STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SSM AUDRAIN HEALTH CARE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
SSM AUDRAIN HEALTH CARE INC (EIN 43-1550298)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201843179349307714
Schema version
2017v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-13T17:02:35-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Crowe LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line19600 Brownsboro Road Suite 400AddressLine1Txt
CityLouisvilleCityNm
State AbbreviationKYStateAbbreviationCd
ZIP402411122ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN431550298EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SSM Audrain Health Care IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSSMABusinessNameControlTxt
Phone5735825000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 Woodfield LaneAddressLine1Txt
CitySt LouisCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63132ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJune L PickettPersonNm
Person TitleSecretaryPersonTitleTxt
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRachel SpurlockPreparerPersonNm
PTINP00520729PTIN
Phone5023263996PhoneNum
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1See Schedule OBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Laura KaiserBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 Woodfield LaneAddressLine1Txt
CitySt LouisCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63132ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$56,731,967GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ssmhealth.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1990FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionOperates an 89-bed community hospital offering a range of services including emergency care, cardiology services, medical imaging, women and child services and diabetes education.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee499TotalEmployeeCnt
Total Volunteers61TotalVolunteersCnt
Total Gross UBI$78,784TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$55,849NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$825,392PYContributionsGrantsAmt
CY Contributions Grants$116,992CYContributionsGrantsAmt
PY Program Service Revenue$56,067,086PYProgramServiceRevenueAmt
CY Program Service Revenue$56,304,180CYProgramServiceRevenueAmt
PY Investment Income-$80,552PYInvestmentIncomeAmt
CY Investment Income-$1,392CYInvestmentIncomeAmt
PY Other Revenue$270,929PYOtherRevenueAmt
CY Other Revenue$304,135CYOtherRevenueAmt
PY Total Revenue$57,082,855PYTotalRevenueAmt
CY Total Revenue$56,723,915CYTotalRevenueAmt
PY Grants And Similar Paid$2,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,536,862PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$29,947,962CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$35,931,911PYOtherExpensesAmt
CY Other Expenses$35,421,150CYOtherExpensesAmt
PY Total Expenses$63,470,773PYTotalExpensesAmt
CY Total Expenses$65,370,112CYTotalExpensesAmt
PY Revenues Less Expenses-$6,387,918PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$8,646,197CYRevenuesLessExpensesAmt
Total Assets BOY$29,301,883TotalAssetsBOYAmt
Total Assets EOY$26,167,518TotalAssetsEOYAmt
Total Liabilities BOY$42,895,931TotalLiabilitiesBOYAmt
Total Liabilities EOY$48,400,224TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$13,594,048NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$22,232,706NetAssetsOrFundBalancesEOYAmt
MissionTHROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$56,447,730ExpenseAmt
Grant$1,000GrantAmt
Revenue$56,225,396RevenueAmt
DescPlease see Schedule O for a complete description of program service accomplishments.Desc
Total Program Service Expenses$56,447,730TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee499EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH HENDERSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5736813000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12505 MISSION DRIVEAddressLine1Txt
CityJEFFERSON CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65109ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Paula Friedman
Vice President, Chief Strategy Officer at SSM Health1.054.0Yes (X)Yes (X)$0$856,416$891,366
William Thompson
Pt Yr President, Pt Yr CEO of SSM Health1.056.0Yes (X)Yes (X)$0$1,280,477$547,089
Kris Zimmer
Treasurer/Asst Sec, Senior VP-Finance SSM Health1.057.0Yes (X)Yes (X)$0$973,103$961,176
Laura S Kaiser
President, President/CEO of SSM Health1.055.0Yes (X)Yes (X)$0$1,325,216$268,145
Christopher Howard
Chief Operations Officer at SSM Health1.055.0Yes (X)$0$985,838$1,036,792
Shane Peng MD
Pt Yr Director, Pt Yr President-Physician and Ambulatory at SSM Health1.047.0Yes (X)$0$1,218,862$203,481
June Pickett
Secretary, Asst VP Governance & Archives, SSM Health1.065.1Yes (X)$0$262,856$51,074
Jim Stratton
Regional CFO20.021.0Yes (X)$0$237,745$37,090
Donna Jacobs
Hospital President-SSM Health St. Mary's Hospital - Audrain40.01.0Yes (X)$259,920$28,569$32,646
Kari Wilson
COO/CNO40.00.0$158,635$0$34,805Yes (X)
Clark Andelin
Physician40.00$483,099$0$30,563Yes (X)
Peter Perll
Physician40.00$437,965$0$16,688Yes (X)
N Eugene Thomas
Physician40.00$333,646$0$30,107Yes (X)
Shahid Waheed
Physician40.00$501,113$0$32,175Yes (X)
Eric Kondro
Physician40.00$342,077$0$12,897Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,516,455TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,169,082TotReportableCompRltdOrgAmt
Total Other Compensation$4,186,094TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MID-MISSOURI ANESTHESIA CONSULTANTS PC
1445 CHRISTY DRIVEJEFFERSON CITYMO65101ANESTHESIOLOGY$1,173,169
REINHARDT CONSTRUCTION COMPANY
627 N ROLLINSCENTRALIAMO65240CONSTRUCTION SERVICES$1,008,694
JACKSON AND COKER HOLDINGS LLC
3000 OLD ALABAMA ROADALPHARETTAGA30022EMPLOYMENT AGENCY$473,692
AUDRAIN EMERGENCY GROUP LLC
PO BOX 82368LAFAYETTELA70598EMERGENCY SERVICES$422,505
Audrain Physician Services LLC
PO Box 82368LafayetteLA70598Physician services$398,650
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt
Related Organizations$104,386RelatedOrganizationsAmt
Government Grants$12,606GovernmentGrantsAmt
Noncash Contributions$1,838NoncashContributionsAmt
Total Contributions$116,992TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE621400$55,839,578$55,839,578
OTHER HEALTHCARE REVENUE621400$464,602$385,818$78,784

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$56,304,180TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$907TotalRevenueColumnAmt
Exclusion$907ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$102,080RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$5,753RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$96,327RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$96,327TotalRevenueColumnAmt
Exclusion$96,327ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$2,299OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$2,299OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,299TotalRevenueColumnAmt
Exclusion-$2,299ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Cafeteria722514$199,658$199,658
Medical staff dues900099$8,150$8,150

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$207,808OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,723,915TotalRevenueColumnAmt
Related Or Exempt Func Income$56,225,396RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$78,784UnrelatedBusinessRevenueAmt
Exclusion$302,743ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Program Services$1,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$453,359TotalAmt
Program Services$193,439ProgramServicesAmt
Management And General$259,920ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$23,223,462TotalAmt
Program Services$20,348,213ProgramServicesAmt
Management And General$2,875,249ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,124,584TotalAmt
Program Services$974,253ProgramServicesAmt
Management And General$150,331ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,591,660TotalAmt
Program Services$3,111,954ProgramServicesAmt
Management And General$479,706ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,554,897TotalAmt
Program Services$1,348,702ProgramServicesAmt
Management And General$206,195ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$442,615TotalAmt
Program Services$251,514ProgramServicesAmt
Management And General$191,101ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$72,223TotalAmt
Management And General$72,223ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,900TotalAmt
Management And General$37,900ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,204,439TotalAmt
Program Services$6,304,100ProgramServicesAmt
Management And General$1,900,339ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,348TotalAmt
Management And General$2,348ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,048,544TotalAmt
Program Services$2,772,660ProgramServicesAmt
Management And General$275,884ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,974,674TotalAmt
Program Services$2,964,301ProgramServicesAmt
Management And General$10,373ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,432,754TotalAmt
Program Services$2,361,988ProgramServicesAmt
Management And General$70,766ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$196,364TotalAmt
Program Services$166,322ProgramServicesAmt
Management And General$30,042ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$90,218TotalAmt
Program Services$83,823ProgramServicesAmt
Management And General$6,395ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,612TotalAmt
Program Services$7,612ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,708,637TotalAmt
Program Services$2,705,404ProgramServicesAmt
Management And General$3,233ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$386,456TotalAmt
Management And General$386,456ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$9,615,219$9,615,219
MEDICAID PROVIDER TAX$3,186,523$3,186,523
LICENSES AND TAXES$50,109$38,716$11,393
Internal management fees$1,952,528$1,952,528

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$11,987TotalAmt
Program Services$11,987ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$65,370,112TotalAmt
Program Services$56,447,730ProgramServicesAmt
Management And General$8,922,382ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$162,230BOYAmt
EOY$139,896EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,049,881BOYAmt
EOY$6,891,470EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,050,073BOYAmt
EOY$909,770EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$540,414BOYAmt
EOY$746,115EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$25,907,808LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,266,709LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,929,377BOYAmt
EOY$15,641,099EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$910,332BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$106,860BOYAmt
EOY$92,131EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,552,716BOYAmt
EOY$1,747,037EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,301,883BOYAmt
EOY$26,167,518EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$28,832,861BOYAmt
EOY$38,526,640EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,063,070BOYAmt
EOY$9,873,584EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,895,931BOYAmt
EOY$48,400,224EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$14,266,576BOYAmt
EOY-$22,951,543EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$352,548BOYAmt
EOY$398,857EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$319,980BOYAmt
EOY$319,980EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$13,594,048BOYAmt
EOY-$22,232,706EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,301,883BOYAmt
EOY$26,167,518EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$8,646,197ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$7,539OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$28,802GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$28,802TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYTHE ORGANIZATION PAID DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYTHE ORGANIZATION PAID DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES.

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$342,786BeginningYearBalanceAmt
Investment Earnings Or Losses$29,755InvestmentEarningsOrLossesAmt
End Year Balance$372,541EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$326,711BeginningYearBalanceAmt
Investment Earnings Or Losses$16,075InvestmentEarningsOrLossesAmt
End Year Balance$342,786EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$337,840BeginningYearBalanceAmt
Investment Earnings Or Losses-$11,129InvestmentEarningsOrLossesAmt
End Year Balance$326,711EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$319,830BeginningYearBalanceAmt
Contributions$150ContributionsAmt
Investment Earnings Or Losses$17,860InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
End Year Balance$337,840EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,342,128BeginningYearBalanceAmt
Contributions$80,000ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$3,102,298AdministrativeExpensesAmt
End Year Balance$319,830EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.0BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.86PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.14TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$590,575OtherCostOrOtherBasisAmt
Book Value$590,575BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,769,226OtherCostOrOtherBasisAmt
Depreciation$1,806,228DepreciationAmt
Book Value$6,962,998BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,038,128OtherCostOrOtherBasisAmt
Depreciation$188,650DepreciationAmt
Book Value$849,478BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,866,414OtherCostOrOtherBasisAmt
Depreciation$8,162,984DepreciationAmt
Book Value$6,703,430BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$643,465OtherCostOrOtherBasisAmt
Depreciation$108,847DepreciationAmt
Book Value$534,618BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,641,099TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$262,312
Due from Affiliates$341,768
Third-party receivable$147,000
Beneficial interest in Foundation$995,957
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,747,037TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
ESTIMATED PENSION LIABILITY$5,734,667
ASSET RETIREMENT OBLIGATION$636,761
DUE TO THIRD-PARTY PAYORS$1,612,275
CAPITAL LEASE$43,629
DUE TO AFFILIATES$701,433
Defined contribution liability$876,000
Third-party patient loans$268,819
FieldValueIRS element (for citing)
Total Liability$9,873,584TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4 Intended uses of endowment fundsALL FUNDS ARE USED TO PROVIDE HEALTH CARE SERVICES AND CAPITAL IMPROVEMENTS.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteSSM AUDRAIN HEALTH CARE, 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 RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2017 OR 2016.

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,940,346TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,940,346NetCommunityBenefitExpnsAmt
Total Expense0.0297TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,749,958TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,837,060DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,912,898NetCommunityBenefitExpnsAmt
Total Expense0.0293TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$532,437TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$361,688DirectOffsettingRevenueAmt
Net Community Benefit Expns$170,749NetCommunityBenefitExpnsAmt
Total Expense0.0026TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$13,222,741TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,198,748DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,023,993NetCommunityBenefitExpnsAmt
Total Expense0.0616TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$59,221TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$56,521NetCommunityBenefitExpnsAmt
Total Expense0.0009TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,674TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,674NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,460TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$36,460NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$104,355TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,700DirectOffsettingRevenueAmt
Net Community Benefit Expns$101,655NetCommunityBenefitExpnsAmt
Total Expense0.0016TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$13,327,096TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,201,448DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,125,648NetCommunityBenefitExpnsAmt
Total Expense0.0631TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

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

Community Support CommunitySupportGrp

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

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

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

Health Improvement Advocacy HealthImprovementAdvocacyGrp

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

Workforce Development WorkforceDevelopmentGrp

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

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$3,217,834BadDebtExpenseAmt
Reimbursed By Medicare$18,460,808ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$22,388,021CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,927,213MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SSM Health St Mary's Hospital - AudrainBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 E MONROEAddressLine1Txt
CityMEXICOCityNm
State AbbreviationMOStateAbbreviationCd
ZIP65265ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.ssmhealthmidmo.com/locations/st-marys-audrainWebsiteAddressTxt
State License36-57StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting GroupAFacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.ssmhealth.com/locations/st-marys-hospital-audrainOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLhttps://www.ssmhealth.com/about/community-health-needs-assessmentsOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.ssmhealth.com/about/community-health-needs-assessmentsStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.ssmhealth.com/for-patients/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.ssmhealth.com/for-patients/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.ssmhealth.com/for-patients/financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility A, 1Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. SSM Health St. Mary's Hospital - Audrain conducted a community health needs assessment which included soliciting feedback from community members in the form of surveys and focus groups. Surveys were administered to SSM Health clinics in Auxvasse, Mexico, Montgomery City, Paris, Perry, Vandalia and Wellsville. Additional surveys were made available in the Montgomery County Health Department. Medical staff and patients responded over a one month period, resulting in completed surveys from 24 providers and 96 patients. Focus groups gathered community feedback from 16 individuals, including representatives from both Audrain and Montgomery County Health Departments. A list of individuals included in primary data collection can be found on page 24 of the CHNA. Additionally, the hospital directed special attention to health issues that impact a significant portion of the community and for which disparities exist with minorities or the underserved. The hospital included voices that represent these groups in their discussions and studies.
Schedule H, Part V, Section B, Line 6a Facility A, 1Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. SSM Health St. Mary's Hospital - Audrain and its affiliate, SSM Health St. Mary's Hospital - Jefferson City, conducted research and prioritization of needs in cooperation with each other.
Schedule H, Part V, Section B, Line 11 Facility A, 1Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. SSM Health's mission statement is "Through our exceptional health care services, we reveal the healing presence of God." During 2015, in collaboration with our community partners, SSM Health St. Mary's Hospital - Audrain conducted a Community Health Needs Assessment (CHNA) and developed a strategic implementation plan for the 2016-2018 cycle. The strategic priorities we will address over the next three years include: heart disease and cancer. The SSM Health Mid-Mo Regional Board approved this CHNA on December 17, 2015. SSM Health St. Mary's Hospital - Audrain last conducted a CHNA in 2012. Based on the 2016-2018 SSM Health St. Mary's Hospital - Audrain CHNA outcomes, heart disease was identified as a primary health need for the service area. The percentage of the Medicare population with a diagnosis of ischemic heart disease in Audrain and Montgomery Counties is 33.4% and 33.7%, respectively, compared to the national average of 28.2%. The following goals were achieved in 2017 to address heart disease and obesity: - Goal: Reduce age-adjusted death rate due to heart disease in our region from 231.4 deaths per 100,000 individuals, as reported in 2015, to 225 deaths per 100,000 individuals by 2018, 2017 showed a below-goal death rate of 219.22. - Goal: Decrease percentage of all-cause/all-location congestive heart failure 30-day hospital readmission rate at SSM Health St. Mary's Hospital - Audrain from 16% in 2015 to 15.3% by 2018, readmission rate was below goal at 13.2% in 2017. Based on the 2016-2018 SSM Health St. Mary's Hospital - Audrain CHNA outcomes, another top health need the service area is cancer. Only second in deaths to heart disease, cancer in the area is influenced by a local economy heavily dependent on agricultural processes that can potentially introduce harmful byproducts into the human system. Tobacco use is also higher in the service area than most communities. The following goals were targeted in 2017 to address access to additional health care specialist and services: - Goal: Reduce the age-adjusted death rate due to cancer in our region from 178.2 deaths per 100,000 individuals, as reported in 2015, to 175 deaths per 100,000 individuals by 2018. - Goal: Increase percentage of stage 1 breast cancer initial diagnosis' from 19.7% (hospital 5-year 2010-2014 baseline average) to 24.7% by 2018. - Goal: Increase percentage of stage 1 lung cancer initial diagnosis' from 37.5% (hospital 5-years 2010-2014 baseline average) to 42.5% in 2018. The Hospital continues to aim for breast and lung cancer initial diagnoses at their goal rates.
FieldValueIRS element (for citing)
Facility15FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
111 WEST BATESWELLSVILLEMO63384OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
1223 EAST MAIN STREETPERRYMO63462OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
201 SOUTH MAIN STREETAUXVASSEMO65231OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
204 WEST WASHINGTONVANDALIAMO63382OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
240 NORTH PICKERINGMONTGOMERY CITYMO63361OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
350 COUNTRY MEADOWS LANEFULTONMO65261OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - PEDIATRICS
3626 SOUTH CLARK STREET SUITE AMEDICOMO65265PEDIATRIC CLINIC
SSM HEALTH URGENT CARE
3626 SOUTH CLARK STREET SUITE CMEXICOMO65265URGENT CARE FACILITY
SSM HEALTH MEDICAL GROUP - PAIN MANAGEMENT
515 EAST PROMENADE STREETMEXICOMO65265PAIN MANAGEMENT CLINIC
SSM HEALTH MEDICAL GROUP - WOMEN'S HEALTH
605 EAST PROMENADE STREET SUITE AMEXICOMO65265OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH MEDICAL GROUP - INTERNAL MEDICINE
600 MEDICAL PARK DRIVEMEXICOMO65265OUTPATIENT PHYSICIAN CLINIC
SSM HEALTH SLEEP CENTER
620 EAST MONROE STREETMEXICOMO65265SLEEP CENTER
SSM HEALTH MEDICAL GROUP - GENERAL SURGERY
626 EAST SUMMIT STREET SUITE FMEXICOMO65265SURGICAL SERVICES
SSM HEALTH CANCER CENTER
713 EAST JACKSON STREETMEXICOMO65265CANCER CENTER
SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE
809 MEDICAL PARK DRIVE SUITE 101MEXICOMO65265OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3bServices eligible under the financial assistance policy will be made available to the patient on a sliding fee scale, in accordance with financial need, as determined in reference to Federal Poverty Levels (FPL) in effect at the time of the determination. The basis for the amounts the hospital will charge patients qualifying for financial assistance is as follows: Patients whose family income is above 200% but not more than 400% of the FPL are eligible to receive discounted services at amounts no greater than the amounts generally billed to the hospital's commercially insured or Medicare patients.
Schedule H, Part I, Line 3cPatients 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 6aSSM Health St. Mary's Hospital - Audrain is part of the integrated health system known as SSM Health. In an effort to maximize its community impact, the organization prepares a community benefit report that highlights the concerns of the community, how to address them, and the progress made. This report, however, is kept internally and is used by the organization to deliver the best care to the community.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceFinancial Assistance Methodology: The cost of financial assistance is calculated in compliance with catholic health association (CHA) guidelines. A cost to charge ratio calculated using the IRS worksheet 2, ratio of patient care cost to charges, was used to compute financial assistance at cost. This is the ratio of total adjusted operating expense to total gross patient revenue. The gross revenue amount is a gross amount - prior to contractual adjustments and bad debts. Both gross revenue and costs are based on charges at date/time of service. Unreimbursed Medicaid Costing Methodology: The cost of unreimbursed Medicaid is calculated in compliance with Catholic Health Association (CHA) guidelines. A cost to charge ratio calculated utilizing IRS Worksheet 2, Ratio of patient care cost to charges, was used to compute unreimbursed Medicaid costs. This is the ratio of total adjusted operating expenses to total gross patient revenue. The gross revenue amount is gross amount - prior to contractual adjustments and bad debts. Both gross revenue and costs are based on charges at date/time of service. Community health improvement services and community benefit operations costing methodology: The costs for these programs were derived from the actual costs incurred in these areas. Subsidized health services costing methodology: The expenditures are determined based on actual invoices or dollar amounts spent and charged to these departments, reduced by any grant revenues restricted for these services, if any. Research costing methodology: Research expenses were taken from the income and expense statements for the research departments, derived from the accounting system. Cash and In-Kind contributions to community groups costing methodology: Contribution expenditures are based on actual invoices that were captured and reported for this program, derived from the accounting system.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountBAD DEBT EXPENSE IS REPORTED BASED ON THE ORGANIZATION'S FINANCIAL STATEMENT REPORTING.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologySSM Health St. Mary's Hospital - Audrain did not make an estimate of the organization's bad debt attributable to patients eligible under the organization's financial assistance policy.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteSSM Health St. Mary's Hospital - Audrain is part of the SSM Health consolidated audit. The footnote that references bad debt expense in the December 31, 2017 consolidated audit is contained on page 19 and 20 of the attached financial statements.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsTHE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceSSM Health St. Mary's Hospital - Audrain 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 SSM Audrain Health Care, Inc. collection and financial assistance policies.
Schedule H, Part V, Section B, Line 16a FAP websiteA - SSM Health St. Mary's Hospital - Audrain: Line 16a URL: https://www.ssmhealth.com/for-patients/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application websiteA - SSM Health St. Mary's Hospital - Audrain: Line 16b URL: https://www.ssmhealth.com/for-patients/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary websiteA - SSM Health St. Mary's Hospital - Audrain: Line 16c URL: https://www.ssmhealth.com/for-patients/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessmentSSM Health (SSMH) participates in Community Benefit according to our vision, Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically, and socially marginalized, will experience improved health in mind, body, spirit and environment. In the tradition of our founders, the Franciscan Sisters of Mary, caring for those in greatest need remains our organizational priority. Today our System Board monitors Community Benefit efforts, and views achievement of our vision as a primary responsibility. The purpose of SSMH'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, SSMH'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 conduced 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). CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: * Collect and enter data: Send out emails reminding staff to submit activities; enter data into Lyon; and run reports to share with leaders. * Finalize and report on prior year: Enter all prior year data into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. 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 assistanceAll SSMH facilities will strive to provide exceptional health care services to all persons in need regardless of their ability to pay. All billing and collection policies reflect the mission and values of SSMH, including our special concern for people who are poor and vulnerable. SSMH facilities offer discounts for hospital services to all uninsured persons. Self-pay discounts apply to everyone who does not have health insurance, no matter their ability to pay. SSMH applies its charity care policies fairly and consistently. Each person is treated as an individual with specific needs for assistance without regard to payment. SSMH embraces its responsibility to serve the communities in which we participate by establishing sound business practices. Charity care is provided to patients based on a sliding scale for household incomes up to four times the federal poverty level. Patients whose household income is no more than two times the federal poverty level are eligible for free hospital services. In addition, an exception to the sliding scale is provided for a patient's balance due if the amount is too large to be reasonably paid through an installment plan over four years given the family income and expenses. 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 informationSSM Health St. Mary's Hospital - Audrain service area includes the Missouri counties of Audrain and Montgomery. The total population for the service area was 37,617 in 2012. Overall population is projected to decline. The MSA has a slightly higher proportion of female population (54%). Additional detailed information on the demographics and community health rankings of the community served by St. Mary's Hospital - Audrain can be found in the hospital's 2015 CHNA on pages 6 and 13 through 20. SSM Health St. Mary's Hospital - Audrain provides these services at its hospitals: J.B. & Greeta B Arthur cancer center, diabetes education, emergency department, healthworks rehabilitation, Jordan-waters heart center, lab services, medchoice clinics, medical imaging, sleep lab, and women's and children's services.
Schedule H, Part VI, Line 5 Promotion of community healthSSM Health St. Mary's Hospital - Audrain 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, SSM Health St. Mary's 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. Mary's Hospital - Audrain 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. SSM Health St. Mary's Hospital - Audrain 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 systemSSM Audrain Health Care is a 501(c)(3) organization and is a member of the integrated health care system known as SSM Health. SSM Health is a 501(c)(3) organization headquartered in St. Louis, Missouri.
Schedule H, Part VI, Line 7 State filing of community benefit reportMO

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Paula Friedman
Vice President, Chief Strategy Officer at SSM Health$0$706,550$0$0$0$149,866$0$871,392$0$19,974$0$1,747,782$0$0
William Thompson
Pt Yr President, Pt Yr CEO of SSM Health$0$661,230$0$0$0$619,247$0$542,525$0$4,564$0$1,827,566$0$562,455
Kris Zimmer
Treasurer/Asst Sec, Senior VP-Finance SSM Health$0$870,069$0$0$0$103,034$0$930,581$0$30,595$0$1,934,279$0$0
Laura S Kaiser
President, President/CEO of SSM Health$0$1,076,161$0$200,000$0$49,055$0$252,000$0$16,145$0$1,593,361$0$0
Christopher Howard
Chief Operations Officer at SSM Health$0$873,028$0$0$0$112,810$0$1,006,272$0$30,520$0$2,022,630$0$0
Shane Peng MD
Pt Yr Director, Pt Yr President-Physician and Ambulatory at SSM Health$0$955,899$0$0$0$262,963$0$170,055$0$33,426$0$1,422,343$0$0
June Pickett
Secretary, Asst VP Governance & Archives, SSM Health$0$229,924$0$0$0$32,932$0$34,295$0$16,779$0$313,930$0$0
Jim Stratton
Regional CFO$0$216,680$0$0$0$21,065$0$17,031$0$20,059$0$274,835$0$0
Donna Jacobs
Hospital President-SSM Health St. Mary's Hospital - Audrain$248,850$21,298$0$0$11,070$7,271$0$25,734$0$6,912$259,920$61,215$0$0
Kari Wilson
COO/CNO$155,852$0$0$0$2,783$0$9,045$0$25,760$0$193,440$0$0$0
Clark Andelin
Physician$456,089$0$0$0$27,010$0$3,894$0$26,669$0$513,662$0$0$0
Peter Perll
Physician$414,983$0$0$0$22,982$0$4,050$0$12,638$0$454,653$0$0$0
N Eugene Thomas
Physician$319,355$0$0$0$14,291$0$3,611$0$26,496$0$363,753$0$0$0
Shahid Waheed
Physician$476,852$0$0$0$24,261$0$4,050$0$28,125$0$533,288$0$0$0
Eric Kondro
Physician$338,540$0$0$0$3,537$0$0$0$12,897$0$354,974$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationThe organization's top management official, the 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 SSM Health board or compensation committee.
Schedule J, Part I, Line 4a Severance or change-of-control paymentSSMH 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 individual received payments under the plan in the current year. Shane Peng, MD 137,423
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planPension Restoration Plan: SSM Health (SSMH) provides this supplemental defined benefit nonqualified retirement plan to any employee who is a participant in the SSMH qualified defined benefit plan who earns over the Internal Revenue Service compensation limit. The plan "restores" the benefits to these employees that would have been provided under the SSMH qualified plan if the regulations did not impose compensation limits. An individual can take a distribution from the plan at (1) age 65 or older if the individual is still employed by SSMH or (2) age 55 or older if the individual is no longer employed by SSMH. No reportable individuals listed on Part VII of Form 990 received distributions from the plan in 2017. 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 distributions from this plan in 2017. All distributions received from the plan in the current year were included in the individual's taxable compensation. June Pickett $18,727 William Thompson $516,375 During 2017, 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 $329,953 William Thompson $542,525 Kris Zimmer $221,291 Christopher Howard $294,342 Shane Peng, MD $71,504 June Pickett $12,318 Jim Stratton $4,124

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a Description of Program ServiceBriefly 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 19 acute care hospitals, one children's hospital, more than 60 outpatient care sites, a pharmacy benefit company, an insurance company, two long-term care facilities, comprehensive home care and hospice services, a technology company, and two Accountable Care Organizations. The health system employs more than 31,000 people and is affiliated with more than 8,500 physicians making it one of the largest employers in every community it serves. SSMH is sponsored by SSM Health Ministries, an independent 8- member body comprised of three Franciscan Sisters of Mary and five lay people who collectively hold certain reserved powers over SSMH. 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 SSM Health St Mary's Hospital - Audrain: SSM Health St Mary's Hospital - Audrain is an 89-bed acute-care hospital with more than 500 employees and 40 active physicians and nurse practitioners in Mexico, Mo. The hospital has a strong primary-care presence with nine rural health clinics in Mexico and the neighboring communities of Perry, Montgomery City, Wellsville, Vandalia and Paris. SSM Health St Mary's Hospital - Audrain's cancer program has earned the Commission on Cancer of the American College of Surgeons Accreditation Aware four times. The Hospital has also been recognized by the Joint Commission for attaining and sustaining excellence in accountability measures for performance for heart attack, heart failure, pneumonia, surgical care and venous thromboembolism. Since 1918, SSM Health St Mary's Hospital - Audrain has been providing for the health care needs of the citizens of Audrain County and surrounding communities. During its long history of service, the hospital has made many changes to better serve its patients. For instance, in 1991, SSM Health St Mary's Hospital - Audrain was the first community hospital in Missouri to lease its facilities and operations to a not-for-profit corporation to establish clinics in communities outside of Audrain County in order to improve patient access to primary-care services. SSM Health St Mary's Hospital - Audrain joined the SSM Health Care system in April 2013 as part of SSM's new Mid-Missouri Region. The region also consists of SSM Health St. Mary's Hospital - Jefferson City in Jefferson City, Mo. SSM Health St Mary's Hospital - Audrain provides the following services at its hospital: SSM Health Cancer Center, diabetes education, emergency department, Healthworks rehabilitation, Jordan-Waters heart center, lab services, medical imaging, sleep lab, and women's and children's services. A complete list of services the Hospital offers can be found at http://www.ssmhealthmidmo.com/medical-services. Describe the organization's approach to providing community benefit: 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 SSMH's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always the goal. To fulfill this commitment, SSMH's Community Benefit is divided into two parts: 1) Community Health Needs Assessment (CHNA), and 2) Community Benefit Inventory for Social Accountability (CBISA). First, CHNA is the 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: Kick-off meeting conducted and updated toolkit distributed; and periodic meetings scheduled to evaluate and monitor progress. Data collected and report made 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). Next, CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: - Collect and enter data: Kick-off meeting conducted and updated toolkit distributed; new staff complete Lyon web-based course; and periodic meetings scheduled to evaluate and monitor progress. Emails sent reminding staff to submit activities; occurrences entered into Lyon; and reports are produced and shared with leaders. - Finalize and report on prior year: All prior year data entered into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. 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, all hospital CHNAs were 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. Description of CHNA Community Benefit Programs: For more information on Community Benefit Programs provided by SSM Health St Mary's Hospital - Audrain, please see Schedule H, Part V.
Form 990, Part III, Line 4b Description of Program Service (Continued)Organization description for tax exemption: In addition to its CHNA community benefit activities, SSM Audrain Health Care 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, SSM Audrain Health Care, 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. SSM Audrain Health Care 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. SSM Health St Mary's Hospital - Audrain 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 Describe the organization's financial assistance policies or programs (e.g., charity care, discounting) for low-income persons and how they are communicated to the public. For information on the financial assistance polices provided by SSM Health St Mary's Hospital - Audrain, please see Schedule H. 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 $ 1,940,346 Cost of Bad Debt $ 1,390,166 Unpaid Cost of Medicaid Services $ 1,912,898 Unpaid Cost of Medicare Services $ 3,927,213 Unpaid Cost of Other Government Programs $ 170,749 Total Quantifiable Uncompensated Care $ 9,341,372
Form 990, Part V, Line 1a Common PaymasterSSM HEALTH CARE CORPORATION, EIN 46-6029223, SERVES AS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, SSM AUDRAIN HEALTH CARE, EIN 43-1550298. THEREFORE, ALL APPLICABLE 1099 AND 1096 IRS TAX FILINGS ARE REPORTED BY SSM HEALTH CARE CORPORATION.
Form 990, Part VI, Line 6 Classes of members or stockholdersTHE SOLE MEMBER OF THE CORPORATION IS SSM REGIONAL HEALTH SERVICES. SSM REGIONAL HEALTH SERVICES IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH SSM AUDRAIN HEALTH CARE, INC. AND SSM REGIONAL HEALTH SERVICES ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND TO APPOINT AND REMOVE THE DIRECTORS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO APPOINT AND REMOVE THE DIRECTORS D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION 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 INTEREST 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 OR 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 bodyThe 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 bodyACCOUNTING/FINANCE PERSONNEL AT EACH SSMH (SSM HEALTH SYSTEM) ENTITY, IN CONJUNCTION WITH SYSTEM FINANCE PERSONNEL, PREPARE INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS INFORMATION IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE SYSTEM OFFICE, WHERE SSMH PERSONNEL PREPARE THE FORM 990. THE RETURN IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM WHO SIGNS AS PAID PREPARER. THE RETURN IS PROVIDED TO ENTITY MANAGEMENT PERSONNEL FOR FINAL REVIEW PRIOR TO FILING. THE COMPLETE FORM 990 IS PROVIDED ELECTRONICALLY TO ALL BOARD MEMBERS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
Form 990, Part VI, Line 12c Conflict of interest policyBOARD 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 DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ONLINE. 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 publicTHE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI 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 FeesMedical Physician, Practitioner, Psychiatrist, Resident, and Therapist - Total Expense: 4114997, Program Service Expense: 4055101, Management and General Expenses: 59896, Fundraising Expenses: ; Recruitment, Consulting, Administrative, and PBS Fees - Total Expense: 3217333, Program Service Expense: 1376890, Management and General Expenses: 1840443, Fundraising Expenses: ; Medical Lab, Radiology, Transportation - Total Expense: 872109, Program Service Expense: 872109, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesChange in beneficial interest in foundation - 85625; Actuarial change in defined benefit obligation - -78086;
Part I Doing Business AsSSM Audrain Health Care, Inc. currently conducts business under the following registered names: Audrain Medical Center Healthworks Mexico Health Services Mexico Surgical Services Specialty Services of Mexico SSM Health Behavioral Health SSM Health Cancer Center SSM Health Medical Group SSM Health Medical Group - Family Medicine SSM Health Medical Group - General Surgery SSM Health Medical Group - Internal Medicine SSM Health Medical Group - Orthopedic Surgery SSM Health Medical Group - Pediatrics SSM Health Medical Group Pulmonary & Critical Care SSM Health Medical Group - Women's Health SSM Health Sleep Center SSM Health St. Mary's Hospital - Audrain SSM Health Urgent Care Jordan-Waters Heart Center

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (42 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
SSM Health Care Corporation
10101 Woodfield LaneSt LouisMO63132466029223Health CareMO501(c)(3)Type ISSM Health Ministriesfalse
SSMHC Liability Trust I
10101 Woodfield LaneSt LouisMO63132436331003InsuranceMO501(c)(3)Type ISSM Health Care Corporationfalse
SSM Consolidated Health Services
10101 Woodfield LaneSt LouisMO63132431473657Health CareMO501(c)(3)Type ISSM Health Care Corporationfalse
SSM Policy Institute
10101 Woodfield LaneSt LouisMO63132431788151Health CareMO501(c)(4)SSM Health Care Corporationfalse
SSM Health Care Portfolio Management Co
10101 Woodfield LaneSt LouisMO63132431825256ManagementMO501(c)(3)Type ISSM Health Care Corporationfalse
SSM Cardinal Glennon Children's Hospital
10101 Woodfield LaneSt LouisMO63132430738490Health CareMO501(c)(3)3SSM Health Care St Louisfalse
Cardinal Glennon Children's Foundation
10101 Woodfield LaneSt LouisMO63132431754347FundraisingMO501(c)(3)7SSM Cardinal Glennon Hospitalfalse
SSM DePaul Health Center Foundation
10101 Woodfield LaneSt LouisMO63132431776109FundraisingMO501(c)(3)7SSM Health Care St Louisfalse
SSM St Joseph Foundation
10101 Woodfield LaneSt LouisMO63132431591556FundraisingMO501(c)(3)7SSM Health Care St Louisfalse
SSM St Clare Health Center Foundation
10101 Woodfield LaneSt LouisMO63132431273310FundraisingMO501(c)(3)7SSM Health Care St Louisfalse
SSM Health Foundation - St Louis
10101 Woodfield LaneSt LouisMO63132431552945FundraisingMO501(c)(3)7SSM Health Care St Louisfalse
SSM Health Care of Oklahoma Inc
10101 Woodfield LaneSt LouisMO63132730657693Health CareOK501(c)(3)3SSM Health Care Corporationfalse
St Anthony Hospital Foundation Inc
10101 Woodfield LaneSt LouisMO63132736104300FundraisingOK501(c)(3)7SSM Health Care of Oklahomafalse
SSM Health Care of Wisconsin Inc
10101 Woodfield LaneSt LouisMO63132430688874Health CareWI501(c)(3)3SSM Health Care Corporationfalse
Dells Medical Building Inc
10101 Woodfield LaneSt LouisMO63132391613292MOBWI501(c)(2)SSM Health Care of Wisconsinfalse
St Mary's Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940686FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
St Clare Health Care Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940683FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
Home Health United Inc
2802 Walton Commons LaneMadisonWI53718391539827Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
Home Care United Inc
2802 Walton Commons LaneMadisonWI53718391776340Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
HHU Xtra Care Inc
2802 Walton Commons LaneMadisonWI53718391705111Health CareWI501(c)(3)10SSM Health Care of Wisconsinfalse
Home Health United - VNS Foundation Inc
2802 Walton Commons LaneMadisonWI53718391839309FundraisingWI501(c)(3)Type INAfalse
SSM Regional Health Services
10101 Woodfield LaneSt LouisMO63132440579850Health CareMO501(c)(3)3SSM Health Care Corporationfalse
St Francis Hospital Foundation
10101 Woodfield LaneSt LouisMO63132431099253FundraisingMO501(c)(3)7SSM Regional Health Servicesfalse
St Mary's Health Center Jefferson City Missouri Foundation
10101 Woodfield LaneSt LouisMO63132431575307FundraisingMO501(c)(3)Type IISSM Regional Health Servicesfalse
St Mary's Hospital Centralia Illinois
10101 Woodfield LaneSt LouisMO63132370662580Health CareIL501(c)(3)3SSM Regional Health Servicesfalse
St Mary's - Good Samaritan Inc
10101 Woodfield LaneSt LouisMO63132364170833Health CareIL501(c)(3)Type ISSM Regional Health Servicesfalse
Good Samaritan Regional Health Center Foundation
10101 Woodfield LaneSt LouisMO63132262884795FundraisingIL501(c)(3)7St Mary's - Good Samaritanfalse
St Mary's Hospital Foundation
10101 Woodfield LaneSt LouisMO63132364636691FundraisingIL501(c)(3)7St Mary's - Good Samaritanfalse
St Mary's Hospital Auxiliary
400 N PleasantCentraliaIL62801237126345FundraisingIL501(c)(3)10St Mary's Hospital Foundationfalse
SSM Health Businesses
10101 Woodfield LaneSt LouisMO63132431333488Health CareMO501(c)(3)10SSM Health Care Corporationfalse
SSM Health Care St Louis
10101 Woodfield LaneSt LouisMO63132431343281Health CareMO501(c)(3)3SSM Health Care Corporationfalse
Centralia Medical Services Bldg Assoc
10101 Woodfield LaneSt LouisMO63132237408025MOBIL501(c)(3)Type IISSM Regional Health Servicesfalse
St Mary's Janesville Foundation Inc
10101 Woodfield LaneSt LouisMO63132273439133FundraisingWI501(c)(3)7SSM Health Care of Wisconsinfalse
Franciscan Sisters of Mary
3221 McKelvey Road Suite 107BridgetonMO63044431012492Religious OrganizationMO501(c)(3)1NAfalse
Lee Dewey Corporation
10101 Woodfield LaneSt LouisMO63132731279603MOBOK501(c)(3)Type ISSM Health Care of Oklahomafalse
SSM Hospice and Home Care Foundation
10101 Woodfield LaneSt LouisMO63132300012246FundraisingMO501(c)(3)7SSM Health Businessesfalse
St Mary's Hospital Auxiliary
100 St Marys Medical PlazaJefferson CityMO65101436049878FundraisingMO501(c)(3)Type IINAfalse
Good Samaritan Hospital Auxiliary
605 North 12th StreetMt VernonIL62864237049599FundraisingIL501(c)(3)Type III-FINAfalse
St Anthony Shawnee Hospital Inc
1000 N Lee AveOklahoma CityOK73102455055149Health CareOK501(c)(3)3SSM Health Care of Oklahomafalse
Audrain Medical Center Foundation Inc
620 E Monroe StreetMexicoMO65265431265060FundraisingMO501(c)(3)Type ISSM Audrain Health Care IncYes (true)
Good Samaritan Regional Health Center
10101 Woodfield LaneSt LouisMO63132430653587Health CareIL501(c)(3)3SSM Regional Health Servicesfalse
SSM-SLUH Inc
10101 Woodfield LaneSt LouisMO63132474196634Health CareMO501(c)(3)3SSM Health Care St Louisfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtUBI Code VUBICodeVAmtOwnershipOwnershipPct
SSM ST JOSEPH ENDOSCOPY CENTER LLC
10101 WOODFIELD LANEST LOUISMO63132270046559SURGERY SERVICESMONAN/A$0$0$00
ST CLARE IMAGING SERVICES
707 14TH STREET SUITE ABARABOOWI53913200122365DIAG SERVICESWINAN/A$0$0$00
MT VERNON RADIATION THERAPY CENTER LLC
10101 WOODFIELD LANEST LOUISMO63132201382620RADIATION THERAPYILNAN/A$0$0$00
SLEEP & NEUROLOGY CENTER OF S ILLINOIS LLC
10101 WOODFIELD LANEST LOUISMO63132208468195DIAG SERVICESILNAN/A$0$0$00
CHOWSMGSI OFFICE BUILDING LLC
10101 WOODFIELD LANEST LOUISMO63132371383861MOBILNAN/A$0$0$00
OZA CANCER CENTER LLC
10101 WOODFIELD LANEST LOUISMO63132201382727MOBILNAN/A$0$0$00
SHAWNEE REAL ESTATE HOLDINGS LLC
1000 N LEE AVEOKLAHOMA CITYOK73102455458304MOBOKNAN/A$0$0$00
SSM HEALTH PHARMACY LLC
10101 WOODFIELD LANEST LOUISMO63132264031708PHARMACYMONAN/A$0$0$00
DEAN CLINIC & ST MARYS HOSPITAL ACCOUNTABLE CARE ORGANIZATION LLC
1808 WEST BELTLINE HIGHWAYMADISONWI53713452995500ACCOUNTABLE CARE ORGANIZATIONWINAN/A$0$0$00
WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC
1808 WEST BELTLINE HIGHWAYMADISONWI53713392016715INFORMATION TECHNOLOGY SERVICESWINAN/A$0$0$00
DEAN HEALTH HOLDINGS LLC
1277 DEMING WAYMADISONWI53717261594709SUPPORT SERVICESWINAN/A$0$0$00
WINGRA BUILDING GROUP
1808 WEST BELTLINE HIGHWAYMADISONWI53713390237060MOBWINAN/A$0$0$00
JANESVILLE RIVERVIEW CLINIC BUILDING PARTNERSHIP
1808 WEST BELTLINE HIGHWAYMADISONWI53713396220698MOBWINAN/A$0$0$00
WINDMILL LLP
50 VILLAGE VIEW LANECHESTERFIELDMO63017431804651INVESTMENTSMONAN/A$0$0$00
B & J MCBRIDE OFFICE BUILDING LLC
1000 N LEE AVEOKLAHOMA CITYOK73102731533449MOBOKNAN/A$0$0$00
1110 N CLASSEN BOULEVARD LLC
1110 N CLASSEN BOULEVARDOKLAHOMA CITYOK73106731158158MOBOKNAN/A$0$0$00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SSM MANAGED CARE ORGANIZATION LLC
10101 WOODFIELD LANEST LOUISMO63132431708511HEALTH PROMOTIONMONAC Corporationfalse
FPP INC
10101 WOODFIELD LANEST LOUISMO63132431465174HEALTH CAREMONAC Corporationfalse
DIVERSIFIED HEALTH SERVICES CORP
10101 WOODFIELD LANEST LOUISMO63132431369305MEDICAL EQUIPMENTMONAC Corporationfalse
SSM CARDIO AND THORACIC SERVICES INC
10101 WOODFIELD LANEST LOUISMO63132260286559HEALTH CAREMONAC Corporationfalse
SSM PROPERTIES INC
10101 WOODFIELD LANEST LOUISMO63132431462486PROPERTY SERVICESMONAC Corporationfalse
SSM DEPAUL MEDICAL GROUP INC
10101 WOODFIELD LANEST LOUISMO63132431715106HEALTH CAREMONAC Corporationfalse
SSM ST CHARLES CLINIC MED GROUP INC
10101 WOODFIELD LANEST LOUISMO63132430626408PHYSICIAN OFFICESMONAC Corporationfalse
HEALTH FIRST PHYS MANAGEMENT
10101 WOODFIELD LANEST LOUISMO63132731534336MEDICAL SERVICESOKNAC Corporationfalse
SSMHCS LIABILITY TRUST II
10101 WOODFIELD LANEST LOUISMO63132816128118INSURANCEMONAC Corporationfalse
SSM NEUROSCIENCES INC
10101 WOODFIELD LANEST LOUISMO63132263413981HEALTH CAREMONAC Corporationfalse
SSM MEDICAL GROUP INC
10101 WOODFIELD LANEST LOUISMO63132431664107PHYSICIAN OFFICESMONAC Corporationfalse
SSMHC INSURANCE COMPANY
10101 WOODFIELD LANEST LOUISMO63132030310431INSURANCECANAC Corporationfalse
SSM ORTHOPEDIC INC
10101 WOODFIELD LANEST LOUISMO63132271557033HEALTH CAREMONAC Corporationfalse
SSM CANCER CARE INC
10101 WOODFIELD LANEST LOUISMO63132271557324HEALTH CAREMONAC Corporationfalse
PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS
10101 WOODFIELD LANEST LOUISMO63132364161526HEALTH CAREILNAC Corporationfalse
DEAN HEALTH SYSTEMS INC
1808 WEST BELTLINE HIGHWAYMADISONWI53713391128616PHYSICIAN OFFICESWINAC Corporationfalse
DEAN HEALTH INSURANCE INC
PO BOX 56099MADISONWI53705391830837INSURANCEWINAC Corporationfalse
DEAN HEALTH PLAN INC
PO BOX 56099MADISONWI53705391535024INSURANCEWINAC Corporationfalse
ST MARYS DEAN VENTURES INC
1808 WEST BELTLINE HIGHWAYMADISONWI53713391628491PHYSICIAN OFFICESWINAC Corporationfalse
DEAN RETAIL SERVICES INC
1808 WEST BELTLINE HIGHWAYMADISONWI53713391717636PROPERTY SERVICESWINAC Corporationfalse
NAVITUS HOLDINGS LLC
1808 WEST BELTLINE HIGHWAYMADISONWI53713800968174PHARMACY BENEFITSWINAC Corporationfalse
OZA ONCOLOGY INC
4117 VETERANS MEMORIAL DRIVEMT VERNONIL62804PHYSICIAN OFFICEILNAC Corporationfalse
SSM Health Janesville Campus Condominium Association Inc
1808 West Beltline HighwayMadisonWI53713832038674Condo associationWINAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Audrain Medical Center Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$93,386InvolvedAmt
Method Of Amount DeterminationCash contributionMethodOfAmountDeterminationTxt