CHILDRENS MEDICAL GROUP INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CHILDRENS MEDICAL GROUP INC (EIN 39-1789197)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-09
- IRS object ID
- 201603149349302600
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-09T14:13:49-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363168081 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIKICH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13400 BISHOPS LANE SUITE 300 | AddressLine1Txt |
| City | BROOKFIELD | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53005 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789197 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S MEDICAL GROUP INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHIL | BusinessNameControlTxt |
| Phone | 4142665420 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARC A CADIEUX | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 4142665420 | PhoneNum |
| Signature | 2016-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRYAN L PAUTSCH CPA | PreparerPersonNm |
| PTIN | P00034913 | PTIN |
| Phone | 2627549400 | PhoneNum |
| Preparation | 2016-11-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEE SCHEDULE O | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SMRITI KHARE MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $54,576,988 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY, ACCESSIBLE PRIMARY HEALTH CARE TO CHILDREN IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 473 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,204,776 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,859,632 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,629,981 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $48,745,732 | CYProgramServiceRevenueAmt |
| PY Investment Income | $116,505 | PYInvestmentIncomeAmt |
| CY Investment Income | -$75,796 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,845 | PYOtherRevenueAmt |
| CY Other Revenue | $47,420 | CYOtherRevenueAmt |
| PY Total Revenue | $50,015,107 | PYTotalRevenueAmt |
| CY Total Revenue | $54,576,988 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $150 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,653,115 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,776,283 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,269,527 | PYOtherExpensesAmt |
| CY Other Expenses | $20,853,790 | CYOtherExpensesAmt |
| PY Total Expenses | $49,922,642 | PYTotalExpensesAmt |
| CY Total Expenses | $54,630,223 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $92,465 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$53,235 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,358,666 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,334,317 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,307,245 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,336,131 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,421 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,814 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,002,978 | ExpenseAmt |
| Grant | $150 | GrantAmt |
| Revenue | $44,290,228 | RevenueAmt |
| Desc | 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, CHHS AND CHW 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 AND TREATMENT SERVICES 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 2015, CMG HAD 27 PHYSICIAN OFFICES WITH 92 PROVIDERS. AS A GROUP THERE WERE 279,360 PEDIATRIC OFFICE VISITS, HEALTH CHECKS AND IMMUNIZATIONS PROVIDED IN 2015. INCLUDED IN THIS NUMBER ARE 44,811 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. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,846,191 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,497,164 | RevenueAmt |
| Desc | 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 DOWNTOWN 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, CHILDREN'S DENTAL CENTER. THESE CLINICS OPERATE AT A LOSS, WHICH WAS FUNDED BY CHW, CONTRIBUTIONS RECEIVED VIA THE CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION, INC., AND BY THE TEMPORARY ENHANCED MEDICAID PRIMARY CARE PAYMENTS PROVIDED BY THE ACCOUNTABLE CARE ACT IN 2015. THESE CLINICS HAD 44,811 PEDIATRIC OFFICE VISITS, HEALTH CHECKS AND IMMUNIZATIONS PROVIDED IN 2015, AND APPROXIMATELY 89% OF THE GROSS CHARGES WERE FROM PATIENTS ENROLLED IN MEDICAID. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $52,849,169 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 473 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS SARAH KAFKA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4142661887 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1997 MS 900 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532011997 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| THOMAS SATO MD | |||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SMRITI KHARE MD | |||||||||
| DIRECTOR/PRESIDENT, CMG | 40.00 | 0.00 | Yes (X) | $0 | $443,456 | $71,447 | Yes (X) | ||
| BRADLEY KIRSCHNER MD | |||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | 40.00 | 0.00 | Yes (X) | $323,322 | $0 | $7,299 | |||
| JOHN KRAEGEL MD | |||||||||
| DIR (THROUGH MAR 2015)/PED PHYSICIAN | 40.00 | 0.00 | Yes (X) | $352,470 | $0 | $13,955 | |||
| SHARYL PALEY MD | |||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | 40.00 | 0.00 | Yes (X) | $443,523 | $0 | $39,258 | |||
| YOLANDA REESE MD | |||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | 40.00 | 0.00 | Yes (X) | $189,362 | $0 | $39,346 | |||
| ROBERT ROHLOFF MD | |||||||||
| DIR/PEDIATRIC PHYSICIAN/DIR CMG QUALITY AND P | 20.00 | 20.00 | Yes (X) | $267,108 | $141,834 | $44,724 | |||
| STEPHANIE WHITT MD | |||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | 40.00 | 0.00 | Yes (X) | $505,261 | $0 | $28,519 | |||
| MARGARET TROY | |||||||||
| CMG CHAIR & DIRECTOR/CHHS PRESIDENT | 0.00 | 40.00 | Yes (X) | $0 | $1,376,051 | $280,989 | Yes (X) | ||
| WELDON GAGE | |||||||||
| TREASURER (THROUGH JAN. 2015) | 0.00 | 40.00 | $0 | $181,445 | $951 | Yes (X) | |||
| SHEILA REYNOLDS | |||||||||
| SECRETARY | 0.00 | 40.00 | $0 | $437,468 | $87,457 | Yes (X) | |||
| MARC CADIEUX | |||||||||
| TREASURER | 0.00 | 40.00 | $0 | $443,414 | $52,167 | Yes (X) | |||
| MARY SISNEY | |||||||||
| VP PRIMARY CARE | 40.00 | 0.00 | $0 | $166,298 | $45,684 | Yes (X) | |||
| WILLIAM JERUC MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 0.00 | $612,377 | $0 | $34,941 | Yes (X) | |||
| SHERYN ABRAHAM MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 0.00 | $611,230 | $0 | $9,918 | Yes (X) | |||
| JASON FRIEDLANDER MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 0.00 | $704,019 | $0 | $39,081 | Yes (X) | |||
| ANDREW LESLIE MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 0.00 | $555,599 | $0 | $39,210 | Yes (X) | |||
| JAYA IYER MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 0.00 | $520,682 | $0 | $10,425 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,084,953 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,189,966 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $845,371 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 69 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THE MEDICAL COLLEGE OF WISCONSIN | |||||
| 8701 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | PHYSICIANS AND NURSE PRACTITIONERS | $1,059,526 |
| MEDICAL STAFFING NETWORK INC | |||||
| PO BOX 840292 | DALLAS | TX | 75284 | TEMPORARY HELP | $180,657 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,859,632 | RelatedOrganizationsAmt |
| Total Contributions | $5,859,632 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SVC REV | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $48,745,732 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,745,732 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $48,745,732 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$75,796 | TotalRevenueColumnAmt |
| Exclusion | -$75,796 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $47,420 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,660 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $5,760 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $47,420 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,576,988 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,787,392 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$70,036 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150 | TotalAmt |
| Program Services | $150 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,368,673 | TotalAmt |
| Program Services | $5,368,673 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,973,150 | TotalAmt |
| Program Services | $24,911,705 | ProgramServicesAmt |
| Management And General | $61,445 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,863 | TotalAmt |
| Program Services | $621,863 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,273,699 | TotalAmt |
| Program Services | $1,273,699 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,538,898 | TotalAmt |
| Program Services | $1,538,898 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,450,000 | TotalAmt |
| Management And General | $1,450,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,527 | TotalAmt |
| Management And General | $35,527 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,892,505 | TotalAmt |
| Program Services | $3,882,605 | ProgramServicesAmt |
| Management And General | $9,900 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,776 | TotalAmt |
| Program Services | $33,776 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,567 | TotalAmt |
| Program Services | $174,567 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,340 | TotalAmt |
| Program Services | $48,467 | ProgramServicesAmt |
| Management And General | $873 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000,590 | TotalAmt |
| Program Services | $4,000,590 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,737 | TotalAmt |
| Program Services | $26,084 | ProgramServicesAmt |
| Management And General | $17,653 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,847 | TotalAmt |
| Program Services | $60,103 | ProgramServicesAmt |
| Management And General | $16,744 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $710,771 | TotalAmt |
| Program Services | $567,078 | ProgramServicesAmt |
| Management And General | $143,693 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,366 | TotalAmt |
| Program Services | $178,892 | ProgramServicesAmt |
| Management And General | $1,474 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,477,883 | $9,477,883 | $0 |
| OTHER EXPENSES | $727,881 | $684,136 | $43,745 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,630,223 | TotalAmt |
| Program Services | $52,849,169 | ProgramServicesAmt |
| Management And General | $1,781,054 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,191,314 | BOYAmt |
| EOY | $291,643 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,537,364 | BOYAmt |
| EOY | $3,240,482 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,565 | BOYAmt |
| EOY | $52,085 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,519,548 | BOYAmt |
| EOY | $1,491,446 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,191 | BOYAmt |
| EOY | $151,969 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,648,332 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,627,110 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,166,762 | BOYAmt |
| EOY | $4,021,222 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,727,922 | BOYAmt |
| EOY | $3,085,470 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,358,666 | BOYAmt |
| EOY | $12,334,317 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,179,085 | BOYAmt |
| EOY | $7,932,359 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,005 | BOYAmt |
| EOY | $704,809 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,856,155 | BOYAmt |
| EOY | $3,698,963 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,307,245 | BOYAmt |
| EOY | $12,336,131 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,421 | BOYAmt |
| EOY | -$1,814 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,421 | BOYAmt |
| EOY | -$1,814 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,358,666 | BOYAmt |
| EOY | $12,334,317 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$53,235 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,922,780 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,398,137 | DepreciationAmt |
| Book Value | $2,524,643 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,657,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,228,973 | DepreciationAmt |
| Book Value | $1,428,816 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $67,763 | OtherCostOrOtherBasisAmt |
| Book Value | $67,763 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,021,222 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED COMPENSATION PLAN ASSETS | $3,046,633 |
| DEPOSITS | $19,587 |
| VENDOR REBATES | $19,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,085,470 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN LIABILITIES | $3,046,633 |
| DUE TO AFFILIATES | $652,330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,698,963 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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, 2015 AND 2014. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SMRITI KHARE MD | ||||||||||||||
| DIRECTOR/PRESIDENT, CMG | $0 | $338,480 | $0 | $101,887 | $0 | $3,089 | $0 | $54,043 | $0 | $17,404 | $0 | $514,903 | $0 | $0 |
| BRADLEY KIRSCHNER MD | ||||||||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | $265,021 | $0 | $58,301 | $0 | $0 | $0 | $4,873 | $0 | $2,426 | $0 | $330,621 | $0 | $0 | $0 |
| JOHN KRAEGEL MD | ||||||||||||||
| DIR (THROUGH MAR 2015)/PED PHYSICIAN | $238,881 | $0 | $95,589 | $0 | $18,000 | $0 | $9,000 | $0 | $4,955 | $0 | $366,425 | $0 | $0 | $0 |
| SHARYL PALEY MD | ||||||||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | $280,449 | $0 | $145,074 | $0 | $18,000 | $0 | $9,000 | $0 | $30,258 | $0 | $482,781 | $0 | $0 | $0 |
| YOLANDA REESE MD | ||||||||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | $165,095 | $0 | $24,267 | $0 | $0 | $0 | $8,314 | $0 | $31,032 | $0 | $228,708 | $0 | $0 | $0 |
| ROBERT ROHLOFF MD | ||||||||||||||
| DIR/PEDIATRIC PHYSICIAN/DIR CMG QUAL | $172,763 | $124,803 | $91,063 | $0 | $3,282 | $17,031 | $0 | $12,908 | $21,771 | $10,045 | $288,879 | $164,787 | $0 | $0 |
| STEPHANIE WHITT MD | ||||||||||||||
| DIRECTOR/PEDIATRIC PHYSICIAN | $304,768 | $0 | $200,493 | $0 | $0 | $0 | $9,000 | $0 | $19,519 | $0 | $533,780 | $0 | $0 | $0 |
| MARGARET TROY | ||||||||||||||
| CMG CHAIR & DIRECTOR/CHHS PRESIDENT | $0 | $813,770 | $0 | $446,931 | $0 | $115,350 | $0 | $232,659 | $0 | $48,330 | $0 | $1,657,040 | $0 | $0 |
| WELDON GAGE | ||||||||||||||
| TREASURER (THROUGH JAN. 2015) | $0 | $53,541 | $0 | $127,883 | $0 | $21 | $0 | $0 | $0 | $951 | $0 | $182,396 | $0 | $0 |
| SHEILA REYNOLDS | ||||||||||||||
| SECRETARY | $0 | $287,272 | $0 | $93,546 | $0 | $56,650 | $0 | $51,224 | $0 | $36,233 | $0 | $524,925 | $0 | $35,371 |
| MARC CADIEUX | ||||||||||||||
| TREASURER | $0 | $273,307 | $0 | $95,252 | $0 | $74,855 | $0 | $47,350 | $0 | $4,817 | $0 | $495,581 | $0 | $0 |
| MARY SISNEY | ||||||||||||||
| VP PRIMARY CARE | $0 | $165,485 | $0 | $0 | $0 | $813 | $0 | $15,491 | $0 | $30,193 | $0 | $211,982 | $0 | $0 |
| WILLIAM JERUC MD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $360,587 | $0 | $233,790 | $0 | $18,000 | $0 | $9,000 | $0 | $25,941 | $0 | $647,318 | $0 | $0 | $0 |
| SHERYN ABRAHAM MD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $459,842 | $0 | $142,540 | $0 | $8,848 | $0 | $9,000 | $0 | $918 | $0 | $621,148 | $0 | $0 | $0 |
| JASON FRIEDLANDER MD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $440,413 | $0 | $245,606 | $0 | $18,000 | $0 | $9,000 | $0 | $30,081 | $0 | $743,100 | $0 | $0 | $0 |
| ANDREW LESLIE MD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $357,273 | $0 | $180,326 | $0 | $18,000 | $0 | $9,000 | $0 | $30,210 | $0 | $594,809 | $0 | $0 | $0 |
| JAYA IYER MD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $322,835 | $0 | $197,847 | $0 | $0 | $0 | $9,000 | $0 | $1,425 | $0 | $531,107 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2015, 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 2015 WERE AS FOLLOWS: M. CADIEUX, $27,750; S. KHARE, M.D., $34,443; AND S. REYNOLDS, $31,624. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2015 WERE: S. REYNOLDS, $35,371. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT AND CEO. THE AMOUNT SET ASIDE IN 2015 WAS $274,540 AND OF THAT, $58,831 WAS PAID AS A VESTED DISTRIBUTION UNDER THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN) MENTIONED ABOVE AND IS INCLUDED IN PART II, COLUMN (B)(III). |
| 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: | 1. SMRITI KHARE, M.D., PRESIDENT OF CMG, ROBERT ROHLOFF, M.D., DIR, CMG QUALITY & PATIENT SAFETY, AND MARY SISNEY, VP PRIMARY CARE - 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 AND DR. ROHLOFF AS MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 2. DRS. KIRSCHNER, KRAEGEL, PALEY, REESE, AND WHITT - COMPENSATION AND BENEFITS LISTED WERE FOR SERVICES PROVIDED AS FULL-TIME EMPLOYEES OF CMG AS PEDIATRIC PHYSICIANS. SERVICES AS MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 3. MARGARET TROY, CMG BOARD CHAIR AND PRESIDENT & CEO OF CHHS, MARC CADIEUX, TREASURER OF CMG AND TREASURER & CFO OF CHHS, WELDON GAGE, TREASURER OF CMG (THROUGH JANUARY 2015) AND TREASURER & CFO OF CHHS (THROUGH JANUARY 2015), AND SHEILA REYNOLDS, SECRETARY OF CMG AND CORPORATE VP & GENERAL COUNSEL OF CHHS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. SERVICES BY MS. TROY AS A MEMBER OF THE BOARD OF DIRECTORS OF CMG WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, BOX C, DOING BUSINESS AS: | CHILDREN'S DENTAL CENTER AND CHILDREN'S HOSPITAL OF 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 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 11 | 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 DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CORPORATE VICE PRESIDENT AND GENERAL COUNSEL OF CHHS. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE AT EACH BOARD AND COMMITTEE MEETING. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ORGANIZATION'S 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 391500074 | OPERATIONAL SUPPORT SERVICES | 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 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 391500075 | FUND DEVELOPMENT | WI | 501(C)(3) | LINE 7 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S PHYSICIAN GROUP PC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 364303682 | PEDIATRIC PHYSICIAN SERVICES | IL | 501(C)(3) | LINE 9 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 390806380 | CHILD WELLBEING SERVICES | WI | 501(C)(3) | LINE 7 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
| CHILDREN'S COMMUNITY HEALTH PLAN INC | |||||||||||
| PO BOX 1997 MS 900 | MILWAUKEE | WI | 532011997 | 271494977 | WISCONSIN MEDICAID HMO | WI | 501(C)(3) | LINE 9 | 0 | CHILDREN'S HOSPITAL & HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRTUAL PICU SYSTEMS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 WYTHE STREET SUITE 101 | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22314 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201414664 | EIN |
| Primary Activities | QUALITY/OUTCOMES ANALYSIS | PrimaryActivitiesTxt |
| Legal Domicile State | DE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL & HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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