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Nonprofiteer
← HSHS WISCONSIN MEDICAL GROUP INC

Form 990 for tax year 2023

Filed by HSHS WISCONSIN MEDICAL GROUP INC.

Totals

Total revenue
$7,277
Total expenses
$3,265,903
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$7,277
Other revenue
$0
Total assets, end of year
-$1,222,856
Total liabilities, end of year
$60,000
Net assets or fund balances, end of year
-$1,282,856
Program services expenses (Part IX)
$2,612,254
Management and general expenses
$653,649
Fundraising expenses
$0
Program service expenses (Part III)
$2,612,254

Program services were 80.0% 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.

Revenue

Part VIII, the statement of revenue.

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $7,277 · unrelated business $7,277

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 11f · Fees: investment management

    total $10,998 · program services $8,330 · management and general $2,668

  • 11g · Fees: other

    total $0 · program services $0 · management and general $0 · fundraising $0

  • 24a · Other expenses: PHYSICIAN SUPPORT & RECRUITMENT

    total $3,254,905 · program services $2,603,924 · management and general $650,981

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,172,156 · end of year -$1,241,105

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $21,970 · end of year $18,249

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $218,356 · end of year $60,000

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $1,975,770 · end of year -$1,282,856

Mission and programs · 2023

Mission

TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY BY PROVIDING PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO THE COMMUNITIES HOSPITAL SISTERS HEALTH SYSTEM SERVES.

  • HSHS WISCONSIN MEDICAL GROUP, INC. ("MGWI") IS A PHYSICIAN ORGANIZATION OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), A HEALTH CARE MINISTRY OF THE CATHOLIC CHURCH. AS A MISSION-BASED ORGANIZATION, IT IS OUR DESIRE TO CONNECT WITH ALL WHO SEEK CARE, HEALING AND HOPE. PRIMARILY THE MISSION IS FILLED THROUGH PATIENT ACCESS OF PRIMARY CARE PROVIDERS, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE AND PEDIATRICS. TO ENSURE ACCESS TO HEALTH CARE FOR ALL, A CHARITY CARE POLICY HAS BEEN IMPLEMENTED FOR ALL PRACTICES OF THE HSHS MEDICAL GROUP. THE CHARITY CARE POLICY HELPS ENSURE THAT ALL WHO COME TO US WILL RECEIVE QUALITY CARE AND ARE TREATED WITH RESPECT AND COMPASSION. THE HSHS WISCONSIN MEDICAL GROUP CHARITY CARE POLICY PROVIDES PATIENTS WITH AN OPPORTUNITY TO QUALIFY FOR FINANCIAL ASSISTANCE WHEN RECEIVING NON-ELECTIVE SERVICES. THE LEVEL OF CHARITY CARE ASSISTANCE FOR WHICH ANY PERSON IS ELIGIBLE IS BASED, IN PART, ON THEIR INCOME COMPARED TO THE CURRENT YEAR FEDERAL POVERTY GUIDELINES. TO QUALIFY FOR CHARITY CARE, A PERSON COMPLETES A TWO-PART INCOME TEST. PART ONE DETERMINES THAT NO OTHER GOVERNMENTAL OR PRIVATE INSURANCE IS AVAILABLE TO THE PERSON AND PART TWO FOLLOWS A PROCESS TO DETERMINE THE CHARITY AMOUNT IN RELATIONSHIP TO THE PERSON'S/FAMILY'S INCOME. THE HSHS WISCONSIN MEDICAL GROUP CHARITY CARE PROGRAM IS BASED ON THE CURRENT YEAR FEDERAL POVERTY GUIDELINES ("FPG") ISSUED BY THE DEPARTMENT OF HEALTH & HUMAN SERVICES ANNUALLY AND PUBLISHED IN THE FEDERAL REGISTER. AN FPG AND CHARITY ALLOWANCE TABLE IS UPDATED ANNUALLY BY THE HSHS WISCONSIN MEDICAL GROUP AND IS USED TO DETERMINE WHETHER THE PERSON QUALIFIES FOR CHARITY CARE AND, IF SO, AT WHAT LEVEL. THE AMOUNT IS DETERMINED BY MULTIPLYING THE ALLOWANCE LEVEL SPECIFIED IN THE TABLE BY TOTAL CHARGES CALCULATED USING THE RATE OF 150% OF THE MEDICARE ALLOWABLE CHARGE FOR EACH ITEM OR SERVICE RENDERED DURING THE VISIT BASED ON THE APPLICABLE MEDICARE LOCALITY. IN CARRYING OUT ITS EXEMPT PURPOSE OF ENSURING PATIENT ACCESS TO HIGH QUALITY HEALTHCARE, MGWI ESTABLISHED A MEDICAL PRACTICE IN ITS WESTERN WISCONSIN MARKET WITH OAKLEAF CLINICS, INC. AN INTEGRATED GROUP MEDICAL PRACTICE CONSISTING OF SIX PHYSICIAN OPERATING DIVISIONS. MGWI'S COLLABORATION WITH OAKLEAF ENABLES THE ORGANIZATION TO IMPROVE ITS ABILITY TO SUBSTANTIALLY DELIVER HIGHER QUALITY, COST EFFECTIVE CARE TO THE RESIDENTS OF WESTERN WISCONSIN, DELIVER MORE COMPREHENSIVE PRIMARY AND SPECIALTY CARE TO PATIENTS AND BE MORE EFFECTIVE IN PHYSICIAN RECRUITMENT AND THE MARKETING AND BRANDING OF THEIR HEALTH CARE SERVICES, RESULTING IN THE ABILITY TO EXPAND SERVICES PROVIDED. THE OAKLEAF CLINIC DISCONTINUED OPERATIONS AS OF 3/22/24.

    Expenses $2,612,254

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Dona McGraw

    SECRETARY (Until 10/31/23)

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Kevin Lewis MD

    President / HSHS SVP & Chief Physician Executive

    Total calculated
    $457,702
    From this org
    $0
    From related orgs
    $418,068
    Other
    $39,634
    Hours/week
    2.5 + 57.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $243,519 related
    Bonus
    $0 + $80,000 related
    Other
    $0 + $94,549 related
    Deferred
    $0 + $29,423 related
    Nontaxable benefits
    $0 + $10,211 related
    Filer's total
    $0 + $457,702 related

  • Alejandro Alvarado MD

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Chris Skorcz

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • David Oligschlaeger DO

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Frank Aguirre MD

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Jerry Gaffner

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Kathy Donovan

    Board Member (Until 10/31/23) / HSHS SVP-Chief Operating Officer

    Total calculated
    $1,121,403
    From this org
    $0
    From related orgs
    $994,799
    Other
    $126,604
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $830,795 related
    Bonus
    $0 + $78,646 related
    Other
    $0 + $85,358 related
    Deferred
    $0 + $125,629 related
    Nontaxable benefits
    $0 + $975 related
    Filer's total
    $0 + $1,121,403 related

  • Kristen Allen

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Larry Hardy

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Lori Kerans

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Pavan Gupta MD

    Board Member / PCC Physician

    Total calculated
    $839,802
    From this org
    $0
    From related orgs
    $833,616
    Other
    $6,186
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $751,308 related
    Bonus
    $0 + $80,999 related
    Other
    $0 + $1,309 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $6,186 related
    Filer's total
    $0 + $839,802 related

  • Peter Kung

    Board Member (Until 10/31/23) / HSHS SVP-Chief Strategy Officer

    Total calculated
    $630,368
    From this org
    $0
    From related orgs
    $513,219
    Other
    $117,149
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $420,501 related
    Bonus
    $0 + $86,203 related
    Other
    $0 + $6,515 related
    Deferred
    $0 + $87,039 related
    Nontaxable benefits
    $0 + $30,110 related
    Filer's total
    $0 + $630,368 related

  • Rachel Broughton

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Michael Scialdone

    Treasurer / HSHS SVP & CFO (began 01/08/24)

    Total calculated
    $0
    Hours/week
    0.3 + 59.7 related

  • Paige Toth

    Secretary (began 11/1/23)

    Total calculated
    $372,277
    From this org
    $0
    From related orgs
    $306,108
    Other
    $66,169
    Hours/week
    4.3 + 55.7 related

    Schedule J breakdown matched by us

    Base
    $0 + $283,016 related
    Bonus
    $0 + $23,092 related
    Other
    $0
    Deferred
    $0 + $33,609 related
    Nontaxable benefits
    $0 + $32,560 related
    Filer's total
    $0 + $372,277 related

  • Patricia Allen

    CFO - CARE DELIVERY

    Total calculated
    $773,133
    From this org
    $0
    From related orgs
    $649,506
    Other
    $123,627
    Hours/week
    3 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $498,772 related
    Bonus
    $0 + $53,821 related
    Other
    $0 + $96,913 related
    Deferred
    $0 + $99,475 related
    Nontaxable benefits
    $0 + $24,152 related
    Filer's total
    $0 + $773,133 related

  • TODD Smart

    Treasurer (UNTIL 5/3/24)

    Total calculated
    $382,133
    From this org
    $0
    From related orgs
    $315,606
    Other
    $66,527
    Hours/week
    0.3 + 59.7 related

    Schedule J breakdown matched by us

    Base
    $0 + $275,819 related
    Bonus
    $0 + $37,512 related
    Other
    $0 + $2,275 related
    Deferred
    $0 + $46,882 related
    Nontaxable benefits
    $0 + $19,645 related
    Filer's total
    $0 + $382,133 related

  • Andrew Watson

    Former CFO (until 1/26/23)

    Total calculated
    $448,996
    From this org
    $0
    From related orgs
    $473,026
    Other
    -$24,030
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $24,082 related
    Bonus
    $0
    Other
    $0 + $448,944 related
    Deferred
    $0 + -$26,581 related
    Nontaxable benefits
    $0 + $2,551 related
    Filer's total
    $0 + $448,996 related

  • Damond Boatwright

    Former Board Member / HSHS President/CEO

    Total calculated
    $1,823,992
    From this org
    $0
    From related orgs
    $1,539,956
    Other
    $284,036
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,245,335 related
    Bonus
    $0 + $294,621 related
    Other
    $0
    Deferred
    $0 + $249,526 related
    Nontaxable benefits
    $0 + $34,510 related
    Filer's total
    $0 + $1,823,992 related

  • Linda Dace

    FORMER CFO

    Total calculated
    $533,657
    From this org
    $0
    From related orgs
    $458,426
    Other
    $75,231
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,588 related
    Bonus
    $0 + $54,243 related
    Other
    $0 + $4,595 related
    Deferred
    $0 + $53,288 related
    Nontaxable benefits
    $0 + $21,943 related
    Filer's total
    $0 + $533,657 related

  • Marc Shelton MD

    Former CHAIR (until 4/6/23) - HSHS Senior VP & CCO

    Total calculated
    $797,191
    From this org
    $0
    From related orgs
    $800,128
    Other
    -$2,937
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $228,750 related
    Bonus
    $0
    Other
    $0 + $571,378 related
    Deferred
    $0 + -$12,322 related
    Nontaxable benefits
    $0 + $9,385 related
    Filer's total
    $0 + $797,191 related

  • Melinda Clark

    Former CEO MED GROUP (until 8/1/22)

    Total calculated
    $714,328
    From this org
    $0
    From related orgs
    $714,328
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $714,328 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $714,328 related

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

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4a Severance or change-of-control payment
ORGANIZATION: HOSPITAL SISTERS HEALTH SYSTEM EIN: 37-1058692 INTERESTED PERSON: MELINDA CLARK AMOUNT: $646,100 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF CEO MED GROUP. ORGANIZATION: HSHS MEDICAL GROUP, INC. - ILLINOIS EIN: 26-3956318 INTERESTED PERSON: ANDREW WATSON AMOUNT: $278,994 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF CFO.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS; THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED and TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2023; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). DAMOND BOATWRIGHT -- $233,026 KATHY DONOVAN -- $109,129 LINDA DACE -- $36,788 PETER KUNG -- $61,911 TODD SMART -- $25,441 KEVIN LEWIS -- $29,423 PATRICIA ALLEN -- $44,695 PAIGE TOTH -- $14,542 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2023; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. MELINDA CLARK -- $68,228 PATRICIA ALLEN -- $34,179 MARC SHELTON -- $571,378 ANDREW WATSON -- $144,565

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.

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.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC

    Related · MEDICAL · IL · 100% owned · share of income $0 · share of assets $0 · general or managing partner

    Directly controlled by HSHS

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • KIARA INC

    C Corporation · HEALTHCARE · IL · 100% owned · share of income $953,484 · share of assets $19,065,022 · controlled entity

    Directly controlled by HSHS

  • LASANTE WISCONSIN INC

    C Corporation · HEALTHCARE · IL · controlled entity

    Directly controlled by KIARA INC

  • LASANTE INC

    C Corporation · HEALTHCARE · IL · controlled entity

    Directly controlled by KIARA INC

  • PREVEA HEALTH SERVICES INC

    C Corporation · HEALTHCARE · WI · 50% owned · share of income -$678,213 · share of assets $23,739,679 · controlled entity

    Directly controlled by HSSI

  • PREVEA CLINIC INC

    C Corporation · HEALTHCARE · WI · controlled entity

    Directly controlled by PHSI

  • RENAISSANCE QUALITY INSURANCE LTD

    C Corporation · INSURANCE · CJ · 100% owned · share of income $0 · share of assets $204,854,765 · controlled entity

    Directly controlled by HSSI

Provenance

Return type
form_990
Tax year
2023
Filed
6 May 2025
IRS schema version
2023v6.0
Source object
202511269349300121

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