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RIPON MEDICAL CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
RIPON MEDICAL CENTER INC (EIN 39-1101287)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202233199349312143
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2022-11-15T12:33:03-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391101287EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ripon Medical Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRIPOBusinessNameControlTxt
Phone9207483101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1845 Parkside StreetAddressLine1Txt
CityRiponCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54971ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRandy CombsPersonNm
Person TitleTreasurerPersonTitleTxt
Phone3149947800PhoneNum
Signature2022-11-15SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBarbaraPersonFirstNm
Person LastPottsPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deann ThurmerBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1845 Parkside StreetAddressLine1Txt
CityRiponCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54971ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$33,115,265GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://www.ssmhealth.com/locations/ripon-community-hospitalWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1936FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE MISSION OF RIPON MEDICAL CENTER IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH, AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers78TotalVolunteersCnt
Total Gross UBI$97,325TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,470,947PYContributionsGrantsAmt
CY Contributions Grants$648,202CYContributionsGrantsAmt
PY Program Service Revenue$25,837,793PYProgramServiceRevenueAmt
CY Program Service Revenue$32,310,452CYProgramServiceRevenueAmt
PY Investment Income$55,236PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$245,418PYOtherRevenueAmt
CY Other Revenue$156,611CYOtherRevenueAmt
PY Total Revenue$29,609,394PYTotalRevenueAmt
CY Total Revenue$33,115,265CYTotalRevenueAmt
PY Grants And Similar Paid$2,165PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$27,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,982,071PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,474,771CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,182,973PYOtherExpensesAmt
CY Other Expenses$15,526,873CYOtherExpensesAmt
PY Total Expenses$29,167,209PYTotalExpensesAmt
CY Total Expenses$29,028,644CYTotalExpensesAmt
PY Revenues Less Expenses$442,185PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,086,621CYRevenuesLessExpensesAmt
Total Assets BOY$61,730,070TotalAssetsBOYAmt
Total Assets EOY$61,474,437TotalAssetsEOYAmt
Total Liabilities BOY$44,426,177TotalLiabilitiesBOYAmt
Total Liabilities EOY$39,911,849TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,303,893NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,562,588NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF RIPON MEDICAL CENTER IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$26,781,946ExpenseAmt
Grant$27,000GrantAmt
Revenue$32,310,452RevenueAmt
DescPLEASE SEE SCHEDULE O FOR A FULL DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS.Desc
Total Program Service Expenses$26,781,946TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jackie TaylorBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6082416949PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11808 W Beltline HwyAddressLine1Txt
CityMadisonCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53713ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Christopher Ogle
Director, Vice Chair1.00Yes (X)Yes (X)$0$0$0
Deann Thurmer
Director, President/CNO-Ripon Memorial Hospital20.020.0Yes (X)Yes (X)$0$312,782$122,942
Joan Karsten
Pt Yr Director, Pt Yr Chairperson1.02.0Yes (X)Yes (X)$0$0$0
Todd Weir
Director, Chairperson1.00Yes (X)Yes (X)$0$0$0
William Boesch
Director, Assistant Treasurer/Secretary1.00Yes (X)Yes (X)$0$0$0
Ellen Sorensen
Director1.00Yes (X)$0$0$0
Karl Bertram MD
Director1.00Yes (X)$0$0$0
Kathryn Munsey
Pt Yr Director1.00Yes (X)$0$0$0
Margaret Heffernan
Director1.00Yes (X)$0$0$0
Mark Thompson MD
Director, Regional President-Medical Groups-Wisconsin1.042.0Yes (X)$0$753,876$287,658
Mary Whitrock
Director1.00Yes (X)$0$0$0
Matthew Lueptow
Director1.00Yes (X)$0$0$0
Rachel Prellwitz
Director1.00Yes (X)$0$0$0
Douglas Long
Secretary, General Counsel at SSM Health1.068.2Yes (X)$0$1,201,678$483,601
Randy Combs
Treasurer, Chief Financial Officer at SSM Health1.066.0Yes (X)$0$1,290,602$485,851
Katherine Vergos
Former Officer0.080.0$0$454,773$213,078Yes (X)
Kris Zimmer
Former Officer0.00.0$0$219,379$0Yes (X)
Kyle Hunter
Former Key Employee0.00.0$0$137,364$5,848Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,370,455TotReportableCompRltdOrgAmt
Total Other Compensation$1,598,978TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AMN Healthcare IncBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line112400 High Bluff DriveAddressLine1Txt
CitySan DiegoCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92130ZIPCd
FieldValueIRS element (for citing)
ServicesStaffing servicesServicesDesc
Compensation$212,039CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$625,218GovernmentGrantsAmt
All Other Contributions$22,984AllOtherContributionsAmt
Total Contributions$648,202TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business622110BusinessCd
Total Revenue Column$32,130,294TotalRevenueColumnAmt
Related Or Exempt Func Income$32,130,294RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$180,158TotalRevenueColumnAmt
Related Or Exempt Func Income$180,158RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$32,310,452TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Cafeteria722514$59,286$59,286
Wellness Center713940$65,075$65,075
Mobile meals900099$32,250$32,250

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$156,611OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,115,265TotalRevenueColumnAmt
Related Or Exempt Func Income$32,310,452RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$97,325UnrelatedBusinessRevenueAmt
Exclusion$59,286ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$27,000TotalAmt
Program Services$27,000ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,803,826TotalAmt
Program Services$10,423,619ProgramServicesAmt
Management And General$380,207ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$509,746TotalAmt
Program Services$491,807ProgramServicesAmt
Management And General$17,939ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,499,834TotalAmt
Program Services$1,447,052ProgramServicesAmt
Management And General$52,782ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$661,365TotalAmt
Program Services$638,090ProgramServicesAmt
Management And General$23,275ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,788TotalAmt
Management And General$1,788ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,081TotalAmt
Management And General$2,081ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,523,513TotalAmt
Program Services$3,668,976ProgramServicesAmt
Management And General$854,537ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,182TotalAmt
Management And General$3,182ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,126,519TotalAmt
Program Services$1,066,727ProgramServicesAmt
Management And General$59,792ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,159,757TotalAmt
Program Services$1,159,667ProgramServicesAmt
Management And General$90ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$777,109TotalAmt
Program Services$697,347ProgramServicesAmt
Management And General$79,762ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,569TotalAmt
Program Services$26,101ProgramServicesAmt
Management And General$468ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,006TotalAmt
Program Services$3,868ProgramServicesAmt
Management And General$138ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,215,386TotalAmt
Program Services$1,215,386ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,589,813TotalAmt
Program Services$2,589,813ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$110,877TotalAmt
Program Services$110,877ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$3,102,005$3,102,005
Medicaid Provider Tax$112,890$112,890
Internal management fees$770,657$770,657
Licenses and taxes$721$721

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$29,028,644TotalAmt
Program Services$26,781,946ProgramServicesAmt
Management And General$2,246,698ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,493,773BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,202,867BOYAmt
EOY$7,124,446EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$535,311BOYAmt
EOY$535,231EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$83,695BOYAmt
EOY$56,614EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$35,257,318LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,916,151LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,602,099BOYAmt
EOY$24,341,167EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,667,477BOYAmt
EOY$1,839,552EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$20,144,848BOYAmt
EOY$27,577,427EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$61,730,070BOYAmt
EOY$61,474,437EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,390,762BOYAmt
EOY$4,958,216EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$606,105BOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,429,310BOYAmt
EOY$34,953,633EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,426,177BOYAmt
EOY$39,911,849EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,303,893BOYAmt
EOY$21,562,588EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,303,893BOYAmt
EOY$21,562,588EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$61,730,070BOYAmt
EOY$61,474,437EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,086,621ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$172,074OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$2,081OtherActivitiesAmt
Total Lobbying Expenditures$2,081TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$660,000OtherCostOrOtherBasisAmt
Book Value$660,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,480,152OtherCostOrOtherBasisAmt
Depreciation$7,782,860DepreciationAmt
Book Value$20,697,292BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$217,492OtherCostOrOtherBasisAmt
Depreciation$48,318DepreciationAmt
Book Value$169,174BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,794,620OtherCostOrOtherBasisAmt
Depreciation$3,084,973DepreciationAmt
Book Value$2,709,647BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$105,054OtherCostOrOtherBasisAmt
Book Value$105,054BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,341,167TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDue from affiliatesDesc
Book Value$27,577,427BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$27,577,427TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
THIRD PARTY PAYOR$1,670,576
CAPITAL LEASE OBLIGATION
ALLOCATED TAX-EXEMPT DEBT - SSM HEALTH CARE CORPORATION$33,283,057
DUE TO AFFILIATES
FieldValueIRS element (for citing)
Total Liability$34,953,633TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationRIPON MEDICAL CENTER, 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 2021 OR 2020.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$191,248TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$191,248NetCommunityBenefitExpnsAmt
Total Expense0.0066TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,584,093TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,421,491DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,162,602NetCommunityBenefitExpnsAmt
Total Expense0.0401TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$596,558TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$732,803DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,371,899TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,154,294DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,353,850NetCommunityBenefitExpnsAmt
Total Expense0.0466TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,090TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$47,090NetCommunityBenefitExpnsAmt
Total Expense0.0016TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$69,292TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$69,292NetCommunityBenefitExpnsAmt
Total Expense0.0024TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$115,492TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$115,492NetCommunityBenefitExpnsAmt
Total Expense0.0040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$231,874TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$231,874NetCommunityBenefitExpnsAmt
Total Expense0.0080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,603,773TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,154,294DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,585,724NetCommunityBenefitExpnsAmt
Total Expense0.0546TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,472TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,472NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,000NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$9,472TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,472NetCommunityBenefitExpnsAmt
Total Expense0.0003TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,121,260BadDebtExpenseAmt
Reimbursed By Medicare$3,804,063ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,766,399CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$37,664MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ripon Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1845 Parkside StreetAddressLine1Txt
CityRiponCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54971ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://www.ssmhealth.com/locations/ripon-community-hospitalWebsiteAddressTxt
State License1024StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting GroupAFacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.ssmhealth.com/resources/about/community-healthOwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.ssmhealth.com/resources/about/community-healthStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3ETHE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility A, 1Facility A, 1 - Ripon Medical Center. The Community Health Needs Assessment is comprised of five different data collection methods to include primary, secondary, qualitative, and quantitative data. Once it was collected, it was organized into five health focus areas. COMMUNITY HEALTH SURVEY The Community Health Survey conducted by JKV Research, LLC., provides primary, quantitative data collected from Fond du Lac County residents. The data provides an overview of behavioral and lifestyle habits as well as prevalence of risk factors and disease conditions existing within the Fond du Lac County adult population. The survey was mailed out to a random sample and 674 adults participated. Aggregate data from six school districts in Fond du Lac County is included in the Community Health Survey report to provide student data when available. PUBLIC INPUT SURVEY The Priority Health Issues Survey was conducted to provide an outlet for the community at large to provide additional input and voice their concerns regarding the most pressing county health issues. The survey was available in hard copy at the health department and online on the health department's website. The survey was available to take in English and Spanish. Residents were encouraged to review key findings from the 2020 Community Health Survey beforehand to provide additional feedback. A total of 284 Fond du Lac County residents completed the survey. The health focus areas ranked most consistently in the top five by respondents were: mental health, alcohol and other drug use, social determinants of health, food security and nutrition and infectious disease. KEY INFORMANT INTERVIEWS A total of 37 Key Informant Interviews were conducted to provide further qualitative data regarding community needs. Key informants identified were considered community experts who can provide valuable insight on pressing health issues in the Fond du Lac County community. The top health focus areas ranked most consistently by key informants were: mental health, alcohol and other drug use, social determinants of health, chronic disease, oral health and food security and nutrition. COMMUNITY CONVERSATIONS New for the 2021 Community Health Assessment was data collected from community conversations These conversations were organized by members of the SSM Health Greater Fond du Lac Region, Fond du Lac County Health Department and other entities that served as host locations for these events. The purpose of these community conversations was to further engage the public and provide an opportunity for various populations to voice their input that may otherwise have not been heard. 16 community conversations were held across the county, providing further information regarding the health needs of residents in Fond du Lac County. Top needs identified from community conversations include: access to resources, mental health, transportation, access to care and racism. Highlights and themes from these conversations can be found throughout the report. SECONDARY DATA Secondary data was collected from local, state, and national health sources to supplement the community health survey and other data collection information listed above. This data helped build a community health profile for Fond du Lac County and allowed this report to be comparable to other counties as well as state and national benchmarks. The secondary data collected is included in throughout the health focus area and the definition of community profiles.
Schedule H, Part V, Section B, Line 6b Facility A, 1Facility A, 1 - Ripon Medical Center. Waupun Memorial Hospital conducted their CHNA in collaboration with Healthy Fond du Lac County and the Fond du Lac County Health Department.
Schedule H, Part V, Section B, Line 11 Facility A, 1Facility A, 1 - Ripon Medical Center. The hospital identified various health needs in the 2021 CHNA. In order to make meaningful impact, and to use its finances most effectively and efficiency, the hospital will place primary focus on the following key priorities: - Mental health - Chronic disease - Substance use Mental health According to the World Health Organization, the definition of health is a "State of complete physical, mental and social well-being, and not merely the absence of disease or infirmity." Mental health is something we all have, and it varies in its degree from time to time. If there is a significant impact on our thinking, feeling and/or behavior, treatment, services or intervention may be required. In general, the sooner one gets treatment, the better the outcome. Having an untreated mental disorder can create serious problems such as increasing the chance of risky behaviors, drug or alcohol addiction, and in extreme cases, death. It also can ruin relationships, cause problems at work, and make it difficult to overcome serious illnesses. Mental Health was identified as the number one priority to address as a result of the 2021 CHNA. Mental health needs in Fond du Lac County may include, but is not limited to challenges, barriers or needs related to provider availability, affordability, transportation, insurance, stigma, substance use, culturally sensitive and diverse providers and services, stress, and suicide. Additionally, statistics show: - 20 deaths by suicide reported in Fond du Lac County in 2020 - 1 in 5 adults reported to have a mental health condition in the past three years - 1 in 5 youth reported they always or nearly always felt sad, blue or depressed - 79% adults report to have their mental health condition under control (down from 96% in 2017) In order to decrease the number of deaths by suicide in Fond du Lac County, as well as increase access to behavioral health services, the hospital's action plan includes the following initiatives: - Expand trainings for Question, Persuade, Refer (QPR), Mental Health First Aid for Adults (MHFA), Youth Mental Health First Aid (YMHFA). Explore additional trainings and programs for suicide prevention and mental health - Potential new partners and collaborations: Businesses and employers - Increase means for data collection, monitoring and evaluation of mental health needs, with community partners such as DCP, and public safety departments - Research universal and individual screening tools for behavioral and mental health needs across the lifespan and develop a plan to assess and expand SBIRT at the Ripon Community Hospital - increase mental health/behavioral health services and access to them - increase mental health resources and navigation tools - develop more universal approach to safety planning across the country - decrease stigma, campaigns, awareness, TIC, ACEs, build community Chronic disease Chronic diseases are illnesses that last a long time, do not go away on their own, are rarely cured, and often result in disability later in life. Multiple health conditions are classified as chronic diseases such as high blood pressure, high cholesterol, heart disease, obesity, diabetes, asthma and more. Nutrition and physical activity are important to maintain and improve overall health and both play a prominent role in obesity prevention and control. As established in the U.S. Dietary Guidelines, good nutrition includes meeting nutrient recommendations yet keeping calories under control. Physical activity means any bodily activity that enhances or maintains physical fitness and overall health. Obesity is one of the most critical health issues of our time and is a complex health issue resulting from many interacting causes and factors in our society, behavior, and genetics. Obesity is also associated with poorer mental health outcomes and reduces quality of life. The burden of obesity and other diet-related chronic diseases are vast, and rates continue to rise. Changes at the community level, such as policies, systems, and environment, are more likely to be effective, although they may be more difficult to achieve. According to Fond du Lac community members responses throughout the assessment, common barriers and challenges to chronic diseases and related health behaviors included, but not limited to, access and affordability to healthy foods, awareness of nutritious food and cooking healthy meals, access to indoor and outdoor recreation, access and affordability of healthcare services. insurance, stigma, transportation, and cultural competencies. Additionally, statistics show: - Heart diseases is the number one cause of death among adults - 75% (3 in 4) adults were classified as at least overweight - About 1 in 3 youth were classified as at least overweight - 52% of adults reported meeting aerobic physical activity guidelines - 23% of adults reported eating the recommended servings of fruit per day - 17% of youth reported eating the recommended servings of fruit per day - 4,920 (6%) households reported they went hungry because they couldn't afford enough food In order to improve residents' weight, physical activity, nutrition, and increase breastfeeding, the hospital has implemented the following action items: - Research and identify chronic disease prevention and self-management classes - increase trail usage, enhance bike and pedestrian master plans - implement a physical activity campaign - increase schools participating in safe routes to school - identify existing efforts and assess impact - increase SNAP usage - increase access to and affordability of fruits and vegetables - assess current food forests or community/shared gardens and increase value/impact - increase health promotion programs offered to low-income housing residents - Increase number of childcare centers and business centers who have adopted the Ten Steps to Breastfeeding-Friendly Toolkit (Promote support for breastfeeding mothers in the workplace, early childhood education settings, and throughout the community Substance use Alcohol and other drug use means any use of a substance that result in negative consequences. This includes a broad array of mood-altering substances such as alcohol, tobacco, prescription substances, and illegal substances like methamphetamine and heroin. Negative consequences or unhealthy uses include but are not limited to, operating a motor vehicle while intoxicated, drinking while pregnant, alcohol dependence, fetal alcohol spectrum disorder, alcohol-related hospitalizations, and more. Substance use was identified as the number three priority to address in the 2022-2024 CHIP. Substance use needs in Fond du Lac County may include, but is not limited to barriers, challenges and needs related tobacco, vaping, drugs (narcotics, marijuana, etc.), prescription medications, and alcohol use, mental health and access to care. Throughout the Community Health Needs Assessment, substance use was consistently ranked as a top priority. Additionally, statistics show: - 25 opioid related deaths in Fond du Lac County in 2020, over double the deaths from 2019 - 74% of adults reported drinking alcohol in the past month - 22% of youth reported drinking alcohol in the past month - 37% of adults reported binge drinking alcohol in the past month - 37% of adults reported binge drinking alcohol in the past month The hospital's action plan includes the following initiatives to decrease underage drinking and binge drinking, and decrease misuse of opioids/prescription medication: - Increase festivals evaluated annually using the Community Events Best Practices Toolkit - Increase number of law enforcement agencies completing annual compliance checks - Decrease Alcohol Outlet density - Awareness and education campaign - Increase number of Narcan trainings and kits distributed - Syringe services program - Prescription medication prescribing practices and pain management - Prescription medication disposal The hospital has no plans to discontinue other community benefit efforts addressing the remaining CHNA-identified needs.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c Discounted Care ExceptionsPatients whose family income exceeds 400% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of the hospital; however the discounted rates shall not be greater than the amounts generally billed to commercially insured [or Medicare] patients. In such cases, other factors may be considered in determining their eligibility for discounted or free services, including: * Bank accounts, investments and other assets * Employment status and earning capacity * Amount and frequency of bills for health care services * Other financial obligations and expenses * Generally, financial responsibility will be no more than 25% of gross family income. The hospital may utilize predictive analytical software or other criteria to assist in making a determination of financial assistance eligibility in situations where the patient qualifies for financial assistance but has not provided the necessary documentation to make a determination. This process is called "presumptive eligibility."
Schedule H, Part I, Line 6a Community benefit report prepared by related organizationSSM HEALTH CARE CORPORATION, 46-6029223
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe amounts reported on Form 990, Schedule H, Part I, Line 7a, 7b, and 7c were determined using the cost to charge ratio derived from worksheet 2 in the schedule h instructions. Form 990, schedule h, part I, Lines 7e, 7f, 7g, 7h, and 7i are reported at cost as reported in the organization's financial statements. The calculation of Schedule H, Part I, Line 7, Column F utilizes 990, Part IX, Line 25, Column A, which does not include Bad Debt Expense.
Schedule H, Part II Community Building ActivitiesRIPON MEDICAL CENTER PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEALTH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING: ENVIRONMENTAL IMPROVEMENTS: Sharps containers are supplied to our patients and customers throughout the community free of charge, with full containers able to be dropped off at all facility sites for disposal; LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: Donation to support the development of the Dr. Richard and Leslie Ridenour Science Center, tuition assistance for vulnerable populations of students.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountAS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyFOR FINANCIAL STATEMENT PURPOSES, SSM Health HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NORTON HOSPITAL'S FINANCIAL ASSISTANCE POLICY ON A GROSS BASIS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteRipon Medical Center Inc. is part of the SSM Health consolidated audit. The footnote that references the treatment of uncollectible accounts and implicit price concessions in the December 31, 2021 consolidated audit is contained on page 13, 14 and 15 of the attached financial statements.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsTHE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceRipon Medical Center has established a written credit and collection policy and procedures. The billing and collection policies and practices reflect the mission and values of SSM Health, including our special concern for people who are poor and vulnerable. Ripon Medical Center embraces its responsibility to serve the communities in which it participates by establishing sound business practices. Ripon Medical Center's billing and collection practices will be fairly and consistently applied. All staff and vendors are expected to treat all patients consistently and fairly regardless of their ability to pay. They respond to patients in a prompt and courteous manner regarding any questions about their bills and provide notification of the availability of financial assistance. All uninsured patients will be provided a standard discount for medically necessary inpatient and outpatient services, including services provided at off-campus outpatient sites. The hospital determined the amount of the discount based on the local managed care market, applicable statutory requirements and other relevant local circumstances. The rate must be no less than the lowest effective discount rate and no greater than the highest effective discount rate for the current managed care contracts of the hospital. Uninsured patients may also qualify for an additional discount based upon financial need under the system financial assistance policy. All accounts due from the patient will receive a statement after discharge or after final adjudication from patient's insurance. Generally the patient will receive 4 months (120 days) of in-house collection efforts (including early out vendors) and 12 months of bad debt collection efforts. The hospital will make Reasonable Efforts to determine FAP eligibility including: 1. The financial assistance summary will be included with each billing statement 2. Extraordinary Collection Activity (ECAs) may not occur until bad debt placement and only after 120 days. 3. ECAs must be suspended if a guarantor submits a FAP application during the application period. 4. Reasonable measures must be taken to reverse ECAs if the application is approved which may include refunding any payments made in excess of amounts owed as an FAP-eligible individual. 5. Bad Debt vendors will gain written approval from SSM prior to engaging in ECAs. SSM will review the accounts and verify satisfactory completion of reasonable efforts during the notification and application period. A waiver is not considered reasonable efforts. Obtaining a signed waiver that an individual does not wish to apply for FAP assistance or receive FAP application information will not meet the requirement to make "reasonable efforts" to determine whether the individual is FAP-eligible before engaging in ECAs. All outside collection agencies must comply with state and federal laws, comply with the association of credit and collection professional's code of ethics and professional responsibility and comply with Ripon Medical Center's collection and financial assistance policies.
Schedule H, Part V, Section B, Line 16a FAP websiteA - Ripon Medical Center: Line 16a URL: https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application websiteA - Ripon Medical Center: Line 16b URL: https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary websiteA - Ripon Medical Center: Line 16c URL: https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessmentSSM Health (SSMH) participates in Community Benefit according to our vision. Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically, and socially marginalized, will experience improved health in mind, body, spirit and environment. In the tradition of our founders, the Franciscan Sisters of Mary, caring for those in greatest need remains our organizational priority. Today our System Board monitors Community Benefit efforts, and views achievement of our vision as a primary responsibility. The purpose of SSM's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always our goal. To fulfill this commitment, SSM's Community Benefit is divided into two parts: 1) Community Health Needs Assessment (CHNA), and 2) Community Benefit Inventory for Social Accountability (CBISA). The CHNA is an assessment and prioritization of community health needs and the adoption and implementation of strategies to address those needs. A CHNA is conducted every three years by each hospital according to the following steps: * Assess and prioritize community health needs: Gather CHNA data from secondary sources; obtain input from stakeholders representing the broad interests of the community through interviews and focus groups; use data to select top health priorities; and complete written CHNA. * Develop, adopt, and implement strategies to address top-health priorities: Establish strategies to address priorities; complete Strategic Implementation Plan; obtain Regional/Divisional Board approval; and integrate strategies into operational plan. * Make CHNA widely available to the public: Publish CHNA and summary document on hospital's website. * Monitor, track, and report progress on top health priorities: Collect data and evaluate progress; report to Regional/Divisional Board every six months and System Board every year; share findings with community stakeholders; and send results to finance for submission to the Internal Revenue Service (IRS). System Office staff and leaders oversee and monitor SSMH's Community Benefit Program, and ensure reporting is in compliance with IRS regulations. In collaboration with community stakeholders and partner organizations, SSM Health Care Corporation also identifies needs based on assessments and research, and SSMH facilities also involve case managers and care team staff to pinpoint critical health issues in the community. All hospital CHNAs are completed, approved, and integrated into the organization's strategic plan. We continue to monitor and assess the progress of our local efforts in the spirit of caring for others and improving community health.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceEach entity providing medical service shall provide information to the public regarding its charity care policies and the qualification requirements for each of its facilities. When standard system notices and communication regarding charity care are available, these must be used. Modifications to the standard may be made to comply with state and local laws, as well as reflect culturally sensitive terminology for the policy. All notices are easy to understand by the general public, culturally appropriate and available in those languages that are prevalent in the community. They provide information about: * The patient's responsibility for payment, * The availability of financial assistance from public programs and entity charity care and payment arrangements, * The entity's charity policy and application process, and * Who to contact to get additional information or financial counseling. The following types of notices to the public are provided: * Signs in the emergency department, outpatient and inpatient registration and public waiting areas. * Brochures or fliers provided at time of registration and available in the financial counseling areas. * Notices sent with or on patient bills or communications sent to patients and guarantors related to medical services. * Applications provided to uninsured patients at the time of registration. The application for charity care, together with any instructions, must clearly state the policies regarding charity care, including excluded services, eligibility criteria and documentation requirements. Information about the entity's charity policies is also provided to public agencies.
Schedule H, Part VI, Line 4 Community informationRipon Community Hospital defines its community as an area similar to its primary service delivery area. This includes the Ripon area, the west portion of Fond du Lac County, much of Green Lake County and small portions of Winnebago and Waushara counties. The hospital's secondary service area includes portions of Fond du Lac County, and small portions of Dodge, Green Lake, Marquette and Waushara counties. Approximately 75% of the hospital's patient population comes from the primary service area, and another 15% from the secondary service area. Ripon Community Hospital is located in Ripon, Wisconsin. The City of Ripon is a thriving community of 7,833 residents located just 20 miles west of the Fox Valley. When compared to Wisconsin, Fond du Lac County's population is slightly older and less diverse. The population in Fond du Lac County, Green Lake County and the SSM Health Greater Fond du Lac Region service area is over 90 percent white and has on average approximately 5 percent Hispanic/Latino population, and between 1 percent to 3 percent Black/African American population. Fond du Lac County has a greater percent of the population with a high school and some college education and has a larger percent of population age 65 and older, compared to Wisconsin. The percent of population in Fond du Lac County with a household income of $50,000-$75,000 is greater compared to Wisconsin, and the percent of individuals living in poverty in Fond du Lac County is less compared to Wisconsin. Additionally, according to the Asset Limited, Income Constrained, Employed (ALICE) index, 24 percent of households are considered an ALICE Household, compared to 23 percent in Wisconsin. An ALICE household describes families who work, earn above the federal poverty level, but do not enough to afford a basic household budget, driving families to make tough choices to support their families, survive and thrive in the community. The highest rates of ALICE are among adults 65 years and older. Therefore, the service areas include people who are at a high risk of not receiving adequate medical care due to being uninsured or underinsured, are experiencing health disparities, or facing other barriers. Additional demographic and statistical data on the hospital's service area can be found throughout the CHNA.
Schedule H, Part VI, Line 5 Promotion of community healthRipon Medical Center, Inc. participates in a wide array of community programs throughout the area to further its exempt purpose of promoting the health of the community. The community initiatives build on the strengths of our communities and systems to improve the quality of life and to create a sense of hope. Community Benefit initiatives build community capacity and individual empowerment through community organizing, leadership development, partnerships, and coalition building. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. In response to the global coronavirus pandemic, Ripon Medical Center Inc worked relentlessly to respond to community needs by developing and implementing strategies to address social needs of those served, providing screening & testing services, personal protective equipment and education throughout the community, as well as treatment for those who presented with COVID-19. Ripon Medical Center promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote community health. Ripon Medical Center also furthers its exempt purpose with the following activities: * Operates an emergency room that is open to all persons regardless of ability to pay, * Has an open medical staff with privileges available to all qualified physicians in the area, * Engages in the training and education of health care professionals, * Participates in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs * All surplus funds generated by SSMH entities are reinvested in improving our patient care delivery system.
Schedule H, Part VI, Line 6 Affiliated health care systemRipon Medical Center, Inc. is a 501(c)(3) organization and is a member of the integrated health care system know as SSM Health.
Schedule H, Part VI, Line 7 State filing of community benefit reportWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Fond du Lac County Health Department
160 S Macy StFond du LacWI54935396005696Government$10,000Save a smile dental program
Society of St Vincent de Paul
2033 Fish Hatchery RoadMadisonWI53713390824876501(c)(3)$10,000Support to neighbors in need in Dane County
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationTHE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Deann Thurmer
Director, President/CNO-Ripon Memorial Hospital$0$273,587$0$36,585$0$2,610$0$96,967$0$25,975$0$435,724$0$31,054
Mark Thompson MD
Director, Regional President-Medical Groups-Wisconsin$0$570,750$0$167,304$0$15,822$0$242,909$0$44,749$0$1,041,534$0$101,417
Kris Zimmer
Former Officer$0$0$0$219,008$0$372$0$0$0$0$0$219,379$0$372
Katherine Vergos
Former Officer$0$374,218$0$79,273$0$1,282$0$175,053$0$38,025$0$667,851$0$70,005
Douglas Long
Secretary, General Counsel at SSM Health$0$683,805$0$374,673$0$143,200$0$460,492$0$23,109$0$1,685,279$0$374,673
Randy Combs
Treasurer, Chief Financial Officer at SSM Health$0$940,014$0$182,693$0$167,895$0$478,907$0$6,945$0$1,776,454$0$82,693
Kyle Hunter
Former Key Employee$0$120,846$0$15,951$0$567$0$3,812$0$2,036$0$143,212$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationThe organization's top management official, president, 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;
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planPension 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 individuals listed on Part VII of Form 990 received distributions from the plan in 2021. 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 2021: Mark Thompson $50,292 Deann Thurmer $25,370 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2021. All distributions received from the plan in the current year were included in the individual's taxable compensation. Kris Zimmer $372

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a Program Service AccomplishmentsBriefly describe the organization's mission: Since it was founded in 1872 by Catholic sisters, SSM Health (SSMH) has existed to meet the health needs of the communities it serves. SSMH is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through one of the largest integrated delivery systems in the nation. With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSMH includes 23 acute care hospitals, one children's hospital, more than 300 physician offices and other outpatient and virtual care services, 10 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company, and an Accountable Care Organization. The health system employs nearly 40,000 people and is affiliated with 11,000 physicians making it one of the largest employers in every community it serves. In the tradition of its founding sisters, SSMH strives to fulfill its mission by providing exceptional health care to everyone who comes to its hospitals, regardless of their ability to pay. About Ripon Medical Center: Ripon Medical Center is a critical access hospital located in Ripon, Wisconsin. A new hospital was opened at the end of 2014, and the facility features private patient rooms, including those for medical/surgical, Intensive Care, and labor/delivery/recovery and postpartum rooms. Surgical Services are available on the hospital's first floor, immediately by the main entrance, and feature three surgical suites and one endoscopic procedure room. Healing spaces have been incorporated into the hospital for patients and families to seek solitude and comfort. A meditation room and healing garden, near the Emergency Department, are key features, as well as a lot of natural lighting. Care at Ripon Medical Center is complemented by hospitalists - physicians that specialize in taking care of patients while they are hospitalized. And, emergency care and urgent care services are available 24-hours-a-day, seven-days-a-week through highly-qualified doctors and nurses in the Emergency Department. The hospital also features a Wellness Center, open 24 hours a day, seven days a week with a large classroom for exercise classes. Ripon Medical Center has also earned a "High Performing" rating for chronic obstructive pulmonary disease (COPD) in recognition of care that was significantly better than the national average, as measured by factors such as patient outcomes. "High Performing" is the highest rating U.S. News awards for COPD care. Fewer than a third of all hospitals received any high-performing rating, and only 57 earned this rating in all nine Procedures & Conditions. Ripon Medical Center also furthers its exempt purpose with the following activities: * Operates an emergency room that is open to all persons regardless of ability to pay * Has an open medical staff with privileges available to all qualified physicians in the area * Engages in the training and education of health care professionals, * Participates in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs * All surplus funds generated by SSMH entities are reinvested in improving our patient care delivery system Quantifiable Uncompensated Care: This section includes a list of the types of programs and services that could be quantified as uncompensated care: Traditional Charity Care $ 191,248 Unpaid Cost of Medicaid $ 1,162,602 Total Quantifiable Uncompensated Care $ 1,353,850
Form 990, Part V, Line 1aALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223.
Form 990, Part V, Line 2aALL APPLICABLE W-2 AND W-3 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, AGNESIAN HEALTHCARE INC, EIN 39-0807236.
Form 990, Part VI, Line 15a Process for determining compensationA 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, Line 15b Process for determining compensationA 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, Line 6 Classes of members or stockholdersThe sole member of the corporation is Agnesian Healthcare Inc. Agnesian Healthcare Inc is a nonprofit 501(C)(3) organization. Both Ripon Medical Center and Agnesian Healthcare Inc are part of the integrated health care system known as SSM Health.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyThe 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, Line 7b Decisions requiring approval by members or stockholdersThe member has the following powers: 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 Section 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 Non-Controlled Subsidiary.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe 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, Line 12c Conflict of interest policyA 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, Line 19 Required documents available to the publicThe 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 VIII, Line 2f Other Program Service RevenueALL OTHER PROGRAM SERVICE REVENUE - Total Revenue: 180158, Related or Exempt Function Revenue: 180158, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other FeesMedical and other professional fees - Total Expense: 4523513, Program Service Expense: 3668976, Management and General Expenses: 854537, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesCHANGE IN BENEFICIAL INTEREST IN FOUNDATION - 172074;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (52 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
SSM Health Care Corporation
10101 Woodfield LaneSt LouisMO63132466029223Health CareMO501(c)(3)Type ISSM Health Ministriesfalse
SSMHC Liability Trust I
10101 Woodfield LaneSt LouisMO63132436331003InsuranceMO501(c)(3)Type ISSM Health Care Corporationfalse
SSM Consolidated Health Services
10101 Woodfield LaneSt LouisMO63132431473657Health CareMO501(c)(3)10SSM Health Care Corporationfalse
SSM Policy Institute
10101 Woodfield LaneSt LouisMO63132431788151Health CareMO501(c)(4)SSM Health Care Corporationfalse
SSM Health Care Portfolio Management Co
10101 Woodfield LaneSt LouisMO63132431825256ManagementMO501(c)(3)Type ISSM Health Care Corporationfalse
SSM Cardinal Glennon Children's Hospital
10101 Woodfield LaneSt LouisMO63132430738490Health CareMO501(c)(3)3SSM Health Care St Louisfalse
Cardinal Glennon Children's Foundation
10101 Woodfield LaneSt LouisMO63132431754347FundraisingMO501(c)(3)7SSM Cardinal Glennon Children's Hospitalfalse
SSM Health Foundation - St Louis
10101 Woodfield LaneSt LouisMO63132431552945FundraisingMO501(c)(3)7SSM Health Care St Louisfalse
SSM Health Care of Oklahoma Inc
10101 Woodfield LaneSt LouisMO63132730657693Health CareOK501(c)(3)3SSM Health Care Corporationfalse
The St Anthony Hospital Foundation Inc
10101 Woodfield LaneSt LouisMO63132736104300FundraisingOK501(c)(3)7SSM Health Care of Oklahomafalse
SSM Health Care of Wisconsin Inc
10101 Woodfield LaneSt LouisMO63132430688874Health CareWI501(c)(3)3SSM Health Care Corporationfalse
Dells Medical Building Inc
10101 Woodfield LaneSt LouisMO63132391613292MOBWI501(c)(2)SSM Health Care of Wisconsinfalse
St Mary's Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940686FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
St Clare Health Care Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940683FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
Home Health United Inc
2802 Walton Commons LaneMadisonWI53718391539827Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
Home Care United Inc
2802 Walton Commons LaneMadisonWI53718391776340Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
HHU Xtra Care Inc
2802 Walton Commons LaneMadisonWI53718391705111Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
SSM Health at Home Foundation of Wisconsin Inc
2802 Walton Commons LaneMadisonWI53718391839309FundraisingWI501(c)(3)Type IHome Health United Incfalse
SSM Regional Health Services
10101 Woodfield LaneSt LouisMO63132440579850Health CareMO501(c)(3)3SSM Health Care Corporationfalse
St Mary's Health Center Jefferson City Missouri Foundation
10101 Woodfield LaneSt LouisMO63132431575307FundraisingMO501(c)(3)Type ISSM Regional Health Servicesfalse
Good Samaritan Regional Health Center
10101 Woodfield LaneSt LouisMO63132430653587Health CareIL501(c)(3)3SSM Regional Health Servicesfalse
St Mary's Hospital Centralia Illinois
10101 Woodfield LaneSt LouisMO63132370662580Health CareIL501(c)(3)3SSM Regional Health Servicesfalse
St Mary's - Good Samaritan Inc
10101 Woodfield LaneSt LouisMO63132364170833Health CareIL501(c)(3)Type ISSM Regional Health Servicesfalse
Good Samaritan Regional Health Center Foundation
10101 Woodfield LaneSt LouisMO63132262884795FundraisingIL501(c)(3)7St Mary's-Good Samaritan Incfalse
St Mary's Hospital Foundation
10101 Woodfield LaneSt LouisMO63132364636691FundraisingIL501(c)(3)7St Mary's-Good Samaritan Incfalse
St Mary's Hospital Auxiliary
400 N PleasantCentraliaIL62801237126345FundraisingIL501(c)(3)10St Mary's Hospital Foundationfalse
SSM Health Businesses
10101 Woodfield LaneSt LouisMO63132431333488Health CareMO501(c)(3)10SSM Health Care Corporationfalse
SSM Health Care St Louis
10101 Woodfield LaneSt LouisMO63132431343281Health CareMO501(c)(3)3SSM Health Care Corporationfalse
Centralia Medical Services Bldg Assoc
10101 Woodfield LaneSt LouisMO63132237408025MOBIL501(c)(3)Type ISSM Regional Health Servicesfalse
St Mary's Janesville Foundation Inc
10101 Woodfield LaneSt LouisMO63132273439133FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
SSM Health Ministries
3221 McKelvey Road Suite 107BridgetonMO63044431012492Religious OrganizationMO501(c)(3)1NAfalse
Lee Dewey Corporation
10101 Woodfield LaneSt LouisMO63132731279603MOBOK501(c)(3)Type ISSM Health Care of Oklahomafalse
SSM Hospice & Home Care Foundation
10101 Woodfield LaneSt LouisMO63132300012246FundraisingMO501(c)(3)7SSM Health Businessesfalse
St Mary's Hospital Auxiliary
100 St Marys Medical PlazaJefferson CityMO65101436049878FundraisingMO501(c)(3)Type IINAfalse
Good Samaritan Hospital Auxiliary
1 Good Samaritan WayMount VernonIL62864237049599FundraisingIL501(c)(3)Type III-FINAfalse
St Anthony Shawnee Hospital Inc
1000 N Lee AveOklahoma CityOK73102455055149Health CareOK501(c)(3)3SSM Health Care of Oklahomafalse
SSM Audrain Health Care Inc
10101 Woodfield LaneSt LouisMO63132431550298Health CareMO501(c)(3)3SSM Regional Health Servicesfalse
Audrain Medical Center Foundation Inc
620 E Monroe StMexicoMO65265431265060FundraisingMO501(c)(3)Type INAfalse
SSM-SLUH Inc
10101 Woodfield LaneSt LouisMO63132474196634Health CareMO501(c)(3)3SSM Health Care St Louisfalse
SSM Health Plan
1277 Deming WayMadisonWI53717831979548InsuranceMO501(c)(4)SSM Health Businessesfalse
Agnesian Healthcare Inc
430 E Division StFond du LacWI54935390807236Health CareWI501(c)(3)3SSM Health Care of Wisconsinfalse
Waupun Memorial Hospital Inc
620 West Brown StreetWaupunWI53963390806265Health CareWI501(c)(3)3Agnesian Healthcare Incfalse
St Francis Home of Fond du Lac Wisconsin Inc
33 Everett StreetFond du LacWI54935391029998Health CareWI501(c)(3)10Agnesian Healthcare Incfalse
Sister Servants of Christ the King Villa Loretto
N8114 County WWMount CalvaryWI53057391022770Health CareWI501(c)(3)10Agnesian Healthcare Incfalse
Villa Rosa Inc
N8120 County WWMount CalvaryWI53057421670962Health CareWI501(c)(3)10Agnesian Healthcare Incfalse
The Christian Home and Rehabilitation Center Incorporated
331 Bly StreetWaupunWI53963390884514Health CareWI501(c)(3)10Agnesian Healthcare Incfalse
The Monroe Clinic Inc
515 22nd AvenueMonroeWI53566390808509Health CareWI501(c)(3)3SSM Health Care of Wisconsinfalse
Monroe Clinic and Hospital Foundation Inc
515 22nd AvenueMonroeWI53566205769038FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
Agnesian Healthcare Foundation Inc
430 E Division StFond du LacWI54935391684956FundraisingWI501(c)(3)Type ISSM Health Care of Wisconsinfalse
Shared Magnetic Resonance Imaging Facility Inc
1104 John Nolen DriveMadisonWI53713391534744Health CareWI501(c)(3)Type ISSM Health Care of Wisconsinfalse
SSM Health Cardinal Glennon Transport
10101 Woodfield LaneSt LouisMO63132863519607Health CareMO501(c)(3)Type ISSM Cardinal Glennon Children's Hospitalfalse
SSM Health Foundation
10101 Woodfield LaneSt LouisMO63132874109859FundraisingMO501(c)(3)Type ISSM Health Care Corporationfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
SSM St Joseph Endoscopy Center LLC
10101 Woodfield LaneSt LouisMO63132270046559Surgery ServicesMONAN/A
St Clare Imaging Services LLC
707 14th Street Suite ABarabooWI53913200122365Diag. ServicesWINAN/A
Mt Vernon Radiation Therapy Center LLC
10101 Woodfield LaneSt LouisMO63132201382620Radiation TherapyILNAN/A
Sleep & Neurology Center of Southern Illinois LLC
10101 Woodfield LaneSt LouisMO63132208468195Diag. ServicesILNAN/A
CHOWSMGSI Office Building LLC
10101 Woodfield LaneSt LouisMO63132371383861MOBILNAN/A
Oza Cancer Center LLC
10101 Woodfield LaneSt LouisMO63132201382727MOBILNAN/A
Shawnee Real Estate Holdings LLC
1000 N Lee AveOklahoma CityOK73102455458304MOBOKNAN/A
Dean Clinic & St Mary's Hospital Accountable Care Organization LLC
1808 West Beltline HighwayMadisonWI53713452995500Accountable Care OrganizationWINAN/A
Wisconsin Integrated Information Technology and Telemedicine Systems LLC
1808 West Beltline HighwayMadisonWI53713392016715Information Technology ServicesWINAN/A
Dean Health Holdings LLC
1277 Deming WayMadisonWI53717261594709Support ServicesWINAN/A
Wingra Building Group
1808 West Beltline HighwayMadisonWI53713390237060MOBWINAN/A
Janesville Riverview Clinic Building Partnership
1808 West Beltline HighwayMadisonWI53713396220698MOBWINAN/A
1110 N Classen Blvd LLC
1110 N Classen BoulevardOklahoma CityOK73106731158158MOBOKNAN/A
SSM St Clare Surgical Center LLC
10101 Woodfield LaneSt LouisMO63132261439695Surgery ServicesMONAN/A
Windmill LLP
50 Village View LaneChesterfieldMO63017431804651InvestmentsMONAN/A
Navitus Health Solutions LLC
361 Integrity DriveMadisonWI53717043608530Pharmacy BenefitsWINAN/A
SSM Select Rehab St Louis LLC
4714 Gettysburg RoadMechanicsburgPA17055263694972Health CareDENAN/A
Epiphany Rx LLC
361 Integrity DriveMadisonWI53717364855405Pharmacy BenefitsDENAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
SSM Managed Care Organization LLC
10101 Woodfield LaneSt LouisMO63132431708511Health PromotionMONAC Corporationfalse
FPP INC & Subs
10101 Woodfield LaneSt LouisMO63132431465174Health CareMONAC Corporationfalse
Diversified Health Services Corp
10101 Woodfield LaneSt LouisMO63132431369305Medical EquipmentMONAC Corporationfalse
SSM Properties Inc
10101 Woodfield LaneSt LouisMO63132431462486Property ServicesMONAC Corporationfalse
HealthFirst Physician Management Services
10101 Woodfield LaneSt LouisMO63132731534336Medical ServicesOKNAC Corporationfalse
SSMHC Liability Trust II
10101 Woodfield LaneSt LouisMO63132816128118InsuranceMONAC Corporationfalse
SSM Medical Group Inc
10101 Woodfield LaneSt LouisMO63132431664107Physician OfficesMONAC Corporationfalse
SSMHC Insurance Company
030310431InsuranceNAC CorporationfalsePO Box 1051 GTGrand CaymanCJKY11102CJ
Physicians Services Corp of Southern Illinois Inc
10101 Woodfield LaneSt LouisMO63132364161526Health CareILNAC Corporationfalse
Dean Health Systems Inc
1808 West Beltline HighwayMadisonWI53713391128616Physician OfficesWINAC Corporationfalse
Dean Health Insurance Inc
PO Box 56099MadisonWI53705391830837InsuranceWINAC Corporationfalse
Dean Health Plan Inc
PO Box 56099MadisonWI53705391535024InsuranceWINAC Corporationfalse
Dean Retail Services Inc
1808 West Beltline HighwayMadisonWI53713391717636Property ServicesWINAC Corporationfalse
Oza Oncology Inc
4117 Veterans Memorial DriveMt VernonIL62804371343746Physician OfficesILNAS Corporationfalse
SSM Health Janesville Campus Condominium Association Inc
1808 West Beltline HighwayMadisonWI53713832038674Condo associationWINAC Corporationfalse
SSM Health Pharmacy LLC
10101 Woodfield LaneSt LouisMO63132264031708PharmacyMONAC Corporationfalse
SSM Health Insurance Company
1277 Deming WayMadisonWI53717834718249InsuranceMONAC Corporationfalse
Navitus Holdings LLC
1808 West Beltline HighwayMadisonWI53713800968174PharmacyWINAC Corporationfalse
MS Community JV LLC
401 Carlson Parkway CP330MinnetonkaMN55305873240022InsuranceDENAC Corporationfalse
Quality Drug Corporation
239 BroadwayLaguna BeachCA92651330644268Pharmacy benefitsCANAC Corporationfalse
St Mary's Hospital Campus Condominium Owners Association Inc
707 South Mills StreetMadisonWI53715000000000Condo associationWINAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd