2014-11-07T15:57:22-06:00 2013-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2013-01-01 391500074 CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC CHIL 4142665420 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 WELDON GAGE TREASURER 4142665420 2014-11-03 1 BRYAN L PAUTSCH CPA P00034913 2627549400 2014-11-03 2013 2015-11-30 17:44:51Z MARGARET TROY 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 53201 121246457 0 X WWW.CHW.ORG X 1985 WI INTEGRATED AND COORDINATED HEALTH SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS. 23 13 899 2988 0 0 13905451 15096540 93657430 104646476 301053 521962 1004312 975497 108868246 121240475 306691 492765 0 0 49032022 64610047 0 0 0 62230458 60263464 111569171 125366276 -2700925 -4125801 70835861 70572534 26320272 40073827 44515589 30498707 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. 0 0 84866665 92181216 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 MIDWEST. 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 $105 MILLION.CHHS OVERSEES AND COORDINATES THE ACTIVITIES OF THE VARIOUS OPERATING ENTITIES WITHIN THE INTEGRATED SYSTEM, INCLUDING THROUGH THE PROVISION OF SUPPORTIVE AND ADMINISTRATIVE SERVICES ON A CONSOLIDATED, CENTRALIZED BASIS. 12713085 982786 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, THE CRI IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES AT PATIENTS' BEDSIDES. RESEARCHERS AT THE 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. IN 2013, CRI RESEARCHERS RECEIVED A $3.3 MILLION, FIVE YEAR GRANT 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.THE CRI ALSO CONTINUES TO FOCUS RESEARCH 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 WAS AWARDED A $10 MILLION GIFT FROM THE MACC FUND (MIDWEST ATHLETES AGAINST CHILDHOOD CANCER). THIS GIFT WILL 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 THE CRI CONTINUE TO FOCUS ON GENETICS AND RARE DISEASE RESEARCH. IN 2013, CHILDREN'S HOSPITAL OF WISCONSIN WAS AWARDED A $1 MILLION, THREE-YEAR GRANT FROM THE W.M. KECK FOUNDATION IN LOS ANGELES TO SUPPORT GENETIC RESEARCH AND TESTING. A TEAM OF RESEARCHERS AND PHYSICIANS FROM CHILDREN'S HOSPITAL AND THE MEDICAL COLLEGE OF WISCONSIN (MCW) WILL DEVELOP A TEST SYSTEM USING GENE EDITING TO GENERATE AND FUNCTIONALLY TEST GENETIC VARIANTS OF INTEREST. THE GOAL IS TO DEVELOP A TEST 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. 8028115 10672849 CHHS PROVIDES VARIOUS OUTPATIENT HEALTH CARE SERVICES. IN 2013, THERE WERE 22,619 VISITS TO THE ORGANIZATION'S URGENT CARE CLINICS, AND 4,638 OUTPATIENT SURGICAL CASES PERFORMED AT THE ORGANIZATION'S AMBULATORY SURGICAL CENTER, THE SURGICENTER OF GREATER MILWAUKEE, LLC (A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES). 4259173 492765 470176 COMMUNITY HEALTH 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, COMMUNITY HEALTH HAS INJURY PREVENTION PROGRAMS WHICH FOCUS ON CAR SEAT AND BIKE HELMET FITTINGS, TO KEEP CHILDREN SAFE AND HEALTHY. COMMUNITY HEALTH 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 2013, THERE WERE 18,888 SCHOOL-BASED NURSE ENCOUNTERS WHICH INCLUDED 946 VISION SCREENINGS. THE SCHOOL-BASED HEALTH CENTERS ALSO EDUCATE CHILDREN AND FAMILIES ABOUT PREVENTIVE CARE. 4259173 492765 470176 109867038 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 1 1 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 5 0 899 1 0 0 0 0 0 0 0 0 0 0 X 23 13 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 WILLIAM J ABRAHAM JR DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL W ALTSCHAEFL DIRECTOR 1.00 1.00 X 0 0 0 THOMAS M BOLGER DIRECTOR 1.00 1.00 X 0 0 0 ELIZABETH BRENNER DIRECTOR 1.00 1.00 X 0 0 0 CURT S CULVER DIRECTOR 1.00 1.00 X 0 0 0 BETH DALEY-ULLEM DIRECTOR 1.00 1.00 X 0 0 0 DAVID J DRURY DIRECTOR/CHAIR 1.00 1.00 X X 0 0 0 DAVID H GILBERT 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 JOSEPH KERSCHNER MD 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 MICHAEL T PEPKE 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 1.00 1.00 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 OWEN J SULLIVAN 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 1231779 0 318154 THOMAS ARENBERG DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL LOVELL DIRECTOR 1.00 1.00 X 0 0 0 PAUL KNOEBEL DIRECTOR 1.00 1.00 X 0 0 0 MARC CADIEUX VP FINANCIAL SERVICES 40.00 0.00 X 199061 0 20997 CINTHIA S CHRISTENSEN EXECUTIVE VP AND CHW PRESIDENT 0.00 40.00 X 0 654973 108969 ROBERT DUNCAN EVP COMMUNITY SERVICES 40.00 0.00 X 402057 0 76003 WELDON GAGE CFO / TREASURER 40.00 0.00 X 510566 0 69978 TRICIA GERAGHTY CORPORATE VP MARKETING & PR 40.00 0.00 X 256466 0 58832 MARC GORELICK MD EXECUTIVE VP CHHS 0.00 40.00 X 0 96585 28234 VERONICA GUNN VP POPULATION HLTH MGMT 40.00 0.00 X 291243 0 25409 STEPHANIE LENZNER VP INFORMATION SERVICES 40.00 0.00 X 185990 0 26541 MICHELLE METTNER VP GOVERNMENT RELATIONS 40.00 0.00 X 249732 0 37888 MICHAEL NAUMAN CORPORATE VP & CIO 40.00 0.00 X 514661 0 84418 MARGARET NIEMER VP CHW 26.00 14.00 X 49487 260241 73808 SHEILA REYNOLDS SECRETARY/CORP VP & GEN.COUNSEL 40.00 0.00 X 383091 0 82165 ROBERT SANDERS CORPORATE VP STRATEGIC MANAGEMENT 40.00 0.00 X 340662 0 67419 THOMAS SHANAHAN VP HUMAN RESOURCES 40.00 0.00 X 235319 0 42888 MARK SHIP VP REVENUE CYCLE (JAN-MAY 2013) 40.00 0.00 X 321195 0 20839 SUZAN BUCHAKLIAN DIR, SURGICAL SERVICES 0.00 40.00 X 0 186949 28356 SMRITI KHARE MD PRESIDENT, CMG 40.00 0.00 X 404878 0 67946 ROY JOHNSON CORP DIRECTOR, IS OPERATIONS 40.00 0.00 X 224061 0 32382 MARK RAKOWSKI VICE PRESIDENT, CCHP 40.00 0.00 X 223889 0 43555 ELIZABETH BEDWELL VP RESEARCH ADMINISTRATION 40.00 0.00 X 191296 0 26422 JULIE SPERKA DIR, REVENUE INTEGRITY 40.00 0.00 X 188453 0 304037 MARTIN VOGEL FORMER HCE/CURRENT CHWF VP 0.00 40.00 X 0 219953 42388 6403886 1418701 1687628 81 1 1 0 MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK RD MILWAUKEE WI 53226 RESEARCH, EDUCATION, MEDICAL LEADERSHIP 10375661 KFORCE INC PO BOX 277997 ATLANTA GA 303847997 IT CONTRACTORS AND CONSULTING 2617344 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 532880314 SOFTWARE LICENSING AND MAINTENANCE 1793107 MICROSOFT LICENSING GP 1401 ELM ST 5TH FLR DEPT 842467 DALLAS TX 75202 SOFTWARE LICENSING AND MAINTENANCE 1734717 CUMBERLAND CONSULTING GROUP LLC 720 COOL SPRINGS BLVD FRANKLIN TN 37067 IT CONSULTING 1633935 65 14123275 955520 17745 15096540 OPER SUPPORT SERVICES 541900 92992773 91677827 1314946 OUTPATIENT HEALTH CARE SERVICES 621400 10664060 10664060 RESEARCH ADMINISTRATION FEE 900099 931044 931044 CHEC FEES 900099 58599 58599 104646476 526886 526886 1058 5982 -4924 -4924 -4924 EDUCATIONAL SERVICES 611430 239022 239022 736475 736475 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AFFILIATES 21217784 27107529 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, 2013 AND 2012. 1 FAMILY & CHILDRENS CENTER 1707 MAIN STREET LA CROSSE WI 54601 390821863 501(C)(3) 47003 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) 37811 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 SEXUAL ASSAULT CRISIS CENTER 35 PARK PLACE SUITE 100 APPLETON WI 54914 391309331 501(C)(3) 10000 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM NORTHWEST CONNECTION FAMILY RESOURCES 15896 W 3RD STREET HAYWARD WI 54843 391800322 501(C)(3) 10000 ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM NEXT DOOR FOUNDATION INC 2545 N 29TH STREET MILWAUKEE WI 53210 391162969 501(C)(3) 213037 ANNUAL HRSA GRANT FOR A PARKING LOT 8 0 PROJECT MANAGEMENT FOR HOME VISITATION OUTCOMES PROJECT 1 10394 N/A SCHOLARSHIPS 1 520 N/A 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. SCHEDULE I, PART III: SCHOLARSHIPS AWARDED TO RECIPIENTS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS. X X X X X X 0 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR / PRESIDENT & CEO 766613 0 410197 0 54969 0 270958 0 47196 0 1549933 0 0 0 MARC CADIEUX VP FINANCIAL SERVICES 198631 0 0 0 430 0 14272 0 6725 0 220058 0 0 0 CINTHIA S CHRISTENSEN EXECUTIVE VP AND CHW PRESIDENT 0 418624 0 169200 0 67149 0 66840 0 42129 0 763942 0 0 ROBERT DUNCAN EVP COMMUNITY SERVICES 276995 0 111150 0 13912 0 43635 0 32368 0 478060 0 0 0 WELDON GAGE CFO / TREASURER 377897 0 132129 0 540 0 47434 0 22544 0 580544 0 0 0 TRICIA GERAGHTY CORPORATE VP MARKETING & PR 238153 0 0 0 18313 0 32950 0 25882 0 315298 0 0 0 VERONICA GUNN VP POPULATION HLTH MGMT 240050 0 50664 0 529 0 0 0 25409 0 316652 0 0 0 STEPHANIE LENZNER VP INFORMATION SERVICES 175443 0 0 0 10547 0 7675 0 18866 0 212531 0 0 0 MICHELLE METTNER VP GOVERNMENT RELATIONS 205672 0 43607 0 453 0 16400 0 21488 0 287620 0 0 0 MICHAEL NAUMAN CORPORATE VP & CIO 362954 0 116381 0 35326 0 53090 0 31328 0 599079 0 0 0 MARGARET NIEMER VP CHW 46040 146015 0 83829 3447 30397 0 48727 4349 20732 53836 329700 0 0 SHEILA REYNOLDS SECRETARY/CORP VP & GEN.COUNSEL 270873 0 92602 0 19616 0 48727 0 33438 0 465256 0 0 0 ROBERT SANDERS CORPORATE VP STRATEGIC MANAGEMENT 256246 0 69283 0 15133 0 41350 0 26069 0 408081 0 0 0 THOMAS SHANAHAN VP HUMAN RESOURCES 208630 0 0 0 26689 0 20853 0 22035 0 278207 0 0 0 MARK SHIP VP REVENUE CYCLE (JAN-MAY 2013) 248850 0 71920 0 425 0 0 0 20839 0 342034 0 0 0 SUZAN BUCHAKLIAN DIR, SURGICAL SERVICES 0 161911 0 0 0 25038 0 7142 0 21214 0 215305 0 0 SMRITI KHARE MD PRESIDENT, CMG 318658 0 60251 0 25969 0 51382 0 16564 0 472824 0 0 0 ROY JOHNSON CORP DIRECTOR, IS OPERATIONS 210620 0 0 0 13441 0 17646 0 14736 0 256443 0 0 0 MARK RAKOWSKI VICE PRESIDENT, CCHP 223265 0 0 0 624 0 17910 0 25645 0 267444 0 0 0 ELIZABETH BEDWELL VP RESEARCH ADMINISTRATION 167941 0 22825 0 530 0 7790 0 18632 0 217718 0 0 0 JULIE SPERKA DIR, REVENUE INTEGRITY 177775 0 0 0 10678 0 274634 0 29403 0 492490 0 0 0 MARTIN VOGEL FORMER HCE/CURRENT CHWF VP 0 204548 0 14380 0 1025 0 17741 0 24647 0 262341 0 0 PART I, LINE 4B IN 2013, 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 2013 WERE AS FOLLOWS: M. TROY, $55,802; C. CHRISTENSEN, $45,340; R. DUNCAN, $29,785; W. GAGE, $38,684; T. GERAGHTY, $24,200; M. GORELICK, M.D., $21,058; M. NAUMAN, $39,240; S. REYNOLDS, $29,777; R. SANDERS, $27,500; AND S. KHARE, M.D., $32,432. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2013 WERE: J. KERSTEN, $7,761. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT AND CEO. THE AMOUNT SET ASIDE IN 2013 WAS $201,306. 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, BARBARA JOERS, CHW VP, 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 56000 0 0 1 56000 FOLEY AND LARDNER LLP DIRECTORS (J. ROTHMAN) 159923 MR. ROTHMAN IS THE CHIEF EXECUTIVE OFFICER AT FOLEY AND LARDNER, LLP. THE ORGANIZATION PAID FOLEY AND LARDNER $159,923 FOR LEGAL SERVICES. 0 JOHNSON INSURANCE DIRECTOR (T. BOLGER) 229693 MR. BOLGER IS THE CHIEF EXECUTIVE OFFICER OF JOHNSON BANK AND ITS PARENT COMPANY JOHNSON FINANCIAL GROUP. THE ORGANIZATION PAID JOHNSON INSURANCE, A SUBSIDIARY OF JOHNSON FINANCIAL GROUP, $229,693 FOR BROKERAGE SERVICES. 0 WE ENERGIES DIRECTOR (C. CULVER) 230920 MR. CULVER IS ON THE BOARD OF DIRECTORS AT WE ENERGIES. THE ORGANIZATION PAID WE ENERGIES $230,920 FOR UTILITIES. 0 WE ENERGIES DIRECTOR (T. BOLGER) 230920 MR. BOLGER, WHO IS ON THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH MARY ELLEN STANEK, WHO IS ON THE BOARD OF DIRECTORS AT WE ENERGIES. THE ORGANIZATION PAID WE ENERGIES $230,920 FOR UTILITIES. 0 JENNIFER MANCE DIRECTOR (K. MANSELL) 26339 JENNIFER MANCE IS THE DAUGHTER OF A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE ORGANIZATION PAID HER $26,339 IN COMPENSATION 0 BMO HARRIS BANK DIRECTOR (M. HOGAN) 293814 MR. HOGAN IS A SENIOR ADVISOR AT BMO HARRIS BANK. THE ORGANIZATION PAID BMO HARRIS BANK $293,814 FOR BANKING AND INVESTMENT SERVICES. 0 KELLY REILLY DIRECTOR (M. WITT) 101475 KELLY REILLY IS THE SPOUSE OF A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS. THE ORGANIZATION PAID HER $101,475 IN COMPENSATION. 0 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 FIVE 1099 FORMS LISTED IN PART V ARE THE FORMS FILED BY THE ORGANIZATION'S DISREGARDED ENTITY. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS OR OFFICERS: ORR AND PEPKE, DRURY AND SCHLIFSKE, DRURY AND SOMMERHAUSER, DRURY AND BRENNER, DRURY AND SULLIVAN, BRENNER AND SULLIVAN, ROTHMAN AND ABRAHAM, SCHLIFSKE AND SOMMERHAUSER, SCHLIFSKE AND MANSELL, MANSELL AND SOMMERHAUSER, ABRAHAM AND QUADRACCI, WITT AND SOMMERHAUSER, KERSCHNER AND BRENNER, KERSCHNER AND CULVER, KERSCHNER AND MELLOWES, KERSCHNER AND SULLIVAN, BOLGER AND SULLIVAN, CULVER AND GORELICK, BRENNER AND GORELICK, KERSCHNER AND GORELICK, MELLOWES AND GORELICK, WILLIAMS AND TROY, WITT AND ABRAHAM, AND SULLIVAN AND GORELICK. 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 10,487,300. MANAGEMENT AND GENERAL EXPENSES 1,362,895. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,850,195. MEDICAL COLLEGE OF WISCONSIN: PROGRAM SERVICE EXPENSES 2,194,323. MANAGEMENT AND GENERAL EXPENSES 423,689. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,618,012. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 166,165. MANAGEMENT AND GENERAL EXPENSES 21,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 187,545. OTHER FEES: PROGRAM SERVICE EXPENSES 6,976,955. MANAGEMENT AND GENERAL EXPENSES 888,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,865,657. GRANT EXPENDITURES: PROGRAM SERVICE EXPENSES 4,898,331. MANAGEMENT AND GENERAL EXPENSES 1,710. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,900,041. FORM 990, PART XI, LINE 9: NET ASSET/CASH TRANSFER TO CHILDREN'S COMMUNITY HEALTH PLAN, INC. -12,500,000. INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHW FOUNDATION 2,970,245. 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