WAUPUN MEMORIAL HOSPITAL: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: WAUPUN MEMORIAL HOSPITAL (EIN 39-0806265)
Tax period: 2023-01-01 to 2023-12-31
Filed: 2024-11-15
IRS object ID: 202423209349318787
Schema version: 2023v5.1
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-11-15T14:49:28-06:00	ReturnTs
Tax Period End	2023-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	466029223	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KEVIN SMITH	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	12800 CORPORATE HILL DRIVE	AddressLine1Txt
City	ST LOUIS	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	63131	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390806265	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WAUPUN MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	WAUP	BusinessNameControlTxt
Phone	9209265519	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 WEST BROWN STREET	AddressLine1Txt
City	WAUPUN	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53963	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	STEPHANIE KING	PersonNm
Person Title	VP FINANCE	PersonTitleTxt
Phone	9209265519	PhoneNum
Signature	2024-11-15	SignatureDt

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Phone	3149947800	PhoneNum
Preparation	2024-11-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2024-10-15 13:58:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SUE ANDERSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 WEST BROWN STREET	AddressLine1Txt
City	WAUPUN	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53963	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$59,986,891	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SSMHEALTH.COM/LOCATIONS/WISCONSIN/WAUPUN-MEMO	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1049	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF WAUPUN MEMORIAL HOSPITAL IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH, AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	82	TotalVolunteersCnt
Total Gross UBI	$19,895	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$76,967	PYContributionsGrantsAmt
CY Contributions Grants	$60,292	CYContributionsGrantsAmt
PY Program Service Revenue	$65,763,727	PYProgramServiceRevenueAmt
CY Program Service Revenue	$59,588,022	CYProgramServiceRevenueAmt
PY Investment Income	-$8,999	PYInvestmentIncomeAmt
CY Investment Income	-$4,487	CYInvestmentIncomeAmt
PY Other Revenue	$117,216	PYOtherRevenueAmt
CY Other Revenue	$343,064	CYOtherRevenueAmt
PY Total Revenue	$65,948,911	PYTotalRevenueAmt
CY Total Revenue	$59,986,891	CYTotalRevenueAmt
PY Grants And Similar Paid	$63,548	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$65,373	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$20,792,564	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$24,224,984	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$36,483,469	PYOtherExpensesAmt
CY Other Expenses	$25,114,003	CYOtherExpensesAmt
PY Total Expenses	$57,339,581	PYTotalExpensesAmt
CY Total Expenses	$49,404,360	CYTotalExpensesAmt
PY Revenues Less Expenses	$8,609,330	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$10,582,531	CYRevenuesLessExpensesAmt
Total Assets BOY	$87,097,613	TotalAssetsBOYAmt
Total Assets EOY	$93,064,323	TotalAssetsEOYAmt
Total Liabilities BOY	$5,111,773	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$441,196	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$81,985,840	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$92,623,127	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE MISSION OF WAUPUN MEMORIAL HOSPITAL IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH, AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$44,721,180	ExpenseAmt
Grant	$65,373	GrantAmt
Revenue	$59,588,022	RevenueAmt
Desc	SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 650 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 12 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 13,900 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMH STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. ABOUT WAUPUN MEMORIAL HOSPITAL:WAUPUN MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN WAUPUN, WISCONSIN, AND PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO WAUPUN AND THE SURROUNDING RURAL AREAS. WAUPUN MEMORIAL HOSPITAL FEATURES A TWO-STORY PROVIDER CLINIC, CONSOLIDATING ALL ITS PROVIDER SERVICES INTO ONE FACILITY WITH A DIRECT CONNECTION TO THE LARGER RESOURCES OF THE HOSPITAL. A STATE-OF-THE-ART SURGERY AREA FEATURES THREE HIGH-TECH OPERATING ROOMS, AN ENDOSCOPY PROCEDURE ROOM, 11 PRE/POSTOPERATIVE PATIENT ROOMS, FOUR POST ANESTHESIA RECOVERY ROOMS AND CENTRALIZED STERILE PROCESSING AREA. THE HOSPITAL'S STAFF OF ASSOCIATES AND VOLUNTEERS IS DEDICATED TO PROVIDING SERVICES IN THE AREAS OF LABORATORY, CARDIOPULMONARY, REHABILITATION, RADIOLOGY, ULTRASOUND, MRI, SURGICAL, EMERGENCY, OUTPATIENT DIALYSIS, MEDICAL/SURGICAL SERVICES, INTENSIVE CARE AND OBSTETRICS.IN 2018, WAUPUN MEMORIAL HOSPITAL RECEIVED CERTIFICATION OF ITS CARDIAC REHAB PROGRAM BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR). WMH WAS RECOGNIZED FOR ITS COMMITMENT TO IMPROVING THE QUALITY OF LIFE BY ENHANCING STANDARDS OF CARE. AACVPR PROGRAM CERTIFICATION IS THE ONLY PEER-REVIEW ACCREDITATION PROCESS DESIGNED TO REVIEW INDIVIDUAL PROGRAMS FOR ADHERENCE TO STANDARDS AND GUIDELINES DEVELOPED AND PUBLISHED BY AACVPR AND OTHER PROFESSIONAL SOCIETIES. EACH PROGRAM IS REVIEWED BY THE AACVPR PROGRAM CERTIFICATION COMMITTEE AND CERTIFICATION IS AWARDED BY THE AACVPR BOARD OF DIRECTORS. AACVPR-CERTIFIED PROGRAMS ARE RECOGNIZED AS LEADERS IN THE FIELD OF CARDIOVASCULAR AND PULMONARY REHABILITATION BECAUSE THEY OFFER THE MOST ADVANCED PRACTICES AVAILABLE. WAUPUN MEMORIAL HOSPITAL ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM QUANTIFIABLE UNCOMPENSATED CARE:THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE QUANTIFIED AS UNCOMPENSATED CARE:TRADITIONAL CHARITY CARE $782,903UNPAID COST OF MEDICAID $154,150TOTAL QUANTIFIABLE UNCOMPENSATED CARE $937,054	Desc
Total Program Service Expenses	$44,721,180	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BRADLEY REACH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6082416949	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1808 W BELTLINE HWY	AddressLine1Txt
City	MADISON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53713	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
DOUG CRONIN
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
KATHY DUCHAC
PT YR DIRECTOR, VICE CHAIR	1.00	1.00	Yes (X)	$0	$0	$0	Yes (X)
SCOTT HANSFIELD
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
JAN HARMSEN
PT YR DIRECTOR, CHAIR	1.00	1.00	Yes (X)	$0	$0	$0	Yes (X)
KATHLEEN HENDRICKS
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
DAVID HOPP
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
AMY MOHR
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
BREANNA NAGEL
PT YR DIRECTOR, CHIEF OF STAFF REPRESENTATIVE	1.00	1.00	Yes (X)	$0	$0	$0
ROBERT NAGLE
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
BRITTANY PAGE
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
KAREN REYNOLDS
PT YR DIRECTOR	1.00	1.00	Yes (X)	$0	$0	$0
RHEA EMMER
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
PENG HER
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
MARK HOLZMAN
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
JOAN KARSTON
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
KATIE KENNEDY
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
PATTI LEITZEN FYE
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
JENNIFER MASKEL
DIRECTOR, PHYSICIAN	1.00	40.00	Yes (X)	$0	$142,795	$14,024
WAYNE MATZKE
DIRECTOR, VICE CHAIR	1.00	4.00	Yes (X)	$0	$0	$0	Yes (X)
THEODORE MILLER
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
OLIVIA OTTE
DIRECTOR	1.00	4.00	Yes (X)	$0	$0	$0
MATTHEW POGODZINSKI
DIRECTOR, PHYSICIAN	1.00	40.00	Yes (X)	$0	$755,367	$62,067
WESLEY SPARKMAN
DIRECTOR, CHAIR	1.00	4.00	Yes (X)	$0	$0	$0	Yes (X)
SUE ANDERSON
DIRECTOR, REGIONAL PRESIDENT	1.00	55.00	Yes (X)	$0	$1,428,914	$540,322	Yes (X)
DEANN THURMER
PT YR DIRECTOR, PRESIDENT/CNO-WAUPUN MEMORIAL HOSP	40.00	0.00		$0	$407,420	$137,142	Yes (X)
RANDY COMBS
TREASURER, CFO AT SSM HEALTH	1.00	55.00		$0	$2,182,354	$1,238,074	Yes (X)
DOUGLAS LONG
SECRETARY, CHIEF LEGAL OFFICER AT SSM HEALTH	1.00	55.00		$0	$1,425,239	$777,013	Yes (X)
STEVE SMOOT
VICE PRESIDENT, COO AT SSM HEALTH	1.00	55.00		$0	$2,054,358	$1,204,489	Yes (X)
THOMAS KIRSCHBAUM
ASSISTANT SECRETARY	1.00	45.00		$0	$532,265	$210,384	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,928,712	TotReportableCompRltdOrgAmt
Total Other Compensation	$4,183,515	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CD SMITH CONSTRUCTION INC
125 CAMELOT DRIVE	FOND DU LAC	WI	54935	CONSTRUCTION SERVICES	$713,586
TRIMEDX HOLDINGS LLC
5451 LAKEVIEW PARKWAY S DR	INDIANAPOLIS	IN	46268	CLINICAL ENGINEERING SERVICES	$579,171
SHARED MEDICAL SERVICES INC
209 LIMESTONE PASS	COTTAGE GROVE	WI	53527	MEDICAL SERVICES	$454,800
J F AHERN CO
855 MORRIS ST	FOND DU LAC	WI	54936	FIRE PROTECTION SERVICES	$379,869
KASCHAK ROOFING INC
2301 W PURDUE ST	MILWAUKEE	WI	53209	CONSTRUCTION SERVICES	$351,096

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	10	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,000	RelatedOrganizationsAmt
Government Grants	$34,579	GovernmentGrantsAmt
All Other Contributions	$24,713	AllOtherContributionsAmt
Total Contributions	$60,292	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE RE	622110	$59,397,961	$59,397,961
340B PHARMACY REVENUE	456110	$21,110	$21,110

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$168,951	TotalRevenueColumnAmt
Related Or Exempt Func Income	$168,951	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$59,588,022	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$4,487	TotalRevenueColumnAmt
Exclusion	-$4,487	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$187,855	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$187,855	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$187,855	TotalRevenueColumnAmt
Exclusion	$187,855	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA REVENUE	722210	$135,314	$135,314
MOBILE MEALS	624200	$19,895		$19,895

Field	Value	IRS element (for citing)
Other Revenue Total	$155,209	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$59,986,891	TotalRevenueColumnAmt
Related Or Exempt Func Income	$59,588,022	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$19,895	UnrelatedBusinessRevenueAmt
Exclusion	$318,682	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$65,373	TotalAmt
Program Services	$65,373	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$19,240,734	TotalAmt
Program Services	$18,790,243	ProgramServicesAmt
Management And General	$450,491	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$955,453	TotalAmt
Program Services	$933,083	ProgramServicesAmt
Management And General	$22,370	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,732,396	TotalAmt
Program Services	$2,668,421	ProgramServicesAmt
Management And General	$63,975	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,296,401	TotalAmt
Program Services	$1,266,048	ProgramServicesAmt
Management And General	$30,353	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$29,282	TotalAmt
Program Services	$29,282	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$16,160	TotalAmt
Program Services	$36	ProgramServicesAmt
Management And General	$16,124	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,500,839	TotalAmt
Program Services	$3,500,839	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$754,970	TotalAmt
Program Services	$740,889	ProgramServicesAmt
Management And General	$14,081	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,446,234	TotalAmt
Program Services	$1,446,234	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,188,632	TotalAmt
Program Services	$1,188,632	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$56,366	TotalAmt
Program Services	$49,747	ProgramServicesAmt
Management And General	$6,619	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$4,143	TotalAmt
Program Services	$3,338	ProgramServicesAmt
Management And General	$805	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$6,757,451	TotalAmt
Program Services	$2,872,413	ProgramServicesAmt
Management And General	$3,885,038	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,749,711	TotalAmt
Program Services	$2,749,711	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$238,240	TotalAmt
Program Services	$118,229	ProgramServicesAmt
Management And General	$120,011	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & EQUI	$8,121,476	$8,119,313	$2,163
LICENSES, DUES & SUBSCR	$94,400	$72,737	$21,663
BANK FEES	$51,296	$770	$50,526

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$104,803	TotalAmt
Program Services	$105,842	ProgramServicesAmt
Management And General	-$1,039	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$49,404,360	TotalAmt
Program Services	$44,721,180	ProgramServicesAmt
Management And General	$4,683,180	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$337,154	BOYAmt
EOY	$355,906	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$5,074,383	BOYAmt
EOY	$6,669,268	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$11,903	BOYAmt
EOY	$31,712	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,353	BOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$51,432,426	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$18,369,051	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$32,643,374	BOYAmt
EOY	$33,063,375	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$305,454	BOYAmt
EOY	$375,013	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$48,722,992	BOYAmt
EOY	$52,569,049	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$87,097,613	BOYAmt
EOY	$93,064,323	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,137,326	BOYAmt
EOY	$296,492	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$974,447	BOYAmt
EOY	$144,704	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,111,773	BOYAmt
EOY	$441,196	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$81,680,386	BOYAmt
EOY	$92,248,114	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$305,454	BOYAmt
EOY	$375,013	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$81,985,840	BOYAmt
EOY	$92,623,127	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$87,097,613	BOYAmt
EOY	$93,064,323	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$10,582,531	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	-$6	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$54,762	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$2,063	OtherActivitiesAmt
Total Lobbying Expenditures	$2,063	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL & STATE HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$190,000	OtherCostOrOtherBasisAmt
Book Value	$190,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$38,759,183	OtherCostOrOtherBasisAmt
Depreciation	$11,628,363	DepreciationAmt
Book Value	$27,130,820	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$813,475	OtherCostOrOtherBasisAmt
Depreciation	$569,565	DepreciationAmt
Book Value	$243,910	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,453,067	OtherCostOrOtherBasisAmt
Depreciation	$6,171,123	DepreciationAmt
Book Value	$5,281,944	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$216,701	OtherCostOrOtherBasisAmt
Book Value	$216,701	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$33,063,375	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATES	$52,172,573
ESTIMATED THIRD PARTY SETTLMENT	$396,476

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$52,569,049	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	THIRD PARTY PAYOR	Desc
Amt	$144,704	Amt

Field	Value	IRS element (for citing)
Total Liability	$144,704	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	WAUPUN MEMORIAL HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2023 OR 2022.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
Most Hospitals Policy	Yes (X)	MostHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$782,903	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$782,903	NetCommunityBenefitExpnsAmt
Total Expense	0.01580	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,051,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,897,142	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$154,151	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$502,858	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$535,603	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,337,054	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,432,745	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$937,054	NetCommunityBenefitExpnsAmt
Total Expense	0.01890	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$48,370	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,370	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$196,363	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$196,363	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$123,602	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$123,602	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$368,335	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$368,335	NetCommunityBenefitExpnsAmt
Total Expense	0.00750	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,705,389	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,432,745	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,305,389	NetCommunityBenefitExpnsAmt
Total Expense	0.02640	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,263	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,263	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,263	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,263	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,549,780	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$4,772,916	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$8,682,391	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,909,475	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 (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
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	WAUPUN MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	620 WEST BROWN STREET	AddressLine1Txt
City	WAUPUN	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53963	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.SSMHEALTH.COM/LOCATIONS/WISCONSIN/	WebsiteAddressTxt
State License	1031	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	WAUPUN MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSES	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSES	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
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 (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BIL/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BIL/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BIL/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 (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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 (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT IS COMPRISED OF FIVE DIFFERENT DATA COLLECTION METHODS TO INCLUDE PRIMARY, SECONDARY, QUALITATIVE, AND QUANTITATIVE DATA. ONCE IT WAS COLLECTED, IT WAS ORGANIZED INTO FIVE HEALTH FOCUS AREAS. COMMUNITY HEAL TH SURVEY THE COMMUNITY HEALTH SURVEY CONDUCTED BY JKV RESEARCH, LLC., PROVIDES PRIMARY, QUANTITATIVE DATA COLLECTED FROM FOND DU LAC COUNTY RESIDENTS. THE DATA PROVIDES AN OVERVIEW OF BEHAVIORAL AND LIFESTYLE HABITS AS WELL AS PREVALENCE OF RISK FACTORS AND DISEASE CONDITIONS EXISTING WITHIN THE FOND DU LAC COUNTY ADULT POPULATION. THE SURVEY WAS MAILED OUT TO A RANDOM SAMPLE AND 674 ADULTS PARTICIPATED. AGGREGATE DATA FROM SIX SCHOOL DISTRICTS IN FOND DU LAC COUNTY IS INCLUDED IN THE COMMUNITY HEAL TH SURVEY REPORT TO PROVIDE STUDENT DATA WHEN AVAILABLE. PUBLIC INPUT SURVEY THE PRIORITY HEALTH ISSUES SURVEY WAS CONDUCTED TO PROVIDE AN OUTLET FOR THE COMMUNITY AT LARGE TO PROVIDE ADDITIONAL INPUT AND VOICE THEIR CONCERNS REGARDING THE MOST PRESSING COUNTY HEALTH ISSUES. THE SURVEY WAS AVAILABLE IN HARD COPY AT THE HEALTH DEPARTMENT AND ONLINE ON THE HEALTH DEPARTMENT'S WEBSITE. THE SURVEY WAS AVAILABLE TO TAKE IN ENGLISH AND SPANISH. RESIDENTS WERE ENCOURAGED TO REVIEW KEY FINDINGS FROM THE 2020 COMMUNITY HEALTH SURVEY BEFOREHAND TO PROVIDE ADDITIONAL FEEDBACK. A TOTAL OF 284 FOND DU LAC COUNTY RESIDENTS COMPLETED THE SURVEY. THE HEAL TH FOCUS AREAS RANKED MOST CONSISTENTLY IN THE TOP FIVE BY RESPONDENTS WERE: MENTAL HEALTH, ALCOHOL AND OTHER DRUG USE, SOCIAL DETERMINANTS OF HEALTH, FOOD SECURITY AND NUTRITION AND INFECTIOUS DISEASE. KEY INFORMANT INTERVIEWS A TOTAL OF 37 KEY INFORMANT INTERVIEWS WERE CONDUCTED TO PROVIDE FURTHER QUALITATIVE DATA REGARDING COMMUNITY NEEDS. KEY INFORMANTS IDENTIFIED WERE CONSIDERED COMMUNITY EXPERTS WHO CAN PROVIDE VALUABLE INSIGHT ON PRESSING HEAL TH ISSUES IN THE FOND DU LAC COUNTY COMMUNITY. THE TOP HEAL TH FOCUS AREAS RANKED MOST CONSISTENTLY BY KEY INFORMANTS WERE: MENTAL HEALTH, ALCOHOL AND OTHER DRUG USE, SOCIAL DETERMINANTS OF HEALTH, CHRONIC DISEASE, ORAL HEALTH AND FOOD SECURITY AND NUTRITION. COMMUNITY CONVERSATIONS NEW FOR THE 2021 COMMUNITY HEAL TH ASSESSMENT WAS DATA COLLECTED FROM COMMUNITY CONVERSATIONS THESE CONVERSATIONS WERE ORGANIZED BY MEMBERS OF THE SSM HEALTH GREATER FOND DU LAC REGION, FOND DU LAC COUNTY HEAL TH DEPARTMENT AND OTHER ENTITIES THAT SERVED AS HOST LOCATIONS FOR THESE EVENTS. THE PURPOSE OF THESE COMMUNITY CONVERSATIONS WAS TO FURTHER ENGAGE THE PUBLIC AND PROVIDE AN OPPORTUNITY FOR VARIOUS POPULATIONS TO VOICE THEIR INPUT THAT MAY OTHERWISE HAVE NOT BEEN HEARD. 16 COMMUNITY CONVERSATIONS WERE HELD ACROSS THE COUNTY, PROVIDING FURTHER INFORMATION REGARDING THE HEALTH NEEDS OF RESIDENTS IN FOND DU LAC COUNTY. TOP NEEDS IDENTIFIED FROM COMMUNITY CONVERSATIONS INCLUDE: ACCESS TO RESOURCES, MENTAL HEALTH, TRANSPORTATION, ACCESS TO CARE AND RACISM. HIGHLIGHTS AND THEMES FROM THESE CONVERSATIONS CAN BE FOUND THROUGHOUT THE REPORT. SECONDARY DATA SECONDARY DATA WAS COLLECTED FROM LOCAL, STATE, AND NATIONAL HEALTH SOURCES TO SUPPLEMENT THE COMMUNITY HEALTH SURVEY AND OTHER DATA COLLECTION INFORMATION LISTED ABOVE. THIS DATA HELPED BUILD A COMMUNITY HEALTH PROFILE FOR FOND DU LAC COUNTY AND ALLOWED THIS REPORT TO BE COMPARABLE TO OTHER COUNTIES AS WELL AS STATE AND NATIONAL BENCHMARKS. THE SECONDARY DATA COLLECTED IS INCLUDED IN THROUGHOUT THE HEALTH FOCUS AREA AND THE DEFINITION OF COMMUNITY PROFILES.
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: HOSPITALS INCLUDED IN THE CHNA WERE AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL), WAUPUN MEMORIAL HOSPITAL, AND RIPON MEDICAL CENTER.
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: WAUPUN MEMORIAL HOSPITAL CONDUCTED THEIR CHNA IN COLLABORATION WITH HEALTHY FOND DU LAC COUNTY AND THE FOND DU LAC COUNTY HEALTH DEPARTMENT.
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES:- MENTAL HEAL TH - CHRONIC DISEASE - SUBSTANCE USEMENTAL HEALTH ACCORDING TO THE WORLD HEALTH ORGANIZATION, THE DEFINITION OF HEAL TH IS A "STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY." MENTAL HEALTH IS SOMETHING WE ALL HAVE, AND IT VARIES IN ITS DEGREE FROM TIME TO TIME. IF THERE IS A SIGNIFICANT IMPACT ON OUR THINKING, FEELING AND/OR BEHAVIOR, TREATMENT, SERVICES OR INTERVENTION MAY BE REQUIRED. IN GENERAL, THE SOONER ONE GETS TREATMENT, THE BETTER THE OUTCOME. HAVING AN UNTREATED MENTAL DISORDER CAN CREATE SERIOUS PROBLEMS SUCH AS INCREASING THE CHANCE OF RISKY BEHAVIORS, DRUG OR ALCOHOL ADDICTION, AND IN EXTREME CASES, DEATH. IT ALSO CAN RUIN RELATIONSHIPS, CAUSE PROBLEMS AT WORK, AND MAKE IT DIFFICULT TO OVERCOME SERIOUS ILLNESSES. MENTAL HEALTH WAS IDENTIFIED AS THE NUMBER ONE PRIORITY TO ADDRESS AS A RESULT OF THE 2021 CHNA. MENTAL HEALTH NEEDS IN FOND DU LAC COUNTY MAY INCLUDE, BUT IS NOT LIMITED TO CHALLENGES, BARRIERS OR NEEDS RELATED TO PROVIDER AVAILABILITY, AFFORDABILITY, TRANSPORTATION, INSURANCE, STIGMA, SUBSTANCE USE, CULTURALLY SENSITIVE AND DIVERSE PROVIDERS AND SERVICES, STRESS, AND SUICIDE. ADDITIONALLY, STATISTICS SHOW:- 20 DEATHS BY SUICIDE REPORTED IN FOND DU LAC COUNTY IN 2020- 1 IN 5 ADULTS REPORTED TO HAVE A MENTAL HEALTH CONDITION IN THE PAST THREE YEARS- 1 IN 5 YOUTH REPORTED THEY ALWAYS OR NEARLY ALWAYS FELT SAD, BLUE OR DEPRESSED- 44% UNSERVED CHILDREN WITH MENTAL ILLNESS IN FOND DU LAC COUNTY- 79% ADULTS REPORT TO HAVE THEIR MENTAL HEALTH CONDITION UNDER CONTROL (DOWN FROM 96% IN 2017)IN ORDER TO DECREASE THE NUMBER OF DEATHS BY SUICIDE IN FOND DU LAC COUNTY, AS WELL AS INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES, THE HOSPITAL'S ACTION PLAN INCLUDES THE FOLLOWING INITIATIVES:- EXPAND TRAININGS FOR QUESTION, PERSUADE, REFER (QPR), MENTAL HEALTH FIRST AID FOR ADULTS (MHFA), YOUTH MENTAL HEALTH FIRST AID (YMHFA). EXPLORE ADDITIONAL TRAININGS AND PROGRAMS FOR SUICIDE PREVENTION AND MENTAL HEALTH - POTENTIAL NEW PARTNERS AND COLLABORATIONS: BUSINESSES AND EMPLOYERS - INCREASE MEANS FOR DATA COLLECTION, MONITORING AND EVALUATION OF MENTAL HEALTH NEEDS, WITH COMMUNITY PARTNERS SUCH AS DCP, AND PUBLIC SAFETY DEPARTMENTS- RESEARCH UNIVERSAL AND INDIVIDUAL SCREENING TOOLS FOR BEHAVIORAL AND MENTAL HEALTH NEEDS ACROSS THE LIFESPAN AND DEVELOP A PLAN TO ASSESS AND EXPAND SBIRT AT THE RIPON COMMUNITY HOSPITAL - INCREASE MENTAL HEALTH/BEHAVIORAL HEAL TH SERVICES AND ACCESS TO THEM - INCREASE MENTAL HEALTH RESOURCES AND NAVIGATION TOOLS - DEVELOP MORE UNIVERSAL APPROACH TO SAFETY PLANNING ACROSS THE COUNTRY - DECREASE STIGMA, CAMPAIGNS, AWARENESS, TIC, ACES, BUILD COMMUNITYCHRONIC DISEASE CHRONIC DISEASES ARE ILLNESSES THAT LAST A LONG TIME, DO NOT GO AWAY ON THEIR OWN, ARE RARELY CURED, AND OFTEN RESULT IN DISABILITY LATER IN LIFE. MULTIPLE HEAL TH CONDITIONS ARE CLASSIFIED AS CHRONIC DISEASES SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, HEART DISEASE, OBESITY, DIABETES, ASTHMA AND MORE. NUTRITION AND PHYSICAL ACTIVITY ARE IMPORTANT TO MAINTAIN AND IMPROVE OVERALL HEALTH AND BOTH PLAY A PROMINENT ROLE IN OBESITY PREVENTION AND CONTROL. AS ESTABLISHED IN THE U.S. DIETARY GUIDELINES, GOOD NUTRITION INCLUDES MEETING NUTRIENT RECOMMENDATIONS YET KEEPING CALORIES UNDER CONTROL. PHYSICAL ACTIVITY MEANS ANY BODILY ACTIVITY THAT ENHANCES OR MAINTAINS PHYSICAL FITNESS AND OVERALL HEALTH. OBESITY IS ONE OF THE MOST CRITICAL HEALTH ISSUES OF OUR TIME AND IS A COMPLEX HEALTH ISSUE RESULTING FROM MANY INTERACTING CAUSES AND FACTORS IN OUR SOCIETY, BEHAVIOR, AND GENETICS. OBESITY IS ALSO ASSOCIATED WITH POORER MENTAL HEALTH OUTCOMES AND REDUCES QUALITY OF LIFE. THE BURDEN OF OBESITY AND OTHER DIET-RELATED CHRONIC DISEASES ARE VAST, AND RATES CONTINUE TO RISE. CHANGES AT THE COMMUNITY LEVEL, SUCH AS POLICIES, SYSTEMS, AND ENVIRONMENT, ARE MORE LIKELY TO BE EFFECTIVE, AL THOUGH THEY MAY BE MORE DIFFICULT TO ACHIEVE. ACCORDING TO FOND DU LAC COMMUNITY MEMBERS RESPONSES THROUGHOUT THE ASSESSMENT, COMMON BARRIERS AND CHALLENGES TO CHRONIC DISEASES AND RELATED HEALTH BEHAVIORS INCLUDED, BUT NOT LIMITED TO, ACCESS AND AFFORDABILITY TO HEALTHY FOODS, AWARENESS OF NUTRITIOUS FOOD AND COOKING HEALTHY MEALS, ACCESS TO INDOOR AND OUTDOOR RECREATION, ACCESS AND AFFORDABILITY OF HEALTHCARE SERVICES. INSURANCE, STIGMA, TRANSPORTATION, AND CULTURAL COMPETENCIES. ADDITIONALLY, STATISTICS SHOW:- HEART DISEASES IS THE NUMBER ONE CAUSE OF DEATH AMONG ADULTS- 75% (3 IN 4) ADULTS WERE CLASSIFIED AS AT LEAST OVERWEIGHT- ABOUT 1 IN 3 YOUTH WERE CLASSIFIED AS AT LEAST OVERWEIGHT - 52% OF ADULTS REPORTED MEETING AEROBIC PHYSICAL ACTIVITY GUIDELINES- 23% OF ADULTS REPORTED EATING THE RECOMMENDED SERVINGS OF FRUIT PER DAY- 17% OF YOUTH REPORTED EATING THE RECOMMENDED SERVINGS OF FRUIT PER DAY - 4,920 (6%) HOUSEHOLDS REPORTED THEY WENT HUNGRY BECAUSE THEY COULDN'T AFFORD ENOUGH FOODIN ORDER TO IMPROVE RESIDENTS' WEIGHT, PHYSICAL ACTIVITY, NUTRITION, AND INCREASE BREASTFEEDING, THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING ACTION ITEMS:- RESEARCH AND IDENTIFY CHRONIC DISEASE PREVENTION AND SELF-MANAGEMENT CLASSES- INCREASE TRAIL USAGE, ENHANCE BIKE AND PEDESTRIAN MASTER PLANS- IMPLEMENT A PHYSICAL ACTIVITY CAMPAIGN- INCREASE SCHOOLS PARTICIPATING IN SAFE ROUTES TO SCHOOL - IDENTIFY EXISTING EFFORTS AND ASSESS IMPACT- INCREASE SNAP USAGE - INCREASE ACCESS TO AND AFFORDABILITY OF FRUITS AND VEGETABLES - ASSESS CURRENT FOOD FORESTS OR COMMUNITY/SHARED GARDENS AND INCREASE VALUE/IMPACT - INCREASE HEALTH PROMOTION PROGRAMS OFFERED TO LOW-INCOME HOUSING RESIDENTS - INCREASE NUMBER OF CHILDCARE CENTERS AND BUSINESS CENTERS WHO HAVE ADOPTED THE TEN STEPS TO BREASTFEEDING-FRIENDLY TOOLKIT (PROMOTE SUPPORT FOR BREASTFEEDING MOTHERS IN THE WORKPLACE, EARLY CHILDHOOD EDUCATION SETTINGS, AND THROUGHOUT THE COMMUNITYSUBSTANCE USE ALCOHOL AND OTHER DRUG USE MEANS ANY USE OF A SUBSTANCE THAT RESULT IN NEGATIVE CONSEQUENCES. THIS INCLUDES A BROAD ARRAY OF MOOD-ALTERING SUBSTANCES SUCH AS ALCOHOL, TOBACCO, PRESCRIPTION SUBSTANCES, AND ILLEGAL SUBSTANCES LIKE METHAMPHETAMINE AND HEROIN. NEGATIVE CONSEQUENCES OR UNHEALTHY USES INCLUDE BUT ARE NOT LIMITED TO, OPERATING A MOTOR VEHICLE WHILE INTOXICATED, DRINKING WHILE PREGNANT, ALCOHOL DEPENDENCE, FETAL ALCOHOL SPECTRUM DISORDER, ALCOHOL-RELATED HOSPITALIZATIONS, AND MORE. SUBSTANCE USE WAS IDENTIFIED AS THE NUMBER THREE PRIORITY TO ADDRESS IN THE 2022-2024 CHIP. SUBSTANCE USE NEEDS IN FOND DU LAC COUNTY MAY INCLUDE, BUT IS NOT LIMITED TO BARRIERS, CHALLENGES AND NEEDS RELATED TOBACCO, VAPING, DRUGS (NARCOTICS, MARIJUANA, ETC.), PRESCRIPTION MEDICATIONS, AND ALCOHOL USE, MENTAL HEALTH AND ACCESS TO CARE. THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT, SUBSTANCE USE WAS CONSISTENTLY RANKED AS A TOP PRIORITY. ADDITIONALLY, STATISTICS SHOW:- 25 OPIOID RELATED DEATHS IN FOND DU LAC COUNTY IN 2020, OVER DOUBLE THE DEATHS FROM 2019 - 74% OF ADULTS REPORTED DRINKING ALCOHOL IN THE PAST MONTH - 22% OF YOUTH REPORTED DRINKING ALCOHOL IN THE PAST MONTH - 37% OF ADULTS REPORTED BINGE DRINKING ALCOHOL IN THE PAST MONTH- 37% OF ADULTS REPORTED BINGE DRINKING ALCOHOL IN THE PAST MONTHTHE HOSPITAL'S ACTION PLAN INCLUDES THE FOLLOWING INITIATIVES TO DECREASE UNDERAGE DRINKING AND BINGE DRINKING, AND DECREASE MISUSE OF OPIOIDS/PRESCRIPTION MEDICATION:- INCREASE FESTIVALS EVALUATED ANNUALLY USING THE COMMUNITY EVENTS BEST PRACTICES TOOLKIT- INCREASE NUMBER OF LAW ENFORCEMENT AGENCIES COMPLETING ANNUAL COMPLIANCE CHECKS- DECREASE ALCOHOL OUTLET DENSITY - AWARENESS AND EDUCATION CAMPAIGN- INCREASE NUMBER OF NARCAN TRAININGS AND KITS DISTRIBUTED - SYRINGE SERVICES PROGRAM- PRESCRIPTION MEDICATION PRESCRIBING PRACTICES AND PAIN MANAGEMENT - PRESCRIPTION MEDICATION DISPOSALTHE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING THE REMAINING CHNA-IDENTIFIED NEEDS.
WAUPUN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 13B: PATIENTS AND THEIR GUARANTOR'S INCOME IS USED IN DETERMINING INCOME LEVEL FOR FREE OR DISCOUNTED CARE.

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PART I, LINE 3C:	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 HEAL TH 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."
PART I, LINE 6A:	SSM HEALTH CARE CORPORATION, 46-6029223
PART I, LINE 7:	THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B, AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H, AND 71 ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE CALCULATION OF SCHEDULE H, PART I, LINE 7, COLUMN F UTILIZES 990, PART IX, LINE 25, COLUMN A, WHICH DOES NOT INCLUDE BAD DEBT EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:	WAUPUN MEMORIAL HOSPITAL PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEAL TH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING: ENVIRONMENTAL IMPROVEMENTS: SHARPS CONTAINERS ARE SUPPLIED TO OUR PATIENTS AND CUSTOMERS THROUGHOUT THE COMMUNITY FREE OF CHARGE, WITH FULL CONTAINERS ABLE TO BE DROPPED OFF AT ALL FACILITY SITES FOR DISPOSAL.
PART III, LINE 2:	AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.
PART III, LINE 3:	FOR FINANCIAL STATEMENT PURPOSES, SSM HEALTH HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THEREFORE, THERE IS NO AMOUNT REPORTED ON PART III, LINE 3 FOR THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER SSM HEALTH'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	WAUPUN MEMORIAL HOSPITAL IS PART OF THE SSM HEALTH CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES THE TREATMENT OF UNCOLLECTIBLE ACCOUNTS AND IMPLICIT PRICE CONCESSIONS IN THE DECEMBER 31, 2023 CONSOLIDATED AUDIT IS CONTAINED ON PAGE 13 AND 14 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEAL TH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.
PART III, LINE 9B:	WAUPUN MEMORIAL HOSPITAL HAS ESTABLISHED A WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEAL TH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. WAUPUN MEMORIAL HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. WAUPUN MEMORIAL HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RATE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY. ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING: 1. THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT 2. EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS. 3. ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD. 4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL. 5.BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSM PRIOR TO ENGAGING IN ECAS. SSM WILL REVIEW THE ACCOUNTS AND VERIFY SATISFACTORY COMPLETION OF REASONABLE EFFORTS DURING THE NOTIFICATION AND APPLICATION PERIOD. A WAIVER IS NOT CONSIDERED REASONABLE EFFORTS. OBTAINING A SIGNED WAIVER THAT AN INDIVIDUAL DOES NOT WISH TO APPLY FOR FAP ASSISTANCE OR RECEIVE FAP APPLICATION INFORMATION WILL NOT MEET THE REQUIREMENT TO MAKE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN ECAS. ALL OUTSIDE COLLECTION AGENCIES MUST COMPLY WITH STATE AND FEDERAL LAWS, COMPLY WITH THE ASSOCIATION OF CREDIT AND COLLECTION PROFESSIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY AND COMPLY WITH WAUPUN MEMORIAL HOSPITAL'S COLLECTION AND FINANCIAL ASSISTANCE POLICIES.
PART VI, LINE 2:	SSM HEALTH (SSMH) PARTICIPATES IN COMMUNITY BENEFIT ACCORDING TO OUR VISION. THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY, AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT AND ENVIRONMENT. IN THE TRADITION OF OUR FOUNDERS, THE FRANCISCAN SISTERS OF MARY, CARING FOR THOSE IN GREATEST NEED REMAINS OUR ORGANIZATIONAL PRIORITY. TODAY OUR SYSTEM BOARD MONITORS COMMUNITY BENEFIT EFFORTS, AND VIEWS ACHIEVEMENT OF OUR VISION AS A PRIMARY RESPONSIBILITY. THE PURPOSE OF SSM'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEAL TH 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 HEAL TH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATA TO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA. DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEALTH PRIORITIES: ESTABLISH STRATEGIES TO ADDRESS PRIORITIES; COMPLETE STRATEGIC IMPLEMENTATION PLAN; OBTAIN REGIONAL/DIVISIONAL BOARD APPROVAL; AND INTEGRATE STRATEGIES INTO OPERATIONAL PLAN. MAKE CHNA WIDELY AVAILABLE TO THE PUBLIC: PUBLISH CHNA AND SUMMARY DOCUMENT ON HOSPITAL'S WEBSITE. MONITOR, TRACK, AND REPORT PROGRESS ON TOP HEALTH PRIORITIES: COLLECT DATA AND EVALUATE PROGRESS; REPORT TO REGIONAL/DIVISIONAL BOARD EVERY SIX MONTHS AND SYSTEM BOARD EVERY YEAR; SHARE FINDINGS WITH COMMUNITY STAKEHOLDERS; AND SEND RESULTS TO FINANCE FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS). SYSTEM OFFICE STAFF AND LEADERS OVERSEE AND MONITOR SSMH'S COMMUNITY BENEFIT PROGRAM, AND ENSURE REPORTING IS IN COMPLIANCE WITH IRS REGULATIONS. IN COLLABORATION WITH COMMUNITY STAKEHOLDERS AND PARTNER ORGANIZATIONS, SSM HEAL TH CARE CORPORATION ALSO IDENTIFIES NEEDS BASED ON ASSESSMENTS AND RESEARCH, AND SSMH FACILITIES ALSO INVOLVE CASE MANAGERS AND CARE TEAM STAFF TO PINPOINT CRITICAL HEALTH ISSUES IN THE COMMUNITY. ALL HOSPITAL CHNAS ARE COMPLETED, APPROVED, AND INTEGRATED INTO THE ORGANIZATION'S STRATEGIC PLAN. WE CONTINUE TO MONITOR AND ASSESS THE PROGRESS OF OUR LOCAL EFFORTS IN THE SPIRIT OF CARING FOR OTHERS AND IMPROVING COMMUNITY HEALTH.
PART VI, LINE 3:	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 COUNSELINGTHE 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.
PART VI, LINE 4:	WAUPUN MEMORIAL HOSPITAL DEFINES ITS COMMUNITY AS AN AREA SIMILAR TO ITS PRIMARY SERVICE DELIVERY AREA. THE PRIMARY SERVICE AREA FOR THE HOSPITAL INCLUDES PART OF WAUPUN AND THE BRANDON AREA IN FOND DU LAC COUNTY, AND PART OF WAUPUN AND FOX LAKE AREA IN DODGE COUNTY. THE HOSPITAL'S SECONDARY SERVICE AREA INCLUDES THE RIPON AREA, PART OF FOND DU LAC COUNTY, AND COMMUNITIES IN DODGE AND GREEN LAKE COUNTIES, SUCH AS MAYVILLE, BEAVER DAM, RANDOLPH, MARKESAN AND MARQUETTE, AND A SMALL PORTION OF COLOMBIA COUNTY.APPROXIMATELY 75% OF THE HOSPITAL'S PATIENT POPULATION COMES FROM THE PRIMARY SERVICE AREA, AND ANOTHER 15% FROM THE SECONDARY SERVICE AREA. WAUPUN MEMORIAL HOSPITAL IS LOCATED IN WAUPUN, WISCONSIN. THE WAUPUN MEMORIAL HOSPITAL SERVICE AREA INCLUDES PORTIONS OF DODGE AND GREEN LAKE COUNTIES. GREEN LAKE COUNTY HAS A POPULATION OF 18,913 PEOPLE. DODGE COUNTY HAS A POPULATION OF 87,715 PEOPLE. BOTH COUNTIES INCLUDE VAST RURAL COMMUNITIES, SUPPORT A LARGE INDUSTRIAL WORKFORCE, AND COMPARED TO FOND DU LAC COUNTY HAVE MORE INDIVIDUALS LIVING IN POVERTY. SOME OF THE LARGE FACTORIES EMPLOY A CONSIDERABLE HISPANIC AND SPANISH SPEAKING POPULATION, ARE ALSO MORE PERSONS IN POVERTY IN DODGE AND GREEN LAKE COUNTIES COMPARED TO FOND DU LAC COUNTY. WAUPUN IS ALSO HOME TO THREE PRISON SYSTEMS, WAUPUN CORRECTIONAL INSTITUTION, DODGE CORRECTIONAL INSTITUTION AND JOHN C BURKE CORRECTIONAL CENTER. DODGE CORRECTIONAL INSTITUTION'S OPERATIONAL CAPACITY IS 1,165 PEOPLE, AND FOR THE YEAR 2020 SAW 5,821 PEOPLE IN THEIR FACILITY. WAUPUN CORRECTIONAL INSTITUTION HAS AN OPERATIONAL CAPACITY OF 1,290 PEOPLE. ADDITIONAL DEMOGRAPHIC AND STATISTICAL DATA ON THE HOSPITAL'S SERVICE AREA CAN BE FOUND THROUGHOUT THE CHNA.
PART VI, LINE 5:	WAUPUN MEMORIAL HOSPITAL PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEAL TH 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 HEAL TH PROGRAMS PROVIDE COMPASSIONATE AND COMPETENT CARE WHILE THEY PROMOTE HEAL TH IMPROVEMENT BY REACHING DIRECTLY INTO THE COMMUNITY TO ENSURE THAT LOW-INCOME AND UNDER-SERVED PERSONS CAN ACCESS HEAL TH CARE SERVICES. IN RESPONSE TO THE GLOBAL CORONAVIRUS PANDEMIC, WAUPUN MEMORIAL HOSPITAL WORKED RELENTLESSLY TO RESPOND TO COMMUNITY NEEDS BY DEVELOPING AND IMPLEMENTING STRATEGIES TO ADDRESS SOCIAL NEEDS OF THOSE SERVED, PROVIDING SCREENING & TESTING SERVICES, PERSONAL PROTECTIVE EQUIPMENT AND EDUCATION THROUGHOUT THE COMMUNITY, AS WELL AS TREATMENT FOR THOSE WHO PRESENTED WITH COVID-19. WAUPUN MEMORIAL HOSPITAL PROMOTES GRASSROOTS ADVOCACY AND ENGAGES PERSONS OF INFLUENCE TO AFFECT SOCIAL AND PUBLIC POLICY CHANGE IN ORDER TO PROMOTE COMMUNITY HEALTH. WAUPUN MEMORIAL HOSPITAL ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, ENGAGES IN THE TRAINING AND EDUCATION OF HEAL TH 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.
PART VI, LINE 6:	WAUPUN MEMORIAL HOSPITAL IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEAL TH CARE SYSTEM KNOW AS SSM HEALTH. SSM HEALTH (SSMH) IS A CENTRALLY MANAGED, FULLY INTEGRATED HEAL TH CARE DELIVERY SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSM HEALTH CARE CORPORATION (SSMHCC) (DOING BUSINESS AS SSMH) IS THE PRINCIPAL NOT-FOR-PROFIT CORPORATION AND HAS BEEN ESTABLISHED AS THE PARENT CORPORATION. SSMH OWNS AND OPERATES 22 ADULT HOSPITALS, ONE PEDIATRIC HOSPITAL, THIRTEEN POST-ACUTE CARE FACILITIES, A NATIONAL PHARMACY BENEFIT MANAGEMENT COMPANY (PBM), AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEAL TH CARE BUSINESSES. SSMH'S HOSPITAL OPERATIONS ARE LOCATED PRIMARILY IN MISSOURI, WISCONSIN, OKLAHOMA AND ILLINOIS, AND ITS RELATED BUSINESSES PROVIDE HEALTH RELATED SERVICES IN 50 STATES. SSMH'S MISSION STATEMENT IS AS FOLLOWS: THROUGH OUR EXCEPTIONAL HEAL TH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. SSMHCC AND MOST OF ITS AFFILIATED SUBSIDIARY CORPORATIONS HAVE BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). CERTAIN SUBSIDIARIES OF SSMH ARE FOR-PROFIT ENTITIES THAT ARE TAXABLE UNDER THE IRC. SSMH IS SPONSORED BY SSM HEAL TH MINISTRIES, AN INDEPENDENT NINE-MEMBER BODY COMPOSED OF TWO FRANCISCAN SISTERS OF MARY, ONE SISTER OF ST. AGNES, ONE JESUIT PRIEST, AND FIVE LAY PERSONS WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMH.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
LIVING HOPE FOOD PANTRY
740 W STATE STREET	FOX LAKE	WI	53933	813450246	501(C)(3)	$5,828	$0	CHARITABLE SUPPORT
MORAINE PARK FOUNDATION
235 N NATIONAL AVE	FOND DU LAC	WI	54936	510188166	501(C)(3)	$10,000	$0	CHARITABLE SUPPORT
ST KATHERINE DREXEL SHELTER - ST VINCENT DE PAUL FOND DU LAC COUNTY
358 N PETERS AVE	FOND DU LAC	WI	54936	390824875	501(C)(3)	$10,000	$0	CHARITABLE SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	0	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	0	SubstantiationRequiredInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
RANDY COMBS
TREASURER, CFO AT SSM HEALTH	$0	$1,242,308	$0	$669,269	$0	$270,777	$0	$1,203,989	$0	$34,085	$0	$3,420,428	$0	$669,269
STEVE SMOOT
VICE PRESIDENT, COO AT SSM HEALTH	$0	$1,173,646	$0	$737,192	$0	$143,520	$0	$1,164,125	$0	$40,364	$0	$3,258,847	$0	$878,090
DOUGLAS LONG
SECRETARY, CHIEF LEGAL OFFICER AT SS	$0	$759,270	$0	$495,539	$0	$170,430	$0	$753,634	$0	$23,379	$0	$2,202,252	$0	$495,539
SUE ANDERSON
DIRECTOR, REGIONAL PRESIDENT	$0	$765,767	$0	$330,759	$0	$332,388	$0	$520,449	$0	$19,873	$0	$1,969,236	$0	$386,663
MATTHEW POGODZINSKI
DIRECTOR, PHYSICIAN	$0	$753,607	$0	$0	$0	$1,760	$0	$19,050	$0	$43,017	$0	$817,434	$0	$0
THOMAS KIRSCHBAUM
ASSISTANT SECRETARY	$0	$388,964	$0	$99,618	$0	$43,683	$0	$172,359	$0	$38,025	$0	$742,649	$0	$99,618
DEANN THURMER
PT YR DIRECTOR, PRESIDENT/CNO-WAUPUN	$0	$317,834	$0	$58,132	$0	$31,454	$0	$111,051	$0	$26,091	$0	$544,562	$0	$84,873
JENNIFER MASKEL
DIRECTOR, PHYSICIAN	$0	$142,370	$0	$0	$0	$425	$0	$10,628	$0	$3,396	$0	$156,819	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	AN INDIVIDUAL LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2023, WHICH WAS INCLUDED IN TAXABLE COMPENSATION.
PART I, LINE 3	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, PRESIDENT, IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B	PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER THE SSMH QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. CAPITAL ACCUMULATION PLAN: SSMH PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMH AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM THIS PLAN IN 2023: DEANN THURMER - $29,866 JENNIFER MASKEL - $2,131 RANDY COMBS - $261,633 DOUGLAS LONG - $161,287 STEVE SMOOT $249,972 SUE ANDERSON - $153,458 THOMAS KIRSCHBAUM - $37,511 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. DEANN THURMER - $26,741 STEVE SMOOT - $140,898 SUE ANDERSON - $132,843

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART V, LINE 1A:	ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223.
FORM 990, PART V, LINE 2A:	ALL APPLICABLE W-2 AND W-3 IRS TAX FORMS ARE REPORTED AND FILED BY A RELATED ORGANIZATION, AGNESIAN HEALTHCARE INC, EIN 39-0807236.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE CORPORATION IS AGNESIAN HEALTHCARE INC. AGNESIAN HEALTHCARE INC IS A NONPROFIT 501 (C)(3) ORGANIZATION. BOTH WAUPUN MEMORIAL HOSPITAL AND AGNESIAN HEALTHCARE INC ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION; B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS; C. TO APPOINT AND REMOVE THE DIRECTORS; D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION; E. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN; F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION; G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY; I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY; K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY; L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS; TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS; AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS; M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION; N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION; O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION; P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO SSMHCC OR TO ANY OTHER ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY SSMHCC, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF SSMHCC AS DETERMINED BY SSMHCC; Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN SSMHCC, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO SSMHCC WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NONCONTROLLED SUBSIDIARY.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION (SSM). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SSM PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST AND INSIDER TRANSACTION POLICY THAT REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON A ANNUAL BASIS TO THE DESIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15	A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19	THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN TEMPORARY NET ASSETS - SPECIAL PURPOSE 69,559. GENERAL LEDGER OFFSET -14,797.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (53 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	Direct Controlling NADirectControllingNACd
SSM HEALTH CARE CORPORATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	466029223	HEALTH CARE	MO	501(C)(3)	LINE 12A, I	SSM HEALTH MINISTRIES	0
SSMHC LIABILITY TRUST I
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	436331003	INSURANCE	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION	0
SSM CONSOLIDATED HEALTH SERVICES
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431473657	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE CORPORATION	0
SSM POLICY INSTITUTE
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431788151	HEALTH CARE	MO	501(C)(4)		SSM HEALTH CARE CORPORATION	0
SSM HEALTH CARE PORTFOLIO MANAGEMENT CO
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431825256	MANAGEMENT	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION	0
SSM CARDINAL GLENNON CHILDREN'S HOSPITAL
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	430738490	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE ST LOUIS	0
CARDINAL GLENNON CHILDREN'S FOUNDATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431754347	FUNDRAISING	MO	501(C)(3)	LINE 7	SSM CARDINAL GLENNON CHILDREN'S HOSPITAL	0
SSM HEALTH FOUNDATION - ST LOUIS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431552945	FUNDRAISING	MO	501(C)(3)	LINE 7	SSM HEALTH CARE ST LOUIS	0
SSM HEALTH CARE OF OKLAHOMA INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	730657693	HEALTH CARE	OK	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION	0
THE ST ANTHONY HOSPITAL FOUNDATION INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	736104300	FUNDRAISING	OK	501(C)(3)	LINE 7	SSM HEALTH CARE OF OKLAHOMA	0
SSM HEALTH CARE OF WISCONSIN INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	430688874	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION	0
DELLS MEDICAL BUILDING INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	391613292	MOB	WI	501(C)(2)		SSM HEALTH CARE OF WISCONSIN	0
ST MARY'S FOUNDATION INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431940686	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN	0
ST CLARE HEALTH CARE FOUNDATION INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431940683	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN	0
HOME HEALTH UNITED INC
2802 WALTON COMMONS LANE	MADISON	WI	53718	391539827	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN	0
HOME CARE UNITED INC
2802 WALTON COMMONS LANE	MADISON	WI	53718	391776340	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN	0
HHU XTRA CARE INC
2802 WALTON COMMONS LANE	MADISON	WI	53718	391705111	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN	0
SSM HEALTH AT HOME FOUNDATION OF WISCONSIN INC
2802 WALTON COMMONS LANE	MADISON	WI	53718	391839309	FUNDRAISING	WI	501(C)(3)	LINE 12A, I	HOME HEALTH UNITED INC	0
SSM REGIONAL HEALTH SERVICES
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	440579850	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION	0
ST MARY'S HEALTH CENTER JEFFERSON CITY MISSOURI FOUNDATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431575307	FUNDRAISING	MO	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES	0
GOOD SAMARITAN REGIONAL HEALTH CENTER
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	430653587	HEALTH CARE	IL	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES	0
ST MARY'S HOSPITAL CENTRALIA ILLINOIS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	370662580	HEALTH CARE	IL	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES	0
ST MARY'S - GOOD SAMARITAN INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	364170833	HEALTH CARE	IL	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES	0
GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	262884795	FUNDRAISING	IL	501(C)(3)	LINE 7	ST MARY'S-GOOD SAMARITAN INC	0
ST MARY'S HOSPITAL FOUNDATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	364636691	FUNDRAISING	IL	501(C)(3)	LINE 7	ST MARY'S-GOOD SAMARITAN INC	0
ST MARY'S HOSPITAL AUXILIARY
400 N PLEASANT	CENTRALIA	IL	62801	237126345	FUNDRAISING	IL	501(C)(3)	LINE 10	ST MARY'S HOSPITAL FOUNDATION	0
SSM HEALTH BUSINESSES
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431333488	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE CORPORATION	0
SSM HEALTH CARE ST LOUIS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431343281	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION	0
CENTRALIA MEDICAL SERVICES BLDG ASSOC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	237408025	MOB	IL	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES	0
ST MARY'S JANESVILLE FOUNDATION INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	273439133	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN	0
SSM HEALTH MINISTRIES
3221 MCKELVEY ROAD SUITE 107	BRIDGETON	MO	63044	431012492	RELIGIOUS ORGANIZATION	MO	501(C)(3)	LINE 1		0	N/A
LEE DEWEY CORPORATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	731279603	MOB	OK	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF OKLAHOMA	0
ST MARY'S HOSPITAL AUXILIARY
100 ST MARYS MEDICAL PLAZA	JEFFERSON CITY	MO	65101	436049878	FUNDRAISING	MO	501(C)(3)	LINE 12B, II		0	N/A
GOOD SAMARITAN HOSPITAL AUXILIARY
1 GOOD SAMARITAN WAY	MOUNT VERNON	IL	62864	237049599	FUNDRAISING	IL	501(C)(3)	LINE 12C, III-FI		0	N/A
ST ANTHONY SHAWNEE HOSPITAL INC
1000 N LEE AVE	OKLAHOMA CITY	OK	73102	455055149	HEALTH CARE	OK	501(C)(3)	LINE 3	SSM HEALTH CARE OF OKLAHOMA	0
SSM AUDRAIN HEALTH CARE INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431550298	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES	0
SSM-SLUH INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	474196634	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE ST LOUIS	0
AGNESIAN HEALTHCARE INC
430 E DIVISION ST	FOND DU LAC	WI	54935	390807236	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE OF WISCONSIN	0
RIPON MEDICAL CENTER INC
845 PARKSIDE STREET	RIPON	WI	54971	391101287	HEALTH CARE	WI	501(C)(3)	LINE 3	AGNESIAN HEALTHCARE INC	0
WAUPUN MEMORIAL HOSPITAL INC
620 WEST BROWN STREET	WAUPUN	WI	53963	390806265	HEALTH CARE	WI	501(C)(3)	LINE 3	AGNESIAN HEALTHCARE INC	0
ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC
33 EVERETT STREET	FOND DU LAC	WI	54935	391029998	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC	0
SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO
N8114 COUNTY WW	MOUNT CALVARY	WI	53057	391022770	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC	0
VILLA ROSA INC
N8120 COUNTY WW	MOUNT CALVARY	WI	53057	421670962	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC	0
THE CHRISTIAN HOME AND REHABILITATION CENTER INCORPORATED
331 BLY STREET	WAUPUN	WI	53963	390884514	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC	0
THE MONROE CLINIC INC
515 22ND AVENUE	MONROE	WI	53566	390808509	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE OF WISCONSIN	0
MONROE CLINIC AND HOSPITAL FOUNDATION INC
515 22ND AVENUE	MONROE	WI	53566	205769038	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN	0
AGNESIAN HEALTHCARE FOUNDATION INC
430 E DIVISION ST	FOND DU LAC	WI	54935	391684956	FUNDRAISING	WI	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF WISCONSIN	0
SHARED MAGNETIC RESONANCE IMAGING FACILITY INC
1104 JOHN NOLEN DRIVE	MADISON	WI	53713	391534744	HEALTH CARE	WI	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF WISCONSIN	0
SSM HEALTH CARDINAL GLENNON TRANSPORT
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	863519607	HEALTH CARE	MO	501(C)(3)	LINE 12A, I	SSM CARDINAL GLENNON CHILDREN'S HOSPITAL	0
SSM HEALTH FOUNDATION
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	874109859	FUNDRAISING	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION	0
SSM HEALTH CARE GROUP
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	880988603	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE ST LOUIS	0
THE SARAH COMMUNITY
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431784657	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH BUSINESSES	0
VISITING NURSE ASSOCIATION OF GREATER ST LOUIS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	430567000	HEALTH CARE	MO	501(C)(3)	LINE 7	SSM HEALTH BUSINESSES	0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
SSM ST JOSEPH ENDOSCOPY CENTER LLC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	270046559	SURGERY SERVICES	MO	N/A	0	0
ST CLARE IMAGING SERVICES LLC
707 14TH STREET SUITE A	BARABOO	WI	53913	200122365	DIAG. SERVICES	WI	N/A	0	0
MT VERNON RADIATION THERAPY CENTER LLC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	201382620	RADIATION THERAPY	IL	N/A	0	Yes (1)
SLEEP & NEUROLOGY CENTER OF SOUTHERN ILLINOIS LLC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	208468195	DIAG. SERVICES	IL	N/A	0	0
SHAWNEE REAL ESTATE HOLDINGS LLC
1000 N LEE AVE	OKLAHOMA CITY	OK	73102	455458304	MOB	OK	N/A	0	0
DEAN CLINIC & ST MARY'S HOSPITAL ACCOUNTABLE CARE ORGANIZATION LLC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	452995500	ACCOUNTABLE CARE ORGANIZATION	WI	N/A	0	0
WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	392016715	INFORMATION TECHNOLOGY SERVICES	WI	N/A	0	0
1110 N CLASSEN BLVD LLC
1110 N CLASSEN BOULEVARD	OKLAHOMA CITY	OK	73106	731158158	MOB	OK	N/A	0	Yes (1)
WINDMILL LLP
50 VILLAGE VIEW LANE	CHESTERFIELD	MO	63017	431804651	INVESTMENTS	MO	N/A	0	0
SSM SELECT REHAB ST LOUIS LLC
4714 GETTYSBURG ROAD	MECHANICSBURG	PA	17055	263694972	HEALTH CARE	DE	N/A	0	0
BLOOM TREE LONG-ONLY FUND QP LP FKA BLOOM TREE PONDEROSA FUNDS QP LP
101 PARK AVENUE 33RD FL	NEW YORK	NY	10178	823704522	INVESTMENTS	DE	N/A	0	0
NECICF II AIV2-B LP
300 DELAWARE AVE STE 210	WILMINGTON	DE	19801	845058167	INVESTMENTS	DE	N/A	0	0
BISON CAPITAL PARTNERS VI-A LP
233 WILSHIRE BLVD STE 425	SANTA MONICA	CA	90401	874006968	INVESTMENTS	DE	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
SSM MANAGED CARE ORGANIZATION LLC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431708511	HEALTH PROMOTION	MO	N/A	C	0
FPP INC & SUBS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431465174	HEALTH CARE	MO	N/A	C	0
DIVERSIFIED HEALTH SERVICES CORP
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431369305	MEDICAL EQUIPMENT	MO	N/A	C	0
SSM PROPERTIES INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431462486	PROPERTY SERVICES	MO	N/A	C	0
HEALTHFIRST PHYSICIAN MANAGEMENT SERVICES
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	731534336	MEDICAL SERVICES	OK	N/A	C	0
SSMHC LIABILITY TRUST II
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	816128118	INSURANCE	MO	N/A	C	0
SSM MEDICAL GROUP INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	431664107	PHYSICIAN OFFICES	MO	N/A	C	0
SSMHC INSURANCE COMPANY
				030310431	INSURANCE		N/A	C	0	PO BOX 1051 GT	GRAND CAYMAN	CJ	CJ
PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS INC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	364161526	HEALTH CARE	IL	N/A	C	0
DEAN HEALTH SYSTEMS INC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	391128616	PHYSICIAN OFFICES	WI	N/A	C	0
DEAN RETAIL SERVICES INC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	391717636	PROPERTY SERVICES	WI	N/A	C	0
SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM ASSOCIATION INC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	832038674	CONDO ASSOCIATION	WI	N/A	C	0
SSM HEALTH PHARMACY LLC
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	264031708	PHARMACY	MO	N/A	C	0
NAVITUS HOLDINGS LLC
1808 WEST BELTLINE HIGHWAY	MADISON	WI	53713	800968174	PHARMACY	WI	N/A	C	0
MS COMMUNITY JV LLC
401 CARLSON PARKWAY CP330	MINNETONKA	MN	55305	873240022	INSURANCE	DE	N/A	C	0
QUALITY DRUG CORPORATION
239 BROADWAY	LAGUNA BEACH	CA	92651	330644268	PHARMACY BENEFITS	CA	N/A	C	0
ST MARY'S HOSPITAL CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC
707 SOUTH MILLS STREET	MADISON	WI	53715	000000000	CONDO ASSOCIATION	WI	N/A	C	0
PARTNERS GROUP PMC PRIVATE CREDIT LP
				981439264	INVESTMENT		N/A	C	0	C/O MAPLES CORPORATE SERVICES LTD	GRAND CAYMAN	CJ	CJ
OMNINHEALTH HOLDINGS
12800 CORPORATE HILL DRIVE	ST LOUIS	MO	63131	884144276	HEALTH CARE CONSULTING	DE	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd