ST MARYS-GOOD SAMARITAN INC: Form 990EZ, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS-GOOD SAMARITAN INC (EIN 36-4170833)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202333199349212733
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T19:54:33+00:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 264532849 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Purk & Associates PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1034 S Brentwood Boulevard Suite 20 | AddressLine1Txt |
| Address Line2 | 00 | AddressLine2Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63117 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364170833 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's - Good Samaritan Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 6184368000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10101 Woodfield Ln | AddressLine1Txt |
| City | St Louis | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63132 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Randy Combs | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 3149947800 | PhoneNum |
| Signature | 2023-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Barbara | PersonFirstNm |
| Person Last | Potts | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Douglas G Pleus | PreparerPersonNm |
| PTIN | P00013488 | PTIN |
| Phone | 3148844022 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | www.ssmhealth.com | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $55,151 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Membership Dues | $55,151 | MembershipDuesAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Special Events Net Income Loss | $0 | SpecialEventsNetIncomeLossAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
| Total Revenue | $55,151 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Other Expenses Total | $26,192 | OtherExpensesTotalAmt |
| Total Expenses | $26,192 | TotalExpensesAmt |
| Excess Or Deficit For Year | $28,959 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $17,427 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $46,386 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,427 | BOYAmt |
| EOY | $46,386 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,427 | BOYAmt |
| EOY | $46,386 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,427 | BOYAmt |
| EOY | $46,386 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | TO IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $26,192 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $26,192 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (14 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Sr M Clarette Stryzewski CSSF | ||||
| Director, Chairperson | 1.000 | $0 | $0 | $0 |
| Damon Harbison | ||||
| Director, Hospital President-SSM Health St. Mary's Hospital | 0 | $0 | $0 | $0 |
| Patty Williams | ||||
| Director | 1.000 | $0 | $0 | $0 |
| Michael Baumgartner | ||||
| Director, Regional President-Southern Illinois | 1.000 | $0 | $0 | $0 |
| Sr M Ramona Dombrowski CSSF | ||||
| Director | 1.000 | $0 | $0 | $0 |
| Matthew Flanigan | ||||
| Director | 1.000 | $0 | $0 | $0 |
| Jeremy Bradford | ||||
| Director, Hospital President-SSM Health Good Samaritan Hospital | 1.000 | $0 | $0 | $0 |
| Erica Ibendahl MD | ||||
| Director, SSM Health Medical Group Physician | 1.000 | $0 | $0 | $0 |
| Sudeep Nair MD | ||||
| Director, SSM Health Medical Group Physician | 1.000 | $0 | $0 | $0 |
| Herb Williams | ||||
| Director | 1.000 | $0 | $0 | $0 |
| Douglas Long | ||||
| Secretary, General Counsel at SSM Health | 1.000 | $0 | $0 | $0 |
| John Snodsmith | ||||
| Regional VP, Finance | 1.000 | $0 | $0 | $0 |
| Randy Combs | ||||
| Treasurer, Chief Financial Officer at SSM Health | 1.000 | $0 | $0 | $0 |
| Rachel Hall | ||||
| Assistant Secretary | 1.000 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Stover | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 N Pleasant | AddressLine1Txt |
| City | Centralia | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6184367545 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 3 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (3 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| ST MARY'S HOSPITAL CENTRALIA ILLINOIS | ||||
| 370662580 | 3 | Yes (true) | $0 | $0 |
| GOOD SAMARITAN REGIONAL HEALTH CENTER | ||||
| 430653587 | 3 | Yes (true) | $0 | $0 |
| CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION | ||||
| 237408025 | 9 | Yes (true) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 3 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | Yes (true) | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 30 FINANCIAL SUPPORT | ST. MARY'S - GOOD SAMARITAN, INC. IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED EXCLUSIVELY TO SUPPORT THE OPERATIONS OF ST. MARY'S HOSPITAL, GOOD SAMARITAN REGIONAL HEALTH CENTER, AND CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION, RELATED TAX-EXEMPT ORGANIZATIONS. THE AMOUNTS OF SUPPORT PROVIDED TO THESE ORGANIZATIONS ON SCHEDULE A, PART I, LINE 11(H)(V) AND LINE 11(H)(VI) DO NOT INCLUDE EXPENSES PAID ON BEHALF OF BUT NOT DIRECTLY TO THESE ORGANIZATIONS. |
| Schedule A, Part IV, Section A, Line 2 Supported Org. Without IRS Status 509(a)1 or (2) | ST. MARY'S - GOOD SAMARITAN, INC. IS A SUPPORTING ORGANIZATION THAT PROVIDES SUPPORT TO ST. MARY'S HOSPITAL CENTRALIA, ILLINOIS AND GOOD SAMARITAN REGIONAL HEALTH CENTER, BOTH TAX EXEMPT HOSPITALS. THROUGH ITS SUPPORT OF THESE TWO HOSPITALS, ST. MARY'S - GOOD SAMARITAN, INC. ALSO PROVIDES SUPPORT TO CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION, A SUPPORTING ORGANIZATION OF TO ST. MARY'S HOSPITAL CENTRALIA, ILLINOIS. CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION PROVIDES OFFICE SPACE TO PHYSICIANS, AN MRI SUITE, AND A CONVENIENT CARE LOCATION TO INCREASE THE AVAILABILITY OF DOCTORS FOR MEDICAL EMERGENCIES AND PROVIDE ADDITIONAL PATIENT ACCESSIBILITY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 16 Other Expenses | SUPPLIES - -29; PROFESSIONAL LIABILITY INSURANCE - 25221; Consulting Fees - 1000; |
| Form 990-EZ, Part II, Line 24b Other Assets | DUE FROM AFFILIATES - BOY:17427,EOY:46386; |
| Form 990-EZ, Part III, Exempt Purpose PRIMARY EXEMPT PURPOSE | TO IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. |
| Form 990-EZ, Part III, Program Services Details | SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 300 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 10 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, A HEALTH INSURANCE COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 11,000 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMH STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. ST. MARY'S - GOOD SAMARITAN, INC. IS COMMITTED TO THE PURPOSE OF ENABLING ITS ENTITIES, SSM HEALTH ST MARY'S HOSPITAL - CENTRALIA AND SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO ALL PERSONS ON THE SOUTHERN ILLINOIS REGION REGARDLESS OF THEIR ABILITY TO PAY. THROUGH ITS GOVERNANCE, OPERATION AND ADMINISTRATION, ST MARY'S - GOOD SAMARITAN, INC. HELPS TO MEET THE COMMUNITY NEEDS IDENTIFIED BY EACH HOSPITAL IN AN ECONOMIC AND EFFICIENT MANNER. THE LEADERS OF ST. MARY'S - GOOD SAMARITAN, INC. PARTICIPATE IN COMMUNITY ORGANIZATIONS WHICH ENABLE THEM TO IDENTIFY COMMUNITY NEEDS. ALL SSMH FACILITIES WILL STRIVE TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF SSMH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMH FACILITIES OFFER DISCOUNTS FOR HOSPITAL SERVICES TO ALL UNINSURED PERSONS. SELF-PAY DISCOUNTS APPLY TO EVERYONE WHO DOES NOT HAVE HEALTH INSURANCE, NO MATTER THEIR ABILITY TO PAY. SSMH WILL APPLY ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMH EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNTIS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. EACH ENTITY PROVIDING MEDICAL SERVICES 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 COMMUNICATIONS 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 WILL BE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. THEY WILL 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 WHOM TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING. THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC SHALL BE PROVIDED: SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS, BROCHURES OR FLIERS 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 AND 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 WILL ALSO BE PROVIDED TO PUBLIC AGENCIES. ST MARY'S - GOOD SAMARITAN, INC. SUPPORTS TWO SSMH HOSPITALS THAT: EACH OPERATE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, HAVE A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY, ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, AND PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. ADDITIONAL INFORMATION REGARDING SSMH'S 2022 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHEALTH.COM. |
| 30 FINANCIAL SUPPORT | ST. MARY'S - GOOD SAMARITAN, INC. IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED EXCLUSIVELY TO SUPPORT THE OPERATIONS OF ST. MARY'S HOSPITAL AND GOOD SAMARITAN REGIONAL HEALTH CENTER, RELATED TAX-EXEMPT ORGANIZATIONS. THE AMOUNTS OF SUPPORT PROVIDED TO ST MARY'S HOSPITAL AND GOOD SAMARITAN REGIONAL HEALTH CENTER ON SCHEDULE A, PART I, LINE 11(H)(VII) DO NOT INCLUDE EXPENSES PAID ON BEHALF OF BUT NOT DIRECTLY TO ST MARY'S HOSPITAL AND GOOD SAMARITAN REGIONAL HEALTH CENTER. |
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