2025-11-17T15:49:43-06:00 2024-12-31 990 2024-01-01 205769038 MONROE CLINIC AND HOSPITAL FOUNDATION MONR 6083242868 515 22ND AVENUE MONROE WI 53566 STEPHANIE KING VP FINANCE 6083242868 2025-11-17 0 2024 2025-03-06 01:10:19Z JANE SYBERS 515 22ND AVENUE MONROE WI 53566 1055694 0 X WWW.GIVETOSSMHEALTH.ORG/FOUNDATIONS/WISCONSIN/MON X 2006 WI 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. THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 13 8 0 9 0 0 360004 375083 201921 223126 253492 419586 -7560 -5072 807857 1012723 196012 840381 0 0 186000 207060 0 0 230985 33929 23925 415941 1071366 391916 -58643 10660660 11337798 2499 182166 10658161 11155632 THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 840381 840381 223126 SUPPORT THE MONROE CLINIC INC WITH EQUIPMENT PURCHASES AND HEALTH CARE PROGRAMS. OTHER ASSISTANCE PROVIDED TO LOCAL ORGANIZATIONS AS NEEDED. 840381 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 13 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JANE SYBERS 6083242868 515 22ND AVENUE MONROE WI 53566 JANE CURRAN-MEULI DIRECTOR & HOSPITAL PRES/CEO 1.00 50.00 X 0 591941 178076 GAINES RICHARDSON DIRECTOR & SSM PHYSICIAN 1.00 50.00 X 0 291330 66313 JANE SYBERS EXECUTIVE DIRECTOR 40.00 0.00 X X 0 124999 44397 JOE KLEIN DIRECTOR, VICE CHAIR & ASST SEC 1.00 0.00 X X 0 0 0 TEENA BUHOLZER DIRECTOR & CHAIR 1.00 0.00 X X 0 0 0 ALESSANDRO ROSSI MD DIRECTOR & ASSISTANT SECRETARY 1.00 0.00 X X 0 0 0 DEB THOMPSON DIRECTOR 1.00 0.00 X 0 0 0 JILL LEITZEN DIRECTOR 1.00 0.00 X 0 0 0 KIM MARKHAM DIRECTOR 1.00 0.00 X 0 0 0 SUZANNE ANDERSON DIRECTOR & REGIONAL PRES 1.00 50.00 X 0 1377728 548240 JIM DAVIDSON MD DIRECTOR 1.00 0.00 X 0 0 0 AMANDA FIELDS DIRECTOR 1.00 0.00 X 0 0 0 RONALD SPIELMAN DIRECTOR 1.00 0.00 X 0 11728 0 DOUGLAS LONG SECRETARY & CLO AT SSM HEALTH 1.00 50.00 X 0 1587150 700771 KEVIN SMITH TREASURER & CFO AT SSM HEALTH 1.00 50.00 X 0 1050477 627081 RANDALL COMBS FORMER OFFICER 0.00 0.00 X 0 1454021 29506 0 6489374 2194384 0 1 1 0 0 132986 18716 1100 222281 55285 375083 223126 223126 223126 318829 318829 100757 0 100757 100757 100757 36909 132986 42476 -5567 -5567 990 495 495 495 1012723 223126 0 414514 795915 795915 44466 44466 192442 192442 14618 14618 11191 11191 8165 8165 521 521 247 247 666 666 BANK FEES 2790 2790 LICENSES, DUES & SUBSCR 345 345 1071366 840381 0 230985 518629 371860 10965938 811668 9330363 10660660 11337798 2499 182166 2499 182166 X 1557234 1944424 9100927 9211208 10658161 11155632 10660660 11337798 X -58643 556116 -2 X 0 1 X 1 1 1 X 319585 1067351 335502 360004 349100 2431542 319585 1067351 335502 360004 349100 2431542 509884 1921658 101938 83865 154219 254528 318829 913379 21602 38969 24916 17786 37899 141172 3486093 510721 0.55120 0.57510 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING ACTIVITIES - 2020 AMOUNT: $ 21,602. 2021 AMOUNT: $ 38,969. 2022 AMOUNT: $ 24,916. 2023 AMOUNT: $ 17,786. 2024 AMOUNT: $ 37,899. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6870697 89901 812852 7773451 5893458 94138 1058980 175879 6870697 5168051 747841 137457 159891 5893458 5489706 252166 843308 1417129 5168051 4610640 29793 849273 5489706 0.15050 0.49770 0.35180 0 0 0 THIRD PARTY PAYABLES 182166 182166 X 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 2024 OR 2023. BIG GOLF 90154 62741 27413 12157 11367 6366 600 2229 HOSPICE LITTLE GOLF 79741 70245 9496 7797 1960 169895 132986 36909 19954 11367 6366 600 4189 42476 -5567 1 THE MONROE CLINIC INC 515 2ND AVENUE MONROE WI 53566 390808509 501(C)(3) 791931 0 SUPPORT FOR SSM HEALTH MONROE HOSPITAL 1 0 EMPLOYEE ASSISTANCE 32 24749 SCHOLARSHIPS 12 18192 PARTY PROGRAM AND FUNERAL ASSISTANCE 15 1525 PART I, LINE 2: 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. 1 0 1 0 0 0 0 0 0 0 DOUGLAS LONG SECRETARY & CLO AT SSM HEALTH 0 813979 0 583198 0 189973 0 676547 0 24224 0 2287921 0 583198 SUZANNE ANDERSON DIRECTOR & REGIONAL PRES 0 787210 0 422941 0 167577 0 527309 0 20931 0 1925968 0 480783 KEVIN SMITH TREASURER & CFO AT SSM HEALTH 0 1034519 0 0 0 15958 0 586407 0 40674 0 1677558 0 0 RANDALL COMBS FORMER OFFICER 0 323766 0 923306 0 206949 0 13881 0 15625 0 1483527 0 923306 JANE CURRAN-MEULI DIRECTOR & HOSPITAL PRES/CEO 0 427455 0 114495 0 49991 0 145793 0 32283 0 770017 0 114495 GAINES RICHARDSON DIRECTOR & SSM PHYSICIAN 0 280636 0 0 0 10694 0 24521 0 41792 0 357643 0 4559 JANE SYBERS EXECUTIVE DIRECTOR 0 114646 0 8753 0 1600 0 14039 0 30358 0 169396 0 8753 PART I, LINE 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, EXECUTIVE DIRECTOR, IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. 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 2024. CAPITAL ACCUMULATION PLAN: SSMH PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMH AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2024. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. GAINES RICHARDSON - $8,130 X 360 55285 MARKET VALUE 0 0 1 0 PART I, COLUMN (B): STOCK - NUMBER OF SHARES DONATED FORM 990 PART V, LINE 1A ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF WISCONSIN, INC. SSM HEALTH 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 SSM HEALTH CARE CORPORATION, THE SOLE MEMBER OF SSM HEALTH CARE OF WISCONSIN, INC., THE MEMBER OF MONROE CLINIC AND HOSPITAL FOUNDATION, 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 FOLLOWING POWERS ARE RESERVED TO SSM HEALTH CARE CORPORATION, THE SOLE MEMBER OF SSM HEALTH CARE OF WISCONSIN, INC., THE SOLE MEMBER OF MONROE CLINIC AND HOSPITAL FOUNDATION: 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 A WRITTEN CONFLICT OF INTEREST APOLICY EXISTS WHICH REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON A ANNUAL BASIS TO THE DESIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 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: ROUNDING -2. SSM HEALTH MINISTRIES 3221 MCKELVEY ROAD SUITE 107 BRIDGETON MO 63044 431012492 RELIGIOUS ORGANIZATION MO 501(C)(3) LINE 1 N/A 0 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 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 ST LOUIS 12800 CORPORATE HILL DRIVE ST LOUIS MO 63131 431343281 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 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 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 3800 PARK AVE ST LOUIS MO 63110 431754347 FUNDRAISING MO 501(C)(3) LINE 7 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 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 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 SSM HEALTH FOUNDATION - 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