHER CANCER RESEARCH IN THREE AREAS: DISCOVERY AND TESTING OF NEW DRUG THERAPIES, INCREASED USE OF CELLULAR THERAPIES AND FURTHER GENETIC RESEARCH FOR PERSONALIZED CANCER THERAPIES. IN ADDITION, OUR RESEARCHERS WERE ACCEPTED INTO THE THERAPEUTIC ADVANCES IN CHILDHOOD LEUKEMIA & LYMPHOMA (TACL) CONSORTIUM. THIS NATIONAL CONSORTIUM WAS ESTABLISHED TO DEVELOP AND CONDUCT PHASE I /II CLINICAL TRIALS OF NEW DRUGS AND NOVEL DRUG COMBINATIONS FOR RECURRENT CHILDHOOD LEUKEMIA OR LYMPHOMA. OUR RESEARCHERS ALSO CONTINUE TO PARTICIPATE IN THE COG (CHILDREN'S ONCOLOGY GROUP) CONSORTIUM FOR PHASE I - IV CLINICAL TRIALS OF NOVEL CANCER THERAPIES.RESEARCHERS AT CRI CONTINUE TO FOCUS ON GENETICS AND RARE DISEASE RESEARCH. CRI RESEARCHERS CONTINUE TO MAKE PROGRESS ON THE $1 MILLION, THREE-YEAR GRANT RECEIVED IN 2013 FROM THE W.M. KECK FOUNDATION IN LOS ANGELES TO SUPPORT GENETIC RESEARCH AND TESTING. A TEAM OF RESEARCHERS AND PHYSICIANS FROM CHW AND THE MEDICAL COLLEGE OF WISCONSIN (MCW) ARE DEVELOPING TEST SYSTEMS USING GENE EDITING TO GENERATE AND FUNCTIONALLY TEST GENETIC VARIANTS OF INTEREST. THE GOAL IS TO DEVELOP TESTS TO RAPIDLY HELP DIAGNOSE PATIENTS AND TREAT RARE DISORDERS, AND BUILD A SYSTEM THAT CAN BE USED BY OTHER LABORATORIES. THE GOAL OF THE PROJECT IS TO UNDERSTAND MORE ABOUT GENETIC VARIANTS OF UNCERTAIN SIGNIFICANCE, IN ORDER TO END THE DIAGNOSTIC ODYSSEY FOR THESE PATIENTS. 7614460 11077888 CHHS PROVIDES VARIOUS OUTPATIENT HEALTH CARE SERVICES. IN 2014, THERE WERE 22,896 VISITS TO THE ORGANIZATION'S URGENT CARE CLINICS, AND 4,398 OUTPATIENT SURGICAL CASES PERFORMED AT THE ORGANIZATION'S AMBULATORY SURGICAL CENTER, THE SURGICENTER OF GREATER MILWAUKEE, LLC (A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES). 14660608 252215 8725480 CHHS OFFERS FREE AND INEXPENSIVE HEALTH EDUCATION PROGRAMS AND RESOURCES TO TEACHERS, CHILDREN AND PARENTS. PROGRAMS OFFERED INCLUDE IN-CLASSROOM PROGRAMS ON HEALTHY EATING AND EXERCISE, BULLYING AND TEEN DEPRESSION. IN ADDITION, CHHS HAS INJURY PREVENTION PROGRAMS WHICH FOCUS ON CAR SEAT AND BIKE HELMET FITTINGS, TO KEEP CHILDREN SAFE AND HEALTHY. CHHS ALSO OFFERS HEALTH-BASED E-LEARNING PROGRAMS THROUGH BLUEKIDS.ORG WHICH HELPS STUDENTS MAKE MORE POSITIVE HEALTH CHOICES.CHHS ALSO PROVIDES SCHOOL-BASED HEALTH CENTERS IN MILWAUKEE SCHOOLS. THESE CENTERS PROVIDE PREVENTIVE CARE, PHYSICALS, IMMUNIZATIONS AND TREATMENT FOR ILLNESSES TO AN AREA THAT PREVIOUSLY DID NOT HAVE PEDIATRICIAN PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. IN 2014, THERE WERE 20,978 SCHOOL-BASED NURSE ENCOUNTERS WHICH INCLUDED 1,184 VISION SCREENINGS. THE SCHOOL-BASED HEALTH CENTERS ALSO EDUCATE CHILDREN AND FAMILIES ABOUT PREVENTIVE CARE. IN 2014 CHHS PARTNERED WITH WISCONSIN'S DEPARTMENT OF HEALTH SERVICES AND THE DEPARTMENT OF CHILDREN AND FAMILIES AND ESTABLISHED A FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS TO ADMINISTER THE COORDINATION OF COMPREHENSIVE HEALTH CARE SERVICES INCLUSIVE OF MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE SERVICES FOR CHILDREN PLACED IN "OUT OF HOME CARE" (A.K.A."FOSTER CARE") IN KENOSHA, MILWAUKEE, OZAUKEE, RACINE, WASHINGTON, AND WAUKESHA COUNTIES IN WISCONSIN. UPON ENROLLMENT INTO THE PROGRAM THESE FOSTER CARE CHILDREN HAVE ACCESS TO CHILDREN'S COMMUNITY HEALTH PLAN'S ("CCHP") PROVIDER NETWORK AS CCHP PROVIDES ADMINISTRATIVE AND UTILIZATION SERVICES FOR CARE4KIDS PROGRAMMING. THROUGH DECEMBER OF 2014, PROGRAM ENROLLMENT WAS 2,494 WHICH REPRESENTED APPROXIMATELY 42% OF THE TOTAL OUT OF HOME CARE POPULATION IN THE STATE OF WISCONSIN. 14660608 252215 8725480 118378050 1 1 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 6 0 946 1 0 0 0 0 0 0 0 0 0 0 X 24 16 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X MS SARAH KAFKA 4142661854 9000 W WISCONSIN AVENUE MILWAUKEE WI 53201 X MICHAEL W ALTSCHAEFL DIRECTOR 1.00 1.00 X 0 0 0 THOMAS ARENBERG DIRECTOR 1.00 1.00 X 0 0 0 THOMAS M BOLGER DIRECTOR (THROUGH DEC 2014) 1.00 1.00 X 0 0 0 ELIZABETH BRENNER DIRECTOR 1.00 1.00 X 0 0 0 BETH DALEY-ULLEM DIRECTOR (THROUGH JUNE 2014) 1.00 1.00 X 0 0 0 DAVID J DRURY DIRECTOR 1.00 1.00 X 0 0 0 JOE GEHRKE DIRECTOR 1.00 1.00 X 0 0 0 MARK R HOGAN DIRECTOR 1.00 1.00 X 0 0 0 PAUL W JONES DIRECTOR 1.00 1.00 X 0 0 0 CHRIS KALTENBACH DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH KERSCHNER MD DIRECTOR 1.00 1.00 X 0 0 0 PAUL KNOEBEL DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL LOVELL DIRECTOR 1.00 1.00 X 0 0 0 KEVIN MANSELL DIRECTOR 1.00 1.00 X 0 0 0 LINDA T MELLOWES DIRECTOR 1.00 1.00 X 0 0 0 C DAVID MYERS DIRECTOR 1.00 1.00 X 0 0 0 ALBERT S ORR III DIRECTOR 1.00 1.00 X 0 0 0 JAMES POPP DIRECTOR 1.00 1.00 X 0 0 0 J JOEL QUADRACCI DIRECTOR 1.00 1.00 X 0 0 0 JAY O ROTHMAN DIRECTOR/CHAIR 1.00 1.00 X X 0 0 0 JOHN E SCHLIFSKE DIRECTOR 1.00 1.00 X 0 0 0 PETER M SOMMERHAUSER DIRECTOR/VICE CHAIR 1.00 1.00 X X 0 0 0 PAUL W SWEENEY DIRECTOR 1.00 1.00 X 0 0 0 PHOEBE W WILLIAMS DIRECTOR 1.00 1.00 X 0 0 0 MARK C WITT DIRECTOR 1.00 1.00 X 0 0 0 MARGARET TROY DIRECTOR / PRESIDENT & CEO 40.00 0.00 X X 1438992 0 261638 MARC CADIEUX VP FINANCIAL SERVICES 40.00 0.00 X 272423 0 22104 CINTHIA S CHRISTENSEN COO CHW AND EVP CHHS 0.00 40.00 X 0 794310 66571 ROBERT DUNCAN EVP COMMUNITY SERVICES 40.00 0.00 X 422429 0 79955 WELDON GAGE CFO / TREASURER 40.00 0.00 X 506220 0 73208 TRICIA GERAGHTY CORP VP MARKETING AND COMM 40.00 0.00 X 314681 0 62356 MARC GORELICK MD EXECUTIVE VP CHHS 0.00 40.00 X 0 465262 84704 VERONICA GUNN VP POPULATION HEALTH MGMT 40.00 0.00 X 308702 0 41920 STEPHANIE LENZNER VP, ENTERPRISE PERF MANAGEMENT 40.00 0.00 X 212306 0 35333 MICHELLE METTNER VP GOVERNMENT RELATIONS 40.00 0.00 X 271567 0 39791 MICHAEL NAUMAN ENTERPRISE PERF MGMT & CIO 40.00 0.00 X 651237 0 90935 MARGARET NIEMER VP CHW 0.00 40.00 X 0 337960 32137 SHEILA REYNOLDS SECRETARY/CORP VP & GEN COUNSEL 40.00 0.00 X 402092 0 86220 MONICA RICCA VP REVENUE CYCLE 40.00 0.00 X 180458 0 31311 ROBERT SANDERS CHIEF ADMINSTRATION OFFICER 40.00 0.00 X 396125 0 80285 THOMAS SHANAHAN VP, HUMAN RESOURCES 40.00 0.00 X 276046 0 45241 SUZAN BUCHAKLIAN DIR, SURGICAL SERVICES 0.00 40.00 X 0 171988 34024 SMRITI KHARE MD PRESIDENT, CMG 40.00 0.00 X 436299 0 69550 MARK RAKOWSKI VICE PRESIDENT, CCHP 4.00 36.00 X 236413 0 44570 ELIZABETH BEDWELL VP RESEARCH ADMINISTRATION 40.00 0.00 X 203886 0 27649 JULIE SPERKA DIR, REVENUE INTEGRITY 40.00 0.00 X 187142 0 43750 KIM PEMBLE DIRECTOR, IS OPERATIONS 40.00 0.00 X 175260 0 26755 MARTIN VOGEL FORMER HCE/CURRENT CHWF VP 0.00 40.00 X 0 259643 47977 6892278 2029163 1427984 18 1 1 0 MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK RD MILWAUKEE WI 53226 RESEARCH, EDUCATION, MEDICAL LEADERSHIP 8696529 FTI CONSULTING PO BOX 418005 BOSTON MA 02241 IT CONTRACTORS AND CONSULTING 2980000 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 532880314 SOFTWARE LICENSING AND MAINTENANCE 2234579 MICROSOFT LICENSING GP 1401 ELM ST 5TH FLR DEPT 842467 DALLAS TX 75202 SOFTWARE LICENSING AND MAINTENANCE 2139372 KELLY SCOTT & MADISON INC 23983 NETWORK PLACE CHICAGO IL 60373 ADVERTISING 1901191 61 12983841 1029514 106891 14120246 OPER SUPPORT SERVICES 541900 92145500 90823897 1321603 OUTPATIENT HEALTH CARE SERVICES 621400 11075692 11075692 PREMIUM REVENUE 524114 8289077 8289077 RESEARCH ADMINISTRATION FEE 900099 1210421 1210421 CHEC FEES 900099 25012 25012 112745702 1068074 1068074 40451 -40451 -40451 -40451 EDUCATIONAL SERVICES 611430 244913 244913 737826 737826 982739 128876310 112406838 0 2349226 X 252215 252215 6519328 6519328 7933653 7061194 872459 45476116 40324522 5151594 2143206 1906123 237083 8099467 7166470 932997 3537014 3130044 406970 332902 277847 55055 424675 377111 47564 477927 424399 53528 51679 30186 21493 21643634 19501130 2142504 3436104 3072678 363426 1104477 961498 142979 12966566 11451347 1515219 4524575 3389226 1135349 660813 592269 68544 264745 227394 37351 4247141 3574375 672766 541046 365745 175301 OTHER EXPENSES 7267038 6151080 1115958 MEDICAL SUPPLIES 1633207 1621869 11338 133537528 118378050 15159478 0 1537584 5970516 65941 153643 1253693 16517697 56000 47333 145500 274894 572121 597841 4049368 5089832 77614719 28687805 44974267 48926914 7955311 8504171 9962749 10040337 70572534 96123178 12708846 18229669 257452 301868 27107529 48732624 40073827 67264161 X 24619598 23602440 5603446 4975608 275663 280969 30498707 28859017 70572534 96123178 X -4661218 308076 2713452 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10000 467926 477926 111928912 112406838 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 296103 547278 547155 477926 1868462 250000 250000 250000 250000 1000000 1500000 16310 10000 10000 36310 1 14383 6136 9660 10859 0 5879110 1026698 17133 1665379 985 5256577 2908864 4237509 40865 1307189 940 5879110 2013572 1748443 27616 879862 905 2908864 1914287 843860 1271 745000 846 2013572 1614564 1249343 30138 978936 822 1914287 0.00000 0.05300 0.94700 0 1 1 1457978 1457978 50420349 15835460 34584889 2827212 429487 2397725 20959911 12305533 8654378 1949269 117325 1831944 48926914 DEFERRED COMPENSATION PLAN ASSETS 3597574 BENEFICIAL INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL OF WISCONSIN FOUND. 5256577 INVESTMENT IN VIRTUAL PICU SYSTEMS, LLC 463267 INVESTMENT IN NORTH SHORE SURGERY CENTER 694141 ORGANIZATIONAL COSTS 13278 OTHER ASSETS 15500 10040337 DEFERRED COMPENSATION PLAN LIABILITY 3597574 RETIREMENT PLAN LIABILITY 3085766 DUE TO AFFILIATES 41565574 LEASE LIABILITY 483710 48732624 X PART IV, LINE 1B: CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHECKING ACCOUNT OF THE WELFARE AUXILIARY OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("WA"). THE ORGANIZATION ALSO PROVIDES ACCOUNTING FUNCTIONS FOR WA. PART V, LINE 4: CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC., A RELATED ENTITY, HOLDS ENDOWMENT FUNDS ON BEHALF OF CHHS. INTENDED USES OF THE FUNDS INCLUDE VARIOUS HEALTH-RELATED EDUCATIONAL SERVICES. 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, 2014 AND 2013. 1 FAMILY & CHILDRENS CENTER 1707 MAIN STREET LA CROSSE WI 54601 390821863 501(C)(3) 47004 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM FAMILY RESOURCE CENTER OF SHEBOYGAN 1209A EASTERN AVENUE PLYMOUTH WI 53073 391857835 501(C)(3) 50000 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM FAMILY RESOURCE CENTER ST CROIX VALLEY INC 857 MAIN STREET PO BOX 2087 BALDWIN WI 54002 391943404 501(C)(3) 38211 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM FAMILY SERVICES OF NORTHEAST WISCONSIN PO BOX 22308 GREEN BAY WI 54305 390827320 501(C)(3) 59000 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM SAFE BABIES HEALTHY FAMILIES 137 WISCONSIN AVENUE WAUKESHA WI 53188 391552886 501(C)(3) 54000 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM 5 0 PART I, LINE 2: MONITORING PROCEDURES - THE CHILD ABUSE PREVENTION FUND IS COMMITTED TO ENSURING A SAFE ENVIRONMENT FOR CHILDREN THROUGH FINANCIAL SUPPORT OF PRIMARY PREVENTION ACTIVITIES THROUGHOUT WISCONSIN, AS WELL AS EDUCATING PROFESSIONALS AND THE PUBLIC ABOUT THE ROLE OF PREVENTION IN ELIMINATING CHILD ABUSE. THE CHILD ABUSE PREVENTION FUND IS A SPECIAL FUNDRAISING INITIATIVE OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM. THE FUND'S FOCUS IS ON OUTCOMES OR RESULTS FOR FAMILIES, CHILDREN AND COMMUNITIES. AGENCIES THAT RECEIVE FUNDING MEET CRITERIA FOR EFFECTIVENESS AND ACCOUNTABILITY. EACH ORGANIZATION FUNDED IS EXPECTED TO DEMONSTRATE POSITIVE OUTCOMES THROUGH SIX-MONTH AND ANNUAL PROGRESS REPORTS. IN MANY CASES, THE CHILDREN'S HOSPITAL AND HEALTH SYSTEM STAFF OVERSEE AND PLAY A ROLE IN HELPING ORGANIZATIONS DEMONSTRATE POSITIVE OUTCOMES. CHILDREN'S HOSPITAL AND HEALTH SYSTEM STAFF ALSO PERFORM SITE VISITS. X X X X X X 0 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR / PRESIDENT & CEO 790343 0 365106 0 283543 0 214138 0 47500 0 1700630 0 227818 0 MARC CADIEUX VP FINANCIAL SERVICES 205773 0 43352 0 23298 0 16351 0 5753 0 294527 0 0 0 CINTHIA S CHRISTENSEN COO CHW AND EVP CHHS 0 443007 0 136020 0 215283 0 21750 0 44821 0 860881 0 180286 ROBERT DUNCAN EVP COMMUNITY SERVICES 285637 0 89354 0 47438 0 44660 0 35295 0 502384 0 33094 0 WELDON GAGE CFO / TREASURER 389629 0 116051 0 540 0 48635 0 24573 0 579428 0 0 0 TRICIA GERAGHTY CORP VP MARKETING AND COMM 245768 0 60500 0 8413 0 33865 0 28491 0 377037 0 0 0 MARC GORELICK MD EXECUTIVE VP CHHS 0 419804 0 40000 0 5458 0 51278 0 33426 0 549966 0 0 VERONICA GUNN VP POPULATION HEALTH MGMT 266642 0 41250 0 810 0 13950 0 27970 0 350622 0 0 0 STEPHANIE LENZNER VP, ENTERPRISE PERF MANAGEMENT 176497 0 26567 0 9242 0 8953 0 26380 0 247639 0 0 0 MICHELLE METTNER VP GOVERNMENT RELATIONS 219144 0 43440 0 8983 0 16550 0 23241 0 311358 0 0 0 MICHAEL NAUMAN ENTERPRISE PERF MGMT & CIO 377029 0 198101 0 76107 0 57010 0 33925 0 742172 0 38493 0 MARGARET NIEMER VP CHW 0 41146 0 40700 0 256114 0 8564 0 23573 0 370097 0 62561 SHEILA REYNOLDS SECRETARY/CORP VP & GEN COUNSEL 279423 0 74443 0 48226 0 49852 0 36368 0 488312 0 28567 0 MONICA RICCA VP REVENUE CYCLE 179925 0 0 0 533 0 7269 0 24042 0 211769 0 0 0 ROBERT SANDERS CHIEF ADMINSTRATION OFFICER 285001 0 75000 0 36124 0 47482 0 32803 0 476410 0 20954 0 THOMAS SHANAHAN VP, HUMAN RESOURCES 209342 0 37282 0 29422 0 21750 0 23491 0 321287 0 0 0 SUZAN BUCHAKLIAN DIR, SURGICAL SERVICES 0 167433 0 0 0 4555 0 10444 0 23580 0 206012 0 0 SMRITI KHARE MD PRESIDENT, CMG 329034 0 81081 0 26184 0 52590 0 16960 0 505849 0 0 0 MARK RAKOWSKI VICE PRESIDENT, CCHP 206236 0 29146 0 1031 0 16524 0 28046 0 280983 0 0 0 ELIZABETH BEDWELL VP RESEARCH ADMINISTRATION 176451 0 26877 0 558 0 8255 0 19394 0 231535 0 0 0 JULIE SPERKA DIR, REVENUE INTEGRITY 169345 0 0 0 17797 0 17443 0 26307 0 230892 0 0 0 KIM PEMBLE DIRECTOR, IS OPERATIONS 173679 0 0 0 1581 0 7126 0 19629 0 202015 0 0 0 MARTIN VOGEL FORMER HCE/CURRENT CHWF VP 0 209707 0 48877 0 1059 0 19150 0 28827 0 307620 0 0 PART I, LINE 4B IN 2014, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2014 WERE AS FOLLOWS: R. DUNCAN, $30,710; W. GAGE, $39,885; T. GERAGHTY, $25,115; M. GORELICK, M.D., $42,528; M. NAUMAN, $40,460; S. REYNOLDS, $30,702; R. SANDERS, $30,932; AND S. KHARE, M.D., $33,440. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2014 WERE: C. CHRISTENSEN, $180,286; R. DUNCAN, $33,094; M. NAUMAN, $38,493; M. NIEMER, $62,561; S. REYNOLDS, $28,567; R. SANDERS, $20,954; AND M. TROY, $227,818. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT & CEO. THE AMOUNT SET ASIDE IN 2014 WAS $197,588. 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 AND SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. CINTHIA CHRISTENSEN, PRESIDENT OF CHW AND EXECUTIVE VICE PRESIDENT OF CHHS, MARGARET NIEMER, CHW VP, MARC GORELICK, M.D., EXECUTIVE VP CHHS, AND SUZAN BUCHAKLIAN, DIRECTOR OF SURGICAL SERVICES - 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 AFFILIATES. THESE AMOUNTS WERE PAID BY CHW. 2. MARTIN VOGEL, VICE PRESIDENT OF PRINCIPAL GIFTS OF CHWF - 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 CHWF. THESE AMOUNTS WERE PAID BY CHWF. PRIOR TO 2011, MR. VOGEL'S COMPENSATION FOR SERVICES AS VICE PRESIDENT OF PRINCIPAL GIFTS OF CHWF WAS PAID BY CHHS AND ALLOCATED TO CHWF. AS A RESULT, MR. VOGEL WAS REPORTED AS A HIGHLY COMPENSATED EMPLOYEE OF CHHS IN PREVIOUS YEARS. M CADIEUX OFFICER EDUCATION X 56000 37333 0 0 1 K PEMBLE HIGHEST COMPENSATED EMPLOYEE EMPLOYMENT INCENTIVE LOAN X 10000 10000 0 0 1 47333 FOLEY AND LARDNER LLP DIRECTORS (J. ROTHMAN) 140517 MR. ROTHMAN IS THE CHIEF EXECUTIVE OFFICER AT FOLEY AND LARDNER, LLP. THE ORGANIZATION PAID FOLEY AND LARDNER $140,517 FOR LEGAL SERVICES. 0 JENNIFER MANCE DIRECTOR (K. MANSELL) 31307 JENNIFER MANCE IS THE DAUGHTER OF A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE ORGANIZATION PAID HER $31,307 IN COMPENSATION 0 KELLY REILLY DIRECTOR (M. WITT) 96293 KELLY REILLY IS THE SPOUSE OF A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE ORGANIZATION PAID HER $96,293 IN COMPENSATION. 0 ANGELA BROWNE OFFICER (M. RICCA) 76770 ANGELA BROWNE IS THE SISTER OF ONE OF THE ORGANIZATION'S OFFICERS. THE ORGANIZATION PAID HER $76,770 IN COMPENSATION. 0 FORM 990, BOX C, DOING BUSINESS AS: CHILDREN'S HOSPITAL OF WISCONSIN COMMUNITY SERVICES FORM 990, PART III, LINE 2 IN 2014 CHHS PARTNERED WITH WISCONSIN'S DEPARTMENT OF HEALTH SERVICES AND THE DEPARTMENT OF CHILDREN AND FAMILIES AND ESTABLISHED A FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS TO ADMINISTER THE COORDINATION OF COMPREHENSIVE HEALTH CARE SERVICES INCLUSIVE OF MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE SERVICES FOR CHILDREN PLACED IN "OUT OF HOME CARE" (A.K.A."FOSTER CARE"). FORM 990, PART V, LINE 1A: THE ORGANIZATION DID NOT FILE ANY 1099 FORMS 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, CHW, WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHW. THE 1099 FORMS FOR SUCH PAYMENTS WERE ISSUED BY CHW, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. THE 1099 FORMS LISTED IN PART V ARE THE FORMS FILED BY THE ORGANIZATION'S DISREGARDED ENTITY. FORM 990, PART VI, SECTION A, LINE 2 SECTION A, LINE 2: BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS OR OFFICERS: DRURY AND SCHLIFSKE, DRURY AND BRENNER, SCHLIFSKE AND SOMMERHAUSER, SCHLIFSKE AND MANSELL, MANSELL AND SOMMERHAUSER, WITT AND SOMMERHAUSER, KERSCHNER AND BRENNER, WILLIAMS AND LOVELL, TROY AND LOVELL, AND WILLIAMS AND TROY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CHHS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CORPORATE VICE PRESIDENT AND GENERAL COUNSEL. 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 CEO AND SENIOR OFFICERS, WITH THE EXCEPTION OF THE VP OF FINANCIAL SERVICES, THE EXECUTIVE VP CHHS, THE VP POPULATION HEALTH MANAGEMENT, THE VP CHW, THE VP INFORMATION SERVICES, THE VP GOVERNMENT RELATIONS, THE VP CHW, THE VP HUMAN RESOURCES, THE VP REVENUE CYCLE, AND THE DIRECTOR OF SURGICAL SERVICES, WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. 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 OTHER OFFICERS AND THE KEY EMPLOYEES EXCEPTED ABOVE 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 CHHS ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. FORM 990, PART VII, LINE 42 SUZAN BUCHAKLIAN IS THE DIRECTOR OF THE ORGANIZATION'S DISREGARDED ENTITY, SURGICENTER OF GREATER MILWAUKEE, LLC, AND ALSO IS DIRECTOR OF SURGICAL SERVICES AT THE ORGANIZATION'S WHOLLY-OWNED SUBSIDIARY, CHILDREN'S HOSPITAL OF WISCONSIN, INC. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 8,539,736. MANAGEMENT AND GENERAL EXPENSES 1,111,563. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,651,299. MEDICAL COLLEGE OF WISCONSIN: PROGRAM SERVICE EXPENSES 1,205,930. MANAGEMENT AND GENERAL EXPENSES 459,139. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,665,069. OTHER FEES: PROGRAM SERVICE EXPENSES 4,832,274. MANAGEMENT AND GENERAL EXPENSES 571,802. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,404,076. GRANT EXPENDITURES: PROGRAM SERVICE EXPENSES 4,923,190. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,923,190. FORM 990, PART XI, LINE 9: NET ASSET/CASH TRANSFER TO CHILDREN'S COMMUNITY HEALTH PLAN, INC. 3,335,984. INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHW FOUNDATION -622,532. SURGICENTER OF GREATER MILWAUKEE LLC 9000 W WISCONSIN AVENUE PO BOX 1997 MILWAUKEE WI 53201 391682308 AMBULATORY SURGERY CENTER/MEDICAL OFFICE BUILDING WI 9658700 23900302 N/A CHILDREN'S HOSPITAL OF WISCONSIN INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 N/A 1 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 N/A 1 CHILDREN'S MEDICAL GROUP INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 N/A 1 CHILDREN'S PHYSICIAN GROUP PC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 364303682 PEDIATRIC PHYSICIAN SERVICES IL 501(C)(3) LINE 9 N/A 1 CHILDREN'S SERVICE SOCIETY OF WISCONSIN 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 390806380 CHILD WELL-BEING SERVICES WI 501(C)(3) LINE 7 N/A 1 CHILDREN'S COMMUNITY HEALTH PLAN INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 271494977 WISCONSIN MEDICAID HMO WI 501(C)(3) LINE 9 N/A 1 CHILDREN'S SPECIALTY GROUP INC 999 N 92ND ST SUITE C740 MILWAUKEE WI 53226 391990012 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 11 N/A 0 VIRTUAL PICU SYSTEMS LLC 401 WYTHE STREET SUITE 101 ALEXANDRIA VA 22314 201414664 QUALITY/OUTCOMES ANALYSIS DE N/A RELATED 201892 715942 0 0 0.33330 MED-HEALTH FINANCIAL SERVICES INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 391547907 COLLECTION SERVICES WI N/A C 1742198 1.00000 1 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 1 0 1 CHILDREN'S HOSPITAL OF WISCONSIN INC - RENT (LINE 1A (IV) ABOVE A 693591 CASH PAID/RECEIVED CHILDREN'S MEDICAL GROUP INC - RENT (LINE 1A (IV) ABOVE) A 249257 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN INC C 7952782 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC C 5031059 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN INC K 74619 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN INC L 82549310 CASH PAID/RECEIVED CHILDREN'S SERVICE SOCIETY OF WISCONSIN L 2000000 CASH PAID/RECEIVED CHILDREN'S MEDICAL GROUP INC L 3816772 CASH PAID/RECEIVED CHILDREN'S COMMUNITY HEALTH PLAN INC L 1000000 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC L 750000 CASH PAID/RECEIVED CHILDREN'S COMMUNITY HEALTH PLAN INC - HEALTHCARE SERVICES TO ENROLLEES L 598250 CASH PAID/RECEIVED MED-HEALTH FINANCIAL SERVICES INC L 350000 CASH PAID/RECEIVED MED-HEALTH FINANCIAL SERVICES INC M 499107 CASH PAID/RECEIVED CHILDREN'S HOSPITAL OF WISCONSIN INC P 356266 CASH PAID/RECEIVED