2024-05-03T11:56:56-05:00 2023-06-30 390747409 REILLY PENNER & BENTON LLP 1233 NORTH MAYFAIR ROAD SUITE 302 MILWAUKEE WI 532263255 990 2022-07-01 391341366 MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS INC MEDI 4149554575 8701 WATERTOWN PLANK RD POBOX 265 MILWAUKEE WI 53226 JUDY A JANKOWSKI SECRETARY/TREASURER 4149554575 2024-05-02 1 JUDY JANKOWSKI 999009999 1 JOSHUA BIERBACH P01449255 4142717800 2024-04-21 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JUDY A JANKOWSKI 8701 WATERTOWN PLANK RD POBOX 26509 MILWAUKEE WI 53226 84489719 0 X WWW.MCW.EDU/GME X 1980 WI THE MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS (MCWAH) IS A CONSORTIUM THAT WAS ESTABLISHED IN 1980 TO FACILITATE THE ADMINISTRATION OF GRADUATE MEDICAL EDUCATION (GME) PROGRAMS CONDUCTED JOINTLY BY THE MEDICAL COLLEGE OF WISCONSIN IN CONJUNCTION WITH MULTIPLE HEALTH CARE INSTITUTIONS. IN ADDITION, MCWAH ENSURES THE ACCREDITATION OF ITS TRAINING PROGRAMS BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME). CURRENTLY, MCWAH EMPLOYS 945 TRAINEES IN 102 ACCREDITED RESIDENCY AND FELLOWSHIP PROGRAMS. 19 0 1262 0 0 0 50000 50000 82261967 83407771 770 7264 787640 1024684 83100377 84489719 0 0 0 0 81049442 82254640 0 0 0 2159297 2354783 83208739 84609423 -108362 -119704 6525600 8830605 1746975 4171684 4778625 4658921 X THE MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS (MCWAH) IS A CONSORTIUM THAT WAS ESTABLISHED IN 1980 TO FACILITATE THE ADMINISTRATION OF GRADUATE MEDICAL EDUCATION (GME) PROGRAMS CONDUCTED JOINTLY BY THE MEDICAL COLLEGE OF WISCONSIN IN CONJUNCTION WITH MULTIPLE HEALTH CARE INSTITUTIONS. IN ADDITION, MCWAH ENSURES THE ACCREDITATION OF ITS TRAINING PROGRAMS BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME). CURRENTLY, MCWAH EMPLOYS 945 TRAINEES IN 102 ACCREDITED RESIDENCY AND FELLOWSHIP PROGRAMS. 0 0 82359008 84432455 TO PROVIDE STIPENDS AND FRINGE BENEFITS TO PARTICIPANTS IN THE GRADUATE MEDICAL TRAINING PROGRAMS CONDUCTED BY THE MEDICAL COLLEGE OF WISCONSIN AND ITS AFFILIATED INSTITUTIONS 82359008 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 8 0 1 1262 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 0 WI X MS JUDY A JANKOWSKI CPA 4149554575 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 KENNETH SIMONS MD EXECUTIVE DIRECTOR - PART YEAR 40.00 28.00 X X 222061 180587 34123 MARK HOHENWALTER MD INTERIM EXECUTIVE DIRECTOR - PART YEAR 20.00 30.00 X X 17145 553367 48359 RICHELLE WEBB-DIXON BOARD MEMBER 0.00 X 0 0 0 ALICIA PILARSKI DO BOARD MEMBER 0.00 X 0 0 0 PETER STAMAS JR MD BOARD MEMBER 0.00 X 0 0 0 ROWENA PUNZALAN MD BOARD MEMBER 0.00 X 0 0 0 DOUGLASS REDING MD BOARD MEMBER 0.00 X 0 0 0 SIDDHARTHA SINGH MD BOARD MEMBER 0.00 X 0 0 0 O'RELL WILLIAMS MD BOARD MEMBER 0.00 X 0 0 0 MICHAEL ERDMANN MD PRESIDENT 0.00 X X 0 0 0 SCOTT TURNER BOARD MEMBER 0.00 X 0 0 0 MICHAEL LAPPEN BOARD MEMBER 0.00 X 0 0 0 BARBARA BRYANT MD BOARD MEMBER 0.00 X 0 0 0 JOHN RAYMOND MD BOARD MEMBER 0.00 X 0 0 0 JEFF VAN DE KREEKE PRESIDENT 0.00 X X 0 0 0 PAUL BURSTEIN MD BOARD MEMBER 0.00 X 0 0 0 RICHARD SHIMP MD BOARD MEMBER 0.00 X 0 0 0 MICHAEL GUTZEIT MD VICE PRESIDENT 0.00 X X 0 0 0 JEFFREY BAHR MD BOARD MEMBER 0.00 X 0 0 0 NATHAN GUNDACKER MD BOARD MEMBER 0.00 X 0 0 0 JACOB BIDWELL MD BOARD MEMBER 0.00 X 0 0 0 JOSEPH E KERSCHNER MD BOARD MEMBER 0.00 X 0 0 0 JOHN SCHNEIDER MD BOARD MEMBER 0.00 X 0 0 0 JUDY JANKOWSKI SECRETARY/TREASURER 50.00 X 129437 0 18415 368643 733954 100897 3 0 1 0 0 50000 50000 BILLINGS TO AFFILIATES 900099 83407771 83407771 83407771 7264 7264 HOUSESTAFF REIMBURSEMENT 900099 1024684 1024684 1024684 84489719 84432455 0 7264 401080 401080 66518108 65953847 564261 10483096 10397787 85309 4852356 4821951 30405 120920 120920 19650 19650 47913 47913 20384 20384 850 850 882 882 3164 3164 5708 5708 953813 953813 ACCREDITATION 549349 549349 RISK MANAGEMENT 176824 176824 RESIDENCY MANAGEMENT SY 175263 175263 MEDICAL EDUCATION SPECI 72251 72251 207812 54786 153026 84609423 82359008 2250415 0 3790921 7521438 371900 371900 2333191 868948 22281 61038 210382 203101 7307 7281 6525600 8830605 1288491 1449271 458484 2722413 1746975 4171684 X 4778625 4658921 4778625 4658921 6525600 8830605 -119704 0 X X 0 1 X 1 0 X X 9 AURORA HEALTH CARE METRO INC 390806181 3 0 0 0 VERSITI WISCONSIN INC 390807235 7 0 0 0 CHILDREN'S HOSPITAL OF WISCONSIN 390812532 3 0 0 0 COLUMBIA ST MARY'S HOSPITAL 390806315 3 0 0 0 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 396105970 3 0 0 0 THE MEDICAL COLLEGE OF WISCONSIN 390806261 2 0 0 0 ASCENSION SE WISCONSIN HOSPITAL INC 390816857 3 0 0 0 ZABLOCKI VA MEDICAL CENTER 5000 W NATIONAL AVE 391326366 6 0 0 0 MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION 396005720 6 0 0 0 9 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 FORM 990, SCHEDULE A, PART IV, SECTION A, LINE 1: THE ORGANIZATION'S SUPPORTED ORGANIZATIONS, OTHER THAN THE MEDICAL COLLEGE OF WISCONSIN, ARE NOT LISTED BY NAME IN THE ORGANIZATION'S GOVERNING DOCUMENTS. AS INDICATED IN THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS, THE AFFILIATED INSTITUTIONS ARE PARTIES TO AFFILIATION AGREEMENTS FORM 990, SCHEDULE A, PART IV, SECTION B, LINE 1: THE MEDICAL COLLEGE OF WISCONSIN AND EACH AFFILIATED INSTITUTION HAS THE RIGHT TO ANNUALLY APPOINT DIRECTORS. IN ADDITION, THE EXECUTIVE DIRECTOR IS AN EX OFFICIO VOTING MEMBER OF THE BOARD. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY THE AFFIRMATIVE VOTE OF TWO-THIRDS OF THE DIRECTORS. FORM 990, SCHEDULE A, PART 1, LINE 11G: MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS, INC. PROVIDES SUPPORT TO FACILITATE THE ADMINISTRATION OF GRADUATE MEDICAL EDUCATION PROGRAMS CONDUCTED JOINTLY WITH THE MEDICAL COLLEGE OF WISCONSIN IN CONJUNCTION WITH HEALTH CARE INSTITUTIONS. NO FINANCIAL SUPPORT IS PROVIDED TO THESE ORGANIZATIONS. FORM 990, SCHEDULE A, SECTION A, LINE 5A: AS INDICATED IN THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS, THE AFFILIATED INSTITUTIONS ARE PARTIES TO AFFILIATION AGREEMENTS. IN ACCORDANCE WITH THE TERMINATION PROVISIONS OF THE AFFILIATION AGREEMENT, MOSAIC FAMILY HEALTH INC (EIN 47-3298660) VOLUNTARILY TERMINATED ITS AFFILIATION AGREEMENT AND CEASED TO BE A SUPPORTED ORGANIZATION AS OF JUNE 30, 2022. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 40676 33395 7281 169706 169706 0 7281 X 86056228 1566509 1566509 84489719 0 84489719 86175932 1566509 1566509 84609423 0 84609423 PART X, LINE 2: MCWAH IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM WISCONSIN INCOME TAXES AND, THEREFORE, HAS MADE NO PROVISION FOR INCOME TAXES. ADDITIONALLY, THE ORGANIZATION HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A "PRIVATE FOUNDATION" WITHIN THE GUIDELINES OF SECTION 509(A) OF THE CODE. MCWAH HAS IMPLEMENTED ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. THIS STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DERECOGNIZING, INTEREST, PENALTIES AND DISCLOSURES REQUIRED. MCWAH BELIEVES THAT INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE MCWAH'S FINANCIAL POSITION, RESULTS OF OPERATIONS OR CASH FLOWS. ACCORDINGLY, MCWAH HAS NOT RECORDED ANY RESERVES, OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS ON JUNE 30, 2023. X 0 0 0 0 0 0 0 0 0 MARK HOHENWALTER MD INTERIM EXECUTIVE DIRECTOR - PART YE 15719 435526 0 78341 1426 39500 850 23550 885 24510 18880 601427 0 0 KENNETH SIMONS MD EXECUTIVE DIRECTOR - PART YEAR 198855 130829 0 34490 23206 15268 14717 9683 6517 4287 243295 194557 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THREE (3) OR MORE MEMBERS OF THE BOARD OF DIRECTORS INCLUDING THE PRESIDENT, VICE-PRESIDENT, AND EXECUTIVE DIRECTOR THAT ARE ELECTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION AND RECOMMENDS TO THE BOARD AN ANNUAL BUDGET FOR THE CORPORATION. AT JUNE 30, 2023, THE EXECUTIVE COMMITTEE WAS REPRESENTED WITH FOUR (4) BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 THE MEDICAL COLLEGE OF WISCONSIN AND EACH AFFILIATED INSTITUTION ARE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL COLLEGE OF WISCONSIN AND EACH AFFILIATED INSTITUTION HAS THE RIGHT TO ANNUALLY APPOINT DIRECTORS. IN ADDITION, THE EXECUTIVE DIRECTOR IS AN EX OFFICIO VOTING MEMBER OF THE BOARD. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY THE AFFIRMATIVE VOTE OF TWO-THIRDS OF THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE SECRETARY/TREASURER OF THE CORPORATION. A COPY OF THE FORM 990 IS PROVIDED TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMITTAL. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL STATEMENT IS SIGNED BY EACH BOARD MEMBER AND BY THE SECRETARY/TREASURER. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR IS NOMINATED BY THE MEDICAL COLLEGE OF WISCONSIN (MCW) AND IS ELECTED BY THE MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS' (MCWAH) BOARD. THE EXECUTIVE DIRECTOR MUST BE A MEMBER OF THE FACULTY OF MCW. MCW SETS THE SALARIES FOR ITS FACULTY. IT UTILIZES THE FACULTY SALARY INFORMATION PROVIDED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) IN CONJUCTION WITH OTHER AVAILABLE SALARY COMPARISON TOOLS. THE MCWAH ADMINISTRATOR/SECRETARY/TREASURER'S COMPENSATION IS DETERMINED BY MCW USING SALARY POLICY GUIDELINES. THE MCWAH EXECUTIVE DIRECTOR AND THE ADMINISTRATOR ARE EMPLOYEES OF MCW. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC RICHELLE WEBB-DIXON - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. ALICIA PILARSKI, DO - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. PETER STAMAS JR, MD - 5000 WEST CHAMBERS, MILWAUKEE, WI 53210. ROWENA PUNZALAN, MD - 638 NORTH 18TH STREET, MILWAUKEE, WI 53233. DOUGLASS REDING, MD - 5000 WEST CHAMBERS, MILWAUKEE, WI 53210. SIDDHARTHA SINGH, MD - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. O'RELL WILLIAMS, MD - 5000 WEST CHAMBERS, MILWAUKEE, WI 53210. MICHAEL ERDMANN, MD - 5000 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295. SCOTT TURNER - 9000 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53201. MICHAEL LAPPEN - 1220 W VLIET ST, MILWAUKEE, WI 53205. BARBARA BRYANT, MD - 638 NORTH 18TH STREET, MILWAUKEE, WI 53233. JOHN RAYMOND, MD - 8701 WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. JEFF VAN DE KREEKE - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. PAUL BURSTEIN, MD - 2301 LAKE DRIVE, MILWAUKEE, WI 53211. RICHARD SHIMP, MD - 2301 LAKE DRIVE, MILWAUKEE, WI 53211. MICHAEL GUTZEIT, MD - 9000 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53201. JEFFREY BAHR MD - 1020 NORTH 12TH STREET SUITE 5120, MILWAUKEE, WI 53233. NATHAN GUNDACKER, MD - 5000 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295. JACOB BIDWELL, MD - 1020 NORTH 12TH STREET SUITE 5120, MILWAUKEE, WI 53233. JOSEPH E. KERSCHNER, MD - 8701 WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. JOHN SCHNEIDER, MD - 1220 W VLIET ST, MILWAUKEE, WI 53205. FORM 990, PART XII, LINE 2C: PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AURORA HEALTH CARE METRO INC 750 W VIRGINIA ST MILWAUKEE WI 53234 390806181 HOSPITAL WI 501(C)(3) 170 B 1 A III N/A 0 VERSITI WISCONSIN INC 638 N 18TH STREET PO BOX 2178 MILWAUKEE WI 532012178 390807235 RECRUITING BLOOD DONORS, COLLECTING, PROCESSING & DISTRIBUTING BLOOD WI 501(C)(3) 170 B 1 A VI N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC 9000 W WISCONSIN AVE PO BOX 1997 MILWAUKEE WI 532012178 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) 170 B 1 A III N/A 0 COLUMBIA ST MARY'S HOSPITAL 2301 LAKE DRIVE MILWAUKEE WI 53211 390806315 ACUTE CARE FACILITY WI 501(C)(3) 170 B 1 A III N/A 0 FROEDTERT MEMORIAL LUTHERAN HOSPITAL INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263522 396105970 HEALTH CARE SERVICES WI 501(C)(3) 170 B 1 A III N/A 0 THE MEDICAL COLLEGE OF WISCONSIN INC 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 532263548 390806261 EDUCATION, RESEARCH, PATIENT SERVICES AND COMMUNITY SERVICES WI 501(C)(3) 170 B 1 A II N/A 0 ASCENSION SE WISCONSIN HOSPITAL INC 5000 WEST CHAMBERS MILWAUKEE WI 53210 390816857 HOSPITAL WI 501(C)(3) 170 B 1 A III N/A 0 ZABLOCKI VA MEDICAL CENTER 5000 W NATIONAL AVENUE MILWAUKEE WI 53295 391326366 MEDICAL CARE FOR VETERANS, EDUCATION, RESEARCH, BACKUP TO D.O.D. WI GOVERNMENT ENTITY N/A 0 MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION 1220 W VLIET ST MILWAUKEE WI 53205 396005720 GOVERNMENT BEHAVIORAL HEALTH WI GOVERNMENT ENTITY N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 ZABLOCKI VA MEDICAL CENTER Q 14470823 ACTUAL AMOUNT OF REIMBURSEMENTS MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION Q 64555 ACTUAL AMOUNT OF REIMBURSEMENTS