2021-11-03T17:34:14-05:00 2020-12-31 990 2020-01-01 390806265 Waupun Memorial Hospital WAUP 9209265519 620 West Brown Street Waupun WI 53963 RANDY COMBS TREASURER 2021-11-03 RANDY COMBS 999009999 2020 2022-09-23 18:48:47Z DEANN THURMER 620 West Brown Street Waupun WI 53963 46719889 false 0928 X https://www.ssmhealth.com/locations/waupun-memorial-hospital X 1949 WI THE MISSION OF WAUPUN MEMORIAL HOSPITAL 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. 11 10 0 90 32273 0 39837 5010426 48136767 41223734 -7441 -58775 588588 485255 48757751 46660640 18819 32705 0 20968930 20684478 0 0 19357965 20844359 40345714 41561542 8412037 5099098 60610439 75719504 5238016 15326773 55372423 60392731 THE MISSION OF WAUPUN MEMORIAL HOSPITAL 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. false false 38936221 32705 41223734 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. 38936221 true true false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true X 0 0 0 true true false false false false false false false false false false false X 11 10 false false false false true true true true true false false false true true true true true false false false X Dennis Bangart 9209292300 430 E Division Street Fond du Lac WI 54935 Deann Thurmer Director, President/CNO-Waupun Memorial Hospital 20.0 20.0 X X 0 314069 83889 Jan Harmsen Director, Chair 1.0 0 X X 0 0 0 Jeffrey Homan Director, Vice Chair 1.0 0 X X 0 0 0 David Hopp Director 1.0 0 X 0 0 0 Doug Cronin Director 1.0 0 X 0 0 0 Karen Reynolds Director 1.0 0 X 0 0 0 Kathleen Hendricks Director 1.0 0 X 0 0 0 Kathy Duchac Director 1.0 0 X 0 0 0 Robert Nagle Director 1.0 0 X 0 0 0 Roxy Schouten Director 1.0 0 X 0 0 0 Scott Hansfield Director, Chief of Staff Rep 1.0 0 X 0 0 0 Kris Zimmer Pt Yr Treasurer, Pt Yr Chief Financial Officer at SSM Health 1.0 67.0 X 0 1717045 73075 Randy Combs Treasurer, Chief Financial Officer at SSM Health 1.0 64.0 X 0 403263 84602 Diane Posthuma Director-RN, Emergency 40.0 0 X 130482 0 6894 Paula Friedman Former Officer 0.0 0.0 X 0 507002 0 130482 2941379 248460 1 true true false SHARED MEDICAL SERVICES INC PO BOX 330 COTTAGE GROVE WI 53527 IMAGING SERVICES 376315 SHEA ELECTRIC & COMMUNICATIONS LLC 1922 S WASHBURN ST OSHKOSH WI 54904 ELECTRICIAN 213650 US FOODSERVICE INC 9399 W HIGGINS ROAD ROSEMONT IL 60018 DIETARY SERVICES 162201 FOND DU LAC REGIONAL CLINIC SC 420 E DIVISION ST FOND DU LAC WI 54935 PHYSICIAN SERVICES 148923 SUPERIOR HEALTH LINENS LLC 5005 S PACKAND AVENUE CUDAHY WI 53110 LAUNDRY/LINEN SERVICES 123354 5 137729 4872697 5010426 Net Patient Service Revenue 621110 41223734 41223734 0 0 0 0 41223734 474 474 343054 343054 0 343054 343054 59249 0 -59249 -59249 -59249 Cafeteria 722210 109928 109928 Mobile meals 900099 32273 32273 0 0 0 0 142201 46660640 41223734 32273 394207 X 32705 32705 16967148 16005317 961831 332653 313796 18857 2331936 2199744 132192 1052741 993063 59678 118 118 2288 2288 8666908 7566395 1100513 0 72601 72601 1432081 1347336 84745 2860 2860 1155275 969304 185971 47653 41126 6527 30635 30635 3361207 3361207 96815 96815 Medical supplies 5721710 5721710 Medicaid Provider Tax 228224 228224 Licenses and taxes 25984 25984 0 0 0 0 41561542 38936221 2625321 0 11807595 7816797 0 0 8322117 12884267 0 0 0 0 0 7013 13205 177119 118355 45398511 9312720 38695367 36085791 0 0 380148 301357 0 1221080 18499732 60610439 75719504 3358719 2718465 0 0 593750 0 0 0 0 0 0 1879297 12014558 5238016 15326773 X 54992275 60091374 380148 301357 55372423 60392731 60610439 75719504 X 5099098 -78790 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2288 2288 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 190000 190000 36858557 5771199 31087358 813475 308425 505050 7535004 3233096 4301908 1475 1475 36085791 Due from affiliates 18427753 OPERATING RIGHT-OF-USE ASSETS 71979 18499732 Due to affiliates 9549128 Third Party Payor 2393393 OPERATING LEASE OBLIGATIONS 72037 12014558 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote WAUPUN MEMORIAL HOSPITAL'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 2020 OR 2019. true true X true X true X true true false true true 98966 98966 0.0024 4241574 2348578 1892996 0.0455 142188 206148 0 0.0 0 0 4482728 2554726 1991962 0.0479 10284 10284 0.0002 13023 13023 0.0003 0 0.0 0 0.0 38490 38490 0.0009 0 0 61797 0 61797 0.0015 0 0 4544525 2554726 2053759 0.0494 0 0.0 0 0.0 0 0.0 2814 2814 0.0001 0 0.0 0 0.0 0 0.0 1302 1302 0.0000 0 0.0 0 0 4116 0 4116 0.0001 true 2367042 9175890 9540095 -364205 X true true 1 1 Waupun Memorial Hospital 620 West Brown Street Waupun WI 53963 https://www.ssmhealth.com/locations/waupun-memorial-hospital 1031 X X X A A 1 false false true X X X X X X X X X 18 true true true true X https://www.ssmhealth.com/resources/about/community-health X true 18 true https://www.ssmhealth.com/resources/about/community-health false true X 200.0 400.0 X X X X X true true X X X true X https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance X https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance X https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE 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, 1 Facility A, 1 - Waupun Memorial Hospital. The hospital facility took into account input from persons who represent the broad interests of the community served through the following process: key informants in Fond du Lac County were identified by the Community Health Assessment Task Force members and interviewed by the Fond du Lac County Health Department. Interviews were completed in-person and electronically via questionnaires in February and March 2018, and interviewees were asked to rank twelve health focus areas from highest to lowest priority, with number one being the top priority health issue to address in Fond du Lac County based on the population served. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - Waupun Memorial Hospital. HOSPITALS INCLUDED IN THE CHNA WERE AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL), WAUPUN MEMORIAL HOSPITAL, AND RIPON MEDICAL CENTER. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - Waupun Memorial Hospital. While Waupun Memorial Hospital conducted their own CHNA, the hospital collaborated extensively with the Fond du Lac County Health Department. Schedule H, Part V, Section B, Line 7 Facility A, 1 Facility A, 1 - Waupun Memorial Hospital. In addition to the County's website, the Healthy 2020 Coalition made the results of the CHNA widely available through a series of community meetings, distribution of community health improvement plan flyers, newspaper articles, and the Healthy 2020 website. www.livingwellfdl.org. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Waupun Memorial Hospital. The hospital identified various health needs in the 2018 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: - Nutrition and physical activity - Mental health - Alcohol and other drug abuse Nutrition and physical activity The hospital has identified nutrition and physical activity as a community health priority. The hospital aims to increase the number of Fond du Lac County residents living at healthy weight for their height through eating healthier and being more active. Additionally, statistics show: - Almost 3 in 4 adults in the area classify as being overweight or obese - Only 1 in 4 adults reported eating the recommended servings of vegetables per day - About half of adults reported eating the recommended servings of fruit per day - Only 1 in 4 met the recommended amount of physical activity and strength training - For youth, 1 in 4 are overweight or obese - Less than half of youth report eating the recommended servings of fruits and vegetables - Only 1 in 5 youth meet the recommended amount of physical activity and strength training The hospital's action plan includes the following initiatives to improve nutrition and physical activity in the community served: - Improve physical activity through the following: - Increase trail usage by 10% from 1496 (2016) total bike/pedestrian counts over a weeklong period to 1646 - Implement one community-wide physical activity campaign - Increase the number of teachers in the FDL School District implementing wearable technology with students from 19 to 21 - Increase the number of schools participating in safe routes to school from 23 to 27 - Improve fruit and vegetable consumption through the following: - Increase SNAP usage at the Wednesday Downtown FDL Farmers Market by 25% from $278 (2018 YTD) to $348 - Increase SNAP usage at the Saturday Downtown FDL Farmers Market by 10% from $5,000 (2018 YTD) to $5,500 - Increase the number of food forests planted from 4 (2018) to 5 - Increase the number of pounds of produce donated at the FDL farmers market by 10% from 3,500 lbs (2018 YTD) to 3,850 lbs - Increase the health promotion programs offered to low-income housing residents from zero to 9 - Improve breastfeeding rates through the following: - Increase the number of childcare centers and business centers who have adopted the Ten Steps to Breastfeeding-Friendly Toolkit from 7 (2017) to 15 - Increase the attendance at the annual Breastfeeding Celebration from 85 (2018) to 125 Mental Health The hospital has identified mental health as a top community health priority. The facility is striving to reduce the stigma around mental health and suicide, increase access to behavioral health services at any age and for those in high-risk groups, and decrease the number of deaths by suicide. Additionally, statistics show: - About 1 in 5 Fond du Lac County residents reported a mental health condition - 5 percent of adults reported to having considered suicide in the last year - 15 percent of high school students reported to having considered suicide in the last year - The number of suicides in Fond du Lac County has nearly doubled from 2013 to 2017 The hospital's action plan includes the following initiatives to address mental health in the community served: - Decrease number of deaths by suicide through earlier identification of mental distress through the following: - Increasing number of those who live and work in Fond du Lac County who are trained as gatekeepers in Question, Persuade, Refer (QPR), Mental Health First Aid for Adults (MHFA), and Youth Mental Health First Aid (YMHFA) - Promoting use of universal and targeted screening across the lifespan in both clinical and non-clinical settings - Reduce stigma around mental health and suicide which can limit help-seeking behaviors with the following: - Education & Awareness activities: Coordinated messaging campaign (via radio, website, newspaper, etc.), including the facts related to mental health conditions, their occurrence in the general population, and the effectiveness of treatment - Promoting positive mental health and resiliency - Partner with individuals who have lived experience to share their stories and inform efforts - Increase access to behavioral health services across the lifespan, and for those in high-risk groups through the following: - Develop a Pathways to Care Mental Health Navigation Tool for Fond du Lac County adults - Develop a more universal approach to safety planning across the county, which includes creating a document with a common language and format that can be used across populations and settings Alcohol and Other Drug Abuse The hospital has identified alcohol and other drug abuse as a key priority to address within the community. The hospital facility with community groups to reduce availability of alcohol and illicit drugs, binge drinking, and to improve procedures to manage and address opioid abuse. Additionally, statistics show: - 1 in 5 adults and youth have reported binge drinking - 1 in 3 youth report very or fairly easy access to prescription medications for misuse - About 1 in 10 youth reported electronic vapor product use over a 30-day period - In 2017, there were 7 opioid overdose deaths in Fond du Lac County The hospital's action plan includes the following initiatives to improve alcohol and other drug abuse in the community served: - Reduce underage drinking and adult binge drinking through the following: - Increase the number of festivals evaluated annually throughout Fond du Lac County from 7 (2017) to 12 - Increase the number of law enforcement agencies completing annual compliance checks from 2 (2017) to 4 - Reduce misuse and abuse of drugs, particularly opioids through the following: - Increase the number Narcan kits distributed annually through community Narcan Trainings from 54 (2017) to 75 - Increase number of providers using the evidence-informed screening tool SBIRT for early intervention and referral for treatment from 0 (2017) to 4 or more The hospital has no plans to discontinue other community benefit efforts addressing the remaining CHNA-identified needs and address additional community needs within its efforts. The following community needs were identified and will be addressed as resources allow (additional descriptions available in the 2018 CHNA): - Trauma-informed care - Social determinants of health Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Waupun Memorial Hospital. Patients and their guarantor's income is used in determining income level for free or discounted care. 0 Schedule H, Part I, Line 3c Discounted Care Exceptions Patients 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 organization SSM Health Care Corporation, 46-6029223 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The 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 Activities WAUPUN MEMORIAL HOSPITAL 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: DISPOSAL OF SHARPS FROM COMMUNITY HOMES; WORKFORCE DEVELOPMENT: JOB SHADOWING FOR FUTURE HEALTH CARE PROFESSIONALS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AS 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 Methodology FOR 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 footnote Waupun Memorial Hospital 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, 2020 consolidated audit is contained on page 13 and 14 of the attached financial statements. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE 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 assistance Waupun Memorial Hospital 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. Waupun Memorial Hospital embraces its responsibility to serve the communities in which it participates by establishing sound business practices. Waupun Memorial Hospital'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 Waupun Memorial Hospital's collection and financial assistance policies. Schedule H, Part V, Section B, Line 16a FAP website A - Waupun Memorial Hospital: 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 website A - Waupun Memorial Hospital: 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 website A - Waupun Memorial Hospital: Line 16c URL: https://www.ssmhealth.com/resources/patients-visitors/pay-my-bill/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment SSM 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 assistance Each 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 information Waupun Memorial Hospital is located in Waupun, Wisconsin, and defines its primary service area as Fond du Lac County, Wisconsin. In 2019, the population of the county was estimated at 103,403 adults. Approximately 17.5% of the population is age 65 or older, and 21.9% have obtained a Bachelor's degree or higher. Over one-third of the population lives in a rural area. The area of Fond du Lac County has an unemployment rate of 3.5%, lower than the state of Wisconsin and the United States as a whole. Median household incomes for the county are also slightly above state and national amounts. Additional demographic and statistical data on Fond du Lac County's residents and their health can be found beginning on page 94 of the 2018 CHNA. Schedule H, Part VI, Line 5 Promotion of community health Waupun Memorial Hospital 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, Waupun Memorial Hospital 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. Waupun Memorial Hospital promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote community health. Waupun Memorial Hospital 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 system Waupun Memorial Hospital 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 report WI true University of Wisconsin Medical Foundation 1685 Highland Ave Room 3165 Madison WI 53705 391824445 501(c)(3) 13000 General support Moraine Park Foundation 235 N National Avenue Fond du Lac WI 54935 510188166 501(c)(3) 10000 General support 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE 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. true true false false false false false false false Deann Thurmer Director, President/CNO-Waupun Memorial Hospital 0 267719 0 43810 0 2540 0 60802 0 23087 0 397958 0 43810 Paula Friedman Former Officer 0 0 0 249317 0 257685 0 0 0 0 0 507002 0 258551 Kris Zimmer Pt Yr Treasurer, Pt Yr Chief Financial Officer at SSM Health 0 370664 0 803048 0 543333 0 56137 0 16938 0 1790120 0 1162526 Randy Combs Treasurer, Chief Financial Officer at SSM Health 0 216927 0 100000 0 86336 0 82693 0 1909 0 487865 0 84600 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The 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 4a Severance or change-of-control payment SSM Health has adopted a severance policy to provide a financial transition in the event of involuntary termination without cause for executive level positions. The amount of the compensation is based on the position held and length of service with SSMH. The following individuals listed in Part VII of the Form 990 received payments under the plan in the current year: Paula Friedman $257,685 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Pension Restoration Plan: SSM Health (SSMH) provides this supplemental defined benefit nonqualified retirement plan to any employee who is a participant in the SSMH qualified defined benefit plan who earns over the Internal Revenue Service compensation limit. The plan "restores" the benefits to these employees that would have been provided under the SSMH qualified plan if the regulations did not impose compensation limits. An individual can take a distribution from the plan at (1) age 65 or older if the individual is still employed by SSMH or (2) age 55 or older if the individual is no longer employed by SSMH. No individuals listed on Part VII of Form 990 received distributions from the plan in 2020. 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 2020: Deann Thurmer $21,600 Kris Zimmer $54,000 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2020. All distributions received from the plan in the current year were included in the individual's taxable compensation. Kris Zimmer $493,428 Randy Combs $84.600 During 2020, the following individuals participated in a nonqualified retirement plan from the organization or a related organization. The amounts reported below represent the change in accrued benefit for each individual and also include amounts accrued under the pension restoration plan: Kris Zimmer $26,226 Form 990, Part III, Line 4a Program Service Accomplishments Briefly 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 Waupun Memorial Hospital: Waupun Memorial Hospital is a critical access hospital located in Waupun, Wisconsin, and provides a full range of inpatient and outpatient services to Waupun and the surrounding rural areas. Waupun Memorial Hospital features a two-story provider clinic, consolidating all its provider services into one facility with a direct connection to the larger resources of the hospital. A state-of-the-art surgery area features three high-tech operating rooms, an endoscopy procedure room, 11 pre/postoperative patient rooms, four post anesthesia recovery rooms and centralized sterile processing area. The hospital's staff of associates and volunteers is dedicated to providing services in the areas of laboratory, cardiopulmonary, rehabilitation, radiology, ultrasound, MRI, surgical, emergency, outpatient dialysis, medical/surgical services, intensive care and obstetrics. In 2018, Waupun Memorial Hospital received certification of its Cardiac Rehab program by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). WMH was recognized for its commitment to improving the quality of life by enhancing standards of care. AACVPR Program Certification is the only peer-review accreditation process designed to review individual programs for adherence to standards and guidelines developed and published by AACVPR and other professional societies. Each program is reviewed by the AACVPR Program Certification Committee and Certification is awarded by the AACVPR Board of Directors. AACVPR-certified programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available. Waupun Memorial Hospital 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 $ 98,966 Unpaid Cost of Medicaid $ 1,892,996 Unpaid Cost of Medicare $ 364,205 Total Quantifiable Uncompensated Care $ 2,356,167 Form 990, Part V, Line 1a ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223. Form 990, Part V, Line 2a ALL 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 compensation A related organization utilized the following to determine compensation: (1) independent compensation consultant; (2) compensation survey or study; (3) approval by the board or compensation committee. Form 990, Part VI, Line 15b Process for determining compensation A related organization utilized the following to determine compensation: (1) independent compensation consultant; (2) compensation survey or study; (3) approval by the board or compensation committee. Form 990, Part VI, Line 6 Classes of members or stockholders The sole member of the corporation is Agnesian Healthcare Inc. Agnesian Healthcare Inc is a nonprofit 501(C)(3) organization. Both Waupun Memorial Hospital 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 body The member has the power to appoint additional, successor or replacement members and to appoint and remove the appointed directors and the ex officio directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The 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 body The Form 990 is prepared by the Tax Department of the parent organization, SSM Health Care Corporation (SSM). The Form 990 is reviewed by certain members of Senior Management. Any questions are addressed to the Tax Director of SSM prior to filing the Form 990 with the Internal Revenue Service. A copy of the Form 990 is provided to the Board of Directors at the next regularly scheduled board meeting. Form 990, Part VI, Line 12c Conflict of interest policy The organization has a written conflict of interest and insider transaction policy that 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 public The year-end audited consolidated financial statements and unaudited quarterly consolidated financial statements for the SSM Health System are made available to the public on SSM Health's website. The organization's Articles of Incorporation are available on the Missouri Secretary of State's website. Copies of the Form 990 and the conflict of interest policy are available to the public upon request. Form 990, Part IX, Line 11g Other Fees Medical and other professional services - Total Expense: 8666908, Program Service Expense: 7566395, Management and General Expenses: 1100513, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN BENEFICIAL INTEREST IN FOUNDATION - -78790; SSM Health Care Corporation 10101 Woodfield Lane St Louis MO 63132 466029223 Health Care MO 501(c)(3) Type I SSM Health Ministries false SSMHC Liability Trust I 10101 Woodfield Lane St Louis MO 63132 436331003 Insurance MO 501(c)(3) Type I SSM Health Care Corporation false SSM Consolidated Health Services 10101 Woodfield Lane St Louis MO 63132 431473657 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Policy Institute 10101 Woodfield Lane St Louis MO 63132 431788151 Health Care MO 501(c)(4) SSM Health Care Corporation false SSM Health Care Portfolio Management Co 10101 Woodfield Lane St Louis MO 63132 431825256 Management MO 501(c)(3) Type I SSM Health Care Corporation false SSM Cardinal Glennon Children's Hospital 10101 Woodfield Lane St Louis MO 63132 430738490 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false Cardinal Glennon Children's Foundation 10101 Woodfield Lane St Louis MO 63132 431754347 Fundraising MO 501(c)(3) 7 SSM Cardinal Glennon Children's Hospital false SSM Health Foundation - St Louis 10101 Woodfield Lane St Louis MO 63132 431552945 Fundraising MO 501(c)(3) 7 SSM Health Care St Louis false SSM Health Care of Oklahoma Inc 10101 Woodfield Lane St Louis MO 63132 730657693 Health Care OK 501(c)(3) 3 SSM Health Care Corporation false The St Anthony Hospital Foundation Inc 10101 Woodfield Lane St Louis MO 63132 736104300 Fundraising OK 501(c)(3) 7 SSM Health Care of Oklahoma false SSM Health Care of Wisconsin Inc 10101 Woodfield Lane St Louis MO 63132 430688874 Health Care WI 501(c)(3) 3 SSM Health Care Corporation false Dells Medical Building Inc 10101 Woodfield Lane St Louis MO 63132 391613292 MOB WI 501(c)(2) SSM Health Care of Wisconsin false St Mary's Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940686 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false St Clare Health Care Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940683 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Home Health United Inc 2802 Walton Commons Lane Madison WI 53718 391539827 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false Home Care United Inc 2802 Walton Commons Lane Madison WI 53718 391776340 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false HHU Xtra Care Inc 2802 Walton Commons Lane Madison WI 53718 391705111 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false SSM Health at Home Foundation of Wisconsin Inc 2802 Walton Commons Lane Madison WI 53718 391839309 Fundraising WI 501(c)(3) Type I Home Health United Inc false SSM Regional Health Services 10101 Woodfield Lane St Louis MO 63132 440579850 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false St Mary's Health Center Jefferson City Missouri Foundation 10101 Woodfield Lane St Louis MO 63132 431575307 Fundraising MO 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center 10101 Woodfield Lane St Louis MO 63132 430653587 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's Hospital Centralia Illinois 10101 Woodfield Lane St Louis MO 63132 370662580 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's - Good Samaritan Inc 10101 Woodfield Lane St Louis MO 63132 364170833 Health Care IL 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center Foundation 10101 Woodfield Lane St Louis MO 63132 262884795 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Foundation 10101 Woodfield Lane St Louis MO 63132 364636691 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Auxiliary 400 N Pleasant Centralia IL 62801 237126345 Fundraising IL 501(c)(3) 10 St Mary's Hospital Foundation false SSM Health Businesses 10101 Woodfield Lane St Louis MO 63132 431333488 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Health Care St Louis 10101 Woodfield Lane St Louis MO 63132 431343281 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false Centralia Medical Services Bldg Assoc 10101 Woodfield Lane St Louis MO 63132 237408025 MOB IL 501(c)(3) Type I SSM Regional Health Services false St Mary's Janesville Foundation Inc 10101 Woodfield Lane St Louis MO 63132 273439133 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false SSM Health Ministries 3221 McKelvey Road Suite 107 Bridgeton MO 63044 431012492 Religious Organization MO 501(c)(3) 1 NA false Lee Dewey Corporation 10101 Woodfield Lane St Louis MO 63132 731279603 MOB OK 501(c)(3) Type I SSM Health Care of Oklahoma false SSM Hospice & Home Care Foundation 10101 Woodfield Lane St Louis MO 63132 300012246 Fundraising MO 501(c)(3) 7 SSM Health Businesses false St Mary's Hospital Auxiliary 100 St Marys Medical Plaza Jefferson City MO 65101 436049878 Fundraising MO 501(c)(3) Type II NA false Good Samaritan Hospital Auxiliary 1 Good Samaritan Way Mount Vernon IL 62864 237049599 Fundraising IL 501(c)(3) Type III-FI NA false St Anthony Shawnee Hospital Inc 1000 N Lee Ave Oklahoma City OK 73102 455055149 Health Care OK 501(c)(3) 3 SSM Health Care of Oklahoma false SSM Audrain Health Care Inc 10101 Woodfield Lane St Louis MO 63132 431550298 Health Care MO 501(c)(3) 3 SSM Regional Health Services false Audrain Medical Center Foundation Inc 620 E Monroe St Mexico MO 65265 431265060 Fundraising MO 501(c)(3) Type I NA false SSM-SLUH Inc 10101 Woodfield Lane St Louis MO 63132 474196634 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false SSM Health Plan 1277 Deming Way Madison WI 53717 831979548 Insurance MO 501(c)(4) SSM Health Businesses false Agnesian Healthcare Inc 430 E Division St Fond du Lac WI 54935 390807236 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Ripon Medical Center Inc 845 Parkside Street Ripon WI 54971 391101287 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc false St Francis Home of Fond du Lac Wisconsin Inc 33 Everett Street Fond du Lac WI 54935 391029998 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Sister Servants of Christ the King Villa Loretto N8114 County WW Mount Calvary WI 53057 391022770 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Villa Rosa Inc N8120 County WW Mount Calvary WI 53057 421670962 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Christian Home and Rehabilitation Center Incorporated 331 Bly Street Waupun WI 53963 390884514 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Monroe Clinic Inc 515 22nd Avenue Monroe WI 53566 390808509 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Monroe Clinic and Hospital Foundation Inc 515 22nd Avenue Monroe WI 53566 205769038 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Agnesian Healthcare Foundation Inc 430 E Division St Fond du Lac WI 54935 391684956 Fundraising WI 501(c)(3) Type I SSM Health Care of Wisconsin false Shared Magnetic Resonance Imaging Facility Inc 1104 John Nolen Drive Madison WI 53713 391534744 Health Care WI 501(c)(3) Type I SSM Health Care of Wisconsin false SSM St Joseph Endoscopy Center LLC 10101 Woodfield Lane St Louis MO 63132 270046559 Surgery Services MO NA N/A St Clare Imaging Services LLC 707 14th Street Suite A Baraboo WI 53913 200122365 Diag. Services WI NA N/A Mt Vernon Radiation Therapy Center LLC 10101 Woodfield Lane St Louis MO 63132 201382620 Radiation Therapy IL NA N/A Sleep & Neurology Center of Southern Illinois LLC 10101 Woodfield Lane St Louis MO 63132 208468195 Diag. Services IL NA N/A CHOWSMGSI Office Building LLC 10101 Woodfield Lane St Louis MO 63132 371383861 MOB IL NA N/A Oza Cancer Center LLC 10101 Woodfield Lane St Louis MO 63132 201382727 MOB IL NA N/A Shawnee Real Estate Holdings LLC 1000 N Lee Ave Oklahoma City OK 73102 455458304 MOB OK NA N/A Dean Clinic & St Mary's Hospital Accountable Care Organization LLC 1808 West Beltline Highway Madison WI 53713 452995500 Accountable Care Organization WI NA N/A Wisconsin Integrated Information Technology and Telemedicine Systems LLC 1808 West Beltline Highway Madison WI 53713 392016715 Information Technology Services WI NA N/A Dean Health Holdings LLC 1277 Deming Way Madison WI 53717 261594709 Support Services WI NA N/A Wingra Building Group 1808 West Beltline Highway Madison WI 53713 390237060 MOB WI NA N/A Janesville Riverview Clinic Building Partnership 1808 West Beltline Highway Madison WI 53713 396220698 MOB WI NA N/A 1110 N Classen Blvd LLC 1110 N Classen Boulevard Oklahoma City OK 73106 731158158 MOB OK NA N/A SSM St Clare Surgical Center LLC 10101 Woodfield Lane St Louis MO 63132 261439695 Surgery Services MO NA N/A Windmill LLP 50 Village View Lane Chesterfield MO 63017 431804651 Investments MO NA N/A Navitus Holdings LLC 1808 West Beltline Highway Madison WI 53713 800968174 Pharmacy Benefits WI NA N/A SSM Managed Care Organization LLC 10101 Woodfield Lane St Louis MO 63132 431708511 Health Promotion MO NA C Corporation false FPP INC & Subs 10101 Woodfield Lane St Louis MO 63132 431465174 Health Care MO NA C Corporation false Diversified Health Services Corp 10101 Woodfield Lane St Louis MO 63132 431369305 Medical Equipment MO NA C Corporation false SSM Properties Inc 10101 Woodfield Lane St Louis MO 63132 431462486 Property Services MO NA C Corporation false HealthFirst Physician Management Services 10101 Woodfield Lane St Louis MO 63132 731534336 Medical Services OK NA C Corporation false SSMHC Liability Trust II 10101 Woodfield Lane St Louis MO 63132 816128118 Insurance MO NA C Corporation false SSM Medical Group Inc 10101 Woodfield Lane St Louis MO 63132 431664107 Physician Offices MO NA C Corporation false SSMHC Insurance Company 10101 Woodfield Lane St Louis MO 63132 030310431 Insurance CJ NA C Corporation false Physicians Services Corp of Southern Illinois Inc 10101 Woodfield Lane St Louis MO 63132 364161526 Health Care IL NA C Corporation false Dean Health Systems Inc 1808 West Beltline Highway Madison WI 53713 391128616 Physician Offices WI NA C Corporation false Dean Health Insurance Inc PO Box 56099 Madison WI 53705 391830837 Insurance WI NA C Corporation false Dean Health Plan Inc PO Box 56099 Madison WI 53705 391535024 Insurance WI NA C Corporation false Dean Retail Services Inc 1808 West Beltline Highway Madison WI 53713 391717636 Property Services WI NA C Corporation false Oza Oncology Inc 4117 Veterans Memorial Drive Mt Vernon IL 62804 371343746 Physician Offices IL NA S Corporation false SSM Health Janesville Campus Condominium Association Inc 1808 West Beltline Highway Madison WI 53713 832038674 Condo association WI NA C Corporation false SSM Health Pharmacy LLC 10101 Woodfield Lane St Louis MO 63132 264031708 Pharmacy MO NA C Corporation false Dane County Cytology Center Inc 2000 Engel Street Suite 201 Madison WI 53713 391414219 Medical Services WI NA C Corporation false SSM Health Insurance Company 1277 Deming Way Madison WI 53717 834718249 Insurance MO NA C Corporation false St Mary's Hospital Campus Condominium Owners Association Inc 707 South Mills Street Madison WI 53715 000000000 Condo association WI NA C Corporation false false false true false false false false false false true true false true false true false false false false