SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL
INC
Employer identification number

39-6105970
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)Froedtert Health Inc
9200 W Wisconsin Avenune

Milwaukee,WI53226
39-2014409 		Management Services WI 501 (c)(3) Ln 12, Type 111 N/A
 
No
(2)Froedtert Hospital Foundation
9200 W Wisconsin Avenue

Milwaukee,WI53226
39-1431192 		Health, welfare, research and education promotion WI 501(c)(3) 10 Froedtert Memorial Lutheran HospitalInc
 
Yes
 
(3)Community Memorial Hospital of MF Inc
W180 N8085 Town Hall Road

Menomonee Falls,WI53051
39-0987025 		Hospital WI 501(c)(3) 3 Froedtert Health Inc
 
 
No
(4)St Josephs Community Hospital of West B
3200 Plesant Valley Road

West Bend,WI53095
39-0806302 		Hospital WI 501(c)(3) 3 Froedtert Health Inc
 
 
No
(5)St Josephs Community Foundation
3200 Pleasant Valley Road

West Bend,WI530953868
39-2034296 		Health and welfare promotion WI 501(c)(3) 7 St Josephs Comm Hosp of West Bend Inc
 
 
No
(6)Community Memorial Foundation of MF Inc
N180 N8085 Town Hall Road

Menomonee Falls,WI53051
39-1635057 		Health and welfare promotion WI 501(c)(3) 10 Community Memorial Hospital of MF Inc
 
 
No
(7)Community Outpatient Health Svc of MF I
W180 N8085 Town Hall Road

Menomonee Falls,WI53051
39-1743056 		Outpatient Medical and Dental Services WI 501(c)(3) 3 Community Memorial Hospital of MF Inc
 
 
No
(8)QHS 1 Inc
9200 W Wisconsin Avenue

Milwaukee,WI53226
20-2636686 		Healthcare Services WI 501(c)(3) Line 12, Type 1 Froedtert Health Inc
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Page 2
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Froedtert Surgery Center LLC

9200 W Wisconsin Ave
Milwaukee,WI53226
20-1499345 		Surgery center WI N/A
         No     No  
(2) D1 Sports Training of Milwaukee LLC

9200 W Wisconsin
Milwaukee,WI53226
47-3322294 		Sports Therapy WI N/A
         No     No  
(3) FMLH MCW Real Estate Ventures LLC

9200 W Wisconsin Ave
Milwaukee,WI53226
26-0629591 		Real Estate WI N/A
         No     No  
(4) Wisconsin Diagnostic Laboratories LLC

9200 W Wisconsin Ave
Milwaukee,WI53226
39-1896819 		Laboratory Services WI N/A
         No     No  
(5) Drexel Town Square Surgery Center LLC

7901 S 6th Street Second Floor
Oak Creek,WI53154
81-4904300 		Surgery Center WI N/A
         No     No  
(6) THP - Froedtert Health Venture LLC

1415 Louisiana Fl 27th
Houston,TX77002
82-3559342 		Health Care TX N/A
         No     No  
(7) F&MCW Network LLC

9200 W Wisconsin Ave
Milwaukee,WI53226
81-4382585 		Health Care WI N/A
         No     No  
(8) Menomonee Falls Ambulatory Surgery Ctr

W180N8045 Town Hall Rd
Menomonee Falls,WI53051
39-1745697 		Health Care WI N/A
         No     No  
(9) Froedert & Medical College of WI ACOLLC

8710 Watertown Plank Rd
Milwaukee,WI53226
81-3159534 		  WI N/A
         No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Froedtert Memorial Lutheran Hsptl Trust

777 E Wisconsin Ave
Milwaukee,WI53202
39-6040438 		Charitable Trust WI N/A
 Trust         No
(2) Harts Mills Insurance Company SPC

62 Forum Lane 3rd Fl
Camana Bay,Grand CaymanKY1-1203
CJ
98-1311808 		Self-Insurance CJ N/A
 C-Corp         No










Schedule R (Form 990) 2019
Page 3
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Froedtert Hospital Foundation

 c 1,932,916  
(2) Froedtert Hospital Foundation

 p 1,537,356  
(3) Froedtert Hospital Foundation

 s 577,160  



Schedule R (Form 990) 2019
Page 4
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Page 5
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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