2025-11-14T09:11:51-06:00 2024-12-31 363168081 SIKICH LLC 17335 GOLF PARKWAY SUITE 500 BROOKFIELD WI 53045 990 2024-01-01 391990012 CHILDREN'S SPECIALTY GROUP INC CHIL 4142665420 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 JASON JARZEMBOWSKI MD CFO 4142665420 2025-11-12 1 0 JILL M BOYLE CPA P01246734 2627549400 2025-11-12 2024 2025-03-06 01:10:19Z JASON JARZEMBOWSKI PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 274583536 0 X WWW.CHILDRENSWI.ORG X 2000 WI PROVIDE THE HIGHEST QUALITY SPECIALTY HEALTH CARE SERVICES TO INFANTS, CHILDREN AND ADOLESCENTS. 2 0 0 13 0 0 0 280741 258589450 274302795 0 0 0 0 258589450 274583536 0 0 0 0 0 0 0 0 0 263215070 276138975 263215070 276138975 -4625620 -1555439 50582009 49106232 0 79662 50582009 49026570 X THE MISSION OF CHILDREN'S SPECIALTY GROUP, INC. ("CSG") IS TO PROVIDE THE HIGHEST QUALITY SPECIALTY HEALTH CARE SERVICES TO INFANTS, CHILDREN AND ADOLESCENTS AND TO ADVANCE THE EFFECTIVENESS OF HEALTH CARE THROUGH EDUCATION AND THE APPLICATION OF LEADING-EDGE RESEARCH AND INNOVATIVE TECHNOLOGIES. 0 0 246934059 274302795 CSG IS A NON-STOCK, NOT-FOR-PROFIT CORPORATION WITH TWO MEMBERS: CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS") AND THE MEDICAL COLLEGE OF WISCONSIN, INC. ("MCW"), BOTH OF WHICH ARE NON-STOCK, NOT-FOR-PROFIT CORPORATIONS.CSG PROVIDES A CRITICAL LINK BETWEEN THE INTEGRATED PEDIATRIC HEALTH CARE DELIVERY NETWORK OF CHHS AND THE COMMITMENT TO EXCELLENCE IN MEDICAL RESEARCH AND EDUCATION OF MCW. APPROXIMATELY 489 MCW FACULTY MEMBERS, WHO SERVE AS ASSOCIATE OR AFFILIATE PHYSICIANS FOR CSG, AND 245 NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS PROVIDE SPECIALTY AND SUBSPECIALTY PEDIATRIC PATIENT CARE SERVICES THROUGH CHHS' HOSPITAL AND HEALTH SYSTEM LOCATIONS, INCLUDING CHILDREN'S HOSPITAL OF WISCONSIN, INC.CSG OFFERS INPATIENT AND OUTPATIENT SPECIALTY CARE IN MORE THAN 70 MEDICAL SUB-SPECIALTIES. THIS SPECIALTY CARE IS AVAILABLE AT CHHS FACILITIES, INCLUDING ITS HOSPITALS, SURGERY CENTER, AND CLINICS THROUGHOUT WISCONSIN, AND ALSO THROUGH VIRTUAL OR TELEHEALTH APPOINTMENTS TO PROVIDE CARE CLOSER TO HOME.CSG PHYSICIANS AND PROVIDERS CONDUCT LEADING-EDGE SCIENTIFIC RESEARCH AND APPLY THIS RESEARCH AND INNOVATION IN PROVIDING THE BEST AND SAFEST SPECIALTY PEDIATRIC CARE. MANY ARE FACULTY MEMBERS WHO TEACH AT MCW, TRAINING OTHER PEDIATRIC SPECIALISTS. 246934059 1 1 0 0 0 0 0 0 0 0 0 0 0 1 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 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X MS SARAH KAFKA 4142668976 PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 CHILDREN'S HOSPITAL AND HEALTH SYSTEM RELATED ORG. 0.00 1.00 X 0 0 0 THE MEDICAL COLLEGE OF WISCONSIN INC RELATED ORG. 0.00 1.00 X 0 0 0 JASON JARZEMBOWSKI MD CEO 34.00 6.00 X 0 645631 60377 JAIME FOXAPNP SECRETARY 40.00 0.00 X 0 148305 24180 MARC CADIEUX TREASURER/SVP & CFO CHHS 0.00 40.00 X 0 1134229 138345 SHELISA DALTON FORMER OFFICER 0.00 40.00 X 0 589325 113035 0 2517490 335937 22 1 1 0 MEDICAL COLLEGE OF WISCONSIN 8701 WATERTOWN PLANK RD MILWAUKEE WI 53226 LEASED PROVIDER & NON-PROVIDER SERVICES, 230447950 CHILDREN'S HOSPITAL AND HEALTH SYSTEM I 9000 W WISCONSIN AVE MILWAUKEE WI 53226 LEASED PROVIDER & NON-PROVIDER SERVICES, 15404603 VERSITI INC 29779 NETWORK PL CHICAGO IL 60673 PHYSICIAN SERVICES/FEES 719673 2 280741 280741 NET PATIENT SVC REV 621110 220285807 220285807 SALARY SUPPORT 541900 53498854 53498854 AFFILIATE SPACE USE INCOME 532000 518029 518029 105 105 274302795 274583536 274302795 0 0 23500000 23500000 27595 27595 5342711 5074417 268294 5673 5673 14264 14264 106469 32200 74269 5003916 4682456 321460 1252917 1226719 26198 779662 732678 46984 1426110 1425970 140 LEASED PROVIDER & NON-P 217686041 216066683 1619358 LEASED SUPPORT & ADMINI 15404603 12399218 3005385 RESEARCH & EDUCATION NO 1605685 1605685 RESIDENT SERVICES 490519 490519 3492810 3149982 342828 276138975 246934059 29204916 0 636258 30313813 24089504 20961 20268196 24359509 50582009 49106232 79662 0 79662 X 50582009 49026570 50582009 49026570 50582009 49106232 -1555439 0 X 0 1 X 1 0 X X 2 THE MEDICAL COLLEGE OF WISCONSIN INC 390806261 2 1 0 0 CHILDREN'S HOSPITAL AND HEALTH SYSTEM INC 391500074 3 1 0 0 2 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 6: THE ORGANIZATION HAS CONTRACTED WITH CERTAIN HOSPITALS TO PROVIDE CLINICAL MANAGEMENT SERVICES AND GRADUATE MEDICAL EDUCATION AT THOSE HOSPITALS. THE MAJORITY OF THESE SERVICES ARE PROVIDED AT CHILDREN'S HOSPITAL OF WISCONSIN, INC., A CLOSELY RELATED AFFILIATE OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. THE ORGANIZATION'S INVOLVEMENT IN THESE ACTIVITIES CARRIES OUT AND FURTHERS THE HEALTH CARE AND EDUCATIONAL PURPOSES OF CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. AND THE MEDICAL COLLEGE OF WISCONSIN, INC. PART IV, SECTION B, LINE 1: THE GOVERNING BODY OF THE ORGANIZATION IS COMPRISED OF ITS TWO MEMBERS/SUPPORTED ORGANIZATIONS, CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. AND THE MEDICAL COLLEGE OF WISCONSIN, INC. AND ANY GOVERNANCE DECISIONS REQUIRE THE APPROVAL OF BOTH MEMBERS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM AFFILIATES 24359509 24359509 X 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, 2024 AND 2023. 0 1 0 0 0 0 0 0 0 MARC CADIEUX TREASURER/SVP & CFO CHHS 0 713591 0 215665 0 204973 0 137499 0 846 0 1272574 0 90953 JASON JARZEMBOWSKI MD CEO 0 510045 0 103440 0 32146 0 27600 0 32777 0 706008 0 0 SHELISA DALTON FORMER OFFICER 0 491183 0 84458 0 13684 0 78882 0 34153 0 702360 0 0 JAIME FOXAPNP SECRETARY 0 148124 0 0 0 181 0 12061 0 12119 0 172485 0 0 PART I, LINE 3 CSG RELIED UPON THE MEDICAL COLLEGE OF WISCONSIN, INC. ("MCW"), A CORPORATE MEMBER OF CSG, TO ESTABLISH THE COMPENSATION OF CSG'S CHIEF EXECUTIVE OFFICER. MCW UTILIZES THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, AND COMPENSATION SURVEY OR STUDY. PART I, LINE 4B BEGINNING IN CALENDAR YEAR 2022, SHELISA DALTON IS A PARTICIPANT IN THE SECTION 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF MCW ("THE PLAN"). UNDER THE PLAN, MCW CONTRIBUTES A DEFINED AMOUNT FOR EACH PARTICIPANT BASED ON A PERCENTAGE OF EACH PARTICIPANT'S BASE SALARY. PARTICIPANTS VEST IN THEIR CONTRIBUTIONS FOR A SPECIFIC PLAN YEAR ON THE LAST DAY OF THE THIRD PLAN YEAR FOLLOWING THAT PLAN YEAR FOR EACH PLAN YEAR THEY ARE A PARTICIPANT. DISTRIBUTIONS ARE MADE TO THE ELIGIBLE PARTICIPANTS IN A SINGLE, LUMP SUM PAYMENT WHEN CONTRIBUTIONS BECOME VESTED. IN 2024, THERE WAS A CHHS EXECUTIVE FLEXIBLE BENEFIT PLAN IN PLACE WHICH WAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (457(F) PLAN). THE CORPORATION CONTRIBUTES 10% OF EACH PARTICIPATING EXECUTIVE'S SALARY. THE AMOUNTS OF EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR PARTICIPATING EXECUTIVES IN 2024 WERE AS FOLLOWS: M. CADIEUX, $112,199. AFTER A VESTING PERIOD, PARTICIPANTS MAY ELECT TO WITHDRAW AMOUNTS PREVIOUSLY CONTRIBUTED AND REPORTED. AMOUNTS WITHDRAWN BY PARTICIPANTS IN 2024 WERE: M. CADIEUX, $90,953. FORM 990, PART VII, COLUMN E & SCHEDULE J, PART II: SALARIES PAID BY RELATED ORGANIZATIONS: 1. JASON JARZEMBOWSKI, M.D., CHIEF EXECUTIVE OFFICER OF CSG AND SENIOR ASSOCIATE DEAN FOR CLINICAL AFFAIRS-PEDIATRIC PRACTICE AT MCW IS COMPENSATED BY MCW FOR: 1. ADMINISTRATOR ROLES AT BOTH CSG AND MCW 2. CLINICAL MANAGEMENT SERVICES PROVIDED TO CHW IN CONNECTION WITH THE ORGANIZATION'S AFFILIATE HOSPITAL CONTRACTS 3. PROFESSOR OF PATHOLOGY AT MCW AND VICE CHAIR FOR PEDIATRIC PATHOLOGY. 2. SHELISA DALTON, FORMER CHIEF OPERATING OFFICER OF CSG, IS COMPENSATED BY MCW FOR SERVICES PROVIDED AS THE CHIEF FINANCIAL OFFICER OF MCW. 3. MARC CADIEUX, TREASURER OF CSG AND SVP & 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. 4. JAIME FOX, APNP, SECRETARY, IS COMPENSATED BY MCW FOR SERVICES PROVIDED AS THE APP SYSTEMS DIRECTOR INPATIENT IN THE HOSPITALIST DIVISION OF PEDIATRICS WITH SERVICES PROVIDED ON BEHALF OF CSG. 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 MCW AND CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. ("CHHS"), WITH APPROPRIATE INTERCOMPANY ARRANGEMENTS BETWEEN THE ORGANIZATION AND CHHS. THE FORMS 1099 FOR SUCH PAYMENTS WERE ISSUED BY CHHS AND MCW, AS THE ENTITIES THAT PROCESSED AND MADE THE PAYMENTS TO THE INDEPENDENT CONTRACTORS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS: CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. (CHHS) AND THE MEDICAL COLLEGE OF WISCONSIN, INC. (MCW). FORM 990, PART VI, SECTION A, LINE 7A THE TWO MEMBERS OF THE ORGANIZATION, CHHS AND MCW ARE THE GOVERNING BODY OF THE ORGANIZATION AND ANY GOVERNANCE DECISIONS REQUIRE THE APPROVAL OF BOTH MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE TWO MEMBERS OF THE ORGANIZATION, CHHS AND MCW ARE THE GOVERNING BODY OF THE ORGANIZATION AND ANY GOVERNANCE DECISIONS REQUIRE THE APPROVAL OF BOTH MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE GOVERNING BODY OF THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON ITS BEHALF. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 OF CSG WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF CHHS BOARD OF DIRECTORS, AND PRIOR TO FILING, A COPY WAS PROVIDED TO MCW, THE OTHER MEMBER OF THE ORGANIZATION, FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUESTED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE DIRECTOR OF CORPORATE COMPLIANCE. THE CHHS 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 ORGANIZATION RELIES ON MCW, A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF ITS CHIEF EXECUTIVE OFFICER AND SECRETARY. THE COMPENSATION OF THE ORGANIZATION'S CFO WAS REVIEWED AND APPROVED BY THE INDEPENDENT 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. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL INFORMATION OF CSG ARE AVAILABLE TO THE PUBLIC UPON REQUEST THROUGH THE CHHS MARKETING AND COMMUNICATION DEPARTMENT. THE MEDICAL COLLEGE OF WISCONSIN INC 8701 WATERTOWN PLANK ROAD MILWAUKEE WI 53226 390806261 EDUCATION/MEDICAL WI 501(C)(3) LINE 2 N/A 0 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500074 AMBULATORY SURGERY CTR, URGENT CARE, & OPERATIONAL SUPPT SVCS WI 501(C)(3) LINE 3 N/A 0 CHILDREN'S HOSPITAL OF WISCONSIN INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390812532 PEDIATRIC HOSPITAL WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391500075 FUND DEVELOPMENT WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S MEDICAL GROUP INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 391789197 PEDIATRIC PHYSICIAN SERVICES WI 501(C)(3) LINE 3 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHILDREN'S SERVICE SOCIETY OF WISCONSIN PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 390806380 CHILD WELFARE SERVICES WI 501(C)(3) LINE 7 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 CHORUS COMMUNITY HEALTH PLANS INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 271494977 WISCONSIN MEDICAID HMO & COMMERCIAL EXCHANGE PLAN WI 501(C)(3) LINE 10 CHILDREN'S HOSPITAL & HEALTH SYSTEM INC 1 WEST ALLIS PRESCRIPTION CENTER INC PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 463421597 PHARMACY WI N/A C 0 WAUWATOSA PRESCRIPTION CENTER INC SKYWALK PHARMACY PO BOX 1997 FINANCE DEPT MILWAUKEE WI 532011997 061654484 PHARMACY WI N/A C 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 0