ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC (EIN 39-1029998)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-15
- IRS object ID
- 202443209349317569
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-15T14:18:42-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391029998 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST FRANCIS HOME OF FOND DU LAC | BusinessNameLine1Txt |
| Business Name Line2 | WISCONSIN INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STFR | BusinessNameControlTxt |
| Phone | 9209265519 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33 EVERETT STREET | AddressLine1Txt |
| City | FOND DU LAC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54935 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE KING | PersonNm |
| Person Title | VP-FINANCE | PersonTitleTxt |
| Phone | 9209265519 | PhoneNum |
| Signature | 2024-11-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRIS THORNOCK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33 EVERETT STREET | AddressLine1Txt |
| City | FOND DU LAC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54935 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,030,240 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/LOCATION-DETA | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO ALL WE SERVE. THE ORGANIZATION PROVIDES SKILLED NURSING CARE, INDEPENDENT LIVING AND ASSISTED LIVING FACILITIES. ST. FRANCIS HOME IS THE HEART OF ITS CARE CAMPUS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,325 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,990 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,078,301 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,989,569 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$92,855 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $41,500 | PYOtherRevenueAmt |
| CY Other Revenue | $29,681 | CYOtherRevenueAmt |
| PY Total Revenue | $11,030,271 | PYTotalRevenueAmt |
| CY Total Revenue | $14,030,240 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $793 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,980,283 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,865,972 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,503,069 | PYOtherExpensesAmt |
| CY Other Expenses | $7,099,909 | CYOtherExpensesAmt |
| PY Total Expenses | $14,483,352 | PYTotalExpensesAmt |
| CY Total Expenses | $15,966,674 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,453,081 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,936,434 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,769,918 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,065,636 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,610,797 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,750,592 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,159,121 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,315,044 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO ALL WE SERVE. THE ORGANIZATION PROVIDES SKILLED NURSING CARE, INDEPENDENT LIVING AND ASSISTED LIVING FACILITIES. ST. FRANCIS HOME IS THE HEART OF ITS CARE CAMPUS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,240,563 | ExpenseAmt |
| Grant | $793 | GrantAmt |
| Revenue | $13,989,569 | RevenueAmt |
| Desc | ST. FRANCIS HOME OF FOND DU LAC, WISCONSIN, INC. OPERATES A NURSING HOME AND RELATED HEALTH CARE FACILITIES PROVIDING VARIOUS PROGRAMS FOR THE CARE OF THE ELDERLY, INJURED, AND SICK. THIS MEDICARE-CERTIFIED SKILLED NURSING FACILITY SPECIALIZES IN LONG-TERM CARE FOR THE ELDERLY. IT PROVIDES THE LATEST IN NURSING HOME CARE, STRESSING A HOME-LIKE ATMOSPHERE FOR RESIDENTS AND OFFERING A SPECIAL UNIT DEDICATED TO THE CARE OF RESIDENTS WITH ALZHEIMER'S DISEASE. ST. CLARE TERRACE OFFERS INDEPENDENT LIVING OPTIONS. THIS SAFE, SECURE COMMUNITY LIVING ENVIRONMENT PROVIDES RESIDENTS A FULFILLING LIFESTYLE IN THEIR RETIREMENT YEARS. ST. FRANCIS TERRACE OFFERS ASSISTED LIVING CARE. THIS IS AN INTERIM CARE OPTION THAT PROVIDES SOME NURSING SUPPORT AND ASSISTANCE, YET ALLOWS PEOPLE TO LIVE INDEPENDENTLY. | Desc |
| Total Program Service Expenses | $14,240,563 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9209265519 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 33 EVERETT STREET | AddressLine1Txt |
| City | FOND DU LAC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54935 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| CAROL HYLAND | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| STEVE FRANKE | |||||||
| PT YR DIRECTOR, ASST SEC/TREAS | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SR STEPHEN BLOESL | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DAVE KUSEK | |||||||
| PT YR DIRECTOR, CHAIRPERSON | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BARB SENN | |||||||
| PT YR DIRECTOR, VICE CHAIRPERSON | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DG GLOEDE | |||||||
| DIRECTOR, PRESIDENT-POST ACUTE | 1.00 | 40.00 | Yes (X) | $0 | $352,791 | $181,038 | Yes (X) |
| SUE BUWALDA | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| RICK VANT HOFF | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JENNY KNUTH | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MARILYN MULDER | |||||||
| PT YR DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| CHRIS THORNOCK | |||||||
| PT YR DIRECTOR, VP MEDICAL GROUP | 1.00 | 40.00 | Yes (X) | $0 | $583,387 | $263,637 | Yes (X) |
| RANDY COMBS | |||||||
| TREASURER, CFO OF SSM HEALTH | 1.00 | 50.00 | $0 | $2,182,354 | $1,238,074 | Yes (X) | |
| DOUGLAS LONG | |||||||
| SECRETARY, GENERAL COUNSEL AT SSM HEALTH | 1.00 | 50.00 | $0 | $1,425,239 | $777,013 | Yes (X) | |
| STEVE SMOOT | |||||||
| VICE PRESIDENT, COO OF SSM HEALTH | 1.00 | 50.00 | $0 | $2,054,358 | $1,204,489 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,598,129 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,664,251 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VAYA WORKFORCE SOLUTIONS | |||||
| 5930 CORNERSTONE CT | SAN DIEGO | CA | 92121 | STAFFING SERVICES | $1,146,445 |
| SYSCO FOOD SERVICES | |||||
| 1350 W TECUMSEH RD | NORMAN | OK | 73069 | DIETARY SERVICES | $504,369 |
| PRN HEALTH SERVICES | |||||
| 1101 E SOUTH RIVER ST | APPLETON | WI | 54915 | THERAPY | $385,667 |
| HEALTH DIMENSIONS CONSULTING INC | |||||
| 12900 WHITEWATER DRIVE | MINNEAPOLIS | MN | 55343 | CONSULTING | $371,576 |
| WISCONSIN POWER & LIGHT | |||||
| PO BOX 52406 | CEDAR RAPIDS | WI | 52406 | UTILITIES | $301,446 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $8,409 | RelatedOrganizationsAmt |
| Government Grants | $2,581 | GovernmentGrantsAmt |
| Total Contributions | $10,990 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 623110 | BusinessCd |
| Total Revenue Column | $13,989,569 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,989,569 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,989,569 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| BEAUTY SHOP | 900099 | $26,646 | $26,646 |
| CAFETERIA REVENUE | 722210 | $3,035 | $3,035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $29,681 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,030,240 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,989,569 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $29,681 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793 | TotalAmt |
| Program Services | $793 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,780,616 | TotalAmt |
| Program Services | $6,653,977 | ProgramServicesAmt |
| Management And General | $126,639 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,103 | TotalAmt |
| Program Services | $356,321 | ProgramServicesAmt |
| Management And General | $6,782 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,170,455 | TotalAmt |
| Program Services | $1,148,595 | ProgramServicesAmt |
| Management And General | $21,860 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $551,798 | TotalAmt |
| Program Services | $541,492 | ProgramServicesAmt |
| Management And General | $10,306 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,290,886 | TotalAmt |
| Program Services | $78,411 | ProgramServicesAmt |
| Management And General | $1,212,475 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,268 | TotalAmt |
| Management And General | $2,268 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,593,123 | TotalAmt |
| Program Services | $2,480,866 | ProgramServicesAmt |
| Management And General | $112,257 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,108 | TotalAmt |
| Program Services | $1,108 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,362 | TotalAmt |
| Program Services | $650,102 | ProgramServicesAmt |
| Management And General | $17,260 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,078 | TotalAmt |
| Program Services | $36,078 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $679,372 | TotalAmt |
| Program Services | $678,226 | ProgramServicesAmt |
| Management And General | $1,146 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,219 | TotalAmt |
| Program Services | $2,970 | ProgramServicesAmt |
| Management And General | $1,249 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,934 | TotalAmt |
| Program Services | $7,674 | ProgramServicesAmt |
| Management And General | $260 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $318,222 | TotalAmt |
| Program Services | $318,222 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $840,535 | TotalAmt |
| Program Services | $685,584 | ProgramServicesAmt |
| Management And General | $154,951 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,985 | TotalAmt |
| Program Services | $39,584 | ProgramServicesAmt |
| Management And General | $50,401 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $282,463 | $282,295 | $168 |
| LICENSES AND TAXES | $200,159 | $200,159 | |
| OTHER EXPENSES | $52,977 | $52,977 | |
| LICENSES DUES & SUBSCRI | $32,938 | $24,849 | $8,089 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280 | TotalAmt |
| Program Services | $280 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,966,674 | TotalAmt |
| Program Services | $14,240,563 | ProgramServicesAmt |
| Management And General | $1,726,111 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,103 | BOYAmt |
| EOY | $10,304 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $549,425 | BOYAmt |
| EOY | $1,778,612 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,449 | BOYAmt |
| EOY | $63,881 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,969,687 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,347,944 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,507,294 | BOYAmt |
| EOY | $13,621,743 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,588,647 | BOYAmt |
| EOY | $2,591,096 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,769,918 | BOYAmt |
| EOY | $18,065,636 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,039 | BOYAmt |
| EOY | $1,376,373 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,021 | BOYAmt |
| EOY | $414,705 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,687,737 | BOYAmt |
| EOY | $5,959,514 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,610,797 | BOYAmt |
| EOY | $7,750,592 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,570,474 | BOYAmt |
| EOY | $7,723,948 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,588,647 | BOYAmt |
| EOY | $2,591,096 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,159,121 | BOYAmt |
| EOY | $10,315,044 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,769,918 | BOYAmt |
| EOY | $18,065,636 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,936,434 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $92,357 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $65,165 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $384,266 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $600,430 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,325 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,990 | CurrentTaxYearAmt |
| Total | $1,064,176 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,638,564 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,348,707 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,723,588 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,078,301 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,989,569 | CurrentTaxYearAmt |
| Total | $62,778,729 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,484 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $33,288 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61,269 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $39,569 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,681 | CurrentTaxYearAmt |
| Total | $211,291 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,751,213 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,766,261 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,385,287 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,121,195 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,030,240 | CurrentTaxYearAmt |
| Total | $64,054,196 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $64,054,196 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,318 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $142,776 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $122,864 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,931 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $271,889 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,318 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $142,776 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $122,864 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,931 | CurrentTaxYearMinus1YearAmt |
| Total | $271,889 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,755,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,909,037 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,508,151 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,123,126 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,030,240 | CurrentTaxYearAmt |
| Total | $64,326,085 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99580 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99520 | PublicSupportPY509Pct |
| Investment Income CY | 0.00420 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,340,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,340,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,584,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,188,400 | DepreciationAmt |
| Book Value | $11,396,266 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $266,631 | OtherCostOrOtherBasisAmt |
| Depreciation | $218,175 | DepreciationAmt |
| Book Value | $48,456 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,736,952 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,941,369 | DepreciationAmt |
| Book Value | $795,583 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,438 | OtherCostOrOtherBasisAmt |
| Book Value | $41,438 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,621,743 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST IN FOUNDATION | Desc |
| Book Value | $2,591,096 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $2,591,096 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $5,035,699 |
| OTHER LIABILITIES | $859,816 |
| THIRD PARTY PAYOR | $63,999 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,959,514 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2022 OR 2023. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RANDY COMBS | ||||||||||||||
| TREASURER, CFO OF SSM HEALTH | $0 | $1,242,308 | $0 | $669,269 | $0 | $270,777 | $0 | $1,203,989 | $0 | $34,085 | $0 | $3,420,428 | $0 | $669,269 |
| STEVE SMOOT | ||||||||||||||
| VICE PRESIDENT, COO OF SSM HEALTH | $0 | $1,173,646 | $0 | $737,192 | $0 | $143,520 | $0 | $1,164,125 | $0 | $40,364 | $0 | $3,258,847 | $0 | $878,090 |
| DOUGLAS LONG | ||||||||||||||
| SECRETARY, GENERAL COUNSEL AT SSM HE | $0 | $759,270 | $0 | $495,539 | $0 | $170,430 | $0 | $753,634 | $0 | $23,379 | $0 | $2,202,252 | $0 | $495,539 |
| CHRIS THORNOCK | ||||||||||||||
| PT YR DIRECTOR, VP MEDICAL GROUP | $0 | $466,669 | $0 | $112,038 | $0 | $4,680 | $0 | $228,224 | $0 | $35,413 | $0 | $847,024 | $0 | $101,538 |
| DG GLOEDE | ||||||||||||||
| DIRECTOR, PRESIDENT-POST ACUTE | $0 | $307,772 | $0 | $43,403 | $0 | $1,616 | $0 | $151,034 | $0 | $30,004 | $0 | $533,829 | $0 | $30,403 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | SEVERAL INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2023, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION. |
| PART I, LINE 3 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (PRESIDENT-POST ACUTE) IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER THE SSMH QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUAL LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. CAPITAL ACCUMULATION PLAN: SSMH PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMH AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM THIS PLAN IN 2023: STEVE SMOOT - $249,972 RANDALL COMBS $261,633 DOUGLAS LONG $161,286 DG GLOEDE $28,146 CHRIS THORNOCK $45,375 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. STEVE SMOOT $140,898 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A | ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, SSM HEALTH CARE CORPORATION, 46-6029223. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS AGNESIAN HEALTHCARE INC. AGNESIAN HEALTHCARE INC IS A NONPROFIT 501 (C)(3) ORGANIZATION. BOTH ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC. AND AGNESIAN HEALTHCARE INC ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED FOR THE MEMBER: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION; B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS; C. TO APPOINT AND REMOVE THE DIRECTORS; D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION; E. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN; F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION; G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY; I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY; L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS; TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS; M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION; N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION; O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION; P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO SSMHCC OR TO ANY OTHER ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY SSMHCC, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF SSMHCC AS DETERMINED BY SSMHCC; Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN SSMHCC, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO SSMHCC WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NONCONTROLLED SUBSIDIARY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION (SSM). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SSM PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | A WRITTEN CONFLICT OF INTEREST AND INSIDER TRANSACTION POLICY EXISTS WHICH REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON A ANNUAL BASIS TO THE DESIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE WISCONSIN SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER: PROGRAM SERVICE EXPENSES 2,480,866. MANAGEMENT AND GENERAL EXPENSES 112,257. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,593,123. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 92,356. ROUNDING 1. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (53 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM HEALTH CARE CORPORATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 466029223 | HEALTH CARE | MO | 501(C)(3) | LINE 12A, I | SSM HEALTH MINISTRIES | 0 | |
| SSMHC LIABILITY TRUST I | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 436331003 | INSURANCE | MO | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE CORPORATION | 0 | |
| SSM CONSOLIDATED HEALTH SERVICES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431473657 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | SSM HEALTH CARE CORPORATION | 0 | |
| SSM POLICY INSTITUTE | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431788151 | HEALTH CARE | MO | 501(C)(4) | SSM HEALTH CARE CORPORATION | 0 | ||
| SSM HEALTH CARE PORTFOLIO MANAGEMENT CO | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431825256 | MANAGEMENT | MO | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE CORPORATION | 0 | |
| SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430738490 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | SSM HEALTH CARE ST LOUIS | 0 | |
| CARDINAL GLENNON CHILDREN'S FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431754347 | FUNDRAISING | MO | 501(C)(3) | LINE 7 | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | 0 | |
| SSM HEALTH FOUNDATION - ST LOUIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431552945 | FUNDRAISING | MO | 501(C)(3) | LINE 7 | SSM HEALTH CARE ST LOUIS | 0 | |
| SSM HEALTH CARE OF OKLAHOMA INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 730657693 | HEALTH CARE | OK | 501(C)(3) | LINE 3 | SSM HEALTH CARE CORPORATION | 0 | |
| THE ST ANTHONY HOSPITAL FOUNDATION INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 736104300 | FUNDRAISING | OK | 501(C)(3) | LINE 7 | SSM HEALTH CARE OF OKLAHOMA | 0 | |
| SSM HEALTH CARE OF WISCONSIN INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430688874 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | SSM HEALTH CARE CORPORATION | 0 | |
| DELLS MEDICAL BUILDING INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 391613292 | MOB | WI | 501(C)(2) | SSM HEALTH CARE OF WISCONSIN | 0 | ||
| ST MARY'S FOUNDATION INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431940686 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| ST CLARE HEALTH CARE FOUNDATION INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431940683 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| HOME HEALTH UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391539827 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| HOME CARE UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391776340 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| HHU XTRA CARE INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391705111 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| SSM HEALTH AT HOME FOUNDATION OF WISCONSIN INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391839309 | FUNDRAISING | WI | 501(C)(3) | LINE 12A, I | HOME HEALTH UNITED INC | 0 | |
| SSM REGIONAL HEALTH SERVICES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 440579850 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | SSM HEALTH CARE CORPORATION | 0 | |
| ST MARY'S HEALTH CENTER JEFFERSON CITY MISSOURI FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431575307 | FUNDRAISING | MO | 501(C)(3) | LINE 12A, I | SSM REGIONAL HEALTH SERVICES | 0 | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430653587 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | SSM REGIONAL HEALTH SERVICES | 0 | |
| ST MARY'S HOSPITAL CENTRALIA ILLINOIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 370662580 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | SSM REGIONAL HEALTH SERVICES | 0 | |
| ST MARY'S - GOOD SAMARITAN INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 364170833 | HEALTH CARE | IL | 501(C)(3) | LINE 12A, I | SSM REGIONAL HEALTH SERVICES | 0 | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 262884795 | FUNDRAISING | IL | 501(C)(3) | LINE 7 | ST MARY'S-GOOD SAMARITAN INC | 0 | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 364636691 | FUNDRAISING | IL | 501(C)(3) | LINE 7 | ST MARY'S-GOOD SAMARITAN INC | 0 | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 400 N PLEASANT | CENTRALIA | IL | 62801 | 237126345 | FUNDRAISING | IL | 501(C)(3) | LINE 10 | ST MARY'S HOSPITAL FOUNDATION | 0 | |
| SSM HEALTH BUSINESSES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431333488 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | SSM HEALTH CARE CORPORATION | 0 | |
| SSM HEALTH CARE ST LOUIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431343281 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | SSM HEALTH CARE CORPORATION | 0 | |
| CENTRALIA MEDICAL SERVICES BLDG ASSOC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 237408025 | MOB | IL | 501(C)(3) | LINE 12A, I | SSM REGIONAL HEALTH SERVICES | 0 | |
| ST MARY'S JANESVILLE FOUNDATION INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 273439133 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| SSM HEALTH MINISTRIES | |||||||||||
| 3221 MCKELVEY ROAD SUITE 107 | BRIDGETON | MO | 63044 | 431012492 | RELIGIOUS ORGANIZATION | MO | 501(C)(3) | LINE 1 | 0 | N/A | |
| LEE DEWEY CORPORATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 731279603 | MOB | OK | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE OF OKLAHOMA | 0 | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 100 ST MARYS MEDICAL PLAZA | JEFFERSON CITY | MO | 65101 | 436049878 | FUNDRAISING | MO | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| GOOD SAMARITAN HOSPITAL AUXILIARY | |||||||||||
| 1 GOOD SAMARITAN WAY | MOUNT VERNON | IL | 62864 | 237049599 | FUNDRAISING | IL | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| ST ANTHONY SHAWNEE HOSPITAL INC | |||||||||||
| 1000 N LEE AVE | OKLAHOMA CITY | OK | 73102 | 455055149 | HEALTH CARE | OK | 501(C)(3) | LINE 3 | SSM HEALTH CARE OF OKLAHOMA | 0 | |
| SSM AUDRAIN HEALTH CARE INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431550298 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | SSM REGIONAL HEALTH SERVICES | 0 | |
| SSM-SLUH INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 474196634 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | SSM HEALTH CARE ST LOUIS | 0 | |
| AGNESIAN HEALTHCARE INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 390807236 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| RIPON MEDICAL CENTER INC | |||||||||||
| 845 PARKSIDE STREET | RIPON | WI | 54971 | 391101287 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | AGNESIAN HEALTHCARE INC | 0 | |
| WAUPUN MEMORIAL HOSPITAL INC | |||||||||||
| 620 WEST BROWN STREET | WAUPUN | WI | 53963 | 390806265 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | AGNESIAN HEALTHCARE INC | 0 | |
| ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC | |||||||||||
| 33 EVERETT STREET | FOND DU LAC | WI | 54935 | 391029998 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | AGNESIAN HEALTHCARE INC | 0 | |
| SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO | |||||||||||
| N8114 COUNTY WW | MOUNT CALVARY | WI | 53057 | 391022770 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | AGNESIAN HEALTHCARE INC | 0 | |
| VILLA ROSA INC | |||||||||||
| N8120 COUNTY WW | MOUNT CALVARY | WI | 53057 | 421670962 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | AGNESIAN HEALTHCARE INC | 0 | |
| THE CHRISTIAN HOME AND REHABILITATION CENTER INCORPORATED | |||||||||||
| 331 BLY STREET | WAUPUN | WI | 53963 | 390884514 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | AGNESIAN HEALTHCARE INC | 0 | |
| THE MONROE CLINIC INC | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 390808509 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| MONROE CLINIC AND HOSPITAL FOUNDATION INC | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 205769038 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | SSM HEALTH CARE OF WISCONSIN | 0 | |
| AGNESIAN HEALTHCARE FOUNDATION INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 391684956 | FUNDRAISING | WI | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE OF WISCONSIN | 0 | |
| SHARED MAGNETIC RESONANCE IMAGING FACILITY INC | |||||||||||
| 1104 JOHN NOLEN DRIVE | MADISON | WI | 53713 | 391534744 | HEALTH CARE | WI | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE OF WISCONSIN | 0 | |
| SSM HEALTH CARDINAL GLENNON TRANSPORT | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 863519607 | HEALTH CARE | MO | 501(C)(3) | LINE 12A, I | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | 0 | |
| SSM HEALTH FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 874109859 | FUNDRAISING | MO | 501(C)(3) | LINE 12A, I | SSM HEALTH CARE CORPORATION | 0 | |
| SSM HEALTH CARE GROUP | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 880988603 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | SSM HEALTH CARE ST LOUIS | 0 | |
| THE SARAH COMMUNITY | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431784657 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | SSM HEALTH BUSINESSES | 0 | |
| VISITING NURSE ASSOCIATION OF GREATER ST LOUIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430567000 | HEALTH CARE | MO | 501(C)(3) | LINE 7 | SSM HEALTH BUSINESSES | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| SSM ST JOSEPH ENDOSCOPY CENTER LLC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 270046559 | SURGERY SERVICES | MO | N/A | 0 | 0 |
| ST CLARE IMAGING SERVICES LLC | |||||||||
| 707 14TH STREET SUITE A | BARABOO | WI | 53913 | 200122365 | DIAG. SERVICES | WI | N/A | 0 | 0 |
| MT VERNON RADIATION THERAPY CENTER LLC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 201382620 | RADIATION THERAPY | IL | N/A | 0 | Yes (1) |
| SLEEP & NEUROLOGY CENTER OF SOUTHERN ILLINOIS LLC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 208468195 | DIAG. SERVICES | IL | N/A | 0 | 0 |
| SHAWNEE REAL ESTATE HOLDINGS LLC | |||||||||
| 1000 N LEE AVE | OKLAHOMA CITY | OK | 73102 | 455458304 | MOB | OK | N/A | 0 | 0 |
| DEAN CLINIC & ST MARY'S HOSPITAL ACCOUNTABLE CARE ORGANIZATION LLC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 452995500 | ACCOUNTABLE CARE ORGANIZATION | WI | N/A | 0 | 0 |
| WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 392016715 | INFORMATION TECHNOLOGY SERVICES | WI | N/A | 0 | 0 |
| 1110 N CLASSEN BLVD LLC | |||||||||
| 1110 N CLASSEN BOULEVARD | OKLAHOMA CITY | OK | 73106 | 731158158 | MOB | OK | N/A | 0 | Yes (1) |
| WINDMILL LLP | |||||||||
| 50 VILLAGE VIEW LANE | CHESTERFIELD | MO | 63017 | 431804651 | INVESTMENTS | MO | N/A | 0 | 0 |
| SSM SELECT REHAB ST LOUIS LLC | |||||||||
| 4714 GETTYSBURG ROAD | MECHANICSBURG | PA | 17055 | 263694972 | HEALTH CARE | DE | N/A | 0 | 0 |
| BLOOM TREE LONG-ONLY FUND QP LP FKA BLOOM TREE PONDEROSA FUNDS QP LP | |||||||||
| 101 PARK AVENUE 33RD FL | NEW YORK | NY | 10178 | 823704522 | INVESTMENTS | DE | N/A | 0 | 0 |
| NECICF II AIV2-B LP | |||||||||
| 300 DELAWARE AVE STE 210 | WILMINGTON | DE | 19801 | 845058167 | INVESTMENTS | DE | N/A | 0 | 0 |
| BISON CAPITAL PARTNERS VI-A LP | |||||||||
| 233 WILSHIRE BLVD STE 425 | SANTA MONICA | CA | 90401 | 874006968 | INVESTMENTS | DE | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SSM MANAGED CARE ORGANIZATION LLC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431708511 | HEALTH PROMOTION | MO | N/A | C | 0 |
| FPP INC & SUBS | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431465174 | HEALTH CARE | MO | N/A | C | 0 |
| DIVERSIFIED HEALTH SERVICES CORP | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431369305 | MEDICAL EQUIPMENT | MO | N/A | C | 0 |
| SSM PROPERTIES INC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431462486 | PROPERTY SERVICES | MO | N/A | C | 0 |
| HEALTHFIRST PHYSICIAN MANAGEMENT SERVICES | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 731534336 | MEDICAL SERVICES | OK | N/A | C | 0 |
| SSMHC LIABILITY TRUST II | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 816128118 | INSURANCE | MO | N/A | C | 0 |
| SSM MEDICAL GROUP INC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431664107 | PHYSICIAN OFFICES | MO | N/A | C | 0 |
| PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS INC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 364161526 | HEALTH CARE | IL | N/A | C | 0 |
| DEAN HEALTH SYSTEMS INC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 391128616 | PHYSICIAN OFFICES | WI | N/A | C | 0 |
| DEAN RETAIL SERVICES INC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 391717636 | PROPERTY SERVICES | WI | N/A | C | 0 |
| SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM ASSOCIATION INC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 832038674 | CONDO ASSOCIATION | WI | N/A | C | 0 |
| SSM HEALTH PHARMACY LLC | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 264031708 | PHARMACY | MO | N/A | C | 0 |
| NAVITUS HOLDINGS LLC | |||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 800968174 | PHARMACY | WI | N/A | C | 0 |
| MS COMMUNITY JV LLC | |||||||||
| 401 CARLSON PARKWAY CP330 | MINNETONKA | MN | 55305 | 873240022 | INSURANCE | DE | N/A | C | 0 |
| QUALITY DRUG CORPORATION | |||||||||
| 239 BROADWAY | LAGUNA BEACH | CA | 92651 | 330644268 | PHARMACY BENEFITS | CA | N/A | C | 0 |
| ST MARY'S HOSPITAL CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC | |||||||||
| 707 SOUTH MILLS STREET | MADISON | WI | 53715 | 000000000 | CONDO ASSOCIATION | WI | N/A | C | 0 |
| OMNINHEALTH HOLDINGS | |||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 884144276 | HEALTH CARE CONSULTING | DE | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |