CHILDRENS HOSPITAL OF WISCONSIN INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: CHILDRENS HOSPITAL OF WISCONSIN INC (EIN 39-0812532)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201323199349302127
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T09:04:21-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	363168081	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SIKICH LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	13400 BISHOPS LANE SUITE 300	AddressLine1
City	BROOKFIELD	City
State	WI	State
ZIP Code	53005	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	390812532	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL OF WISCONSIN INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CHIL	NameControl
Phone	4142665420	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	9000 W WISCONSIN AVE PO BOX 1997 NO	AddressLine1
Address Line2	MS 900	AddressLine2
City	MILWAUKEE	City
State	WI	State
ZIP Code	53201	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	WELDON GAGE	Name
Title	TREASURER	Title
Phone	4142665420	Phone
Date Signed	2013-11-10	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BRYAN L PAUTSCH CPA	Name
PTIN	P00034913	PTIN
Phone	2627549400	Phone
Date Prepared	2013-11-10	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	CINDY CHRISTENSEN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	9000 W WISCONSIN AVE PO BOX 1997 NO	AddressLine1
Address Line2	MS 90	AddressLine2
City	MILWAUKEE	City
State	WI	State
ZIP Code	53201	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	696544670	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CHW.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1894	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	PEDIATRIC HEALTH CARE SERVICES	ActivityOrMissionDescription
Nbr Voting Members Governing Body	25	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	17	NbrIndependentVotingMembers
Total Nbr Employees	3666	TotalNbrEmployees
Total Nbr Volunteers	338	TotalNbrVolunteers
Total Gross UBI	138182	TotalGrossUBI
Net Unrelated Business Txbl Income	-71361	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	22263687	ContributionsGrantsPriorYear
Contributions Grants Current Year	15053773	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	537023949	ProgramServiceRevenuePriorYear
Program Service Revenue CY	533784943	ProgramServiceRevenueCY
Investment Income Prior Year	10609400	InvestmentIncomePriorYear
Investment Income Current Year	8239508	InvestmentIncomeCurrentYear
Other Revenue Prior Year	8803401	OtherRevenuePriorYear
Other Revenue Current Year	9031363	OtherRevenueCurrentYear
Total Revenue Prior Year	578700437	TotalRevenuePriorYear
Total Revenue Current Year	566109587	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	14355877	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	12557033	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	205262259	SalariesEtcPriorYear
Salaries Etc Current Year	213111810	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	293217191	OtherExpensePriorYear
Other Expenses Current Year	309688106	OtherExpensesCurrentYear
Total Expenses Prior Year	512835327	TotalExpensesPriorYear
Total Expenses Current Year	535356949	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	65865110	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	30752638	RevenuesLessExpensesCY
Total Assets BOY	1217648841	TotalAssetsBOY
Total Assets EOY	1270795904	TotalAssetsEOY
Total Liabilities BOY	467244057	TotalLiabilitiesBOY
Total Liabilities EOY	456687546	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	750404784	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	814108358	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE MISSION OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. IS TO PROVIDE A COMPREHENSIVE AND INTEGRATED PEDIATRIC HEALTH CARE MODEL THAT DELIVERS SUPERIOR QUALITY AND VALUE BY OFFERING THE BEST SOLUTION FOR THE TOTAL HEALTH CARE NEEDS OF CHILDREN WITHIN OUR COMMUNITY, STATE AND REGION.AS A PREMIER AND STANDARD-SETTING LEADER IN DELIVERY OF PEDIATRIC CLINICAL SERVICE, EDUCATION AND RESEARCH, CHILDREN'S HOSPITAL ADVOCATES FOR CHILDREN AND BRINGS A COMMITMENT TO EXCELLENCE TO OUR PATIENTS AND FAMILIES, MEDICAL STAFF, EMPLOYEES AND COMMUNITIES IN ADDRESSING THE HEALTH AND WELL-BEING OF CHILDREN.OUR MISSION IS OUR CHILDREN (AND IT SPELLS "CARE"):CAREGIVING - OFFERING HIGH QUALITY, COMPREHENSIVE MEDICAL CAREADVOCACY - SPEAKING UP AND PROTECTING CHILDRENRESEARCH - FINDING CURES TO THE ILLNESSES THAT AFFECT CHILDRENEDUCATION - SHARE WHAT WE LEARN AND TEACHING OTHERS TO CARE FOR KIDS	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	421201663	Expense
Grants	12557033	Grants
Revenue	533922902	Revenue
Description	INPATIENT SERVICES:CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW" OR "THE HOSPITAL") OPERATES A 296-BED HOSPITAL AT ITS MILWAUKEE CAMPUS, WHICH INCLUDES AN EMERGENCY ROOM OPEN ON A 24/7 BASIS. IT IS A FREESTANDING WISCONSIN HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN AND IS ONE OF THE LEADING CENTERS FOR PEDIATRIC HEALTH CARE IN THE U.S. THE HOSPITAL SERVES CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE, TO CHILDREN FROM WISCONSIN, THE UPPER PENINSULA OF MICHIGAN, NORTHERN ILLINOIS AND BEYOND. IN 2012, 24,085 CHILDREN WERE ADMITTED TO THE MILWAUKEE HOSPITAL, WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT (NICU), PEDIATRIC INTENSIVE CARE UNIT (PICU), A CANCER AND BLOOD DISORDERS CENTER, MEDICAL/SURGICAL UNITS AND A DAY SURGERY SHORT STAY UNIT. THE HOSPITAL ALSO OPERATES A SEPARATELY-LICENSED 42-BED PEDIATRIC HOSPITAL, WHICH INCLUDES A NICU AND A PEDIATRIC MEDICAL/SURGICAL UNIT, LOCATED AT THEDA CLARK MEDICAL CENTER IN NEENAH, WIS., THROUGH WHICH IT PROVIDES PEDIATRIC EXPERTISE TO THE GREATER FOX VALLEY AND GREEN BAY AREAS. IN 2012, 1,284 CHILDREN WERE ADMITTED TO THE FOX VALLEY CAMPUS.OUTPATIENT AND AMBULATORY SERVICES:THE HOSPITAL PROVIDES A FULL ARRAY OF OUTPATIENT AMBULATORY, DIAGNOSTIC, TREATMENT AND SURGICAL SERVICES. PROVIDERS AT MORE THAN 70 SUBSPECIALTY CLINICS DIAGNOSE AND TREAT A WIDE VARIETY OF PEDIATRIC DISORDERS. THE HOSPITAL IS A CERTIFIED LEVEL 1 PEDIATRIC TRAUMA CENTER, AND HANDLED 61,732 VISITS TO THE EMERGENCY DEPARTMENT IN 2012. OUTPATIENT SERVICES ARE OFFERED AT ACCESSIBLE LOCATIONS THROUGHOUT SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS, AND IN THE FOX VALLEY AND GREEN BAY MARKETS. THE HOSPITAL'S NATIONALLY KNOWN AND RECOGNIZED SPECIALTY PROGRAMS INCLUDE THOSE FOR TREATING CHILDREN WITH AIRWAY, DIGESTIVE AND VOICE CONDITIONS; BURNS; CANCER AND BLOOD DISORDERS; CONGENITAL AND ACQUIRED HEART DEFECTS AND DISEASES; CRANIOFACIAL DISORDERS; DERMATOLOGY, BIRTHMARKS AND VASCULAR ANOMALIES; DIABETES; GASTROINTESTINAL PROBLEMS; GENETIC DISORDERS; HIV; NEUROLOGICAL DISORDERS; ORTHOPEDIC CONDITIONS (INCLUDING SPINE, SPORTS MEDICINE, CONCUSSION); IMMUNODEFICIENCIES AND IMMUNE DYSREGULATION SYNDROMES; PSYCHIATRY; SLEEP DISORDERS; SOLID ORGAN TRANSPLANTATION; SPEECH AND HEARING DISORDERS; AND SPASTICITY AND OTHER TONE AND MOBILITY CONDITIONS. THE HOSPITAL PROVIDES PRIMARY CARE, DENTAL CARE AND CHILD PROTECTIVE SERVICES TO UNDERSERVED CHILDREN AT CLINICS IN CENTRAL CITY MILWAUKEE NEIGHBORHOODS. THE HOSPITAL ALSO OFFERS CASE MANAGEMENT SERVICES AND A FULL RANGE OF MEDICAL, PSYCHOLOGICAL, NURSING AND SOCIAL SERVICES FOR CHILDREN WITH DEVELOPMENTAL, BEHAVIORAL AND LEARNING PROBLEMS. IN 2012, THERE WERE A TOTAL OF 322,716 OUTPATIENT VISITS.RESEARCH, EDUCATION AND COMMUNITY OUTREACH:THE HOSPITAL IS INVOLVED IN EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS.RESEARCH: THE HOSPITAL AND ITS CHILDREN'S RESEARCH INSTITUTE PARTICIPATE IN AN ARRAY OF RESEARCH INITIATIVES SEEKING TO IMPROVE THE DIAGNOSIS AND TREATMENT OF CONGENITAL AND ACQUIRED PEDIATRIC HEALTH CONDITIONS. THESE RESEARCH INITIATIVES INCLUDE BEHAVIORAL HEALTH, EPILEPSY AND OTHER NEUROLOGICAL CONDITIONS; ORGAN TRANSPLANTATION; BIRTH DEFECTS AND FETAL ANOMALIES; IMMUNOLOGICAL CONDITIONS, BLOOD DISORDERS AND VARIOUS CHILDHOOD CANCERS; AND ENVIRONMENTAL HEALTH CONDITIONS. ADDITIONAL RESEARCH IS CONDUCTED IN COLLABORATION WITH ACADEMIC INVESTIGATORS AT THE MEDICAL COLLEGE OF WISCONSIN, MARQUETTE UNIVERSITY, UNIVERSITY OF WISCONSIN-MADISON AND OTHER INSTITUTIONS. NURSING RESEARCH INCLUDES STUDIES REGARDING PAIN MANAGEMENT, QUALITY OF LIFE, COPING SKILLS, FAMILY READINESS AND SEDATION PROTOCOLS.EDUCATION: THE HOSPITAL IS A MAJOR TEACHING AFFILIATE OF THE MEDICAL COLLEGE OF WISCONSIN, WITH THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ROTATING THROUGH THE HOSPITAL FOR REQUIRED AND ELECTIVE ROTATIONS. THE HOSPITAL ALSO MAINTAINS A THREE-YEAR PEDIATRIC RESIDENCY PROGRAM, A TWO-YEAR DENTAL TRAINING PROGRAM AND ACADEMIC FELLOWSHIP PROGRAMS IN AN ARRAY OF SPECIALTIES. THE HOSPITAL HAS RELATIONSHIPS WITH MORE THAN TWO DOZEN UNIVERSITIES FOR THE CLINICAL EDUCATION OF PEDIATRIC NURSES AND OTHER HEALTH CARE PROFESSIONAL STUDENTS, AS WELL AS HEALTH CARE ADMINISTRATION AND VARIOUS OTHER DISCIPLINES. THE HOSPITAL'S PEDIATRIC SPECIALISTS ALSO PROVIDE EDUCATION AND TRAINING TO HEALTH CARE PROFESSIONALS AT COMMUNITY HOSPITALS, PRIMARY CARE CLINICS AND SCHOOLS THROUGHOUT WISCONSIN IN CONNECTION WITH THE IDENTIFICATION, DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH AND WELFARE CONDITIONS. COMMUNITY OUTREACH: THE HOSPITAL OFFERS A WIDE VARIETY OF COMMUNITY EDUCATION, OUTREACH AND CHILD HEALTH ADVOCACY PROGRAMS. THROUGH COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS CHILD HEALTH, INJURY PREVENTION, PARENTING, MANAGEMENT OF CHRONIC DISEASES, AND PREVENTIVE HEALTH, THE HOSPITAL REACHES THOUSANDS OF FAMILIES. ALONG WITH THE MEDICAL COLLEGE, THE HOSPITAL SPONSORS THE CENTER FOR THE ADVANCEMENT OF UNDERSERVED CHILDREN, WHICH SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF UNDERSERVED CHILDREN. THE HOSPITAL PARTICIPATES IN AND STAFFS THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, THROUGH WHICH PROVIDERS AROUND THE STATE WORK COLLABORATIVELY TO RAISE AWARENESS OF CHILDREN'S HEALTH ISSUES, INCREASE ACCESS TO PEDIATRIC CARE, AND PROMOTE BEST PRACTICES. OTHER COMMUNITY OUTREACH AND ADVOCACY INITIATIVES INCLUDE, FOR EXAMPLE, CAR SEAT CLINICS, THE DANIEL M. SOREF FAMILY RESOURCE CENTER AND PROJECT ADAM (EDUCATION AND PREVENTION INITIATIVES IN THE AREA OF PEDIATRIC SUDDEN CARDIAC DEATH).	Description
Total Program Service Expense	421201663	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	1	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	525	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	3666	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	25	NbrVotingGoverningBodyMembers
Number Independent Voting Members	17	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	WI	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MS SARAH KAFKA	NamePerson
Telephone Number	4142661854	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	9000 W WISCONSIN AVE	AddressLine1
City	MILWAUKEE	City
State	WI	State
ZIP Code	53201	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (48 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
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 (DEC 2012)	1.00	1.00	X	0	0	0
DAVID J DRURY
DIRECTOR / CHAIR	1.00	1.00	X	0	0	0	X
DAVID H GILBERT
DIRECTOR	1.00	1.00	X	0	0	0
SUSAN HERMA
DIRECTOR (JAN - JUN 2012)	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 (JUN - DEC 2012)	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
LARRY A RAMBO
DIRECTOR (JAN - AUG 2012)	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	0	0	0	X
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 (APR - DEC 2012)	1.00	1.00	X	0	0	0
MARK C WITT
DIRECTOR	1.00	1.00	X	0	0	0
MARGARET TROY
DIRECTOR / CHHS PRESIDENT	0.00	40.00	X	0	1263624	291068	X
ELIZABETH BEDWELL
VP RESEARCH ADMINISTRATION	0.00	40.00		0	105027	14638	X
MARC CADIEUX
INTERIM TREASURER (JAN 2012)	0.00	40.00		0	238911	22520	X
CINTHIA S CHRISTENSEN
PRESIDENT & COO	40.00	0.00		679101	0	92874	X
WELDON GAGE
TREASURER / CFO	0.00	40.00		0	362086	70172	X
MICHAEL GUTZEIT MD
VP, CHW / CHIEF MEDICAL OFFICER	40.00	0.00		475486	0	80218	X
BARBARA JOERS
VICE PRESIDENT, CHW	40.00	0.00		277373	0	29006	X
JULIET KERSTEN
VICE PRESIDENT, CHW	40.00	0.00		294203	0	39843	X
NANCY KOROM
VP, CHW / CHIEF NURSING OFFICER	40.00	0.00		431059	0	72919	X
SHEILA REYNOLDS
SECRETARY	0.00	40.00		0	389028	76385	X
MARK SHIP
VP REVENUE CYCLE	7.00	33.00		33039	285169	37576	X
DONNA JAMIESON
EXECUTIVE DIR, PATIENT CARE	40.00	0.00		172874	0	48318		X
TOM LAUSTEN
DIRECTOR, PHARMACY SVS	40.00	0.00		166320	0	36299		X
ERIN YALE
DIR, DIAG IMAGING & EMERGENCY	40.00	0.00		167934	0	29870		X
SUZAN BUCHAKLIAN
DIR, SURGICAL SERVICES	40.00	0.00		152325	0	27352		X
LORI BARBEAU DDS
MEDICAL DIRECTOR DENTAL PROGRAM	40.00	0.00		268617	0	44296			X
ANDREW SCHMITT MD
HOSPITALIST	40.00	0.00		250508	0	32646			X
MARYLYN RANTA MD
DIR, CHW PHYSICIAN AFFAIRS	40.00	0.00		238618	0	48532			X
SHANE FISHER DDS
PEDIATRIC DENTIST	40.00	0.00		233483	0	27144			X
A CHARLES POST DDS
PROGRAM ADMIN DENTAL RESIDENCY	40.00	0.00		235099	0	28346			X
TIMOTHY L BIRKENSTOCK
FORMER TREASURER	0.00	0.00		0	232256	1866				X
RAMESH SACHDEVA MD
FORMER CHHS VP (JAN - JUN 2012)	0.00	40.00		0	274351	10232				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4076039	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3150452	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1162120	TotalOtherCompensation
Number Individuals GT100 K	125	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MEDICAL COLLEGE OF WISCONSIN INC
8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	HEALTHCARE PROF/ ACADEMIC/ADMIN	32065910
MEDICAL COLLEGE OF WI AFFILATED
8701 WATERTOWN PLANK RD	MILWAUKEE	WI	53226	RESIDENT SERVICES	10841018
BLOOD CENTER OF WISCONSIN INC
638 N 18TH ST	MILWAUKEE	WI	532332121	BLOOD PRODUCTS/LAB SERVICES	9918394
DELOITTE CONSULTING LLP
PO BOX 7247-6447	PHILADELPHIA	PA	191706447	CONSULTING	9873089
PARAGON DEV SYS INC
1823 EXECUTIVE DRIVE	OCONOMOWOC	WI	53066	IT HARDWARE AND CONSULTING	6929537

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	35	NumberOfContractorsGT100K
Federated Campaigns	69120	FederatedCampaigns
Related Organizations	4221133	RelatedOrganizations
Government Grants	9822280	GovernmentGrants
All Other Contributions	941240	AllOtherContributions
Total Contributions	15053773	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
NET PATIENT SVC REV	621990	527284154	527284154
RENTAL INCOME	531120	5364790	1098186	$4,266,604
SHARED SERVICES	541900	1135999	1135999

Field	Value	IRS element (for citing)
Total Program Service Revenue	533784943	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	11706332	TotalRevenueColumn
Exclusion	$11,706,332	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	126943789	Securities
Other	24470	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	127819015	Securities
Other	2616068	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-875226	Securities
Other	-2591598	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-3466824	TotalRevenueColumn
Exclusion	-$3,466,824	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA	722210	2456543	$2,456,543
PHARMACY SALES TO EMPLOYEES	446110	1422442	$1,422,442
REBATES AND DISCOUNTS	900099	1221697		1221697

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	3930681	TotalRevenueColumn
Related Or Exempt Function Income	3182866	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	138182	UnrelatedBusinessRevenue
Exclusion	$609,633	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	9031363	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	566109587	TotalRevenueColumn
Related Or Exempt Function Income	533922902	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	138182	UnrelatedBusinessRevenue
Exclusion	$16,994,730	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	12557033	Total
Program Services	12557033	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	4717251	Total
Management And General	4717251	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	162099688	Total
Program Services	139232112	ProgramServices
Management And General	22867576	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	10127165	Total
Program Services	8147662	ProgramServices
Management And General	1979503	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	24045788	Total
Program Services	22654255	ProgramServices
Management And General	1391533	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	12121918	Total
Program Services	10206708	ProgramServices
Management And General	1915210	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	71036370	Total
Program Services	89213	ProgramServices
Management And General	70947157	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	464061	Total
Management And General	464061	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	26964902	Total
Program Services	26964902	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	12696	Total
Program Services	12696	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	300753	Total
Program Services	284105	ProgramServices
Management And General	16648	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	132675	Total
Program Services	101873	ProgramServices
Management And General	30802	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	19743712	Total
Program Services	16191751	ProgramServices
Management And General	3551961	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	664878	Total
Program Services	351461	ProgramServices
Management And General	313417	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	14334869	Total
Program Services	14334869	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	40952888	Total
Program Services	40952888	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2075021	Total
Program Services	18341	ProgramServices
Management And General	2056680	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	59058650	59028413	30237
PURCHASED SERVICES	41747699	41747699
HOSPITAL ASSESSMENT TAX	12435088	12435088
RESIDENT STIPENDS AND B	5779677	5779677

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	13984167	Total
Program Services	10110917	ProgramServices
Management And General	3873250	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	535356949	Total
Program Services	421201663	ProgramServices
Management And General	114155286	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	25844365	BOY
EOY	20934534	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	2723265	BOY
EOY	1890349	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	72520526	BOY
EOY	78401999	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	10000	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	542960	BOY
EOY	511460	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3821990	BOY
EOY	4089825	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5146262	BOY
EOY	5162899	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	706488873	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	261932253	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	416857607	BOY
EOY	444556620	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	302582557	BOY
EOY	298749648	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	387609309	BOY
EOY	416488570	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1217648841	BOY
EOY	1270795904	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	68674395	BOY
EOY	73260669	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	749791	BOY
EOY	1157530	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	272942555	BOY
EOY	269599134	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	124877316	BOY
EOY	112670213	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	467244057	BOY
EOY	456687546	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	603203769	BOY
EOY	649591292	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	31037095	BOY
EOY	36839166	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	116163920	BOY
EOY	127677900	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	750404784	BOY
EOY	814108358	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1217648841	BOY
EOY	1270795904	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	30752638	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	3115865	ReconciliationUnrealizedInvest
Reconcilation Other Changes	29835071	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	1	AgentTrusteeEtc
Beginning Balance	364237	BeginningBalance
Additions During Year	133078	AdditionsDuringYear
Distributions During Year	117515	DistributionsDuringYear
Ending Balance	379800	EndingBalance
Included On FS	0	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	320201015	BeginningOfYearBalance
Contributions	12951629	Contributions
Investment Earnings Or Losses	13134597	InvestmentEarningsOrLosses
Grants Or Scholarships	7676552	GrantsOrScholarships
Administrative Expenses	1093625	AdministrativeExpenses
End Of Year Balance	337517064	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	319718349	BeginningOfYearBalance
Contributions	8809809	Contributions
Investment Earnings Or Losses	501862	InvestmentEarningsOrLosses
Grants Or Scholarships	7914215	GrantsOrScholarships
Administrative Expenses	914790	AdministrativeExpenses
End Of Year Balance	320201015	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	301025999	BeginningOfYearBalance
Contributions	13508585	Contributions
Investment Earnings Or Losses	13344633	InvestmentEarningsOrLosses
Grants Or Scholarships	7310168	GrantsOrScholarships
Administrative Expenses	850700	AdministrativeExpenses
End Of Year Balance	319718349	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	246110966	BeginningOfYearBalance
Contributions	12400322	Contributions
Investment Earnings Or Losses	48806039	InvestmentEarningsOrLosses
Grants Or Scholarships	6291328	GrantsOrScholarships
End Of Year Balance	301025999	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	294258148	BeginningOfYearBalance
Contributions	20363545	Contributions
Investment Earnings Or Losses	-54457713	InvestmentEarningsOrLosses
Grants Or Scholarships	14053014	GrantsOrScholarships
End Of Year Balance	246110966	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.51300	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.37800	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.10900	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	478859224	OtherCostOrOtherBasis
Depreciation	179172635	Depreciation
Book Value	299686589	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	7313370	OtherCostOrOtherBasis
Depreciation	3045685	Depreciation
Book Value	4267685	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	205782378	OtherCostOrOtherBasis
Depreciation	77831368	Depreciation
Book Value	127951010	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	14533901	OtherCostOrOtherBasis
Depreciation	1882565	Depreciation
Book Value	12651336	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	444556620	TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM AFFILIATES	32756014
BENEFICIAL INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL OF WISCONSIN FOUND.	383017854
457 PLAN ASSETS	714702

Field	Value	IRS element (for citing)
Total Book Value Other Assets	416488570	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
RESERVE FOR MEDICAL EDUCATION GRANT SETTLEMENTS	$3,269,016
CAPITAL AND OTHER LEASE OBLIGATIONS	$1,951,126
FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS	$39,133,337
457 PLAN LIABILITY	$714,702
ACCRUED PENSION	$64,920,143
ESTIMATED THIRD PARTY PAYER SETTLEMENTS	$2,681,889

Field	Value	IRS element (for citing)
Total Of Amounts	112670213	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART IV, LINE 1B:	CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHILDREN'S HOSPITAL OF WISCONSIN MEDICAL STAFF FUNDS MONEY MARKET AND CHECKING ACCOUNT. AN EMPLOYEE OF THE ORGANIZATION ALSO PROVIDES ALL MONTHLY ACCOUNTING FUNCTIONS.
PART V, LINE 4:	CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC., A RELATED ENTITY, HOLDS ENDOWMENT FUNDS ON BEHALF OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. INTENDED USES OF THE FUNDS INCLUDE VARIOUS HEALTH-RELATED SERVICES, CAPITAL PROJECTS AND RESEARCH.	DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X, LINE 2:	CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent350	X	Pcent350
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1042389	TotalCommunityBenefitExpense
Net Community Benefit Expense	1042389	NetCommunityBenefitExpense
Percent Of Total Expense	0.00200	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	231655711	TotalCommunityBenefitExpense
Direct Offsetting Revenue	179767603	DirectOffsettingRevenue
Net Community Benefit Expense	51888108	NetCommunityBenefitExpense
Percent Of Total Expense	0.09420	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	232698100	TotalCommunityBenefitExpense
Direct Offsetting Revenue	179767603	DirectOffsettingRevenue
Net Community Benefit Expense	52930497	NetCommunityBenefitExpense
Percent Of Total Expense	0.09620	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6318423	TotalCommunityBenefitExpense
Direct Offsetting Revenue	992928	DirectOffsettingRevenue
Net Community Benefit Expense	5325495	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	31186325	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7638384	DirectOffsettingRevenue
Net Community Benefit Expense	23547941	NetCommunityBenefitExpense
Percent Of Total Expense	0.04430	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7464294	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2741098	DirectOffsettingRevenue
Net Community Benefit Expense	4723196	NetCommunityBenefitExpense
Percent Of Total Expense	0.00890	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6655528	TotalCommunityBenefitExpense
Net Community Benefit Expense	6655528	NetCommunityBenefitExpense
Percent Of Total Expense	0.01250	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	522191	TotalCommunityBenefitExpense
Net Community Benefit Expense	522191	NetCommunityBenefitExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	52146761	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11372410	DirectOffsettingRevenue
Net Community Benefit Expense	40774351	NetCommunityBenefitExpense
Percent Of Total Expense	0.07670	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	284844861	TotalCommunityBenefitExpense
Direct Offsetting Revenue	191140013	DirectOffsettingRevenue
Net Community Benefit Expense	93704848	NetCommunityBenefitExpense
Percent Of Total Expense	0.17290	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	1070998	TotalCommunityBuildingExpense
Direct Offsetting Revenue	5638	DirectOffsettingRevenue
Net Community Building Expense	1065360	NetCommunityBuildingExpense
Percent Of Total Expense	0.00200	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	1198911	TotalCommunityBuildingExpense
Direct Offsetting Revenue	17241	DirectOffsettingRevenue
Net Community Building Expense	1181670	NetCommunityBuildingExpense
Percent Of Total Expense	0.00220	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	62412	TotalCommunityBuildingExpense
Net Community Building Expense	62412	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	3308	TotalCommunityBuildingExpense
Net Community Building Expense	3308	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	2335629	TotalCommunityBuildingExpense
Direct Offsetting Revenue	22879	DirectOffsettingRevenue
Net Community Building Expense	2312750	NetCommunityBuildingExpense
Percent Of Total Expense	0.00430	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$4,129,248	BadDebtExpenseAmount
Amount Attributable To	100000	AmountAttributableTo
Amount Reimbursed By Medicare	1194013	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	1148179	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	45834	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	2	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Childrens HospitalChildrensHospital	Teaching HospitalTeachingHospital	Research FacilityResearchFacility	Er24 HoursEr24Hours
CHILDREN'S HOSPITAL OF WISCONSIN INC
1	9000 W WISCONSIN AVE	MILWAUKEE	WI	53201	X	X	X	X	X	X
CHILDREN'S HOSPITAL OF WI-FOX VALLEY
2	130 S 2ND STREET	NEENAH	WI	54956	X	X	X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumber	Eligibility Criteria ExplainedEligibilityCriteriaExplained	Uses FPG FreeUsesFPGFree	FPG Free PercentFPGFreePercent	Uses FPG DiscountedUsesFPGDiscounted	FPG Discount PercentFPGDiscountPercent	Explains BasisExplainsBasis	Income LevelIncomeLevel	Asset LevelAssetLevel	Medical IndigencyMedicalIndigency	Explains Application MethodExplainsApplicationMethod	Includes Publicity MeasuresIncludesPublicityMeasures	Other PublicityOtherPublicity	Actions On NonpaymentActionsOnNonpayment	Collection ActivitiesCollectionActivities	Notify Upon AdmissionNotifyUponAdmission	Notified All PatientsNotifiedAllPatients	Documented DeterminationDocumentedDetermination	Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy	Used Other MethodUsedOtherMethod	Amounts Generally BilledAmountsGenerallyBilled	Gross ChargesGrossCharges
CHILDREN'S HOSPITAL OF WISCONSIN INC
1	1	1	200.000000000000	1	350.000000000000	1	X	X	X	1	1	X	1	0	X	X	X	1	X	0	0
CHILDREN'S HOSPITAL OF WI-FOX VALLEY
2	1	1	200.000000000000	1	350.000000000000	1	X	X	X	1	1	X	1	0	X	X	X	1	X	0	0

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	5	NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
CHW FOX VALLEY BEHAVIORAL HEALTH
1820 N APPLETON RD	MENASHA	WI	54952	PATIENT CARE SERVICES
CHILD ADVOCACY CENTER - FOX VALLEY
325 N COMMERCIAL ST SUITE 400	NEENAH	WI	54956	PATIENT CARE SERVICES
CHILD ADVOCACY CENTER - RACINE
2405 NORTHWESTERN AVE SUITE 2058	RACINE	WI	53404	PATIENT CARE SERVICES
CHILD ADVOCACY CENTER - WAUKESHA
101 W BROADWAY 2ND FLOOR	WAUKESHA	WI	53186	PATIENT CARE SERVICES
DOWNTOWN HEALTH CENTER
1020 N 12TH ST	MILWAUKEE	WI	53233	URBAN HEALTH CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("THE HOSPITAL") USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. THE HOSPITAL IS DEDICATED TO ENSURING THAT PATIENTS RECEIVE ALL MEDICALLY NECESSARY CARE. IN FURTHERANCE OF THAT OBJECTIVE, THE HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE POLICY ("FAP"), PURSUANT TO WHICH THE HOSPITAL PROVIDES DISCOUNTED OR FREE CARE TO PATIENTS WHO ARE UNINSURED OR OTHERWISE UNABLE TO PAY ALL OR A PORTION OF THEIR BILLED CHARGES. THE POLICY GENERALLY PROVIDES THAT ELIGIBILITY IS DETERMINED BASED ON HOUSEHOLD INCOME, FAMILY SIZE AND AVAILABLE ASSETS, AND SPECIFICALLY INCORPORATES CRITERIA SET FORTH UNDER THE WISCONSIN MEDICAID PROGRAM AND THE FEDERAL POVERTY GUIDELINES.
PART I, LINE 6A: CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE SOLE CORPORATE MEMBER OF THE HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF THE HOSPITAL AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE OR UPON REQUEST.
PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO, DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, TO CALCULATE THE AMOUNTS REPORTED IN LINES 7A AND 7B FOR CHARITY CARE AT COST AND UNREIMBURSED MEDICAID. FOR LINES 7E, 7F, 7G, 7H, AND 7I, THE HOSPITAL USED COSTS TAKEN FROM ITS ACCOUNTING SYSTEM. FOR LINE 7G, THE COSTS FROM THE ACCOUNTING SYSTEM WERE ADJUSTED FOR MEDICAID, MEDICARE, AND CHARITY CARE PATIENTS, AS THE COST RELATED TO THESE PATIENTS WAS TAKEN INTO ACCOUNT IN LINES 7A AND 7B. THE WISCONSIN MEDICAID PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED OR UNDERINSURED. HOSPITAL REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND THE AVAILABILITY OF STATE AID AND TO ASSIST THEM IN BECOMING ENROLLED IN THE PROGRAM THAT PROVIDES THE PATIENT WITH THE GREATEST BENEFIT. FOR THAT REASON, THE AMOUNT OF TRUE "CHARITY CARE" RENDERED BY THE HOSPITAL IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION.PART I, LINE 7, COLUMN (F): BAD DEBT EXPENSE OF $4,129,248 IS INCLUDED IN TOTAL EXPENSES IN PART IX, LINE 25, COLUMN (A), BUT EXCLUDED IN THE CALCULATION OF "PERCENT OF TOTAL EXPENSES" REPORTED IN COLUMN (F).
PART I, LINE 7G: THE HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7G $375,000 PAID TO CHILDREN'S MEDICAL GROUP, INC. ("CMG"), WHICH IS A SECTION 501(C)(3) ORGANIZATION AND AN AFFILIATE OF THE HOSPITAL THAT PROVIDES PRIMARY CARE PHYSICIAN SERVICES IN SOUTHEASTERN WISCONSIN. THE PAYMENTS WERE MADE TO SUBSIDIZE THE NEXT DOOR PEDIATRIC CLINIC AND OTHER CMG CLINICS WITHIN MILWAUKEE COUNTY THAT PROVIDE PRIMARY CARE PRIMARILY TO CHILDREN ENROLLED IN THE WISCONSIN MEDICAID PROGRAM OR WHO ARE UNINSURED.
PART II: THE HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS FOR CHILDREN, SUCH AS POVERTY AND ENVIRONMENTAL ISSUES. THESE COMMUNITY-BUILDING ACTIVITIES INCLUDE STAFF PARTICIPATION ON COMMUNITY BOARDS, COALITIONS AND/OR COMMITTEES WHICH ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. THE HOSPITAL PROVIDES SUPPORT TO MANY PROGRAMS THAT HELP COMMUNITY MEMBERS KEEP THEIR CHILDREN AND FAMILIES HEALTHY. EXAMPLES INCLUDE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, THE SOUTHEAST AND NORTHEAST REGIONAL CENTERS FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, THE DANIEL M. SOREF FAMILY RESOURCE CENTER, AND A FREE GUARDIANSHIP CLINIC. THE HOSPITAL ALSO PROVIDES FINANCIAL SUPPORT TO CHHS TO SUPPORT THE SAFE KIDS WISCONSIN COALITION AND SAFE KIDS SOUTHEAST WISCONSIN COALITION.THE HOSPITAL STAFFS THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A STATEWIDE COALITION THAT WORKS TO IMPROVE THE HEALTH OF WISCONSIN CHILDREN AND REDUCE DISPARITIES IN AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE SERVICES. THE ALLIANCE IS GUIDED BY A STATEWIDE 28 MEMBER ADVISORY BOARD AND PARTNERS WITH HUNDREDS OF ORGANIZATIONS AND INDIVIDUALS TO RAISE AWARENESS OF CHILD HEALTH CONCERNS, MOBILIZE LEADERS, IMPACT PUBLIC HEALTH, AND IMPLEMENT PROGRAMS PROVEN TO WORK. THE ALLIANCE IS PARTIALLY FUNDED THROUGH A WISCONSIN DEPARTMENT OF HEALTH SERVICES MATERNAL CHILD HEALTH GRANT, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND OTHER PUBLIC AND PRIVATE FUNDING. THE ALLIANCE IS FINANCIALLY SUPPORTED BY THE HOSPITAL THROUGH STAFF AND OTHER RESOURCES TO CARRY ON THE ALLIANCE'S PROGRAMS. THE ALLIANCE'S KEY INITIATIVES ARE: ASTHMA, GRIEF AND BEREAVEMENT, INJURY PREVENTION AND CHILD DEATH REVIEW, LEAD POISONING, ORAL HEALTH COALITION, AND REACH OUT AND READ PROGRAM. THE ALLIANCE LEADS AND MANAGES THE INFANT DEATH CENTER, REACH OUT AND READ WISCONSIN COALITION, WISCONSIN ASTHMA COALITION, AND THE WISCONSIN ORAL HEALTH COALITION. THE HOSPITAL ALSO SUPPORTS THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. IT IS 1 OF 5 REGIONAL CENTERS DEDICATED TO SUPPORTING FAMILIES WITH CHILDREN WHO HAVE SPECIAL HEALTH CARE NEEDS AND THE PROVIDERS WHO CARE FOR THEM. IT IS FUNDED THROUGH A TITLE 5 MATERNAL AND CHILD HEALTH BLOCK GRANT, EXPENDITURES INCURRED BY CHILDREN'S HOSPITAL TO MATCH THE BLOCK GRANT INCLUDING STAFF AND OTHER PROGRAM EXPENSES, AND CHARITABLE DONATIONS. FAMILIES AND PROVIDERS CAN CALL THE CENTER FOR INFORMATION, REFERRAL AND PROBLEM-SOLVING RELATED TO COMMUNITY AND STATE SERVICES, HEALTH BENEFITS ASSISTANCE, TRANSITION PLANNING, AND EMOTIONAL SUPPORT. EACH YEAR THE STAFF OFFERS TRAINING SUCH AS "CARE IN THE COMMUNITY" AND OTHER SESSIONS THAT FOCUS ON YOUTH TRANSITIONS. STAFF ALSO PARTICIPATE IN NUMEROUS COMMUNITY INITIATIVES AND PARTNER WITH AREA PEDIATRICIANS AND OTHER HEALTH CARE PROVIDERS TO INCORPORATE EARLY IDENTIFICATION AND SCREENING METHODS INTO THEIR PRACTICES. IN 2012, STAFF SHARED THEIR EXPERTISE, LEADERSHIP AND TECHNICAL ASSISTANCE WITH MORE THAN 18 COMMUNITY AGENCIES AND COMMITTEES, WHICH INCLUDE SOUTHEAST REGION AUTISM CORE TEAM, MILWAUKEE COUNTY COMMISSION FOR PERSONS WITH DISABILITIES, PATIENT AT RISK, WISCONSIN CHILDREN'S LONG TERM CARE ADVISORY COMMITTEE AND MANY MORE. THE CENTER SERVES EIGHT COUNTIES. IN THE FOX VALLEY, THE HOSPITAL ALSO SUPPORTS THE NORTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, WHICH PROVIDES SIMILAR SERVICES TO THE SOUTHEAST CENTER DESCRIBED ABOVE WITH A FOCUS ON COUNTIES IN WISCONSIN'S FOX VALLEY. THE DANIEL M. SOREF FAMILY RESOURCE CENTER LOCATED ON THE FIRST FLOOR OF THE HOSPITAL'S MILWAUKEE CAMPUS OFFERS PARENT-TO-PARENT SUPPORT, INFORMATION, REFERRALS AND HELP CONNECTING TO HOSPITAL AND COMMUNITY RESOURCES. THE CENTER OFFERS SPIRITUAL CARE, THE KATIE BECKETT PROGRAM, PATIENT RELATIONS, INTERPRETERS, FAMILY ACCOMMODATIONS AND THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. STAFF MEMBERS ARE TRAINED TO HELP CHILDREN, YOUNG ADULTS AND THEIR FAMILIES FIND ANSWERS TO QUESTIONS ABOUT LOCAL RESOURCES, SUPPORT GROUPS, FUNDING OPTIONS AND MORE. THE RESOURCE CENTER HAS COMPUTERS, A CONSULT ROOM, BUSINESS CENTER AND OTHER RESOURCES FOR FAMILIES. THEY CAN CHECK OUT ENTERTAINMENT DVDS, VIDEO GAMES, TABLETS AND LAPTOPS FOR INPATIENT USE. THE RESOURCE CENTER ALSO HAS A LENDING LIBRARY WITH BOOKS, VIDEOS AND ARTICLES ON A VARIETY OF HEALTH CONDITIONS AND TOPICS. IN 2012, THE FAMILY RESOURCE CENTER SERVED MORE THAN 22,500 VISITORS. THE HOSPITAL ALSO OPERATES A FREE GUARDIANSHIP CLINIC, WHICH PROVIDES PARENTS IN NEED WITH PRO BONO LEGAL SERVICES TO SECURE GUARDIANSHIP WHEN THEIR SPECIAL NEEDS CHILD TURNS 18.THE HOSPITAL SUPPORTS WORKFORCE DEVELOPMENT THROUGH JOB SHADOWING, WHICH MOSTLY OCCURS AT THE MILWAUKEE HOSPITAL CAMPUS. ADDITIONALLY, THE HOSPITAL CONTINUES TO PARTNER WITH EASTER SEALS ON A PROGRAM CALLED PROJECT SEARCH, AN INNOVATIVE WORKFORCE AND CAREER DEVELOPMENT MODEL FOR YOUNG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THROUGH PROJECT SEARCH, YOUNG ADULTS WITH DISABILITIES RECEIVE INTERNSHIPS WITHIN THE HOSPITAL TO GAIN ON-THE-JOB TRAINING AND OTHER CAREER DEVELOPMENT SKILLS TO SECURE COMPETITIVE EMPLOYMENT. LAST YEAR, 12 INTERNS GRADUATED FROM THE PROGRAM-TWO WERE HIRED ON AT CHILDREN'S HOSPITAL. IN THE FOX VALLEY, THE HOSPITAL AND THEDA CLARK MEDICAL CENTER PARTNERED WITH ROOSEVELT ELEMENTARY SCHOOL TO PROMOTE HEALTHY HABITS AND CIVIC RESPONSIBILITY TO STUDENTS.THE HOSPITAL'S PARENT ORGANIZATION, CHHS, ALSO PERFORMS COMMUNITY BUILDING ACTIVITIES INCLUDING COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WHICH ARE FURTHER DISCUSSED IN SCHEDULE H PART VI, LINE 6.
PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. SEE PAGES 25-26 OF THE ATTACHED FINANCIAL STATEMENTS. THE AMOUNT REPORTED IN PART III, SECTION A, LINE 2 IS THE HOSPITAL'S ACTUAL BAD DEBT EXPENSE INCLUDED AS A REDUCTION OF PATIENT REVENUE, AND IS THE SUM OF ALL OF THE UNCOLLECTED PATIENT ACCOUNT BALANCES SENT TO THIRD PARTY COLLECTIONS, REDUCED BY ACTUAL COLLECTIONS, REDUCED BY ANY ACCOUNTS RETURNED TO THE HOSPITAL BY THE THIRD PARTY COLLECTION AGENCY, AND INCREASED BY AN ESTIMATE FOR UNCOLLECTIBLE ACCOUNTS WHEN APPLICABLE. THE AMOUNT DOES NOT INCLUDE DISCOUNTS PROVIDED UNDER THE HOSPITAL'S FAP, INCLUDING DISCOUNTS PROVIDED TO SELF-PAY ACCOUNTS, WHICH ARE ALSO REPORTED AS A REDUCTION OF PATIENT REVENUE. THE AMOUNT REPORTED IN PART III, SECTION A, LINE 3 IS AN ESTIMATE BASED ON THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY BY ANALYZING PAST ACTIVITY FOR ACCOUNTS CLASSIFIED AS BAD DEBT THAT SUBSEQUENTLY QUALIFIED FOR CHARITY CARE WHEN ADDITIONAL ELIGIBILITY INFORMATION WAS RECEIVED. THE HOSPITAL DID NOT INCLUDE BAD DEBT EXPENSE AS A COMMUNITY BENEFIT IN PART III, LINE 7 OR IN THE CALCULATION OF COMMUNITY BENEFIT EXPENSES, WHERE APPLICABLE.
PART III, LINE 8: THE HOSPITAL USED ITS FILED MEDICARE COST REPORT TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED ON PART III, SECTION B. AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID SUBSTANTIALLY LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE THESE MEDICALLY NECESSARY SERVICES TO THIS POPULATION.
PART III, LINE 9B: UNDER THE HOSPITAL'S POLICIES AND PROCEDURES, THE HOSPITAL UNDERTAKES EXTENSIVE MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, THE HOSPITAL AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE MEDICAID PROGRAM. IN CASES WHERE MEDICAID COVERAGE IS NOT AVAILABLE, THE HOSPITAL SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FAP. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, HOSPITAL PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS CANNOT BE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO THE INACCESSIBILITY OF THE FAMILY, OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION; IN SUCH CASES, THE HOSPITAL FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS IN AN EFFORT TO REACH THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ACCOUNTS ARE SENT TO COLLECTIONS (AN AFFILIATED ORGANIZATION WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS) ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN WITHOUT SUCCESS.
PART V, SECTION B, LINE 11: ALTHOUGH THE HOSPITAL'S FAP LIMITS ELIGIBILITY AT 350 PERCENT OF THE FPG, THE HOSPITAL MAY PROVIDE FINANCIAL ASSISTANCE FOR FAMILIES ABOVE 350 PERCENT OF THE FPG SINCE THE HOSPITAL MAKES ADDITIONAL CONSIDERATIONS FOR THE MEDICALLY INDIGENT.	CHILDREN'S HOSPITAL OF WISCONSIN, INC.
PART V, SECTION B, LINE 11: ALTHOUGH THE HOSPITAL'S FAP LIMITS ELIGIBILITY AT 350 PERCENT OF THE FPG, THE HOSPITAL MAY PROVIDE FINANCIAL ASSISTANCE FOR FAMILIES ABOVE 350 PERCENT OF THE FPG SINCE THE HOSPITAL MAKES ADDITIONAL CONSIDERATIONS FOR THE MEDICALLY INDIGENT.	CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 14G: THE HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE CHILDREN'S FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES HAVE ACCESS TO THE FAP IN THE PATIENT HANDBOOK UPON ADMISSION. HOWEVER, THE FULL WRITTEN POLICY WAS NOT POSTED OR PROVIDED ON ADMISSION OR IN BILLING INVOICES.	CHILDREN'S HOSPITAL OF WISCONSIN, INC.
PART V, SECTION B, LINE 14G: THE HOSPITAL INFORMS THE PUBLIC OF THE AVAILABILITY OF THE CHILDREN'S FAP VIA ITS WEBSITE, BILLING INVOICES, AND AT VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL'S FACILITIES. ADDITIONALLY, PATIENT FAMILIES ARE INFORMED OF THE FAP UPON ADMISSION. HOWEVER, THE FULL WRITTEN POLICY WAS NOT POSTED OR PROVIDED ON ADMISSION OR IN BILLING INVOICES.	CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT THAT THE HOSPITAL CHARGES TO FAP-ELIGIBLE INDIVIDUALS WHO APPLY FOR FINANCIAL ASSISTANCE IS 80% OF THE HOSPITAL'S GROSS CHARGE. PATIENTS WITH FAMILY INCOME EQUAL TO 200 PERCENT OF THE FPG AND BELOW WILL RECEIVE FREE CARE WHEN THEY APPLY FOR FINANCIAL ASSISTANCE, AND A SLIDING SCALE IS USED WHEN FAMILY INCOME IS BETWEEN 200 AND 350 PERCENT OF THE FPG. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE OVERALL AVERAGE DISCOUNT GIVEN TO COMMERCIAL PAYERS.	CHILDREN'S HOSPITAL OF WISCONSIN, INC.
PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT THAT THE HOSPITAL CHARGES TO FAP-ELIGIBLE INDIVIDUALS WHO APPLY FOR FINANCIAL ASSISTANCE IS 80% OF THE HOSPITAL'S GROSS CHARGE. PATIENTS WITH FAMILY INCOME EQUAL TO 200 PERCENT OF THE FPG AND BELOW WILL RECEIVE FREE CARE WHEN THEY APPLY FOR FINANCIAL ASSISTANCE, AND A SLIDING SCALE IS USED WHEN FAMILY INCOME IS BETWEEN 200 AND 350 PERCENT OF THE FPG. TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE OVERALL AVERAGE DISCOUNT GIVEN TO COMMERCIAL PAYERS.	CHILDREN'S HOSPITAL OF WI-FOX VALLEY
PART VI, LINE 2: THE HOSPITAL, IN COLLABORATION WITH A TEAM OF OTHER HOSPITAL SYSTEMS, HEALTH CARE PROVIDERS, COMMUNITY AGENCIES, LOCAL PUBLIC HEALTH DEPARTMENTS, COMMUNITY STAKEHOLDERS AND OTHER HEALTH PROFESSIONALS, HAS DEVELOPED A COMMUNITY NEEDS ASSESSMENT SURVEY TO ASSESS THE NEEDS OF THE COMMUNITY. IN ADDITION, THE HOSPITAL USES SECONDARY DATA SUCH AS THE WISCONSIN FAMILY HEALTH SURVEY, COUNTY HEALTH RANKING REPORT AND THE WISCONSIN HEALTHIEST PEOPLE 2020 TO ASSESS THE NEEDS OF THE COMMUNITY.
PART VI, LINE 3: AS INDICATED ABOVE, THE HOSPITAL WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF WISCONSIN, AND WHERE APPROPRIATE, FEDERAL PROGRAMS. WHERE SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER THE HOSPITAL'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON THE HOSPITAL'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENTS' FAMILIES. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND THE HOSPITAL'S TRAINED FINANCIAL SERVICES COUNSELORS AND SOCIAL WORKERS. THE HOSPITAL MAKES EXTENSIVE EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED.
PART VI, LINE 4: THE HOSPITAL PROVIDES CARE TO CHILDREN FROM URBAN, RURAL, AND SUBURBAN AREAS, REGARDLESS OF RACE, GENDER, ETHNICITY, INCOME, DISABILITY, OR COUNTRY OF ORIGIN. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE PRIMARILY TO CHILDREN FROM SOUTHEASTERN WISCONSIN, BUT TREATS PATIENTS FROM THE ENTIRE STATE OF WISCONSIN, THE UPPER PENINSULA OF MICHIGAN, NORTHERN ILLINOIS, AND THROUGHOUT THE UNITED STATES. APPROXIMATELY HALF OF THE HOSPITAL'S PATIENTS ARE MEDICAID BENEFICIARIES, AND IN 2012 APPROXIMATELY HALF OF GROSS CHARGES WERE FROM PATIENTS ENROLLED IN MEDICAID.
PART VI, LINE 5: THE HOSPITAL PROMOTES THE HEALTH AND SAFETY OF CHILDREN LOCATED THROUGHOUT ITS SERVICE AREA. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. THE HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL OFFERS SPECIALTY CLINICS THAT ARE COMFORTABLE AND ACCESSIBLE TO FAMILIES. IN MILWAUKEE, THE HOSPITAL OFFERS CLINICS IN THE CENTRAL, DOWNTOWN AND SOUTHWEST PART OF THE CITY. FAMILIES MAY ALSO ACCESS SERVICES IN THE FOX VALLEY, GREEN BAY AND KENOSHA AREAS. THE HOSPITAL FUNDS SCHOOL-BASED HEALTH CENTERS IN EIGHT MILWAUKEE PUBLIC SCHOOLS. THESE CENTERS PROVIDE PREVENTATIVE CARE, PHYSICALS, IMMUNIZATIONS AND TREATMENT FOR ILLNESSES TO AREAS THAT PREVIOUSLY DID NOT HAVE PEDIATRIC PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. IN 2012, THERE WERE 17,476 SCHOOL-BASED NURSE ENCOUNTERS WHICH INCLUDED 2,206 VISION AND HEARING SCREENINGS.THE HOSPITAL SPONSORS THE DOWNTOWN HEALTH CENTER. LOCATED IN DOWNTOWN MILWAUKEE, THE MISSION OF THIS CLINIC IS TO IMPROVE HEALTH AND ADVANCE HEALTH EQUITY FOR THE MOST VULNERABLE CHILDREN IN MILWAUKEE THROUGH AN ACADEMIC PRIMARY CARE MEDICAL HOME. ON-SITE SERVICES INCLUDE ACUTE AND CHRONIC CARE, WELL-CHILD EXAMINATIONS, LABORATORY STUDIES, AND VISION AND HEARING SCREENINGS. CRIB, CAR SEAT AND BIKE HELMET DISTRIBUTION AND FITTINGS, SAFE-SLEEPING TECHNIQUES, AND GUN-LOCK EDUCATION ARE OTHER SPECIAL CLINIC ACTIVITIES THAT ARE AVAILABLE AT THIS SITE, MOSTLY FREE OF CHARGE. THE CENTER HAD APPROXIMATELY 6,300 VISITS IN 2012, AND 91 PERCENT OF THE CHILDREN SEEN WERE INSURED BY MEDICAID. ADOLESCENTS HAVE ACCESS TO SOCIAL SERVICES, CONTRACEPTIVE MANAGEMENT, FAMILY PLANNING, AND ALCOHOL AND DRUG ABUSE COUNSELING SERVICES. IN ADDITION, CHILDREN'S HOSPITAL PROVIDES SPECIALTY CARE SERVICES INCLUDING DENTAL, PSYCHOLOGICAL AND CHILD PROTECTIVE SERVICES AT THIS DOWNTOWN LOCATION. THE DOWNTOWN HEALTH CENTER ALSO OFFERS FREE LEGAL CONSULTATIONS TO FAMILIES IN COLLABORATION WITH MARQUETTE LAW SCHOOL TO HELP FAMILIES ADDRESS HOUSING, UTILITY, AND OTHER ISSUES THAT IMPACT THEIR CHILD'S HEALTH.CHILDREN'S HOSPITAL OF WISCONSIN'S EDUCATION ARM, COMMUNITY HEALTH, EDUCATES CHILDREN AND FAMILIES REGARDING A WIDE RANGE OF ISSUES IMPACTING THE HEALTH AND SAFETY OF CHILDREN. RESOURCES AND PROGRAMS ARE AVAILABLE FOR CHILDREN, PARENTS, TEACHERS, AND CAREGIVERS TO HELP KEEP WISCONSIN'S CHILDREN HEALTHY AND SAFE. ONLINE LEARNING PROGRAMS ARE A RESOURCE FOR TEACHERS TO USE IN THEIR CLASSROOMS TO DELIVER AN OUTCOMES-BASED HEALTH CURRICULUM TO STUDENTS IN GRADE K5-8. COMMUNITY HEALTH'S INJURY PREVENTION TEAM OFFERS COMMUNITY-BASED EDUCATIONAL EVENTS INCLUDING BIKE HELMET FITTINGS AND CAR SEAT CHECKS. THEY ALSO DELIVER IMPORTANT FIRE PROTECTION AND PEDESTRIAN SAFETY EDUCATION THROUGHOUT WISCONSIN. IN 2012, COMMUNITY HEALTH STAFF COMPLETED A SUCCESSFUL TOUR OF THE KOHL'S CARES: GREAT SAFETY ADVENTURE TO SCHOOLS AND COMMUNITY EVENTS THROUGHOUT EASTERN WISCONSIN. MORE THAN 20,000 KIDS AND PARENTS WERE TAUGHT HOW TO BE SAFE AT HOME. THE HOSPITAL'S CAR SEAT CLINIC IS A COLLABORATION BETWEEN THE HOSPITAL, ITS INJURY PREVENTION PROGRAM, SAFE KIDS WISCONSIN COALITION AND SAFE KIDS SOUTHEAST WISCONSIN COALITION. IT OFFERS CAR SEAT CLINICS IN TWO LOCATIONS NEAR THE MILWAUKEE HOSPITAL CAMPUS AND DOWNTOWN MILWAUKEE. TRAINED CHILD PASSENGER SAFETY TECHNICIANS MAKE CERTAIN THAT INFANT AND TODDLER CAR SEATS AND BOOSTER SEATS ARE INSTALLED CORRECTLY AND ARE APPROPRIATE FOR THE AGE AND SIZE OF THE CHILDREN USING THEM. THE PROGRAM ALSO PROVIDES LOW-COST OR FREE CAR OR BOOSTER SEATS FOR FAMILIES IN NEED.THE WISCONSIN POISON CENTER, WHICH IS STAFFED BY REGISTERED NURSES SUPPORTED BY M.D. TOXICOLOGISTS 24 HOURS A DAY, 365 DAYS A YEAR, PROVIDES IMMEDIATE AND AUTHORITATIVE PHONE CONSULTATION IN CASES OF ACCIDENTAL OR INTENTIONAL POISONING IN ADULTS AND CHILDREN FOR PATIENTS AND HOSPITALS ACROSS WISCONSIN. THE CENTER ALSO HAS A VARIETY OF PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS ALERTING PEOPLE TO SPECIFIC TOXIC DANGERS. THESE INCLUDE HOSPITAL GRAND ROUNDS LECTURES FOR PHYSICIANS, TRAINING FOR EMERGENCY MEDICAL TECHNICIANS, BABY SITTER WORKSHOPS, AND PRESCHOOL POISON PREVENTION EDUCATION. THE POISON CENTER ALSO TRIAGES CALLS FOR MPOWER, AN ALCOHOL AND DRUG CRISIS LINE FOR TEENS. PROJECT ADAM (AUTOMATIC DEFIBRILLATORS IN ADAM'S MEMORY) IS A PROGRAM OF THE HOSPITAL COMMITTED TO MAKING AUTOMATED EXTERNAL DEFIBRILLATORS UNIVERSALLY AVAILABLE TO ALL CHILDREN AND ADOLESCENTS BY BEING A NATIONAL RESOURCE FOR IMPLEMENTING PEDIATRIC PUBLIC ACCESS DEFIBRILLATION PROGRAMS IN SCHOOLS. IT IS ALSO WORKING TOWARD ERADICATING SUDDEN CARDIAC DEATH IN CHILDREN THROUGH EDUCATION AND PREVENTION INITIATIVES. SINCE IT BEGAN, THE HOSPITAL CELEBRATED 71 LIVES SAVED THROUGH PROJECT ADAM. ADDITIONALLY, THE HOSPITAL OPERATES CHILD ADVOCACY CENTERS IN MILWAUKEE, RACINE, KENOSHA, WALWORTH COUNTY, CENTRAL WISCONSIN (WAUSAU), THE FOX VALLEY, AND CHIPPEWA VALLEY (EAU CLAIRE). EACH CENTER IS A SAFE PLACE FOR KIDS WHO MAY HAVE BEEN ABUSED OR NEGLECTED. THE CENTERS BRING TOGETHER A TEAM OF SPECIALLY TRAINED PROFESSIONALS WHO EVALUATE AND INVESTIGATE CASES OF CHILD ABUSE, PROVIDE MEDICAL CARE AND HELP CHILDREN AND THEIR FAMILIES TO HEAL. THE CENTERS ARE A COLLABORATION OF THE HOSPITAL AND DOZENS OF LAW ENFORCEMENT, JUDICIAL AND LOCAL AND SOCIAL SERVICE ORGANIZATIONS.THE HOSPITAL'S SPECIAL NEEDS PROGRAM OFFERS COMPREHENSIVE CARE COORDINATION FOR CHILDREN WITH MULTIPLE MEDICAL NEEDS. THE GOAL IS TO ENSURE FAMILIES HAVE THE BEST POSSIBLE CARE IN AND OUT OF THE HOSPITAL. THE HOSPITAL PARTNERS WITH PATIENTS, FAMILIES, PRIMARY CARE AND OTHER HEALTH CARE PROVIDERS TO IMPROVE CARE COORDINATION. STAFF ALSO WORK WITH FAMILIES TO DEVELOP WRITTEN TRANSITION PLANS BASED ON NEEDS OR ISSUES THAT SHOULD BE ADDRESSED BEFORE A YOUTH IS READY TO TRANSITION TO ADULT CARE.FIGHT ASTHMA MILWAUKEE, WHICH IS LED AND SUPPORTED BY MEDICAL STAFF AT THE HOSPITAL, IS A COALITION THAT WORKS TO REDUCE AND ELIMINATE DISPARITIES IN ASTHMA CARE AND DEVELOP A SUSTAINABLE STRATEGY FOR ASTHMA CONTROL IN THE COMMUNITY. FIGHT ASTHMA MILWAUKEE PROVIDES COMMUNITY-WIDE ASTHMA EDUCATION FOR PARENTS, CAREGIVERS, HEALTH CARE PROFESSIONALS AND SCHOOL STAFF.THE INFANT DEATH CENTER ("IDC") IS A STATEWIDE PROGRAM ADMINISTERED THROUGH CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, A HOSPITAL LED AND STAFFED COALITION. THE CENTER PROVIDES INFORMATION AND SUPPORT TO WISCONSIN FAMILIES AND OTHERS AFFECTED BY THE SUDDEN AND UNEXPECTED DEATH OF AN INFANT. THE IDC STRIVES TO INCREASE HEALTHY BIRTH OUTCOMES AND REDUCE INFANT DEATHS. THE CENTER WORKS TOGETHER WITH OTHER PROFESSIONALS IN OUTREACH, EDUCATION AND INFANT MORTALITY REVIEW PROGRAMS. IN PARTNERSHIP WITH PUBLIC HEALTH SYSTEMS AND NATIONAL INFANT MORTALITY PROGRAMS, THE IDC MAINTAINS INFORMATION THAT ASSISTS IN THE STUDY AND UNDERSTANDING OF THE CAUSES OF INFANT DEATHS. THE INFORMATION IS USED FOR STATISTICAL REPORTING.IN 2010, THE HOSPITAL LAUNCHED A MULTIYEAR, SYSTEM WIDE EFFORT TO INCREASE IMMUNIZATION RATES FOR ALL CHILDREN IN THE HOSPITAL'S SERVICE AREA. THIS INITIATIVE IS KEY TO ACHIEVING THE HEALTH SYSTEM'S VISION OF HELPING WISCONSIN'S CHILDREN TO BE THE HEALTHIEST IN THE NATION. THE HOSPITAL PARTNERS WITH THE LOCAL HEALTH DEPARTMENTS AS WELL AS COMMUNITY INITIATIVES TO ENHANCE ITS PROGRAM IMPROVEMENT EFFORTS AND TO LEARN FROM AND CONTRIBUTE TO COMMUNITY EFFORTS. ADDITIONALY, THE HOSPITAL WORKS WITH THE STATE OF WISCONSIN TO RECEIVE ITS PERFORMANCE DATA FROM THE WISCONSIN IMMUNIZATION REGISTRY. DATA SHOW AN INCREASE IN PERCENT IMMUNIZATION COMPLIANCE FOR CHILDREN'S FOR EACH OF THE THREE YEARS OF THE INITIATIVE SO FAR. LAST YEAR, MORE THAN 225 DOSES OF VACCINES WERE ADMINISTERED AT CHILDREN'S IMMUNIZATION CLINIC, A PARTNERSHIP BETWEEN THE HOSPITAL AND THE CITY OF MILWAUKEE HEALTH DEPARTMENT. IN 2012, THE HOSPITAL ALSO FOCUSED ON EDUCATING ALL WHO CARE FOR CHILDREN ABOUT SAFE INFANT SLEEP PRACTICES. THIS MULTIYEAR INITIATIVE FOCUSES ON REDUCING THE RISK FACTORS FOR SUDDEN INFANT DEATH SYNDROME AND OTHER SLEEP-RELATED DEATHS IN CHILDREN UNDER AGE 1. DOOR HANGERS WERE CREATED TO EDUCATE AND REMIND CAREGIVERS ABOUT THE ABC'S OF SAFE INFANT SLEEP. (CONTINUED ON PAGE 59).
PART VI, LINE 6: THE HOSPITAL IS PART OF AN AFFILIATED GROUP OF ORGANIZATIONS UNDER THE CONTROL OF CHHS, WHICH PROVIDES VARIOUS CENTRALIZED ADMINISTRATIVE AND SUPPORTING SERVICES FOR THE HOSPITAL AND ITS AFFILIATES. AMONG THE AFFILIATED ENTITIES, THE HOSPITAL AND CERTAIN OTHER ENTITIES (INCLUDING CHILDREN'S MEDICAL GROUP, INC. AND CHILDREN'S PHYSICIAN GROUP, P.C.) DIRECTLY PROVIDE INSTITUTIONAL AND PROFESSIONAL PEDIATRIC HEALTHCARE SERVICES IN A VARIETY OF ACCESSIBLE LOCATIONS THROUGHOUT WISCONSIN AND NORTHERN ILLINOIS. ANOTHER HOSPITAL AFFILIATE IS CHILDREN'S SERVICE SOCIETY OF WISCONSIN ("CSSW"). THIS SOCIAL SERVICE ORGANIZATION ADDRESSES THE CHALLENGES FACED BY CHILDREN, WHICH OFTEN DIRECTLY IMPACT THEIR PHYSICAL AND MENTAL HEALTH AND WELLBEING. CSSW OFFERS CHILD WELFARE SERVICES IN FOUR CORE AREAS (PUBLIC CHILD WELFARE, CHILD AND FAMILY COUNSELING, OUT-OF-HOME CARE AND PREVENTION SERVICES) FROM LOCATIONS THROUGHOUT WISCONSIN. SERVICES INCLUDE: FINDING LOVING, STABLE HOMES FOR CHILDREN IN NEED OF A FAMILY THROUGH FOSTER CARE AND ADOPTION; REDUCING STRESS AND CONFLICT, ENHANCING PARENTING SKILLS AND STRENGTHENING FAMILY TIES THROUGH TRAUMA-INFORMED MENTAL HEALTH SERVICES COUNSELING; PROVIDING SERVICES TO CHILDREN IN OUT-OF-HOME CARE, ADVOCATING FOR THEIR SAFETY, WELL-BEING AND TIMELY REUNIFICATION WITH BIRTHPARENTS WHENEVER POSSIBLE; PROVIDING FOSTER PARENTS WHO ARE CARING FOR CHILDREN WITH SPECIAL MEDICAL OR EMOTIONAL NEEDS WITH A MUCH NEEDED BREAK THROUGH OUR RESPITE CARE PROGRAM; OFFERING FREE, CONFIDENTIAL AND SUPPORTIVE GUIDANCE TO HELP PARENTS DEALING WITH AN UNPLANNED PREGNANCY; PROVIDING INTENSIVE IN-HOME THERAPY TO KEEP CHILDREN SAFE IN THEIR HOMES AND PREVENT OUT-OF-HOME PLACEMENT; ASSISTING YOUNG ADULTS TRANSITIONING OUT OF FOSTER CARE BY GIVING THEM THE SKILLS, TRAINING, GUIDANCE AND SUPPORT ENABLING THEM TO MAKE IT ON THEIR OWN; PROVIDING PARENTS WITH SUPPORT AND GUIDANCE TO HELP THEM BE THE BEST PARENTS THEY CAN BE; AND PROVIDING CHILDREN WHO HAVE BEEN HARMED OR HURT A SAFE PLACE TO GO TO BE INTERVIEWED AND PROVIDING THEM RESOURCES TO HELP THEM HEAL.CSSW ALSO RUNS PROJECT UJIMA, A PROGRAM THAT PROVIDES CASE MANAGEMENT, EMOTIONAL SUPPORT AND RESOURCES TO FAMILIES WHOSE CHILDREN HAVE EXPERIENCED INTERPERSONAL COMMUNITY-BASED VIOLENCE OR WHO HAVE LOST A FAMILY MEMBER (OF ANY AGE) TO HOMICIDE IN MILWAUKEE COUNTY.CHHS HAS TWO KEY PROGRAMS TO PROMOTE HIGH QUALITY CARE. CHILDREN'S RESEARCH INSTITUTE CARRIES ON RESEARCH INITIATIVES AIMED AT IMPROVING THE DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH CONDITIONS, AND THE NATIONAL OUTCOMES CENTER GATHERS AND PUBLICIZES DATA TO ASSIST PEDIATRIC HEALTHCARE PROVIDERS IN IDENTIFYING THE MOST EFFECTIVE TREATMENT METHODS. CHHS PERFORMS COMMUNITY HEALTH IMPROVEMENT ADVOCACY ON BEHALF OF THE HOSPITAL AND ITS AFFILIATES. IN 2012, CHHS ACTIVELY ADVOCATED BEFORE THE STATE LEGISLATURE FOR ADEQUATE COVERAGE AND ACCESS TO HEALTH SERVICES FOR PREGNANT WOMEN AND CHILDREN AND WAS SUCCESSFUL IN SECURING STATE FUNDING FOR THE STATE'S MEDICAID PROGRAM AND MAINTAINING PROGRAM ELIGIBILITY. CHHS ALSO LED THE ADVOCACY FOR THE SUCCESSFUL PASSAGE OF YOUTH SPORTS CONCUSSION LEGISLATION, WHICH NOW ENSURES THAT ALL YOUTH PLAYING SCHOOL AND CLUB SPORTS WILL BE EDUCATED ABOUT CONCUSSIONS AND THAT SAFE CRITERIA ARE IN PLACE FOR REMOVAL FROM AND RETURN TO PLAY. IN ADDITION, CHHS CHAMPIONED EFFORTS TO PARTNER WITH THE STATE IN THE FUNDING OF A FAMILY JUSTICE CENTER WHICH WILL SERVE WOMEN AND CHILDREN WHO ARE VICTIMS OF DOMESTIC VIOLENCE. CHHS ALSO PARTNERED WITH OTHER ORGANIZATIONS TO EDUCATE POLICY MAKERS AND THE PUBLIC ABOUT THE IMPORTANCE OF PULSE OXIMETRY SCREENING FOR ALL NEWBORNS IN WISCONSIN AND TO FIGHT EFFORTS TO LEGALIZE RAW (UNPASTEURIZED) MILK. ON THE FEDERAL LEVEL, CHHS ADVOCATED TO PROTECT MEDICAID PROGRAMS AND EDUCATED OUR DELEGATION ABOUT THE IMPORTANCE OF ACCESS AND COVERAGE OF MEDICAL SERVICES FOR PREGNANT WOMEN AND CHILDREN. CHHS ALSO ADVOCATED FOR AND EDUCATED CONGRESSIONAL MEMBERS ABOUT THE IMPORTANCE OF TRAINING FOR PEDIATRIC PHYSICIANS AND PEDIATRIC SPECIALISTS.IN ADDITION TO ADVOCACY, CHHS'S COMMUNITY SERVICES DIVISION HAS INITIATED A COMMUNITY-BASED EFFORT TO IMPROVE CHILD HEALTH THAT ACKNOWLEDGES THE INFLUENCE OF SOCIAL, CULTURAL AND ENVIRONMENTAL FACTORS ON HEALTH AND RECOGNIZES THAT SUCH INFLUENCES MAY HAVE PARTICULARLY DELETERIOUS EFFECTS WHEN THEY OCCUR DURING CRITICAL PERIODS OVER ONE'S LIFE COURSE. CHHS IS BRINGING THE FULL SPECTRUM OF THE SYSTEM'S RESOURCES TO BEAR IN THE COMMUNITY ENGAGEMENT EFFORT. BY CONNECTING OUR VAST CLINICAL AND COMMUNITY-BASED RESOURCES - SCHOOL NURSES, COMMUNITY PEDIATRICIANS, SOCIAL WORKERS, HEALTH EDUCATORS, FOSTER CARE PARENTS, HOSPITALISTS, EMERGENCY DEPARTMENT STAFF, RESEARCHERS AND POLICY MAKERS - CHHS IS FACILITATING COMMUNITY HEALTH IMPROVEMENT BOTH DIRECTLY (E.G. EXPANDING MENTAL HEALTH AND DENTAL CARE IN UNDERSERVED AREAS), AND INDIRECTLY (E.G. BRINGING LAW ENFORCEMENT TO THE COMMUNITY CONVERSATION RE: CRIME REDUCTION; SUPPORTING POLICY CHANGES AT THE LOCAL, STATE AND NATIONAL LEVELS THAT HAVE AN IMPACT ON CHILD HEALTH). AS A PARTNER AND FACILITATOR, CHHS'S STAFF HAS ENCOURAGED LEADERS FROM THE PRIORITY COMMUNITIES TO IDENTIFY KEY AREAS FOR STRATEGIC INTERVENTION. AS A RESULT OF SEVERAL FACILITATED LISTENING SESSIONS, TWO OF THE THREE COMMUNITIES HAVE ARTICULATED HEALTH AS A KEY AREA FOR STRATEGIC INTERVENTION AND THE COMMUNITIES NOW ARE IDENTIFYING SPECIFIC CATEGORIES WITHIN THE LARGER RUBRIC OF "HEALTH" ON WHICH TO CONCENTRATE IMPROVEMENT EFFORTS. CHHS HAS SELECTED THREE NEIGHBORHOODS FOR INITIAL ENGAGEMENT EFFORTS. THESE NEIGHBORHOODS - METCALFE PARK, FRANKLIN HEIGHTS/AMANI NEIGHBORHOOD AND LINDSAY HEIGHTS - WERE IDENTIFIED BECAUSE THEY HAD A HIGH CONCENTRATION OF PEDIATRIC-AGED RESIDENTS; THERE WERE SIGNIFICANT, BUT MODIFIABLE, CHALLENGES TO CHILD HEALTH OUTCOMES; AND THEY HAD EXISTING TRUSTED COMMUNITY RESOURCES THAT WERE WILLING TO PARTNER WITH CHHS TO ENGAGE THE COMMUNITY IN NEW WAYS TO IMPROVE CHILD HEALTH OUTCOMES. ONE STRATEGY BEING IMPLEMENTED IS USING COMMUNITY "NAVIGATORS" - TRUSTED LOCAL RESIDENTS WHO EDUCATE NEIGHBORS ABOUT A SPECIFIC BEHAVIOR CHANGE OR RESOURCE UTILIZATION THAT WILL RESULT IN IMPROVED HEALTH OUTCOMES. CHHS'S FOCUS IS TO HAVE RELEVANT, ACCURATE, RESIDENT-LEVEL INFORMATION REGARDING TRUSTED SOURCES OF INFORMATION AND DIRECT INFLUENCES ON RESIDENT'S BEHAVIORS. CHHS IS PARTNERING WITH THE COMPREHENSIVE CENTER OF EXCELLENCE FOR HEALTH EQUITY IN WISCONSIN TO UTILIZE COMMUNITY-MAPPED "WAYS OF KNOWING" TO BEST UNDERSTAND DIRECT INFLUENCES ON HEALTH BEHAVIORS IN THE SELECTED COMMUNITIES. THE COMMUNITY NAVIGATORS ARE WORKING COLLABORATIVELY WITH THE CENTER'S COMMUNITY HEALTH EDUCATOR TO FOSTER KEY RELATIONSHIPS WITHIN THE COMMUNITY. CHHS WILL FACILITATE THE DEVELOPMENT OF CULTURALLY AND LINGUISTICALLY APPROPRIATE EDUCATIONAL MATERIALS FOR THE COMMUNITY NAVIGATORS AND WILL LEAD THE TRAINING OF BOTH THE COMMUNITY NAVIGATORS AND THE CENTER'S COMMUNITY HEALTH EDUCATOR. THIS COORDINATED APPROACH WILL ALLOW CHHS AND THE CENTER TO FACILITATE EFFECTIVE COMMUNITY TRANSFORMATION THAT IS RESPECTFUL OF THE LOCAL CULTURE. IN ADDITION, THE COLLABORATION ALLOWS FOR COMMUNITY-LED MEASUREMENT OF IDENTIFIED OUTCOMES - FACILITATING COMMUNITY EMPOWERMENT AND CONTRIBUTING TO SUSTAINABLE CHANGES.THESE AFFILIATED PROGRAMS AND ACTIVITIES SEEK TO ENSURE THAT CHILDREN HAVE ACCESS TO HIGH-QUALITY HEALTH AND SOCIAL SERVICES.PART VI, LINE 7: CHHS, THE SOLE CORPORATE MEMBER OF THE HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF THE HOSPITAL AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE OR UPON REQUEST.
MORE THAN 10,000 HANGERS WERE DISTRIBUTED AT COMMUNITY EVENTS. WINDOW CLINGS ALSO WERE CREATED AND DISPLAYED IN PATIENT ROOMS AT THE HOSPITAL. SAFE SLEEP MESSAGES WERE PRINTED IN ENGLISH AND SPANISH. THE HOSPITAL ALSO PARTNERED WITH THE MILWAUKEE ADMIRALS HOCKEY TEAM TO PRODUCE A VIDEO HIGHLIGHTING THE ABCS OF SAFE SLEEP. IT WAS PLAYED ON THE JUMBOTRON DURING ADMIRALS GAMES FOR MOST OF THE SEASON.	DESCRIPTION OF COMMUNITY HEALTH PROMOTION-CONTINUED	SCHEDULE H, PART VI, LINE 5

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (38 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AMERICAN FAMILY CHILDREN'S HOSPITAL
600 HIGHLAND AVENUE	MADISON	WI	53792	391835630	501(C)(3)	5000	ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE
BAYFIELD COUNTY PUBLIC HEALTH DEPARTMENT
117 E 5TH STREET	WASHBURN	WI	54891	396005670	BAYFIELD COUNTY	9972	DENTAL SEALANT EXPANSION GRANT
BROWN COUNTY ORAL HEALTH PARTNERSHIP
331 N BROADWAY	GREEN BAY	WI	54303	208969896	501(C)(3)	26957	DENTAL SEALANT EXPANSION GRANT
CHIPPEWA COUNTY HEALTH DEPARTMENT
711 N BRIDGE ST ROOM 121	CHIPPEWA FALLS	WI	54729	396005678	CHIPPEWA COUNTY	6523	ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE
CITY OF WEST ALLIS
11301 W LINCOLN AVE	WEST ALLIS	WI	53227	396005651	CITY OF WEST ALLIS	5000	ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE
CLARK COUNTY HEALTH DEPARTMENT
517 COURT STREET	NEILLSVILLE	WI	54456	396005679	CLARK COUNTY	3431	DENTAL SEALANT GRANT
CLARK COUNTY HEALTH DEPARTMENT
517 COURT STREET	NEILLSVILLE	WI	54456	396005679	CLARK COUNTY	2411	DENTAL SEALANT EXPANSION GRANT
COLUMBIA COUNTY
PO BOX 132	PORTAGE	WI	53901	396005681	COLUMBIA COUNTY	18078	DENTAL SEALANT EXPANSION GRANT
COLUMBIA ST MARY'S FOUNDATION
2320 N LAKE DRIVE	MILWAUKEE	WI	53211	391494981	501(C)(3)	51250	DENTAL SEALANT GRANT
FOND DU LAC SCHOOL DISTRICT
72 W 9TH STREET	FOND DU LAC	WI	54935	391411371	501(C)(3)	5000	ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE
IN HEALTH COMMUNITY WELLNESS FREE CLINIC
109 E BLUFF STREET	BOSCOBEL	WI	53805	331170597	501(C)(3)	5538	DENTAL SEALANT EXPANSION GRANT
JUST KIDS DENTAL
PO BOX 146	TWO HARBORS	MN	55616	272311353	501(C)(3)	10539	DENTAL SEALANT GRANT
KENOSHA COMMUNITY CENTER
625 57TH STE 700	KENOSHA	WI	53140	391789874	KENOSHA COUNTY	40998	DENTAL SEALANT GRANT
KENOSHA COMMUNITY CENTER
625 57TH STE 700	KENOSHA	WI	53140	391789874	KENOSHA COUNTY	9002	DENTAL SEALANT EXPANSION GRANT
MARATHON COUNTY
1000 LAKE VIEW DRIVE RM 100	WAUSAU	WI	54403	396005716	MARATHON COUNTY	5000	ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE
MARQUETTE UNIVERSITY
PO BOX 1881	MILWAUKEE	WI	53201	390806251	501(C)(3)	8792	DENTAL SEALANT GRANT
MARQUETTE UNIVERSITY
PO BOX 1881	MILWAUKEE	WI	53201	390806251	501(C)(3)	48703	DENTAL SEALANT EXPANSION GRANT
PORTAGE COUNTY HEALTH & HUMAN SERVICES
817 WHITING AVENUE	STEVENS POINT	WI	54481	396005731	PORTAGE COUNTY	18818	DENTAL SEALANT GRANT
PORTAGE COUNTY HEALTH & HUMAN SERVICES
817 WHITING AVENUE	STEVENS POINT	WI	54481	396005731	PORTAGE COUNTY	6986	DENTAL SEALANT EXPANSION GRANT
PRICE COUNTY HEALTH DEPARTMENT
104 S EYDER AVENUE	PHILLIPS	WI	54555	396005733	PRICE COUNTY	26415	DENTAL SEALANT EXPANSION GRANT
PROFESSIONAL DENTAL HYGIENE EXPRESS
5388 STATE HWY 64	BLOOMER	WI	54724	274969600		25000	DENTAL SEALANT GRANT
PROFESSIONAL DENTAL HYGIENE EXPRESS
5388 STATE HWY 64	BLOOMER	WI	54724	274969600		20238	DENTAL SEALANT EXPANSION GRANT
RICHLAND COUNTY
221 W SEMINARY	RICHLAND CENTER	WI	53581	396005735	RICHLAND COUNTY	3990	DENTAL SEALANT GRANT
RICHLAND COUNTY
221 W SEMINARY	RICHLAND CENTER	WI	53581	396005735	RICHLAND COUNTY	13810	DENTAL SEALANT EXPANSION GRANT
SCENIC BLUFFS COMMUNITY HEALTH CENTER
268 FRONT STREET	CASHTON	WI	54619	391760445	501(C)(3)	7153	DENTAL SEALANT EXPANSION GRANT
SHAWANO COUNTY HEALTH DEPARTMENT
311 N MAIN ST RM 7	SHAWANO	WI	54166	396005743	SHAWANO COUNTY	2455	DENTAL SEALANT GRANT
SHAWANO COUNTY HEALTH DEPARTMENT
311 N MAIN ST RM 7	SHAWANO	WI	54166	396005743	SHAWANO COUNTY	3065	DENTAL SEALANT EXPANSION GRANT
SMILES 4 LIFE
W286 N991 SHEPHERDS WAY	WAUKESHA	WI	53188	454063576	501(C)(3)	9900	DENTAL SEALANT EXPANSION GRANT
TREMPEALEAU COUNTY HUMAN SERVICES
36245 MAIN STREET	WHITEHALL	WI	54773	396005747	TREMPEALEAU COUNTY	12845	DENTAL SEALANT EXPANSION GRANT
VILAS COUNTY HEALTH DEPARTMENT
330 COURT STREET	EAGLE RIVER	WI	54521	396005751	VILAS COUNTY	26434	DENTAL SEALANT EXPANSION GRANT
WALWORTH COUNTY
W4051 COUNTY ROAD NN	ELKHORN	WI	53121	396005752	WALWORTH COUNTY	60895	DENTAL SEALANT EXPANSION GRANT
WAUKESHA COUNTY COMMUNITY DENTAL CENTER
210 NW BARSTOW STREET 305	WAUKESHA	WI	53188	391355301	WAUKESHA COUNTY	7521	DENTAL SEALANT EXPANSION GRANT
WAUSHARA COUNTY HEALTH DEPARTMENT
PO BOX 837	WAUTOMA	WI	54982	396005759	WAUSHARA COUNTY	5459	DENTAL SEALANT EXPANSION GRANT
WOOD COUNTY HEALTH DEPARTMENT
400 MARKET STREET	WISCONSIN RAPIDS	WI	54494	396005763	WOOD COUNTY	12910	DENTAL SEALANT GRANT
WOOD COUNTY HEALTH DEPARTMENT
400 MARKET STREET	WISCONSIN RAPIDS	WI	54494	396005763	WOOD COUNTY	19001	DENTAL SEALANT EXPANSION GRANT
CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC
9000 W WISCONSIN AVE PO BOX 1997	MILWAUKEE	WI	53201	391500074	501(C)(3)	9136944	RESEARCH, HEALTH EDUCATION, AND OTHER GRANTS TO AFFILIATE
CHILDREN'S PHYSICIAN GROUP PC
9000 W WISCONSIN AVE PO BOX 1997	MILWAUKEE	WI	53201	364303682	501(C)(3)	2500000	GRANTS TO AFFILIATE
CHILDREN'S MEDICAL GROUP INC
9000 W WISCONSIN AVE PO BOX 1997	MILWAUKEE	WI	53201	391789197	501(C)(3)	375000	GRANTS TO AFFILIATE

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	26	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: MONITORING PROCEDURES - THE ORGANIZATION RECEIVES GRANT FUNDING FROM VARIOUS STATE AND FEDERAL AGENCIES. SOME OF THE GRANT AWARDS ARE SUB-AWARDED TO OTHER AGENCIES BASED ON THE REQUIREMENTS OF THE INDIVIDUAL GRANT AGREEMENTS. IN ORDER TO MONITOR THE USE OF THE FUNDS, THE ORGANIZATION ENTERS INTO SIGNED AGREEMENTS WITH THE SUB-GRANTEE AGENCIES TO OUTLINE THE TERMS OF THE ARRANGEMENTS INCLUDING THE PROPER USE OF FUNDS. THESE AGREEMENTS REQUIRE AGENCIES TO PROVIDE CERTIFICATIONS OF EXPENSES SUBMITTED FOR REIMBURSEMENT ALONG WITH DESCRIPTIONS OF THE ACTUAL EXPENSES INCURRED COMPARED TO THE BUDGETED AWARD TOTAL. EACH AWARD IS MONITORED BY A DESIGNATED EMPLOYEE OF THE ORGANIZATION WHO VERIFIES THAT ALL SERVICES ARE PROVIDED ACCORDING TO THE CONTRACT, APPROVES PAYMENTS TO THE AGENCY, AND ENSURES THAT THE AWARD OBJECTIVES ARE MET. IN SOME CASES, THE ORGANIZATION REQUIRES THE AGENCY TO SUBMIT A COPY OF ITS ANNUAL OMB 133 AUDIT ALONG WITH ANY RELEVANT AUDIT FINDINGS. ADDITIONALLY, CHW 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (21 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARGARET TROY
DIRECTOR / CHHS PRESIDENT	0	759976	0	376671	0	126977	0	259150	0	31918	0	1554692	0	50833
MARC CADIEUX
INTERIM TREASURER (JAN 2012)	0	189232	0	34000	0	15679	0	15814	0	6706	0	261431	0	0
CINTHIA S CHRISTENSEN
PRESIDENT & COO	424640	0	152683	0	101778	0	65020	0	27854	0	771975	0	33569	0
WELDON GAGE
TREASURER / CFO	0	336629	0	25000	0	457	0	51785	0	18387	0	432258	0	0
MICHAEL GUTZEIT MD
VP, CHW / CHIEF MEDICAL OFFICER	293944	0	98893	0	82649	0	53030	0	27188	0	555704	0	24709	0
BARBARA JOERS
VICE PRESIDENT, CHW	197229	0	62672	0	17472	0	8500	0	20506	0	306379	0	0	0
JULIET KERSTEN
VICE PRESIDENT, CHW	212342	0	67842	0	14019	0	18500	0	21343	0	334046	0	13331	0
NANCY KOROM
VP, CHW / CHIEF NURSING OFFICER	284040	0	83844	0	63175	0	49010	0	23909	0	503978	0	23511	0
SHEILA REYNOLDS
SECRETARY	0	259682	0	78354	0	50992	0	48690	0	27695	0	465413	0	18023
MARK SHIP
VP REVENUE CYCLE	32876	186798	0	77404	163	20967	0	16000	3548	18028	36587	319197	0	18414
DONNA JAMIESON
EXECUTIVE DIR, PATIENT CARE	171010	0	1000	0	864	0	14591	0	33727	0	221192	0	0	0
TOM LAUSTEN
DIRECTOR, PHARMACY SVS	155010	0	1000	0	10310	0	13519	0	22780	0	202619	0	0	0
ERIN YALE
DIR, DIAG IMAGING & EMERGENCY	158985	0	2000	0	6949	0	7088	0	22782	0	197804	0	0	0
SUZAN BUCHAKLIAN
DIR, SURGICAL SERVICES	150215	0	0	0	2110	0	6315	0	21037	0	179677	0	0	0
LORI BARBEAU DDS
MEDICAL DIRECTOR DENTAL PROGRAM	243324	0	0	0	25293	0	21000	0	23296	0	312913	0	0	0
ANDREW SCHMITT MD
HOSPITALIST	241970	0	0	0	8538	0	7500	0	25146	0	283154	0	0	0
MARYLYN RANTA MD
DIR, CHW PHYSICIAN AFFAIRS	218838	0	500	0	19280	0	20808	0	27724	0	287150	0	0	0
SHANE FISHER DDS
PEDIATRIC DENTIST	203777	0	0	0	29706	0	12315	0	14829	0	260627	0	0	0
A CHARLES POST DDS
PROGRAM ADMIN DENTAL RESIDENCY	193987	0	0	0	41112	0	20044	0	8302	0	263445	0	0	0
TIMOTHY L BIRKENSTOCK
FORMER TREASURER	0	0	0	0	0	232256	0	0	0	1866	0	234122	0	0
RAMESH SACHDEVA MD
FORMER CHHS VP (JAN - JUN 2012)	0	168842	0	84377	0	21132	0	0	0	10232	0	284583	0	20257

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 3	CHW AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE CORPORATE MEMBER OF CHW, SHARE A BOARD OF DIRECTORS WHICH INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE. THIS COMMITTEE IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF CHW'S PRESIDENT, AND USED THE METHODS LISTED AND CHECKED IN SCHEDULE J LINE 3.
PART I, LINES 4A-B	UNTIL MARCH 2011, TIMOTHY BIRKENSTOCK SERVED AS TREASURER & CFO OF CHHS. BY VIRTUE OF THAT ROLE, MR. BIRKENSTOCK SERVED AS THE TREASURER OF CHW UNTIL HIS SEPARATION FROM CHHS IN 2011. CHHS PAID CERTAIN AMOUNTS AS SEVERANCE TO MR. BIRKENSTOCK PURSUANT TO A WRITTEN AGREEMENT. CASH PAYMENTS MADE TO MR. BIRKENSTOCK IN 2012 TOTALED $234,122. PART I, LINE 4B: IN 2012, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 7% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2012 WERE AS FOLLOWS: M. TROY, $54,180; C. CHRISTENSEN, $44,020; W. GAGE, $43,852; M. GUTZEIT, M.D., $32,030; N. KOROM, $29,010; AND S. REYNOLDS, $30,190. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2012 WERE: M. TROY, $50,833; C. CHRISTENSEN, $33,569; M. GUTZEIT, M.D., $24,709; J. KERSTEN, $13,331; N. KOROM, $23,511; S. REYNOLDS, $18,023; M. SHIP, $18,414; AND R. SACHDEVA, M.D. $20,257. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT AND CEO. THE AMOUNT SET ASIDE IN 2012 WAS $191,470.
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.
PART III	FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. MARGARET TROY, PRESIDENT & CEO OF CHHS, ELIZABETH BEDWELL, VP RESEARCH ADMINISTRATION, MARC CADIEUX, INTERIM TREASURER OF CHW (JANUARY 2012) AND INTERIM TREASURER & CFO OF CHHS (JANUARY 2012), WELDON GAGE, TREASURER OF CHW AND TREASURER & CFO OF CHHS, SHEILA REYNOLDS, SECRETARY OF CHW AND CORPORATE VICE PRESIDENT & GENERAL COUNSEL OF CHHS, AND MARK SHIP, VP REVENUE CYCLE - 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 CHW WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 2. RAMESH SACHDEVA, M.D., CHHS VP AND CHIEF QUALITY OFFICER 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. DR. SACHDEVA IS LISTED AS A FORMER OFFICER OF CHW AS HE PREVIOUSLY SERVED AS VICE PRESIDENT OF QUALITY & OUTCOMES PRIOR TO HIS TRANSFER TO CHHS. 3. TIMOTHY L. BIRKENSTOCK, FORMER TREASURER OF CHW AND FORMER TREASURER & CFO OF CHHS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID BY CHHS AS SEVERANCE FOR PREVIOUS SERVICES PROVIDED AS TREASURER & CFO OF CHHS.	SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY
A	391337855	97710BCS9	2008-07-29	152300000	SEE PART VI	0	0	0
WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY
B	391337855	97710BCC4	2008-06-25	100771610	SEE PART VI	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceeds	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	152300953	149225000	1000301	2075652	2009	1	0	1	1
B	113903904	100000000	771610	13132293	2009	1	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Engage Bond Counsel ContractsEngageBondCounselContracts	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	1	1	1	0	0.00300	0.00100	0.00400	1	0	1
B	0	0	1	1	0	0.00000	0.00000	0.00000	1	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
A	0	0	1	0	0	0	0	0	1
B	0	0	1	0	0	0	0	0	1

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	0
B	0

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	SCHEDULE K SUPPLENTAL INFORMATION	Identifier
Explanation	CONSIDER THE FOLLOWING FOR PART VI: SCHEDULE K, PART I, LINE A, COLUMN (F): THE SERIES 2008B BONDS WERE ISSUED TO REFUND SEVERAL SERIES OF PRIOR BONDS, INCLUDING: (1) THE ISSUER'S SERIES 2007-3 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON NOVEMBER 20, 2007 TO REFUND A PORTION OF THE ISSUER'S SERIES 1998 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON JUNE 2, 1998. (2) THE ISSUER'S SERIES 2004B BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON MAY 6, 2004 TO CONSTRUCT AND EQUIP CERTAIN HEALTH CARE FACILITIES (INCLUDING A MEDICAL OFFICE BUILDING/CHILDREN'S CORPORATE CENTER, PARKING STRUCTURE, TUNNEL, UTILITIES AND A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. THE SERIES 2008 BONDS ALSO FUNDED CONSTRUCTION, RENOVATION AND EQUIPPING OF CERTAIN HEALTH CARE FACILITIES (A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. SCHEDULE K, PART I, LINE B, COLUMN (F): THE SERIES 2008A BONDS WERE ISSUED TO REFUND THE ISSUER'S SERIES 2007-1 AND SERIES 2007-2 BONDS (CHILDREN'S HOSPITAL OF WISCONSIN), WHICH WERE ISSUED ON NOVEMBER 20, 2007 FOR THE CONSTRUCTION, RENOVATION AND EQUIPPING OF CERTAIN HEALTH CARE FACILITIES (A NEW PATIENT TOWER) AND TO PAY COSTS OF ISSUANCE. SCHEDULE K, PART II, LINE 3, COLUMN (A): THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO INVESTMENT PROCEEDS OF $953. SCHEDULE K, PART II, LINE 3, COLUMN (B): THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO INVESTMENT PROCEEDS OF $48,153 AND TRANSFERRED PROCEEDS FROM THE SERIES 2007-1 AND SERIES 2007-2 BONDS OF $13,084,140. SCHEDULE K, PART III, COLUMN B, LINE 3A: THE ORGANIZATION HAS DETERMINED BASED ON A LEGAL REVIEW THAT A MANAGEMENT CONTRACT WITH RESPECT TO THE PROPERTY FINANCED BY THE BOND ISSUE LISTED IN COLUMN B DOES NOT RESULT IN PRIVATE BUSINESS USE.	Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

Field	Value	IRS element (for citing)
Name Person	SUZAN BUCHAKLIAN	NamePerson
Relationship With Organization	KEY EMPLOYEE	RelationshipWithOrganization
Purpose Of Loan	RECRUITMENT INCENTIVE APPROVED BY SENIOR LEADERSHIP	PurposeOfLoan
Loan From Organization	X	LoanFromOrganization
Original Principal	$10,000	OriginalPrincipalAmount
Balance Due	10000	BalanceDue
Default	0	Default
Approved By Board	0	ApprovedByBoard
Written Agreement	1	WrittenAgreement

Field	Value	IRS element (for citing)
Total Balance Due	10000	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
JOHNSON CONTROLS INC
DIRECTOR (CD MYERS)	464870	MR. MYERS IS VICE PRESIDENT AND PRESIDENT, BUILDING EFFICIENCY AT JOHNSON CONTROLS, INC. THE ORGANIZATION PAID $464,870 TO JOHNSON CONTROLS, INC. IN MAINTENANCE FEES FOR HEATING, VENTILATION, AND AIR CONDITIONING INSTALLATION AND REPAIR.	0
HUMANA
DIRECTOR (L RAMBO)	675197	MR. RAMBO WAS THE SENIOR EXECUTIVE FOR STRATEGIC PARTNERSHIIPS OF HUMANA, INC. THE ORGANIZATION PAID HUMANA FOR THIRD PARTY ADMINISTRATOR SERVICES FOR ITS SELF-INSURED HEALTH PLAN IN THE AMOUNT OF $675,197.	0
HUMANA
DIRECTOR (L RAMBO)	28861515	MR. RAMBO WAS THE SENIOR EXECUTIVE FOR STRATEGIC PARTNERSHIPS OF HUMANA, INC. THE ORGANIZATION RECEIVED APPROXIMATELY $28,861,515 FROM HUMANA FOR HEALTH CARE SERVICES PROVIDED TO HUMANA ENROLLEES.	0
BAIRD ADVISORS
DIRECTOR (T BOLGER)	276606	MR. BOLGER, WHO IS ON THE ORGANIZATION'S BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH MARY ELLEN STANEK, THE MANAGING DIRECTOR AND CHIEF INVESTMENT OFFICER FOR BAIRD ADVISORS. THE ORGANIZATION PAID BAIRD ADVISORS $276,606 FOR INVESTMENT SERVICES.	0
WE ENERGIES
DIRECTOR (C CULVER)	6354821	MR. CULVER IS ON THE BOARD OF DIRECTORS AT WE ENERGIES. THE ORGANIZATION PAID WE ENERGIES $6,354,821 FOR UTILITIES.	0
UNIVERSITY OF WISCONSIN-MILWAUKEE
DIRECTOR (D GILBERT)	165716	MR. GILBERT IS PRESIDENT OF THE UNIVERSITY OF WISCONSIN-MILWAUKEE FOUNDATION, WHICH IS PART OF THE UNIVERSITY OF WISCONSIN-MILWAUKEE SYSTEM. THE ORGANIZATION PAID $165,716 TO THE UNIVERSITY OF WISCONSIN-MILWAUKEE FOUNDATION FOR EDUCATIONAL PROGRAMS.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: 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, PEPKE AND ALTSCHAEFL, MANSELL AND SOMMERHAUSER, ABRAHAM AND QUADRACCI, HERMA AND SOMMERHAUSER, WITT AND SOMMERHAUSER, KERSCHNER AND BRENNER, KERSCHNER AND CULVER, KERSCHNER AND MELLOWES, AND KERSCHNER AND SULLIVAN.
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 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS/CHW BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CHW.
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 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 PRESIDENTS, TREASURER, SECRETARY, VP CHIEF MEDICAL OFFICER, AND VP CHIEF NURSING OFFICER 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 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 CHHS ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE CHHS PUBLIC RELATIONS DEPARTMENT.
FORM 990, PART XI, LINE 9:	CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 790,221. INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL FOUNDATION 27,471,082. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 1,573,768.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, SCHEDULE R, PART V, LINE 1E:	PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED MAY 1, 2004, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEE 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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
9000 W WISCONSIN AVE PO BOX 1997	MILWAUKEE	WI	53201	391500074	OPERATIONAL SUPPORT SERVICES	WI	501(C)(3)	LINE 3	N/A	0
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		1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
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		1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
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		1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
9000 W WISCONSIN AVE PO BOX 1997	MILWAUKEE	WI	53201	390806380	CHILD WELFARE SERVICES	WI	501(C)(3)	LINE 7		1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
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		1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS INC
8701 WATERTOWN PLANK ROAD	MILWAUKEE	WI	53226	391341366	GRADUATE MEDICAL EDUCATION SUPPORT	WI	501(C)(3)	LINE 11 TYPE 1	N/A	0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	VIRTUAL PICU SYSTEMS LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	401 WYTHE STREET SUITE 101	AddressLine1
City	ALEXANDRIA	City
State	VA	State
ZIP Code	22314	ZIPCode

Field	Value	IRS element (for citing)
EIN	201414664	EIN
Primary Activity	QUALITY/OUTCOMES ANALYSIS	PrimaryActivity
Legal Domicile State	DE	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeType
Disproportionate Allocations	0	DisproportionateAllocations
General Or Managing Partner	0	GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	MED-HEALTH FINANCIAL SERVICES INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	9000 W WISCONSIN AVE PO BOX 1997	AddressLine1
City	MILWAUKEE	City
State	WI	State
ZIP Code	53201	ZIPCode

Field	Value	IRS element (for citing)
EIN	391547907	EIN
Primary Activity	COLLECTION SERVICES	PrimaryActivity
Legal Domicile State	WI	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL & HEALTH SYSTEM INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity
Controlled Org	1	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	1	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CHILDREN'S MEDICAL GROUP INC - RENT (LINE 1A (IV) ABOVE)
A	347682	CASH PAID/RECEIVED
CHILDREN'S SERVICE SOCIETY OF WISCONSIN - RENT (LINE 1A (IV) ABOVE)
A	11190	CASH PAID/RECEIVED
CHILDREN'S PHYSICIAN GROUP PC
B	2500000	CASH PAID/RECEIVED
CHILDREN'S MEDICAL GROUP INC
B	375000	CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
C	4221133	CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
E	253504134	NET BOOK VALUE
CHILDREN'S COMMUNITY HEALTH PLAN INC - PATIENT REIMBURSEMENT
L	8823223	CASH PAID/RECEIVED
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
L	64813	CASH PAID/RECEIVED
MED-HEALTH FINANCIAL SERVICES INC
M	1083834	CASH PAID/RECEIVED
CHILDREN'S COMMUNITY HEALTH PLAN INC - WI MEDICAID PASS THROUGH PAYMENTS
S	13104209	CASH PAID/RECEIVED