2024-05-07T11:13:32-05:00 2023-06-30 135565207 KPMG LLP 191 WEST NATIONWIDE BLVD SUITE 500 COLUMBUS OH 432152568 990 2022-07-01 272042610 FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC FROE 4148053000 W126 N7338 FLINT DRIVE MENOMONEE FALLS WI 53051 ALICIA M MAITLAND SVP - FINANCE 4148053000 2024-05-07 1 ALICIA MAITLAND XXX-XX-XXXX 0 MOLLIE P LONGHOUSE P00294881 6142492300 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CATHERINE A JACOBSON W126 N7338 FLINT DRIVE MENOMONEE FALLS WI 53051 371274237 0 X WWW.FROEDTERT.COM X 2010 WI FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.ADVANCE THE HEALTH OF THE PEOPLE OF THE DIVERSE COMMUNITIES WE SERVETHROUGH EXCEPTIONAL CARE ENHANCED BY INNOVATION AND DISCOVERY. 10 10 2728 10 0 0 0 0 294248742 325311497 -2145 -1895 39699935 45962740 333946532 371272342 0 0 0 0 186472676 209426977 0 0 0 147473856 161845365 333946532 371272342 0 0 110083015 110196599 52115132 42572970 57967883 67623629 X FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC. ADVANCE THE HEALTH OF THE PEOPLE OF THE DIVERSE COMMUNITIES WE SERVE THROUGH EXCEPTIONAL CARE ENHANCED BY INNOVATION AND DISCOVERY. 0 0 143128930 0 159500226 FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.'S (CP) SPECIALTY DEPARTMENTS SAW OVER 539,000 PATIENT VISITS IN FY23. CP HAS OVER 929 SPECIALTY PROVIDERS WHO PROVIDE SERVICES INCLUDING AREAS SUCH AS OBSTETRICS, SURGERY, BEHAVIORAL HEALTH, CARDIOLOGY, AND SEVERAL OTHERS. 108127588 0 120495379 CP'S PRIMARY CARE DEPARTMENTS SAW OVER 573,000 PATIENT VISITS IN FY23. CP HAS OVER 542 PRIMARY CARE PROVIDERS WHO PROVIDE SERVICES IN THE AREAS OF FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, AND WALK-IN CLINIC. 40664614 0 45315892 CP'S ANCILLARY DEPARTMENTS SAW OVER 558,000 PATIENT VISITS IN FY23. CP PROVIDES ANCILLARY SERVICES IN THE AREAS OF LABORATORY, RADIOLOGY, AND REHABILITATION SERVICES. 41245069 0 45962740 AS PART OF OPERATING AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS AND PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY, OTHER REVENUE IS DERIVED IN THE FOLLOWING AREAS:REVENUE FROM HEALTH SYSTEM AFFILIATES - CONSISTS OF REVENUE DERIVED FROM MEDICAL AND ADMINISTRATIVE SERVICES PROVIDED TO SJH, CMH, FMLH, AND FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, AFFILIATED ORGANIZATIONS. SERVICES INCLUDE PHYSICIAN AND STAFF COVERAGE, MEDICAL DIRECTORS, HOSPITALISTS, AND LABORATORY SERVICES. ALL OF THESE SERVICES SUPPORT THE DELIVERY OF HEALTHCARE TO THE COMMUNITY.OTHER DEPARTMENT OPERATING REVENUE - REVENUE DERIVED FROM DIFFERENT SERVICES THROUGH THE PROCESS OF PROVIDING PATIENT CARE AND IN THE NORMAL OPERATION OF A MEDICAL FACILITY. INCLUDED IN THIS CATEGORY ARE ITEMS SUCH AS LEASED STAFF REVENUE AND COVID RELIEF FUNDS. CORPORATE ALLOCATED REVENUE - REVENUE PASSED THROUGH FROM FH, AN AFFILIATED ORGANIZATION. 41245069 0 45962740 333166201 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2728 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X DAVID DIRKSMEYER 4148053000 N74 W12501 LEATHERWOOD CT MENOMONEE FALLS WI 530514490 X BEHL MARK DIRECTOR 1.00 0.00 X 0 0 0 CAMPBELL SUSAN DIRECTOR 1.00 0.00 X 0 0 0 KERSCHNER JOSEPH MD DIRECTOR 1.00 0.00 X 0 0 0 KOPS CHRISTOPHER DIRECTOR (TERM JUL22) 1.00 0.00 X 0 0 0 LESTER MATTHEW DIRECTOR (START AUG22) 1.00 0.00 X 0 0 0 LIEN CYNTHIA MD DIRECTOR 1.00 0.00 X 0 0 0 OLSON DAVID DIRECTOR 1.00 0.00 X 0 0 0 SILVERSTEIN ROY MD DIRECTOR 1.00 0.00 X 0 0 0 HAWIG SCOTT DIRECTOR & TREASURER 1.00 0.00 X X 0 0 0 JACOBSON CATHERINE DIRECTOR & BOD CHAIR 1.00 0.00 X X 0 0 0 RAYMOND JOHN MD DIRECTOR & BOD V. CHAIR 1.00 0.00 X X 0 0 0 GHAFERI AMIR MD PRESIDENT (START DEC22) 1.00 0.00 X 0 0 0 MATHEWS VINCENT MD INTERIM PRESIDENT (TERM JAN23) 1.00 0.00 X 0 0 0 MARX DOUGLAS DO CHIEF MEDICAL OFFICER 50.00 0.00 X 867126 0 90947 TESMER ANN SR VP CLINICAL OPERATIONS 50.00 0.00 X 530796 0 126807 MILLER AMY MD CHIEF MEDICAL OFFICER 50.00 0.00 X 574854 0 55625 DIESTELHORST AMY MD DOCTOR-OB/GYN 50.00 0.00 X 673225 0 49990 QURYSHI MIR DOCTOR-INTERNAL MEDICINE 50.00 0.00 X 609141 0 46306 STERNBERG ADAM DOCTOR 50.00 0.00 X 570979 0 45666 GUMINA ROSEANN DOCTOR-OB/GYN 50.00 0.00 X 556679 0 43692 LOVELL CANDICE DOCTOR-FAMILY MEDICINE 50.00 0.00 X 546291 0 47799 4929091 0 506832 422 0 1 0 0 SPECIALTY CARE SERVICES 621990 159500226 159500226 PRIMARY CARE SERVICES 621110 120495379 120495379 ANCILLARY CARE SERVICES 621990 45315892 45315892 325311497 1895 -1895 -1895 -1895 MANAGEMENT FEES 900099 21156541 21156541 CORPORATE ALLOCATED REVENUE 900099 16177420 16177420 OTHER DEPT OPERATING REVENUE 900099 8628779 8628779 45962740 371272342 371274237 0 -1895 X 2412686 2412686 194381719 188922213 5459506 87522 87522 59513 58732 781 12485537 12021877 463660 22365 22365 122903106 108808464 14094642 1305339 1255657 49682 535297 512739 22558 31769140 30180683 1588457 118818 97227 21591 341421 316603 24818 6366496 6048171 318325 118902 118902 CORPORATE ALLOCATIONS 74627340 43350977 31276363 MEDICAL SUPPLIES 32971990 32964662 7328 ALL OTHER DIRECT EXPENS 2185626 767456 1418170 PROFESSIONAL DUES & LIC 607925 202159 405766 -112028400 -92460321 -19568079 371272342 333166201 38106141 0 600 600 0 0 0 0 33735678 36539913 0 0 0 0 0 0 1389761 1338855 18430 109784 155095949 82906152 74920896 72189797 0 0 0 0 0 0 0 0 17650 17650 110083015 110196599 50186156 40988795 0 0 0 0 0 0 0 0 0 0 1928976 1584175 0 0 52115132 42572970 X 57967883 67623629 0 0 57967883 67623629 110083015 110196599 X 0 9655746 X 0 1 X 1 1 1 X 39238019 4505549 34732470 22483070 9685529 12797541 93122135 68715074 24407061 252725 252725 72189797 X PART X, LINE 2: FROEDTERT HEALTH, INC. (FH), THE PARENT ENTITY INTO WHICH CP'S FINANCIAL RESULTS ARE CONSOLIDATED, APPLIES ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC TOPIC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2023 AND 2022, FH DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. 0 1 0 0 0 0 0 1 0 MARX DOUGLAS DO CHIEF MEDICAL OFFICER 666299 0 177485 0 23342 0 58050 0 32897 0 958073 0 0 0 DIESTELHORST AMY MD DOCTOR-OB/GYN 583591 0 67352 0 22282 0 19300 0 30690 0 723215 0 0 0 TESMER ANN SR VP CLINICAL OPERATIONS 343519 0 163641 0 23636 0 94598 0 32209 0 657603 0 1619 0 QURYSHI MIR DOCTOR-INTERNAL MEDICINE 544963 0 41139 0 23039 0 16400 0 29906 0 655447 0 0 0 MILLER AMY MD CHIEF MEDICAL OFFICER 492752 0 59568 0 22534 0 19300 0 36325 0 630479 0 0 0 STERNBERG ADAM DOCTOR 504219 0 45949 0 20811 0 16400 0 29266 0 616645 0 0 0 GUMINA ROSEANN DOCTOR-OB/GYN 484207 0 47541 0 24931 0 20750 0 22942 0 600371 0 0 0 LOVELL CANDICE DOCTOR-FAMILY MEDICINE 479517 0 45423 0 21351 0 17850 0 29949 0 594090 0 0 0 PART I, LINE 3 COMPENSATION OF CEO/EXECUTIVE DIRECTOR ESTABLISHED BY AFFILIATED ORGANIZATION, FROEDTERT HEALTH, THROUGH THE USE OF COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. VINCENT MATHEWS, MD, IS THE INTERIM PRESIDENT OF CP THROUGH JANUARY 2023 AND AMIR GHAFERI, MD, IS THE PRESIDENT OF CP EFFECTIVE DECEMBER 2022 FOR FISCAL YEAR 2023 AND BOTH ARE EMPLOYED BY THE MEDICAL COLLEGE OF WISCONSIN. PART I, LINE 4B 457(F) DISTRIBUTIONS: TESMER, ANN - $1,619 457(F) PLAN PARTICIPANTS: MILLER, AMY TESMER, ANN PART I, LINE 7 BONUS COMPENSATION IS PAID BASED UPON ATTAINMENT OF SPECIFIC GOALS RELATED TO THE ORGANIZATION'S STRATEGY, SERVICE, QUALITY AND FINANCIAL STRENGTH. THE AMOUNT OF COMPENSATION IS CALCULATED USING SPECIFIED PERCENTAGES OF BASE SALARY FOR ACHIEVEMENT OF PARTICULAR GOAL LEVELS. HOWEVER, THE FROEDTERT HEALTH SYSTEM BOARD COMMITTEE WHICH ADMINISTERS THE BONUS COMPENSATION PROGRAM HAS DISCRETION OVER WHETHER TO PAY THE BONUS IN ANY GIVEN YEAR OR TO AMEND, CHANGE OR TERMINATE THE PROGRAM AT ANY TIME. PART II, LINES 1 THROUGH 2 AND 4 THROUGH 8: INCENTIVE COMPENSATION IS PAID BASED UPON ATTAINMENT OF SPECIFIC GOALS RELATED TO THE ORGANIZATION'S CLINICAL QUALITY, PATIENT CARE SERVICE AND CERTAIN OTHER INDIVIDUAL PERFORMANCE METRICS. THE AMOUNT OF COMPENSATION IS CALCULATED USING SPECIFIC PERCENTAGES OF COMPENSATION FOR ACHIEVEMENT OF PARTICULAR GOAL LEVELS. CP'S BOARD OF DIRECTORS ADMINISTERS THE INCENTIVE COMPENSATION PROGRAM AND HAS DISCRETION TO APPROVE, AMEND OR CHANGE THE MIX OR TYPE OF METRICS USED. FORM 990, PART VI, SECTION A, LINE 2 DOUGLAS MARX, AMY MILLER, ANN TESMER, SUSAN CAMPBELL: BUSINESS RELATIONSHIP SCOTT HAWIG, CATHERINE JACOBSON, MARK BEHL DAVID OLSON: BUSINESS RELATIONSHIP WITH MARK BEHL, CATHERINE JACOBSON, SCOTT HAWIG MARK BEHL: BUSINESS RELATIONSHIP WITH SCOTT HAWIG, CATHERINE JACBOSON CATHERINE JACOBSON: BUSINESS RELATIONSHIP WITH SCOTT HAWIG, MARK BEHL FORM 990, PART VI, SECTION A, LINE 6 FH AND THE MEDICAL COLLEGE OF WISCONSIN (MCW) ARE THE CORPORATE MEMBERS OF CP. FORM 990, PART VI, SECTION A, LINE 7A FH AND MCW EACH HAVE THE AUTHORITY TO APPOINT 5 BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B FH AND MCW JOINTLY EXERCISE RETAINED AUTHORITIES AND EACH MEMBER HAS CERTAIN POWERS RETAINED BY IT ONLY, AS DEFINED IN CP'S CORPORATE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FH (AN AFFILIATED ORGANIZATION) ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FH FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FH AUDIT COMMITTEE AND BOARD OF DIRECTORS AND CP'S BOARD OF DIRECTORS. FINALLY, THE 990 IS FILED AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT-CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE-PRESIDENT-GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTEREST EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF CP WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE CCO AT LEAST ANNUALLY TO THE FH, INC. AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - COMPENSATION REVIEW & APPROVAL PROCESS - CEO & TOP MANAGEMENT COMPENSATION OF TOP MANAGEMENT IS PAID BY AN AFFILIATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE AFFILIATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. LINE 15B - COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS PAID BY AN AFFILIATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE AFFILIATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION: FH'S QUARTERLY FINANCIAL INFORMATION (WHICH INCLUDES THE OPERATING RESULTS OF CP) IS MADE AVAILABLE TO THE PUBLIC ONLINE THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. GOVERNING DOCUMENTS AND COI POLICY: DOCUMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES-MEDICAL: PROGRAM SERVICE EXPENSES 101,070,577. MANAGEMENT AND GENERAL EXPENSES 2,701,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 103,771,735. PURCHASED SERVICES-GENERAL: PROGRAM SERVICE EXPENSES 3,577,648. MANAGEMENT AND GENERAL EXPENSES 11,154,925. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,732,573. REPAIRS & MAINT: PROGRAM SERVICE EXPENSES 3,413,031. MANAGEMENT AND GENERAL EXPENSES 16,023. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,429,054. LANDSCAPING: PROGRAM SERVICE EXPENSES 724,202. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 724,202. OTHER: PROGRAM SERVICE EXPENSES 11,624. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,624. CONSULTING: PROGRAM SERVICE EXPENSES 11,382. MANAGEMENT AND GENERAL EXPENSES 222,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 233,918. PART IX, LINE 24E CP HAS ENTERED INTO AFFILIATE SUPPORT AGREEMENTS WITH FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC. (FMLH), COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC. (CMH) AND ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. (SJH), TO ENSURE ACCESS TO PRIMARY AND SPECIALTY CARE FOR THEIR PATIENTS. THESE AGREEMENTS PROVIDE AGGREGATE FINANCIAL SUPPORT TO CP IN AN AMOUNT EQUAL TO CP'S ANNUAL NET DEFICIT (EXPENSES AND LOSSES IN EXCESS OF REVENUES AND GAINS). THE AMOUNT OF THIS SUPPORT IS INCLUDED IN PART IX LINE 24E OF THE FORM 990, AND RESULTS IN CP'S REVENUE LESS EXPENSES EQUALING $0 FOR THE FISCAL YEAR ENDED JUNE 30, 2023. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES 9,655,746.