Civic Intelligence

Children'S Physician Group PC

990 • Fiscal year 2014 • EIN 36-4303682

Jan 01, 2014 to Dec 31, 2014 • Filed on Nov 05, 2015

9000 W Wisconsin Ave PO Box 1997Milwaukee, WI 53201

(414) 266-5420

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

100th percentile

13.41x

Higher debt load relative to assets than 100% of similar nonprofits.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2014

Liabilities / Revenue

98th percentile

8.24x

Higher debt load relative to revenue than 98% of similar nonprofits.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2014

Net Margin

79th percentile

21%

Higher net margin than 79% of similar nonprofits.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2014

Top Officer Pay

99th percentile

$611,140

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 88.2% of source-year revenue.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Source year 2014

Asset Growth

6th percentile

-29%

Faster asset growth than 6% of similar nonprofits.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2013 to 2014

Revenue Growth

1st percentile

-91%

Faster revenue growth than 1% of similar nonprofits.

2014 filings • 501(c)3 • $500k-$1M nonprofits • Annualized from 2013 to 2014

Assets

Down

$425,877

Down $176,370 (-29%) from 2013

Net Assets

Up

-$5,285,727

Up $148,158 (+2.7%) from 2013

Liabilities

Down

$5,711,604

Down $324,528 (-5.4%) from 2013

Revenue

Down

$693,244

Down $6,779,310 (-91%) from 2013

Expenses

Down

$545,086

Down $7,702,633 (-93%) from 2013

Net Income

Up

$148,158

Up $923,323 (+119%) from 2013

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$10M$5.0M$0-$5.0M-$10MAssets 2010: $1,423,476Liabilities 2010: $4,982,005Net Assets 2010: -$3,558,5292010Assets 2011: $1,329,397Liabilities 2011: $5,764,274Net Assets 2011: -$4,434,8772011Assets 2012: $1,451,121Liabilities 2012: $6,109,841Net Assets 2012: -$4,658,7202012Assets 2013: $602,247Liabilities 2013: $6,036,132Net Assets 2013: -$5,433,8852013Assets 2014: $425,877Liabilities 2014: $5,711,604Net Assets 2014: -$5,285,7272014Assets 2015: $271,313Liabilities 2015: $271,313Net Assets 2015: $02015Assets 2016: $268,907Liabilities 2016: $161,339Net Assets 2016: $107,5682016Assets 2017: $290,306Liabilities 2017: $189,983Net Assets 2017: $100,3232017

Highlighted filing

2014

Assets$425,877
Liabilities$5,711,604
Net Assets-$5,285,727

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$10M$5.0M$0-$5.0MExpenses 2010: $6,685,1202010Expenses 2011: $5,552,0952011Expenses 2012: $4,965,0012012Revenue 2013: $7,472,554Expenses 2013: $8,247,719Net Income 2013: -$775,1652013Revenue 2014: $693,244Expenses 2014: $545,086Net Income 2014: $148,1582014Revenue 2015: $5,602,771Expenses 2015: $317,044Net Income 2015: $5,285,7272015Revenue 2016: $116,483Expenses 2016: $8,915Net Income 2016: $107,5682016Revenue 2017: $25,270Expenses 2017: $32,515Net Income 2017: -$7,2452017

Highlighted filing

2014

Revenue$693,244
Expenses$545,086
Net Income$148,158
Jump To
Filing Snapshot
Filing Period
Jan 1, 2014 to Dec 31, 2014
Signed
Nov 5, 2015
Return Version
2014v5.0
Gross Receipts
$693,244
Mission and Program Overview

Mission

Provide medical care to patients and families in northern illinois and surrounding areas.

Provide quality, accessible specialty health care to children in n. Il and surrounding areas.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$226,967$274,544▲ $47,577
Accounts Receivable$160,716$0▼ $160,716
Total Assets$602,247$425,877▼ $176,370
Other Assets Total$214,564$151,333▼ $63,231
Liabilities
Other Liabilities$5,609,415$5,164,318▼ $445,097
Accounts Payable and Accrued Expenses$426,717$547,286▲ $120,569
Total Liabilities$6,036,132$5,711,604▼ $324,528
Net Assets / Fund Balance
Unrestricted Net Assets$-5,433,885$-5,285,727▲ $148,158
Total Net Assets Fund Balance$-5,433,885$-5,285,727▲ $148,158
Total Liabilities and Net Assets / Fund Balance$602,247$425,877▼ $176,370

Asset Categories

AssetBook ValueDepreciationBasis
Other Assets Org$151,333--
Compensation and Service Providers

Board Members and Trustees

NameTitle
Michael Gutzeit MdDirector/pres & Treas
Juliet KerstenCPG Secretary
Revenue and Support

Revenue Composition

Contributions and Grants
$665,691
Program Service Revenue
$17,006
Investment Income
$8,605
Other Revenue
$1,942
Change in Net Assets
$148,158
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$533,090
Salaries, Compensation, and Employee Benefits$11,996
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Occupancy$303,873--$303,873
Other Expenses$148,067--$148,067
Insurance$47,791--$47,791
All Other Expenses$30,151--$30,151
Other Salaries and Wages$8,293--$8,293
Office Expenses$3,160--$3,160
Payroll Taxes$3,003--$3,003
Other Employee Benefits$700--$700
Fees for Service Investment Mgmnt Fees$48--$48
Total Functional Expenses$545,086$0$0$545,086
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Long Term Lease$5,012,985
Deferred Compensation Plan Liabilities$151,333
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

Illinois law requires that all of the stock of cpg be held by an individual licensed to practice medicine in the state of illinois. All of the corporation's stock is held by michael gutzeit, m.d., a physician executive employed by children's hospital and health system, inc. ("chhs") and its wholly owned subsidiary, children's medical group ("cmg"), in trust for the benefit of chhs. The trust agreement, together with the articles of incorporation and bylaws of cpg, set forth the authority of dr. Gutzeit as trustee and shareholder, as well as limitations on such authority. The documents provide that chhs, as beneficiary under the agreement, has various other reserve powers and authority in relation to the corporation.

Form 990, Part VI, Section A, Line 7A

The sole stockholder of the organization has the authority to elect himself to the board of directors.

Form 990, Part VI, Section A, Line 7B

Cpg has a single shareholder who holds the corporation's stock in trust for chhs. Through the sole shareholder, chhs has certain reserve powers over the decisions made by the board of directors of cpg including amendment of the articles of incorporation and bylaws; and approval of the annual budget and any debt.

Form 990, Part VI, Section B, Line 11

The form 990 of cpg was reviewed by management, the audit and compliance committee, and other advisors of chhs and prior to filing, a copy was provided to the director of cpg.

Form 990, Part VI, Section B, Line 12C

Annually, all directors, officers and key employees are requested to submit a conflict of interest disclosure to the corporate vice president and general counsel of chhs. A list of potential conflicts is prepared and is available at each board and committee meeting. The compliance department monitors and periodically reviews transactions between the organization and board members or entities with which they are affiliated.

Form 990, Part VI, Section B, Line 15

The compensation of the organization's president/treasurer was reviewed and approved by the independent compensation committee of chhs. 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 to be paid was reasonable and comparable to amounts paid by similarly situated organizations. The process followed by the committee, including the data relied upon and the committee's decisions, was thoroughly and timely documented. Compensation of the other officer was set by supervisory executives in consultation with chhs human resources leaders. The process included review by independent persons who, using a variety of external sources (as indicated on schedule j), confirmed that total compensation amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations. The process and data relied on were thoroughly and timely documented.

Form 990, Part VI, Section C, Line 19

The governing documents, conflict of interest policy and financial information of cpg are available to the public upon request through the chhs marketing and communication department.

Form 990, Part I, Line 4 and Part VI, Line 1B

Children's physician group, p.c. ("cpg") is an illinois professional corporation. Pursuant to a first restated trust agreement dated january 1, 2006 (the "agreement"), cpg is a "captive pc" in relation to children's hospital and health system, inc. ("chhs"), a tax-exempt wisconsin corporation serving as the parent entity of an integrated system of provider organizations addressing the health care needs of children in southeastern wisconsin, northern illinois and surrounding areas. Because illinois law requires that all of the stock of cpg be held by an individual licensed to practice medicine in the state of illinois, all of cpg's stock is held by michael gutzeit, m.d., a physician executive employed by chhs/cmg, in trust for the benefit of chhs. The agreement, together with cpg's articles of incorporation and bylaws, set forth the authority of the physician, as trustee and shareholder, in relation to cpg, as well as limitations on such authority. Illinois law further requires that the board of directors of the corporation consist solely of individuals licensed to practice medicine in the state of illinois. The physician executive is the sole director of cpg. Because the physician executive is a compensated employee of chhs, he may not be considered "independent" for purposes of form 990. However, as acknowledged by the irs in its cpe text for fiscal year 1997, in a multi-entity hospital system, the board of a subsidiary non-profit health care organization is considered to be comprised of independent community members if it is controlled by an exempt organization whose board is comprised of a majority of voting members who are independent community members. Cpg meets this standard because, via the agreement and its articles of incorporation and bylaws, cpg is controlled by chhs, the governing board of which includes independent community members as a majority thereof.

Filing and Contact Details

Filer

Filer Name
CHILDREN'S PHYSICIAN GROUP PC
EIN
36-4303682
Phone
4142665420
Address
9000 W WISCONSIN AVE PO BOX 1997, MILWAUKEE, WI 53201

Signing Officer

Name
Michael Gutzeit Md
Title
President
Phone
4142665420
Signed
2015-11-05
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Michael Gutzeit Md
Formed
1999
Legal Domicile
Il
Voting Board Members
1
Independent Board Members
0
Employees
1
Volunteers
0

Preparer

Firm
Sikich Llp
Address
13400 BISHOPS LANE SUITE 300, BROOKFIELD, WI 53005
Preparer
Bryan L Pautsch CPA
Phone
2627549400
Supplemental Narrative

Additional Explanations

Form 990, Part V, Line 1A

The organization did not file any forms 1099 during the taxable year. Although the organization did retain independent contractors, the compensation amounts owed to such contractors were processed and paid by a related entity, children's hospital of wisconsin, inc. ("chw"), with appropriate intercompany arrangements between the organization and chw. The forms 1099 for such payments were issued by chw, as the entity that processed and made the payments to the independent contractors.

Financial Statement Notes

PART X, LINE 2:

Footnote 2 income taxes: chhs evaluates its uncertain tax positions on an annual basis, and there have been no uncertain tax positions recorded for the years ended december 31, 2014 and 2013.

Raw XML AppendixShowing 400 of 524 raw XML fields

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IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt06009836
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IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
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IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
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IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
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IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/FootnoteTextInd0X
IRS990ScheduleD/OtherAssetsOrgGrp/BookValueAmt0151333
IRS990ScheduleD/OtherAssetsOrgGrp/Desc0DEFERRED COMPENSATION PLAN ASSETS
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt0151333
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt15012985
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DEFERRED COMPENSATION PLAN LIABILITIES
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc1LONG TERM LEASE
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0FOOTNOTE 2 INCOME TAXES: CHHS EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0PART X, LINE 2:
IRS990ScheduleD/TotalBookValueLandBuildingsAmt00
IRS990ScheduleD/TotalBookValueOtherAssetsAmt0151333
IRS990ScheduleD/TotalLiabilityAmt05164318
IRS990ScheduleJ/AnyNonFixedPaymentsInd00
IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd00
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd00
IRS990ScheduleJ/EquityBasedCompArrngmInd00
IRS990ScheduleJ/InitialContractExceptionInd00
IRS990/ScheduleJRequiredInd01
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount10
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt164651
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt0341886
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt1230805
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt119150
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt10
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt10
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt11170
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0MICHAEL GUTZEIT MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1JULIET KERSTEN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0DIRECTOR/PRES & TREAS
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1CPG SECRETARY
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt10
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt1344260
IRS990ScheduleJ/SeverancePaymentInd00
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0CPG RELIED UPON CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS") TO ESTABLISH THE COMPENSATION OF CPG'S PRESIDENT. CHHS USED ITS INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE THE COMPENSATION.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1IN 2014, THERE WAS A CHHS FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN) FOR QUALIFIED OFFICERS/EXECUTIVES. THE ORGANIZATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR QUALIFIED EXECUTIVES IN 2014 WERE AS FOLLOWS: M. GUTZEIT, M.D., $36,985. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PAST PARTICIPANTS IN 2014 WERE: M. GUTZEIT, M.D., $36,654.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt2SALARIES PAID BY RELATED ORGANIZATIONS: 1. MICHAEL GUTZEIT, M.D., PRESIDENT AND TREASURER OF CPG (BEGINNING AUGUST 2013) AND VP CHW / CHIEF MEDICAL OFFICER, AND JULIET KERSTEN, SECRETARY OF CPG AND VICE PRESIDENT, CHILDREN'S HOSPITAL OF WISCONSIN, INC. (CHW) - REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS AND OTHER COMPENSATION LISTED IN PART VII AND SCHEDULE J WERE PAID FOR SERVICES PROVIDED TO CHW (40 HOURS PER WEEK). THESE AMOUNTS WERE PAID BY CHW.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 3
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc1PART I, LINE 4B
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II:
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd01
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION DID NOT FILE ANY FORMS 1099 DURING THE TAXABLE YEAR. ALTHOUGH THE ORGANIZATION DID RETAIN INDEPENDENT CONTRACTORS, THE COMPENSATION AMOUNTS OWED TO SUCH CONTRACTORS WERE PROCESSED AND PAID BY A RELATED ENTITY, CHILDREN'S HOSPITAL OF WISCONSIN, INC. ("CHW"), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHW. THE FORMS 1099 FOR SUCH PAYMENTS WERE ISSUED BY CHW, AS THE ENTITY THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1ILLINOIS LAW REQUIRES THAT ALL OF THE STOCK OF CPG BE HELD BY AN INDIVIDUAL LICENSED TO PRACTICE MEDICINE IN THE STATE OF ILLINOIS. ALL OF THE CORPORATION'S STOCK IS HELD BY MICHAEL GUTZEIT, M.D., A PHYSICIAN EXECUTIVE EMPLOYED BY CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS") AND ITS WHOLLY OWNED SUBSIDIARY, CHILDREN'S MEDICAL GROUP ("CMG"), IN TRUST FOR THE BENEFIT OF CHHS. THE TRUST AGREEMENT, TOGETHER WITH THE ARTICLES OF INCORPORATION AND BYLAWS OF CPG, SET FORTH THE AUTHORITY OF DR. GUTZEIT AS TRUSTEE AND SHAREHOLDER, AS WELL AS LIMITATIONS ON SUCH AUTHORITY. THE DOCUMENTS PROVIDE THAT CHHS, AS BENEFICIARY UNDER THE AGREEMENT, HAS VARIOUS OTHER RESERVE POWERS AND AUTHORITY IN RELATION TO THE CORPORATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE SOLE STOCKHOLDER OF THE ORGANIZATION HAS THE AUTHORITY TO ELECT HIMSELF TO THE BOARD OF DIRECTORS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3CPG HAS A SINGLE SHAREHOLDER WHO HOLDS THE CORPORATION'S STOCK IN TRUST FOR CHHS. THROUGH THE SOLE SHAREHOLDER, CHHS HAS CERTAIN RESERVE POWERS OVER THE DECISIONS MADE BY THE BOARD OF DIRECTORS OF CPG INCLUDING AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; AND APPROVAL OF THE ANNUAL BUDGET AND ANY DEBT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE FORM 990 OF CPG WAS REVIEWED BY MANAGEMENT, THE AUDIT AND COMPLIANCE COMMITTEE, AND OTHER ADVISORS OF CHHS AND PRIOR TO FILING, A COPY WAS PROVIDED TO THE DIRECTOR OF CPG.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5ANNUALLY, ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CORPORATE VICE PRESIDENT AND GENERAL COUNSEL OF CHHS. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE AT EACH BOARD AND COMMITTEE MEETING. THE COMPLIANCE DEPARTMENT MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/TREASURER WAS REVIEWED AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF CHHS. 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 TO BE PAID WAS REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. COMPENSATION OF THE OTHER OFFICER WAS SET BY SUPERVISORY EXECUTIVES IN CONSULTATION WITH CHHS HUMAN RESOURCES LEADERS. THE PROCESS INCLUDED REVIEW BY INDEPENDENT PERSONS WHO, USING A VARIETY OF EXTERNAL SOURCES (AS INDICATED ON SCHEDULE J), CONFIRMED THAT TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CPG ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8CHILDREN'S PHYSICIAN GROUP, P.C. ("CPG") IS AN ILLINOIS PROFESSIONAL CORPORATION. PURSUANT TO A FIRST RESTATED TRUST AGREEMENT DATED JANUARY 1, 2006 (THE "AGREEMENT"), CPG IS A "CAPTIVE PC" IN RELATION TO CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), A TAX-EXEMPT WISCONSIN CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH CARE NEEDS OF CHILDREN IN SOUTHEASTERN WISCONSIN, NORTHERN ILLINOIS AND SURROUNDING AREAS. BECAUSE ILLINOIS LAW REQUIRES THAT ALL OF THE STOCK OF CPG BE HELD BY AN INDIVIDUAL LICENSED TO PRACTICE MEDICINE IN THE STATE OF ILLINOIS, ALL OF CPG'S STOCK IS HELD BY MICHAEL GUTZEIT, M.D., A PHYSICIAN EXECUTIVE EMPLOYED BY CHHS/CMG, IN TRUST FOR THE BENEFIT OF CHHS. THE AGREEMENT, TOGETHER WITH CPG'S ARTICLES OF INCORPORATION AND BYLAWS, SET FORTH THE AUTHORITY OF THE PHYSICIAN, AS TRUSTEE AND SHAREHOLDER, IN RELATION TO CPG, AS WELL AS LIMITATIONS ON SUCH AUTHORITY. ILLINOIS LAW FURTHER REQUIRES THAT THE BOARD OF DIRECTORS OF THE CORPORATION CONSIST SOLELY OF INDIVIDUALS LICENSED TO PRACTICE MEDICINE IN THE STATE OF ILLINOIS. THE PHYSICIAN EXECUTIVE IS THE SOLE DIRECTOR OF CPG. BECAUSE THE PHYSICIAN EXECUTIVE IS A COMPENSATED EMPLOYEE OF CHHS, HE MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS CPE TEXT FOR FISCAL YEAR 1997, IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. CPG MEETS THIS STANDARD BECAUSE, VIA THE AGREEMENT AND ITS ARTICLES OF INCORPORATION AND BYLAWS, CPG IS CONTROLLED BY CHHS, THE GOVERNING BOARD OF WHICH INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART V, LINE 1A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION A, LINE 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION A, LINE 7A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION A, LINE 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART VI, SECTION B, LINE 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8FORM 990, PART I, LINE 4 AND PART VI, LINE 1B
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd01
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/DirectControllingEntityName/BusinessNameLine1Txt0CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EIN0391547907
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/EntityTypeTxt0C
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/LegalDomicileStateCd0WI
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/PrimaryActivitiesTxt0COLLECTION SERVICES
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/RelatedOrganizationName/BusinessNameLine1Txt0MED-HEALTH FINANCIAL SERVICES INC
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/AddressLine1Txt09000 W WISCONSIN AVE PO BOX 1997
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/CityNm0MILWAUKEE
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/StateAbbreviationCd0WI
IRS990ScheduleR/IdRelatedOrgTxblCorpTrGrp/USAddress/ZIPCd053201
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/DirectControllingEntityName/BusinessNameLine1Txt0CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/DisproportionateAllocationsInd00
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/EIN0201414664
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/GeneralOrManagingPartnerInd00
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/LegalDomicileStateCd0DE
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/PredominantIncomeTypeTxt0RELATED
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/PrimaryActivitiesTxt0QUALITY/OUTCOMES ANALYSIS
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/RelatedOrganizationName/BusinessNameLine1Txt0VIRTUAL PICU SYSTEMS LLC
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/AddressLine1Txt0401 WYTHE STREET SUITE 101
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/CityNm0ALEXANDRIA
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/StateAbbreviationCd0VA
IRS990ScheduleR/IdRelatedOrgTxblPartnershipGrp/USAddress/ZIPCd022314
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd10
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd20
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd30
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd40
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd50
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt0CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt1CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt2CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt3CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt4CHILDREN'S HOSPITAL & HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd0N/A
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt1CHILDREN'S HOSPITAL OF WISCONSIN INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt2CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt3CHILDREN'S MEDICAL GROUP INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt4CHILDREN'S SERVICE SOCIETY OF WISCONSIN
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt5CHILDREN'S COMMUNITY HEALTH PLAN INC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0391500074
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN1390812532
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN2391500075
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN3391789197
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN4390806380
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN5271494977
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt1501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt2501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt3501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt4501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt5501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd1WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd2WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd3WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd4WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd5WI
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0OPERATIONAL SUPPORT SERVICES
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt1PEDIATRIC HOSPITAL
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt2FUND DEVELOPMENT
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt3PEDIATRIC PHYSICIAN SERVICES
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt4CHILD WELL-BEING SERVICES
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt5WISCONSIN MEDICAID HMO

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