2021-11-05T10:52:50-05:00 2020-12-31 363168081 SIKICH LLP 13400 BISHOPS LANE SUITE 300 BROOKFIELD WI 53005 990 2020-01-01 391789197 CHILDREN'S MEDICAL GROUP INC CHIL 4142665420 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARC A CADIEUX TREASURER 4142665420 2021-11-05 1 MARC CADIEUX 999009999 JILL M BOYLE CPA P01246734 2627549400 2021-11-01 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SEE SCHEDULE O SMRITI KHARE MD PO BOX 1997 MS 900 MILWAUKEE WI 532011997 89538376 0 X WWW.CHILDRENSWI.ORG X 1994 WI PROVIDE QUALITY, ACCESSIBLE PRIMARY HEALTH CARE TO CHILDREN IN THE COMMUNITY. 10 0 601 0 0 0 10325626 27502210 70473692 62003250 -26384 -5937 352605 29474 81125539 89528997 0 0 0 0 53302772 53066185 0 0 0 27857873 36462812 81160645 89528997 -35106 0 34861601 32246252 34861601 32246252 0 0 X TO PROVIDE QUALITY, ACCESSIBLE PRIMARY HEALTH CARE SERVICES TO ALL CHILDREN IN OUR COMMUNITY, ADVOCATE FOR THE WELL-BEING OF ALL CHILDREN, EDUCATE CHILDREN, FAMILIES, HEALTH CARE PROFESSIONALS AND OUR COMMUNITY REGARDING THE HEALTH OF CHILDREN. 0 0 61308674 57155601 CHILDREN'S MEDICAL GROUP, INC. ("CMG") IS ORGANIZED AS A NON STOCK NON PROFIT CORPORATION WITH A SOLE MEMBER, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), A SECTION 501(C)(3) ORGANIZATION. CMG IS AFFILIATED WITH CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW"), A SECTION 501(C)(3) ORGANIZATION WHICH IS THE ONLY HOSPITAL IN WISCONSIN DEVOTED SOLELY TO THE PROVISION OF MEDICAL SERVICES TO CHILDREN. THE PRIMARY PURPOSE OF CMG IS TO PROVIDE QUALITY PRIMARY CARE MEDICAL SERVICES TO CHILDREN IN THE COMMUNITY, STATE, AND REGION. THE AFFILIATED GROUP IS ONE OF ONLY A HANDFUL OF ORGANIZATIONS THROUGHOUT THE U.S. THAT FOCUSES SOLELY ON THE CRITICAL MEDICAL NEEDS OF CHILDREN AND THE SPECIAL CARE REQUIRED BY THEM. THE PRINCIPAL FUNCTION OF CMG IS TO PROVIDE PRIMARY MEDICAL DIAGNOSIS, TREATMENT SERVICES, AND PREVENTATIVE CARE THROUGH OUTPATIENT CLINICS AND COMMUNITY HEALTH SCREENING AND EDUCATION SERVICES. CMG ALSO PARTICIPATES IN PRIMARY CARE MEDICAL EDUCATION AND TRAINING THROUGH THE MEDICAL COLLEGE OF WISCONSIN AND GRADUATE MEDICAL EDUCATION PROGRAMS ALREADY ESTABLISHED AT CHW. CMG PROVIDES CARE TO CHILDREN WHO ARE RESIDENTS OF SOUTHEASTERN WISCONSIN AT LOCATIONS WHERE THERE IS A DEMONSTRATED COMMUNITY NEED FOR MEDICAL DIAGNOSIS AND TREATMENT. IN 2020, CMG HAD 25 PHYSICIAN OFFICES WITH 132 PROVIDERS. AS A GROUP THERE WERE 281,605 PEDIATRIC OFFICE VISITS, HEALTH CHECKS AND IMMUNIZATIONS PROVIDED IN 2020. INCLUDED IN THIS NUMBER ARE 34,317 PEDIATRIC OFFICE VISITS, HEALTH CHECKS AND IMMUNIZATIONS DESCRIBED IN LINE 4B.IN RESPONSE TO THE CHANGING NEEDS OF THE COMMUNITY FOR MEDICAL SERVICES, ADVANCES IN PEDIATRIC MEDICINE AND THE INCREASING EMPHASIS ON PREVENTIVE MEDICAL CARE, CMG PROVIDES SERVICES IN FURTHERANCE OF THE MISSION OF CHW AND OTHER MEMBERS OF THE AFFILIATED GROUP. INCREASINGLY, PATIENTS HAVE BEEN SEEKING PRIMARY MEDICAL CARE THROUGH THE EMERGENCY ROOM FACILITIES OF HOSPITALS. THE EMERGENCY ROOM IS THE MOST COSTLY AND INEFFICIENT METHOD OF PROVIDING SUCH CARE TO PATIENTS. BY MAKING PRIMARY CARE AVAILABLE TO A GREATER PORTION OF THE GENERAL PUBLIC, CMG PROVIDES QUALITY, EFFICIENT PRIMARY PEDIATRIC CARE AT A LOWER COST. CMG IS STRUCTURED TO BETTER SERVE THE RESIDENTS OF SOUTHEASTERN WISCONSIN BY PROVIDING INCREASED ACCESS TO QUALITY MEDICAL CARE, EXPANDING COMMUNITY MEDICAL EDUCATION EFFORTS AND IMPROVING THE QUALITY OF PEDIATRIC CARE.DURING THE COVID-19 PANDEMIC, CHILDREN'S PIVOTED TO PROVIDE THE CARE KIDS AND FAMILIES NEED AS SAFELY AS POSSIBLE. THIS INCLUDED A SIGNIFICANT INCREASE IN USE OF TELEHEALTH (INCLUDING FOR MENTAL AND BEHAVIORAL HEALTH NEEDS) AND SUPPORTING OUR COMMUNITY THROUGH TESTING, VACCINATION AND PEDIATRIC HEALTH AND SAFETY ADVICE AND RECOMMENDATIONS. 11202770 4877123 CMG OPERATES CLINICS IN UNDERSERVED AREAS IN THE MILWAUKEE AREA, INCLUDING A SITE LOCATED ON THE NEXT DOOR FOUNDATION CAMPUS IN MILWAUKEE'S CENTRAL CITY, IN ADDITION TO THE MIDTOWN HEALTH CENTER AND COMMUNITY CLINICS. THESE CLINICS PROVIDE PRIMARY CARE SERVICES INCLUDING PREVENTIVE CARE, PHYSICALS, IMMUNIZATIONS AND TREATMENT FOR ILLNESSES TO AREAS THAT PREVIOUSLY DID NOT HAVE PEDIATRIC PRACTICES AVAILABLE TO ATTEND TO THE COMMUNITY'S NEEDS. ADDITIONALLY, TO MEET THE DENTAL NEEDS OF UNDERSERVED CHILDREN IN THE CITY OF MILWAUKEE, CMG HAS A PEDIATRIC DENTAL PRACTICE, DENTAL CENTER MIDTOWN. THESE CLINICS OPERATE AT A LOSS, WHICH WAS FUNDED BY CHW OR CONTRIBUTIONS RECEIVED VIA THE CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC. THESE CLINICS HAD 34,317 PEDIATRIC OFFICE VISITS, HEALTH CHECKS AND IMMUNIZATIONS PROVIDED IN 2020, AND APPROXIMATELY 83% OF THE GROSS CHARGES WERE FROM PATIENTS ENROLLED IN MEDICAID. 72511444 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 601 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MS SARAH KAFKA 4142661887 PO BOX 1997 MS 900 MILWAUKEE WI 532011997 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0.00 40.00 X 0 1977316 57166 MARC CADIEUX TREASURER 0.00 40.00 X 0 839342 94857 SMRITI KHARE MD DIRECTOR/PRESIDENT/CHAIR 0.00 40.00 X X 0 745559 130838 MICHELLE METTNER SECRETARY 0.00 40.00 X 0 648967 106666 JASON FRIEDLANDER MD PEDIATRIC PHYSICIAN 40.00 0.00 X 612949 0 44285 SHERYN ABRAHAM MD PEDIATRIC PHYSICIAN 40.00 0.00 X 597572 0 39441 PATTI-MARIE YOUNG MD PEDIATRIC PHYSICIAN 40.00 0.00 X 470172 0 10777 ROBERT ROHLOFF MD MED DIR HEALTH MGT & CMTY SVC 40.00 0.00 X 416900 0 56693 JAYA IYER MD PEDIATRIC PHYSICIAN 40.00 0.00 X 424408 0 11327 CHRISTOPHER SCHWAKE MD DIRECTOR/MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 361803 0 44657 BOYD MILLER MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 319726 0 48986 DANIEL DORRINGTON MD DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 311829 0 44261 STEVE JEREB MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 293774 0 56021 MARY SISNEY VP PRIMARY CARE 40.00 0.00 X 282543 0 59747 YOLANDA WOLFF MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 287111 0 51961 KATHRYN FEE MD DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 305973 0 13120 CHRISTEN MCALPINE-TESFAI MD DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 260499 0 7473 BARBARA CALKINS MD DIRECTOR/PEDIATRIC PHYSICIAN 30.00 0.00 X 239380 0 9902 CYNTHIA RUNNING MD DIRECTOR/PEDIATRIC PHYSICIAN 30.00 0.00 X 197348 0 45916 YOLANDA REESE MD DIRECTOR/PEDIATRIC PHYSICIAN 40.00 0.00 X 171456 0 40119 JASON JARZEMBOWSKI MD DIRECTOR (AS OF 08/01/2020) 1.00 0.00 X 0 0 0 THOMAS SATO MD DIRECTOR (THROUGH 07/31/2020) 1.00 0.00 X 0 0 0 5553443 4211184 974213 116 0 1 0 TRIAGE 4 PEDIATRICS PO BOX 261923 PLANO TX 75026 ANSWERING SERVICES 323300 THE MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK RD MILWAUKEE WI 53226 PHYSICIANS AND NURSE PRACTITIONERS 321948 CTR FOR TRANSFORMATION AND INNOVATION 16350 BRUCE B DOWNS BLVD TAMPA FL 33647 CONSULTING SERVICE 154000 CLEAN POWER LLC PO BOX 88369 MILWAUKEE WI 53288 CLEANING SERVICE 143022 MIRON CONSTRUCTION CO INC PO BOX 1372 GREEN BAY WI 54305 BUILDING CONTRACTOR 106643 5 25994556 1507654 27502210 NET PATIENT SVC REV 621110 61749371 61749371 RENTAL INCOME 532000 204012 204012 SALARY SUPPORT 900099 49867 49867 62003250 3442 3442 9379 -9379 -9379 -9379 OTHER MISCELLANEOUS 900099 29474 29474 29474 89528997 62032724 0 -5937 3453602 2801243 652359 40766249 38466034 2300215 2322534 2271496 51038 3917280 3758806 158474 2606520 2468878 137642 13132056 13132056 1010132 742774 267358 590 590 374446 374446 423 381 42 6582208 6458298 123910 28573 21704 6869 52895 50384 2511 2228662 2105943 122719 144672 142558 2114 MEDICAL SUPPLIES 12180440 12180440 OTHER EXPENSES 727715 667469 60246 89528997 72511444 17017553 0 446431 465247 4874271 3485425 103857 93734 1310181 1458806 596166 586371 19342070 9036033 12235492 10306037 15295203 15850632 34861601 32246252 9030207 8050334 3043008 3221503 22788386 20974415 34861601 32246252 X 0 0 34861601 32246252 0 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12044316 5811356 6232960 7262761 3224677 4038084 34993 34993 10306037 DEFERRED COMPENSATION PLAN ASSETS 8688510 LEASE ASSETS 7162122 15850632 DEFERRED COMPENSATION PLAN LIABILITIES 8688510 DUE TO AFFILIATES 4924481 LEASE LIABILITY AND OTHER 7361424 20974415 X 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, 2020 AND 2019. 0 1 0 0 0 0 0 1 0 MARGARET TROY DIRECTOR/CHHS PRESIDENT 0 1060734 0 529018 0 387564 0 21150 0 36016 0 2034482 0 0 MARC CADIEUX TREASURER 0 595303 0 187603 0 56436 0 91485 0 3372 0 934199 0 31926 SMRITI KHARE MD DIRECTOR/PRESIDENT/CHAIR 0 514011 0 190762 0 40786 0 98049 0 32789 0 876397 0 35945 MICHELLE METTNER SECRETARY 0 452620 0 141900 0 54447 0 78146 0 28520 0 755633 0 8095 JASON FRIEDLANDER MD PEDIATRIC PHYSICIAN 474124 0 118484 0 20341 0 9750 0 34535 0 657234 0 0 0 SHERYN ABRAHAM MD PEDIATRIC PHYSICIAN 471170 0 106061 0 20341 0 9750 0 29691 0 637013 0 0 0 PATTI-MARIE YOUNG MD PEDIATRIC PHYSICIAN 403242 0 65640 0 1290 0 9750 0 1027 0 480949 0 0 0 ROBERT ROHLOFF MD MED DIR HEALTH MGT & CMTY SVC 368913 0 24065 0 23922 0 24000 0 32693 0 473593 0 0 0 JAYA IYER MD PEDIATRIC PHYSICIAN 351690 0 51928 0 20790 0 9750 0 1577 0 435735 0 0 0 CHRISTOPHER SCHWAKE MD DIRECTOR/MEDICAL DIRECTOR/PEDIATRIC 355685 0 5557 0 561 0 9750 0 34907 0 406460 0 0 0 BOYD MILLER MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 304398 0 12917 0 2411 0 18300 0 30686 0 368712 0 0 0 DANIEL DORRINGTON MD DIRECTOR/PEDIATRIC PHYSICIAN 260062 0 41292 0 10475 0 9750 0 34511 0 356090 0 0 0 STEVE JEREB MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 280130 0 11903 0 1741 0 21150 0 34871 0 349795 0 0 0 MARY SISNEY VP PRIMARY CARE 231369 0 48141 0 3033 0 24000 0 35747 0 342290 0 0 0 YOLANDA WOLFF MD MEDICAL DIRECTOR/PEDIATRIC PHYSICIAN 274573 0 11497 0 1041 0 21150 0 30811 0 339072 0 0 0 KATHRYN FEE MD DIRECTOR/PEDIATRIC PHYSICIAN 250354 0 35614 0 20005 0 9750 0 3370 0 319093 0 0 0 CHRISTEN MCALPINE-TESFAI MD DIRECTOR/PEDIATRIC PHYSICIAN 203428 0 56687 0 384 0 6725 0 748 0 267972 0 0 0 BARBARA CALKINS MD DIRECTOR/PEDIATRIC PHYSICIAN 224204 0 14136 0 1040 0 9534 0 368 0 249282 0 0 0 CYNTHIA RUNNING MD DIRECTOR/PEDIATRIC PHYSICIAN 167054 0 29346 0 948 0 8404 0 37512 0 243264 0 0 0 YOLANDA REESE MD DIRECTOR/PEDIATRIC PHYSICIAN 156556 0 14185 0 715 0 7187 0 32932 0 211575 0 0 0 PART I, LINE 3 CMG RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC.("CHHS"), THE CORPORATE MEMBER OF CMG, TO ESTABLISH THE COMPENSATION OF CMG'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION. PART I, LINE 4B IN 2020, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2020 WERE AS FOLLOWS: M. CADIEUX, $70,335, S. KHARE, M.D., $76,899, AND M. METTNER, $56,996. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2020 WERE: M. CADIEUX, $31,926; S. KHARE, M.D, $35,945; AND M. METTNER, $8,095. PART I, LINE 7 CERTAIN EXECUTIVES PARTICIPATE IN AN ANNUAL BONUS PLAN THAT PROVIDES COMPENSATION BASED ON ACHIEVING SPECIFIC PRE-DEFINED GOALS. BONUS CRITERIA ARE COMPRISED OF BOTH SYSTEM LEVEL AND EXECUTIVE SPECIFIC COMPONENTS. SUCH CRITERIA PERTAIN TO MATTERS WITHIN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF THE ORGANIZATION AND ITS AFFILIATES IN ALIGNMENT WITH SYSTEM-WIDE BALANCED MEASURES. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. SMRITI KHARE, M.D., PRESIDENT OF CMG AND BOARD CHAIR 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 CMG. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY DR. KHARE AS A MEMBER OF THE BOARD OF DIRECTORS WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 2. DRS. CALKINS, DORRINGTON, FEE, MCALPINE-TESFAI, REESE, RUNNING, AND SCHWAKE - COMPENSATION AND BENEFITS LISTED WERE FOR SERVICES PROVIDED AS FULL-TIME EMPLOYEES OF CMG. SERVICES AS MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 3. MARGARET TROY, PRESIDENT & CEO OF CHHS, MARC CADIEUX, TREASURER OF CMG AND TREASURER & CFO OF CHHS, AND MICHELLE METTNER, SECRETARY OF CMG AND CORP VP GOVT & LEGAL AFFAIRS - 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 CMG WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. FORM 990, BOX C, DOING BUSINESS AS: CHILDREN'S WISCONSIN - PRIMARY CARE FORM 990, PART V, LINE 1A THE ORGANIZATION DID NOT FILE ANY FORMS 1099 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, CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW"), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHW. THE FORMS 1099 FOR SUCH PAYMENTS WERE ISSUED BY CHW, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: TROY AND SATO, AND TROY AND JARZEMBOWSKI. 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; AND APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF CHHS SELECTS THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 OF CMG WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CMG. 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 DIRECTOR OF CORPORATE COMPLIANCE. 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 OFFICERS WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS (THE ORGANIZATION'S CORPORATE MEMBER). 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 THE KEY EMPLOYEE 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 CMG ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. FORM 990, PART I, LINE 4 AND PART VI, LINE 1B CHILDREN'S MEDICAL GROUP, INC. ("CMG") IS A WISCONSIN NONSTOCK CORPORATION. CMG IS AN AFFILIATE OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), A TAX-EXEMPT WISCONSIN CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH CARE NEEDS OF CHILDREN IN SOUTHEASTERN WISCONSIN AND SURROUNDING AREAS. AS THE CORPORATE MEMBER OF CMG, CHHS HOLDS VARIOUS RESERVE POWERS IN RELATION TO CMG, INCLUDING AUTHORITY TO APPOINT CMG'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF CMG CONSISTS OF CERTAIN PHYSICIANS WHO ARE EMPLOYED BY CMG, ALONG WITH REPRESENTATIVES OF CHHS'S EXECUTIVE LEADERSHIP. AS EMPLOYEES OF EITHER CMG OR CHHS, NONE OF THESE DIRECTORS MAY BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS CPE TEXT FOR FISCAL YEAR 1997, IN A MULTI ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. CMG MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF CHHS, AND CHHS'S GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. CHILDREN'S HOSPITAL & HEALTH SYSTEM INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S PHYSICIAN GROUP PC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 364303682 PEDIATRIC PHYSICIAN SERVICES IL 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 MS 900 MILWAUKEE WI 532011997 390806380 CHILD WELLBEING SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S COMMUNITY HEALTH PLAN INC PO BOX 1997 MS 900 MILWAUKEE WI 532011997 271494977 WISCONSIN MEDICAID HMO WI 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 0 CHILDREN'S SPECIALTY GROUP INC 999 N 92ND ST SUITE C740 MILWAUKEE WI 53226 391990012 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 12A, I N/A 0 WEST ALLIS PRESCRIPTION CENTER INC 6737 W WASHINGTON ST STE 1100 WEST ALLIS WI 53214 463421597 PHARMACY WI N/A C 0 WAUWATOSA PRESCRIPTION CENTER INC SKYWALK PHARMACY 9000 W WISCONSIN AVE WAUWATOSA WI 53226 061654484 PHARMACY WI N/A C 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1