ST ANTHONY SHAWNEE HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY SHAWNEE HOSPITAL INC (EIN 45-5055149)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-04
- IRS object ID
- 202003099349302365
- Schema version
- 2019v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-04T15:34:00-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455055149 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Shawnee Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STAN | BusinessNameControlTxt |
| Phone | 4053955626 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 Woodfield Lane | AddressLine1Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Doug Long | PersonNm |
| Person Title | Secretary | PersonTitleTxt |
| Signature | 2020-11-04 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSM Health St Anthony Hospital - Shawnee | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Charles Skillings | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 Woodfield Lane | AddressLine1Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $143,061,672 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | TO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 955 | TotalEmployeeCnt |
| Total Volunteers | 89 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $678,286 | PYContributionsGrantsAmt |
| CY Contributions Grants | $138,876 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $133,059,904 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $142,088,740 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,568 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,421 | CYInvestmentIncomeAmt |
| PY Other Revenue | $607,071 | PYOtherRevenueAmt |
| CY Other Revenue | $670,502 | CYOtherRevenueAmt |
| PY Total Revenue | $134,358,829 | PYTotalRevenueAmt |
| CY Total Revenue | $142,907,539 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $109,098 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $118,023 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $51,438,905 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,024,197 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $71,955,870 | PYOtherExpensesAmt |
| CY Other Expenses | $78,408,514 | CYOtherExpensesAmt |
| PY Total Expenses | $123,503,873 | PYTotalExpensesAmt |
| CY Total Expenses | $133,550,734 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,854,956 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,356,805 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $245,166,332 | TotalAssetsBOYAmt |
| Total Assets EOY | $303,635,734 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $145,421,672 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $194,534,269 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $99,744,660 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $109,101,465 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $126,943,675 | ExpenseAmt |
| Grant | $118,023 | GrantAmt |
| Revenue | $142,088,740 | RevenueAmt |
| Desc | Please see Schedule O for a complete description of program service accomplishments. | Desc |
| Total Program Service Expenses | $126,943,675 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 955 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennifer Pierce | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4053955626 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1102 W McArthur | AddressLine1Txt |
| City | Shawnee | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Joe Hodges | ||||||||||
| Director, Chairperson, Regional President - SSM Health Care of Oklahoma | 1.0 | 42.0 | Yes (X) | Yes (X) | $0 | $926,611 | $523,258 | |||
| Patrick Mccruden | ||||||||||
| Director, Vice Chair, Chief Mission Integration Officer-SSM Health | 1.0 | 42.0 | Yes (X) | Yes (X) | $0 | $416,432 | $294,191 | |||
| Duke Ligon | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Gregory McKinnis | ||||||||||
| Director, Physician at SSM Health St. Anthony Hospital | 1.0 | 2.0 | Yes (X) | $0 | $1,181 | $0 | ||||
| Iftikhar Ahmad | ||||||||||
| Director, Physician at SSM Health St. Anthony Hospital | 1.0 | 41.0 | Yes (X) | $0 | $0 | $0 | ||||
| Margaret Salyer | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Marion McMillan | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Natalie Shirley | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Paige Bass | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Teresa Rose-Crook | ||||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||||
| Charles Skillings | ||||||||||
| Hospital President, SSM Health St. Anthony Hospital - Shawnee | 40.0 | 0 | Yes (X) | $563,967 | $0 | $166,430 | ||||
| Doug Long | ||||||||||
| Secretary, General Counsel at SSM Health | 1.0 | 65.2 | Yes (X) | $0 | $229,550 | $471,986 | ||||
| Kris Zimmer | ||||||||||
| Treasurer, Chief Financial Officer at SSM Health | 1.0 | 67.0 | Yes (X) | $0 | $1,365,634 | $813,620 | ||||
| Paula Friedman | ||||||||||
| Pt Yr Vice President, Pt Yr Senior VP-Strategic Development SSM Health | 1.0 | 58.0 | Yes (X) | $0 | $1,384,920 | $282,580 | ||||
| Ramona Carey | ||||||||||
| Assistant Secretary | 1.0 | 41.0 | Yes (X) | $0 | $73,615 | $22,600 | ||||
| Shasta Manuel | ||||||||||
| System Vice President-Finance | 10.0 | 32.0 | Yes (X) | $0 | $423,343 | $141,324 | ||||
| Angela Mohr | ||||||||||
| Executive Vice President/COO/CNO | 40.0 | 0 | $247,026 | $0 | $78,047 | Yes (X) | ||||
| Cathy Broome | ||||||||||
| Administrative Director - Nursing | 40.0 | 0 | $137,097 | $0 | $17,306 | Yes (X) | ||||
| Gaynell Anderson | ||||||||||
| Chief Medical Officer | 40.0 | 0 | $320,776 | $0 | $40,201 | Yes (X) | ||||
| Adam Hogue | ||||||||||
| Physician Assistant | 40.0 | 0 | $344,740 | $0 | $41,913 | Yes (X) | ||||
| Manikumar Bheemarasetti | ||||||||||
| Physician | 40.0 | 0 | $455,383 | $0 | $31,376 | Yes (X) | ||||
| Sailaja Adari | ||||||||||
| Physician | 40.0 | 0 | $358,457 | $0 | $54,678 | Yes (X) | ||||
| Troy Norred | ||||||||||
| Physician | 40.0 | 0 | $867,858 | $0 | $24,400 | Yes (X) | ||||
| Venkata Damera | ||||||||||
| Physician | 40.0 | 0 | $506,707 | $0 | $42,636 | Yes (X) | ||||
| Christopher Howard | ||||||||||
| Former Officer | 0.0 | 0.0 | $0 | $566,322 | $218,976 | Yes (X) | ||||
| Laura Kaiser | ||||||||||
| Former Officer | 0.0 | 48.0 | $0 | $2,153,858 | $2,027,129 | Yes (X) | ||||
| Linda Brown | ||||||||||
| Former Key Employee | 40.0 | 0 | $164,050 | $0 | $43,858 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,966,061 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,541,468 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $5,336,509 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 50 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Shawnee Medical Center Clinic | |||||
| 1501 N Airport Drive | Shawnee | OK | 74804 | Clinical services | $13,071,920 |
| CLINICAL PARTNERS PA | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ANESTHESIA BILLING | $927,380 |
| Shawnee Surgical Services LLC | |||||
| PO Box 68 | Shawnee | OK | 74802 | Surgical services | $453,384 |
| AMN Healthcare Inc | |||||
| 12400 HIGH BLUFF DRIVE | San Diego | CA | 92130 | Staffing services | $398,089 |
| Comprehensive Pharmacy Services LLC | |||||
| 6409 QUAIL HOLLOW ROAD | Memphis | TN | 38120 | Pharmacy services | $391,663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $138,876 | RelatedOrganizationsAmt |
| Total Contributions | $138,876 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $142,088,740 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $142,088,740 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $142,088,740 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,421 | TotalRevenueColumnAmt |
| Exclusion | $9,421 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $113,551 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $51,440 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $62,111 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,111 | TotalRevenueColumnAmt |
| Exclusion | $62,111 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $89,773 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $102,693 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,920 | TotalRevenueColumnAmt |
| Exclusion | -$12,920 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722320 | $555,955 | $555,955 |
| JOINT VENTURE INCOME | 900099 | $65,356 | $65,356 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $621,311 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $142,907,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $142,088,740 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $679,923 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,023 | TotalAmt |
| Program Services | $118,023 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,570,850 | TotalAmt |
| Program Services | $1,541,431 | ProgramServicesAmt |
| Management And General | $29,419 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,119,033 | TotalAmt |
| Program Services | $40,370,189 | ProgramServicesAmt |
| Management And General | $748,844 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,923,217 | TotalAmt |
| Program Services | $1,887,199 | ProgramServicesAmt |
| Management And General | $36,018 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,493,341 | TotalAmt |
| Program Services | $7,353,005 | ProgramServicesAmt |
| Management And General | $140,336 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,917,756 | TotalAmt |
| Program Services | $2,863,112 | ProgramServicesAmt |
| Management And General | $54,644 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,699 | TotalAmt |
| Program Services | $389,699 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,841 | TotalAmt |
| Management And General | $9,841 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,800 | TotalAmt |
| Management And General | $4,800 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,120 | TotalAmt |
| Management And General | $11,120 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,684,553 | TotalAmt |
| Program Services | $22,097,515 | ProgramServicesAmt |
| Management And General | $2,587,038 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,398 | TotalAmt |
| Management And General | $57,398 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,867,350 | TotalAmt |
| Program Services | $5,688,102 | ProgramServicesAmt |
| Management And General | $179,248 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,327,988 | TotalAmt |
| Program Services | $5,327,988 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,125,493 | TotalAmt |
| Program Services | $3,069,372 | ProgramServicesAmt |
| Management And General | $56,121 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,643 | TotalAmt |
| Program Services | $119,711 | ProgramServicesAmt |
| Management And General | $87,932 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,682 | TotalAmt |
| Program Services | $15,072 | ProgramServicesAmt |
| Management And General | $16,610 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,014,616 | TotalAmt |
| Program Services | $3,014,616 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,422,658 | TotalAmt |
| Program Services | $7,422,658 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $608,436 | TotalAmt |
| Program Services | $608,436 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $22,370,608 | $22,370,608 | |
| Medicaid Provider Tax | $2,626,044 | $2,626,044 | |
| Internal management fees | $2,587,690 | $2,587,690 | |
| Licenses and taxes | $60,895 | $60,895 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,550,734 | TotalAmt |
| Program Services | $126,943,675 | ProgramServicesAmt |
| Management And General | $6,607,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,427 | BOYAmt |
| EOY | $106,276 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,463,051 | BOYAmt |
| EOY | $19,322,546 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,179,685 | BOYAmt |
| EOY | $2,306,527 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,708 | BOYAmt |
| EOY | $367,328 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $115,305,071 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,479,712 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,424,226 | BOYAmt |
| EOY | $75,825,359 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $541,761 | BOYAmt |
| EOY | $497,498 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,286 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,933,262 | BOYAmt |
| EOY | $21,933,262 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,322,926 | BOYAmt |
| EOY | $183,276,938 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,166,332 | BOYAmt |
| EOY | $303,635,734 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,187,651 | BOYAmt |
| EOY | $61,169,278 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,234,021 | BOYAmt |
| EOY | $133,364,991 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,421,672 | BOYAmt |
| EOY | $194,534,269 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,066,374 | BOYAmt |
| EOY | $109,101,465 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,286 | BOYAmt |
| EOY | $0 | EOYAmt |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,744,660 | BOYAmt |
| EOY | $109,101,465 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,166,332 | BOYAmt |
| EOY | $303,635,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,356,805 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $11,120 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,120 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL AND STATE HOSPITAL ASSOCIATIONS AND PORTIONS OF THE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,000,668 | OtherCostOrOtherBasisAmt |
| Book Value | $2,000,668 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,081,070 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,755,447 | DepreciationAmt |
| Book Value | $61,325,623 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $396,778 | OtherCostOrOtherBasisAmt |
| Depreciation | $86,467 | DepreciationAmt |
| Book Value | $310,311 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,640,889 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,637,798 | DepreciationAmt |
| Book Value | $12,003,091 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $185,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $185,666 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $75,825,359 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $108,189 |
| DUE FROM AFFILIATES | $180,877,307 |
| THIRD-PARTY RECEIVABLE | $751,116 |
| OPERATING RIGHT-OF-USE ASSETS | $1,540,326 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $183,276,938 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $129,074,209 |
| CAPITAL LEASE OBLIGATION | $2,079,965 |
| Third-party payable | $361,434 |
| RETIREMENT LIABILITIES | $306,720 |
| OPERATING LEASE OBLIGATIONS | $1,542,663 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $133,364,991 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | ST. ANTHONY SHAWNEE HOSPITAL, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH (SSMH), A RELATED ORGANIZATION. 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 RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS IN 2019 OR 2018. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,197,621 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,197,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0314 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,347,676 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,898,230 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,507,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,143,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $22,053,220 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,042,163 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,197,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0314 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $76,447 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $76,447 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0006 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $154,620 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $154,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $291,437 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $291,437 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0022 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $522,504 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $522,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0039 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $22,575,724 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,042,163 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,720,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0353 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,730 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,730 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,066 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,066 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $141 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,197 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,197 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $22,134 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,134 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,168,968 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $33,433,752 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,791,781 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$358,029 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHAWNEE SURGICAL REALTY LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MEDICAL BUILDING | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.2806 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.7194 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANTHONY SHAWNEE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1102 W MCARTHUR | AddressLine1Txt |
| City | SHAWNEE | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital | WebsiteAddressTxt |
| State License | 2162 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | A | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | https://www.ssmhealth.com/about/chna | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.ssmhealth.com/about/chna | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.ssmhealth.com/resources/for-patients/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.ssmhealth.com/resources/for-patients/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.ssmhealth.com/resources/for-patients/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 - St Anthony Shawnee Hospital. The hospital took into account input from persons who represent the broad interests of the community served when conducting its most recent CHNA. The hospital conducted an online community survey which was reviewed by community partners. The process benefited from input from several individual community leaders representing diverse constituencies. Additionally, the hospital looked at its community profile, its consistent health needs, and the associated social determinants of health. |
| Schedule H, Part V, Section B, Line 11 Facility A, 1 | Facility A, 1 - St. Anthony Shawnee 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: - Chronic disease prevention and management - Substance abuse - Food scarcity Chronic disease prevention and management Six in ten Americans live with at least one chronic disease, like heart disease and obesity. These contribute to the leading causes of death and disability in the United States, and the leading driver of healthcare costs. Healthy lifestyle is a key component for better management and even prevention of chronic disease. Making healthier choices easier is a major contributor to assisting individuals in resulting with healthier lifestyles, and as a result living healthier longer. Additionally, statistics show: - Obesity is a risk factor that is commonly associated with heart disease. It is defined as a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health - Obesity has been found to reduce life expectancy, and it is one of the leading preventable causes of death worldwide - There is convincing evidence that the consumption of high levels of processed foods, which are high in fats and sugars, promotes obesity as compared to whole foods - In Pottawatomie County, heart disease is still the leading cause of death for all ages combined, at 240.1 deaths per 100,000 population (2011-2015). The rate increased from the previous 2008-2012 data at 236.2 deaths per 100,000 population - Obesity / overweight was selected by the focus group as the #1 health challenge for the community - 70.7% of Shawnee residents are obese / overweight The hospital's action plan includes the following initiatives to improve chronic disease in the community served: - Ensure the Fruit and VeggieRx Pilot Program is affective with at least 50 participants in its first campaign - The overarching vision for the Fruit and VeggieRX Pilot Program is to broadly integrate fruit and vegetable prescription programs into the SSM St. Anthony Hospital -Shawnee healthcare system as a powerful tool for combating diet-related chronic disease - The Fruit and VeggieRX Pilot Program aims to initiate and strengthen conversations between healthcare providers and patients to provide education for the benefits of fresh fruits and vegetables in relationship to heart disease and obesity, increase access to fresh foods, and reduce obstacles of nourishment - Participants are recruited through a screening process for readiness by physician and/or care managers - Participants receive required program elements for participation to include check-ins, educational cooking classes, grocery store tours, and 12-week follow-up visit - Each participant receives a packet of vouchers dependent on family size equivalent to $120 for single/couple or $240 for families, to be redeemed for fresh fruits and vegetables at the local participating grocery store Substance abuse Utilization of addictive substances, including tobacco/vape use and prescription drug misuse remain high in Pottawatomie County. Tobacco use has predominantly negative effects on human health and concern about health effects of tobacco has a long history, which can lead to lung cancer, and increases the risk of heart disease and strokes. Research has focused primarily on cigarette tobacco smoking. Tobacco smoke contains more than fifty chemicals that cause cancer as well as nicotine, which is a highly addictive psychoactive drug. In addition, the effects of vaping include a toxic aerosol that is found to be highly detrimental to the lungs and body. Opioid use and addiction have negative physical and mental effects on the body and subsequent health risks, including overdose and death. Additionally, statistics show: - Tobacco use is high in Pottawatomie County, with 24.5% of adults smoking compared to the state's average of 23.3% - Unintentional Poisoning Death Rates involved at least one prescription opioid at a rate higher for Pottawatomie County compared to the state rate - In 2016, there were 444 opioid related overdose deaths in Oklahoma -a rate of 11.6 deaths per 100,000 persons -compared to the national rate of 13.3 deaths per 100,000 - There is a culture of tobacco use in the community, especially in the manufacturing sector and among low-income populations - Oklahoma has strong pre-emption laws that restrict what city governments can do with regards to tobacco policy. Only recently were cities allowed to enact tobacco-free policies for city property - Focus-group participants stated that older smokers tend to ignore tobacco-free signage and some adults continue to smoke on school property during sporting events despite signage - There is an abundance of tobacco retailers through the city of Shawnee, many with drive-thru windows, which are so popular that they cause traffic issues with waiting line queues The hospital's action plan includes the following initiatives to address substance abuse in the community served: - SSM Health St Anthony Hospital -Shawnee leadership serves as key stakeholders on the Well-Being Coalition to facilitate completion of the four components of the designated Well-Being District, which encompasses approximately one-third of the city - To facilitate District Tobacco Enforcement, comply with district certification criteria and support other businesses in the district through the following: - Have and enforce a Tobacco free policy - Eliminate sales of tobacco products in all grocers in district - All public parks in district posted as Tobacco Free, with implementation of signage for enforcement - Facilitate opportunities for smoking cessation to current tobacco users through the following: - Provide referral to Oklahoma Quit Line to all inpatients identified on admission as users of tobacco products - Supply activity kits for hands-on education - Facilitate opportunities for smoking-prevention education by assisting employers seeking resources for tobacco cessation and partnering with schools to create after-school programs for prevention education Food scarcity In 2017 it was estimated that 1 in 8 Americans were food insecure, equating to 40 million Americans including more than 12 million children. In Oklahoma, one in six people struggle with hunger with one in four children being food insecure. Hospitals are uniquely positioned to address hunger issues and boost resource utilization because of the link between food insecurity, nutrition, obesity, and overall health. Additionally, statistics show: - Nearly half of the households that receive SNAP (Supplemental Nutrition Assistance Program) benefits in Oklahoma have children - Over 16% of residents are food insecure - Food Insecurity leads to negative health implications including the following: - Increased incidence of chronic conditions including diabetes, cardiovascular disease, and poverty-related obesity - Exacerbation of existing health issues, particularly for elderly patients with chronic and acute diseases, which can also speed the onset of degenerative diseases - Poor maternal and infant health linked to higher rates of infant mortality and low birthweight babies - Fragile pediatric health associated with two to four times as any individual health problems in children, including weight loss, fatigue, headaches, stomach aches, and frequent colds - Psycho-social deficiencies linked to developmental delays, learning and behavioral problems The hospital's action plan includes the following initiatives to improve food scarcity in the community served: - Establish the hospital as a resource and community partner to address food scarcity, reframing hunger as a health issues and leveraging trusted health care provider relationships - Implement routine screening for food insecurity to identify what may otherwise be an invisible need - Secure food resources for immediate need, working with local experts and identifying the hospital as a stocked source for food items - Educate employees on issues of food scarcity in the community and resources available - Increase employee volunteer hours donated to identified agencies (such as Community Market of Pottawatomie County, Community Renewal, Kickapoo Park Community Garden) from 24 in 2018 to 48 in 2019 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 but have not been prioritized due to the hospital's limited resources at this time (additional descriptions available in the 2018 CHNA): - Mental health - Health care access and medication cost - Health literacy - Transportation limitations - Exercise/physical activity |
| Schedule H, Part V, Section B, Line 11 Facility A, 2 | Facility A, 2 - St. Anthony Shawnee Hospital (continued). During 2019, the following activities were performed to help address the issues identified in the CHNA: Chronic disease prevention and management * Launch of the VeggieRx program, the overarching vision of which is to broadly integrate fruit and vegetable prescription programs into the SSM St. Anthony Hospital -Shawnee healthcare system as a powerful tool for combating diet-related chronic disease. * The VeggieRx Pilot Program aims to initiate and strengthen conversations between healthcare providers and patients to provide education for the benefits of fresh fruits and vegetables in relationship to heart disease and obesity, increase access to fresh foods and reduce obstacles of nourishment. * Participants are recruited through a screening process for readiness by physician and/or care managers. Enrollment includes Baseline Program Survey with required health metrics of height, weight, BMI, circumference Blood pressure, and blood sugar. * Participants receive required program elements for participation to include check-ins, educational cooking classes, grocery store tours, and 12 week follow-up visit. * Each participant receives a packet of vouchers dependent on family size equivalent to $120 for single/couple or $240 for families, to be redeemed for fresh fruits and vegetables at the local participating grocery store. * At the completion of the program the data is collected to provide a de-identified file of participant pre-and post-metrics. * 54 patients enrolled in the program's pilot cohort in 2019 In addition to VeggieRx, the hospital participated in the following activities to promote chronic disease and management: * Consumer health information shared on social media about chronic disease and information about how to live a healthy lifestyle. * Promoted internally and externally National Walking Day- Wednesday, April 3, 2019. * Offered the Roadmap to Living with COPD program throughout 2019. The program is led by the hospital's Respiratory Therapy and Palliative Care teams, and provides education and encouragement to patients, caregivers and family members. * Developed for our staff and visitors a Blue Zones Shawnee campus walking map that gave different options (distance) for walking around campus, whether inside or outside. * Promoted Blue Zones inspired meals that were prepared in Cafe Substance Abuse * Ministry leadership served as a stakeholder on the Well-Being Coalition to facilitate completion of the four components of the designated Well-Being District, which encompasses approximately one-third of the city. This district includes the hospital. * To facilitate tobacco enforcement in the Well-Being District, the hospital complied with certification criteria and supported other businesses in the district: Had and enforced a tobacco free policy, Eliminated the sale of tobacco products at all grocers in the district, All public parks in the district received signage indicating its status as a tobacco free area and an enforcement phone number * Provided referrals to the Oklahoma Quit Line for all patients who requested a referral for tobacco cessation support * Hospital participated in the statewide OK to Quit Week through internal and external promotion of the program * Hospital participated in #KickButtsDay, a campaign for tobacco-free children, through internal and external promotion Food scarcity * Implemented routine screening for food insecurity for hospital patients: Incorporated short, validated screening questions into patient assessment tool upon admission and deployed social worker/case manager to confirm food insecurity * Provided immediate follow-up referrals to Community Market of Pottawatomie County (CMPC) for patients identified as food insecure * Referred patients identified as receiving inadequate healthy food consumption to the VeggieRx program * Ministry associates toured CMPC to increase awareness of food insecurity issues and availability of resources in the community * Mission Awareness Team led annual Feed a Family Campaign, raising funds to feed 100 families through CMPC * One ministry executive served on the CMPC board * Hospital donated fruit trees to the community garden at Kickapoo Park * Adopted a classroom at Jefferson Elementary, a public school where the majority of students are eligible for free lunches. When hospital leadership provide "party days" for the classroom, they made sure to provide enough food for the party and provided food for the students to take home after school. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| SURGERY CENTER AT ST ANTHONY SHAWNEE | ||||
| 1106 W MCARTHUR | SHAWNEE | OK | 74804 | OUTPATIENT SURGERY |
| FAMILY HEALTHCARE ASSOCIATES | ||||
| 3204 MEDICAL PARK | SHAWNEE | OK | 74804 | PHYSICIAN - FAMILY HEALTH |
| URGENT CARE CLINIC | ||||
| 3200 MEDICAL PARK | SHAWNEE | OK | 74804 | URGENT CARE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 | SSM HEALTH ST. ANTHONY HOSPITAL - SHAWNEE 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: ECONOMIC DEVELOPMENT: PARTICIPATION WITH THE CHAMBER OF COMMERCE AND SHAWNEE FORWARD, COMMUNITY SUPPORT: INVOLVEMENT WITH BLUE ZONES PROJECT, a community-wide well-being improvement initiative to help make healthy choices easier for everyone in THE community, COALITION BUILDING: PARTNERING WITH LOCAL SCHOOLS AND THE FAMILY JUSTICE CENTER BOARD, COMMUNITY HEALTH IMPROVEMENT ADVOCACY: VARIOUS HEALTH ALLIANCES INCLUDING THE POTTAWATOMIE COUNTY ALLIANCE TOWARD COMMUNITY AND REGIONAL EPIDEMIOLOGICAL OUTCOMES WORKGROUP. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | St. Anthony Shawnee Hospital, 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, 2019 consolidated audit is contained on page 11 and 12 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 | St. Anthony Shawnee 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, The Health Center embraces its responsibility to serve the communities in which it participates by establishing sound business practices. The Health 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 St. Anthony Shawnee Hospital collection and financial assistance policies. |
| Schedule H, Part V, Section B, Line 16a FAP website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16a URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16b URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16c URL: https://www.ssmhealth.com/resources/for-patients/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 | SSM Health St. Anthony Hospital - Shawnee is located in Shawnee, Oklahoma and defines its primary service area as in Pottawatomie County, which according to 2017 population estimates, has a population of 72,226 persons. Residents of the county account for nearly 70% of the total patients served by the hospital. Of the hospital's community, only 16.2% have a Bachelor's degree and almost 15% do not have a High School diploma. Rates of individuals in poverty are higher in the county, at 18.2%, as compared to state and national rates. Additionally, median household income was reported at $44,688 in 2015, significantly lower than Oklahoma and U.S. medians. Thirty percent of the Pottawatomie County population is age 55 and over. County-wide smoking rates for adults is 24.5%, while excessive drinking is reported at 13%. Nearly 40 percent of Pottawatomie County residents are obese. Additional detailed information on the SSM Health St Anthony Hospital - Shawnee service area can be found in the 2018 CHNA. |
| Schedule H, Part VI, Line 5 Promotion of community health | St. Anthony Shawnee Hospital, 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. Focusing on a broad definition of health, St. Anthony Shawnee Hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Anthony Hospital Shawnee, Inc. promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. St. Anthony Shawnee Hospital, Inc. 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 | ST. ANTHONY SHAWNEE HOSPITAL IS A 501(C) (3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH SSM HEALTH CARE OF OKLAHOMA, INC. THE HOSPITAL IS PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE FOR THE CENTRAL OKLAHOMA REGION. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | OK |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Oklahoma Baptist University | ||||||||
| 500 W University | Box 61027 | Shawnee | OK | 74804 | 730579264 | 501(c)(3) | $90,000 | General support |
| Shawnee Forward Inc | ||||||||
| 231 N Bell | Shawnee | OK | 74801 | 823127939 | 501(c)(3) | $12,873 | General support | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S GRANTS WERE MADE TO TAX- EXEMPT, UNDER SECTION 501(C)(3), ORGANIZATIONS. THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joe Hodges | ||||||||||||||
| Director, Chairperson, Regional President - SSM Health Care of Oklahoma | $0 | $647,086 | $0 | $145,302 | $0 | $134,224 | $0 | $497,073 | $0 | $26,185 | $0 | $1,449,869 | $0 | $225,568 |
| Patrick Mccruden | ||||||||||||||
| Director, Vice Chair, Chief Mission Integration Officer-SSM Health | $0 | $344,641 | $0 | $59,744 | $0 | $12,047 | $0 | $270,850 | $0 | $23,341 | $0 | $710,623 | $0 | $59,744 |
| Christopher Howard | ||||||||||||||
| Former Officer | $0 | $0 | $0 | $0 | $0 | $566,322 | $0 | $214,327 | $0 | $4,649 | $0 | $785,299 | $0 | $0 |
| Laura Kaiser | ||||||||||||||
| Former Officer | $0 | $1,591,955 | $0 | $536,550 | $0 | $25,353 | $0 | $2,013,276 | $0 | $13,853 | $0 | $4,180,987 | $0 | $536,550 |
| Kris Zimmer | ||||||||||||||
| Treasurer, Chief Financial Officer at SSM Health | $0 | $887,868 | $0 | $230,489 | $0 | $247,277 | $0 | $797,538 | $0 | $16,082 | $0 | $2,179,255 | $0 | $340,596 |
| Doug Long | ||||||||||||||
| Secretary, General Counsel at SSM Health | $0 | $149,400 | $0 | $0 | $0 | $80,150 | $0 | $469,438 | $0 | $2,548 | $0 | $701,536 | $0 | $0 |
| Paula Friedman | ||||||||||||||
| Pt Yr Vice President, Pt Yr Senior VP-Strategic Development SSM Health | $0 | $270,134 | $0 | $189,852 | $0 | $924,934 | $0 | $278,843 | $0 | $3,736 | $0 | $1,667,500 | $0 | $618,871 |
| Shasta Manuel | ||||||||||||||
| System Vice President-Finance | $0 | $340,783 | $0 | $46,367 | $0 | $36,194 | $0 | $114,585 | $0 | $26,739 | $0 | $564,667 | $0 | $76,273 |
| Charles Skillings | ||||||||||||||
| Hospital President, SSM Health St. Anthony Hospital - Shawnee | $347,194 | $0 | $62,209 | $0 | $154,563 | $0 | $147,062 | $0 | $19,368 | $0 | $730,397 | $0 | $174,104 | $0 |
| Linda Brown | ||||||||||||||
| Former Key Employee | $111,278 | $0 | $19,643 | $0 | $33,129 | $0 | $16,464 | $0 | $27,394 | $0 | $207,908 | $0 | $43,507 | $0 |
| Angela Mohr | ||||||||||||||
| Executive Vice President/COO/CNO | $211,819 | $0 | $26,498 | $0 | $8,710 | $0 | $53,774 | $0 | $24,273 | $0 | $325,074 | $0 | $33,926 | $0 |
| Cathy Broome | ||||||||||||||
| Administrative Director - Nursing | $135,387 | $0 | $0 | $0 | $1,710 | $0 | $7,342 | $0 | $9,964 | $0 | $154,403 | $0 | $0 | $0 |
| Gaynell Anderson | ||||||||||||||
| Chief Medical Officer | $315,077 | $0 | $0 | $0 | $5,699 | $0 | $14,965 | $0 | $25,236 | $0 | $360,977 | $0 | $0 | $0 |
| Venkata Damera | ||||||||||||||
| Physician | $386,009 | $0 | $111,784 | $0 | $8,914 | $0 | $15,200 | $0 | $27,436 | $0 | $549,342 | $0 | $0 | $0 |
| Adam Hogue | ||||||||||||||
| Physician Assistant | $182,738 | $0 | $151,663 | $0 | $10,339 | $0 | $14,364 | $0 | $27,550 | $0 | $386,653 | $0 | $0 | $0 |
| Troy Norred | ||||||||||||||
| Physician | $604,648 | $0 | $260,890 | $0 | $2,320 | $0 | $0 | $0 | $24,400 | $0 | $892,258 | $0 | $0 | $0 |
| Manikumar Bheemarasetti | ||||||||||||||
| Physician | $311,123 | $0 | $143,787 | $0 | $474 | $0 | $31,131 | $0 | $246 | $0 | $486,760 | $0 | $0 | $0 |
| Sailaja Adari | ||||||||||||||
| Physician | $357,701 | $0 | $0 | $0 | $756 | $0 | $25,792 | $0 | $28,886 | $0 | $413,136 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | The organization's top management official, hospital 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 $470,555 Christopher Howard $564,308 |
| 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 2019. 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 2019: Patrick McCruden $42,132 Joe Hodges $76,879 Kris Zimmer $105,240 Shasta Manuel $27,254 Charles Skillings $27,420 Angela Mohr $8,652 Laura Kaiser $314,000 Linda Brown $5,946 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2019. All distributions received from the plan in the current year were included in the individual's taxable compensation. Joe Hodges $80,266 Paula Friedman $429,019 Kris Zimmer $111,962 Shasta Manuel $29,906 Charles Skillings $111,895 Angela Mohr $7,428 Linda Brown $23,863 During 2019, 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: Joe Hodges $23,497 Paula Friedman $9,691 Kris Zimmer $66,609 Shasta Manuel $2,439 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 St. Anthony Shawnee Hospital: SSM Health St. Anthony Hospital - Shawnee has been providing health care services for over 50 years to Shawnee and the surrounding communities of Pottawatomie County. St Anthony Shawnee along with SSM Health Care of Oklahoma comprise the Oklahoma region of SSMH. St Anthony Shawnee also includes an urgent care facility, with services including acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, cardiology, diagnostic laboratory and imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services, respiratory care, and women's services. In 2018, the hospital earned the Guardian of Excellence - Clinical Quality award from Press Ganey, and also the Premier Award for Quality, High-Value Health Care Citation of Merit in 2017. SSM Health St. Anthony Hospital - Shawnee has received an 'A' Leapfrog Hospital Safety Grade annually since 2016. St. Anthony Shawnee 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 $ 4,197,621 Unpaid Cost of Medicare $ 358,029 Total Quantifiable Uncompensated Care $ 4,555,650 |
| Form 990, Part V, Line 1a | ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223. |
| 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 CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF OKLAHOMA, INC. SSM HEALTH CARE OF OKLAHOMA, INC. IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH ST. ANTHONY SHAWNEE HOSPITAL, INC. AND SSM HEALTH CARE OF OKLAHOMA, 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 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 ELECT AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO 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 THE AMENDMENTS TO THE Certificate 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 AUTHORIZE OR 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 THE MEMBER of the member OR TO ANY 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 THE MEMBER of the member, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER of the member AS DETERMINED BY THE MEMBER of the member. Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER of the member, 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 THE MEMBER 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 8b Documentation of meetings held by committees of governing body | The organization does not have any committees with authority to act on behalf of the governing body. |
| 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 | BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY OF THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISION ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. |
| 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 SSM HEALTH ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE OKLAHOMA SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, Line 11g Other Fees | Medical and other professional fees - Total Expense: 24684553, Program Service Expense: 22097515, Management and General Expenses: 2587038, Fundraising Expenses: ; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (50 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| 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 |
| Waupun Memorial Hospital Inc | ||||||||||
| 620 West Brown Street | Waupun | WI | 53963 | 390806265 | 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 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | UBI Code VUBICodeVAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM St Joseph Endoscopy Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 270046559 | Surgery Services | MO | NA | N/A | $0 | $0 | $0 | 0 |
| St Clare Imaging Services LLC | ||||||||||||
| 707 14th Street Suite A | Baraboo | WI | 53913 | 200122365 | Diag. Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Mt Vernon Radiation Therapy Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 201382620 | Radiation Therapy | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Sleep & Neurology Center of Southern Illinois LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 208468195 | Diag. Services | IL | NA | N/A | $0 | $0 | $0 | 0 |
| CHOWSMGSI Office Building LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 371383861 | MOB | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Oza Cancer Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 201382727 | MOB | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Shawnee Real Estate Holdings LLC | ||||||||||||
| 1000 N Lee Ave | Oklahoma City | OK | 73102 | 455458304 | MOB | OK | NA | N/A | $0 | $0 | $0 | 0 |
| 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 | $0 | $0 | $0 | 0 |
| Wisconsin Integrated Information Technology and Telemedicine Systems LLC | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 392016715 | Information Technology Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Dean Health Holdings LLC | ||||||||||||
| 1277 Deming Way | Madison | WI | 53717 | 261594709 | Support Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Wingra Building Group | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 390237060 | MOB | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Janesville Riverview Clinic Building Partnership | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 396220698 | MOB | WI | NA | N/A | $0 | $0 | $0 | 0 |
| 1110 N Classen Blvd LLC | ||||||||||||
| 1110 N Classen Boulevard | Oklahoma City | OK | 73106 | 731158158 | MOB | OK | NA | N/A | $0 | $0 | $0 | 0 |
| SSM St Clare Surgical Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 261439695 | Surgery Services | MO | NA | N/A | $0 | $0 | $0 | 0 |
| Windmill LLP | ||||||||||||
| 50 Village View Lane | Chesterfield | MO | 63017 | 431804651 | Investments | MO | NA | N/A | $0 | $0 | $0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM Managed Care Organization LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431708511 | Health Promotion | MO | NA | C Corporation | $0 | $0 | 0 | false |
| FPP INC & Subs | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431465174 | Health Care | MO | NA | C Corporation | $0 | $0 | 0 | false |
| Diversified Health Services Corp | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431369305 | Medical Equipment | MO | NA | C Corporation | $0 | $0 | 0 | false |
| SSM Properties Inc | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431462486 | Property Services | MO | NA | C Corporation | $0 | $0 | 0 | false |
| HealthFirst Physician Management Services | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 731534336 | Medical Services | OK | NA | C Corporation | $0 | $0 | 0 | false |
| SSMHC Liability Trust II | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 816128118 | Insurance | MO | NA | C Corporation | $0 | $0 | 0 | false |
| SSM Medical Group Inc | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431664107 | Physician Offices | MO | NA | C Corporation | $0 | $0 | 0 | false |
| SSMHC Insurance Company | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 030310431 | Insurance | NA | C Corporation | $0 | $0 | 0 | false | |
| Physicians Services Corp of Southern Illinois Inc | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 364161526 | Health Care | IL | NA | C Corporation | $0 | $0 | 0 | false |
| Dean Health Systems Inc | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391128616 | Physician Offices | WI | NA | C Corporation | $0 | $0 | 0 | false |
| Dean Health Insurance Inc | ||||||||||||
| PO Box 56099 | Madison | WI | 53705 | 391830837 | Insurance | WI | NA | C Corporation | $0 | $0 | 0 | false |
| Dean Health Plan Inc | ||||||||||||
| PO Box 56099 | Madison | WI | 53705 | 391535024 | Insurance | WI | NA | C Corporation | $0 | $0 | 0 | false |
| SMDV Office Building | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391628491 | Physician Offices | WI | NA | C Corporation | $0 | $0 | 0 | false |
| Dean Retail Services Inc | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391717636 | Property Services | WI | NA | C Corporation | $0 | $0 | 0 | false |
| Navitus Holdings LLC | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 800968174 | Pharmacy Benefits | WI | NA | C Corporation | $0 | $0 | 0 | false |
| Oza Oncology Inc | ||||||||||||
| 4117 Veterans Memorial Drive | Mt Vernon | IL | 62804 | 371343746 | Physician Offices | IL | NA | S Corporation | $0 | $0 | 0 | false |
| SSM Health Janesville Campus Condominium Association Inc | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 832038674 | Condo association | WI | NA | C Corporation | $0 | $0 | 0 | false |
| SSM Health Pharmacy LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 264031708 | Pharmacy | MO | NA | C Corporation | $0 | $0 | 0 | false |
| Dane County Cytology Center Inc | ||||||||||||
| 2000 Engel Street Suite 201 | Madison | WI | 53713 | 391414219 | Medical Services | WI | NA | C Corporation | $0 | $0 | 0 | false |
| SSM Health Insurance Company | ||||||||||||
| 1277 Deming Way | Madison | WI | 53717 | 834718249 | Insurance | MO | NA | C Corporation | $0 | $0 | 0 | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |