MONROE CLINIC AND HOSPITALFOUNDATION: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- MONROE CLINIC AND HOSPITALFOUNDATION (EIN 20-5769038)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-15
- IRS object ID
- 202433209349313538
- 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 B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-15T12:50:35-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205769038 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONROE CLINIC AND HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONR | BusinessNameControlTxt |
| Phone | 6083242868 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 22ND AVENUE | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53566 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE KING | PersonNm |
| Person Title | VP FINANCE | PersonTitleTxt |
| Phone | 6083242868 | PhoneNum |
| Signature | 2024-11-15 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHANIE KING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 22ND AVENUE | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53566 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $834,239 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GIVETOSSMHEALTH.ORG/FOUNDATIONS/WISCONSIN/MON | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | MONROE CLINIC AND HOSPITAL FOUNDATION SERVES AND ENHANCES THE HEALING MISSION OF MONROE CLINIC BY COMBINING THE GIVING SPIRIT OF OUR COMMUNITIES WITH ALL WHO ENTER THROUGH OUR DOORS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $335,502 | PYContributionsGrantsAmt |
| CY Contributions Grants | $360,004 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $201,921 | CYProgramServiceRevenueAmt |
| PY Investment Income | $193,350 | PYInvestmentIncomeAmt |
| CY Investment Income | $253,492 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,802 | PYOtherRevenueAmt |
| CY Other Revenue | -$7,560 | CYOtherRevenueAmt |
| PY Total Revenue | $527,050 | PYTotalRevenueAmt |
| CY Total Revenue | $807,857 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $231,780 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $196,012 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $174,264 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $186,000 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $219,929 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $58,991 | PYOtherExpensesAmt |
| CY Other Expenses | $33,929 | CYOtherExpensesAmt |
| PY Total Expenses | $465,035 | PYTotalExpensesAmt |
| CY Total Expenses | $415,941 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $62,015 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $391,916 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,309,828 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,660,660 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $321 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,499 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,309,507 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,658,161 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $196,012 | ExpenseAmt |
| Grant | $196,012 | GrantAmt |
| Revenue | $201,921 | RevenueAmt |
| Desc | SUPPORT THE MONROE CLINIC INC WITH EQUIPMENT PURCHASES AND HEALTH CARE PROGRAMS. OTHER ASSISTANCE PROVIDED TO LOCAL ORGANIZATIONS AS NEEDED. | Desc |
| Total Program Service Expenses | $196,012 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | Yes (1) | 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 |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | JANE SYBERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6083242868 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 22ND AVENUE | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53566 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 |
|---|---|---|---|---|---|---|---|
| JANE CURRAN-MEULI | |||||||
| DIRECTOR, PRESIDENT/CEO OF THE MONROE CLINIC INC | 1.00 | 40.00 | Yes (X) | $0 | $552,926 | $201,977 | |
| GAINES RICHARDSON | |||||||
| DIRECTOR, PHYSICIAN AT THE MONROE CLINIC | 1.00 | 40.00 | Yes (X) | $0 | $269,341 | $64,201 | |
| JANE SYBERS | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | Yes (X) | $0 | $123,304 | $45,619 | Yes (X) |
| JOE KLEIN | |||||||
| DIRECTOR & CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TEENA BUHOLZER | |||||||
| DIRECTOR, VICE CHAIR, ASSISTANT TREASURER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| ALESSANDRO ROSSI MD | |||||||
| DIRECTOR, ASSISTANT SECRETARY | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DEB THOMPSON | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JILL LEITZEN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KIM MARKHAM | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SUE ANDERSON | |||||||
| DIRECTOR, REGIONAL PRESIDENT OF SSM HEALTH WISCONS | 1.00 | 40.00 | Yes (X) | $0 | $1,428,914 | $540,322 | |
| JIM DAVIDSON MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| AMANDA FIELDS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RANDY COMBS | |||||||
| TREASURER, CFO AT SSM HEALTH | 1.00 | 50.00 | $0 | $2,182,354 | $1,238,074 | Yes (X) | |
| DOUGLAS LONG | |||||||
| SECRETARY, CHIEF LEGAL OFFICER AT SSM HEALTH | 1.00 | 50.00 | $0 | $1,425,239 | $777,013 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,982,078 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,867,206 | 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 |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $131,796 | FundraisingAmt |
| Related Organizations | $15,705 | RelatedOrganizationsAmt |
| Government Grants | $1,340 | GovernmentGrantsAmt |
| All Other Contributions | $211,163 | AllOtherContributionsAmt |
| Noncash Contributions | $77,334 | NoncashContributionsAmt |
| Total Contributions | $360,004 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $201,921 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $201,921 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $201,921 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $254,528 | TotalRevenueColumnAmt |
| Exclusion | $254,528 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,036 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,036 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,036 | TotalRevenueColumnAmt |
| Exclusion | -$1,036 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $16,976 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $131,796 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $25,346 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,370 | TotalRevenueColumnAmt |
| Exclusion | -$8,370 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $810 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $810 | TotalRevenueColumnAmt |
| Exclusion | $810 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $807,857 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $201,921 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $245,932 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,815 | TotalAmt |
| Program Services | $161,815 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,197 | TotalAmt |
| Program Services | $34,197 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,710 | TotalAmt |
| Fundraising | $172,710 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,290 | TotalAmt |
| Fundraising | $13,290 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345 | TotalAmt |
| Fundraising | $345 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,968 | TotalAmt |
| Fundraising | $21,968 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,537 | TotalAmt |
| Fundraising | $4,537 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $343 | TotalAmt |
| Fundraising | $343 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75 | TotalAmt |
| Fundraising | $75 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt |
|---|---|---|
| BANK FEES | $2,412 | $2,412 |
| LICENSES, DUES & SUBSCR | $145 | $145 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,104 | TotalAmt |
| Fundraising | $4,104 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,941 | TotalAmt |
| Program Services | $196,012 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $219,929 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,929 | BOYAmt |
| EOY | $518,629 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $811,668 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,825,899 | BOYAmt |
| EOY | $9,330,363 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,309,828 | BOYAmt |
| EOY | $10,660,660 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $321 | BOYAmt |
| EOY | $2,499 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $321 | BOYAmt |
| EOY | $2,499 | 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 | $1,171,972 | BOYAmt |
| EOY | $1,557,234 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,137,535 | BOYAmt |
| EOY | $9,100,927 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,309,507 | BOYAmt |
| EOY | $10,658,161 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,309,828 | BOYAmt |
| EOY | $10,660,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $391,916 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $981,123 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$24,387 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $305,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $319,585 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,067,351 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $335,502 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $360,004 | CurrentTaxYearAmt |
| Total | $2,387,782 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $305,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $319,585 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,067,351 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $335,502 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $360,004 | CurrentTaxYearAmt |
| Total | $2,387,782 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $503,302 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,884,480 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $131,298 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,938 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $83,865 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $154,219 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $254,528 | CurrentTaxYearAmt |
| Total | $725,848 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $59,671 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,602 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $38,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,916 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,786 | CurrentTaxYearAmt |
| Total | $162,944 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,276,574 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $201,921 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.57510 | PublicSupportCY170Pct |
| Public Support PY170 | 0.59330 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | FUNDRAISING ACTIVITIES - 2019 AMOUNT: $ 59,671. 2020 AMOUNT: $ 21,602. 2021 AMOUNT: $ 38,969. 2022 AMOUNT: $ 24,916. 2023 AMOUNT: $ 17,786. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,893,458 | BeginningYearBalanceAmt |
| Contributions | $94,138 | ContributionsAmt |
| Investment Earnings Or Losses | $1,058,980 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $175,879 | OtherExpendituresAmt |
| End Year Balance | $6,870,697 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,168,051 | BeginningYearBalanceAmt |
| Contributions | $747,841 | ContributionsAmt |
| Investment Earnings Or Losses | $137,457 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $159,891 | OtherExpendituresAmt |
| End Year Balance | $5,893,458 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,489,706 | BeginningYearBalanceAmt |
| Contributions | $252,166 | ContributionsAmt |
| Investment Earnings Or Losses | $843,308 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,417,129 | OtherExpendituresAmt |
| End Year Balance | $5,168,051 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,610,640 | BeginningYearBalanceAmt |
| Contributions | $29,793 | ContributionsAmt |
| Investment Earnings Or Losses | $849,273 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $5,489,706 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,745,187 | BeginningYearBalanceAmt |
| Contributions | $127,089 | ContributionsAmt |
| Investment Earnings Or Losses | $867,013 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $128,649 | OtherExpendituresAmt |
| End Year Balance | $4,610,640 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.14310 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.38490 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.47200 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $811,668 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $811,668 | TotalBookValueSecuritiesAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM-RELATED INVESTMENTS | Desc |
| Book Value | $9,330,363 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $9,330,363 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYABLES | Desc |
| Amt | $2,499 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,499 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE OPERATING ENDOWMENT HAS BEEN ESTABLISHED TO SUPPORT THE OPERATING COST OF THE MONROE CLINIC AND HOSPITAL FOUNDATION. THE FUTURE OF HEATH CARE ENDOWMENT HAS BEEN ESTABLISHED TO PROVIDE FUNDING FOR THE GRANTS AND PROGRAMS THAT SUPPORT THE MONROE CLINIC AND HOSPITAL FOUNDATIONS MISSION. |
| PART X, LINE 2: | MONROE CLINIC AND HOSPITAL FOUNDATION'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. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BIG GOLF | Event1Nm |
| Gross Receipts Event1 | $89,740 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $74,510 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $15,230 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $9,541 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,650 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $6,974 | OtherDirectExpensesEvent1Amt |
| Event2 | HOSPICE LITTLE GOLF | Event2Nm |
| Gross Receipts Event2 | $59,032 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $57,286 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $1,746 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $3,181 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $148,772 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $131,796 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $16,976 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $9,541 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $5,650 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $10,155 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $25,346 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$8,370 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MONROE CLINIC INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 2ND AVENUE | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53566 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 390808509 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $145,852 | CashGrantAmt |
| Non Cash Assistance | $15,963 | NonCashAssistanceAmt |
| Valuation Method Used | BOOK | ValuationMethodUsedDesc |
| Non Cash Assistance | FOOD & GIFT BASKETS FOR EMPLOYEE APPRECIATION & WHEELCHAIR FOR PATIENTS | NonCashAssistanceDesc |
| Purpose Of Grant | SUPPORT FOR SSM HEALTH MONROE HOSPITAL | PurposeOfGrantTxt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EMPLOYEE ASSISTANCE | 4 | $6,219 |
| SCHOLARSHIPS | 29 | $27,978 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS TO ORGANIZATIONS WERE MADE TO RELATED ORGANIZATIONS THAT ARE TAX-EXEMPT UNDER SECTION 501(C)(3). THE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. ALL GRANTS TO INDIVIDUALS INCLUDE A GRANT APPLICATION PROCESS THROUGH A PARTNER ORGANIZATION. APPROVED GRANT APPLICATIONS ARE FORWARDED TO THE FOUNDATION AND THE FOUNDATION PAYS THE REQUESTED EXPENDITURES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | 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 (6 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 |
| 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 OF SSM | $0 | $765,767 | $0 | $330,759 | $0 | $332,388 | $0 | $520,449 | $0 | $19,873 | $0 | $1,969,236 | $0 | $253,821 |
| JANE CURRAN-MEULI | ||||||||||||||
| DIRECTOR, PRESIDENT/CEO OF THE MONRO | $0 | $388,761 | $0 | $118,561 | $0 | $45,604 | $0 | $171,633 | $0 | $30,344 | $0 | $754,903 | $0 | $118,561 |
| GAINES RICHARDSON | ||||||||||||||
| DIRECTOR, PHYSICIAN AT THE MONROE CL | $0 | $262,337 | $0 | $0 | $0 | $7,004 | $0 | $24,691 | $0 | $39,510 | $0 | $333,542 | $0 | $10,361 |
| JANE SYBERS | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $110,500 | $0 | $11,230 | $0 | $1,574 | $0 | $16,003 | $0 | $29,616 | $0 | $168,923 | $0 | $11,230 |
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 COMPENSATION OF THE EXECUTIVE DIRECTOR IS PAID FOR BY THE MONROE CLINIC, A RELATED ORGANIZATION. THE MONROE CLINIC ESTABLISHES MARKET-BASED COMPENSATION THROUGH A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, 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: RANDALL COMBS - $153,458 DOUGLAS LONG - $161,286 GAINES RICHARDSON, MD - $8,297 JANE CURRAN-MEULI - $38,469 SUE ANDERSON - $153,458 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. GAINES RICHARDSON, MD - $4,559 SUE ANDERSON - $132,843 |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $5,988 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $7,078 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 265 | ContributionCnt |
| Noncash Contributions Rpt F990 | $41,272 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $900 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | AUCTION ITEMS | 73 | $15,908 | MARKET VALUE |
| Yes (X) | STAFF APPRECIATION | 3 | $1,230 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | STOCK - NUMBER OF SHARES DONATED ALL OTHER ITEMS - NUMBER OF DONATIONS | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF WISCONSIN, INC. SSM HEAL TH CARE OF WISCONSIN, INC, IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH MONROE CLINIC AND HOSPITAL FOUNDATION AND SSM HEALTH CARE OF WISCONSIN, 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 ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES OF THE CORPORATION. B) TO REVIEW THE EFFECTIVENESS OF THE CORPORATION IN FULFILLING THE MISSION, PHILOSOPHY, AND VALUES OF THE CORPORATION. C) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS WHICH AFFECT THE RESERVED POWERS OF THE MEMBER. D) TO FIX THE NUMBER OF DIRECTORS OF THIS CORPORATION, APPOINT THE BOARD OF DIRECTORS OF THIS CORPORATION AND REMOVE SUCH DIRECTORS AT ANY TIME WITH OR WITHOUT CAUSE. E) UPON THE RECOMMENDATION OF THE BOARD OF DIRECTORS, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION. F) TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS. G) RESERVED. H) TO APPROVE THE ESTABLISHMENT OF ANY NEW SUBSIDIARY OR AFFILIATE OF THE CORPORATION. I) TO APPROVE ANY ACQUISITIONS, JOINT VENTURES OR OTHER CORPORATE AFFILIATIONS. J) TO REVIEW AND APPROVE THE STRATEGIC, LONG-RANGE PLAN OF THE CORPORATION. K) TO RECEIVE AND REVIEW THE ANNUAL REPORT PREPARED BY THE EXECUTIVE DIRECTOR OF THE CORPORATION. L) TO APPROVE ANY AGREEMENT PURSUANT TO WHICH A THIRD PARTY OBTAINS THE RIGHT OR OBLIGATION TO MANAGE ALL OR SUBSTANTIALLY ALL OF THE OPERATIONS OF THE CORPORATION OR APPROVE ANY AGREEMENT PURSUANT TO WHICH THE CORPORATION MANAGES ANY ENTITY OR INSTITUTION WHICH IS NOT AN AFFILIATE OF SSMHCC. M) TO APPROVE FOR THIS CORPORATION, OR FOR ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING SHAREHOLDER OR MEMBER, THE ACQUISITION OF LAND OR BUILDINGS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE, TRANSFER, ASSIGNMENT, OR ENCUMBRANCE OF THE ASSETS OF SUCH CORPORATION. N) TO APPROVE THE DISSOLUTION AND/OR LIQUIDATION OF THIS CORPORATION OR ANY CORPORATION OF WHICH THIS CORPORATION IS THE CONTROLLING SHAREHOLDER OR MEMBER OR THE CONSOLIDATION OR MERGER OF THIS CORPORATION WITH ANOTHER CORPORATION OR ENTITY OR THE CLOSURE OF ANY INSTITUTION OR MAJOR MINISTRY OR WORK CONDUCTED BY THE CORPORATION. O) TO REMOVE AND APPOINT THE SECRETARY AND TREASURER OF THE CORPORATION. |
| 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 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, CONFLICT OF INTEREST STATEMENTS AND POLICY ARE DISTRIBUTED TO MEMBERS OF THE BOARD AND ANY EMPLOYEE WHO HAS AUTHORITY TO ENTER INTO CONTRACTS AND OTHER TRANSACTIONS ON BEHALF OF MONROE CLINIC. THE COMPLETED FORMS ARE REVIEWED BY ADMINISTRATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S COMPENSATION PLAN IS REVIEWED AND APPROVED AT FORMAL MEETINGS OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT NON-EMPLOYEE MEMBERS WHO HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENT TO BE REVIEWED AND RECOMMENDED BY THE COMPENSATION COMMITTEE. THE COMMITTEE REVIEWS COMPARABLE WISCONSIN AND NATIONAL COMPENSATION DATA AND ESTABLISHES BASE COMPENSATION AT THE COMPARABLE MARKET MEDIAN BY THE POSITION AS OUTLINED IN THE COMPENSATION COMMITTEE CHARTER.ADDITIONALLY, THE COMMITTEE HAS AUTHORITY TO RETAIN A COMPENSATION CONSULTANT TO ASSIST THE COMMITTEE IN EVALUATING SENIOR MANAGEMENT COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE YEAR-END AUDITED CONSOLIDATED FINANCE STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE WISCONSIN SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | DIRECT DONOR BENEFIT -24,387. |
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 (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 | Yes (1) | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments