2026-05-07T10:16:28-05:00 2025-10-31 420714325 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 606063392 990 2024-11-01 366652702 SwedishAmerican Hospital Self Insurance Trust SWED 7796964009 1401 E State Street Rockford IL 61104 Patricia DeWane VP, CFO and Treasurer 7796964009 2026-05-04 1 1 Rebekuh Eley P01247672 3126343400 2026-05-04 2024 2025-03-06 01:10:19Z Travis Andersen 1313 East State St Rockford IL 61104 3248603 0 X www.uwhealth.org X 1976 IL Management and payment of Malpractice and General Liability claims of UW Health SwedishAmerican Hospital. 15 10 0 10 0 0 0 0 0 0 57070 352694 0 0 57070 352694 0 0 0 0 0 0 0 0 0 3081580 110641 3081580 110641 -3024510 242053 8485703 8861321 0 0 8485703 8861321 Through excellence in healthcare and compassionate service, we care for our community. 0 0 68491 0 0 Management and payment of Malpractice and General Liability claims of UW Health SwedishAmerican Hospital. 68491 1 0 0 0 0 0 0 0 0 0 0 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 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Patricia DeWane 7796964009 1313 East State St Rockford IL 61104 Carey Gehl Trustee 2.00 55.00 X 0 940260 188210 Peter D Newcomer MD MMM Trustee 2.00 55.00 X 0 2013365 276798 Travis Andersen President/CEO 0.10 40.30 X X 0 1480475 197423 Allen Williams MD Trustee 2.00 42.00 X 0 343630 65467 Jeffrey S Hultman Chmn of the Board 2.00 6.00 X X 0 0 0 Michael Broski 1st Vice Chmn/Secry 2.00 8.00 X X 0 0 0 Kenneth Copeland Director 2.00 4.00 X 0 0 0 Justin Franklin Director 2.00 4.00 X 0 0 0 Jeffrey J Kaney Sr Director 2.00 4.00 X 0 0 0 Kathleen Kelly MD Director 2.00 4.00 X 0 0 0 Marco T Lenis Director 2.00 4.00 X 0 0 0 Pamela Maher Director 2.00 4.00 X 0 0 0 Anqunette Parham Director 2.00 4.00 X 0 0 0 Daniel T Ross Director 2.00 4.00 X 0 0 0 Thomas R Walsh Director 2.00 4.00 X 0 0 0 James Cole DO VP Medical Affairs/CMO 0.10 40.10 X 0 415111 102591 Patricia DeWane VP, CFO, & Treasurer 0.10 40.30 X 0 699978 74016 Timothy Flynn MD President, SA Medical Group 0.10 40.10 X 0 606222 105468 Rosa Jeschke VP Human Resources 0.10 40.10 X 0 423826 38329 Julia Zimmerman VP Strategic Growth 0.10 40.20 X 0 325494 74916 Sal Ababneh COO & President of UWNI Hospitals 0.10 40.10 X 0 320506 109821 Christopher Carter VP Operations & Org Mgmt 0.10 40.10 X 0 281214 22566 Deanna Berg Int. VP Pt. Svcs/CNO (until 9/30/24) 0.10 40.10 X 0 227716 26697 Patrick Lundquist VP Clinics 0.10 40.10 X 0 137483 30715 Kristie Geil VP Patient Services/CNO 0.10 40.10 X 0 76983 19126 Anna Taylor Former VP Patient Svcs. & CNO 0.00 0.00 X 0 266181 22062 Michael Polizzotto Former CMO/CIO 0.00 0.00 X 0 424156 54049 0 8982600 1408254 0 1 1 0 0 352630 352630 2895973 2895909 64 64 64 352694 0 0 352694 X 42150 42150 Shared Services 68491 68491 110641 68491 42150 0 1803657 2264367 6682046 6596954 8485703 8861321 0 0 X 0 0 0 0 0 0 8485703 8861321 8485703 8861321 242053 133565 0 X 0 1 X 1 0 X X 1 SwedishAmerican Hospital 362222696 3 1 110641 0 1 110641 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 X Part X, Line 2: SwedishAmerican Hospital Self Insurance Trust has received a determination letter from the Internal Revenue Service (IRS) stating it is tax-exempt under Section 501(c)(3) of the Code. SA Hospital Self Insurance Trust files a Form 990 (Return of Organization Exempt from Income Tax) annually. When this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: tax-exempt status of each entity, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income (UBTI). UBTI is reported on Internal Revenue Service Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the tax position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the more likely than not recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with the tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. At June 30, 2025 and 2024, there were no unrecognized tax benefits identified or recorded as liabilities. The Form 990 filed by the Trust is subject to examination for up to three years from the extended due date of each return. 1 1 0 0 0 0 0 0 0 Peter D Newcomer MD MMM Trustee 0 857230 0 506753 0 649382 0 275370 0 1428 0 2290163 0 649382 Travis Andersen President/CEO 0 763703 0 272187 0 444585 0 137588 0 59835 0 1677898 0 387533 Carey Gehl Trustee 0 653425 0 285886 0 949 0 143334 0 44876 0 1128470 0 0 Patricia DeWane VP, CFO, & Treasurer 0 411023 0 98999 0 189956 0 58432 0 15584 0 773994 0 186230 Timothy Flynn MD President, SA Medical Group 0 479252 0 119842 0 7128 0 65176 0 40292 0 711690 0 0 James Cole DO VP Medical Affairs/CMO 0 311464 0 103647 0 0 0 102536 0 55 0 517702 0 0 Michael Polizzotto Former CMO/CIO 0 424156 0 0 0 0 0 19965 0 34084 0 478205 0 0 Rosa Jeschke VP Human Resources 0 273354 0 66238 0 84234 0 25128 0 13201 0 462155 0 76716 Sal Ababneh COO & President of UWNI Hospitals 0 315704 0 0 0 4802 0 42526 0 67295 0 430327 0 0 Allen Williams MD Trustee 0 332626 0 7726 0 3278 0 26400 0 39067 0 409097 0 0 Julia Zimmerman VP Strategic Growth 0 258577 0 63519 0 3398 0 39809 0 35107 0 400410 0 0 Christopher Carter VP Operations & Org Mgmt 0 255243 0 25971 0 0 0 11480 0 11086 0 303780 0 0 Anna Taylor Former VP Patient Svcs. & CNO 0 67872 0 0 0 198309 0 21678 0 384 0 288243 0 0 Deanna Berg Int. VP Pt. Svcs/CNO (until 9/30/24) 0 204203 0 23513 0 0 0 3502 0 23195 0 254413 0 0 Patrick Lundquist VP Clinics 0 123593 0 0 0 13890 0 17720 0 12995 0 168198 0 0 Part I, Line 3 All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by UW Health SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes. Part I, Lines 4a-b Severance payments during 2024 include: Anna Taylor - $198,309;. These payments are reported as taxable compensation on Part II, column (B)(iii). Contributions to the 457(f) plan during 2024 include: Travis Andersen - $129,008; Faisal Ababneh - $36,776; Timothy Flynn MD - $38,776; Patricia DeWane - $32,032; Julia Zimmerman - $20,552; Rosa Jeschke - $21,432; Patrick Lundquist - $17,720; James Cole - $33,536; Christopher Carter - $11,480; Anna Taylor - $16,140; Carey Gehl - $116,424; Peter Newcomer - $206,370; Kristie Geil - $18,900. Payments from the 457(f) plan during 2024 include: Peter Newcomer - $649,382; Travis Anderson - $387,533; Patricia DeWane - $186,230; Rosa Jeschke - $76,716. These payments are reported as taxable income on Part II, column (B) (iii). Part II, Column F: The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column (B) (iii). Form 990, Part VI, Section A, line 6 UW Health SwedishAmerican Hospital elects the members and retains reserve powers over SwedishAmerican Hospital Self Insurance Trust. Form 990, Part VI, Section A, line 7a UW Health SwedishAmerican Hospital elects the members. Form 990, Part VI, Section A, line 7b UW Health SwedishAmerican Hospital retains reserve powers over SwedishAmerican Hospital Self Insurance Trust. Form 990, Part VI, Section B, line 11b A draft version of the Form 990 was reviewed by the Chief Financial Officer. The entire Board of Directors was provided with a copy of the Form 990 before it was filed. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with its conflict of interest policies, which apply to all members of the Board of Directors and to all employees. Procedures are in place to identify conflicts of both directors and employees. Director conflicts are handled by Board deliberation and Board vote from which the interested director is excluded. Employee conflicts are handled by the Compliance Department and in certain instances may require separate Board action. The Board is provided with periodic compliance reports regarding conflicts of interest. Form 990, Part VI, Section B, line 15 All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by UW Health SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements have not been made available to the public. The consolidated audited financial statements of SwedishAmerican Health System, which includes SwedishAmerican Hospital Self Insurance Trust, are available upon request. Form 990, Part IX, line 11g Miscellaneous: Program service expenses 0. Management and general expenses 42,150. Fundraising expenses 0. Total expenses 42,150. Generations Fertility Care 2365 Deming Way Middleton WI 53562 273496527 Reproductive endocrinology and infertility services WI 501(c)(3) Line 10 N/A 0 Isthmus Project Inc 600 Highland Avenue Madison WI 53792 832278676 Research and innovation WI 501(c)(3) Line 12a, I University of WI Hospital and Clinics Authority 0 Madison Surgery Center 7974 UW Health Court Middleton WI 53562 391940656 Health care services and training WI 501(c)(3) Line 10 N/A 0 Regional Division Inc 7974 UW Health Court No MC1020 Middleton WI 53562 391446049 Regional Parent Corp. to manage and direct activities of entities. WI 501(c)(3) Line 12a, I University of WI Hospital and Clinics Authority 0 SwedishAmerican Health Foundation 1415 E State Street Rockford IL 61104 363097493 Supports fundraising for SwedishAmerican Hospital IL 501(c)(3) Line 7 SwedishAmerican Health System Corporation 0 SwedishAmerican Health System Corporation 1401 E State Street Rockford IL 61104 363241458 Parent Corp. to manage and direct activities of entities IL 501(c)(3) Line 12a, I Regional Division Inc 0 SwedishAmerican Hospital 1401 E State Street Rockford IL 61104 362222696 Hospital IL 501(c)(3) Line 3 SwedishAmerican Health System Corporation 0 SwedishAmerican Realty Corporation 1313 E State Street Rockford IL 61104 363248013 Title Holding Company leases properties to subsidiaries IL 501(c)(2) SwedishAmerican Health System Corporation 0 University Health Care Inc 7974 UW Health Court Middleton WI 53562 472553196 Support Organization WI 501(c)(3) Line 12a, I University of WI Hospital and Clinics Authority 0 University of Wisconsin Hospital and Clinics Authority 7974 UW Health Court Middleton WI 53562 391835630 Hospital and Clinics WI 501(c)(3) Line 3 N/A 0 University of Wisconsin Medical Foundation 7974 UW Health Court Middleton WI 53562 391824445 Physician Services WI 501(c)(3) Line 10 University of WI Hospital and Clinics Authority 0 UW Health ACO Inc 7974 UW Health Court Middleton WI 53562 455490584 Accountable Care Organization WI 501(c)(3) Line 10 University of WI Hospital and Clinics Authority 0 Wisconsin Therapies Inc 7974 UW Health Court Middleton WI 53562 391807425 Infusion Therapy WI 501(c)(3) Line 12a, I University of WI Hospital and Clinics Authority 0 Chartwell Wisconsin Enterprises LLC 2241 Pinehurst Drive Middleton WI 53562 391796267 Parent Entity of CW and CMW-HR WI N/A 0 0 Sixth Street Medical LLC 7974 UW Health Court Middleton WI 53562 472705724 Real Estate WI N/A 0 0 Three Rivers Partners LLC 1313 East State Street Rockford IL 61104 262231757 Information Technology Services IL N/A 0 0 The Featherstone Partnership LP 1016 Featherstone Road Rockford IL 61107 363861021 Surgical Center of Parent Entity IL N/A 0 0 Physician's Care Network 1313 East State Street Rockford IL 61104 363455791 Health Services IL N/A C 0 Quartz Health Benefit Plans Corporation 840 Carolina Street Sauk City WI 53583 391450766 Health Maintenance Organization WI N/A C 0 Quartz Health Insurance Corporation 840 Carolina Street Sauk City WI 53583 391565691 Health Maintenance Organization WI N/A C 0 Quartz Health Solutions Inc 840 Carolina Street Sauk City WI 53583 465710709 Insurance WI N/A C 0 Quartz Holding Company 840 Carolina Street Sauk City WI 53583 821728929 Holding Company WI N/A C 0 State & Charles Inc 1313 East State Street Rockford IL 61104 363321193 Holding Company IL N/A C 0 SwedishAmerican Health Managment Corp 1401 East State Street Rockford IL 61104 363246511 Management Services IL N/A C 0 Wisconsin Dialysis Inc 3034 Fish Hatchery Road Fitchburg WI 53713 300072647 Dialysis Services WI N/A C 0 Charitable Remainder Unitrusts (5) Trust IL N/A T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1