CHILDRENS HOSPITAL OF WISCONSIN INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHILDRENS HOSPITAL OF WISCONSIN INC (EIN 39-0812532)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-10
- IRS object ID
- 201133149349301423
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-10T09:51:13-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOLBCO SC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13400 BISHOPS LANE SUITE 300 | AddressLine1 |
| City | BROOKFIELD | City |
| State | WI | State |
| ZIP Code | 53005 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390812532 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL OF WISCONSIN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHIL | NameControl |
| Phone | 4142665420 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 W WISCONSIN AVE PO BOX 1997 NO | AddressLine1 |
| Address Line2 | MS 900 | AddressLine2 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53201 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARC CADIEUX | Name |
| Title | CFO | Title |
| Phone | 4142665420 | Phone |
| Date Signed | 2011-10-31 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRYAN L PAUTSCH | Name |
| Phone | 2627549400 | Phone |
| Date Prepared | 2011-10-31 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARGARET TROY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 W WISCONSIN AVE PO BOX 1997 NO | AddressLine1 |
| Address Line2 | MS 90 | AddressLine2 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 635028209 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CHW.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1894 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | PEDIATRIC HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 25 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 3774 | TotalNbrEmployees |
| Total Nbr Volunteers | 375 | TotalNbrVolunteers |
| Total Gross UBI | 183349 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -17738 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 17287587 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 19245594 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 557886987 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 524038329 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5879898 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8315179 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7672860 | OtherRevenuePriorYear |
| Other Revenue Current Year | 7847097 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 588727332 | TotalRevenuePriorYear |
| Total Revenue Current Year | 559446199 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 466781 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 495578 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 221114802 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 212227531 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 292652523 | OtherExpensePriorYear |
| Other Expenses Current Year | 305533639 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 514234106 | TotalExpensesPriorYear |
| Total Expenses Current Year | 518256748 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 74493226 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 41189451 | RevenuesLessExpensesCY |
| Total Assets BOY | 1082493881 | TotalAssetsBOY |
| Total Assets EOY | 1153583040 | TotalAssetsEOY |
| Total Liabilities BOY | 387505204 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 403541346 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 694988677 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 750041694 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. IS TO PROVIDE A COMPREHENSIVE AND INTEGRATED PEDIATRIC HEALTH CARE MODEL THAT DELIVERS SUPERIOR QUALITY AND VALUE BY OFFERING THE BEST SOLUTION FOR THE TOTAL HEALTH CARE NEEDS OF CHILDREN WITHIN OUR COMMUNITY, STATE AND REGION.AS A PREMIER AND STANDARD-SETTING LEADER IN THE DELIVERY OF PEDIATRIC CLINICAL SERVICE, EDUCATION AND RESEARCH, CHILDREN'S HOSPITAL ADVOCATES FOR CHILDREN AND BRINGS A COMMITMENT TO EXCELLENCE TO OUR PATIENTS AND FAMILIES, MEDICAL STAFF, EMPLOYEES AND COMMUNITIES IN ADDRESSING THE HEALTH AND WELL-BEING OF CHILDREN.OUR MISSION IS OUR CHILDREN (AND IT SPELLS "CARE"):CAREGIVING - OFFERING HIGH QUALITY, COMPREHENSIVE MEDICAL CAREADVOCACY - SPEAKING UP AND PROTECTING CHILDRENRESEARCH - FINDING CURES TO THE ILLNESSES THAT AFFECT CHILDRENEDUCATION - SHARING WHAT WE LEARN AND TEACHING OTHERS TO CARE FOR KIDS | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 428156005 | Expense |
| Grants | 495578 | Grants |
| Revenue | 524038329 | Revenue |
| Description | INPATIENT SERVICES:CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW" OR "THE HOSPITAL") OPERATES A 296-BED HOSPITAL AT ITS MILWAUKEE CAMPUS, WHICH INCLUDES AN EMERGENCY ROOM OPEN ON A 24/7 BASIS. IT IS A FREESTANDING WISCONSIN HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN AND IS ONE OF THE LEADING CENTERS FOR PEDIATRIC HEALTH CARE IN THE U.S. THE HOSPITAL SERVES CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE, TO CHILDREN FROM WISCONSIN, THE UPPER PENINSULA OF MICHIGAN, NORTHERN ILLINOIS AND BEYOND. IN 2010, 24,615 CHILDREN WERE ADMITTED TO THE MILWAUKEE CAMPUS, WHICH INCLUDES A NEONATAL INTENSIVE CARE UNIT (NICU), PEDIATRIC INTENSIVE CARE UNIT (PICU), A HEMATOLOGY, ONCOLOGY, AND TRANSPLANT UNIT, MEDICAL/SURGICAL UNITS, AND A DAY SURGERY SHORT STAY UNIT. THE HOSPITAL ALSO OPERATES A SEPARATELY-LICENSED 42-BED PEDIATRIC HOSPITAL, WHICH INCLUDES A NICU AND A PEDIATRIC MEDICAL/SURGICAL UNIT, LOCATED ON THE CAMPUS OF THEDA CLARK MEDICAL CENTER IN NEENAH, WIS., THROUGH WHICH IT PROVIDES PEDIATRIC EXPERTISE TO THE GREATER FOX VALLEY AREA.OUTPATIENT AND AMBULATORY SERVICES:THE HOSPITAL PROVIDES A FULL ARRAY OF OUTPATIENT SURGICAL, DIAGNOSTIC AND AMBULATORY SERVICES, INCLUDING MORE THAN 70 SUBSPECIALTY CLINICS PROVIDING OUTPATIENT DIAGNOSIS AND TREATMENT FOR A WIDE VARIETY OF PEDIATRIC DISORDERS. THE HOSPITAL IS A CERTIFIED LEVEL 1 PEDIATRIC TRAUMA CENTER, AND HANDLED 61,928 VISITS DURING 2010. OTHER OUTPATIENT SERVICES ARE OFFERED AT ACCESSIBLE LOCATIONS THROUGHOUT SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS, AND IN WISCONSIN'S FOX VALLEY. THE HOSPITAL'S NATIONALLY KNOWN AND RECOGNIZED SPECIALTY PROGRAMS INCLUDE THOSE FOR TREATING CHILDREN WITH AIRWAY, DIGESTIVE AND VOICE CONDITIONS; BURNS; CANCER AND BLOOD DISORDERS; CONGENITAL AND ACQUIRED HEART DEFECTS AND DISEASES; CRANIOFACIAL DISORDERS; DERMATOLOGY, BIRTHMARKS AND VASCULAR ANOMALIES; DIABETES; GASTROINTESTINAL PROBLEMS; GENETIC DISORDERS; HIV; NEUROLOGICAL DISORDERS; ORTHOPEDIC CONDITIONS; IMMUNODEFICIENCIES AND IMMUNE DYSREGULATION SYNDROMES; PSYCHIATRY; SLEEP DISORDERS; ORGAN TRANSPLANTATION; SPEECH AND HEARING DISORDERS; AND SPASTICITY AND OTHER TONE AND MOBILITY CONDITIONS. THE HOSPITAL PROVIDES PRIMARY CARE, DENTAL CARE AND CHILD PROTECTIVE SERVICES TO DISADVANTAGED AND UNDERPRIVILEGED CHILDREN THROUGH CLINICS IN DOWNTOWN MILWAUKEE. THE HOSPITAL ALSO OFFERS CASE MANAGEMENT SERVICES AND A FULL RANGE OF MEDICAL, PSYCHOLOGICAL, NURSING AND SOCIAL SERVICES FOR CHILDREN WITH DEVELOPMENTAL, BEHAVIORAL AND LEARNING PROBLEMS.RESEARCH, EDUCATION AND COMMUNITY OUTREACH:THE HOSPITAL CARRIES ON EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS.IN COLLABORATION WITH ACADEMIC INVESTIGATORS AT THE MEDICAL COLLEGE OF WISCONSIN, MARQUETTE UNIVERSITY, UNIVERSITY OF WISCONSIN-MADISON AND OTHER INSTITUTIONS, THE HOSPITAL AND CHILDREN'S RESEARCH INSTITUTE PARTICIPATE IN AN ARRAY OF RESEARCH INITIATIVES SEEKING TO IMPROVE THE DIAGNOSIS AND TREATMENT OF CONGENITAL AND ACQUIRED PEDIATRIC HEALTH CONDITIONS. THESE RESEARCH INITIATIVES INCLUDE, FOR EXAMPLE, BEHAVIORAL HEALTH, EPILEPSY AND OTHER NEUROLOGICAL CONDITIONS; ORGAN TRANSPLANTATION; BIRTH DEFECTS AND FETAL ANOMALIES; IMMUNOLOGICAL CONDITIONS, BLOOD DISORDERS AND VARIOUS CHILDHOOD CANCERS; AND ENVIRONMENTAL HEALTH CONDITIONS. NURSING RESEARCH ALSO IS CARRIED ON AT THE HOSPITAL, INCLUDING, FOR EXAMPLE, STUDIES REGARDING PAIN MANAGEMENT, QUALITY OF LIFE, COPING SKILLS, FAMILY READINESS AND SEDATION PROTOCOLS.THE HOSPITAL IS A MAJOR TEACHING AFFILIATE OF THE MEDICAL COLLEGE OF WISCONSIN, WITH THIRD- AND FOURTH-YEAR MEDICAL STUDENTS ROTATING THROUGH THE HOSPITAL FOR REQUIRED AND ELECTIVE ROTATIONS. THE HOSPITAL ALSO HAS A THREE-YEAR PEDIATRIC RESIDENCY PROGRAM, A TWO-YEAR DENTAL TRAINING PROGRAM AND ACADEMIC FELLOWSHIP PROGRAMS IN AN ARRAY OF SPECIALTIES. THE HOSPITAL HAS RELATIONSHIPS WITH OVER TWO DOZEN UNIVERSITIES FOR THE CLINICAL PEDIATRIC EDUCATION OF NURSING AND OTHER HEALTH CARE PROFESSIONAL STUDENTS, AS WELL AS HEALTH CARE ADMINISTRATION STUDENTS AND VARIOUS OTHER DISCIPLINES. THE HOSPITAL'S PEDIATRIC SPECIALISTS ALSO PROVIDE EDUCATION AND TRAINING TO HEALTH CARE PROFESSIONALS AT COMMUNITY HOSPITALS, PRIMARY CARE CLINICS AND SCHOOLS THROUGHOUT WISCONSIN IN CONNECTION WITH THE IDENTIFICATION, DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH AND WELFARE CONDITIONS. THE HOSPITAL PARTICIPATES IN A WIDE VARIETY OF COMMUNITY EDUCATION, OUTREACH AND CHILD HEALTH ADVOCACY PROGRAMS. THROUGH COMMUNITY EDUCATION PROGRAMS ON TOPICS SUCH AS CHILD HEALTH, INJURY PREVENTION, PARENTING, MANAGEMENT OF CHRONIC DISEASES, AND PREVENTIVE HEALTH, THE HOSPITAL REACHES OUT TO THOUSANDS OF FAMILIES THROUGHOUT THE GEOGRAPHIC REGION. ALONG WITH THE MEDICAL COLLEGE, THE HOSPITAL SPONSORS THE CENTER FOR THE ADVANCEMENT OF URBAN CHILDREN, WHICH SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF URBAN CHILDREN. THE HOSPITAL PARTICIPATES IN THE CHILDREN'S HEALTH ALLIANCE OF WISCONSIN, THROUGH WHICH PROVIDERS AROUND THE STATE WORK COLLABORATIVELY TO RAISE AWARENESS OF CHILDREN'S HEALTH ISSUES, INCREASE ACCESS TO PEDIATRIC CARE, AND PROMOTE BEST PRACTICES. OTHER COMMUNITY OUTREACH AND ADVOCACY INITIATIVES INCLUDE, FOR EXAMPLE, CAR SEAT CLINICS, THE DANIEL M. SOREF FAMILY RESOURCE CENTER, A FETAL CONCERNS PROGRAM, AND PROJECT ADAM (EDUCATION AND PREVENTION INITIATIVES IN THE AREA OF PEDIATRIC SUDDEN CARDIAC DEATH). | Description |
| Total Program Service Expense | 428156005 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 604 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 3774 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 25 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MR JASON PELSIS | NamePerson |
| Telephone Number | 4142665997 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 W WISCONSIN AVE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (47 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| WILLIAM J ABRAHAM JR | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MICHAEL W ALTSCHAEFL | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| THOMAS M BOLGER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| ELIZABETH BRENNER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| CURT S CULVER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| DAVID J DRURY | |||||||||
| DIRECTOR/CHAIR | 1.00 | X | 0 | 0 | 0 | X | |||
| DAVID H GILBERT | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| SUSAN HERMA | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MARK R HOGAN | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| PAUL W JONES | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| JOSEPH KERSCHNER MD | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| ROBERT M KLIEGMAN MD | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MARLENE MELZER LANGE MD | |||||||||
| DIRECTOR | 1.00 | X | 35000 | 0 | 0 | ||||
| C DAVID MYERS | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| KEITH T OLDHAM MD | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| ALBERT S ORR III | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MICHAEL T PEPKE | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| J JOEL QUADRACCI | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| LARRY A RAMBO | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| JAY O ROTHMAN | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| JOHN E SCHLIFSKE | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| JOHN S SHIELY | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| PETER M SOMMERHAUSER | |||||||||
| DIRECTOR/VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X | |||
| OWEN J SULLIVAN | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| TIMOTHY W SULLIVAN | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MARK C WITT | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MARGARET TROY | |||||||||
| DIRECTOR/PRESIDENT | 40.00 | X | 0 | 997755 | 247005 | X | |||
| CINTHIA S CHRISTENSEN | |||||||||
| EXECUTIVE VP | 40.00 | 516425 | 0 | 82730 | X | ||||
| TIMOTHY L BIRKENSTOCK | |||||||||
| TREASURER | 40.00 | 0 | 596957 | 81491 | X | ||||
| SHEILA REYNOLDS | |||||||||
| SECRETARY | 40.00 | 0 | 353276 | 64317 | X | ||||
| LAWRENCE DUNCAN | |||||||||
| VP REGIONAL SVCS (JAN. - JUNE 2010) | 40.00 | 0 | 217359 | 12389 | X | ||||
| LEE ANNE EDDY | |||||||||
| VP AMBULATORY & DIAGNOSTIC SERVICES | 40.00 | 271891 | 0 | 51333 | X | ||||
| MICHAEL GUTZEIT MD | |||||||||
| VP CHIEF MEDICAL OFFICER | 40.00 | 415980 | 0 | 73069 | X | ||||
| BARBARA JOERS | |||||||||
| VP SURGICAL SERVICES | 40.00 | 103870 | 0 | 15700 | X | ||||
| JULIET KERSTEN | |||||||||
| VP REGIONAL SVCS (JUNE - DEC. 2010) | 40.00 | 0 | 201424 | 57975 | X | ||||
| NANCY KOROM | |||||||||
| VP PATIENT CARE SERVICES | 40.00 | 372098 | 0 | 67646 | X | ||||
| MARK SHIP | |||||||||
| VP ACCESS & REFERRAL SERVICES | 40.00 | 295441 | 0 | 58338 | X | ||||
| DONNA JAMIESON | |||||||||
| EXECUTIVE DIRECTOR OF PATIENT CARE | 40.00 | 191344 | 0 | 44202 | X | ||||
| TOM LAUSTEN | |||||||||
| DIRECTOR OF PHARMACY SERVICES | 40.00 | 150248 | 0 | 32364 | X | ||||
| MARY O'CONNER | |||||||||
| DIRECTOR OF SURGICAL SERVICES | 40.00 | 159446 | 0 | 25591 | X | ||||
| JEFFERY GLASSHEIM MD | |||||||||
| PEDIATRIC PHYSICIAN | 40.00 | 289913 | 0 | 21503 | X | ||||
| ANDREW SCHMIDT MD | |||||||||
| HOSPITALIST | 40.00 | 237260 | 0 | 30808 | X | ||||
| LORI BARBEAU DDS | |||||||||
| MEDICAL DIRECTOR DENTAL PROGRAM | 40.00 | 231864 | 0 | 37248 | X | ||||
| THOMAS NICHOLS MD | |||||||||
| HOSPITALIST | 40.00 | 206251 | 0 | 34086 | X | ||||
| A CHARLES POST DDS | |||||||||
| PROGRAM ADMIN DENTAL RESIDENCY | 40.00 | 197942 | 0 | 27380 | X | ||||
| RAMESH SACHDEVA MD | |||||||||
| CORP VP & CHIEF QUALITY OFFICER | 40.00 | 0 | 378816 | 58468 | X | ||||
| JON E VICE - FORMER | |||||||||
| DIRECTOR/PRESIDENT | 0.00 | 0 | 5795708 | 39648 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3674973 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 8541295 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1163291 | TotalOtherCompensation |
| Number Individuals GT100 K | 114 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MEDICAL COLLEGE OF WISCONSIN INC | |||||
| 8701 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | HEALTHCARE PROF/ ACAD/ADMIN | 26189901 |
| MEDICAL COLLEGE OF WI AFFIL HSPTLS | |||||
| 8701 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | RESIDENT SERVICES | 9888914 |
| BLOOD CENTER OF SE WISCONSIN INC | |||||
| 638 N 18TH ST | MILWAUKEE | WI | 532332121 | BLOOD PRODUCTS/LAB SERVICES | 9463934 |
| THEDA CARE INC | |||||
| 122 E COLLEGE AVE | APPLETON | WI | 549128025 | PATIENT HEALTH SRVCS | 4316449 |
| FLIGHT FOR LIFE MILWAUKEE | |||||
| 2611 AVIATION RD | WAUKESHA | WI | 53186 | AIR TRANSPORT SRVCS | 1634400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 48 | NumberOfContractorsGT100K |
| Related Organizations | 5127015 | RelatedOrganizations |
| Government Grants | 12926860 | GovernmentGrants |
| All Other Contributions | 1191719 | AllOtherContributions |
| Noncash Contributions | 212940 | NoncashContributions |
| Total Contributions | 19245594 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT SVC REV | 621990 | 517028418 | 517028418 | |
| RENTAL INCOME | 531120 | 5295662 | 1051525 | $4,244,137 |
| SHARED SERVICES | 541900 | 1714249 | 1714249 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 524038329 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8325562 | TotalRevenueColumn |
| Exclusion | $8,325,562 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 75554392 | Securities |
| Other | 17235 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 75077658 | Securities |
| Other | 504352 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 476734 | Securities |
| Other | -487117 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10383 | TotalRevenueColumn |
| Exclusion | -$10,383 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA | 722210 | 2255595 | $2,255,595 | |
| PHARMACY SALES TO EMPL | 446110 | 1524996 | $1,524,996 | |
| REBATES AND DISCOUNTS | 900099 | 1304299 | 1304299 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2762207 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2027310 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 183349 | UnrelatedBusinessRevenue |
| Exclusion | $551,548 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 7847097 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 559446199 | TotalRevenueColumn |
| Related Or Exempt Function Income | 523125801 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 183349 | UnrelatedBusinessRevenue |
| Exclusion | $16,891,455 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 495578 | Total |
| Program Services | 495578 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4241969 | Total |
| Management And General | 4241969 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162145806 | Total |
| Program Services | 136756331 | ProgramServices |
| Management And General | 25389475 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7028216 | Total |
| Program Services | 5980730 | ProgramServices |
| Management And General | 1047486 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26503160 | Total |
| Program Services | 22265001 | ProgramServices |
| Management And General | 4238159 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12308380 | Total |
| Program Services | 10228059 | ProgramServices |
| Management And General | 2080321 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47235034 | Total |
| Program Services | 1256619 | ProgramServices |
| Management And General | 45978415 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 421946 | Total |
| Management And General | 421946 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22335112 | Total |
| Program Services | 22335112 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12312 | Total |
| Program Services | 12312 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4711426 | Total |
| Program Services | 2703482 | ProgramServices |
| Management And General | 2007944 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 876457 | Total |
| Program Services | 876457 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19215311 | Total |
| Program Services | 18237575 | ProgramServices |
| Management And General | 977736 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 596551 | Total |
| Program Services | 278897 | ProgramServices |
| Management And General | 317654 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95323 | Total |
| Program Services | 40393 | ProgramServices |
| Management And General | 54930 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14730091 | Total |
| Program Services | 14730091 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17070336 | Total |
| Program Services | 17070336 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37244888 | Total |
| Program Services | 37244888 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1779296 | Total |
| Program Services | 20751 | ProgramServices |
| Management And General | 1758545 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 58981217 | 58981217 | |
| PURCHASED SERVICES | 39281909 | 39251073 | 30836 |
| HOSPITAL ASSESSMENT TAX | 12593303 | 12593303 | |
| RESIDENT STIPENDS AND B | 9352767 | 9352767 | |
| NON-MEDICAL SUPPLIES | 3559205 | 3012153 | 547052 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15441155 | Total |
| Program Services | 14432880 | ProgramServices |
| Management And General | 1008275 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 518256748 | Total |
| Program Services | 428156005 | ProgramServices |
| Management And General | 90100743 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7639515 | BOY |
| EOY | 14715003 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2387431 | BOY |
| EOY | 2635976 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62158370 | BOY |
| EOY | 58844806 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15000 | BOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 499252 | BOY |
| EOY | 555000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3236907 | BOY |
| EOY | 3260083 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5418700 | BOY |
| EOY | 5344745 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 624020445 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 219180910 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 420668064 | BOY |
| EOY | 404839535 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 227126123 | BOY |
| EOY | 281227397 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 353344519 | BOY |
| EOY | 382160495 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1082493881 | BOY |
| EOY | 1153583040 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52623469 | BOY |
| EOY | 59647371 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 847522 | BOY |
| EOY | 765066 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 280001195 | BOY |
| EOY | 276090977 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54033018 | BOY |
| EOY | 67037932 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 387505204 | BOY |
| EOY | 403541346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 566962678 | BOY |
| EOY | 603323347 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27873778 | BOY |
| EOY | 32280031 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100152221 | BOY |
| EOY | 114438316 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 694988677 | BOY |
| EOY | 750041694 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1082493881 | BOY |
| EOY | 1153583040 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 41189451 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 13863566 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 1 | AgentTrusteeEtc |
| Beginning Balance | 175595 | BeginningBalance |
| Additions During Year | 156253 | AdditionsDuringYear |
| Distributions During Year | 114187 | DistributionsDuringYear |
| Ending Balance | 217661 | EndingBalance |
| Included On FS | 0 | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 301025999 | BeginningOfYearBalance |
| Contributions | 13508585 | Contributions |
| Investment Earnings Or Losses | 13344633 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 7310168 | GrantsOrScholarships |
| Administrative Expenses | 850700 | AdministrativeExpenses |
| End Of Year Balance | 319718349 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 246110966 | BeginningOfYearBalance |
| Contributions | 12400322 | Contributions |
| Investment Earnings Or Losses | 48806039 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 6291328 | GrantsOrScholarships |
| End Of Year Balance | 301025999 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 294258148 | BeginningOfYearBalance |
| Contributions | 20363545 | Contributions |
| Investment Earnings Or Losses | -54457713 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 14053014 | GrantsOrScholarships |
| End Of Year Balance | 246110966 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.54100 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.35800 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.10100 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 460647151 | OtherCostOrOtherBasis |
| Depreciation | 144327495 | Depreciation |
| Book Value | 316319656 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6561797 | OtherCostOrOtherBasis |
| Depreciation | 2759156 | Depreciation |
| Book Value | 3802641 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 145323668 | OtherCostOrOtherBasis |
| Depreciation | 70993539 | Depreciation |
| Book Value | 74330129 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11487829 | OtherCostOrOtherBasis |
| Depreciation | 1100720 | Depreciation |
| Book Value | 10387109 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 404839535 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATES | 27033950 |
| BENEFICIAL INTEREST IN NET ASSETS OF CHILDREN'S HOSP & HEALTH SYSTEM FOUND. | 354815314 |
| 457 PLAN ASSETS | 311231 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 382160495 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| RESERVE FOR MEDICAL EDUCATION GRANT SETTLEMENTS | $3,923,015 |
| CAPITAL AND OTHER LEASE OBLIGATIONS | $2,463,547 |
| FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS | $18,443,873 |
| 457 PLAN LIABILITY | $311,231 |
| ACCRUED PENSION | $40,116,067 |
| ESTIMATED THIRD PARTY PAYER SETTLEMENTS | $1,780,199 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 67037932 | TotalOfAmounts |
| Total Revenue | 559446199 | TotalRevenue |
| Total Expenses | 518256748 | TotalExpenses |
| Excess Or Deficit For Year | 41189451 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 3609238 | NetUnrealizedGLOnInvestments |
| Other | $10,254,328 | OtherAmount |
| Total Adjustments | 13863566 | TotalAdjustments |
| Excess Or Deficit Per FS | 55053017 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 547401830 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 3609238 | NetUnrealizedGainsInvestments |
| Other Revenues | -12331150 | OtherRevenues |
| Revenue Not Rptd F990 | -8721912 | RevenueNotRptdF990 |
| Revenue Subtotal | 556123742 | RevenueSubtotal |
| Other Revenues Not Included | 3322457 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 3322457 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 559446199 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 495573512 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 495573512 | ExpensesSubtotal |
| Other Expenses Not Included | 22683236 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 22683236 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 518256748 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 1B: | CERTAIN EMPLOYEES OF THE ORGANIZATION HAVE SIGNING AUTHORITY FOR THE CHILDREN'S HOSPITAL OF WISCONSIN MEDICAL STAFF FUNDS MONEY MARKET AND CHECKING ACCOUNT. AN EMPLOYEE OF THE ORGANIZATION ALSO PROVIDES ALL MONTHLY ACCOUNTING FUNCTIONS. | |
| PART V, LINE 4: | CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION, INC. A RELATED ENTITY, HOLDS ENDOWMENT FUNDS ON BEHALF OF CHILDREN'S HOSPITAL OF WISCONSIN, INC. INTENDED USES OF THE FUNDS INCLUDE VARIOUS HEALTH-RELATED SERVICES, CAPITAL PROJECTS AND RESEARCH. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| PART X: | THE HOSPITAL (CHILDREN'S HOSPITAL OF WISCONSIN, INC.) EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITONS RECORDED IN 2010 OR 2009. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -6,718,250 INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL FOUNDATION 31,146,294 PENSION-RELATED CHANGE OTHER THAN NET PERIODIC PENSION COST -14,173,716 TOTAL PART XI, LINE 8 10,254,328 | ||
| PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -6,718,250 NET INTEREST COST - FIXED PAYER INTEREST RATE SWAPS -5,175,462 INVESTMENT FEES -421,945 TAX EXPENSE -15,493 TOTAL PART XII, LINE 2D -12,331,150 PART XII, LINE 4B - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS-CAPITAL ACQUISITIONS 3,322,457 | ||
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: PAYMENTS TO AFFILIATES 17,070,336 NET INTEREST COST - FIXED PAYER INTEREST RATE SWAPS 5,175,462 INVESTMENT FEES 421,945 TAX EXPENSE 15,493 TOTAL PART XIII, LINE 4B 22,683,236 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 941479 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 941479 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 222586033 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 173340512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49245521 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09580 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 223527512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 173340512 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 50187000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09760 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5640162 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22386 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5617776 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01090 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29757992 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7427498 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 22330494 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04340 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12527758 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6136079 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6391679 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01240 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7811906 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7811906 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01520 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 613937 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 613937 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 56351755 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13585963 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 42765792 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08320 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 279879267 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 186926475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 92952792 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.18080 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 178750 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 178750 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1345207 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 43738 | DirectOffsettingRevenue |
| Net Community Building Expense | 1301469 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1264746 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 300 | DirectOffsettingRevenue |
| Net Community Building Expense | 1264446 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1390 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1390 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 324 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 324 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2790417 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 44038 | DirectOffsettingRevenue |
| Net Community Building Expense | 2746379 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,078,686 | BadDebtExpenseAmount |
| Amount Attributable To | 130000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 653248 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1184031 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -530783 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 11 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (11 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Childrens HospitalChildrensHospital | Teaching HospitalTeachingHospital | Research FacilityResearchFacility | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL OF WISCONSIN INC | |||||||||||
| 1 | 9000 W WISCONSIN AVE | MILWAUKEE | WI | 53201 | X | X | X | X | X | X | |
| CHILDREN'S HOSPITAL OF WI-FOX VALLEY | |||||||||||
| 2 | 130 S 2ND STREET | NEENAH | WI | 54956 | X | X | X | ||||
| CHW CLINICS - NEW BERLIN | |||||||||||
| 3 | 4855 S MOORELAND ROAD | NEW BERLIN | WI | 53151 | X | X | X | X | HOSPITAL OUTPATIENT SERVICES | ||
| CHW CLINICS - GREENWAY | |||||||||||
| 4 | 3365 S 103RD ST | GREENFIELD | WI | 53227 | X | X | X | X | HOSPITAL OUTPATIENT SERVICES | ||
| CHILDREN'S DENTAL CENTER | |||||||||||
| 5 | 1020 N 12TH ST | MILWAUKEE | WI | 53233 | X | X | X | HOSPITAL OUTPATIENT SERVICES | |||
| CHILD PROTECTION CENTER | |||||||||||
| 6 | 1020 N 12TH ST | MILWAUKEE | WI | 53233 | X | X | X | HOSPITAL OUTPATIENT SERVICES | |||
| GENETICS CENTER | |||||||||||
| 7 | 1092 N 92ND ST | WAUWATOSA | WI | 53226 | X | X | X | X | HOSPITAL OUTPATIENT SERVICES | ||
| CHILD DEVELOPMENT CENTER | |||||||||||
| 8 | 13800 W NORTH AVE SUITE 120 | BROOKFIELD | WI | 53005 | X | X | X | HOSPITAL OUTPATIENT SERVICES | |||
| CHW CLINICS - KENOSHA | |||||||||||
| 9 | 6308 8TH AVE SUITE 3090 | KENOSHA | WI | 53143 | X | X | X | HOSPITAL OUTPATIENT SERVICES | |||
| KENOSHA CHILD ADVOCACY CENTER | |||||||||||
| 10 | 6308 8TH AVE SUITE 3090 | KENOSHA | WI | 53143 | X | X | X | HOSPITAL OUTPATIENT SERVICES | |||
| CHW CLINICS - GREEN BAY | |||||||||||
| 11 | 555 REDBIRD CIRCLE | DE PERE | WI | 54115 | X | X | HOSPITAL OUTPATIENT SERVICES | ||||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 0 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 0 | IncludesPublicityMeasures |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CHILDREN'S HOSPITAL OF WISCONSIN | ||||
| 1020 N 12TH ST 5TH FLOOR | MILWAUKEE | WI | 53233 | MENTAL HEALTH OUTPATIENT CLINIC |
| CHW FOX VALLEY BEHAVIORAL HEALTH | ||||
| 1820 N APPLETON RD | MENASHA | WI | 54952 | PATIENT CARE SERVICES |
| CHILD ADVOCACY CENTER - FOX VALLEY | ||||
| 325 N COMMERCIAL ST SUITE 400 | NEENAH | WI | 54956 | PATIENT CARE SERVICES |
| CHILD ADVOCACY CENTER - RACINE | ||||
| 2405 NORTHWESTERN AVE SUITE 2058 | RACINE | WI | 53404 | PATIENT CARE SERVICES |
| CHILD ADVOCACY CENTER - WAUKESHA | ||||
| 101 W BROADWAY 2ND FLOOR | WAUKESHA | WI | 53186 | PATIENT CARE SERVICES |
| DOWNTOWN HEALTH CENTER | ||||
| 1020 N 12TH ST | MILWAUKEE | WI | 53233 | URBAN HEALTH CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("THE HOSPITAL") USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. THE HOSPITAL IS DEDICATED TO ENSURING THAT PATIENTS RECEIVE ALL MEDICALLY NECESSARY CARE. IN FURTHERANCE OF THAT OBJECTIVE, THE HOSPITAL MAINTAINS AND IMPLEMENTS VARIOUS POLICIES (INCLUDING A CHARITY CARE POLICY AND SELF-PAY POLICY), PURSUANT TO WHICH THE HOSPITAL PROVIDES DISCOUNTED OR FREE CARE TO PATIENTS WHO ARE UNINSURED OR OTHERWISE UNABLE TO PAY ALL OR A PORTION OF THEIR BILLED CHARGES. THE POLICIES GENERALLY PROVIDE THAT ELIGIBILITY IS DETERMINED BASED ON HOUSEHOLD INCOME, FAMILY SIZE AND AVAILABLE ASSETS, AND SPECIFICALLY INCORPORATES CRITERIA SET FORTH UNDER THE WISCONSIN MEDICAID PROGRAM AND THE FEDERAL POVERTY GUIDELINES. |
| PART I, LINE 6A: CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE SOLE CORPORATE MEMBER OF THE HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF THE HOSPITAL AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON THE HOSPITAL'S WEB SITE OR UPON REQUEST. |
| PART I, LINE 7: THE WISCONSIN MEDICAID PROGRAM PROVIDES COVERAGE FOR THE VAST MAJORITY OF CHILDREN WHO REQUIRE MEDICAL CARE BUT ARE UNINSURED OR UNDERINSURED. HOSPITAL REPRESENTATIVES WORK EXTENSIVELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND THE AVAILABILITY OF STATE AID AND TO ASSIST THEM IN BECOMING ENROLLED IN THE PROGRAM THAT PROVIDES THE PATIENT WITH THE GREATEST BENEFIT. FOR THAT REASON, THE AMOUNT OF TRUE "CHARITY CARE" RENDERED BY THE HOSPITAL IS CONSIDERABLY SMALLER THAN LEVELS EXPERIENCED BY COMMUNITY HOSPITALS OR OTHER FACILITIES SERVING THE ADULT POPULATION.PART I, LINE 7, COLUMN (F): BAD DEBT EXPENSE OF $4,218,627 IS INCLUDED IN TOTAL EXPENSES IN PART IX, LINE 25, COLUMN (A), BUT EXCLUDED IN THE CALCULATION OF "PERCENT OF TOTAL EXPENSES" REPORTED IN COLUMN (F). |
| PART II: THE HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS FOR CHILDREN, SUCH AS POVERTY AND ENVIRONMENTAL ISSUES. THESE COMMUNITY-BUILDING ACTIVITIES INCLUDE STAFF PARTICIPATION ON COMMUNITY BOARDS, COALITIONS AND/OR COMMITTEES WHICH ASSIST IN IMPROVING THE HEALTH OF THE COMMUNITY. IN ADDITION, THE HOSPITAL HOSTED LISTENING SESSIONS WITH COMMUNITY LEADERS AND ORGANIZERS IN THREE AT-RISK NEIGHBORHOODS TO LEARN MORE ABOUT COMMUNITY NEEDS AND HOW BEST TO ADDRESS THOSE NEEDS. THE HOSPITAL CONDUCTS OR PARTICIPATES IN MANY PROGRAMS THAT HELP COMMUNITY MEMBERS KEEP THEIR CHILDREN AND FAMILIES HEALTHY. EXAMPLES INCLUDE:CHILDREN'S HEALTH ALLIANCE OF WISCONSIN IS A STATEWIDE ORGANIZATION THAT WORKS TO IMPROVE THE HEALTH OF WISCONSIN CHILDREN AND REDUCE DISPARITIES IN AVAILABILITY AND ACCESSIBILITY OF HEALTH CARE SERVICES. THE ALLIANCE BRINGS PEOPLE TOGETHER TO RAISE AWARENESS, INCREASE ACCESS TO QUALITY CARE AND PROMOTE BEST PRACTICES. THE ALLIANCE IS PARTIALLY FUNDED THROUGH A MATERNAL AND CHILD HEALTH, WISCONSIN DEPARTMENT OF HEALTH SERVICES GRANT AND OTHER PUBLIC AND PRIVATE FUNDING. THE ALLIANCE IS FINANCIALLY SUPPORTED BY THE HOSPITAL THROUGH STAFF AND OTHER RESOURCES TO CARRY ON THE ALLIANCE'S PROGRAMS. THE ALLIANCE LEADS AND MANAGES THE FOLLOWING KEY INITIATIVES: ASTHMA, GRIEF AND BEREAVEMENT, INJURY PREVENTION AND CHILD DEATH REVIEW, LEAD POISONING, ORAL HEALTH COALITION, AND REACH OUT AND READ.THE DANIEL M. SOREF FAMILY RESOURCE CENTER LOCATED ON THE FIRST FLOOR OF THE HOSPITAL'S MILWAUKEE CAMPUS OFFERS PARENT-TO-PARENT SUPPORT, INFORMATION, REFERRALS AND HELP CONNECTING TO HOSPITAL AND COMMUNITY RESOURCES. THE CENTER OFFERS SPIRITUAL CARE, THE KATIE BECKETT PROGRAM, PATIENT RELATIONS, INTERPRETERS, FAMILY ACCOMMODATIONS AND THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. THE CENTER HAS FAMILY COMPUTERS, A CONSULT ROOM, FAMILY BUSINESS CENTER AND OTHER RESOURCES FOR FAMILIES. FAMILIES ALSO CAN CHECK OUT ENTERTAINMENT DVDS, VIDEO GAMES, AS WELL AS LAPTOPS FOR INPATIENT USE. STAFF MEMBERS ARE TRAINED TO HELP CHILDREN, YOUNG ADULTS AND THEIR FAMILIES FIND ANSWERS TO QUESTIONS ABOUT LOCAL RESOURCES, SUPPORT GROUPS, FUNDING OPTIONS AND MORE. THE CENTER ALSO HAS A LENDING LIBRARY WITH BOOKS, VIDEOS AND ARTICLES ON A VARIETY OF HEALTH CONDITIONS AND TOPICS.THE INFANT DEATH CENTER ("IDC") IS A STATEWIDE PROGRAM ADMINISTERED THROUGH CHILDREN'S HEALTH ALLIANCE OF WISCONSIN. THE CENTER PROVIDES INFORMATION AND SUPPORT TO WISCONSIN FAMILIES AND OTHERS AFFECTED BY THE SUDDEN AND UNEXPECTED DEATH OF AN INFANT. THE IDC STRIVES TO INCREASE HEALTHY BIRTH OUTCOMES AND REDUCE INFANT DEATHS. THE CENTER WORKS TOGETHER WITH OTHER PROFESSIONALS IN OUTREACH, EDUCATION AND INFANT MORTALITY REVIEW PROGRAMS. IN PARTNERSHIP WITH PUBLIC HEALTH SYSTEMS AND NATIONAL INFANT MORTALITY PROGRAMS, THE IDC MAINTAINS INFORMATION THAT ASSISTS IN THE STUDY AND UNDERSTANDING OF THE CAUSES OF INFANT DEATHS. THE INFORMATION IS USED FOR STATISTICAL REPORTING.THE HOSPITAL'S SPECIAL NEEDS PROGRAM OFFERS COMPREHENSIVE CARE COORDINATION FOR CHILDREN WITH MULTIPLE MEDICAL NEEDS WHO DO NOT HAVE EXISTING CARE COORDINATION SERVICES. THE GOAL IS TO ENSURE FAMILIES HAVE THE BEST POSSIBLE CARE IN AND OUT OF THE HOSPITAL. THE HOSPITAL PARTNERS WITH PATIENTS, FAMILIES, PRIMARY CARE AND OTHER HEALTH CARE PROVIDERS TO IMPROVE CARE COORDINATION. STAFF ALSO WORK WITH FAMILIES TO DEVELOP WRITTEN TRANSITION PLANS BASED ON NEEDS OR ISSUES THAT SHOULD BE ADDRESSED BEFORE A YOUTH IS READY TO TRANSITION TO ADULT CARE.THE HOSPITAL ALSO SUPPORTS THE SOUTHEAST REGIONAL CENTER FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS PROGRAM. IT IS ONE OF FIVE REGIONAL CENTERS DEDICATED TO SUPPORTING FAMILIES WITH CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS AND THE PROVIDERS WHO CARE FOR THEM. IT IS FUNDED THROUGH A TITLE 5 MATERNAL AND CHILD HEALTH BLOCK GRANT, CHILDREN'S HOSPITAL AND CHARITABLE DONATIONS. FAMILIES AND PROVIDERS CAN CALL THE CENTER FOR INFORMATION, REFERRAL AND PROBLEM-SOLVING RELATED TO COMMUNITY AND STATE SERVICES, HEALTH BENEFITS ASSISTANCE, TRANSITION PLANNING AND EMOTIONAL SUPPORT. EACH YEAR THE STAFF OFFERS TRAINING SUCH AS "CARE IN THE COMMUNITY" AS WELL AS OTHER SESSIONS ON YOUTH TRANSITIONS. STAFF ALSO PARTICIPATE IN NUMEROUS COMMUNITY INITIATIVES AND PARTNER WITH AREA PEDIATRICIANS AND OTHER HEALTH CARE PROVIDERS TO INCORPORATE EARLY IDENTIFICATION AND SCREENING METHODS INTO THEIR PRACTICES. THE SOUTHEAST CENTER SERVES EIGHT COUNTIES. THE HOSPITAL ALSO OPERATES A FREE GUARDIANSHIP CLINIC, WHICH PROVIDES PARENTS IN NEED WITH PRO BONO LEGAL SERVICES TO SECURE GUARDIANSHIP WHEN THEIR SPECIAL NEEDS CHILD TURNS 18.FIGHT ASTHMA MILWAUKEE, WHICH IS LED AND SUPPORTED BY MEDICAL STAFF AT THE HOSPITAL, WORKS TO REDUCE AND ELIMINATE DISPARITIES IN ASTHMA CARE AND DEVELOP A SUSTAINABLE STRATEGY FOR ASTHMA CONTROL IN THE COMMUNITY. FIGHT ASTHMA MILWAUKEE PROVIDES COMMUNITY-WIDE ASTHMA EDUCATION FOR PARENTS, CAREGIVERS, HEALTH CARE PROFESSIONALS AND SCHOOL STAFF.IN THE FOX VALLEY, THE HOSPITAL AND THEDA CLARK MEDICAL CENTER PARTNER WITH ROOSEVELT ELEMENTARY SCHOOL TO PROMOTE TO STUDENTS HEALTHY HABITS AND CIVIC RESPONSIBILITY. STAFF MEMBERS FROM BOTH HOSPITALS MENTOR STUDENTS THROUGH THE BACKYARD BUDDIES PROGRAM. THE HOSPITAL ALSO PARTNERS WITH LOCAL ORGANIZATIONS IN THE FOX VALLEY TO IMPROVE THE HEALTH OF THE CHILDREN IN THE COMMUNITY THROUGH NUMEROUS EVENTS SUCH AS A BIKE HELMET SAFETY EVENT AT THE YMCA, HEALTHY KIDS DAY, AND THE APPLETON AREA SCHOOL DISTRICT'S EDUCATION FOR HEALTHY KIDS SUMMER INSTITUTE. EACH SPRING, THE HOSPITAL AND THEDA CLARK MEDICAL CENTER COLLABORATE TO OFFER FREE HOSPITAL TOURS TO FIRST-GRADE STUDENTS FROM LOCAL PUBLIC AND PRIVATE SCHOOLS. STAFF ALSO PROVIDE EDUCATION TO OTHER HEALTH CARE PROVIDERS AND PROFESSIONALS IN THE COMMUNITY ON TOPICS SUCH AS CHILD ABUSE, NEONATAL RESUSCITATION, CHILD AND ADOLESCENT MENTAL HEALTH AND DIABETES. THE HOSPITAL OPERATES CHILD ADVOCACY CENTERS IN MILWAUKEE, RACINE, KENOSHA, WALWORTH COUNTY, CENTRAL WISCONSIN (WAUSAU), THE FOX VALLEY, AND CHIPPEWA VALLEY (EAU CLAIRE). EACH CENTER IS A SAFE PLACE FOR KIDS WHO MAY HAVE BEEN ABUSED OR NEGLECTED. THE CENTERS BRING TOGETHER A TEAM OF SPECIALLY TRAINED PROFESSIONALS WHO EVALUATE AND INVESTIGATE CASES OF CHILD ABUSE, PROVIDE MEDICAL CARE AND HELP CHILDREN AND THEIR FAMILIES TO HEAL. THE CENTERS ARE A COLLABORATION OF THE HOSPITAL AND DOZENS OF LAW ENFORCEMENT, JUDICIAL AND LOCAL AND SOCIAL SERVICE ORGANIZATIONS.VOLUNTEERS FROM THE HOSPITAL ANNUALLY STAFF THE SUMMER CAMP FOR BURN INJURED YOUTH, SPONSORED BY THE WISCONSIN ALLIANCE FOR FIRE SAFETY. THE CAMP IS A STATEWIDE EFFORT TO OFFER A SUMMER CAMPING EXPERIENCE FOR YOUTH WHO HAVE ENDURED SIGNIFICANT BURN INJURIES, PROVIDING THEM AN OPPORTUNITY TO HAVE FUN, MAKE FRIENDS AND IMPROVE SELF-ESTEEM. PART III, LINE 3: THE HOSPITAL ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY BY ANALYZING PAST ACTIVITY FOR ACCOUNTS CLASSIFIED AS BAD DEBT THAT SUBSEQUENTLY QUALIFIED FOR CHARITY CARE WHEN ADDITIONAL ELIGIBILITY INFORMATION WAS RECEIVED. |
| PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. BAD DEBT REPORTED IN PART III, SECTION A IS CALCULATED BASED ON THE HOSPITAL'S OVERALL RATIO OF PATIENT CARE COST TO CHARGES CALCULATED USING THE METHODOLOGY IN WORKSHEET 2 OF SCHEDULE H INSTRUCTIONS. |
| PART III, LINE 8: THE HOSPITAL USED ITS FILED MEDICARE COST REPORT TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED ON PART III, SECTION B. AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID SUBSTANTIALLY LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. |
| PART III, LINE 9B: UNDER THE HOSPITAL'S POLICIES AND PROCEDURES, THE HOSPITAL UNDERTAKES MEASURES TO COMMUNICATE WITH THE FAMILIES OF PATIENTS WITH SELF-PAY BALANCES. IN MANY CASES, THE HOSPITAL AND FAMILIES WORK TOGETHER TO OBTAIN COVERAGE THROUGH THE STATE MEDICAID PROGRAM. IN CASES WHERE MEDICAID COVERAGE IS NOT AVAILABLE, THE HOSPITAL SEEKS TO OBTAIN INFORMATION NECESSARY TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE PROGRAM. ONCE A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED CARE HAS BEEN DETERMINED, THE BALANCE ON THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. IN ADDITION, HOSPITAL PERSONNEL WORK CLOSELY WITH FAMILIES TO DETERMINE THEIR ABILITY TO PAY THE ADJUSTED BALANCES; SUCH EFFORTS OFTEN RESULT IN PAYMENT PLANS INTENDED TO PERMIT THE GRADUAL PAYMENT OF AMOUNTS DUE WITHOUT IMPOSING UNDUE FINANCIAL HARDSHIP ON FAMILIES ALREADY DEALING WITH THE CHALLENGES OF CHILDREN'S HEALTH ISSUES. UNFORTUNATELY, THERE REMAIN CIRCUMSTANCES WHERE PATIENTS CANNOT BE DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE DUE TO THE INACCESSIBILITY OF THE FAMILY, OR THE FAMILY'S INABILITY OR REFUSAL TO PROVIDE THE REQUIRED INFORMATION; IN SUCH CASES, THE HOSPITAL FOLLOWS AN ESTABLISHED MULTI-STEP PROCESS IN AN EFFORT TO REACH THE FAMILY AND PROVIDE THEM WITH INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE PROGRAM. ACCOUNTS ARE SENT TO COLLECTIONS (AN AFFILIATED ORGANIZATION WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS) ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN, WITHOUT SUCCESS. |
| PART VI, LINE 2: IN ADDITION TO LOCAL LISTENING SESSIONS AND OTHER EFFORTS DESCRIBED WITHIN SCHEDULE H, THE HOSPITAL USES SECONDARY DATA SUCH AS THE WISCONSIN HEALTHIEST PEOPLE 2010 TO ASSESS THE NEEDS OF THE COMMUNITY. THE HOSPITAL IS CURRENTLY WORKING ON THE DEVELOPMENT OF A COMMUNITY NEEDS ASSESSMENT WITH A TEAM OF HEALTH CARE PROVIDERS, COMMUNITY AGENCIES, CLINICS, LOCAL HEALTH DEPARTMENTS AND OTHER PUBLIC HEALTH PROFESSIONALS WHO WILL CONDUCT A COMMUNITY NEEDS ASSESSMENT IN 2012. |
| PART VI, LINE 3: AS INDICATED ABOVE, THE HOSPITAL WORKS CLOSELY WITH PATIENTS' FAMILIES TO HELP THEM UNDERSTAND AND ENROLL IN MEDICAL ASSISTANCE PROGRAMS AVAILABLE THROUGH THE STATE OF WISCONSIN, AND WHERE APPROPRIATE, FEDERAL PROGRAMS. WHERE SUCH PROGRAMS ARE NOT AVAILABLE, HOWEVER, PATIENTS MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER THE HOSPITAL'S ESTABLISHED POLICIES AND PROCEDURES. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS PUBLICIZED THROUGH VARIOUS MEASURES, INCLUDING INFORMATION ON THE HOSPITAL'S WEBSITE AND WRITTEN BROCHURES OR OTHER MATERIALS PROVIDED TO PATIENTS' FAMILIES. THE MOST SIGNIFICANT EDUCATION, HOWEVER, OCCURS IN DIRECT DIALOGUE BETWEEN PATIENT FAMILIES AND THE HOSPITAL'S TRAINED FINANCIAL SERVICES COUNSELORS AND SOCIAL WORKERS. THE HOSPITAL MAKES EXTENSIVE EFFORTS TO PROVIDE FACE-TO-FACE DIALOGUE, AS WELL AS COMMUNICATION VIA TELEPHONE, E-MAIL AND OTHER MEANS, AS NECESSARY TO ENSURE THAT FAMILIES ARE PROVIDED WITH SUFFICIENT INFORMATION REGARDING ALTERNATIVES FOR OBTAINING FREE OR DISCOUNTED CARE, AS WELL AS THE BILLING AND COLLECTION PROCESS GENERALLY. THE COMMUNICATION PROCESS IS SUPPORTED BY INTERPRETER SERVICES AS NEEDED. |
| PART VI, LINE 4: THE HOSPITAL PROVIDES CARE TO CHILDREN FROM URBAN, RURAL, AND SUBURBAN AREAS, REGARDLESS OF RACE, GENDER, ETHNICITY, INCOME, DISABILITY, OR COUNTRY OF ORIGIN. THE HOSPITAL PROVIDES ACUTE LEVEL SERVICES, AS WELL AS EMERGENCY AND SPECIALTY CARE TO CHILDREN FROM WISCONSIN, UPPER PENINSULA OF MICHIGAN, NORTHERN ILLINOIS AND THROUGHOUT THE UNITED STATES. APPROXIMATELY 49 PERCENT OF GROSS CHARGES FOR PATIENT SERVICES WERE GENERATED FROM SERVICES TO MEDICAID BENEFICIARIES IN 2010. |
| PART VI, LINE 6: THE HOSPITAL PROMOTES THE HEALTH AND SAFETY OF CHILDREN LOCATED THROUGHOUT ITS SERVICE AREA. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. THE HOSPITAL'S BOARD OF DIRECTORS CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL OFFERS SPECIALTY CLINICS THAT ARE COMFORTABLE AND ACCESSIBLE TO FAMILIES. IN MILWAUKEE, THE HOSPITAL OFFERS CLINICS IN THE CENTRAL, DOWNTOWN AND SOUTHWEST PART OF THE CITY. FAMILIES ALSO MAY ACCESS SERVICES IN THE FOX VALLEY, GREEN BAY AND KENOSHA AREAS. IN 2009, THE HOSPITAL OPENED A MULTISPECIALTY AMBULATORY CENTER IN NEW BERLIN, WIS., TO PROVIDE FAMILIES WITH EASY ACCESS TO CARE. THE HOSPITAL FUNDS SCHOOL-BASED HEALTH CENTERS IN MILWAUKEE SCHOOLS AND AT A SITE LOCATED IN THE NEXT DOOR FOUNDATION. THESE CENTERS PROVIDE PREVENTATIVE 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 2010, THERE WERE 15,750 SCHOOL-BASED NURSE ENCOUNTERS AND 5,071 PHYSICIAN OFFICE VISITS AT THE NEXT DOOR FOUNDATION SITE.THE HOSPITAL, IN COLLABORATION WITH THE MEDICAL COLLEGE OF WISCONSIN, SPONSORS THE DOWNTOWN HEALTH CENTER. LOCATED IN DOWNTOWN MILWAUKEE, THE MISSION OF THIS CLINIC IS TO IMPROVE HEALTH AND ADVANCE HEALTH EQUITY FOR THE MOST VULNERABLE CHILDREN IN MILWAUKEE THROUGH AN ACADEMIC PRIMARY CARE MEDICAL HOME. ON-SITE SERVICES INCLUDE ACUTE AND CHRONIC CARE, WELL-CHILD EXAMINATIONS, LABORATORY STUDIES, AND VISION AND HEARING SCREENINGS. CRIB, CAR SEAT AND BIKE HELMET DISTRIBUTION AND FITTINGS, SAFE-SLEEPING TECHNIQUES, AND GUN-LOCK EDUCATION, ARE OTHER SPECIAL CLINIC ACTIVITIES THAT ARE AVAILABLE AT THIS SITE, MOSTLY FREE OF CHARGE. APPROXIMATELY 7,200 CHILDREN, INCLUDING 500 CHILDREN IN FOSTER CARE, ARE SEEN ANNUALLY AT THE CENTER, AND 92 PERCENT OF THEM ARE INSURED BY MEDICAID/BADGERCARE PLUS. ADOLESCENTS HAVE ACCESS TO SOCIAL SERVICES, CONTRACEPTIVE MANAGEMENT, FAMILY PLANNING, AND ALCOHOL AND DRUG ABUSE COUNSELING SERVICES. IN ADDITION, CHILDREN'S HOSPITAL PROVIDES SPECIALTY CARE SERVICES INCLUDING DENTAL, PSYCHOLOGICAL AND CHILD PROTECTIVE SERVICES AT THIS DOWNTOWN LOCATION.THE HOSPITAL FUNDS CHILDREN'S HEALTH EDUCATION CENTER ("CHEC"), WHICH SEEKS TO EDUCATE THE PUBLIC REGARDING A WIDE RANGE OF ISSUES IMPACTING THE HEALTH AND SAFETY OF CHILDREN. THE CENTER OFFERS RESOURCES AND PROGRAMS FOR CHILDREN, PARENTS, TEACHERS, AND CAREGIVERS TO HELP KEEP WISCONSIN'S CHILDREN HEALTHY AND SAFE. BLUEKIDS.ORG E-LEARNING PROGRAMS, OFFERED THROUGH CHEC, ARE A RESOURCE FOR TEACHERS TO USE IN THEIR CLASSROOMS TO DELIVER AN OUTCOMES-BASED HEALTH CURRICULUM TO STUDENTS IN GRADE K5-8. CHEC'S INJURY PREVENTION TEAM OFFERS COMMUNITY-BASED EDUCATIONAL EVENTS INCLUDING BIKE HELMET FITTINGS AND CAR SEAT CHECKS, AND DELIVERS IMPORTANT FIRE PROTECTION AND PEDESTRIAN SAFETY EDUCATION THROUGHOUT WISCONSIN.THE HOSPITAL'S CAR SEAT CLINIC IS A COLLABORATION BETWEEN THE HOSPITAL, CHEC, SAFE KIDS WISCONSIN AND SAFE KIDS SOUTHEAST WISCONSIN TO OFFER CAR SEAT CLINICS IN TWO LOCATIONS NEAR THE MILWAUKEE HOSPITAL CAMPUS. TRAINED CHILD PASSENGER SAFETY SPECIALISTS MAKE CERTAIN THAT INFANT, TODDLER CAR SEATS AND/OR BOOSTER SEATS ARE INSTALLED CORRECTLY AND THAT THEY ARE APPROPRIATE FOR THE AGE AND SIZE OF THE CHILD USING THEM. IN SOME CASES, THE PROGRAM ALSO PROVIDES LOW-COST OR FREE CAR AND/OR BOOSTER SEATS FOR FAMILIES IN NEED.THE WISCONSIN POISON CENTER, WHICH IS STAFFED BY REGISTERED NURSES 24 HOURS A DAY, 365 DAYS A YEAR, PROVIDES IMMEDIATE AND AUTHORITATIVE PHONE CONSULTATION IN CASES OF ACCIDENTAL OR INTENTIONAL POISONING IN ADULTS AND CHILDREN. THE CENTER HAS A VARIETY OF PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS ALERTING PEOPLE TO SPECIFIC TOXIC DANGERS. THESE INCLUDE HOSPITAL GRAND ROUNDS LECTURES FOR PHYSICIANS, TRAINING FOR EMERGENCY MEDICAL TECHNICIANS, BABY SITTER WORKSHOPS, AND PRESCHOOL POISON PREVENTION EDUCATION. THE POISON CENTER ALSO TRIAGES CALLS FOR MPOWER, AN ALCOHOL AND DRUG CRISIS LINE FOR TEENS. PROJECT ADAM (AUTOMATIC DEFIBRILLATORS IN ADAM'S MEMORY) IS COMMITTED TO MAKING AUTOMATED EXTERNAL DEFIBRILLATORS UNIVERSALLY AVAILABLE TO ALL CHILDREN AND ADOLESCENTS BY BEING A NATIONAL RESOURCE FOR IMPLEMENTING PEDIATRIC PUBLIC ACCESS DEFIBRILLATION PROGRAMS IN SCHOOLS. IT ALSO IS WORKING TOWARD ERADICATING SUDDEN CARDIAC DEATH IN CHILDREN THROUGH EDUCATION AND PREVENTION INITIATIVES. IN 2010, THE HOSPITAL LAUNCHED A MULTI-YEAR, SYSTEM-WIDE EFFORT TO INCREASE IMMUNIZATION RATES AMONG CHILDREN. THIS INITIATIVE IS KEY TO ACHIEVING THE HEALTH SYSTEM'S VISION OF HELPING WISCONSIN'S CHILDREN TO BE THE HEALTHIEST IN THE NATION. AS PART OF THE INITIATIVE: -THE HOSPITAL HAS PARTNERED WITH THE MILWAUKEE HEALTH DEPARTMENT AND COMMUNITY ORGANIZATIONS TO SPREAD THE WORD THAT VACCINES ARE SAFE AND NECESSARY. -HEALTH CARE PROVIDERS DISCUSS THE IMPORTANCE AND SAFETY OF IMMUNIZATIONS WITH PARENTS DURING VISITS TO OUR HOSPITAL AND CLINICS. -AT EACH VISIT, HEALTH CARE PROVIDERS USE THE WISCONSIN IMMUNIZATION REGISTRY ("WIR") TO CHECK THE IMMUNIZATION STATUS OF PATIENTS YOUNGER THAN 25 MONTHS AND UPDATE INFORMATION IN THE WIR DATABASE, IF NEEDED. -IF A CHILD IS NOT UP TO DATE ON IMMUNIZATIONS, PARENTS AND STAFF PARTNER TO IDENTIFY WHERE THE RECOMMENDED IMMUNIZATIONS CAN BE ADMINISTERED. -IF NECESSARY, HOSPITAL STAFF HELP CONNECT PARENTS WITH A "MEDICAL HOME," A PLACE WHERE CHILDREN CAN RECEIVE PRIMARY CARE ON A REGULAR BASIS. |
| PART VI, LINE 7: THE HOSPITAL IS PART OF AN AFFILIATED GROUP OF ORGANIZATIONS UNDER THE CONTROL OF CHHS, WHICH PROVIDES VARIOUS CENTRALIZED ADMINISTRATIVE AND SUPPORTING SERVICES FOR THE HOSPITAL AND ITS AFFILIATES. AMONG THE AFFILIATED ENTITIES, THE HOSPITAL AND CERTAIN OTHER ENTITIES (INCLUDING CHILDREN'S MEDICAL GROUP, INC. AND CHILDREN'S PHYSICIAN GROUP, P.C.) DIRECTLY PROVIDE INSTITUTIONAL AND PROFESSIONAL PEDIATRIC HEALTHCARE SERVICES IN A VARIETY OF ACCESSIBLE LOCATIONS THROUGHOUT WISCONSIN AND NORTHERN ILLINOIS. ANOTHER HOSPITAL AFFILIATE IS CHILDREN'S SERVICE SOCIETY OF WISCONSIN ("CSSW"). THIS SOCIAL SERVICE ORGANIZATION ADDRESSES THE CHALLENGES FACED BY CHILDREN, WHICH OFTEN DIRECTLY IMPACT THEIR PHYSICAL AND MENTAL HEALTH AND WELLBEING.CSSW OFFERS CHILD WELFARE SERVICES IN FOUR CORE AREAS (PUBLIC CHILD WELFARE, CHILD AND FAMILY COUNSELING, OUT-OF-HOME CARE AND PREVENTION SERVICES) FROM LOCATIONS THROUGHOUT WISCONSIN. SERVICES INCLUDE: -LOCATING LOVING, STABLE HOMES FOR CHILDREN IN NEED OF A FAMILY THROUGH FOSTER CARE AND ADOPTION. -REDUCING STRESS AND CONFLICT, ENHANCING PARENTING SKILLS AND STRENGTHENING FAMILY TIES THROUGH COUNSELING. -PROVIDING SERVICES TO CHILDREN IN OUT-OF-HOME CARE, ADVOCATING FOR THEIR SAFETY, WELL-BEING AND TIMELY REUNIFICATION WITH BIRTHPARENTS WHENEVER POSSIBLE. -OFFERING FREE, CONFIDENTIAL AND SUPPORTIVE GUIDANCE TO HELP BIRTHPARENTS DEALING WITH AN UNPLANNED PREGNANCY. -PROVIDING INTENSIVE IN-HOME SERVICES TO KEEP CHILDREN SAFE IN THEIR HOMES AND PREVENT OUT-OF-HOME PLACEMENT. -ASSISTING YOUNG ADULTS TRANSITIONING OUT OF FOSTER CARE BY GIVING THEM THE SKILLS, TRAINING, GUIDANCE AND SUPPORT ENABLING THEM TO MAKE IT ON THEIR OWN. -PROVIDING PARENTS WITH SUPPORT AND GUIDANCE TO HELP THEM BE THE BEST PARENTS THEY CAN BE, INCLUDING: -ONGOING REASSESSMENT OF CHILD SAFETY; -FAMILY ASSESSMENT; -DEVELOPMENT OF CASE PLANS; -COORDINATION OF SERVICE; -IMPLEMENTATION OF SAFETY SERVICES THAT ENSURE A FAMILY CAN STAY TOGETHER. CHHS HAS TWO KEY PROGRAMS TO PROMOTE CUTTING EDGE, HIGH QUALITY CARE. CHILDREN'S RESEARCH INSTITUTE CARRIES ON RESEARCH INITIATIVES AIMED AT IMPROVING THE DIAGNOSIS AND TREATMENT OF PEDIATRIC HEALTH CONDITIONS, AND NATIONAL OUTCOMES CENTER GATHERS AND PUBLICIZES DATA TO ASSIST PEDIATRIC HEALTHCARE PROVIDERS IN IDENTIFYING THE MOST EFFECTIVE TREATMENT METHODS. THESE AFFILIATED PROGRAMS SEEK TO ENSURE THAT CHILDREN HAVE ACCESS TO HIGH-QUALITY HEALTH AND SOCIAL SERVICES.PART VI, LINE 7: CHHS, THE SOLE CORPORATE MEMBER OF THE HOSPITAL, PREPARES A COMMUNITY BENEFIT REPORT ON BEHALF OF THE HOSPITAL AND ITS AFFILIATES. THE REPORT IS FILED WITH THE WISCONSIN HOSPITAL ASSOCIATION AND IS ALSO AVAILABLE ON THE SYSTEM'S WEB SITE OR UPON REQUEST. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (26 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| MEDICAL COLLEGE OF WISCONSIN | |||||||
| 8701 WATERTOWN PLANK ROAD | MILWAUKEE | WI | 53226 | 390806261 | 501(C)(3) | 4878 | ADDRESSING ASTHMA FROM A PUBLIC HEALTH PERSPECTIVE |
| ADAMS COUNTY PUBLIC HEALTH DEPARTMENT | |||||||
| 108 E NORTH STREET | FRIENDSHIP | WI | 53934 | 396005665 | ADAMS COUNTY | 5000 | DENTAL SEALANT EXPANSION GRANT |
| JANESVILLE SCHOOL DISTRICT | |||||||
| 2921 MOHICAN ROAD | JANESVILLE | WI | 535452285 | 396002726 | 501(C)(3) | 14303 | DENTAL SEALANT EXPANSION GRANT |
| JUNEAU COUNTY HEALTH DEPARTMENT | |||||||
| 220 E STATE STREET | MAUSTON | WI | 53948 | 396005706 | JUNEAU COUNTY | 11689 | DENTAL SEALANT EXPANSION GRANT |
| KENOSHA COUNTY DIVISION OF HEALTH | |||||||
| 8600 SHERIDAN ROAD 600 | KENOSHA | WI | 53143 | 396005707 | KENOSHA COUNTY | 23045 | DENTAL SEALANT EXPANSION GRANT |
| MERITER FOUNDATION | |||||||
| 202 S PARK STREET | MADISON | WI | 53715 | 237098688 | 501(C)(3) | 5000 | DENTAL SEALANT EXPANSION GRANT |
| NEENAH MENASHA DENTAL CLINIC INC | |||||||
| 316 E 20TH STREET | KAUKAUNA | WI | 54130 | 391471332 | 501(C)(3) | 11204 | DENTAL SEALANT EXPANSION GRANT |
| PORTAGE COUNTY HEALTH & HUMAN SERVICES | |||||||
| 817 WHITING AVENUE | STEVENS POINT | WI | 54481 | 396005731 | PORTAGE COUNTY | 10000 | DENTAL SEALANT EXPANSION GRANT |
| SCHOOL DISTRICT OF SUPERIOR | |||||||
| PO BOX 146 | TWO HARBORS | MN | 55616 | 396004736 | SCHOOL DISTRICT | 10463 | DENTAL SEALANT EXPANSION GRANT |
| WALWORTH COUNTY HEALTH & HUMAN SERVICES | |||||||
| W4051 COUNTY ROAD NN | ELKHORN | WI | 53121 | 396005752 | WALWORTH COUNTY | 9621 | DENTAL SEALANT EXPANSION GRANT |
| BAYFIELD COUNTY PUBLIC HEALTH DEPARTMENT | |||||||
| 117 E 5TH STREET | BAYFIELD | WI | 54891 | 396005670 | BAYFIELD COUNTY | 5000 | DENTAL SEALANT GRANT |
| BROWN COUNTY HEALTH DEPARTMENT | |||||||
| 610 SOUTH BROADWAY | GREEN BAY | WI | 54305 | 396005671 | BROWN COUNTY | 64371 | DENTAL SEALANT GRANT |
| COLUMBIA ST MARY'S FOUNDATION | |||||||
| 2320 N LAKE DRIVE | MILWAUKEE | WI | 53211 | 391494981 | 501(C)(3) | 19893 | DENTAL SEALANT GRANT |
| COLUMBIA ST MARY'S MADRE ANGEAL | |||||||
| 1730 S 13TH STREET | MILWAUKEE | WI | 53204 | 391494981 | 501(C)(3) | 45673 | DENTAL SEALANT GRAMT |
| PRICE COUNTY HEALTH DEPARTMENT | |||||||
| 104 S EYDER AVENUE | PHILLIPS | WI | 54555 | 396005733 | PRICE COUNTY | 22075 | DENTAL SEALANT GRANT |
| SAUK COUNTY HEALTH DEPARTMENT | |||||||
| 505 BROADWAY 372 | BARABOO | WI | 53913 | 396005740 | SAUK COUNTY | 27136 | DENTAL SEALANT GRANT |
| VILAS COUNTY PUBLIC HEALTH | |||||||
| 330 COURT STREET | EAGLE RIVER | WI | 54521 | 396005751 | VILAS COUNTY | 15000 | DENTAL SEALANT GRANT |
| WAUSHERA COUNTY HEALTH DEPARTMENT | |||||||
| PO BOX 837 | WAUTOMA | WI | 54982 | 396005759 | WAUSHERA COUNTY | 6918 | DENTAL SEALANT GRANT |
| WOOD COUNTY HEALTH DEPARTMENT | |||||||
| 400 MARKET STREET | WISCONSIN RAPIDS | WI | 54494 | 396005763 | WOOD COUNTY | 10000 | DENTAL SEALANT GRANT |
| JEFFERSON COUNTY PUBLIC HEALTH DEPARTMENT | |||||||
| N3995 ANNEX ROAD | JEFFERSON | WI | 53549 | 396005705 | JEFFERSON COUNTY | 6290 | MCH BLOCK GRANT - CHILDREN WITH SPECIAL NEEDS |
| KENOSHA COUNTY DIVISION OF HEALTH | |||||||
| 8600 SHERIDAN ROAD 600 | KENOSHA | WI | 53143 | 396005707 | KENOSHA COUNTY | 7400 | MCH BLOCK GRANT - CHILDREN WITH SPECIAL NEEDS |
| SET MINISTRY | |||||||
| 2977 N 50TH STREET | MILWAUKEE | WI | 53210 | 391618277 | 501(C)(3) | 15700 | MCH BLOCK GRANT - CHILDREN WITH SPECIAL NEEDS |
| UNITED CEREBRAL PALSY | |||||||
| 7519 W OKLAHOMA AVENUE | MILWAUKEE | WI | 53219 | 391143353 | 501(C)(3) | 36133 | MCH BLOCK GRANT - CHILDREN WITH SPECIAL NEEDS |
| MARSHFIELD CLINIC | |||||||
| 1000 NORTH OAK AVENUE | MARSHFIELD | WI | 54449 | 390452970 | 501(C)(3) | 25121 | STATE OF WI - GENETICS SYSTEM GRANT |
| MEDICAL COLLEGE OF WISCONSIN | |||||||
| 8701 WATERTOWN PLANK ROAD | MILWAUKEE | WI | 53226 | 390806261 | 501(C)(3) | 14165 | STATE OF WI - GENETICS SYSTEM GRANT |
| UNIVERSITY OF WISCONSIN - MADISON | |||||||
| DRAWER 538 | MILWAUKEE | WI | 53278 | 396006492 | 501(C)(3) | 69500 | STATE OF WI - GENETICS SYSTEM GRANT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 26 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: MONITORING PROCEDURES - THE ORGANIZATION RECEIVES GRANT FUNDING FROM VARIOUS STATE AND FEDERAL AGENCIES. SOME OF THE GRANT AWARDS ARE SUB-AWARDED TO OTHER AGENCIES BASED ON THE REQUIREMENTS OF THE INDIVIDUAL GRANT AGREEMENTS. IN ORDER TO MONITOR THE USE OF THE FUNDS, THE ORGANIZATION ENTERS INTO SIGNED AGREEMENTS WITH THE SUB-GRANTEE AGENCIES TO OUTLINE THE TERMS OF THE ARRANGEMENTS INCLUDING THE PROPER USE OF FUNDS. THESE AGREEMENTS REQUIRE AGENCIES TO PROVIDE CERTIFICATIONS OF EXPENSES SUBMITTED FOR REIMBURSEMENT ALONG WITH DESCRIPTIONS OF THE ACTUAL EXPENSES INCURRED COMPARED TO THE BUDGETED AWARD TOTAL. EACH AWARD IS MONITORED BY A DESIGNATED EMPLOYEE OF THE ORGANIZATION WHO VERIFIES THAT ALL SERVICES ARE PROVIDED ACCORDING TO THE CONTRACT, APPROVES PAYMENTS TO THE AGENCY, AND ENSURES THAT THE AWARD OBJECTIVES ARE MET. IN SOME CASES, THE ORGANIZATION REQUIRES THE AGENCY TO SUBMIT A COPY OF ITS ANNUAL OMB 133 AUDIT ALONG WITH ANY RELEVANT AUDIT FINDINGS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARGARET TROY | |||||||||||||
| 0 | 696337 | 0 | 238920 | 0 | 62498 | 0 | 213436 | 0 | 33569 | 0 | 1244760 | 0 | 0 |
| CINTHIA S CHRISTENSEN | |||||||||||||
| 350953 | 0 | 111248 | 0 | 54224 | 0 | 48174 | 0 | 34556 | 0 | 599155 | 0 | 31657 | 0 |
| TIMOTHY L BIRKENSTOCK | |||||||||||||
| 0 | 413954 | 0 | 124887 | 0 | 58116 | 0 | 52773 | 0 | 28718 | 0 | 678448 | 0 | 20063 |
| SHEILA REYNOLDS | |||||||||||||
| 0 | 234291 | 0 | 80785 | 0 | 38200 | 0 | 35168 | 0 | 29149 | 0 | 417593 | 0 | 9703 |
| LAWRENCE DUNCAN | |||||||||||||
| 0 | 105794 | 0 | 52668 | 0 | 58897 | 0 | 0 | 0 | 12389 | 0 | 229748 | 0 | 9361 |
| LEE ANNE EDDY | |||||||||||||
| 190049 | 0 | 53726 | 0 | 28116 | 0 | 33932 | 0 | 17401 | 0 | 323224 | 0 | 9421 | 0 |
| MICHAEL GUTZEIT MD | |||||||||||||
| 278910 | 0 | 79359 | 0 | 57711 | 0 | 42983 | 0 | 30086 | 0 | 489049 | 0 | 12402 | 0 |
| JULIET KERSTEN | |||||||||||||
| 0 | 152005 | 0 | 39319 | 0 | 10100 | 0 | 26735 | 0 | 31240 | 0 | 259399 | 0 | 7380 |
| NANCY KOROM | |||||||||||||
| 263553 | 0 | 78965 | 0 | 29580 | 0 | 38480 | 0 | 29166 | 0 | 439744 | 0 | 6784 | 0 |
| MARK SHIP | |||||||||||||
| 209391 | 0 | 57200 | 0 | 28850 | 0 | 29624 | 0 | 28714 | 0 | 353779 | 0 | 16160 | 0 |
| DONNA JAMIESON | |||||||||||||
| 165531 | 0 | 25000 | 0 | 813 | 0 | 15739 | 0 | 28463 | 0 | 235546 | 0 | 0 | 0 |
| TOM LAUSTEN | |||||||||||||
| 148872 | 0 | 0 | 0 | 1376 | 0 | 10676 | 0 | 21688 | 0 | 182612 | 0 | 0 | 0 |
| MARY O'CONNER | |||||||||||||
| 147064 | 0 | 0 | 0 | 12382 | 0 | 14284 | 0 | 11307 | 0 | 185037 | 0 | 0 | 0 |
| JEFFERY GLASSHEIM MD | |||||||||||||
| 257038 | 0 | 0 | 0 | 32875 | 0 | 0 | 0 | 21503 | 0 | 311416 | 0 | 0 | 0 |
| ANDREW SCHMIDT MD | |||||||||||||
| 229177 | 0 | 0 | 0 | 8083 | 0 | 7268 | 0 | 23540 | 0 | 268068 | 0 | 0 | 0 |
| LORI BARBEAU DDS | |||||||||||||
| 231128 | 0 | 0 | 0 | 736 | 0 | 15231 | 0 | 22017 | 0 | 269112 | 0 | 0 | 0 |
| THOMAS NICHOLS MD | |||||||||||||
| 185035 | 0 | 0 | 0 | 21216 | 0 | 13558 | 0 | 20528 | 0 | 240337 | 0 | 0 | 0 |
| A CHARLES POST DDS | |||||||||||||
| 195223 | 0 | 0 | 0 | 2719 | 0 | 17667 | 0 | 9713 | 0 | 225322 | 0 | 0 | 0 |
| RAMESH SACHDEVA MD | |||||||||||||
| 0 | 285632 | 0 | 86213 | 0 | 6971 | 0 | 29577 | 0 | 28891 | 0 | 437284 | 0 | 5274 |
| JON E VICE - FORMER | |||||||||||||
| 0 | 647628 | 0 | 0 | 0 | 5148080 | 0 | 0 | 0 | 39648 | 0 | 5835356 | 0 | 4895003 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINES 4A-B | UNTIL JANUARY 2009, JON VICE SERVED AS PRESIDENT/CEO OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), WHICH IS THE CORPORATE MEMBER OF CHW. BY VIRTUE OF THAT ROLE, MR. VICE ALSO SERVED AS A DIRECTOR AND PRESIDENT OF CHW. IN JANUARY 2009, MR. VICE RETIRED AFTER 30 YEARS OF SERVICE WITH CHHS AND ITS AFFILIATES. CHHS PAID CERTAIN AMOUNTS AS SEVERANCE OR EARLY RETIREMENT INCOME TO MR. VICE, WHO SERVED AS PRESIDENT/CEO THROUGH JANUARY 2009. THESE AMOUNTS WERE PAID PURSUANT TO A WRITTEN AGREEMENT ENTERED INTO IN MAY 2008. CASH PAYMENTS MADE TO MR. VICE IN 2010 TOTALED $650,638. HOWEVER, BECAUSE AMOUNTS PAYABLE UNDER THE ARRANGEMENT WERE DEEMED TO HAVE VESTED IN 2010, THE PRESENT VALUE OF PAYMENTS TO BE MADE IN FUTURE YEARS (BASED ON ACTUARIAL ESTIMATES) WAS REPORTED AS TAXABLE INCOME FOR 2010 ACCORDINGLY. PART I, LINE 4B: IN 2010, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 7% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2010 WERE AS FOLLOWS: T. BIRKENSTOCK $30,723; M. TROY $50,820; L. EDDY $13,432; M. GUTZEIT, M.D. $20,933; N. KOROM $18,730; R. SACHDEVA, M.D. $20,251; M. SHIP $14,924; C. CHRISTENSEN $26,124; J. KERSTEN $11,028; S. REYNOLDS $18,018. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2010 WERE: T. BIRKENSTOCK $20,063; L. DUNCAN $9,361; L. EDDY $9,421; M. GUTZEIT, M.D. $12,402; N. KOROM $6,784; R. SACHDEVA, M.D. $5,274; C. CHRISTENSEN $31,657; M. SHIP $16,160; J. KERSTEN $7,380; S. REYNOLDS $9,703. CHHS HAS REPORTED ADDITIONAL AMOUNTS SET ASIDE FOR A NONQUALIFIED RETIREMENT PLAN ON BEHALF OF ITS PRESIDENT & CEO. THE AMOUNT SET ASIDE IN 2010 WAS $152,816. | |
| 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 ESTABLISHED ON AN EXECUTIVE BY EXECUTIVE BASIS. SUCH CRITERIA PERTAIN TO MATTERS IN THE EXECUTIVE'S AREA OF RESPONSIBILITY, AS WELL AS ACHIEVEMENT OF OVERALL STRATEGIC OBJECTIVES OF CHHS AND ITS AFFILIATES. | |
| PART III | FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. MARGARET TROY, DIRECTOR & PRESIDENT OF CHW AND PRESIDENT & CEO 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 AS A MEMBER OF THE BOARD OF DIRECTORS OF CHW WERE PROVIDED ON A PART-TIME VOLUNTARY BASIS. 2. TIMOTHY L. BIRKENSTOCK, TREASURER OF CHW AND TREASURER & CFO 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. 3. SHEILA REYNOLDS, SECRETARY OF CHW AND CORPORATE VICE PRESIDENT & 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. 4. LAWRENCE DUNCAN, VICE PRESIDENT OF REGIONAL SERVICES OF CHHS THROUGH JUNE 2010 - 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. 5. JULIET KERSTEN, VICE PRESIDENT OF REGIONAL SERVICES OF CHHS BEGINNING JUNE 2010 - 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. 6. RAMESH SACHDEVA, M.D., CORPORATE VP AND CHIEF QUALITY OFFICER OF CHHS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED (40 HOURS PER WEEK) TO CHHS AND ITS AFFILIATES. THESE AMOUNTS WERE PAID BY CHHS. 7. JON E. VICE, FORMER DIRECTOR & PRESIDENT OF CHW AND FORMER PRESIDENT & CEO OF CHHS - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID BY CHHS AS DESCRIBED ABOVE. | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710BCS9 | 2008-07-29 | 152300000 | SEE PART V | 0 | 0 | 0 |
| WI HEALTH & EDUCATIONAL FACILITIES AUTHORITY | |||||||
| 391337855 | 97710BCC4 | 2008-06-25 | 100771610 | SEE PART V | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|
| 152300953 | 1000301 | 2075652 | 2009 | 1 | 0 | 0 | 1 |
| 113903904 | 771610 | 13132293 | 2009 | 1 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 1 | 1 | 0 | 1 | 0.00200 | 0.00100 | 0.00300 | 1 |
| 0 | 0 | 1 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K SUPPLENTAL INFORMATION | Identifier |
| Explanation | SCHEDULE K, PART I, LINE A, DESCRIPTION OF PURPOSE, WHEFA SERIES 2008B: - $49,225,000 WAS ISSUED TO REFUND SERIES 2007-3 BONDS. THE 2007-3 BONDS WERE ISSUED NOVEMBER 20, 2007 TO REFUND A PORTION ($47,110,000) OF THE WHEFA SERIES 1998 BONDS. THE 1998 BONDS WERE ISSUED JUNE 2, 1998. - $100,000,000 WAS ISSUED TO REFUND SERIES 2004B BONDS. THE 2004B BONDS WERE ISSUED MAY 6, 2004 TO CONSTRUCT AND EQUIP CERTAIN HEALTH CARE FACILITIES (CORPORATE CENTER, PARKING STRUCTURE, TUNNEL, UTILITIES, AND NEW PATIENT TOWER) AND TO PAY ISSUANCE COSTS INCLUDING THE BOND INSURANCE POLICY PREMIUM. - $2,060,980 WAS ISSUED TO CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH CARE FACILITIES (NEW PATIENT TOWER). - $1,014,020 WAS ISSUED TO PAY 2008B BOND ISSUE COSTS. - TOTAL ISSUE FROM 2008B BONDS = $152,300,000 SCHEDULE K, PART I, LINE B, DESCRIPTION OF PURPOSE, WHEFA SERIES 2008A: - $100,000,000 WAS ISSUED TO REFUND SERIES 2007-1 AND 2007-2 BONDS. THE 2007-1 AND 2007-2 BONDS WERE ISSUED NOVEMBER 20, 2007 TO CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH CARE FACILITIES (NEW PATIENT TOWER) AND TO PAY ISSUANCE COSTS INCLUDING THE BOND INSURANCE POLICY PREMIUM. - $771,610 WAS ISSUED TO PAY 2008A BOND ISSUE COSTS. - TOTAL ISSUE FROM 2008A BONDS = $100,771,610 SCHEDULE K, PART III, COLUMN B, LINE 3A: THE ORGANIZATION HAS DETERMINED BASED ON A LEGAL REVIEW THAT A MANAGEMENT CONTRACT WITH RESPECT TO THE PROPERTY FINANCED BY THE BOND ISSUE LISTED IN COLUMN B DOES NOT RESULT IN PRIVATE BUSINESS USE. SCHEDULE K, ADDITIONAL INFORMATION: THE ORGANIZATION HAS $22,890,000 OF WHEFA SERIES 1998 BONDS OUTSTANDING AS OF DECEMBER 31, 2010 WHICH ARE NOT INCLUDED ON SCHEDULE K PART I AS THEY WERE ISSUED PRIOR TO DECEMBER 31, 2002. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| UNIVERSITY OF WI-MILWAUKEE | |||
| DIRECTOR(D GILBERT) | 169897 | MR. GILBERT IS PRESIDENT OF THE UNIVERSITY OF WISCONSIN-MILWAUKEE FOUNDATION, WHICH IS PART OF THE UNIVERSITY OF WISCONSIN-MILWAUKEE SYSTEM. THE ORGANIZATION PAID $169,897 TO THE UNIVERSITY OF WISCONSIN-MILWAUKEE FOUNDATION FOR EDUCATIONAL PROGRAMS. | 0 |
| MI BANK | |||
| DIRECTOR (M HOGAN) | 136577 | MR. HOGAN IS EXECUTIVE VICE PRESIDENT & CHIEF CREDIT OFFICER OF M&I MARSHALL & ILSLEY BANK, INC. THE ORGANIZATION PAID $136,577 TO MARSHALL & ILSLEY TRUST COMPANY N.A., AN AFFILIATE OF M&I MARSHALL & ILSLEY BANK, INC., FOR INVESTMENT SERVICES. | 0 |
| JOHNSON CONTROLS INC | |||
| DIRECTOR (CD MYERS) | 301911 | MR. MYERS IS PRESIDENT-BUILDING EFFICIENCY DIVISION OF JOHNSON CONTROLS, INC. THE ORGANIZATION PAID $301,911 TO JOHNSON CONTROLS, INC. FOR HEATING, VENTILATION, AND AIR CONDITIONING INSTALLATION AND REPAIR. | 0 |
| HUMANA | |||
| DIRECTOR (L RAMBO) | 661498 | MR. RAMBO IS THE REGIONAL CHIEF EXECUTIVE OFFICER OF HUMANA, INC. THE ORGANIZATION PAID HUMANA FOR TPA SERVICES FOR ITS SELF-INSURED HEALTH PLAN IN THE AMOUNT OF $661,498. | 0 |
| HUMANA | |||
| DIRECTOR (L RAMBO) | 30495545 | MR. RAMBO IS THE REGIONAL CHIEF EXECUTIVE OFFICER OF HUMANA, INC. THE ORGANIZATION RECEIVED APPROXIMATELY $30,495,545 FROM HUMANA FOR HEALTH CARE SERVICES PROVIDED TO HUMANA ENROLLEES. | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | MEDICAL EQUIPMENT | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 212940 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | REPLACEMENT COST | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | CHILDREN'S HOSPITAL OF WISCONSIN, INC. RECEIVED AN ULTRASOUND MACHINE VALUED AT $212,940, BASED ON WHAT IT WOULD HAVE COST THE HOSPITAL TO BUY A SIMILAR MACHINE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS EXIST BETWEEN THE FOLLOWING BOARD MEMBERS: ABRAHAM AND ROTHMAN; BRENNER AND DRURY; BRENNER AND O. SULLIVAN; DRURY AND SOMMERHAUSER; DRURY AND SCHLIFSKE; DRURY AND O. SULLIVAN; SCHLIFSKE AND SOMMERHAUSER; SOMMERHAUSER AND HERMA; AND O. SULLIVAN AND KLIEGMAN. | |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ARTICLES OF INCORPORATION AND BYLAWS OF THE HOSPITAL WERE AMENDED IN 2010 AS PART OF A SYSTEM-WIDE RESTRUCTURING. THE COMPOSITION OF THE BOARD OF DIRECTORS WAS CHANGED TO CREATE A SHARED BOARD OF DIRECTORS WITH CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), THE HOSPITAL'S SOLE CORPORATE MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS A SOLE CORPORATE MEMBER WHICH IS CHHS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | CHHS, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, ELECTS THE ORGANIZATION'S GOVERNING BODY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE CORPORATE MEMBER, CHHS, HAS CERTAIN RESERVE POWERS OVER THE CORPORATION, INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; APPROVAL OF MERGER, CONSOLIDATION OR THE CREATION OF ANY SUBSIDIARIES BY THE CORPORATION; APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT; AND SELECTION OF THE PRESIDENT. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO ALL DIRECTORS OF CHW. | |
| ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED 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 12C | |
| THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, EXECUTIVE VP, TREASURER, SECRETARY, VP OF REGIONAL SERVICES (DUNCAN), VP CHIEF MEDICAL OFFICER, AND VP OF PATIENT CARE SERVICES WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS. WITH THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), THE COMMITTEE CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INVOLVED REVIEW BY INDEPENDENT PERSONS WHO 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 B, LINE 15 | |
| THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CHHS ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE CHHS PUBLIC RELATIONS DEPARTMENT. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 3,609,238. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -6,718,250. INCREASE IN BENEF. INTEREST IN NET ASSETS OF CHILDREN'S HOSPITAL FOUNDATION 31,146,294. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -14,173,716. TOTAL TO FORM 990, PART XI, LINE 5: 13,863,566. | FORM 990, PART XI, LINE 5: |
| PURSUANT TO AN AMENDED AND RESTATED MASTER TRUST INDENTURE DATED MAY 1, 2004, CHILDREN'S HOSPITAL OF WISCONSIN, INC. AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION, INC. ARE MEMBERS OF AN OBLIGATED GROUP WHICH JOINTLY AND SEVERALLY GUARANTEE CERTAIN DEBT ISSUED BY A MEMBER OF THE OBLIGATED GROUP THROUGH THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PAYMENT OF SCHEDULED PRINCIPAL AND INTEREST IS SECURED BY A PLEDGE OF THE HOSPITAL'S AND FOUNDATION'S GROSS UNRESTRICTED RECEIPTS. | FORM 990, SCHEDULE R, PART V, LINE 1E: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 391500074 | OPERATIONAL SUPPORT SERVICES | WI | 501(C)(3) | LINE 3 | N/A | 0 | |
| CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION INC | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 391500075 | FUND DEVELOPMENT | WI | 501(C)(3) | LINE 7 | 1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |
| CHILDREN'S MEDICAL GROUP INC | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 391789197 | PEDIATRIC PHYSICIAN SERVICES | WI | 501(C)(3) | LINE 3 | 1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |
| CHILDREN'S PHYSICIAN GROUP PC | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 364303682 | PEDIATRIC PHYSICIAN SERVICES | IL | 501(C)(3) | LINE 9 | 1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 390806380 | CHILD WELFARE SERVICES | WI | 501(C)(3) | LINE 7 | 1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |
| CHILDREN'S COMMUNITY HEALTH PLAN INC | |||||||||||
| 9000 W WISCONSIN AVE PO BOX 1997 | MILWAUKEE | WI | 53201 | 271494977 | WISCONSIN MEDICAID HMO | WI | 501(C)(3) | LINE 9 | 1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | |
| MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS INC | |||||||||||
| 8701 WATERTOWN PLANK ROAD | MILWAUKEE | WI | 53226 | 391341366 | GRADUATE MEDICAL EDUCATION SUPPORT | WI | 501(C)(3) | LINE 11 TYPE 1 | N/A | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRTUAL PICU SYSTEMS LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 WYTHE STREET SUITE 101 | AddressLine1 |
| City | ALEXANDRIA | City |
| State | VA | State |
| ZIP Code | 22314 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201414664 | EIN |
| Primary Activity | QUALITY/OUTCOMES ANALYSIS | PrimaryActivity |
| Legal Domicile State | DE | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 0 | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MED-HEALTH FINANCIAL SERVICES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9000 W WISCONSIN AVE PO BOX 1997 | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391547907 | EIN |
| Primary Activity | COLLECTION SERVICES | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CHILDREN'S MEDICAL GROUP INC - RENT (LINE 1A (IV) ABOVE) | ||
| A | 331667 | CASH PAID/RECEIVED |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN - RENT (LINE 1A (IV) ABOVE) | ||
| A | 6358 | CASH PAID/RECEIVED |
| CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC - RENT (LINE 1A (IV) ABOVE) | ||
| A | 30359 | CASH PAID/RECEIVED |
| CHILDREN'S PHYSICIAN GROUP PC | ||
| B | 3700000 | CASH PAID/RECEIVED |
| CHILDREN'S MEDICAL GROUP INC | ||
| B | 883130 | CASH PAID/RECEIVED |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN | ||
| B | 2524754 | CASH PAID/RECEIVED |
| CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION INC | ||
| C | 5127017 | CASH PAID/RECEIVED |
| CHILDREN'S HOSPITAL AND HEALTH SYSTEM FOUNDATION INC | ||
| E | 253200977 | NET BOOK VALUE |
| CHILDREN'S MEDICAL GROUP INC | ||
| K | 78234 | CASH PAID/RECEIVED |
| CHILDREN'S COMMUNITY HEALTH PLAN INC - PATIENT REIMBURSEMENT | ||
| K | 10042213 | CASH PAID/RECEIVED |
| CHILDREN'S SERVICE SOCIETY OF WISCONSIN | ||
| K | 358505 | CASH PAID/RECEIVED |
| MED-HEALTH FINANCIAL SERVICES INC | ||
| L | 978096 | CASH PAID/RECEIVED |
| CHILDREN'S COMMUNITY HEALTH PLAN INC - ASSESSMENT PASS THROUGH PAYMENTS | ||
| R | 4464323 | CASH PAID/RECEIVED |
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