ST ANTHONY SHAWNEE HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY SHAWNEE HOSPITAL INC (EIN 45-5055149)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-10
- IRS object ID
- 201743149349303014
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-10T14:06:13-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Crowe Horwath LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9600 Brownsboro Road Suite 400 | AddressLine1Txt |
| City | Louisville | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 402411122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455055149 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Shawnee Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STAN | BusinessNameControlTxt |
| Phone | 4053955626 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 Woodfield Lane | AddressLine1Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | June L Pickett | PersonNm |
| Person Title | Secretary | PersonTitleTxt |
| Signature | 2017-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rachel Spurlock | PreparerPersonNm |
| PTIN | P00520729 | PTIN |
| Phone | 5023263996 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Laura Kaiser | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 Woodfield Lane | AddressLine1Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $110,394,656 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ssmhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | TO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 940 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $15,936,463 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,603 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $101,503,404 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $109,367,278 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,109,431 | PYOtherRevenueAmt |
| CY Other Revenue | $843,950 | CYOtherRevenueAmt |
| PY Total Revenue | $118,549,298 | PYTotalRevenueAmt |
| CY Total Revenue | $110,218,831 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $14,307 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $45,100 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,154,006 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,257,313 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $54,786,447 | PYOtherExpensesAmt |
| CY Other Expenses | $64,424,344 | CYOtherExpensesAmt |
| PY Total Expenses | $95,954,760 | PYTotalExpensesAmt |
| CY Total Expenses | $113,726,757 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $22,594,538 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,507,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $125,664,232 | TotalAssetsBOYAmt |
| Total Assets EOY | $140,958,902 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $74,747,999 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $93,728,471 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $50,916,233 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $47,230,431 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $99,901,306 | ExpenseAmt |
| Grant | $45,100 | GrantAmt |
| Revenue | $109,367,278 | RevenueAmt |
| Desc | Please see Schedule O for a complete description of program service accomplishments. | Desc |
| Total Program Service Expenses | $99,901,306 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 940 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jennifer Pierce | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4053955626 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1102 W McArthur | AddressLine1Txt |
| City | Shawnee | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Joe Hodges | |||||||||
| Director, President | 1.0 | 43.0 | Yes (X) | Yes (X) | $0 | $826,424 | $311,976 | ||
| Christopher Howard | |||||||||
| Chair, Pres-Hospital Operations of SSM Health | 1.0 | 55.0 | Yes (X) | Yes (X) | $0 | $1,129,635 | $404,326 | ||
| Sr Mary Jean Ryan FSM | |||||||||
| Pt Yr Director & Pt Yr Chairperson | 1.0 | 6.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| William Thompson | |||||||||
| Vice Chair, President/CEO of SSM Health | 1.0 | 56.0 | Yes (X) | Yes (X) | $0 | $1,732,435 | $242,602 | ||
| MT Berry | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Martha Burger | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Mike Collison | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| David Harlow | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Jenee Lister | |||||||||
| Director | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | |||
| Marion McMillan | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Robert Rader MD | |||||||||
| Director | 1.0 | 41.0 | Yes (X) | $0 | $236,813 | $110,447 | |||
| Margaret Salyer | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Kersey Winfree MD | |||||||||
| Director | 1.0 | 43.0 | Yes (X) | $0 | $552,811 | $115,073 | |||
| Ramona Carey | |||||||||
| Assistant Secretary | 1.0 | 41.0 | Yes (X) | $0 | $72,342 | $53,871 | |||
| Paula Friedman | |||||||||
| Vice President, Senior VP-Strategic Development SSM Health | 1.0 | 54.0 | Yes (X) | $0 | $940,690 | $388,689 | |||
| Shasta Manuel | |||||||||
| System VP Finance/CFO | 10.0 | 31.0 | Yes (X) | $0 | $367,483 | $81,312 | |||
| June Pickett | |||||||||
| Secretary | 1.0 | 65.1 | Yes (X) | $0 | $281,543 | $35,564 | |||
| Charles Skillings | |||||||||
| Hospital President | 40.0 | 0 | Yes (X) | $0 | $405,843 | $69,229 | |||
| Kris Zimmer | |||||||||
| Treasurer, Senior VP-Finance SSM Health | 1.0 | 57.0 | Yes (X) | $0 | $1,105,377 | $344,110 | |||
| Angela Mohr | |||||||||
| Executive Vice President | 40.0 | 0 | $213,039 | $0 | $34,898 | Yes (X) | |||
| Linda Brown | |||||||||
| VP - Support | 40.0 | 0 | $158,253 | $0 | $33,778 | Yes (X) | |||
| Gaynell Anderson | |||||||||
| Physician | 40.0 | 0 | $312,974 | $0 | $32,973 | Yes (X) | |||
| Kenneth Darvin | |||||||||
| Physician | 40.0 | 0 | $290,023 | $0 | $58,210 | Yes (X) | |||
| David Hadley | |||||||||
| Physician | 40.0 | 0 | $298,441 | $0 | $32,419 | Yes (X) | |||
| David Heon | |||||||||
| Physician | 40.0 | 0 | $334,301 | $0 | $8,517 | Yes (X) | |||
| Venkata Damera | |||||||||
| Physician | 40.0 | 0 | $396,130 | $0 | $28,006 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,003,161 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,651,396 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,386,000 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 36 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Shawnee Medical Center Clinic | ||||||
| 1501 N Airport Drive | Shawnee | OK | 74804 | Clinical services | $12,497,350 | |
| Turner Construction Company | ||||||
| 1220 Washington Street | Kansas City | MO | 64105 | Construction services | $9,314,765 | Suite 100 |
| CLINICAL PARTNERS PA | ||||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | ANESTHESIA BILLING | $1,964,329 | |
| Comprehensive Cancer Center | ||||||
| 3525 NW 56th Street | Oklahoma City | OK | 73112 | Clinical research services | $1,311,693 | 150C |
| SODEXO MANAGEMENT INC | ||||||
| PO BOX 536922 | ATLANTA | GA | 303536922 | DIETARY AND ENVIRO SERVICES | $761,538 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 32 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Government Grants | $7,234 | GovernmentGrantsAmt |
| All Other Contributions | $369 | AllOtherContributionsAmt |
| Total Contributions | $7,603 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $108,188,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $108,188,358 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,178,920 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,178,920 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $109,367,278 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $252,857 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,479 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $174,378 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $174,378 | TotalRevenueColumnAmt |
| Exclusion | $174,378 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $132,843 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $97,346 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,497 | TotalRevenueColumnAmt |
| Exclusion | $35,497 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 722320 | BusinessCd |
| Total Revenue Column | $634,075 | TotalRevenueColumnAmt |
| Exclusion | $634,075 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $634,075 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,218,831 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $109,367,278 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $843,950 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,100 | TotalAmt |
| Program Services | $45,100 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $987,382 | TotalAmt |
| Management And General | $987,382 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,048,670 | TotalAmt |
| Program Services | $30,572,213 | ProgramServicesAmt |
| Management And General | $5,476,457 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,251,045 | TotalAmt |
| Program Services | $1,902,761 | ProgramServicesAmt |
| Management And General | $348,284 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,363,582 | TotalAmt |
| Program Services | $6,153,294 | ProgramServicesAmt |
| Management And General | $1,210,288 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,606,634 | TotalAmt |
| Program Services | $2,157,524 | ProgramServicesAmt |
| Management And General | $449,110 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,308,000 | TotalAmt |
| Program Services | $300,000 | ProgramServicesAmt |
| Management And General | $2,008,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,809 | TotalAmt |
| Management And General | $94,809 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,272 | TotalAmt |
| Management And General | $118,272 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,654,823 | TotalAmt |
| Program Services | $21,147,534 | ProgramServicesAmt |
| Management And General | $1,507,289 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,730 | TotalAmt |
| Management And General | $118,730 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,081,256 | TotalAmt |
| Program Services | $6,907,798 | ProgramServicesAmt |
| Management And General | $173,458 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,719,478 | TotalAmt |
| Program Services | $1,642,144 | ProgramServicesAmt |
| Management And General | $77,334 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,256,357 | TotalAmt |
| Program Services | $3,222,182 | ProgramServicesAmt |
| Management And General | $34,175 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,129 | TotalAmt |
| Program Services | $137,292 | ProgramServicesAmt |
| Management And General | $59,837 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,435 | TotalAmt |
| Program Services | $21,825 | ProgramServicesAmt |
| Management And General | $4,610 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,635,350 | TotalAmt |
| Program Services | $2,635,350 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,012,034 | TotalAmt |
| Program Services | $4,715,946 | ProgramServicesAmt |
| Management And General | $296,088 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $859,788 | TotalAmt |
| Management And General | $859,788 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $16,433,493 | $16,433,493 | |
| MEDICAID PROVIDER TAX | $1,868,943 | $1,868,943 | |
| LICENSES AND TAXES | $39,447 | $37,907 | $1,540 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,726,757 | TotalAmt |
| Program Services | $99,901,306 | ProgramServicesAmt |
| Management And General | $13,825,451 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $529,763 | BOYAmt |
| EOY | $34,358 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,472,244 | BOYAmt |
| EOY | $19,953,153 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,890,985 | BOYAmt |
| EOY | $2,054,664 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,017,626 | BOYAmt |
| EOY | $924,611 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $110,778,959 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,477,524 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,291,609 | BOYAmt |
| EOY | $87,301,435 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,933,262 | BOYAmt |
| EOY | $21,978,430 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,478,743 | BOYAmt |
| EOY | $8,712,251 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,664,232 | BOYAmt |
| EOY | $140,958,902 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,423,083 | BOYAmt |
| EOY | $18,729,653 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,324,916 | BOYAmt |
| EOY | $74,998,818 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,747,999 | BOYAmt |
| EOY | $93,728,471 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,866,233 | BOYAmt |
| EOY | $47,230,431 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,916,233 | BOYAmt |
| EOY | $47,230,431 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,664,232 | BOYAmt |
| EOY | $140,958,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,507,926 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$177,876 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $2,788 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,788 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND PORTIONS OF THE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND PORTIONS OF THE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,000,668 | OtherCostOrOtherBasisAmt |
| Book Value | $2,000,668 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,349,812 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,619,287 | DepreciationAmt |
| Book Value | $66,730,525 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,297,598 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,858,237 | DepreciationAmt |
| Book Value | $11,439,361 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,130,881 | OtherCostOrOtherBasisAmt |
| Book Value | $7,130,881 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $87,301,435 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| THIRD-PARTY RECEIVABLE | $109,779 |
| OTHER RECEIVABLES | $68,423 |
| OTHER ASSETS | $1,296,820 |
| DUE FROM AFFILIATES | $7,237,229 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,712,251 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $68,846,246 |
| INTERCO LOANS PAYABLE | |
| PENSION FUNDING LIABILITY | $573,132 |
| CAPITAL LEASE OBLIGATION | $3,218,169 |
| Third-party payable | $1,162,271 |
| Defined contribution liability | $1,199,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $74,998,818 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | ST. ANTHONY SHAWNEE HOSPITAL, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH (SSMH), A RELATED ORGANIZATION. SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS IN 2016 OR 2015. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $950,616 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $950,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0084 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,056,974 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,217,257 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,527,697 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,051,677 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $476,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0042 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $13,535,287 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,268,934 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,426,636 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0125 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,354 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,684 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $233,803 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $233,803 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0021 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $258,157 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $256,487 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0023 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $13,793,444 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,270,604 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,683,123 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0148 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,255 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,255 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,168 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,423 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,423 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $20,093,597 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $27,926,276 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,701,689 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $224,587 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHAWNEE SURGICAL REALTY LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MEDICAL BUILDING | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.25 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.75 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANTHONY SHAWNEE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1102 W MCARTHUR | AddressLine1Txt |
| City | SHAWNEE | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.stanthonyshawnee.com | WebsiteAddressTxt |
| State License | 2162 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | A | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.ssmhealth.com/about/community-health-needs-assessments | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://www.stanthonyshawnee.com/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.ssmhealth.com/about/community-health-needs-assessments | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.ssmhealth.com/for-patients/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.ssmhealth.com/for-patients/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.ssmhealth.com/for-patients/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility A, 1 | Facility A, 1 - St Anthony Shawnee Hospital. St Anthony Shawnee Hospital took into account input from persons who represent the broad interests of the community through the use of focus groups and online surveys. In June 2015, St Anthony Shawnee Hospital distributed interview questions to over 50 individuals with a range of expertise including public health officials, educators, public servants, and clinicians - all considered key informants in the community in the area of public health. In addition, the online survey was distributed to over 200 community members and residents of Pottawatomie County. The questions were designed to get information on how they perceive Pottawatomie County in regards to access and utilization of health services, insurance status, health status and risk factors/behaviors, as well as social/ physical/environmental concerns. The goal was to verify initial data research and make sure the findings were reflective of the experiences of the Pottawatomie County community, identify any information gaps that may limit the ability to assess the community's health needs and develop a better understanding of the health issues of uninsured persons, low-income persons, and minority groups in the community (see pages 19-22 of the CHNA). |
| Schedule H, Part V, Section B, Line 6a Facility A, 1 | Facility A, 1 - St Anthony Shawnee Hospital. The CHNA was conducted in partnership with St Anthony Hospital of Oklahoma City. Both hospitals are affiliates of SSM Health. |
| Schedule H, Part V, Section B, Line 11 Facility A, 1 | Facility A, 1 - St. Anthony Shawnee Hospital. SSM Health's mission statement is "Through our exceptional health care services, we reveal the healing presence of God." In 2015, in collaboration with our community partners, St. Anthony Shawnee Hospital 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: prescription drug abuse, heart disease, and obesity. The SSM Health Care of Oklahoma Regional Board approved this CHNA on November 11, 2015. St. Anthony Shawnee Hospital last conducted a CHNA in 2012. The St. Anthony Shawnee Hospital 2016 - 2018 CHNA showed that prescription drug abuse is a major concern in the area. Of the 800 prescription drug abuse deaths in Oklahoma from 2007-2013, 17% (135) of them were in Pottawatomie County. Approximately one-fifth of all drug overdose deaths in Pottawatomie County were from prescription pain medications. Problematic prescribing practices are a leading contributor to the epidemic but safe and informed prescribing practices and instituting sensible prescribing guidelines can help combat the problem. The following goals were established in 2016 to address prescription drug abuse: - Goal: Decrease the number of deaths due to prescription drug abuse in Pottawatomie County from 22.5 in 2015 to 21.2 by 2018, initial measures will be available in 2017. - Goal: Reduce the number of prescription overdose patients seen in St. Anthony's emergency department from 14 in 2016 to 13 in 2018. The St. Anthony Shawnee Hospital 2016 - 2018 CHNA indicated Heart Disease is the leading cause of death for Pottawatomie County, alone accounting for over $90 million a year in medical cost for the county. Heart disease is affected by numerous lifestyle behaviors including smoking, uncontrolled blood pressure and cholesterol, diabetes, stress and depression, an unhealthy diet and lack of exercise. SSM Health and St. Anthony Shawnee Hospital offer a wide scope of programs with the goal of creating healthy lifestyle behaviors and reducing the risk of heart disease in the community. The following goals were identified for 2016 to address heart disease. - Goal: Reduce the number of deaths due to coronary heart disease in Pottawatomie County from 161.1 deaths per 100,000 persons in 2015 to 159.1 deaths per 100,000 persons by 2018, data indicates improved death rate of 147.4 deaths per 100,000 in 2016. - Goal: Reduce the 30-day readmissions rate for Congestive Heart Failure (CHF) patients from a baseline of 18.6% to under 15.25% in 2018, readmission rate in 2016 fell drastically to 15.63%. The St. Anthony Shawnee Hospital 2016 - 2018 CHNA revealed obesity as a top priority for its service area. Lifestyle complications that lead to increased risk of obesity include physical inactivity combined with unhealthy diet and eating habits, and often affect minorities and those living under financial distress in greater numbers. Childhood obesity increases the risk for bone and joint problems, sleep apnea, bullying and low self-esteem. Additionally, weight problems in children and young adults increases the likelihood of cardiovascular diseases such as high cholesterol and high blood pressure. The following goals were set in 2016 to address obesity: - Goal: Reduce the age-adjusted death rate due to diabetes in Pottawatomie County from 31.6 deaths per 100,000 persons reported in 2015 to the statewide average of 29.3 deaths per 100,000 persons by 2018. - Goal: Decrease the percentage of obese adults in Pottawatomie County from 36.4% in 2015 to 34.4% by 2018, 34.2% of adults were obese in the county in 2016. - Goal: Reduce the average BMI of individuals enrolled in the prevention program from 34.7 in 2016 to 34.2 by 2018, data is not yet available. To determine the community needs the hospital could address, the hospital used a point rating system to identify the top thirteen community needs. A full list of needs and points totals can be found on page 20 2015 CHNA. St. Anthony Shawnee Hospital's internal work group further refined the list to determine which of the top ten identified needs would develop into strategic action plans. This was done by using an internal rating scale that considered: the number of people in the PSA that are affected by the problem; how well the concern aligns with the hospital's mission and strategies, what resources are required to address the issue; and could the health need be measurably impacted. This process resulted in three needs being prioritized. Even though there was an extensive list of identified community health needs, not all can be addressed. For a list of needs the hospital will not address and why, see page 23 of the 2015 CHNA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| SURGERY CENTER AT ST ANTHONY SHAWNEE | ||||
| 1106 W MCARTHUR | SHAWNEE | OK | 74804 | OUTPATIENT SURGERY |
| URGENT CARE CLINIC | ||||
| 1900 GORDIN COOPER | SHAWNEE | OK | 74804 | URGENT CARE CLINIC |
| FAMILY HEALTHCARE ASSOCIATES | ||||
| 3204 MEDICAL PARK | SHAWNEE | OK | 74804 | PHYSICIAN - FAMILY HEALTH |
| MULTISPECIALTY CLINIC AT ST ANTHONY | ||||
| 3200 MEDICAL PARK | SHAWNEE | OK | 74804 | PHYSICIAN - SPECIALTY |
Supplemental Information Detail SupplementalInformationDetail (19 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3b ELIGIBILITY FOR DISCOUNTED CARE | Services 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 3c DISCOUNTED CARE EXCEPTIONS | Patients whose family income exceeds 400% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of the hospital; however the discounted rates shall not be greater than the amounts generally billed to commercially insured [or Medicare] patients. In such cases, other factors may be considered in determining their eligibility for discounted or free services, including: * Bank accounts, investments and other assets * Employment status and earning capacity * Amount and frequency of bills for health care services * Other financial obligations and expenses * Generally, financial responsibility will be no more than 25% of gross family income. The hospital may utilize predictive analytical software or other criteria to assist in making a determination of financial assistance eligibility in situations where the patient qualifies for financial assistance but has not provided the necessary documentation to make a determination. This process is called "presumptive eligibility." |
| Schedule H, Part I, Line 6a COMMUNITY BENEFIT ANNUAL REPORT | St. Anthony Shawnee Hospital, Inc. is part of the integrated health system known as SSM Health. In an effort to strengthen its community benefit program, SSM Health plans for, measures, and communicates community benefits provided to persons who are low income, the unpaid costs of public programs and other activities that respond to community need, improve community health, or reach out to low income and vulnerable persons. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | Financial 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 II Community Building Activities | ST ANTHONY SHAWNEE HOSPITAL PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEALTH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING: COMMUNITY BUILDING - ECONOMIC DEVELOPMENT: PARTICIPATION IN LION'S CLUB WEEKLY MEETINGS, CHAMBER OF COMMERCE, AND COLLABORATION WITH BLUE ZONES PROJECT, WHICH WORKS TO CREATE HEALTHIER CIRIES, STATES, AND BUSINESSES. COMMUNITY BUILDING - COALITION BUILDING: INVOLVEMENT WITH UNITED WAY, INCLUDING BOARD AND AUDIT MEETINGS, AND DAYS OF CARING. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | BAD DEBT EXPENSE IS REPORTED BASED ON THE ORGANIZATION'S FINANCIAL STATEMENT REPORTING. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | St. Anthony Shawnee Hospital, Inc. 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 footnote | St. Anthony Shawnee Hospital, Inc. is part of the SSM Health consolidated audit. The footnote that references bad debt expense in the December 31, 2016 consolidated audit is contained on page 18 and 19 of the attached financial statements. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | The cost of providing care to Medicare eligible patients is greater than the reimbursement that Medicare allows on the Medicare cost report. St. Anthony Shawnee Hospital, Inc. considers this shortfall as a component of community benefit because the reimbursement is not negotiated and services are provided regardless of the patients' ability to pay. The Medicare costs reported on Line 6 were obtained from the 2016 Medicare cost report. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | St. Anthony Shawnee Hospital has established a written credit and collection policy and procedures. The billing and collection policies and practices reflect the mission and values of SSM Health, including our special concern for people who are poor and vulnerable, The Health Center embraces its responsibility to serve the communities in which it participates by establishing sound business practices. The Health Center's billing and collection practices will be fairly and consistently applied. All staff and vendors are expected to treat all patients consistently and fairly regardless of their ability to pay. They respond to patients in a prompt and courteous manner regarding any questions about their bills and provide notification of the availability of financial assistance. All uninsured patients will be provided a standard discount for medically necessary inpatient and outpatient services, including services provided at off-campus outpatient sites. The hospital determined the amount of the discount based on the local managed care market, applicable statutory requirements and other relevant local circumstances. The rate must be no less than the lowest effective discount rate and no greater than the highest effective discount rate for the current managed care contracts of the hospital. Uninsured patients may also qualify for an additional discount based upon financial need under the system financial assistance policy. All accounts due from the patient will receive a statement after discharge or after final adjudication from patient's insurance. Generally the patient will receive 4 months (120 days) of in-house collection efforts (including early out vendors) and 12 months of bad debt collection efforts. The hospital will make Reasonable Efforts to determine FAP eligibility including: 1. The financial assistance summary will be included with each billing statement 2. Extraordinary Collection Activity (ECAs) may not occur until bad debt placement and only after the expiration of the notification period. 3. ECAs must be suspended if a guarantor submits a FAP application during the application period. 4. Reasonable measures must be taken to reverse ECAs if the application is approved which may include refunding any payments made in excess of amounts owed as an FAP-eligible individual. 5. Bad Debt vendors will gain written approval from SSM prior to engaging in ECAs. SSM will review the accounts and verify satisfactory completion of reasonable efforts during the notification and application period. A waiver is not considered reasonable efforts. Obtaining a signed waiver that an individual does not wish to apply for FAP assistance or receive FAP application information will not meet the requirement to make "reasonable efforts" to determine whether the individual is FAP-eligible before engaging in ECAs. All outside collection agencies must comply with state and federal laws, comply with the association of credit and collection professional's code of ethics and professional responsibility and comply with St. Anthony Shawnee Hospital collection and financial assistance policies. |
| Schedule H, Part V, Section B, Line 16a FAP website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16a URL: https://www.ssmhealth.com/for-patients/financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16b URL: https://www.ssmhealth.com/for-patients/financial-assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | A - ST ANTHONY SHAWNEE HOSPITAL: Line 16c URL: https://www.ssmhealth.com/for-patients/financial-assistance; |
| Schedule H, Part VI, Line 2 Needs assessment | SSM Health (SSM) participates in Community Benefit according to our vision, Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically, and socially marginalized, will experience improved health in mind, body, spirit and environment. In the tradition of our founders, the Franciscan Sisters of Mary, caring for those in greatest need remains our organizational priority. Today our System Board monitors Community Benefit efforts, and views achievement of our vision as a primary responsibility. The purpose of SSM's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always our goal. To fulfill this commitment, SSM's Community Benefit is divided into two parts: 1) Community Health Needs Assessment (CHNA), and 2) Community Benefit Inventory for Social Accountability (CBISA). The CHNA is an assessment and prioritization of community health needs and the adoption and implementation of strategies to address those needs. A CHNA is conducted every three years by each hospital according to the following steps: * Assess and prioritize community health needs: Gather CHNA data from secondary sources; obtain input from stakeholders representing the broad interests of the community through interviews and focus groups; use data to select top health priorities; and complete written CHNA. * Develop, adopt, and implement strategies to address top-health priorities: Establish strategies to address priorities; complete Strategic Implementation Plan; obtain Regional/Divisional Board approval; and integrate strategies into operational plan. * Make CHNA widely available to the public: Publish CHNA and summary document on hospital's website. * Monitor, track, and report progress on top health priorities: Collect data and evaluate progress; report to Regional/Divisional Board every six months and System Board every year; share findings with community stakeholders; and send results to finance for submission to the Internal Revenue Service (IRS). 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 SSM'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. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | All 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 information | St Anthony Shawnee Hospital is located in Shawnee, Oklahoma, in the northern section of Pottawatomie County. Pottawatomie County, with a population of 70,424 is considered the Primary Service area (PSA). The Pottawatomie County is predicted to experience a projected growth rate of 3.16% by 2016. This is only slightly higher than the projected growth rate for the state of Oklahoma, at 3%, and lower than the national projection of 4%. When comparing 2011 data and projections for 2016, it shows a negative growth rate for the 15 - 17 and 25 - 54 age groups. Estimates suggest that the largest growing segment of the population from 2011 to 2016 will be the 65+ cohort, with an estimated increase of 1.3% to reach 16% of the county's population by 2016. Additional detailed information concerning the demographic data of the St Anthony Shawnee service area can be found on pages 6 and 14 through 17 of the 2015 CHNA. St Anthony Shawnee Hospital is a 96-bed facility providing health care services for close to 50 years to Shawnee and the surrounding communities of Pottawatomie County. To address the healthcare needs, St Anthony Shawnee Hospital's services include acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, heart cath lab, diagnostic imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services. |
| Schedule H, Part VI, Line 5 Promotion of community health | St. Anthony Shawnee Hospital, Inc. participates in a wide array of community programs throughout the area to further its exempt purpose of promoting the health of the community. The community initiatives build on the strengths of our communities and systems to improve the quality of life and to create a sense of hope. Community Benefit initiatives build community capacity and individual empowerment through community organizing, leadership development, partnerships, and coalition building. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. Focusing on a broad definition of health, St. Anthony Shawnee Hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Anthony Hospital Shawnee, Inc. promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. St. Anthony Shawnee Hospital, Inc. also furthers its exempt purpose with the following activities: * Operates an emergency room that is open to all persons regardless of ability to pay, * Has an open medical staff with privileges available to all qualified physicians in the area, * Has a governing body in which independent persons representative of the community comprise a majority * Engages in the training and education of health care professionals, * Participates in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs * All surplus funds generated by SSMH entities are reinvested in improving our patient care delivery system. |
| Schedule H, Part VI, Line 6 Affiliated health care system | ST. ANTHONY SHAWNEE HOSPITAL IS A 501(C) (3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH SSM HEALTH CARE OF OKLAHOMA, INC. THE HOSPITAL IS PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE FOR THE CENTRAL OKLAHOMA REGION. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | OK |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Gregory's University | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 W MacArthur | AddressLine1Txt |
| City | Shawnee | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74804 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 730685198 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $37,600 | CashGrantAmt |
| Purpose Of Grant | General support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S GRANTS WERE MADE TO GOVERNMENTAL OR TAX- EXEMPT, UNDER SECTION 501(C)(3), ORGANIZATIONS. THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joe Hodges | ||||||||||||||
| Director, President | $0 | $635,030 | $0 | $144,149 | $0 | $47,245 | $0 | $278,981 | $0 | $32,995 | $0 | $1,138,400 | $0 | $144,149 |
| Christopher Howard | ||||||||||||||
| Chair, Pres-Hospital Operations of SSM Health | $0 | $872,531 | $0 | $157,325 | $0 | $99,779 | $0 | $369,852 | $0 | $34,474 | $0 | $1,533,961 | $0 | $157,325 |
| William Thompson | ||||||||||||||
| Vice Chair, President/CEO of SSM Health | $0 | $1,010,243 | $0 | $384,123 | $0 | $338,069 | $0 | $221,076 | $0 | $21,526 | $0 | $1,975,037 | $0 | $460,221 |
| Robert Rader MD | ||||||||||||||
| Director | $0 | $234,605 | $0 | $0 | $0 | $2,208 | $0 | $82,690 | $0 | $27,757 | $0 | $347,260 | $0 | $0 |
| Kersey Winfree MD | ||||||||||||||
| Director | $0 | $430,645 | $0 | $71,460 | $0 | $50,706 | $0 | $74,423 | $0 | $40,650 | $0 | $667,884 | $0 | $71,460 |
| Paula Friedman | ||||||||||||||
| Vice President, Senior VP-Strategic Development SSM Health | $0 | $705,000 | $0 | $114,197 | $0 | $121,493 | $0 | $368,230 | $0 | $20,459 | $0 | $1,329,379 | $0 | $114,197 |
| Shasta Manuel | ||||||||||||||
| System VP Finance/CFO | $0 | $336,478 | $0 | $27,680 | $0 | $3,325 | $0 | $56,044 | $0 | $25,268 | $0 | $448,795 | $0 | $27,680 |
| June Pickett | ||||||||||||||
| Secretary | $0 | $229,851 | $0 | $19,802 | $0 | $31,890 | $0 | $10,977 | $0 | $24,587 | $0 | $317,107 | $0 | $19,802 |
| Charles Skillings | ||||||||||||||
| Hospital President | $0 | $336,639 | $0 | $54,577 | $0 | $14,627 | $0 | $36,963 | $0 | $32,266 | $0 | $475,072 | $0 | $54,577 |
| Kris Zimmer | ||||||||||||||
| Treasurer, Senior VP-Finance SSM Health | $0 | $870,802 | $0 | $148,371 | $0 | $86,204 | $0 | $310,798 | $0 | $33,312 | $0 | $1,449,487 | $0 | $148,371 |
| Angela Mohr | ||||||||||||||
| Executive Vice President | $192,038 | $0 | $19,434 | $0 | $1,567 | $0 | $12,013 | $0 | $22,885 | $0 | $247,937 | $0 | $19,434 | $0 |
| Linda Brown | ||||||||||||||
| VP - Support | $139,073 | $0 | $16,237 | $0 | $2,943 | $0 | $10,488 | $0 | $23,290 | $0 | $192,031 | $0 | $16,237 | $0 |
| Gaynell Anderson | ||||||||||||||
| Physician | $311,354 | $0 | $0 | $0 | $1,620 | $0 | $7,774 | $0 | $25,199 | $0 | $345,947 | $0 | $0 | $0 |
| Kenneth Darvin | ||||||||||||||
| Physician | $288,114 | $0 | $0 | $0 | $1,909 | $0 | $16,195 | $0 | $42,015 | $0 | $348,233 | $0 | $0 | $0 |
| David Hadley | ||||||||||||||
| Physician | $297,183 | $0 | $0 | $0 | $1,258 | $0 | $7,335 | $0 | $25,084 | $0 | $330,860 | $0 | $0 | $0 |
| David Heon | ||||||||||||||
| Physician | $331,298 | $0 | $0 | $0 | $3,003 | $0 | -$27,921 | $0 | $36,438 | $0 | $342,818 | $0 | $0 | $0 |
| Venkata Damera | ||||||||||||||
| Physician | $395,332 | $0 | $0 | $0 | $798 | $0 | $6,538 | $0 | $21,468 | $0 | $424,136 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Tax indemnification and gross-up payments | The following individuals listed on Part VII, Section A received a tax indemnification/gross up payment in 2016. The payment was included in their taxable compensation. Kenneth Darvin |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | The organization's top management official, hospital president, is compensated by a related organization that utilized the following to determine compensation: (1) Independent Compensation Consultant; (2) compensation survey or study; (3) approval by the board or compensation committee. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement 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 SSMH's 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 this plan during 2016. 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 2016. All distributions received from the plan in the current year were included in the individuals' taxable compensation. William Thompson $294,066 June Pickett $18,727 DURING 2016, 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: JOE HODGES $198,127 WILLIAM THOMPSON $3,108 CHRISTOPHER HOWARD $257,997 ROBERT RADER, MD $79,750 KERSEY WINFREE, MD $36,300 RAMONA CAREY $34,315 PAULA FRIEDMAN $276,866 SHASTA MANUEL $24,815 JUNE PICKETT ($11,000) CHARLES SKILLINGS $5,568 KRIS ZIMMER $201,583 ANGELA MOHR $1,717 LINDA BROWN $2,480 GAYNELL ANDERSON $3,846 KENNETH DARVIN $16,195 DAVID HADLEY $3,580 DAVID HEON ($31,590) VENKATA DAMERA $2,563 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a Description of Program Service | Briefly describe the organization's mission: Since it was founded in 1872 by Catholic sisters, SSM Health (SSMH) has existed to meet the health needs of the communities it serves. SSMH is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through one of the largest integrated delivery systems in the nation. With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSMH includes 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 St. Anthony Shawnee Hospital: St. Anthony Shawnee Hospital is a 96-bed facility with approximately 60 physicians and 550 health care professionals that have provided health care services for over 50 years to Shawnee and the surrounding communities of Pottawatomie County to address the healthcare needs. St Anthony Shawnee Hospital along with SSM Health Care of Oklahoma comprise the Oklahoma region of SSMH. St Anthony Shawnee Hospital also includes an urgent care facility, with services including acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, cardiology, diagnostic laboratory and imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services, respiratory care, and women's services. In 2016, St. Anthony Shawnee Hospital earned an 'A' Leapfrog Hospital Safety Grade, one of 844 hospitals nationwide. Developed under the guidance of an Expert Panel, the safety grade uses 30 measures of publicly available hospital safety data to assign grades A-F to more than 2,600 U.S. Hospitals twice a year. According to the 2014 Hospital Consumer Assessment of Healthcare Providers and Systems, St. Anthony Shawnee Hospital scored above both the national average and average for Oklahoma hospitals in nine out of eleven patient satisfaction categories, demonstrating the hospital's continued commitment to high-quality care. Describe the organization's approach to providing community benefit: SSM Health (SSM) participates in Community Benefit according to our vision, Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically, and socially marginalized, will experience improved health in mind, body, spirit and environment. In the tradition of our founders, the Franciscan Sisters of Mary, caring for those in greatest need remains our organizational priority. Today our System Board monitors Community Benefit efforts, and views achievement of our vision as a primary responsibility. The purpose of SSM's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always the goal. To fulfill this commitment, SSM's Community Benefit is divided into two parts: 1) Community Health Needs Assessment (CHNA), and 2) Community Benefit Inventory for Social Accountability (CBISA). 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 SSM'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 CHNA Community Benefit Programs provided by St. Anthony Shawnee Hospital, please see Schedule H, Part V. |
| Form 990, Part III, Line 4b Description of Program Service (Continued) | Organizational description for tax exemption: In addition to its CHNA community benefit activities, St. Anthony Hospital Shawnee, Inc. participates in a wide array of community programs throughout the area to further its exempt purpose of promoting the health of the community. The community initiatives build on the strengths of our communities and systems to improve the quality of life and to create a sense of hope. Community Benefit initiatives build community capacity and individual empowerment through community organizing, leadership development, partnerships, and coalition building. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. Focusing on a broad definition of health, St. Anthony Shawnee Hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Anthony Hospital Shawnee, Inc. promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. St Anthony Shawnee, along with three Catholic healthcare systems, is partnering with St Gregory University in Shawnee to establish a Catholic nursing program. The program will offer the traditional Bachelor of Nursing degree and a bridge program to the Bachelor of Science in Nursing, The program will provide new nurses with significant clinical experience and help meet the needs for current and future nurses. St. Anthony Hospital Shawnee, Inc. also furthers its exempt purpose with the following activities: * Operates a Level III Trauma 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, * Has a governing body in which independent persons representative of the community comprise a majority * 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 policies provided by St. Anthony Shawnee Hospital, please see Schedule H. Quantifiable Uncompensated Care: The following is a list of the types of programs and services that could be included as uncompensated care: Traditional Charity Care $ 950,616 Unpaid Cost of Other Means-Tested Programs $ 476,020 Cost of Bad Debt $ 5,724,746 --------------- Total Quantifiable Uncompensated Care $ 7,151,382 |
| Form 990, Part VI, Line 1a Common Paymaster | SSM HEALTH CARE CORPORATION, EIN 46-6029223, SERVES AS THE COMMON PAYING AGENT FOR THE FILING ORGANIZATION, St Anthony Shawnee Hospital, Inc., EIN 45-5055149. 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 stockholders | THE SOLE CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF OKLAHOMA, INC. SSM HEALTH CARE OF OKLAHOMA, INC. IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH ST. ANTHONY SHAWNEE HOSPITAL, INC. AND SSM HEALTH CARE OF OKLAHOMA, INC. ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE MEMBER HAS THE POWER TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO DIRECTORS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO ELECT AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE Certificate of INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER of the member OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER of the member, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER of the member AS DETERMINED BY THE MEMBER of the member. Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER of the member, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | ACCOUNTING/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 policy | BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY OF THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISION ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR SSM HEALTH ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE OKLAHOMA SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | All other program service revenue - Total Revenue: 1178920, Related or Exempt Function Revenue: 1178920, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part IX, Line 11g Other Fees | Medical Physician, Practitioner, Psychiatrist, Resident, and Therapist - Total Expense: 13179386, Program Service Expense: 13179386, Management and General Expenses: , Fundraising Expenses: ; Recruitment, Consulting, Administrative, and PBS Fees - Total Expense: 8752800, Program Service Expense: 7251216, Management and General Expenses: 1501584, Fundraising Expenses: ; Medical Lab, Radiology, Transportation - Total Expense: 722637, Program Service Expense: 716932, Management and General Expenses: 5705, Fundraising Expenses: ; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (42 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SSM Health Care Corporation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 466029223 | Health Care | MO | 501(c)(3) | Type I | SSM Health Ministries | false |
| SSMHC Liability Trust I | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 436331003 | Insurance | MO | 501(c)(3) | Type I | SSM Health Care Corporation | false |
| SSM Consolidated Health Services | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431473657 | Health Care | MO | 501(c)(3) | Type I | SSM Health Care Corporation | false |
| SSM Policy Institute | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431788151 | Health Care | MO | 501(c)(4) | SSM Health Care Corporation | false | |
| SSM Health Care Portfolio Management Co | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431825256 | Management | MO | 501(c)(3) | Type I | SSM Health Care Corporation | false |
| SSM Cardinal Glennon Children's Hospital | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 430738490 | Health Care | MO | 501(c)(3) | 3 | SSM Health Care St Louis | false |
| Cardinal Glennon Children's Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431754347 | Fundraising | MO | 501(c)(3) | 7 | SSM Cardinal Glennon Hospital | false |
| SSM DePaul Health Center Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431776109 | Fundraising | MO | 501(c)(3) | 7 | SSM Health Care St Louis | false |
| SSM St Joseph Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431591556 | Fundraising | MO | 501(c)(3) | 7 | SSM Health Care St Louis | false |
| SSM St Clare Health Center Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431273310 | Fundraising | MO | 501(c)(3) | 7 | SSM Health Care St Louis | false |
| SSM St Mary's Health Center Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431552945 | Fundraising | MO | 501(c)(3) | 7 | SSM Health Care St Louis | false |
| SSM Health Care of Oklahoma Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 730657693 | Health Care | OK | 501(c)(3) | 3 | SSM Health Care Corporation | false |
| St Anthony Hospital Foundation Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 736104300 | Fundraising | OK | 501(c)(3) | 7 | SSM Health Care of Oklahoma | false |
| Dells Medical Building Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 391613292 | MOB | WI | 501(c)(2) | SSM Health Care of Wisconsin | false | |
| St Mary's Foundation Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431940686 | Fundraising | WI | 501(c)(3) | 7 | SSM Health Care of Wisconsin | false |
| St Clare Health Care Foundation Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431940683 | Fundraising | WI | 501(c)(3) | 7 | SSM Health Care of Wisconsin | false |
| Home Health United Inc | ||||||||||
| 2802 Walton Commons Lane | Madison | WI | 53718 | 391539827 | Health Care | WI | 501(c)(3) | 10 | SSM Health Care of Wisconsin | false |
| Home Care United Inc | ||||||||||
| 2802 Walton Commons Lane | Madison | WI | 53718 | 391776340 | Health Care | WI | 501(c)(3) | 10 | SSM Health Care of Wisconsin | false |
| HHU Xtra Care Inc | ||||||||||
| 2802 Walton Commons Lane | Madison | WI | 53718 | 391705111 | Health Care | WI | 501(c)(3) | 10 | SSM Health Care of Wisconsin | false |
| Home Health United - VNS Foundation Inc | ||||||||||
| 2802 Walton Commons Lane | Madison | WI | 53718 | 391839309 | Fundraising | WI | 501(c)(3) | Type I | NA | false |
| SSM Regional Health Services | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 440579850 | Health Care | MO | 501(c)(3) | 3 | SSM Health Care Corporation | false |
| St Francis Hospital Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431099253 | Fundraising | MO | 501(c)(3) | 7 | SSM Regional Health Services | false |
| St Mary's Health Center Jefferson City Missouri Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431575307 | Fundraising | MO | 501(c)(3) | Type II | SSM Regional Health Services | false |
| Good Samaritan Regional Health Center | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 430653587 | Health Care | IL | 501(c)(3) | 3 | SSM Regional Health Services | false |
| St Mary's Hospital Centralia Illinois | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 370662580 | Health Care | IL | 501(c)(3) | 3 | SSM Regional Health Services | false |
| St Mary's - Good Samaritan Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 364170833 | Health Care | IL | 501(c)(3) | Type I | SSM Regional Health Services | false |
| Good Samaritan Regional Health Center Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 262884795 | Fundraising | IL | 501(c)(3) | 7 | St Mary's - Good Samaritan Inc | false |
| St Mary's Hospital Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 364636691 | Fundraising | IL | 501(c)(3) | 7 | St Mary's - Good Samaritan Inc | false |
| St Mary's Hospital Auxiliary | ||||||||||
| 400 N Pleasant | Centralia | IL | 62801 | 237126345 | Fundraising | IL | 501(c)(3) | 10 | St Mary's Hospital Foundation | false |
| SSM Health Businesses | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431333488 | Health Care | MO | 501(c)(3) | 10 | SSM Health Care Corporation | false |
| SSM Health Care St Louis | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431343281 | Health Care | MO | 501(c)(3) | 3 | SSM Health Care Corporation | false |
| Centralia Medical Services Bldg Assoc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 237408025 | MOB | IL | 501(c)(3) | Type II | SSM Regional Health Services | false |
| St Mary's Janesville Foundation Inc | ||||||||||
| 2901 Landmark PL Ste 300 | Madison | WI | 53713 | 273439133 | Fundraising | WI | 501(c)(3) | 7 | SSM Health Care of Wisconsin | false |
| Franciscan Sisters of Mary | ||||||||||
| 3221 McKelvey Road Suite 107 | St Louis | MO | 63044 | 431012492 | Religious Organization | MO | 501(c)(1) | NA | false | |
| Lee Dewey Corporation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 731279603 | MOB | OK | 501(c)(3) | Type I | SSM Health Care of Oklahoma | false |
| SSM Hospice and Home Care Foundation | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 300012246 | Fundraising | MO | 501(c)(3) | 7 | SSM Health Businesses | false |
| St Mary's Hospital Auxiliary | ||||||||||
| 100 St Marys Medical Plaza | Jefferson City | MO | 65101 | 436049878 | Fundraising | MO | 501(c)(3) | Type II | NA | false |
| Good Samaritan Hospital Auxiliary | ||||||||||
| 605 North 12th Street | Mt Vernon | IL | 62864 | 237049599 | Fundraising | IL | 501(c)(3) | Type III-FI | NA | false |
| SSM Health Care of Wisconsin Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 430688874 | Health Care | WI | 501(c)(3) | 3 | SSM Health Care Corporation | false |
| SSM Audrain Health Care Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431550298 | Health Care | MO | 501(c)(3) | 3 | SSM Regional Health Services | false |
| Audrain Medical Center Foundation Inc | ||||||||||
| 620 E Monroe Street | Mexico | MO | 65265 | 431265060 | Fundraising | MO | 501(c)(3) | Type I | SSM Audrain Health Care Inc | false |
| SSM-SLUH Inc | ||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 474196634 | Health Care | MO | 501(c)(3) | 3 | SSM Health Care St Louis | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | UBI Code VUBICodeVAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM St Joseph Endoscopy Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 270046559 | Surgery Services | MO | NA | N/A | $0 | $0 | $0 | 0 |
| St Clare Imaging Services | ||||||||||||
| 707 14th Street Suite A | Baraboo | WI | 53913 | 200122365 | Diag Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Mt Vernon Radiation Therapy Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 201382620 | Radiation Therapy | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Sleep & Neurology Center of S Illinois LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 208468195 | Diag Services | IL | NA | N/A | $0 | $0 | $0 | 0 |
| ChowSMGSI Office Building LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 371383861 | MOB | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Oza Cancer Center LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 201382727 | MOB | IL | NA | N/A | $0 | $0 | $0 | 0 |
| Shawnee Real Estate Holdings LLC | ||||||||||||
| 1000 N Lee Ave | Oklahoma City | OK | 73102 | 455458304 | MOB | OK | NA | N/A | $0 | $0 | $0 | 0 |
| SSM Health Pharmacy LLC | ||||||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 264031708 | Pharmacy | MO | NA | N/A | $0 | $0 | $0 | 0 |
| Dean Clinic & St Marys Hospital Accountable Care Organization LLC | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 452995500 | Accountable Care Organization | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Wisconsin Integrated Information Technology and Telemedicine Systems LLC | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 392016715 | Information Technology Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Dean Health Holdings LLC | ||||||||||||
| 1277 Deming Way | Madison | WI | 53717 | 261594709 | Support Services | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Wingra Building Group | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 390237060 | MOB | WI | NA | N/A | $0 | $0 | $0 | 0 |
| Janesville Riverview Clinic Building Partnership | ||||||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 396220698 | MOB | WI | NA | N/A | $0 | $0 | $0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SSM Managed Care Organization LLC | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431708511 | Health Promotion | MO | NA | C Corporation | false |
| FPP Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431465174 | Health Care | MO | NA | C Corporation | false |
| Diversified Health Services Corp | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431369305 | Medical Equipment | MO | NA | C Corporation | false |
| SSM Cardio and Thoracic Services Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 260286559 | Health Care | MO | NA | C Corporation | false |
| SSM Properties Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431462486 | Property Services | MO | NA | C Corporation | false |
| SSM Depaul Medical Group Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431715106 | Health Care | MO | NA | C Corporation | false |
| SSM St Charles Clinic Med Group Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 430626408 | Physician Offices | MO | NA | C Corporation | false |
| Health First Phys Management | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 731534336 | Medical Services | OK | NA | C Corporation | false |
| SSMHCS Liability Trust II | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 816128118 | Insurance | MO | NA | C Corporation | false |
| SSM Neurosciences Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 263413981 | Health Care | MO | NA | C Corporation | false |
| SSM Medical Group Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 431664107 | Physician Offices | MO | NA | C Corporation | false |
| SSMHC Insurance Company | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 030310431 | Insurance | CA | NA | C Corporation | false |
| SSM Orthopedic Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 271557033 | Health Care | MO | NA | C Corporation | false |
| SSM Cancer Care Inc | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 271557324 | Health Care | MO | NA | C Corporation | false |
| Physicians Services Corp of Southern Illinois | |||||||||
| 10101 Woodfield Lane | St Louis | MO | 63132 | 364161526 | Health Care | IL | NA | C Corporation | false |
| Dean Health Systems Inc | |||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391128616 | Physician Offices | WI | NA | C Corporation | false |
| Dean Health Insurance Inc | |||||||||
| PO Box 56099 | Madison | WI | 53705 | 391830837 | Insurance | WI | NA | C Corporation | false |
| Dean Health Plan Inc | |||||||||
| PO Box 56099 | Madison | MO | 53705 | 391535024 | Insurance | WI | NA | C Corporation | false |
| St Marys Dean Ventures Inc | |||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391628491 | Physician Offices | WI | NA | C Corporation | false |
| Dean Retail Services Inc | |||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 391717636 | Property Services | WI | NA | C Corporation | false |
| Navitus Holdings LLC | |||||||||
| 1808 West Beltline Highway | Madison | WI | 53713 | 800968174 | Pharmacy Benefits | WI | NA | C Corporation | false |
| Oza Oncology Inc | |||||||||
| 4117 Veterans Memorial Drive | Mt Vernon | IL | 62804 | 371343746 | Physician Offices | IL | NA | C Corporation | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |