2022-11-15T13:35:55-06:00 2021-12-31 990 2021-01-01 436331003 SSMHC Liability Trust I SSMH 3149947800 10101 Woodfield Ln St Louis MO 63132 Randy Combs Treasurer 3149947800 2022-11-15 Barbara Potts 999009999 2021 2022-09-23 18:48:47Z Randy Combs 10101 Woodfield Ln St Louis MO 63132 51161074 false X www.ssmhealth.com X 1986 MO To provide support and assistance to SSM Health, an integrated health care system operating in four states, to enable their mission of providing exceptional health care services. 2 0 0 0 0 0 0 29009345 35731974 8487514 15429100 0 37496859 51161074 0 0 5753 3363 0 0 48502544 35581921 48508297 35585284 -11011438 15575790 200492517 216786212 133845407 134617157 66647110 82169055 Through our exceptional health care services, we reveal the healing presence of God. false false 35374602 0 35731974 TO PROVIDE SUPPORT AND ASSISTANCE TO SSM HEALTH (SSMH) TO ENABLE THEIR MISSION AND PURPOSE. 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. 35374602 true false false false false false false false false false true false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false false false false false false false X 2 0 false false true false false false false true false false false false true true true true true false false false X Penny Hagan 3149892976 10101 Woodfield Ln St Louis MO 63132 Randy Combs Trustee, Chief Financial Officer at SSM Health 1.0 66.0 X 0 1290602 485851 The Northern Trust Company Trustee 1.0 0 X 3363 191876 0 Kris Zimmer Former Trustee 0.0 0.0 X 0 219379 0 3363 1701858 485851 0 true true false LOCKTON COMPANIES 3 CITY PLACE DRIVE SUITE 900 ST LOUIS MO 63141 CONSULTING SERVICES 1383346 CCMSI 2 EAST MAIN STREET SUITE 208 DANVILLE IL 61832 THIRD PARTY ADMINISTRATOR 925650 ARMSTRONG TEASDALE LLP ONE METROPOLITAN SQUARE ST LOUIS MO 63102 LEGAL SERVICES 768736 SANDBERG PHOENIX & VON GONTARD PC 515 N 6TH STREET 15TH FLOOR ST LOUIS MO 63101 LEGAL SERVICES 706973 JOHNSON HANAN & VOSLER ATTORNEYS 9801 N BROADWAY EXTENSION OKLAHOMA CITY OK 73114 LEGAL SERVICES 617929 12 0 Additions by Insured 524298 35731974 35731974 0 0 0 0 35731974 2479784 2479784 0 0 12949316 12949316 0 12949316 12949316 0 0 0 0 0 51161074 35731974 0 15429100 3363 3363 210682 210682 2413094 2413094 0 0 Insurance Claims 32081233 32081233 Licenses & Taxes 876912 876912 0 0 0 0 35585284 35374602 210682 0 9439795 139529624 1704536 0 0 0 0 262503 0 0 0 0 169191604 34779256 0 19894079 42477332 200492517 216786212 970996 387827 0 0 132874411 134229330 133845407 134617157 X 66647110 82169055 66647110 82169055 200492517 216786212 15575790 -53845 0 X false true X true false X X 1 SSM HEALTH CARE CORPORATION 466029223 3 true 35374602 0 1 35374602 0 true false false false false false false false false false false false false false false true false SSM Comprehensive Investment Program 34779256 F 34779256 Collateral held under securities lending agreement 4074782 Due from affiliates 38402550 42477332 Unearned Participant Revenue 13255775 Est Workers Comp Liab Losses 22241000 Est Prof & General Liab Losses 94657773 Payable Under Securities Lending Agreement 4074782 134229330 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SSMHC LIABILITY TRUST I'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 RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2021 OR 2020. false true false false false false false false false Kris Zimmer Former Trustee 0 0 0 219008 0 372 0 0 0 0 0 219379 0 372 Randy Combs Trustee, Chief Financial Officer at SSM Health 0 940014 0 182693 0 167895 0 478907 0 6945 0 1776454 0 82693 The Northern Trust Company Trustee 3363 191876 0 0 0 0 0 0 0 0 3363 191876 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 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 2021. 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 2021: NONE The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2021. All distributions received from the plan in the current year were included in the individual's taxable compensation. Kris Zimmer $372 Schedule J, Part I, Line 3 COMPENSATION TO TRUSTEES THE ORGANIZATION'S TRUSTEES ARE COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY: (3) APPROVAL BY THE SSM HEALTH BOARD OF DIRECTORS. Form 990, Part VI, Line 4 Significant changes to organizational documents The organization made changes to their trust agreement for the following: 1) updating the list of individuals authorized to provide director to the Trustee regarding trust fund matters. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body The organization does not have any committees with authority to act on behalf of the governing body. Form 990, Part VI, Line 11b Review of form 990 by governing body 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 governing body at the next regularly scheduled board meeting. Form 990, Part VI, Line 12c Conflict of interest policy Board members are required to complete a conflict of interest disclosure statement annually. The President and Secretary of the Board oversee compliance with this requirement. All Board members with an identified conflict of interest abstain from Board discussions and votes when applicable. Employees with purchasing authority and/or ability to influence purchasing decisions are assigned the conflict of interest disclosure course (COI) which must be completed on line. Periodically through the year, the entity's corporate responsibility contact person (with the help of the entity's learning management system coordinator) sends department managers a list of employees who have not yet completed their COI so they can remind the employees and ensure the employees have time in their schedule to complete the required course. Resolution of any conflicts that are disclosed must be documented and kept on file at the entity. Supervisors verify required course completion prior to year end. Form 990, Part VI, Line 19 Required documents available to the public The year-end audited consolidated financial statements and unaudited quarterly consolidated financial statements for the SSM Health System are made available to the public on SSM Health's website. Copies of the Form 990 and the organization's conflict of interest policy are available to the public upon request. SSM Health Care Corporation 10101 Woodfield Lane St Louis MO 63132 466029223 Health Care MO 501(c)(3) Type I SSM Health Ministries false SSM Consolidated Health Services 10101 Woodfield Lane St Louis MO 63132 431473657 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Policy Institute 10101 Woodfield Lane St Louis MO 63132 431788151 Health Care MO 501(c)(4) SSM Health Care Corporation false SSM Health Care Portfolio Management Co 10101 Woodfield Lane St Louis MO 63132 431825256 Management MO 501(c)(3) Type I SSM Health Care Corporation false SSM Cardinal Glennon Children's Hospital 10101 Woodfield Lane St Louis MO 63132 430738490 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false Cardinal Glennon Children's Foundation 10101 Woodfield Lane St Louis MO 63132 431754347 Fundraising MO 501(c)(3) 7 SSM Cardinal Glennon Children's Hospital false SSM Health Foundation - St Louis 10101 Woodfield Lane St Louis MO 63132 431552945 Fundraising MO 501(c)(3) 7 SSM Health Care St Louis false SSM Health Care of Oklahoma Inc 10101 Woodfield Lane St Louis MO 63132 730657693 Health Care OK 501(c)(3) 3 SSM Health Care Corporation false The St Anthony Hospital Foundation Inc 10101 Woodfield Lane St Louis MO 63132 736104300 Fundraising OK 501(c)(3) 7 SSM Health Care of Oklahoma false SSM Health Care of Wisconsin Inc 10101 Woodfield Lane St Louis MO 63132 430688874 Health Care WI 501(c)(3) 3 SSM Health Care Corporation false Dells Medical Building Inc 10101 Woodfield Lane St Louis MO 63132 391613292 MOB WI 501(c)(2) SSM Health Care of Wisconsin false St Mary's Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940686 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false St Clare Health Care Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940683 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Home Health United Inc 2802 Walton Commons Lane Madison WI 53718 391539827 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false Home Care United Inc 2802 Walton Commons Lane Madison WI 53718 391776340 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false HHU Xtra Care Inc 2802 Walton Commons Lane Madison WI 53718 391705111 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false SSM Health at Home Foundation of Wisconsin Inc 2802 Walton Commons Lane Madison WI 53718 391839309 Fundraising WI 501(c)(3) Type I Home Health United Inc false SSM Regional Health Services 10101 Woodfield Lane St Louis MO 63132 440579850 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false St Mary's Health Center Jefferson City Missouri Foundation 10101 Woodfield Lane St Louis MO 63132 431575307 Fundraising MO 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center 10101 Woodfield Lane St Louis MO 63132 430653587 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's Hospital Centralia Illinois 10101 Woodfield Lane St Louis MO 63132 370662580 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's - Good Samaritan Inc 10101 Woodfield Lane St Louis MO 63132 364170833 Health Care IL 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center Foundation 10101 Woodfield Lane St Louis MO 63132 262884795 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Foundation 10101 Woodfield Lane St Louis MO 63132 364636691 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Auxiliary 400 N Pleasant Centralia IL 62801 237126345 Fundraising IL 501(c)(3) 10 St Mary's Hospital Foundation false SSM Health Businesses 10101 Woodfield Lane St Louis MO 63132 431333488 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Health Care St Louis 10101 Woodfield Lane St Louis MO 63132 431343281 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false Centralia Medical Services Bldg Assoc 10101 Woodfield Lane St Louis MO 63132 237408025 MOB IL 501(c)(3) Type I SSM Regional Health Services false St Mary's Janesville Foundation Inc 10101 Woodfield Lane St Louis MO 63132 273439133 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false SSM Health Ministries 3221 McKelvey Road Suite 107 Bridgeton MO 63044 431012492 Religious Organization MO 501(c)(3) 1 NA false Lee Dewey Corporation 10101 Woodfield Lane St Louis MO 63132 731279603 MOB OK 501(c)(3) Type I SSM Health Care of Oklahoma false SSM Hospice & Home Care Foundation 10101 Woodfield Lane St Louis MO 63132 300012246 Fundraising MO 501(c)(3) 7 SSM Health Businesses false St Mary's Hospital Auxiliary 100 St Marys Medical Plaza Jefferson City MO 65101 436049878 Fundraising MO 501(c)(3) Type II NA false Good Samaritan Hospital Auxiliary 1 Good Samaritan Way Mount Vernon IL 62864 237049599 Fundraising IL 501(c)(3) Type III-FI NA false St Anthony Shawnee Hospital Inc 1000 N Lee Ave Oklahoma City OK 73102 455055149 Health Care OK 501(c)(3) 3 SSM Health Care of Oklahoma false SSM Audrain Health Care Inc 10101 Woodfield Lane St Louis MO 63132 431550298 Health Care MO 501(c)(3) 3 SSM Regional Health Services false Audrain Medical Center Foundation Inc 620 E Monroe St Mexico MO 65265 431265060 Fundraising MO 501(c)(3) Type I NA false SSM-SLUH Inc 10101 Woodfield Lane St Louis MO 63132 474196634 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false SSM Health Plan 1277 Deming Way Madison WI 53717 831979548 Insurance MO 501(c)(4) SSM Health Businesses false Agnesian Healthcare Inc 430 E Division St Fond du Lac WI 54935 390807236 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Ripon Medical Center Inc 845 Parkside Street Ripon WI 54971 391101287 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc false Waupun Memorial Hospital Inc 620 West Brown Street Waupun WI 53963 390806265 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc false St Francis Home of Fond du Lac Wisconsin Inc 33 Everett Street Fond du Lac WI 54935 391029998 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Sister Servants of Christ the King Villa Loretto N8114 County WW Mount Calvary WI 53057 391022770 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Villa Rosa Inc N8120 County WW Mount Calvary WI 53057 421670962 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Christian Home and Rehabilitation Center Incorporated 331 Bly Street Waupun WI 53963 390884514 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Monroe Clinic Inc 515 22nd Avenue Monroe WI 53566 390808509 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Monroe Clinic and Hospital Foundation Inc 515 22nd Avenue Monroe WI 53566 205769038 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Agnesian Healthcare Foundation Inc 430 E Division St Fond du Lac WI 54935 391684956 Fundraising WI 501(c)(3) Type I SSM Health Care of Wisconsin false Shared Magnetic Resonance Imaging Facility Inc 1104 John Nolen Drive Madison WI 53713 391534744 Health Care WI 501(c)(3) Type I SSM Health Care of Wisconsin false SSM Health Cardinal Glennon Transport 10101 Woodfield Lane St Louis MO 63132 863519607 Health Care MO 501(c)(3) Type I SSM Cardinal Glennon Children's Hospital false SSM Health Foundation 10101 Woodfield Lane St Louis MO 63132 874109859 Fundraising MO 501(c)(3) Type I SSM Health Care Corporation false SSM St Joseph Endoscopy Center LLC 10101 Woodfield Lane St Louis MO 63132 270046559 Surgery Services MO NA N/A St Clare Imaging Services LLC 707 14th Street Suite A Baraboo WI 53913 200122365 Diag. Services WI NA N/A Mt Vernon Radiation Therapy Center LLC 10101 Woodfield Lane St Louis MO 63132 201382620 Radiation Therapy IL NA N/A Sleep & Neurology Center of Southern Illinois LLC 10101 Woodfield Lane St Louis MO 63132 208468195 Diag. Services IL NA N/A CHOWSMGSI Office Building LLC 10101 Woodfield Lane St Louis MO 63132 371383861 MOB IL NA N/A Oza Cancer Center LLC 10101 Woodfield Lane St Louis MO 63132 201382727 MOB IL NA N/A Shawnee Real Estate Holdings LLC 1000 N Lee Ave Oklahoma City OK 73102 455458304 MOB OK NA N/A Dean Clinic & St Mary's Hospital Accountable Care Organization LLC 1808 West Beltline Highway Madison WI 53713 452995500 Accountable Care Organization WI NA N/A Wisconsin Integrated Information Technology and Telemedicine Systems LLC 1808 West Beltline Highway Madison WI 53713 392016715 Information Technology Services WI NA N/A Dean Health Holdings LLC 1277 Deming Way Madison WI 53717 261594709 Support Services WI NA N/A Wingra Building Group 1808 West Beltline Highway Madison WI 53713 390237060 MOB WI NA N/A Janesville Riverview Clinic Building Partnership 1808 West Beltline Highway Madison WI 53713 396220698 MOB WI NA N/A 1110 N Classen Blvd LLC 1110 N Classen Boulevard Oklahoma City OK 73106 731158158 MOB OK NA N/A SSM St Clare Surgical Center LLC 10101 Woodfield Lane St Louis MO 63132 261439695 Surgery Services MO NA N/A Windmill LLP 50 Village View Lane Chesterfield MO 63017 431804651 Investments MO NA N/A Navitus Health Solutions LLC 361 Integrity Drive Madison WI 53717 043608530 Pharmacy Benefits WI NA N/A SSM Select Rehab St Louis LLC 4714 Gettysburg Road Mechanicsburg PA 17055 263694972 Health Care DE NA N/A Epiphany Rx LLC 361 Integrity Drive Madison WI 53717 364855405 Pharmacy Benefits DE NA N/A SSM Managed Care Organization LLC 10101 Woodfield Lane St Louis MO 63132 431708511 Health Promotion MO NA C Corporation false FPP INC & Subs 10101 Woodfield Lane St Louis MO 63132 431465174 Health Care MO NA C Corporation false Diversified Health Services Corp 10101 Woodfield Lane St Louis MO 63132 431369305 Medical Equipment MO NA C Corporation false SSM Properties Inc 10101 Woodfield Lane St Louis MO 63132 431462486 Property Services MO NA C Corporation false HealthFirst Physician Management Services 10101 Woodfield Lane St Louis MO 63132 731534336 Medical Services OK NA C Corporation false SSMHC Liability Trust II 10101 Woodfield Lane St Louis MO 63132 816128118 Insurance MO NA C Corporation false SSM Medical Group Inc 10101 Woodfield Lane St Louis MO 63132 431664107 Physician Offices MO NA C Corporation false SSMHC Insurance Company PO Box 1051 GT Grand Cayman CJ KY11102 030310431 Insurance CJ NA C Corporation false Physicians Services Corp of Southern Illinois Inc 10101 Woodfield Lane St Louis MO 63132 364161526 Health Care IL NA C Corporation false Dean Health Systems Inc 1808 West Beltline Highway Madison WI 53713 391128616 Physician Offices WI NA C Corporation false Dean Health Insurance Inc PO Box 56099 Madison WI 53705 391830837 Insurance WI NA C Corporation false Dean Health Plan Inc PO Box 56099 Madison WI 53705 391535024 Insurance WI NA C Corporation false Dean Retail Services Inc 1808 West Beltline Highway Madison WI 53713 391717636 Property Services WI NA C Corporation false Oza Oncology Inc 4117 Veterans Memorial Drive Mt Vernon IL 62804 371343746 Physician Offices IL NA S Corporation false SSM Health Janesville Campus Condominium Association Inc 1808 West Beltline Highway Madison WI 53713 832038674 Condo association WI NA C Corporation false SSM Health Pharmacy LLC 10101 Woodfield Lane St Louis MO 63132 264031708 Pharmacy MO NA C Corporation false SSM Health Insurance Company 1277 Deming Way Madison WI 53717 834718249 Insurance MO NA C Corporation false Navitus Holdings LLC 1808 West Beltline Highway Madison WI 53713 800968174 Pharmacy WI NA C Corporation false MS Community JV LLC 401 Carlson Parkway CP330 Minnetonka MN 55305 873240022 Insurance DE NA C Corporation false Quality Drug Corporation 239 Broadway Laguna Beach CA 92651 330644268 Pharmacy benefits CA NA C Corporation false St Mary's Hospital Campus Condominium Owners Association Inc 707 South Mills Street Madison WI 53715 000000000 Condo association WI NA C Corporation false false false false false false false false false false false false true true true true true false false false