Form 990 for tax year 2022

Totals

Total revenue

$284,617,307

Total expenses

$281,989,310

Contributions and grants received

$69,319,923

Grants paid

$0

Program service revenue

$213,882,720

Investment income

$308,193

Other revenue

$1,106,471

Total assets, end of year

$109,506,894

Total liabilities, end of year

$89,514,878

Net assets or fund balances, end of year

$19,992,016

Program services expenses (Part IX)

$270,390,706

Management and general expenses

$11,598,604

Fundraising expenses

$0

Program service expenses (Part III)

$270,390,706

Program services were 95.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Mission and programs · 2022

• CHHS IS THE PARENT ORGANIZATION OF AN INTEGRATED SYSTEM OF ENTITIES PROVIDING COMPREHENSIVE MEDICAL CARE AND SOCIAL SERVICES TO CHILDREN FROM WISCONSIN AND THROUGHOUT THE COUNTRY. THE SYSTEM INCLUDES WISCONSIN'S ONLY FREESTANDING HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN, AS WELL AS VARIOUS OTHER FACILITIES PROVIDING INPATIENT AND OUTPATIENT CARE FOR CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE SYSTEM ALSO INCLUDES EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS. ON AN AGGREGATE BASIS, THE ENTITIES WITHIN THE SYSTEM PROVIDED COMMUNITY BENEFITS OF NEARLY $171 MILLION.CHHS OVERSEES AND COORDINATES THE ACTIVITIES OF THE VARIOUS OPERATING ENTITIES WITHIN THE INTEGRATED SYSTEM, THROUGH THE PROVISION OF SUPPORTIVE AND ADMINISTRATIVE SERVICES ON A CONSOLIDATED, CENTRALIZED BASIS.

  Expenses $215,737,665 · Revenue $177,718,498

• AS A CHILDREN'S HOSPITAL IN AN ACADEMIC MEDICAL CENTER, RESEARCH IS INTERWOVEN INTO THE CARE WE PROVIDE EVERY DAY. CHILDREN'S ALLOCATES A PORTION OF ITS ANNUAL BUDGET TO PEDIATRIC RESEARCH IN ORDER TO STIMULATE RESEARCH ACTIVITY WHICH IS FOCUSED SOLELY ON IMPROVING CHILD HEALTH OUTCOMES. THIS RESEARCH IS FOCUSED ON IMPROVING DIAGNOSTICS, DISCOVERING AND TESTING NEW THERAPIES, AND IMPROVING THE WAY WE PREVENT AND MANAGE SOME OF THE MOST COMPLEX MEDICAL CONDITIONS. PHYSICIAN-SCIENTISTS, NURSE-SCIENTISTS, RESEARCHERS AND TECHNICIANS AT THE CHILDREN'S RESEARCH INSTITUTE (CRI) SEEK ANSWERS TO THE TOUGHEST QUESTIONS IN PEDIATRIC MEDICINE. THIS INNOVATIVE CULTURE HELPS TO ATTRACT AND RETAIN THE BEST AND BRIGHTEST MINDS TO OUR ORGANIZATION. SINCE ITS INCEPTION IN 2003, CRI HAS GROWN TO INCLUDE MORE THAN 150 RESEARCHERS SPANNING ALL DIAGNOSTIC, MEDICAL, AND SURGICAL SPECIALTIES. TOGETHER THEY FORM THE LARGEST CONCENTRATION OF 100% PEDIATRIC RESEARCH IN WISCONSIN. CHILDREN'S RESEARCH INSTITUTE PROVIDES INFRASTRUCTURE AND FINANCIAL SUPPORT FOR PEDIATRIC RESEARCHERS CONDUCTING CHILD HEALTH RESEARCH. CRI'S ACADEMIC PARTNERS INCLUDE THE MEDICAL COLLEGE OF WISCONSIN, UW-MILWAUKEE, AND MARQUETTE UNIVERSITY. TYPES OF SUPPORT INCLUDE THE FOLLOWING: - SUPPLEMENTAL GRANT SUPPORT FOR EARLY STAGE INVESTIGATORS- COMPETITIVE PILOT GRANTS TO HELP INVESTIGATORS TEST NEW IDEAS- SHARED SERVICES, INCLUDING A PEDIATRIC TRANSLATIONAL RESEARCH UNIT STAFFED BY PEDIATRIC NURSES TRAINED ON THE COMPLEXITIES OF REGULATED CLINICAL RESEARCH- DEDICATED LABORATORY SPACE FOR PEDIATRIC RESEARCHERS.A FEW EXAMPLES OF ONGOING RESEARCH PROJECTS ARE DESCRIBED BELOW.CHILDREN'S HAS SIGNIFICANT EFFORTS IN CHILDHOOD CANCER RESEARCH, INCLUDING IMPROVING SURVIVORSHIP AND QUALITY OF LIFE FOR CHILDREN BATTLING SOME OF THE TOUGHEST FORMS OF THE DISEASE. ONGOING LABORATORY RESEARCH EFFORTS INCLUDE CANCER IMMUNOTHERAPY PROJECTS, WHERE OUR LABS ENGINEER NOVEL ANTIBODIES AND INCORPORATE THEM INTO ANTIBODY-BASED PRODUCTS FOR THERAPY SUCH AS BISPECIFIC ANTIBODIES AND CHIMERIC ANTIGEN RECEPTORS THAT FUNCTION TO REDIRECT POTENT IMMUNE EFFECTOR CELLS TOWARD ELIMINATION OF TUMOR CELLS. IN ADDITION, OUR RESEARCHERS ARE ACTIVE WITH THE THERAPEUTIC ADVANCES IN CHILDHOOD LEUKEMIA & LYMPHOMA (TACL) CONSORTIUM. THIS NATIONAL CONSORTIUM WAS ESTABLISHED TO DEVELOP AND CONDUCT PHASE I /II CLINICAL TRIALS OF NEW DRUGS AND NOVEL DRUG COMBINATIONS FOR RECURRENT CHILDHOOD LEUKEMIA OR LYMPHOMA. OUR RESEARCHERS ALSO CONTINUE TO PARTICIPATE IN THE COG (CHILDREN'S ONCOLOGY GROUP) CONSORTIUM FOR CLINICAL TRIALS OF NOVEL PEDIATRIC CANCER THERAPIES.RESEARCH IN IMPROVING NURSING CARE IS ALSO PART OF OUR RESEARCH PORTFOLIO, INCLUDING ONE PROJECT STUDYING WAYS TO ASSIST FAMILIES IN MANAGING COMPLEX CARE ISSUES AFTER THEY LEAVE THE HOSPITAL, POTENTIALLY IMPROVING ACCESS TO CARE AND POST DISCHARGE OUTCOMES FOR TRANSPLANT PATIENTS. THIS STUDY IS EVALUATING A NOVEL FAMILY CENTERED SELF-MANAGEMENT INTERVENTION THAT INCORPORATES AN INDIVIDUALIZED DAILY POST-DISCHARGE INTERACTIVE COMMUNICATION BETWEEN FAMILIES AND TRANSPLANT NURSES VIA MOBILE TECHNOLOGY. THE TOOL TRACKS DAILY FAMILY COPING, FAMILY SELF-MANAGEMENT BEHAVIORS OF COMPLEX CARE AT HOME, AND PARENT MANAGEMENT OF CHILDREN'S TRANSPLANT SYMPTOMS. THE TOOL MAY RESULT IN A PRE-IDENTIFIED TRIGGER AND ACTIVATE IMMEDIATE NOTIFICATION TO THE TRANSPLANT NURSE. THE ULTIMATE GOAL OF THE PROJECT IS TO IMPROVE ACCESS TO CARE.RESEARCHERS IN THE NEONATAL INTENSIVE CARE UNIT CONTINUE TO IMPROVE UNDERSTANDING OF PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN (PPHN), A LIFE-THREATENING CONDITION WHICH RESULTS FROM FAILURE OF PULMONARY VASCULAR RESISTANCE TO DECREASE AT BIRTH. IMPAIRED ANGIOGENESIS IN THE LUNG IS A KEY CONTRIBUTOR TO THE FAILED ADAPTATION. ENDOTHELIAL NITRIC OXIDE SYNTHASE (ENOS) PLAYS A CENTRAL ROLE IN THE REGULATION OF ANGIOGENESIS AND PULMONARY VASODILATION AT BIRTH. ONGOING STUDIES ARE INVESTIGATING THE CONTRIBUTION OF ENOS DYSFUNCTION TO IMPAIRED MITOCHONDRIAL BIOGENESIS AND EPIGENETIC ALTERATIONS IN ENOS GENE EXPRESSION IN PPHN, POTENTIALLY LEADING TO NOVEL THERAPY DEVELOPMENT TO RESTORE MITOCHONDRIAL BIOGENESIS AND ANGIOGENESIS IN INFANTS WITH PPHN.RESEARCHERS AT CRI ARE INVESTIGATING WAYS TO IMPROVE CARE FOR HEART TRANSPLANT PATIENTS, INCLUDING THE DEVELOPMENT OF A NEW METHOD TO MONITOR PEDIATRIC HEART TRANSPLANT RECIPIENTS AND IDENTIFY EARLY SIGNS OF TRANSPLANT REJECTION. TYPICALLY, HEART TRANSPLANT PATIENTS MUST UNDERGO A SERIES OF EIGHT TO TWELVE BIOPSIES PER YEAR TO MONITOR FOR TRANSPLANT REJECTION. THIS INVASIVE APPROACH POSES CERTAIN RISKS, AND CAN BE DIFFICULT FOR CHILDREN WHO HAVE ALREADY SPENT A CONSIDERABLE AMOUNT OF TIME HOSPITALIZED. THE RESEARCHERS HAVE DESIGNED A NONINVASIVE APPROACH THAT INVOLVES A SIMPLE BLOOD DRAW. THE LEVEL OF DONOR DNA IN THE BLOOD SERVES AS A BAROMETER OF HEART HEALTH; MORE THAN ONE-PERCENT OF DONOR DNA IN THE BLOOD INDICATES REJECTION. IN A PILOT STUDY, THIS METHOD SHOWED 100% SENSITIVITY. THIS NON-INVASIVE TEST IS ALSO BEING STUDIED IN CONJUNCTION WITH CARDIAC MAGNETIC RESONANCE IMAGING TO DETERMINE IF THESE TWO METHODS TOGETHER CAN DETECT CARDIAC ABNORMALITIES CONSISTENT WITH TRANSPLANT REJECTION.

  Expenses $13,510,162 · Revenue $1,341,024

• CHHS PROVIDES VARIOUS OUTPATIENT HEALTH CARE SERVICES. IN 2022, THERE WERE 78,139 VISITS TO THE ORGANIZATION'S URGENT CARE CLINICS, AND 5,552 OUTPATIENT SURGICAL CASES PERFORMED AT THE ORGANIZATION'S AMBULATORY SURGICAL CENTER, THE SURGICENTER OF GREATER MILWAUKEE, LLC (A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES).

  Expenses $23,749,023 · Revenue $28,239,937

• CHHS OFFERS FREE AND INEXPENSIVE HEALTH EDUCATION PROGRAMS AND RESOURCES AT NO CHARGE TO TEACHERS, CHILDREN AND PARENTS. IN ADDITION, CHHS PROVIDES INJURY PREVENTION PROGRAMS WHICH FOCUS ON CAR SEAT AND BIKE HELMET FITTINGS, TO KEEP CHILDREN SAFE AND HEALTHY. CHILDREN'S SCHOOL NURSE PROGRAM PROVIDES FULL-TIME REGISTERED NURSES FOR HEALTH CARE SERVICES IN 11 K-5 AND K-8 MILWAUKEE PUBLIC SCHOOLS AT NO COST TO MPS OR TO STUDENTS AND FAMILIES, SERVING OVER 4,000 STUDENTS ANNUALLY WHO MIGHT OTHERWISE NOT HAVE ACCESS TO HEALTH CARE. THE SCHOOL NURSES ADVOCATE FOR A COLLABORATIVE AND HOLISTIC APPROACH TO ADDRESS THE PHYSICAL, MENTAL, AND SOCIAL-EMOTIONAL WELLBEING NEEDS OF STUDENTS. THIS WORK INCLUDES ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH BY ASSISTING FAMILIES IN ACCESSING COMMUNITY RESOURCES THROUGH COORDINATION WITH THE COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS. THE SCHOOL NURSES BRING TOGETHER PARENTS/CAREGIVERS, SCHOOL SUPPORT STAFF, PRIMARY AND SPECIALTY CARE PROVIDERS, AND MENTAL HEALTH PROVIDERS TO ADDRESS AND IMPROVE THE OVERALL HEALTH AND WELLNESS OF THE STUDENTS THEY CARE FOR. IN ADDITION TO PROVIDING DAILY CARE TO STUDENTS SUCH AS MEDICATION ADMINISTRATION, G-TUBE FEEDINGS AND OTHER COMPLEX HEALTH PROCEDURES ONLY A HEALTH CARE PROVIDER CAN ADMINISTER IN THE SCHOOL SETTING SCHOOL NURSES PROVIDE MANY OTHER ESSENTIAL SERVICES. EXAMPLES OF OTHER SERVICES INCLUDE EDUCATING STUDENTS AND FAMILIES ON THE IMPORTANCE OF PREVENTIVE CARE, CONDUCTING HEALTH SCREENINGS INCLUDING VISION AND BEHAVIORAL HEALTH ASSESSMENTS, ASSISTING FAMILIES WITH ESTABLISHING MEDICAL AND DENTAL HOMES, COMMUNICABLE DISEASE SURVEILLANCE AND REPORTING, CHRONIC DISEASE MANAGEMENT, AND ASSESSING AND DEVELOPING SCHOOL SAFETY AND EMERGENCY PREPAREDNESS PLANS. AS THE HEALTH EXPERT IN THE SCHOOL, THE NURSES ALSO OFFER CLASSROOM EDUCATION ON A VARIETY OF TOPICS SUCH AS MINDFULNESS, HYGIENE, RESTORATIVE PRACTICES, SELF-CARE AND ANTI-BULLYING.AN INCREASING NUMBER OF STUDENTS ARE ENTERING SCHOOLS EACH YEAR WITH SPECIAL NEEDS AND COMPLEX HEALTH CONDITIONS (ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER, DIABETES, LIFE-THREATENING ALLERGIES, ASTHMA, SICKLE CELL DISEASE, AND SEIZURES) THAT REQUIRE EXTENSIVE INTERVENTION AND COORDINATION THROUGHOUT THE SCHOOL DAY TO KEEP KIDS HEALTHY AND IN THE CLASSROOM LEARNING. AS THE ONLY HEALTH CARE EXPERT IN THE SCHOOLS, THE SCHOOL NURSES PLAY A VITAL ROLE ON THE SPECIAL EDUCATION TEAMS TO ADVISE AND ADVOCATE FOR SPECIAL EDUCATION SERVICES NECESSARY FOR STUDENTS WITH MEDICAL CONCERNS TO ACCESS A FAIR AND EQUAL EDUCATION. FOR CHRONIC ILLNESSES SUCH AS ASTHMA, DIABETES, SEIZURES OR SICKLE CELL ANEMIA, THE SCHOOL NURSES WORK WITH PARENTS AND FAMILIES TO CREATE CARE PLANS HELPING GUIDE THE STUDENTS TO SELF-MANAGEMENT BY THE TIME THEY REACH HIGH SCHOOL, WITH A GOAL OF DECREASED URGENT CARE AND EMERGENCY DEPARTMENT VISITS, INCREASED FOCUS ON PREVENTION AND UTILIZATION OF PRIMARY CARE PROVIDERS. DURING THE 2022-23 SCHOOL YEAR THE SCHOOL NURSES WERE ACTIVE TEAM MEMBERS ON DEVELOPING 26 BEHAVIOR PLANS, 40 INDIVIDUAL EDUCATION PROGRAMS AND FOURTEEN (14) 504 PLANS FOR STUDENTS WITH DISABILITIES. FOR THE 2022-23 SCHOOL YEAR, ALL STUDENTS RETURNED TO THE CLASSROOM FULL-TIME. SCHOOL NURSES WERE ESSENTIAL PARTNERS IN HELPING STUDENTS RE-ACCLIMATE TO ROUTINES AND SOCIAL NORMS IN THE SCHOOL ENVIRONMENT, HELPING SUPPORT STAFF TO MANAGE BEHAVIORS AND SOCIAL-EMOTIONAL CONCERNS TO BE BETTER ABLE TO FOCUS ON LEARNING IN THE CLASSROOM. COLLABORATION AND ADVOCACY FOR STUDENTS AND PARENTS EXPERIENCING CHALLENGES WITH THE NEW ROUTINES WERE CRITICAL DURING THIS SCHOOL YEAR. CHILDREN'S NURSES COMPLETED 9,136 STUDENT ENCOUNTERS FROM 1,760 INDIVIDUAL STUDENTS, SERVING ABOUT 47% OF THE TOTAL STUDENT POPULATION OVER THE COURSE OF THE 2022-23 SCHOOL YEAR. GETTING BACK TO SCHOOL ROUTINES, TRANSPORTATION AND ATTENDANCE REMAINED A CHALLENGE THIS YEAR AND OF THE TOTAL STUDENT POPULATION SERVED BY CHILDREN'S WISCONSIN SCHOOL NURSE PROGRAM, APPROXIMATELY 55% MET THE CRITERIA FOR CHRONIC ABSENTEEISM. THE SCHOOL NURSE TEAM WORKED DILIGENTLY TO HELP ENSURE STUDENTS AND FAMILIES HAD WHAT THEY NEEDED TO ATTEND SCHOOL AND BE HEALTHY, SAFE AND READY TO LEARN, INCLUDING MONITORING ATTENDANCE, OUTREACH TO PARENTS, AND ADVOCATING FOR POSITIVE ATTENDANCE INTERVENTIONS TO GET KIDS TO SCHOOL. PRIOR TO THE PANDEMIC, THERE WAS A DECLINING TREND IN THE NUMBER OF STUDENTS WHO WERE UP TO DATE ON VACCINATIONS REQUIRED BY LAW FOR SCHOOL ATTENDANCE. FOLLOWING THE PANDEMIC THAT TREND CONTINUED AND WAS MADE WORSE BY THE PANDEMIC'S REQUIREMENTS FOR QUARANTINE, ISOLATION ALONG WITH DECREASED ACCESS TO IN-PERSON HEALTH CARE VISITS. IN AN ATTEMPT TO LESSEN THE IMPACT AND IMPROVE THE VACCINATION COMPLIANCE RATES, CHILDREN'S SCHOOL NURSES, IN PARTNERSHIP WITH MPS AND THE MILWAUKEE HEALTH DEPARTMENT, HELD SCHOOL-BASED VACCINE CLINICS. THE NURSES WERE A CRITICAL COMPONENT TO THE SUCCESS OF THE PROGRAM, PLANNING, COORDINATING AND CONDUCTING OUTREACH CALLS TO PARENTS OF THOSE STUDENTS BEHIND SCHEDULE. THE NURSE USED THEIR ESTABLISHED AND TRUSTED RELATIONSHIP WITH THE FAMILIES TO OBTAIN CONSENTS AND ENROLL STUDENTS IN THE ONE-DAY CLINICS AT SIX OF CHILDREN'S PARTNER SCHOOLS. OVERALL, 70 STUDENTS AND 69 STAFF WERE SERVED PROVIDING 249 TOTAL VACCINATIONS INCLUDING FLU AND COVID.SINCE 2014 CHHS PARTNERED WITH WISCONSIN'S DEPARTMENT OF HEALTH SERVICES AND THE DEPARTMENT OF CHILDREN AND FAMILIES AND ESTABLISHED A FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS TO ADMINISTER THE COORDINATION OF COMPREHENSIVE HEALTH CARE SERVICES INCLUSIVE OF MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE SERVICES FOR CHILDREN PLACED IN "OUT OF HOME CARE" (A.K.A."FOSTER CARE") IN KENOSHA, MILWAUKEE, OZAUKEE, RACINE, WASHINGTON, AND WAUKESHA COUNTIES IN WISCONSIN. UPON ENROLLMENT INTO THE PROGRAM THESE FOSTER CARE CHILDREN HAVE ACCESS TO CHORUS COMMUNITY HEALTH PLANS ("CCHP") PROVIDER NETWORK AS CCHP PROVIDES ADMINISTRATIVE AND UTILIZATION SERVICES FOR CARE4KIDS PROGRAMMING. THROUGH DECEMBER OF 2022, PROGRAM ENROLLMENT WAS 2,850 WHICH REPRESENTED APPROXIMATELY 40% OF THE TOTAL OUT OF HOME CARE POPULATION IN THE STATE OF WISCONSIN

  Expenses $17,393,856 · Revenue $6,463,841

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

• CHILDREN'S HOSPITAL OF WISCONSIN INC

  501(C)(3) · PEDIATRIC HOSPITAL · WI · controlled entity

• CHILDREN'S HOSPITAL OF WISCONSIN FOUNDATION INC

  501(C)(3) · FUND DEVELOPMENT · WI · controlled entity

  Directly controlled by CHILDREN'S HOSPITAL & HEALTH SYSTEM INC

• CHILDREN'S MEDICAL GROUP INC

  501(C)(3) · PEDIATRIC PHYSICIAN SERVICES · WI · controlled entity

  Directly controlled by CHILDREN'S HOSPITAL & HEALTH SYSTEM INC

• CHILDREN'S SERVICE SOCIETY OF WISCONSIN

  501(C)(3) · CHILD WELLFARE SERVICES · WI · controlled entity

  Directly controlled by CHILDREN'S HOSPITAL & HEALTH SYSTEM INC

• CHORUS COMMUNITY HEALTH PLANS INC

  501(C)(3) · WISCONSIN MEDICAID HMO · WI · controlled entity

  Directly controlled by CHILDREN'S HOSPITAL & HEALTH SYSTEM INC

• CHILDREN'S SPECIALTY GROUP INC

  501(C)(3) · PEDIATRIC PHYSICIAN SERVICES · WI

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Provenance

Return type

form_990

Tax year

2022

Filed

26 October 2023

IRS schema version

2022v5.0

Source object

202313039349301411

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.