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CHILDRENS HOSPITAL AND HEALTH SYSTEM INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHILDRENS HOSPITAL AND HEALTH SYSTEM INC (EIN 39-1500074)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201343199349302049
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:04:33-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN363168081EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SIKICH LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line113400 BISHOPS LANE SUITE 300AddressLine1
CityBROOKFIELDCity
StateWIState
ZIP Code53005ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391500074EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL AND HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone4142665420Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 W WISCONSIN AVE PO BOX 1997AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWELDON GAGEName
TitleTREASURERTitle
Phone4142665420Phone
Date Signed2013-11-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRYAN L PAUTSCH CPAName
PTINP00034913PTIN
Phone2627549400Phone
Date Prepared2013-11-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARGARET TROYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line19000 W WISCONSIN AVE PO BOX 1997AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts109100391GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHW.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionINTEGRATED AND COORDINATED HEALTH SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees685TotalNbrEmployees
Total Nbr Volunteers3294TotalNbrVolunteers
Total Gross UBI251155TotalGrossUBI
Net Unrelated Business Txbl Income10979NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year13557884ContributionsGrantsPriorYear
Contributions Grants Current Year13905451ContributionsGrantsCurrentYear
Program Service Revenue Prior Year80082979ProgramServiceRevenuePriorYear
Program Service Revenue CY93657430ProgramServiceRevenueCY
Investment Income Prior Year326861InvestmentIncomePriorYear
Investment Income Current Year301053InvestmentIncomeCurrentYear
Other Revenue Prior Year667238OtherRevenuePriorYear
Other Revenue Current Year1004312OtherRevenueCurrentYear
Total Revenue Prior Year94634962TotalRevenuePriorYear
Total Revenue Current Year108868246TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year303897GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY306691GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year48857138SalariesEtcPriorYear
Salaries Etc Current Year49032022SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year46114465OtherExpensePriorYear
Other Expenses Current Year62230458OtherExpensesCurrentYear
Total Expenses Prior Year95275500TotalExpensesPriorYear
Total Expenses Current Year111569171TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-640538RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2700925RevenuesLessExpensesCY
Total Assets BOY72842210TotalAssetsBOY
Total Assets EOY70835861TotalAssetsEOY
Total Liabilities BOY18966118TotalLiabilitiesBOY
Total Liabilities EOY26320272TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY53876092NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY44515589NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS") IS COMMITTED TO ENSURING A HEALTHIER FUTURE FOR CHILDREN BY PROVIDING AN INTEGRATED AND COORDINATED HEALTH AND SOCIAL SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense70365841Expense
Grants298681Grants
Revenue80353856Revenue
DescriptionCHHS IS THE PARENT ORGANIZATION OF AN INTEGRATED SYSTEM OF ENTITIES PROVIDING COMPREHENSIVE MEDICAL CARE AND SOCIAL SERVICES TO CHILDREN FROM WISCONSIN AND THROUGHOUT THE MIDWEST. THE SYSTEM INCLUDES WISCONSIN'S ONLY FREESTANDING HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN, AS WELL AS VARIOUS OTHER FACILITIES PROVIDING INPATIENT AND OUTPATIENT CARE FOR CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE SYSTEM ALSO INCLUDES EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS. ON AN AGGREGATE BASIS, THE ENTITIES WITHIN THE SYSTEM PROVIDED COMMUNITY BENEFITS OF OVER $117 MILLION.CHHS OVERSEES AND COORDINATES THE ACTIVITIES OF THE VARIOUS OPERATING ENTITIES WITHIN THE INTEGRATED SYSTEM, INCLUDING THROUGH THE PROVISION OF SUPPORTIVE AND ADMINISTRATIVE SERVICES ON A CONSOLIDATED, CENTRALIZED BASIS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense12432628Expense
Revenue1009739Revenue
DescriptionCHILDREN'S RESEARCH INSTITUTE ("CRI") IS A PROGRAM OF CHHS THAT ADVANCES PEDIATRIC MEDICAL RESEARCH IN WISCONSIN AND BEYOND. WITH A FOCUS ON TRANSLATIONAL RESEARCH, THE CRI IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES AT PATIENTS' BEDSIDES. RESEARCHERS AT THE CRI CONTINUE TO INVESTIGATE IMMUNE RESPONSES TO CANCER CELLS, POTENTIAL IMMUNE THERAPIES FOR CANCER, AND WAYS TO MAKE BONE MARROW TRANSPLANTS (BMTS) SAFER. IN 2012, A CRI RESEARCHER RECEIVED A $250,000 GRANT FROM HYUNDAI HOPE ON WHEELS FOUNDATION TO DEVELOP AN APPROACH THAT ALLOWS MORE CHILDREN TO RECEIVE BMTS FOR CANCER WITH FEWER COMPLICATIONS. CHILDREN WHO DEVELOP HIGHLY AGGRESSIVE CANCERS OFTEN REQUIRE A BMT TO CURE THEIR DISEASE. HOWEVER, BMTS CAN HAVE SERIOUS SIDE EFFECTS. IN ADDITION TO CONTINUED RESEARCH EFFORTS IN THE LABORATORY, CHILDREN'S HOSPITAL OF WISCONSIN, A CHHS AFFILIATE, CONTINUES TO PARTICIPATE IN THE CHILDREN'S ONCOLOGY GROUP CONSORTIUM, WHICH INCLUDES PARTICIPATION IN EARLY-PHASE CLINICAL RESEARCH WHEN PATIENTS NO LONGER BENEFIT FROM TRADITIONAL CANCER TREATMENTS. THE CRI ALSO CONTINUES TO FOCUS RESEARCH EFFORTS ON TYPE I DIABETES. IN 2012, RESEARCHERS AT THE CRI RECEIVED A $4.3 MILLION GRANT FROM THE NATIONAL INSTITUTES OF HEALTH'S NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES, A $400,000 GRANT FROM THE JUVENILE DIABETES RESEARCH FOUNDATION, AND A $300,000 GRANT FROM THE AMERICAN DIABETES ASSOCIATION TO STUDY A POTENTIAL PREDICTIVE MARKER OF THE DEVELOPMENT OF TYPE I DIABETES AND TO IDENTIFY PATHWAYS THAT COULD POTENTIALLY LEAD TO THERAPEUTIC INTERVENTIONS FOR PATIENTS WHO DEVELOP THE DISEASE.RESEARCHERS AT THE CRI ARE STUDYING THE USE OF A COMPOUND TO PROTECT THE LUNGS OF NEWBORNS AGAINST DAMAGE FROM EXPOSURE TO EXCESSIVE LEVELS OF OXYGEN. NEWBORN BABIES, PARTICULARLY THOSE BORN PREMATURELY, WHO ARE PUT ON BREATHING MACHINES AND RECEIVE HIGH LEVELS OF OXYGEN, ARE LIKELY TO DEVELOP A CONDITION CALLED BRONCHOPULMONARY DYSPLASIA (BPD). BPD CAN IMPAIR THE PROPER GROWTH OF BLOOD VESSELS AND CELLS IN THE LUNG. BABIES WITH BPD ARE SUSCEPTIBLE TO LUNG INFECTION AND CAN DEVELOP CHRONIC DAMAGE TO LUNG TISSUE. IN ADDITION, RESEARCHERS ARE USING TRANSLATIONAL AND BASIC SCIENCE APPROACHES TO EXAMINE THE PATHOGENESIS OF BPD.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8399770Expense
Revenue11618081Revenue
DescriptionCHHS PROVIDES VARIOUS OUTPATIENT HEALTH CARE SERVICES. IN 2012, THERE WERE 22,161 VISITS TO THE ORGANIZATION'S URGENT CARE CLINICS, AND 5,237 OUTPATIENT SURGICAL CASES PERFORMED AT THE ORGANIZATION'S AMBULATORY SURGICAL CENTER, THE SURGICENTER OF GREATER MILWAUKEE, LLC (A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES).Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense6049364Expense
Grants8010Grants
Revenue194517Revenue
DescriptionOTHER PROGRAMS OF CHHS INCLUDE THE OUTCOMES ANALYSIS SERVICES AT NATIONAL OUTCOMES CENTER ("NOC") AND HEALTH EDUCATION SERVICES AT CHILDREN'S HEALTH EDUCATION CENTER ("CHEC"). NOC PROVIDES PROFESSIONAL SERVICES ON A CONTRACTUAL BASIS FOR DATA MANAGEMENT AND ANALYSIS SERVICES AND REVIEWS OF CLINICAL OUTCOMES PURSUANT TO HEALTH RELATED STUDIES FOCUSED ON ENHANCING MORE EFFECTIVE AND EFFICIENT DELIVERY OF HEALTH CARE.CHEC OFFERS FREE AND INEXPENSIVE HEALTH EDUCATION PROGRAMS AND RESOURCES TO TEACHERS, CHILDREN AND PARENTS. PROGRAMS OFFERED INCLUDE IN-CLASSROOM PROGRAMS ON HEALTHY EATING AND EXERCISE, BULLYING AND TEEN DEPRESSION. IN ADDITION, CHEC ALSO HAS INJURY PREVENTION PROGRAMS WHICH FOCUS ON CAR SEAT AND BIKE HELMET FITTINGS, TO KEEP CHILDREN SAFE AND HEALTHY. ADDITIONALLY, CHEC OFFERS HEALTH-BASED E-LEARNING PROGRAMS THROUGH BLUEKIDS.ORG WHICH HELPS STUDENTS MAKE MORE POSITIVE HEALTH CHOICES. ADDITIONALLY, CHHS PROVIDES SCHOOL-BASED HEALTH CENTERS IN MILWAUKEE SCHOOLS. THESE CENTERS PROVIDE PREVENTIVE CARE, PHYSICALS, IMMUNIZATIONS AND TREATMENT FOR ILLNESSES TO AN AREA THAT PREVIOUSLY DID NOT HAVE PEDIATRICIAN PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. IN 2012, THERE WERE 17,476 SCHOOL-BASED NURSE ENCOUNTERS WHICH INCLUDED 2,206 VISION AND HEARING SCREENINGS. THE SCHOOL-BASED HEALTH CENTERS ALSO EDUCATE CHILDREN AND FAMILIES ABOUT PREVENTIVE CARE.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp6049364TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt8010TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev194517TotalOfOtherProgramServiceRev
Total Program Service Expense97247603TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109624NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees685NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MS SARAH KAFKABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4142661854TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19000 W WISCONSIN AVENUEAddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (50 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
WILLIAM J ABRAHAM JR
DIRECTOR1.001.00X000
MICHAEL W ALTSCHAEFL
DIRECTOR1.001.00X000
THOMAS M BOLGER
DIRECTOR1.001.00X000
ELIZABETH BRENNER
DIRECTOR1.001.00X000
CURT S CULVER
DIRECTOR1.001.00X000
BETH DALEY-ULLEM
DIRECTOR (DEC 2012)1.001.00X000
DAVID J DRURY
DIRECTOR/CHAIR1.001.00X000X
DAVID H GILBERT
DIRECTOR1.001.00X000
SUSAN HERMA
DIRECTOR (JAN - JUN 2012)1.001.00X000
MARK R HOGAN
DIRECTOR1.001.00X000
PAUL W JONES
DIRECTOR1.001.00X000
JOSEPH KERSCHNER MD
DIRECTOR1.001.00X000
KEVIN MANSELL
DIRECTOR1.001.00X000
LINDA T MELLOWES
DIRECTOR (JUN - DEC 2012)1.001.00X000
C DAVID MYERS
DIRECTOR1.001.00X000
ALBERT S ORR III
DIRECTOR1.001.00X000
MICHAEL T PEPKE
DIRECTOR1.001.00X000
J JOEL QUADRACCI
DIRECTOR1.001.00X000
LARRY A RAMBO
DIRECTOR (JAN - AUG 2012)1.001.00X000
JAY O ROTHMAN
DIRECTOR1.001.00X000
JOHN E SCHLIFSKE
DIRECTOR1.001.00X000
PETER M SOMMERHAUSER
DIRECTOR/VICE CHAIR1.001.00X000X
PAUL W SWEENEY
DIRECTOR1.001.00X000
OWEN J SULLIVAN
DIRECTOR1.001.00X000
PHOEBE W WILLIAMS
DIRECTOR (APR - DEC 2012)1.001.00X000
MARK C WITT
DIRECTOR1.001.00X000
MARGARET TROY
DIRECTOR / PRESIDENT & CEO40.000.00X12636240291068X
MARC CADIEUX
INTERIM TREASURER / CFO (JAN 2012)40.000.00238911022520X
CINTHIA S CHRISTENSEN
EXECUTIVE VP AND CHW PRESIDENT0.0040.00067910192874X
ROBERT DUNCAN
EVP COMMUNITY SERVICES40.000.00400496064825X
WELDON GAGE
CFO / TREASURER40.000.00362086070172X
TRICIA GERAGHTY
CORPORATE VP MARKETING & PR40.000.004268508288X
VERONICA GUNN
VP POPULATION HLTH MGMT40.000.00276741032045X
MICHELLE METTNER
VP GOVERNMENT RELATIONS40.000.00251994035439X
MICHAEL NAUMAN
CORPORATE VP & CIO40.000.00531496075966X
MARGARET NIEMER
CORPORATE VP HUMAN RESOURCES40.000.00360321066813X
SHEILA REYNOLDS
SEC / CORPORATE VP & GENERAL COUNSEL40.000.00389028076385X
RAMESH SACHDEVA MD
CORPORATE VP & CHIEF QUALITY OFFICER40.000.00274351010232X
ROBERT SANDERS
CORPORATE VP STRATEGIC MANAGEMENT40.000.00298169057550X
MARK SHIP
VP REVENUE CYCLE33.007.002851693303937576X
DENISE AUGUSTIN
SURGICENTER EXECUTIVE DIRECTOR40.000.00181276038995X
SMRITI KHARE MD
PRESIDENT, CMG40.000.00338148066619X
MARK RAKOWSKI
CCHP EXECUTIVE DIRECTOR40.000.00224542041684X
ROY JOHNSON
CORP DIRECTOR, IS OPERATIONS40.000.00216415033889X
THOMAS SHANAHAN
CORP DIR, HUMAN RESOURCES & OD40.000.00200061039506X
STEPHANIE LENZNER
CORP DIR, INFO MGMT & PLANNING40.000.00188064020705X
JAMES MILLER
FORMER CHWF PRES & CEO(JAN-NOV 2012)0.0040.00052473270286X
MARTIN VOGEL
FORMER HCE/CURRENT CHWF VP0.0040.00022914438169X
THOMAS DUNIGAN MD
FORMER HCE/CMG PHYSICIAN0.0040.00022065618709X
TIMOTHY L BIRKENSTOCK
FORMER TREASURER / CFO0.000.0023225601866X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6555833TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1686672TotalReportableCompFrmRltdOrgs
Total Other Compensation1312181TotalOtherCompensation
Number Individuals GT100 K76NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDICAL COLLEGE OF WISCONSIN
8701 WATERTOWN PLANK RDMILWAUKEEWI53226RESEARCH, EDUCATION, MEDICAL LEADERSHIP10192102
DELOITTE CONSULTING LLP
PO BOX 7247-6447PHILADELPHIAPA191706447CONSULTING AND MANAGEMENT2824322
EPIC SYSTEMS CORPORATION
PO BOX 88314MILWAUKEEWI532880314SOFTWARE LICENSING AND MAINTENANCE2187064
MICROSOFT LICENSING GP
1401 ELM ST 5TH FLR DEPT 842467DALLASTX75202SOFTWARE LICENSING AND MAINTENANCE1475641
KFORCE INC
PO BOX 277997ATLANTAGA303847997IT CONTRACTORS AND CONSULTING1307146
FieldValueIRS element (for citing)
Number Of Contractors GT100 K56NumberOfContractorsGT100K
Related Organizations13472225RelatedOrganizations
Government Grants335834GovernmentGrants
All Other Contributions97392AllOtherContributions
Total Contributions13905451TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
OPER SUPPORT SERVICES5419008096200379547569251155$1,163,279
OUTPATIENT HEALTH CARE SERVICES6214001161299911612999
RESEARCH ADMINISTRATION FEE900099933461933461
DATA MANAGEMENT & ANALYSIS5419009117691176
CHEC FEES9000995779157791
FieldValueIRS element (for citing)
Total Program Service Revenue93657430TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column409283TotalRevenueColumn
Exclusion$409,283ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real71115Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real71115Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column71115TotalRevenueColumn
Exclusion$71,115ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities114947Securities
Other8968Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other232145Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities114947Securities
Other-223177Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-108230TotalRevenueColumn
Exclusion-$108,230ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionEDUCATIONAL SERVICESDescription
Business Code611430BusinessCode
Total Revenue Column280478TotalRevenueColumn
Related Or Exempt Function Income280478RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column652719TotalRevenueColumn
Related Or Exempt Function Income652719RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue933197TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column108868246TotalRevenueColumn
Related Or Exempt Function Income93176193RelatedOrExemptFunctionIncome
Unrelated Business Revenue251155UnrelatedBusinessRevenue
Exclusion$1,535,447ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total266988Total
Program Services266988ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total39703Total
Program Services39703ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total7410308Total
Program Services6363182ProgramServices
Management And General1047126ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31422075Total
Program Services27364156ProgramServices
Management And General4057919ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2384001Total
Program Services2083911ProgramServices
Management And General300090ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4928369Total
Program Services4276519ProgramServices
Management And General651850ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2887269Total
Program Services2501349ProgramServices
Management And General385920ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total52171Total
Program Services200ProgramServices
Management And General51971ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total293834Total
Program Services260043ProgramServices
Management And General33791ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total288132Total
Program Services254997ProgramServices
Management And General33135ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total446480Total
Program Services395135ProgramServices
Management And General51345ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18587909Total
Program Services16232007ProgramServices
Management And General2355902ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total351780Total
Program Services342356ProgramServices
Management And General9424ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1123637Total
Program Services973387ProgramServices
Management And General150250ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11442898Total
Program Services10110168ProgramServices
Management And General1332730ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3544097Total
Program Services2516961ProgramServices
Management And General1027136ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total930249Total
Program Services840952ProgramServices
Management And General89297ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total15356Total
Program Services11439ProgramServices
Management And General3917ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4295284Total
Program Services3661063ProgramServices
Management And General634221ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1941931Total
Program Services1588262ProgramServices
Management And General353669ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES62862985613251673047
RESEARCH57784125778412
MEDICAL SUPPLIES178811717847003417

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5063873Total
Program Services3988462ProgramServices
Management And General1075411ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total111569171Total
Program Services97247603ProgramServices
Management And General14321568ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1481883BOY
EOY450989EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY366562BOY
EOY385546EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1606901BOY
EOY1742884EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY28000BOY
EOY56000EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY69500BOY
EOY77500EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY439776BOY
EOY545480EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5218454BOY
EOY4904570EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis71528273LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec23234144LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY51303435BOY
EOY48294129EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6590694BOY
EOY7806050EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5737005BOY
EOY6572713EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY72842210BOY
EOY70835861EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13548825BOY
EOY14724661EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY190604BOY
EOY281790EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5226689BOY
EOY11313821EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18966118BOY
EOY26320272EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY51862520BOY
EOY41606725EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1776104BOY
EOY2657644EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY237468BOY
EOY251220EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY53876092BOY
EOY44515589EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY72842210BOY
EOY70835861EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2700925ReconcilationRevenueExpenses
Reconciliation Unrealized Invest145129ReconciliationUnrealizedInvest
Reconcilation Other Changes-6804707ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals16310FilingOrganizationsTotals

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals530968FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals547278FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals96700325FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals97247603FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus3374061CurrentYearMinus3
Current Year Minus2282225CurrentYearMinus2
Current Year Minus1296103CurrentYearMinus1
Current Year547278CurrentYear
Total1499667Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures

FieldValueIRS element (for citing)
Current Year16310CurrentYear
Total16310Total

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Beginning Balance217666BeginningBalance
Additions During Year587042AdditionsDuringYear
Distributions During Year687057DistributionsDuringYear
Ending Balance117651EndingBalance
Included On FS0IncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2013572BeginningOfYearBalance
Contributions1748443Contributions
Investment Earnings Or Losses27616InvestmentEarningsOrLosses
Grants Or Scholarships879862GrantsOrScholarships
Administrative Expenses905AdministrativeExpenses
End Of Year Balance2908864EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1914287BeginningOfYearBalance
Contributions843860Contributions
Investment Earnings Or Losses1271InvestmentEarningsOrLosses
Grants Or Scholarships745000GrantsOrScholarships
Administrative Expenses846AdministrativeExpenses
End Of Year Balance2013572EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1614564BeginningOfYearBalance
Contributions1249343Contributions
Investment Earnings Or Losses30138InvestmentEarningsOrLosses
Grants Or Scholarships978936GrantsOrScholarships
Administrative Expenses822AdministrativeExpenses
End Of Year Balance1914287EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Contributions1614564Contributions
End Of Year Balance1614564EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.08600PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.91400TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1457978OtherCostOrOtherBasis
Book Value1457978BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis50005077OtherCostOrOtherBasis
Depreciation11762426Depreciation
Book Value38242651BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis291402OtherCostOrOtherBasis
Depreciation172452Depreciation
Book Value118950BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis19413141OtherCostOrOtherBasis
Depreciation11229488Depreciation
Book Value8183653BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis360675OtherCostOrOtherBasis
Depreciation69778Depreciation
Book Value290897BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings48294129TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES662175
DEFERRED COMPENSATION PLAN ASSETS1874050
BENEFICIAL INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL OF WISCONSIN FOUND.2908865
INVESTMENT IN VIRTUAL PICU SYSTEMS, LLC430342
INVESTMENT IN NORTH SHORE SURGERY CENTER663713
INVESTMENT IN MED-HEALTH FINANCIAL SERVICES, INC.9000
ORGANIZATIONAL COSTS24568
FieldValueIRS element (for citing)
Total Book Value Other Assets6572713TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION PLAN LIABILITY$1,874,051
RETIREMENT PLAN LIABILITY$3,059,090
DUE TO AFFILIATES$6,380,680
FieldValueIRS element (for citing)
Total Of Amounts11313821TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 1B:CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHECKING ACCOUNT OF THE CENTER FOR INTERNATIONAL HEALTH, INC. ("CIH"). ADDITIONALLY, CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHECKING ACCOUNT OF THE WELFARE AUXILIARY OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("WA"). THE ORGANIZATION ALSO PROVIDES ACCOUNTING FUNCTIONS FOR WA. THE AMOUNTS IN PART IV ARE THE COMBINED TOTALS FOR THESE TWO INDIVIDUAL ACCOUNTS.
PART V, LINE 4:CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC., A RELATED ENTITY, HOLDS ENDOWMENT FUNDS ON BEHALF OF CHHS. INTENDED USES OF THE ENDOWMENT FUNDS INCLUDE VARIOUS HEALTH-EDUCATION RELATED PROJECTS.DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:
PART X, LINE 2:FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
FAMILY & CHILDRENS CENTER
1707 MAIN STREETLA CROSSEWI54601390821863501(C)(3)49636ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
FAMILY RESOURCE CENTER OF SHEBOYGAN
1209A EASTERN AVENUEPLYMOUTHWI53073391857835501(C)(3)68906ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
FAMILY RESOURCE CENTER ST CROIX VALLEY INC
857 MAIN STREET PO BOX 2087BALDWINWI54002391943404501(C)(3)18905ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
FAMILY SERVICES OF NORTHEAST WISCONSIN
PO BOX 22308GREEN BAYWI54305390827320501(C)(3)59000ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
SAFE BABIES HEALTHY FAMILIES
137 WISCONSIN AVENUEWAUKESHAWI53188391552886501(C)(3)54000ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
SEXUAL ASSAULT CRISIS CENTER
35 PARK PLACE SUITE 100APPLETONWI54914391309331501(C)(3)14942ANNUAL GRANT FOR A CHILD ABUSE PREVENTION PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants6TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuation
PROJECT MANAGEMENT FOR HOME VISITATION OUTCOMES PROJECT231693N/A
SCHOLARSHIPS118010N/A

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: MONITORING PROCEDURES - THE CHILD ABUSE PREVENTION FUND IS COMMITTED TO ENSURING A SAFE ENVIRONMENT FOR CHILDREN THROUGH FINANCIAL SUPPORT OF PRIMARY PREVENTION ACTIVITIES THROUGHOUT WISCONSIN, AS WELL AS EDUCATING PROFESSIONALS AND THE PUBLIC ABOUT THE ROLE OF PREVENTION IN ELIMINATING CHILD ABUSE. THE CHILD ABUSE PREVENTION FUND IS A SPECIAL FUNDRAISING INITIATIVE OF CHHS. THE FUND'S FOCUS IS ON OUTCOMES OR RESULTS FOR FAMILIES, CHILDREN AND COMMUNITIES. AGENCIES THAT RECEIVE FUNDING MEET CRITERIA FOR EFFECTIVENESS AND ACCOUNTABILITY. EACH ORGANIZATION FUNDED IS EXPECTED TO DEMONSTRATE POSITIVE OUTCOMES THROUGH SIX-MONTH AND ANNUAL PROGRESS REPORTS. IN MANY CASES, CHHS STAFF OVERSEE AND PLAY A ROLE IN HELPING ORGANIZATIONS DEMONSTRATE POSITIVE OUTCOMES. CHHS STAFF ALSO PERFORM SITE VISITS. SCHEDULE I, PART III: SCHOLARSHIPS AWARDED TO RECIPIENTS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MARGARET TROY
DIRECTOR / PRESIDENT & CEO759976037667101269770259150031918015546920508330
MARC CADIEUX
INTERIM TREASURER / CFO (JAN 2012)189232034000015679015814067060261431000
CINTHIA S CHRISTENSEN
EXECUTIVE VP AND CHW PRESIDENT0424640015268301017780650200278540771975033569
ROBERT DUNCAN
EVP COMMUNITY SERVICES26793108219005037503742002740504653210203290
WELDON GAGE
CFO / TREASURER33662902500004570517850183870432258000
VERONICA GUNN
VP POPULATION HLTH MGMT2212570550000484085000235450308786000
MICHELLE METTNER
VP GOVERNMENT RELATIONS1981890413520124530135000219390287433000
MICHAEL NAUMAN
CORPORATE VP & CIO337354010502008912204983002613606074620254920
MARGARET NIEMER
CORPORATE VP HUMAN RESOURCES23647607247705136804467002214304271340190260
SHEILA REYNOLDS
SEC / CORPORATE VP & GENERAL COUNSEL25968207835405099204869002769504654130180230
RAMESH SACHDEVA MD
CORPORATE VP & CHIEF QUALITY OFFICER1688420843770211320001023202845830202570
ROBERT SANDERS
CORPORATE VP STRATEGIC MANAGEMENT19451505990104375303513002242003557190135820
MARK SHIP
VP REVENUE CYCLE186798328767740402096716316000018028354831919736587184140
DENISE AUGUSTIN
SURGICENTER EXECUTIVE DIRECTOR154993018477078060150130239820220271000
SMRITI KHARE MD
PRESIDENT, CMG280997054931022200544710121480404767000
MARK RAKOWSKI
CCHP EXECUTIVE DIRECTOR185591029046099050172910243930266226000
ROY JOHNSON
CORP DIRECTOR, IS OPERATIONS1839520100000224630171730167160250304000
THOMAS SHANAHAN
CORP DIR, HUMAN RESOURCES & OD176978010000220830186980208080239567000
STEPHANIE LENZNER
CORP DIR, INFO MGMT & PLANNING166558010000011506057090149960208769000
JAMES MILLER
FORMER CHWF PRES & CEO(JAN-NOV 2012)031544408405001252380463000239860595018026337
MARTIN VOGEL
FORMER HCE/CURRENT CHWF VP02009580139270142590172240209450267313013614
THOMAS DUNIGAN MD
FORMER HCE/CMG PHYSICIAN020027900020377084000103090239365020377
TIMOTHY L BIRKENSTOCK
FORMER TREASURER / CFO000023225600018660234122000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINES 4A-BUNTIL MARCH 2011, TIMOTHY BIRKENSTOCK SERVED AS TREASURER & CFO OF CHHS. 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. UNTIL NOVEMBER 2012, JAMES MILLER SERVED AS PRESIDENT OF CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. THE FOUNDATION PAID CERTAIN AMOUNTS AS SEVERANCE TO MR. MILLER PURSUANT TO A WRITTEN AGREEMENT. CASH PAYMENTS MADE TO MR. MILLER IN 2012 TOTALED $75,692. PART I, LINE 4B: IN 2012, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F)). THE ORGANIZATION 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; R. DUNCAN, $28,920; W. GAGE, $43,852; T. GERAGHTY, $8,288; M. NAUMAN, $36,330; M. NEIMER, $26,170; S. REYNOLDS, $30,190; R. SANDERS, $21,630; AND S. KHARE, M.D., $35,971. 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; R. DUNCAN, $20,329; J. KERSTEN, $13,331; M. NAUMAN, $25,492; M. NEIMER, $19,026; S. REYNOLDS, $18,023; R. SACHDEVA, M.D., $20,257; R. SANDERS, $13,582; M. SHIP, $18,414; T. DUNIGAN, M.D., $20,377; J. MILLER, $26,337; AND M. VOGEL, $13,614. 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 7CERTAIN 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 IIIFORM 990, PART VII, COLUMN E AND SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. CINTHIA CHRISTENSEN, PRESIDENT OF CHW AND EXECUTIVE VICE PRESIDENT OF CHHS AND MARK SHIP, VP OF 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 CHW AND AFFILIATES. THESE AMOUNTS WERE PAID BY CHW. 2. JAMES MILLER, PRESIDENT AND CEO OF CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. ("CHWF") (JAN NOV 2012) - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHWF. THESE AMOUNTS WERE PAID BY CHWF. PRIOR TO 2011, MR. MILLER'S COMPENSATION FOR SERVICES AS PRESIDENT AND CEO OF CHWF WAS PAID BY CHHS AND ALLOCATED TO CHWF. AS A RESULT, MR. MILLER WAS REPORTED AS A HIGHLY COMPENSATED EMPLOYEE OF CHHS IN PREVIOUS YEARS. 3. MARTIN VOGEL, VICE PRESIDENT OF PRINCIPAL GIFTS OF CHWF - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHWF. THESE AMOUNTS WERE PAID BY CHWF. PRIOR TO 2011, MR. VOGEL'S COMPENSATION FOR SERVICES AS VICE PRESIDENT OF PRINCIPAL GIFTS OF CHWF WAS PAID BY CHHS AND ALLOCATED TO CHWF. AS A RESULT, MR. VOGEL WAS REPORTED AS A HIGHLY COMPENSATED EMPLOYEE OF CHHS IN PREVIOUS YEARS. 4. THOMAS DUNIGAN, M.D., PEDIATRIC PHYSICIAN, FORMER PRESIDENT OF CMG AND PRESIDENT AND TREASURER OF CHILDREN'S PHYSICIAN GROUP, P.C. ("CPG") - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED TO CMG (40 HOURS PER WEEK) AND CPG (1 HOUR PER WEEK). THESE AMOUNTS WERE PAID BY CMG.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Loan Table LoanTable

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1M CADIEUXBusinessNameLine1
FieldValueIRS element (for citing)
Relationship With OrganizationOFFICERRelationshipWithOrganization
Purpose Of LoanEDUCATIONPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$56,000OriginalPrincipalAmount
Balance Due56000BalanceDue
Default0Default
Approved By Board0ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due56000TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
HUMANA
DIRECTOR (L. RAMBO)171365MR. RAMBO WAS THE SENIOR EXECUTIVE FOR STRATEGIC PARTNERSHIPS OF HUMANA, INC. THE ORGANIZATION PAID HUMANA FOR TPA SERVICES FOR ITS SELF-INSURED HEALTH PLAN IN THE AMOUNT OF $171,365.0
HUMANA
DIRECTOR (L. RAMBO)830281MR. RAMBO WAS THE SENIOR EXECUTIVE FOR STRATEGIC PARTNERSHIPS OF HUMANA, INC. THE ORGANIZATION RECEIVED APPROXIMATELY $830,281 FROM HUMANA FOR HEALTH CARE SERVICES PROVIDED TO HUMANA ENROLLEES.0
FOLEY AND LARDNER LLP
DIRECTORS (J. ROTHMAN & W. ABRAHAM, JR.)187596MR. ROTHMAN IS THE CHIEF EXECUTIVE OFFICER AT FOLEY AND LARDNER, LLP AND MR. ABRAHAM IS A KEY EMPLOYEE. THE ORGANIZATION PAID FOLEY AND LARDNER $187,596 FOR LEGAL SERVICES.0
JOHNSON INSURANCE
DIRECTOR (T. BOLGER)204094MR. BOLGER IS THE CHIEF EXECUTIVE OFFICER OF JOHNSON BANK AND ITS PARENT COMPANY JOHNSON FINANCIAL GROUP. THE ORGANIZATION PAID JOHNSON INSURANCE, A SUBSIDIARY OF JOHNSON FINANCIAL GROUP, $204,094 FOR BROKERAGE SERVICES.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS OR OFFICERS: ORR AND PEPKE, DRURY AND SCHLIFSKE, DRURY AND SOMMERHAUSER, DRURY AND BRENNER, DRURY AND SULLIVAN, BRENNER AND SULLIVAN, ROTHMAN AND ABRAHAM, SCHLIFSKE AND SOMMERHAUSER, SCHLIFSKE AND MANSELL, PEPKE AND ALTSCHAEFL, MANSELL AND SOMMERHAUSER, ABRAHAM AND QUADRACCI, HERMA AND SOMMERHAUSER, WITT AND SOMMERHAUSER, KERSCHNER AND BRENNER, KERSCHNER AND CULVER, KERSCHNER AND MELLOWES, KERSCHNER AND SULLIVAN, BRENNER AND SACHDEVA, CULVER AND SACHDEVA, KERSCHNER AND SACHDEVA, MELLOWES AND SACHDEVA, AND SULLIVAN AND SACHDEVA.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CHHS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CORPORATE VICE PRESIDENT AND GENERAL COUNSEL. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE AT EACH BOARD AND COMMITTEE MEETING. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF THE ORGANIZATION'S CEO AND SENIOR OFFICERS, WITH THE EXCEPTION OF THE INTERIM TREASURER / CFO, THE CORPORATE VP MARKETING & PR, THE VP POPULATION HLTH MGMT, THE VP GOVERNMENT RELATIONS, THE VP REVENUE CYCLE, AND THE SURGICENTER EXECUTIVE DIRECTOR, WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF OTHER OFFICERS AND THE KEY EMPLOYEES EXCEPTED ABOVE WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19THE 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 IX, LINE 11GCONSULTING FEES: PROGRAM SERVICE EXPENSES 13,579,718. MANAGEMENT AND GENERAL EXPENSES 1,764,596. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,344,314. RESEARCH ADMINISTRATION FEES: PROGRAM SERVICE EXPENSES 1,333,349. MANAGEMENT AND GENERAL EXPENSES 291,588. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,624,937. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 89,827. MANAGEMENT AND GENERAL EXPENSES 11,673. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 101,500. OTHER FEES: PROGRAM SERVICE EXPENSES 1,229,113. MANAGEMENT AND GENERAL EXPENSES 288,045. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,517,158.OTHER FEES
FORM 990, PART XI, LINE 9:NET ASSET/CASH TRANSFER TO CHILDREN'S COMMUNITY HEALTH PLAN, INC. -7,700,000. INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL FOUNDATION 895,293.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART V, LINE 1A:THE ORGANIZATION DID NOT FILE ANY 1099 FORMS DURING THE TAXABLE YEAR. ALTHOUGH THE ORGANIZATION DID RETAIN INDEPENDENT CONTRACTORS, THE COMPENSATION AMOUNTS OWED TO SUCH CONTRACTORS WERE PROCESSED AND PAID BY A RELATED ENTITY, CHW, WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHW. THE 1099 FORMS FOR SUCH PAYMENTS WERE ISSUED BY CHW, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. THE 1099 FORMS LISTED IN PART V ARE THE FORMS FILED BY THE ORGANIZATION'S DISREGARDED ENTITY.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SURGICENTER OF GREATER MILWAUKEE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19000 W WISCONSIN AVENUE PO BOX 1997AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53201ZIPCode
FieldValueIRS element (for citing)
EIN391682308EIN
Primary ActivitiesAMBULATORY SURGERY CENTER/MEDICAL OFFICE BUILDINGPrimaryActivities
Legal Domicile StateWILegalDomicileState
Total Income10279408TotalIncome
EOY Assets22826279EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
CHILDREN'S HOSPITAL OF WISCONSIN INC
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201390812532PEDIATRIC HOSPITALWI501(C)(3)LINE 3N/A1
CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201391500075FUND DEVELOPMENTWI501(C)(3)LINE 7N/A1
CHILDREN'S MEDICAL GROUP INC
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201391789197PEDIATRIC PHYSICIAN SERVICESWI501(C)(3)LINE 3N/A1
CHILDREN'S PHYSICIAN GROUP PC
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201364303682PEDIATRIC PHYSICIAN SERVICESIL501(C)(3)LINE 9N/A1
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201390806380CHILD WELFARE SERVICESWI501(C)(3)LINE 7N/A1
CHILDREN'S COMMUNITY HEALTH PLAN INC
9000 W WISCONSIN AVE PO BOX 1997MILWAUKEEWI53201271494977WISCONSIN MEDICAID HMOWI501(C)(3)LINE 9N/A1
CHILDREN'S SPECIALTY GROUP INC
999 N 92ND ST SUITE C740MILWAUKEEWI53226391990012PEDIATRIC PHYSICIAN SERVICESWI501(C)(3)LINE 11N/A0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1VIRTUAL PICU SYSTEMS LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1401 WYTHE STREET SUITE 101AddressLine1
CityALEXANDRIACity
StateVAState
ZIP Code22314ZIPCode
FieldValueIRS element (for citing)
EIN201414664EIN
Primary ActivityQUALITY/OUTCOMES ANALYSISPrimaryActivity
Legal Domicile StateDELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income118490ShareOfTotalIncome
Share Of EOY Assets608765ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.33330PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MED-HEALTH FINANCIAL SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19000 W WISCONSIN AVE PO BOX 1997AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53201ZIPCode
FieldValueIRS element (for citing)
EIN391547907EIN
Primary ActivityCOLLECTION SERVICESPrimaryActivity
Legal Domicile StateWILegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income3804033ShareOfTotalIncome
Share Of EOY Assets3678563ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (19 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CHILDREN'S HOSPITAL OF WISCONSIN INC - RENT (LINE 1A (IV) ABOVE
A558388CASH PAID/RECEIVED
CHILDREN'S MEDICAL GROUP INC - RENT (LINE 1A (IV) ABOVE)
A238508CASH PAID/RECEIVED
CHILDREN'S SERVICE SOCIETY OF WISCONSIN - RENT (LINE 1A (IV) ABOVE)
A1152CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN INC
C9136944CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
C4335281CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN INC
K66690CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN INC
L70739388CASH PAID/RECEIVED
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
L2094798CASH PAID/RECEIVED
CHILDREN'S MEDICAL GROUP INC
L3505826CASH PAID/RECEIVED
CHILDREN'S COMMUNITY HEALTH PLAN INC
L1009174CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
L746081CASH PAID/RECEIVED
CHILDREN'S PHYSICIAN GROUP PC
L182040CASH PAID/RECEIVED
MED-HEALTH FINANCIAL SERVICES INC
L594832CASH PAID/RECEIVED
CHILDREN'S COMMUNITY HEALTH PLAN INC - PATIENT REIMBURSEMENT
L481370CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN INC
M70866CASH PAID/RECEIVED
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
M170909CASH PAID/RECEIVED
MED-HEALTH FINANCIAL SERVICES INC
M58482CASH PAID/RECEIVED
CHILDREN'S HOSPITAL OF WISCONSIN INC
P239681CASH PAID/RECEIVED
CHILDREN'S COMMUNITY HEALTH PLAN INC
R7700000CASH PAID/RECEIVED