2020-11-04T15:30:24-06:00 2019-12-31 990 2019-01-01 390807236 Agnesian Healthcare Inc AGNE 9209265519 430 E Division St Fond du Lac WI 54935 Doug Long Secretary 2020-11-04 2019 2021-01-29 14:40:06Z Katherine Vergos 430 E Division St Fond du Lac WI 54935 467636366 false 0928 X https://www.agnesian.com/ X 1892 WI THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH. 17 7 2313 402 3972663 0 427564 568781 195999850 403484831 192582 7275923 12623015 27328663 209243011 438658198 83162 575203 0 99801256 202779057 0 228402 101622402 228296154 201506820 431650414 7736191 7007784 654431153 776804116 197327913 292818515 457103240 483985601 THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH. false false 356402104 575203 418854515 Please see Schedule O for a complete description of program service accomplishments. 356402104 true true false true false false false false false true true false true true true false true false false false false false false false false true true true false true true true false false false false false false false false true false false false false true true true true false false true X 292 0 true 2313 true true true true CJ false false false false false false false false false false X 17 7 true false false false true true true true true false false false true true true true true true true true true X Dennis Bangart 9209292300 430 E Division Street Fond du Lac WI 54935 Paula Friedman Pt Yr Director/Vice President, Pt Yr Senior VP-Strategic Development SSM Health 1.0 58.0 X X 0 1384920 282580 Steven Little Pt Yr Director, Pt Yr Regional Chief Operating Officer, Wisconsin 1.0 45.0 X X 0 1395599 9512 Thor Gilbertson Director, Vice Chairperson 1.0 0 X X 0 0 0 Wayne Matzke Director, Chairperson 1.0 0 X X 0 0 0 Mark Thompson Director, Regional Chief Medical Officer 1.0 43.0 X X 0 575194 219571 Dr Doug Fownes Director 1.0 0 X 0 0 0 Dr Jeffery Strong Director 1.0 0 X 0 0 0 Dr Judith Westphal Director 1.0 0 X 0 0 0 Dr Ted Miller Director 1.0 0 X 0 0 0 Dr Toni Stanley Director 1.0 0 X 0 0 0 Joan Karsten Director 1.0 1.0 X 0 0 0 Marysue Michels Director 1.0 0 X 0 0 0 Sr Hertha Longo Director 1.0 0 X 0 0 0 Sr Marie Scott Director 1.0 0 X 0 0 0 Sr Susan Stucki Director 1.0 1.0 X 0 0 0 Stephen Peterson Director 1.0 0 X 0 0 0 Thomas Schneider Director 1.0 0 X 0 0 0 Thomas Schuessler Director 1.0 0 X 0 0 0 Doug Long Secretary, General Counsel at SSM Health 1.0 65.2 X 0 229550 471986 Katherine Vergos President - St. Agnes Hospital 40.0 0.0 X 465436 0 128135 Kris Zimmer Treasurer, Chief Financial Officer at SSM Health 1.0 67.0 X 0 1365634 813620 Barbara Knutzen President - AHE, CLW and Performance 40.0 0 X 189646 0 31634 James Mugan Sr VP - Medical Group and Medical Affairs 40.0 0 X 339080 0 54660 Michael Degere VP - Population Health Management 40.0 0 X 362739 0 63025 Michael Drees COO - Fond du Lac Regional Clinic 40.0 0 X 304815 0 60752 Jacob Waidelich Physician 40.0 0 X 565464 0 11388 John Choi Physician 40.0 0 X 686071 0 52288 Michael Vander Kooy Radiation Oncologist 40.0 0 X 707472 0 61757 Steven Flurry Anesthesiologist 40.0 0 X 671433 0 53072 Yasir Hatahet Intensivist/Pulmonologist 40.0 0 X 552375 0 58671 Bonnie Schmitz Former Key Employee 0.0 0 X 604554 0 269 Nancy Birschbach Former Key Employee 0.0 40.0 X 0 356040 118475 5449084 5306938 2491394 183 true true false FOND DU LAC REGIONAL CLINIC SC 420 E DIVISION ST FOND DU LAC WI 54935 PHYSICIAN SERVICES 52613459 CD SMITH CONSTRUCTION PO BOX 1066 FOND DU LAC WI 54935 CONSTRUCTION SERVICES 5272351 CERNER CORP 2800 ROCKCREEK PKWY KANSAS CITY MO 64141 COMPUTER SERVICES 4276904 WILLIAMS MONTGOMERY & JOHN LTD 233 S WACKER DR 6800 CHICAGO IL 60606 LEGAL SERVICES 2128667 MEDICAL COLLEGE OF WI 8701 WATERTOWN PLANK RD PO BOX 26 WAUWATOSA WI 53226 PHYSICIAN SERVICES 1822101 73 568781 568781 Net patient service revenue 621110 403484831 403484831 0 0 0 0 403484831 4669444 4669444 269445 269445 0 269445 269445 3437555 831076 3437555 -831076 2606479 2606479 37729122 28147092 9582030 3071729 6510301 Laboratory 621500 16270618 15369684 900934 Cafeteria 722210 1206570 1206570 0 0 0 0 17477188 438658198 418854515 3972663 15262239 X 575203 575203 1999923 1887335 110520 2068 153707639 145054526 8494209 158904 8027996 7576053 443644 8299 28563712 26955692 1578491 29529 10479787 9889818 579135 10834 17729180 17729180 54800 54800 10380 10380 79500630 37913012 41586822 796 782901 782901 18440070 16695059 1737185 7826 10114 10114 7364344 5751405 1612939 1169101 983802 175582 9717 582452 457903 124120 429 4889810 4889810 21734637 21734637 1528457 1528457 Medical supplies 63864783 63864783 Medicaid Provider Tax 5112788 5112788 Licenses and taxes 5521707 5521707 0 0 0 0 431650414 356402104 75019908 228402 15673154 39259155 4581521 5707220 0 81225369 74846607 0 0 0 0 0 4792318 3797416 4841068 3055737 287523014 40534389 253767003 246988625 0 229658875 262830962 21288458 16627456 0 38603387 123690938 654431153 776804116 44540950 51359055 0 283578 308869 0 0 0 0 0 0 152503385 241150591 197327913 292818515 X 451305858 477760012 5797382 6225589 457103240 483985601 654431153 776804116 X 7007784 25271058 -5396481 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10380 10380 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 14684350 14684350 193819603 16505194 177314409 5977894 1579480 4398414 58163105 22449715 35713390 14878062 0 14878062 246988625 SSM COMPREHENSIVE INVESTMENT PROGRAM 262830962 F 262830962 Due from affiliates 117831938 OPERATING RIGHT-OF-USE ASSETS 5859000 123690938 Third Party Payor 2155000 Capital Lease Obligations 1968062 Allocated tax-exempt debt: SSM Health Care Corporation 117430192 Due to affiliates 113735819 OPERATING LEASE OBLIGATIONS 5861518 241150591 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote AGNESIAN HEALTHCARE INC'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2019 OR 2018. true true X true X 165 true X true true true false true true 1223547 1223547 0.0028 44590433 21247656 23342777 0.0541 82057 243564 0 0.0 0 0 45896037 21491220 24566324 0.0569 1748481 424347 1324134 0.0031 63180 63180 0.0001 216781 35896 180885 0.0004 6980 6980 0.0000 114664 114664 0.0003 0 0 2150086 460243 1689843 0.0039 0 0 48046123 21951463 26256167 0.0608 0 0.0 0 0.0 15169 15169 0.0000 686 686 0.0000 0 0.0 3902 3902 0.0000 0 0.0 44790 44790 0.0001 0 0.0 0 0 64547 0 64547 0.0001 true 24059789 36979964 44732780 -7752816 X true true 1 1 St Agnes Hospital 430 E Division Street Fond du lac WI 54935 https://www.agnesian.com/locations/st-agnes-hospital 120 X X X A A 1 false false true X X X X X X X X X 18 true true true true X https://www.agnesian.com/locations/st-agnes-hospital X https://www.ssmhealth.com/about/chna true 18 true https://www.ssmhealth.com/about/chna false true X 165.0 300.0 X X X X X X X true true X X X X true X https://www.agnesian.com/page/financial-assistance X https://www.agnesian.com/page/financial-assistance X https://www.agnesian.com/page/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - St. Agnes Hospital. The hospital facility took into account input from persons who represent the broad interests of the community served through the following process: key informants in Fond du Lac County were identified by the Community Health Assessment Task Force members and interviewed by the Fond du Lac County Health Department. Interviews were completed in-person and electronically via questionnaires in February and March 2018, and interviewees were asked to rank twelve health focus areas from highest to lowest priority, with number one being the top priority health issue to address in Fond du Lac County based on the population served. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - St. Agnes Hospital. Hospitals included in the CHNA were Agnesian Healthcare (St. Agnes Hospital), Waupun Memorial Hospital, and Ripon Medical Center. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - St. Agnes Hospital. St. Agnes Hospital collaborated extensively with the Fond du Lac County Health Department. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - St. Agnes Hospital. The hospital identified various health needs in the 2018 CHNA. In order to make meaningful impact, and to use its finances most effectively and efficiency, the hospital will place primary focus on the following key priorities: - Nutrition and physical activity - Mental health - Alcohol and other drug abuse Nutrition and physical activity The hospital has identified nutrition and physical activity as a community health priority. The hospital aims to increase the number of Fond du Lac County residents living at healthy weight for their height through eating healthier and being more active. Additionally, statistics show: - Almost 3 in 4 adults in the area classify as being overweight or obese - Only 1 in 4 adults reported eating the recommended servings of vegetables per day - About half of adults reported eating the recommended servings of fruit per day - Only 1 in 4 met the recommended amount of physical activity and strength training - For youth, 1 in 4 are overweight or obese - Less than half of youth report eating the recommended servings of fruits and vegetables - Only 1 in 5 youth meet the recommended amount of physical activity and strength training The hospital's action plan includes the following initiatives to improve nutrition and physical activity in the community served: - Improve physical activity through the following: - Increase trail usage by 10% from 1496 (2016) total bike/pedestrian counts over a weeklong period to 1646 - Implement one community-wide physical activity campaign - Increase the number of teachers in the FDL School District implementing wearable technology with students from 19 to 21 - Increase the number of schools participating in safe routes to school from 23 to 27 - Improve fruit and vegetable consumption through the following: - Increase SNAP usage at the Wednesday Downtown FDL Farmers Market by 25% from $278 (2018 YTD) to $348 - Increase SNAP usage at the Saturday Downtown FDL Farmers Market by 10% from $5,000 (2018 YTD) to $5,500 - Increase the number of food forests planted from 4 (2018) to 5 - Increase the number of pounds of produce donated at the FDL farmers market by 10% from 3,500 lbs (2018 YTD) to 3,850 lbs - Increase the health promotion programs offered to low-income housing residents from zero to 9 - Improve breastfeeding rates through the following: - Increase the number of childcare centers and business centers who have adopted the Ten Steps to Breastfeeding-Friendly Toolkit from 7 (2017) to 15 - Increase the attendance at the annual Breastfeeding Celebration from 85 (2018) to 125 Mental Health The hospital has identified mental health as a top community health priority. The facility is striving to reduce the stigma around mental health and suicide, increase access to behavioral health services at any age and for those in high-risk groups, and decrease the number of deaths by suicide. Additionally, statistics show: - About 1 in 5 Fond du Lac County residents reported a mental health condition - 5 percent of adults reported to having considered suicide in the last year - 15 percent of high school students reported to having considered suicide in the last year - The number of suicides in Fond du Lac County has nearly doubled from 2013 to 2017 The hospital's action plan includes the following initiatives to address mental health in the community served: - Decrease number of deaths by suicide through earlier identification of mental distress through the following: - Increasing number of those who live and work in Fond du Lac County who are trained as gatekeepers in Question, Persuade, Refer (QPR), Mental Health First Aid for Adults (MHFA), and Youth Mental Health First Aid (YMHFA) - Promoting use of universal and targeted screening across the lifespan in both clinical and non-clinical settings - Reduce stigma around mental health and suicide which can limit help-seeking behaviors with the following: - Education & Awareness activities: Coordinated messaging campaign (via radio, website, newspaper, etc.), including the facts related to mental health conditions, their occurrence in the general population, and the effectiveness of treatment - Promoting positive mental health and resiliency - Partner with individuals who have lived experience to share their stories and inform efforts - Increase access to behavioral health services across the lifespan, and for those in high-risk groups through the following: - Develop a Pathways to Care Mental Health Navigation Tool for Fond du Lac County adults - Develop a more universal approach to safety planning across the county, which includes creating a document with a common language and format that can be used across populations and settings Alcohol and Other Drug Abuse The hospital has identified alcohol and other drug abuse as a key priority to address within the community. The hospital facility with community groups to reduce availability of alcohol and illicit drugs, binge drinking, and to improve procedures to manage and address opioid abuse. Additionally, statistics show: - 1 in 5 adults and youth have reported binge drinking - 1 in 3 youth report very or fairly easy access to prescription medications for misuse - About 1 in 10 youth reported electronic vapor product use over a 30-day period - In 2017, there were 7 opioid overdose deaths in Fond du Lac County The hospital's action plan includes the following initiatives to improve alcohol and other drug abuse in the community served: - Reduce underage drinking and adult binge drinking through the following: - Increase the number of festivals evaluated annually throughout Fond du Lac County from 7 (2017) to 12 - Increase the number of law enforcement agencies completing annual compliance checks from 2 (2017) to 4 - Reduce misuse and abuse of drugs, particularly opioids through the following: - Increase the number Narcan kits distributed annually through community Narcan Trainings from 54 (2017) to 75 - Increase number of providers using the evidence-informed screening tool SBIRT for early intervention and referral for treatment from 0 (2017) to 4 or more The hospital has no plans to discontinue other community benefit efforts addressing additional community needs within its efforts. The following community needs were identified and will be addressed as resources allow (additional descriptions available in the 2018 CHIP): - Trauma-informed care - Social determinants of health Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - St. Agnes Hospital (Continued). During 2019, the following activities were performed to help address the issues identified in the CHNA: Nutrition and Physical Activity: * Fond du Lac County's Living Well Coalition. In 2019, Dr. Heather Schmidt, Nicole Wiegert, Terri St. Lawrence and Joel Mason from Agnesian Healthcare, a Member of SSM Health, were members of the Living Well Coalition. The Living Well Coalition's focus is on the Nutrition/Physical activity pillar for Healthy Fond du Lac 2020. * POWER Program. Healthy Lifestyle/weight loss program for patients preparing for surgery which incorporates healthy eating/physical activity. Dr. Schmidt sees the program participant and incorporates a dietitian from Agnesian along with a physical activity component. In the Ripon Area, the Ripon Wellness Center assists participants. * Summer of Fun program. Summer program for children living in poverty. Program was offered approximately 3 days/week. Two days/week the Fond du Lac Recreation Department and area volunteers provided outdoor physical activities for the children to participate in. Children were also provided lunch and a healthy snack/water each day. * Healthy Living with diabetes. This is a 6 week workshop designed for adults with type 2 diabetes or pre-diabetes and their caregivers. It Teaches participants skills to effectively manage diabetes or delay the onset of diabetes. Topics include healthy eating and physical activity. This program is a community collaboration. We had 3 SSM associates trained to facilitate the class. * Letter of support. Letter of support was drafted to UW-Extension Education, Agriculture and Recreation Committee all to use local trails (Wild Goose Trail) to be physically active; opposing winter ATV use on the trails. * Fruit tree donation. Donated 2 fruit trees to the community garden at Hamilton Park. * Referrals to Livestrong, Healthy Living program at YMCA. Agnesian HealthCare continues to collaborate with the YMCA to refer patients to free programs that promote healthy living, nutrition and physical activity. In 2019, Care Management referred at least 293 patients to the YMCA for the above listed programs. * Health Resource Center Programming. Offered various cooking demos and physical activity options (i.e. yoga) for our community through our health resource center in 2019. Mental Health: * Healthy Fond du Lac 2020's Mental Health Priority Team. In 2019, Dr. Matthew Doll of Agnesian Healthcare served on Healthy Fond du Lac 2020 Mental Health Priority Team. * Suicide Prevention - Yscreen. In 2019, Agnesian Healthcare rolled out the Columbia Screening tool in partnership with YScreen as part of a broad and community-wide suicide prevention program. As part of the effort, Agnesian Healthcare provided training and process improvement to the community health coalition and community partners. YScreen, a mental health screening tool for all 9th graders, was utilized throughout the county. * Suicide Prevention - Clinician Training. As part of a community-wide suicide prevention program, Agnesian Healthcare also hosted and training clinicians on motivation interviewing for potentially suicidal individuals. * Suicide Prevention - Safety Plans, Zero Suicide, QPR, TIC and ACEs. As part of a broader effort to reduce and prevent suicides in Fond du Lac County, Agnesian Healthcare piloted the Stanley Brown safety plan tool for all providers to use. Agnesian also provided training and process improvement activities for the Zero Suicide effort as well as additional training on QPR, trauma informed care (TIC) and adverse childhood experiences (ACEs). Alcohol and Other Drug Abuse: * Drug Free Communities. As part of efforts to address Healthy Fond du Lac 2020's Alcohol and Other Drug Abuse priority area, members of Agnesian Healthcare, a unit of SSM Health, participated in Fond du Lac County's Drug Free Communities program. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - St. Agnes Hospital. Patients and their guarantor's income is used in determining income level for free or discounted care. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - St. Agnes Hospital. Uninsured patients are automatically given a discount ranging in percentage based on the total amount due. 3 Fond du Lac Regional Clinic 420 E Division Street Fond du lac WI 54935 Outpatient physician clinic Consultants Lab of Wisconsin LLC 430 E Division Street Fond du lac WI 54935 Laboratory and testing Agnesian Healthcare Enterprises LLC 430 E Division Street Fond du lac WI 54935 Pharmaceuticals, home health, and medical supplies 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 AGNESIAN HEALTHCARE INC 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: COMMUNITY SUPPORT: VARIOUS COMMUNITY EDUCATIONAL EVENTS AND SUPPORT GROUPS, ENVIRONMENTAL IMPROVEMENTS: MANAGEMENT OF THE SHARPS HOME COLLECTION AND DISPOSAL PROGRAM, COALITION BUILDING: INVOLVEMENT WITH SCHOOL DISTRICTS AND BOARDS, AND PUBLIC HEALTH DEPARTMENTS TO IMPROVE COMMUNITY HEALTH MEASURES, WORKFORCE DEVELOPMENT: JOB SHADOWING, AND CLINICAL WORK EXPERIENCE PROGRAMS (IN PARTNERSHIP WITH COLLEGES AND OTHER HEALTH CARE ORGANIZATIONS). 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 Agnesian Healthcare 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. AGNES HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. PAYMENT IS DUE WITHIN 30 DAYS OF RECEIPT OF A STATEMENT. IF PATIENTS DO NOT SET UP ACCEPTABLE PAYMENT ARRANGEMENTS, BILLS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. FINANCIAL COUNSELORS WORK WITH ALL PATIENTS ON AN INDIVIDUAL BASIS AND MAY OFFER EXTENDED MONTHLY PAYMENTS WITHOUT INTEREST BASED ON DOLLAR AMOUNT, PRIVATE PAY DISCOUNTS (INDIVIDUALS WHO DO NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE BILLED AT A REDUCED RATE), OR GUARANTEED BANK LOANS. IF PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, THEIR EXPENSES ARE RECLASSIFIED AS CHARITY CARE. PATIENTS WHO RECEIVED A COLLECTION NOTICE COULD APPLY FOR CHARITY CARE. IF THEIR APPLICATION IS APPROVED, THIS WOULD TRIGGER A TRANSFER OF EXPENSES FROM BAD DEBT TO CHARITY CARE. Schedule H, Part V, Section B, Line 16a FAP website A - St. Agnes Hospital: Line 16a URL: https://www.agnesian.com/page/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - St. Agnes Hospital: Line 16b URL: https://www.agnesian.com/page/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - St. Agnes Hospital: Line 16c URL: https://www.agnesian.com/page/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 St. Agnes Hospital is located in Fond du Lac, Wisconsin, and defines its primary service area as Fond du Lac County, Wisconsin. In 2015, the population of the county was estimated at 102,793 adults. Approximately 17.5% of the population is age 65 or older, and 21.9% have obtained a Bachelor's degree or higher. Over one-third of the population lives in a rural area. The area of Fond du Lac County has a poverty rate of 7.7%, significantly lower than the state of Wisconsin and U.S. as a whole. Median household incomes for the county are also slightly above state and national amounts. Additional demographic and statistical data on Fond du Lac County's residents and their health can be found beginning on page 94 of the 2018 CHNA. Schedule H, Part VI, Line 5 Promotion of community health Agnesian Healthcare 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, Agnesian Healthcare Inc's 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. Agnesian Healthcare Inc promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote community health. Agnesian Healthcare 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 Agnesian Healthcare Inc is a 501(c)(3) organization and is a member of the integrated health care system know as SSM Health. Schedule H, Part VI, Line 7 State filing of community benefit report WI true Arc of Fond du Lac 500 N Park Avenue Fond du Lac WI 54935 391034161 501(c)(3) 50000 General support Moraine Park Technical College 235 N National Ave Fond du Lac WI 54936 391088212 Government 50000 General support Marian University 45 South National Avenue Fond du Lac WI 54935 391024723 501(c)(3) 62500 General support Ripon Area School District 1120 Metomen Street Ripon WI 54971 396004200 Government 8903 General support Boys & Girls Club of FDL 76 W 2nd Street Fond du Lac WI 54935 391896496 501(c)(3) 60000 General support ASTOP Inc 21 S Marr St Fond du Lac WI 54935 391707358 501(c)(3) 22000 General support Envision Greater FDL Inc 23 S Main Street No 101 Fond du Lac WI 54935 390284470 501(c)(6) 80000 General support Fond du Lac County Health Department 160 S Macy St Fond du Lac WI 54935 396005696 Government 100000 General support Children's Museum of FDL 75 West Scott St Fond du Lac WI 54935 562471187 501(c)(3) 11000 General support Fond du Lac Soccer Association PO Box 1292 Fond du Lac WI 54935 391369383 501(c)(3) 30000 General support Solutions Center 39 N Sophia Street Fond du Lac WI 54935 391452956 501(c)(3) 15000 General support Fond du Lac Area YMCA 90 W Second St Fond du Lac WI 54935 390806436 501(c)(3) 15000 General support Fond du Lac Food Pantry 573 W Rolling Meadows Dr Fond du Lac WI 54936 510156435 501(c)(3) 26800 General support 12 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT. X X X X true true false false false false false false false Paula Friedman Pt Yr Director/Vice President, Pt Yr Senior VP-Strategic Development SSM Health 0 270134 0 189852 0 924934 0 278843 0 3736 0 1667500 0 618871 Steven Little Pt Yr Director, Pt Yr Regional Chief Operating Officer, Wisconsin 0 119395 0 274864 0 1001341 0 5133 0 4379 0 1405111 0 112832 Mark Thompson Director, Regional Chief Medical Officer 0 494318 0 76618 0 4259 0 188808 0 30763 0 794765 0 76618 Kris Zimmer Treasurer, Chief Financial Officer at SSM Health 0 887868 0 230489 0 247277 0 797538 0 16082 0 2179255 0 340596 Doug Long Secretary, General Counsel at SSM Health 0 149400 0 0 0 80150 0 469438 0 2548 0 701536 0 0 Katherine Vergos President - St. Agnes Hospital 359780 0 99450 0 6206 0 125305 0 2830 0 593571 0 0 0 Nancy Birschbach Former Key Employee 0 282526 0 72043 0 1472 0 93377 0 25098 0 474515 0 22043 Bonnie Schmitz Former Key Employee 9272 0 130715 0 464567 0 269 0 0 0 604824 0 0 0 James Mugan Sr VP - Medical Group and Medical Affairs 301869 0 21157 0 16054 0 23625 0 31035 0 393740 0 0 0 Barbara Knutzen President - AHE, CLW and Performance 132400 0 17551 0 39695 0 16496 0 15137 0 221279 0 0 0 Michael Degere VP - Population Health Management 331658 0 23331 0 7750 0 23625 0 39400 0 425764 0 0 0 Michael Drees COO - Fond du Lac Regional Clinic 266880 0 18912 0 19023 0 22773 0 37979 0 365567 0 0 0 Yasir Hatahet Intensivist/Pulmonologist 493094 0 36508 0 22772 0 20001 0 38670 0 611046 0 0 0 Michael Vander Kooy Radiation Oncologist 655404 0 0 0 52068 0 23625 0 38132 0 769229 0 0 0 John Choi Physician 531286 0 151181 0 3604 0 23625 0 28663 0 738359 0 0 0 Steven Flurry Anesthesiologist 627105 0 0 0 44328 0 23625 0 29447 0 724505 0 0 0 Jacob Waidelich Physician 563714 0 0 0 1750 0 0 0 11388 0 576852 0 0 0 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: Steven Little $928,541 Paula Friedman $470,555 Bonnie Schmitz $401,794 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: Mark Thompson $38,000 Kris Zimmer $105,240 Katherine Vergos $28,428 Nancy Birschbach $22,550 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. Steven Little $56,667 Paula Friedman $429,019 Kris Zimmer $111,962 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: Paula Friedman $9,691 Kris Zimmer $66,609 A Wisconsin Health and Educational Facilities Authority 391337855 97712DXT8 2017-08-10 62792652 Finance capital improvements and refund 2010 and 2012 bonds false false false A 1320000 63093975 24742759 656999 23199248 14541303 102004 true true false true A false false false false 0.0 0.0 0.0 false false true A false true false false false true true A true CD Smith Construction WAYNE E MATZKE, DIRECTOR/OFFICER, IS ON BOARD OF DIRECTORS OF INTERESTED PERSON 5272351 Construction services false FOND DU LAC REGIONAL CLINIC SC DIRECTORS ARE EMPLOYEE-OWNERS OF INTERESTED PERSON 52613459 Physician services false HOLIDAY AUTO ENTITY OWNED BY THOR H GILBERTSON, DIRECTOR/OFFICER 64423 SALES AND SERVICE TO VEHICLES false Cynthia Schneider FAMILY MEMBER OF THOMAS SCHNEIDER, DIRECTOR 29632 EMPLOYMENT false Schedule L, Part IV, Column (b) FOND DU LAC REGIONAL CLINIC SC OWNERS THE FOLLOWING DIRECTORS LISTED ON FORM 990, PART VII, ARE EMPLOYEE-OWNERS OF THE FOND DU LAC REGIONAL CLINIC: DR DOUG FOWNES, DR JEFFERY STRONG, DR TONI STANLEY, AND DR TED MILLER. 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 Agnesian Healthcare Inc: Agnesian Healthcare Inc, operating as St. Agnes Hospital, has been providing healing care for almost 125 years. The hospital has grown into both an inpatient and outpatient facility providing innovative community and regional healthcare services to the greater Fond du Lac area. As a nonprofit Catholic institution, St. Agnes Hospital serves people of all faiths and beliefs. It is a leader in providing quality state-of-the-art healthcare services, whether it is cancer treatment; comprehensive heart care through the Dale Michels Center for Heart Care, including angioplasty and open-heart surgery; home or hospice care; maternity services; laser surgery; sports medicine; behavioral health services; women's health services; occupational health services; rehabilitation services and 24-hour emergency care. In 2018, St. Agnes Hospital received the American Heart Association's Get With The Guidelines - Heart Failure Silver Plus Quality Achievement Award. The award recognizes the hospital's commitment to ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines founded in the latest scientific evidence. St. Agnes Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of heart failure patients at a set level for a designated period. St. Agnes also earned The Joint Commission's Gold Seal of Approval and the American Heart Association/American Stroke Association's Heart-Check mark for advanced certification and quality for primary stroke centers. The hospital was also one of the 250 recipients of Healthgrades' 2018 Distinguished Hospital Award for Clinical Excellence. Agnesian Healthcare 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 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 $ 1,223,547 Unpaid Cost of Medicaid $ 23,342,777 Unpaid Cost of Medicare $ 7,752,816 Total Quantifiable Uncompensated Care $ 32,319,140 Form 990, Part VI, Line 2 Family/business relationships amongst interested persons DR DOUG FOWNES, DR JEFFERY STRONG, DR TONI STANLEY, AND DR TED MILLER - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders The sole member of the corporation is SSM Health Care of Wisconsin, Inc. SSM Health Care of Wisconsin, Inc, is a nonprofit 501(C)(3) organization. Both Agnesian Healthcare Inc and SSM Health Care of Wisconsin, Inc. are part of the integrated health care system known as SSM Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The member has the power to appoint additional, successor or replacement members and to appoint and remove the appointed directors and the ex officio directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The member has the following powers: A. to establish and change the mission, philosophy and values of the Corporation; B. to appoint additional, successor or replacement Members; C. to appoint and remove the Directors; D. to appoint and remove the President of the Corporation and the chief executive officer of any operating division of the Corporation; E. to approve amendments to the Articles of Incorporation of the Corporation as provided therein; F. to approve amendments to the Bylaws of the Corporation; G. to approve the merger, consolidation or dissolution of the Corporation; H. to approve the formation of a Controlled Subsidiary or a Remotely Controlled Subsidiary; I. to approve the sale of all or substantially all of the assets of the Corporation; J. to approve the acquisition or disposition by the Corporation of another legal entity or an interest in another legal entity; K. to authorize or approve the acquisition or disposition by the Corporation of real property or any interest in real property; L. to establish centralized employee benefit, insurance, investment, financing, corporate responsibility, performance assessment and improvement and other operational and support programs; to require the participation of the Corporation in such programs; and to authorize the opening and closing of bank accounts and investment accounts in the name of the Corporation in connection with such programs; M. to approve the strategic, financial and human resources plan of the Corporation; N. to appoint the auditor and corporate counsel for the Corporation; O. to authorize and approve borrowing money and entering into financial guaranties by the Corporation, including actions relating to the formation, joining, operation, withdrawal from and termination of a credit group or an obligated group and the granting of security interests in the property of the Corporation; P. to require the Corporation to transfer assets, including but not limited to cash, to SSMHCC or to any other entity exempt from federal income tax as an organization described in §501(c)(3) of the Internal Revenue Code of 1986, as amended, or the corresponding provision of any future United States Internal Revenue Law, which is controlled by SSMHCC, to the extent necessary to accomplish the mission, goals and objectives of SSMHCC as determined by SSMHCC; Q. to approve the transfer of assets by the Corporation to any entity other than SSMHCC, other than transfers made in the ordinary course of operations of the Corporation which will not require Member approval; and R. to determine the extent to which and the manner in which the powers described in this section which are reserved to SSMHCC with respect to the Corporation are to be included in the governing documents of any Controlled Subsidiary, Remotely Controlled Subsidiary or Non-Controlled Subsidiary and exercised with respect to any Controlled Subsidiary, any Remotely Controlled Subsidiary or any Non-Controlled Subsidiary. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 is prepared by the Tax Department of the parent organization, SSM Health Care Corporation (SSM). The Form 990 is reviewed by certain members of Senior Management. Any questions are addressed to the Tax Director of SSM prior to filing the Form 990 with the Internal Revenue Service. A copy of the Form 990 is provided to the Board of Directors at the next regularly scheduled board meeting. Form 990, Part VI, Line 12c Conflict of interest policy A written conflict of interest and insider transaction policy exists which requires each director, principal officer, trustee or committee member to disclose on a annual basis to the designated authority a conflict of interest disclosure statement. The designated authority ensures that all statements are completed, reviews them for conflicts, and submits to the board for review any conflict of interest disclosure statements that disclose actual or potential conflicts. Form 990, Part VI, Line 15a Process to establish compensation of top management official Determination of compensation of the CEO and officers includes analysis of comparable compensation to the board of directors. The board of directors, who are independent, review and approve the compensation package for officers, and contemporaneous substantiation of the deliberation and decision is included in the board minutes. The final agreement is documented with a written contract, which is signed by both parties. Form 990, Part VI, Line 15b Process to establish compensation of other employees An annual survey is performed by an outside company. Form 990, Part VI, Line 19 Required documents available to the public The year-end audited consolidated financial statements and unaudited quarterly consolidated financial statements for the SSM Health System are made available to the public on SSM Health's website. The organization's Articles of Incorporation are available on the Wisconsin Secretary of State's website. Copies of the Form 990 and the conflict of interest policy are available to the public upon request. Form 990, Part IX, Line 11g Other Fees Medical and other professional fees - Total Expense: 79500630, Program Service Expense: 37913012, Management and General Expenses: 41586822, Fundraising Expenses: 796; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in beneficial interest in foundation - 3031277; Fund balance transfers - -8427758; Consultants Laboratory of Wisconsin LLC 430 E Division Street Fond du lac WI 54935 391528550 Lab services WI 28858377 14651523 Agnesian Healthcare Inc Agnesian Healthcare Enterprises LLC 430 E Division Street Fond du lac WI 54935 392038757 Retail pharmacy WI 9568369 7751222 Agnesian Healthcare Inc SSM Health Care Corporation 10101 Woodfield Lane St Louis MO 63132 466029223 Health Care MO 501(c)(3) Type I SSM Health Ministries false SSMHC Liability Trust I 10101 Woodfield Lane St Louis MO 63132 436331003 Insurance MO 501(c)(3) Type I SSM Health Care Corporation false SSM Consolidated Health Services 10101 Woodfield Lane St Louis MO 63132 431473657 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Policy Institute 10101 Woodfield Lane St Louis MO 63132 431788151 Health Care MO 501(c)(4) SSM Health Care Corporation false SSM Health Care Portfolio Management Co 10101 Woodfield Lane St Louis MO 63132 431825256 Management MO 501(c)(3) Type I SSM Health Care Corporation false SSM Cardinal Glennon Children's Hospital 10101 Woodfield Lane St Louis MO 63132 430738490 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false Cardinal Glennon Children's Foundation 10101 Woodfield Lane St Louis MO 63132 431754347 Fundraising MO 501(c)(3) 7 SSM Cardinal Glennon Children's Hospital false SSM Health Foundation - St Louis 10101 Woodfield Lane St Louis MO 63132 431552945 Fundraising MO 501(c)(3) 7 SSM Health Care St Louis false SSM Health Care of Oklahoma Inc 10101 Woodfield Lane St Louis MO 63132 730657693 Health Care OK 501(c)(3) 3 SSM Health Care Corporation false The St Anthony Hospital Foundation Inc 10101 Woodfield Lane St Louis MO 63132 736104300 Fundraising OK 501(c)(3) 7 SSM Health Care of Oklahoma false SSM Health Care of Wisconsin Inc 10101 Woodfield Lane St Louis MO 63132 430688874 Health Care WI 501(c)(3) 3 SSM Health Care Corporation false Dells Medical Building Inc 10101 Woodfield Lane St Louis MO 63132 391613292 MOB WI 501(c)(2) SSM Health Care of Wisconsin false St Mary's Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940686 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false St Clare Health Care Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940683 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Home Health United Inc 2802 Walton Commons Lane Madison WI 53718 391539827 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false Home Care United Inc 2802 Walton Commons Lane Madison WI 53718 391776340 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false HHU Xtra Care Inc 2802 Walton Commons Lane Madison WI 53718 391705111 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false SSM Health at Home Foundation of Wisconsin Inc 2802 Walton Commons Lane Madison WI 53718 391839309 Fundraising WI 501(c)(3) Type I Home Health United Inc false SSM Regional Health Services 10101 Woodfield Lane St Louis MO 63132 440579850 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false St Mary's Health Center Jefferson City Missouri Foundation 10101 Woodfield Lane St Louis MO 63132 431575307 Fundraising MO 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center 10101 Woodfield Lane St Louis MO 63132 430653587 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's Hospital Centralia Illinois 10101 Woodfield Lane St Louis MO 63132 370662580 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's - Good Samaritan Inc 10101 Woodfield Lane St Louis MO 63132 364170833 Health Care IL 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center Foundation 10101 Woodfield Lane St Louis MO 63132 262884795 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Foundation 10101 Woodfield Lane St Louis MO 63132 364636691 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Auxiliary 400 N Pleasant Centralia IL 62801 237126345 Fundraising IL 501(c)(3) 10 St Mary's Hospital Foundation false SSM Health Businesses 10101 Woodfield Lane St Louis MO 63132 431333488 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Health Care St Louis 10101 Woodfield Lane St Louis MO 63132 431343281 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false Centralia Medical Services Bldg Assoc 10101 Woodfield Lane St Louis MO 63132 237408025 MOB IL 501(c)(3) Type I SSM Regional Health Services false St Mary's Janesville Foundation Inc 10101 Woodfield Lane St Louis MO 63132 273439133 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false SSM Health Ministries 3221 McKelvey Road Suite 107 Bridgeton MO 63044 431012492 Religious Organization MO 501(c)(3) 1 NA false Lee Dewey Corporation 10101 Woodfield Lane St Louis MO 63132 731279603 MOB OK 501(c)(3) Type I SSM Health Care of Oklahoma false SSM Hospice & Home Care Foundation 10101 Woodfield Lane St Louis MO 63132 300012246 Fundraising MO 501(c)(3) 7 SSM Health Businesses false St Mary's Hospital Auxiliary 100 St Marys Medical Plaza Jefferson City MO 65101 436049878 Fundraising MO 501(c)(3) Type II NA false Good Samaritan Hospital Auxiliary 1 Good Samaritan Way Mount Vernon IL 62864 237049599 Fundraising IL 501(c)(3) Type III-FI NA false St Anthony Shawnee Hospital Inc 1000 N Lee Ave Oklahoma City OK 73102 455055149 Health Care OK 501(c)(3) 3 SSM Health Care of Oklahoma false SSM Audrain Health Care Inc 10101 Woodfield Lane St Louis MO 63132 431550298 Health Care MO 501(c)(3) 3 SSM Regional Health Services false Audrain Medical Center Foundation Inc 620 E Monroe St Mexico MO 65265 431265060 Fundraising MO 501(c)(3) Type I NA false SSM-SLUH Inc 10101 Woodfield Lane St Louis MO 63132 474196634 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false SSM Health Plan 1277 Deming Way Madison WI 53717 831979548 Insurance MO 501(c)(4) SSM Health Businesses false Ripon Medical Center Inc 845 Parkside Street Ripon WI 54971 391101287 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc true Waupun Memorial Hospital Inc 620 West Brown Street Waupun WI 53963 390806265 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc true 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 true 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 true Villa Rosa Inc N8120 County WW Mount Calvary WI 53057 421670962 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc true The Christian Home and Rehabilitation Center Incorporated 331 Bly Street Waupun WI 53963 390884514 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc true The Monroe Clinic Inc 515 22nd Avenue Monroe WI 53566 390808509 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Monroe Clinic and Hospital Foundation Inc 515 22nd Avenue Monroe WI 53566 205769038 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Agnesian Healthcare Foundation Inc 430 E Division St Fond du Lac WI 54935 391684956 Fundraising WI 501(c)(3) Type I SSM Health Care of Wisconsin false Shared Magnetic Resonance Imaging Facility Inc 1104 John Nolen Drive Madison WI 53713 391534744 Health Care WI 501(c)(3) Type I SSM Health Care of Wisconsin false SSM St Joseph Endoscopy Center LLC 10101 Woodfield Lane St Louis MO 63132 270046559 Surgery Services MO NA N/A 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 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 false false true false false false false false false true true false true true true true false false false Agnesian Healthcare Foundation Inc C 568781 Book The Christian Home and Rehabilitation Center Incorporated M 27736 Cash payments St Francis Home of Fond du Lac Wisconsin M 201678 Cash payments Sister Servants of Christ the King Villa Loretto M 58058 Cash payments Ripon Medical Center M 36757 Cash payments