SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
MEDICAL COLLEGE OF WISCONSIN AFFILIATED
HOSPITALS INC
Employer identification number

39-1341366
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THREE (3) OR MORE MEMBERS OF THE BOARD OF DIRECTORS INCLUDING THE PRESIDENT, VICE-PRESIDENT, AND EXECUTIVE DIRECTOR THAT ARE ELECTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION AND RECOMMENDS TO THE BOARD AN ANNUAL BUDGET FOR THE CORPORATION. AT JUNE 30, 2018, THE EXECUTIVE COMMITTEE WAS REPRESENTED WITH FIVE (5) BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 6 THE MEDICAL COLLEGE OF WISCONSIN AND EACH AFFILIATED INSTITUTION ARE MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL COLLEGE OF WISCONSIN AND EACH AFFILIATED INSTITUTION HAS THE RIGHT TO ANNUALLY APPOINT DIRECTORS. IN ADDITION, THE EXECUTIVE DIRECTOR IS AN EX OFFICIO VOTING MEMBER OF THE BOARD. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY THE AFFIRMATIVE VOTE OF TWO-THIRDS OF THE DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE SECRETARY/TREASURER OF THE CORPORATION. A COPY OF THE FORM 990 IS PROVIDED TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMITTAL.
FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL STATEMENT IS SIGNED BY EACH BOARD MEMBER AND BY THE SECRETARY/TREASURER.
FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR IS NOMINATED BY THE MEDICAL COLLEGE OF WISCONSIN (MCW) AND IS ELECTED BY THE MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS' (MCWAH) BOARD. THE EXECUTIVE DIRECTOR MUST BE A MEMBER OF THE FACULTY OF MCW. MCW SETS THE SALARIES FOR ITS FACULTY. IT UTILIZES THE FACULTY SALARY INFORMATION PROVIDED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) IN CONJUCTION WITH OTHER AVAILABLE SALARY COMPARISON TOOLS. THE MCWAH ADMINISTRATOR/SECRETARY/TREASURER'S COMPENSATION IS DETERMINED BY MCW USING SALARY POLICY GUIDELINES. THE MCWAH EXECUTIVE DIRECTOR AND THE ADMINISTRATOR ARE EMPLOYEES OF MCW.
FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST
FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC RURIC C. ANDERSON, MD MBA - 1020 NORTH 12TH STREET SUITE 5120, MILWAUKEE, WI 53233. JACOB BIDWELL, MD - 1020 NORTH 12TH STREET SUITE 5120, MILWAUKEE, WI 53233. JERRY GOTTSCHALL, MD - 638 NORTH 18TH STREET, MILWAUKEE, WI 53233. THOMAS ABSHIRE, MD - 638 NORTH 18TH STREET, MILWAUKEE, WI 53233. JEFFREY BAHR MD - 1020 NORTH 12TH STREET SUITE 5120, MILWAUKEE, WI 53233. MICHAEL GUTZEIT, MD - 9000 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53201. RICHARD SHIMP, MD - 2301 LAKE DRIVE, MILWAUKEE, WI 53211. PAUL BURSTEIN, MD - 2301 LAKE DRIVE, MILWAUKEE, WI 53211. JEFF VAN DE KREEKE - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. ANDREW RESNICK, MD MBA - 9200 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53226. JOHN RAYMOND, MD - 8701 WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. JOSEPH E. KERSCHNER, MD - 8701 WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. JOHN SCHNEIDER, MD - 9455 WEST WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. MICHAEL LAPPEN - 9455 WEST WATERTOWN PLANK ROAD, MILWAUKEE, WI 53226. MARC CADIEUX - 9000 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53201. SCOTT TURNER - 9000 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53201. MICHAEL ERDMANN, MD - 5000 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295. JEROME VAN RUISWYK MD - 5000 WEST NATIONAL AVENUE, MILWAUKEE, WI 53295. DANIEL ROSS, MD - 5000 WEST CHAMBERS, MILWAUKEE, WI 53210. ROBERT M. STERN, MD - 5000 WEST CHAMBERS, MILWAUKEE, WI 53210. GREG LONG, MD - 229 SOUTH MORRISON STREET, APPLETON, WI 54911. LAWRENCE DONATELLE, MD - 229 SOUTH MORRISON STREET, APPLETON, WI 54911.
FORM 990, PART XII, LINE 2C: PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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