2023-05-14T12:36:47-05:00 2022-06-30 420714325 RSM US LLP 30 S Wacker Drive Ste 3300 Chicago IL 60606 990 2021-07-01 391824445 University of Wisconsin Medical Foundation Inc UNIV 6082657131 7974 UW Health Court Middleton WI 53562 Jodilynn Vitello VP of Finance 6082657131 2023-05-08 1 Jodilynn Vitello XXX-XX-XXXX Rebekuh Eley P01247672 3126343400 2023-05-08 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Alan Kaplan MD 7974 UW Health Court Middleton WI 53562 1199081326 0 X www.uwhealth.org X 1995 WI University of Wisconsin Medical Foundation (UWMF) supports the teaching, research and service missions of the University of Wisconsin School of Medicine and Public Health by promoting the delivery of excellent and innovative patient care by faculty and staff who serve local, regional, national and international populations. 15 4 5535 4 222027 184511 218103907 244896888 820165566 901631979 6947195 7434315 5217078 5216594 1050433746 1159179776 57200117 55238235 0 0 702419312 750754971 0 0 0 293539052 313648868 1053158481 1119642074 -2724735 39537702 827644125 763282988 440073832 364861442 387570293 398421546 X University of Wisconsin Medical Foundation (UWMF) supports the teaching, research and service missions of the University of Wisconsin School of Medicine and Public Health by promoting the delivery of excellent and innovative patient care by faculty and staff who serve local, regional, national and international populations. 0 0 890988769 55768 903486136 Funding allocated to provide healthcare for the benefit of, and in support of, the purpose of the University of Wisconsin School of Medicine and Public Health. Delivery of patient care serving local, regional, national, and international populations. 195161769 45063805 Funding provided to support the teaching/academic mission and support the University of Wisconsin School of Medicine and Public Health. 10032472 10032472 Funding allocated to provide medical research for the benefit of, and in support of, the purpose of the University of Wisconsin School of Medicine and Public Health. 86190 86190 Other Program Revenue and Expenses allocated to provide medical education for the benefit of and in support of the purpose of the University of Wisconsin School of Medicine and Public Health. 86190 86190 1096269200 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 5535 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 15 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IL X Robert W Flannery SVPCFO 6082657131 7974 UW Health Court Middleton WI 53562 Alan Kaplan MD Chairman of the Board 1.00 39.00 X X 0 3001694 742217 Jamie Hess MD Vice Chair and President (as of 11/01/21) 1.00 39.00 X X 286312 0 58063 John Frohna MD MPH President (Until 10/31/21) 1.00 39.00 X X 238996 0 25602 Kelsie Doty CAO 40.00 0.00 X X 290484 0 61226 Petros Anagnostopoulos MD Director 1.00 39.00 X 1378747 0 59436 Stephen Nakada MD Director 1.00 39.00 X 1070757 0 59436 Laurel Rice MD Director (until 10/31/21) 1.00 39.00 X 798559 0 59436 Terri Young MD MBA Director (Until 12/31/21) 1.00 39.00 X 781304 0 58063 Lynn Schnapp MD Director 1.00 39.00 X 682036 0 2063 Elizabeth Trowbridge MD Director 1.00 39.00 X 437786 0 55657 J Carter Ralphe MD Director (Until 12/31/21) 1.00 39.00 X 388223 0 48924 Sandra Kamnetz MD Director 1.00 39.00 X 385008 0 58063 Jennifer Alexander Director 1.00 0.00 X 0 0 0 Ronald Anderson Director 1.00 0.00 X 0 0 0 Deb Archer Director 1.00 0.00 X 0 0 0 George Kamperschroer Director 1.00 0.00 X 0 0 0 Sarah McAchran MD Director (as of 01/01/22) 1.00 0.00 X 374921 0 58063 Kelly McQueen MD Director (as of 01/01/22) 1.00 0.00 X 649645 0 58063 Rebecca Minter MD Director (as of 10/31/21) 1.00 0.00 X 1072014 0 59436 Jodi Vitello Treasurer 1.00 39.00 X 0 437492 90945 Kelly Wilson Secretary 1.00 39.00 X 0 828014 137942 Peter Newcomer Medical Director 1.00 39.00 X 1067942 0 175206 Mustafa Baskaya Physician 39.00 1.00 X 1545451 0 58063 Samuel Poore Physician 39.00 1.00 X 1292367 0 58063 Geoffrey Baer Physician 39.00 1.00 X 1330722 0 58063 Katherine Gast Physician 39.00 1.00 X 1339917 0 14563 Andrea Spiker Physician 39.00 1.00 X 1203782 0 15936 Robert Flannery Former CAO 40.00 0.00 X 1111867 0 169655 Nizar Jarjour Former President 39.00 1.00 X 567079 0 58063 18293919 4267200 2300247 1881 1 1 1 0 229352876 15544012 244896888 Patient Services 621111 643179187 643179187 Premium Revenue 900099 254432554 254432554 Medicare QPP Incentive 900099 2397427 2397427 1622811 1506980 115831 901631979 4846215 2222 4843993 1312178 187 1311991 1311991 103974 1208017 40617825 38028567 1158 2589258 -1158 2588100 2588100 3725795 1871638 1854157 1854157 Legal Revenue 900099 480258 480258 Income Tax Refund 900099 165786 165786 1404402 1404402 2050446 1159179776 903370305 222027 10690556 55238235 55238235 8551768 7076880 1474888 649044483 629616724 19427759 16922965 16922965 46550261 46550261 29685494 29685494 38697200 37637247 1059953 89388 89388 124617 124617 47765 47765 1451271 1451271 834177 834177 30439623 30439623 2607930 2607930 3031181 3031181 1196269 1196269 13463028 13463028 1916647 1916647 Reimb. of Med School Ex 150097964 150097964 Drugs and Patient Care 57888105 57888105 Due and Subscriptions 3363318 3363318 Recruitment 1199881 1199881 7200504 7200504 1119642074 1096269200 23372874 0 348675969 259909685 69998635 84323883 5480583 5309891 1055949 819473 217439459 116827976 54724964 100611483 208297589 181408191 75843689 76705010 63566747 54195372 827644125 763282988 120325977 132797324 15287492 279020 20520000 17735000 283940363 214050098 440073832 364861442 X 387570293 398421546 387570293 398421546 827644125 763282988 X 39537702 -33888346 5201897 X 0 1 X 1 0 X 110594924 138204587 158164850 218103907 244896888 869965156 817469698 828351162 783958482 823149896 905241943 4158171181 928064622 966555749 942123332 1041253803 1150138831 5028136337 0 0 0 5028136337 7826122 7912005 8285122 6713847 6035080 36772176 7826122 7912005 8285122 6713847 6035080 36772176 750810 632582 129341 182983 1695716 299869 236359 798942 870848 2050446 4256464 936190613 975454923 951839978 1048967839 1158407340 5070860693 0.99160 0.99140 0.00730 0.00780 X Schedule A, Part III, Line 12, Explanation of Other Income: Other Non-Program Revenue - 2017 Amount: $ 299,869. 2018 Amount: $ 236,359. 2019 Amount: $ 798,942. 2020 Amount: $ 510,567. 2021 Amount: $ 1,884,660. Income Tax Refund - 2020 Amount: $ 360,281. 2021 Amount: $ 165,786. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7959113 7959113 73820692 36656768 37163924 12793003 9023395 3769608 56267721 53052747 3214974 66598930 18095066 48503864 100611483 University Health Care, Inc. 46444683 F Madison Medical Center 14737132 F Chartwell Wisconsin Enterprises 4951259 F Madison Surgery Center 4735477 F Wisconsin Dialysis, Inc. 2710530 F Wisconsin Sleep, Inc. 1644566 F Transformation Surgery Center, Inc. 518020 F Generations Fertility Care, Inc. 963343 F 76705010 Due From Related Organizations 42204904 Other Accounts Receivable 10745090 Executive Deferred Compensation 939446 Lease Receivable 305932 54195372 Due to Related Organizations 163175225 Executive Deferred Compensation 939446 Lease Lability - Long-Term 40823567 Lease Lability - Short-Term 8817928 Deferred Inflow 293932 214050098 1 UW School of Medicine and Public Health 750 Highland Avenue Madison WI 53705 396006492 State of Wisconsin 45063805 0 Support Functions of the Medical School University of Wisconsin Foundation 1848 University Avenue Madison WI 53708 390743975 501(c)(3) 10032472 0 Research Support Orthopaedic Research and Education Foundation 6300 N River Road Ste 700 Rosemont IL 60019 366009467 501(c)(3) 33000 0 Support Functions of the Organization The Salvation Army 11315 W Watertown Plank Road Wauwatosa WI 53226 362167910 501(c)(3) 10040 0 Support Functions of the Organization Focused Interruption Coaltion LLC 655 W Badger Road Madison WI 53713 823738337 501(c)(3) 9000 0 Support Functions of the Organization Healthy Classrooms Foundation Inc PO Box 260199 Madison WI 53726 263490947 501(c)(3) 8000 0 Support Functions of the Organization YMCA Madison 101 E Mifflin Street Madison WI 53703 390806303 501(c)(3) 7650 0 Support Functions of the Organization The Arnold P Gold Foundation 619 E Palisade Ave Englewood Clifs NJ 076321812 223052098 501(c)(3) 7000 0 Support Functions of the Organization American Lung Association in Wisconsin 13100 W Lisbon Road Ste 700 Brookfield WI 53005 131632524 501(c)(3) 6000 0 Support Functions of the Organization Wisconsin Alliance for Women's Health 147 S Butler Street Madison WI 53703 800287566 501(c)(3) 5500 0 Support Functions of the Organization 10 0 Part I, Line 2: The grant schedule for UW School of Medicine is based on an agreement at a fixed amount. UWMF makes a contribution to UW Foundation for R&D based on agreed upon levels of funding. X 1 1 X X X 0 1 0 0 0 0 0 0 0 Alan Kaplan MD Chairman of the Board 0 1706357 0 1275000 0 20337 0 692765 0 49452 0 3743911 0 0 Mustafa Baskaya Physician 1205168 0 340283 0 0 0 58000 0 63 0 1603514 0 0 0 Petros Anagnostopoulos MD Director 1161739 0 217008 0 0 0 58000 0 1436 0 1438183 0 0 0 Geoffrey Baer Physician 1122021 0 208701 0 0 0 58000 0 63 0 1388785 0 0 0 Katherine Gast Physician 1110432 0 229485 0 0 0 14500 0 63 0 1354480 0 0 0 Samuel Poore Physician 1105066 0 187301 0 0 0 58000 0 63 0 1350430 0 0 0 Robert Flannery Former CAO 762140 0 343575 0 6152 0 134594 0 35061 0 1281522 0 0 0 Peter Newcomer Medical Director 720632 0 347310 0 0 0 173770 0 1436 0 1243148 0 0 0 Andrea Spiker Physician 1203032 0 750 0 0 0 14500 0 1436 0 1219718 0 0 0 Rebecca Minter MD Director (as of 10/31/21) 1072014 0 0 0 0 0 58000 0 1436 0 1131450 0 0 0 Stephen Nakada MD Director 1070757 0 0 0 0 0 58000 0 1436 0 1130193 0 0 0 Kelly Wilson Secretary 0 573629 0 254385 0 0 0 107560 0 30382 0 965956 0 0 Laurel Rice MD Director (until 10/31/21) 798559 0 0 0 0 0 58000 0 1436 0 857995 0 0 0 Terri Young MD MBA Director (Until 12/31/21) 704845 0 76459 0 0 0 58000 0 63 0 839367 0 0 0 Kelly McQueen MD Director (as of 01/01/22) 649645 0 0 0 0 0 58000 0 63 0 707708 0 0 0 Lynn Schnapp MD Director 682036 0 0 0 0 0 0 0 2063 0 684099 0 0 0 Nizar Jarjour Former President 566329 0 750 0 0 0 58000 0 63 0 625142 0 0 0 Jodi Vitello Treasurer 0 333884 0 101340 0 2268 0 56545 0 34400 0 528437 0 0 Elizabeth Trowbridge MD Director 387271 0 46951 0 3564 0 54544 0 1113 0 493443 0 0 0 Sandra Kamnetz MD Director 377792 0 7216 0 0 0 58000 0 63 0 443071 0 0 0 J Carter Ralphe MD Director (Until 12/31/21) 387473 0 750 0 0 0 48861 0 63 0 437147 0 0 0 Sarah McAchran MD Director (as of 01/01/22) 374171 0 750 0 0 0 58000 0 63 0 432984 0 0 0 Kelsie Doty CAO 222888 0 65130 0 2466 0 48184 0 13042 0 351710 0 0 0 Jamie Hess MD Vice Chair and President (as of 11/01/21) 285562 0 750 0 0 0 58000 0 63 0 344375 0 0 0 John Frohna MD MPH President (Until 10/31/21) 235698 0 3298 0 0 0 24166 0 1436 0 264598 0 0 0 Part I, Line 1a UWMF reimburses Chairs and the Dean of the Medical School for the business use of their social club dues. As a business expense, amounts are not taxable. Part I, Line 4b SEVERAL MEMBERS OF THE BOARD PARTICIPATE IN SUPPLEMENTAL, NON-QUALIFIED RETIREMENT PLANS THROUGH UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION, OR RELATED ORGANIZATIONS. THOSE INDIVIDUALS PARTICIPATE IN A 457(F) PLAN. IN 2021, THE FOLLOWING EMPLOYER CONTRIBUTIONS WERE MADE: - Kelsie Doty $10,894 - Robert Flannery $97,204 - Alan Kaplan $670,000 - Jodi Vitello $33,780 - Kelly Wilson $84,795 - Peter Newcomer $115,770 There were no distributions made in 2021. Part II, Column B: Certain individuals received compensation from the University of Wisconsin School of Medicine and Public Health, an unrelated organization, for their services as physicians or professors. The following individuals have this compensation reported on Schedule J, Part II, Column b(i): - Petros Anagnostopoulos $76,555 - Geoffrey Baer $64,691 - Mustafa Baskaya $83,806 - John Frohna $78,929 - Jamie Hess $52,994 - Sandra Kamnetz $124,744 - Rebecca Minter $272,163 - Stephen Nakada $246,205 - Peter Newcomer $119,971 - Samuel Poore $36,902 - John Ralphe $143,586 - Laurel Rice $191,334 - Lynn Schnapp $228,519 - Elizabeth Trowbridge $216,529 - Terri Young $211,522 - Katherine Gast $54,060 - Andrea Spiker $35,348 - Nizar Jarjour $246,054 - Sarah McAchran $77,519 - Kelly McQueen $207,134 Form 990, Part VI, Section A, line 6 The sole member of the Organization is the University of Wisconsin Hospitals and Clinics Authority. Form 990, Part VI, Section A, line 7a The sole member of the Organization has the power to approve Faculty and Chair directors nominated for the Board. Form 990, Part VI, Section A, line 7b The sole member of the Organization has the overall rights to govern, direct, and oversee the property, funds, business, and affairs of the Organization except when reserved to the Board of Directors. Form 990, Part VI, Section B, line 11b Form 990 is completed by the Organization's External Accounting Firm. Key Finance employees review the Form 990 to determine it is complete and accurate. The return is provided to the members of the board of directors before filing. The return is submitted for filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The Compliance and Legal Department reviews conflict of interest forms. If potential conflicts are found, there is a discussion between legal services, the CAO, and the individual. The Compliance Department issues questionnaires annually and there is 100% compliance in responding. If there is a conflict, the fix is to recuse oneself from any vote. If it is a sensitive matter, the fix is to recuse oneself from the discussion and the vote. The conflict of interest policy provides a process for both voluntary and involuntary recusal. Form 990, Part VI, Section B, line 15 The Executive Compensation of the Authority Board is responsible for defining the compensation philosophy and standards and otherwise ensure that the compensation strategies and practices of the Authority are consistent with applicable law and its charitable mission. The Executive Compensation Committee consists of the Chairperson, the Vice Chairperson, and two (2) or more other independent members of the Board appointed by the Chairperson. The Executive Compensation Committee recommends the compensation of the CEO to the full Board and establishes guidelines by which executive compensation for the titles of Vice President and Senior Vice President is managed. Each year an assessment of UW Health executive compensation to Market benchmarks is conducted. Typically, this is conducted by engaging independent compensation consultants. A Compensation Review Committee (CRC) has been established. The Committee consists exclusively of the public directors. The CRC shall act in accordance with the Foundation's compensation principles and policy. The committee shall make final decisions on such matters after satisfying itself that the standards set in the Corporation's compensation principles and procedure policy have been met. The Committee may request additional data or information prior to approving matters within its jurisdiction. The CRC shall take final action to approve or disapprove departmental compensation formulae and policy. The Committee engages an Independent Compensation Consultant to review physician compensation. Outliers identified are substantiated. A presentation is made to the CRC for approval. Form 990, Part VI, Section C, line 19 The financial statements, bylaws, articles, conflict of interest policies, tax returns, and Form 1023 are available upon request from the corporate office for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part XI, line 9: Equity Interest in Income of Joint Ventures 3,486,561. GASB Statement No. 87, Restatement 1,715,336. Generations Fertility Care 2365 Deming Way Middleton WI 53562 273496527 Reproductive endocrinology and infertility services WI 501(c)(3) Line 10 N/A 1 Isthmus Project Inc 600 Highland Avenue Madison WI 53792 832278676 Research and Innovation WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 1 Madison Surgery Center 7974 UW Health Court Middleton WI 53562 391940656 Health care services and training WI 501(c)(3) Line 10 N/A 1 Quartz Health Plan Corporation 840 Carolina Street Sauk City WI 53583 391807071 Health Maintenance Organization WI 501(C)(4) University Health Care 1 Quartz Health Plan MN Corporation 840 Carolina Street Sauk City WI 53583 452633920 Health Insurance WI 501(C)(4) Quartz Health Plan Corporation 1 Regional Division Inc 7974 UW Health Court No MC1020 Middleton WI 53562 391446049 Regional Parent Corp. to manage and direct activities of entities WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 1 SwedishAmerican Foundation 1415 East State Street Rockford IL 61104 363097493 Supports fundraising for SwedishAmerican Hospital IL 501(c)(3) Line 7 SwedishAmerican Hospital 1 SwedishAmerican Health System Corporation 1401 East State Street Rockford IL 61104 363241458 Parent Corporation to manage and direct activites of entities IL 501(c)(3) Line 12a Regional Division Inc 1 SwedishAmerican Hospital 1401 East State Street Rockford IL 61104 362222696 Hospital IL 501(c)(3) Line 3 SwedishAmerican Health System Corporation 1 SwedishAmerican Hospital Self Insurance Trust 1401 East State Street Rockford IL 61104 366652702 Hospital Malpractice Trust VT 501(c)(3) Line 12a SwedishAmerican Hospital 1 SwedishAmerican Realty Corporation 1313 East State Street Rockford IL 61104 363248013 Title Holding Company IL 501(c)(2) SwedishAmerican Health System Corporation 1 University of Wisconsin Hospital and Clinics Authority 7974 UW Health Court Middleton WI 53562 391835630 Hospital and Clinics WI 501(c)(3) Line 3 N/A 0 University Health Care Inc 7974 UW Health Court Middleton WI 53562 472553196 Support Organization WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 1 UW Health ACO Inc 7974 UW Health Court Middleton WI 53562 455490584 Accountable Care Organization WI 501(c)(3) Line 10 University of WI Hospital and Clinics Authority 1 Wisconsin Therapies Inc 7974 UW Health Court Middleton WI 53562 391807425 Infusion Therapy WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 1 Chartwell Wisconsin Enterprises LLC 2241 Pinehurst Drive Middleton WI 53562 391796267 Parent entity of CW and CMW-HR WI N/A Related 143334 9229645 0 2222 0 0.50000 Madison Medical Center LLP 7974 UW Health Court Middleton WI 53562 391329429 Real Estate WI N/A 0 0 Northern Illinois Vein Clinic 2550 Charles Street Rockford IL 61108 201642329 Outpatient Health Services IL N/A 0 0 Sixth Street Medical LLC 7974 UW Health Court Middleton WI 53562 472705724 Real Estate WI N/A 0 0 Three Rivers Partners LLC 1313 East State Street Rockford IL 61104 262231757 Information Technology Services IL N/A 0 0 Health Professionals of Wisconsin 301 South Westfield Road Madison WI 53717 391806711 Real Estate WI N/A C 1 Physician's Care Network 1313 East State Street Rockford IL 61104 363455791 Health Services IL N/A C 1 Quartz Health Benefit Plans Corporation 840 Carolina Street Sauk City WI 53583 391450766 Health Maintenance Organization WI N/A C 1 Quartz Holding Company 840 Carolina Street Sauk City WI 53583 821728929 Holding Company WI N/A C 1 Quartz Health Solutions 840 Carolina Street Sauk City WI 53583 465710709 Insurance WI N/A C 1 Quartz Health Insurance Corporation 840 Carolina Street Sauk City WI 53583 391565691 Health Maintenance Organization WI N/A C 1 SARI Insurance Company 76 St Paul Street Suite 500 Burlington VT 054014477 030308753 Captive Insurance Company VT N/A C 1 State & Charles Inc 1313 East State Street Rockford IL 61104 363321193 Holding Company IL N/A C 1 SwedishAmerican Health Management Corp 1401 East State Street Rockford IL 61104 363246511 Management Services IL N/A C 1 Wisconsin Dialysis 3034 Fish Hatchery Road Fitchburg WI 53713 300072647 Dialysis Services WI N/A C 1 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 Madison Medical Center LLP L 115831 FMV Madison Medical Center LLP K 1916017 FMV Madison Surgery Center O 9103851 FMV Madison Surgery Center L 1966115 FMV Madison Surgery Center C 3100000 FMV Madison Surgery Center A 1780043 FMV UW Health ACO Inc O 536608 FMV UW Health ACO Inc M 95007 FMV