GOOD SAMARITAN REGIONAL HEALTH CENTER: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN REGIONAL HEALTH CENTER (EIN 43-0653587)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-17
- IRS object ID
- 202523219349317247
- Schema version
- 2024v5.2
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-17T15:14:16-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430653587 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 3149947800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12800 CORPORATE HILL DRIVE | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63131 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE KING | PersonNm |
| Person Title | VP-FINANCE | PersonTitleTxt |
| Phone | 3149947800 | PhoneNum |
| Signature | 2025-11-17 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSM HEALTH GOOD SAMARITAN HOSPITAL-MT VERNON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAMON HARBISON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12800 CORPORATE HILL DRIVE | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63131 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $264,543,787 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/GOOD-SAMARITA | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO CONTINUE THE HEALING MINISTRY OF JESUS CHRIST BY IMPROVING & PROVIDING REGIONAL, COST EFFECTIVE QUALITY HEALTH SERVICES FOR EVERYONE, WITH SPECIAL CONCERN FOR THE POOR AND VULNERABLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1176 | TotalEmployeeCnt |
| Total Volunteers | 116 | TotalVolunteersCnt |
| Total Gross UBI | $5,777,559 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,527,398 | PYContributionsGrantsAmt |
| CY Contributions Grants | $168,742 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $244,307,865 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $259,740,049 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,545,396 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,002 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,625,928 | PYOtherRevenueAmt |
| CY Other Revenue | $4,616,994 | CYOtherRevenueAmt |
| PY Total Revenue | $253,006,587 | PYTotalRevenueAmt |
| CY Total Revenue | $264,543,787 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $214,372 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $223,667 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $85,505,209 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $84,301,812 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $4,134 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $128,323,947 | PYOtherExpensesAmt |
| CY Other Expenses | $135,387,690 | CYOtherExpensesAmt |
| PY Total Expenses | $214,043,528 | PYTotalExpensesAmt |
| CY Total Expenses | $219,913,169 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $38,963,059 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $44,630,618 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $180,544,115 | TotalAssetsBOYAmt |
| Total Assets EOY | $169,943,814 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $94,152,472 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $86,458,780 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $86,391,643 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $83,485,034 | 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 | $186,826,780 | ExpenseAmt |
| Grant | $223,667 | GrantAmt |
| Revenue | $259,740,049 | RevenueAmt |
| Desc | SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON IS KNOWN FOR PROVIDING EXCEPTIONAL HEALTH CARE AND CONSISTENTLY PUTTING PATIENT'S NEEDS FIRST. OUR 134-BED FACILITY WAS RECOGNIZED WITH A CITATION OF MERIT AWARD FOR OUTSTANDING PATIENT CARE, PRESENTED BY QUEST BY PREMIER INC., SSM HEALTH GOOD SAMARITAN IS PROUD TO SERVE OUR COMMUNITY.WE ARE AN ORGANIZATION OF CAREGIVERS. WE REPRESENT OUR TINIEST PATIENTS THROUGH THE INNOVATIVE NICU TELEMEDICINE PROGRAM, IN CONJUNCTION WITH SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL. THROUGH OUR LEADING HOSPITAL SERVICES LIKE CARDIOLOGY, CANCER CARE, ROBOTIC SURGERY AND ADVANCED IMAGING SERVICES, WE HELP OUR PATIENTS DISCOVER A PATH TO HEALING. | Desc |
| Total Program Service Expenses | $186,826,780 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1176 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARK STOVER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6184367545 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH PLEASANT AVE | AddressLine1Txt |
| City | CENTRALIA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW FLANIGAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEREMY FOTHERINGHAM | ||||||||||
| DIRECTOR, CHAIR, REGIONAL PRESIDENT | 1.00 | 50.00 | Yes (X) | $0 | $1,310,180 | $630,158 | Yes (X) | |||
| PAULA FRIEDMAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAMON HARBISON | ||||||||||
| DIRECTOR, HOSPITAL PRESIDENT | 25.00 | 25.00 | Yes (X) | $0 | $575,496 | $220,573 | ||||
| MONICA HEINZMAN | ||||||||||
| DIRECTOR, VP-OPS AT SSM HEALTH | 25.00 | 25.00 | Yes (X) | $242,205 | $0 | $81,960 | ||||
| JEAN BENOIT HOULE | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| TENA HOYT | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| ERICA IBENDAHL | ||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | 0.00 | 40.00 | Yes (X) | $0 | $785,986 | $79,299 | ||||
| JEREMY MIDURA | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| SUDEEP NAIR | ||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $518,099 | $91,598 | ||||
| SUZIE SCHMIDT | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| RAJENDRA SHROFF | ||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $139,833 | $39,815 | ||||
| PATRICIA WILLIAMS | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| SUSAN NIEPOETTER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| DOUGLAS LONG | ||||||||||
| SECRETARY, CLO AT SSM HEALTH | 1.00 | 50.00 | $0 | $1,587,150 | $700,771 | Yes (X) | ||||
| STEVEN SMOOT | ||||||||||
| VICE PRESIDENT, COO AT SSM HEALTH | 1.00 | 50.00 | $0 | $2,364,935 | $1,119,698 | Yes (X) | ||||
| RACHEL HALL | ||||||||||
| ASSISTANT SECRETARY | 40.00 | 0.00 | $93,198 | $0 | $32,595 | Yes (X) | ||||
| JOHN SNODSMITH | ||||||||||
| REGIONAL VP, FINANCE | 25.00 | 25.00 | $0 | $320,127 | $90,119 | Yes (X) | ||||
| KEVIN SMITH | ||||||||||
| TREASURER, CFO AT SSM HEALTH | 0.00 | 50.00 | $0 | $1,050,477 | $627,081 | Yes (X) | ||||
| MARCIA LYSAGHT | ||||||||||
| VP PATIENT CARE SERVICES, CNO | 25.00 | 25.00 | $0 | $411,334 | $100,938 | Yes (X) | ||||
| JULIE LONG | ||||||||||
| VP - STRATEGIC PLANNING | 40.00 | 0.00 | $0 | $462,567 | $156,252 | Yes (X) | ||||
| JAYANTHI SUPPIAH | ||||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | $347,404 | $0 | $64,442 | Yes (X) | ||||
| HOLLIE COLLE | ||||||||||
| VP HOSPITAL OPERATIONS | 40.00 | 0.00 | $0 | $224,852 | $71,324 | Yes (X) | ||||
| BROOKE WILLOWS | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $598,652 | $0 | $26,976 | Yes (X) | ||||
| JIGGAR HINDIA | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $557,058 | $0 | $57,536 | Yes (X) | ||||
| JOHN FLICK | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $413,911 | $0 | $52,913 | Yes (X) | ||||
| TRENTON GRIMM | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $379,414 | $0 | $70,546 | Yes (X) | ||||
| FAISAL RASHID | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $630,292 | $0 | $75,197 | Yes (X) | ||||
| MICHAEL BAUMGARTNER | ||||||||||
| FORMER OFFICER | 0.00 | 0.00 | $0 | $182,141 | $11,296 | Yes (X) | ||||
| MATTHEW KINSELLA | ||||||||||
| FMR OFF, REGIONAL VP FINANCE WI | 0.00 | 50.00 | $0 | $561,331 | $175,077 | Yes (X) | ||||
| KAREN REWERTS | ||||||||||
| FMR OFF, VP FINANCIAL OPS | 0.00 | 50.00 | $0 | $845,480 | $234,843 | Yes (X) | ||||
| RANDALL COMBS | ||||||||||
| FORMER OFFICER | 1.00 | 50.00 | $0 | $1,454,021 | $29,506 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,262,134 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,794,009 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $4,840,513 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 143 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANESTHESIA ASSOCIATES OF SOUTHERN ILLINO | |||||
| 2700 TURNBERRY DRIVE | MARION | IL | 62959 | MEDICAL SERVICES | $1,577,609 |
| TRIMEDX HOLDINGS LLC | |||||
| 5451 LAKEVIEW PARKWAY S DR | INDIANAPOLIS | IN | 46268 | CLINICAL ENGINEERING SERVICES | $894,785 |
| VAYA WORKFORCE SOLUTIONS LLC | |||||
| 5930 CORNERSTONE CT W STE300 | SAN DIEGO | CA | 92121 | STAFFING SERVICES | $521,440 |
| PEDIATRIC GROUP LLC | |||||
| 3412 OFFICE PARK DR | MARION | IL | 62959 | MEDICAL SERVICES | $375,862 |
| JACKSON & COKER HOLDINGS LLC | |||||
| PO BOX 277638 | ATLANTA | GA | 30384 | STAFFING SERVICES | $361,722 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $52,875 | RelatedOrganizationsAmt |
| Government Grants | $89,113 | GovernmentGrantsAmt |
| All Other Contributions | $26,754 | AllOtherContributionsAmt |
| Total Contributions | $168,742 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE | 622110 | $245,252,741 | $245,252,741 | |
| PHARMACY REVENUE | 446110 | $5,800,451 | $22,892 | $5,777,559 |
| 340B PHARMACY | 446110 | $4,566,837 | $4,566,837 | |
| VALUE BASED CARE REV | 622110 | $2,804,520 | $2,804,520 | |
| CORPORATE FEES | 561000 | $1,130,343 | $1,130,343 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $185,157 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $185,157 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $259,740,049 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $421,007 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $421,007 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $421,007 | TotalRevenueColumnAmt |
| Exclusion | $421,007 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $18,002 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $18,002 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,002 | TotalRevenueColumnAmt |
| Exclusion | $18,002 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| JOINT VENTURE REVENUE | 561000 | $3,495,211 | $3,495,211 |
| CAFETERIA REVENUE | 722514 | $700,776 | $700,776 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,195,987 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $264,543,787 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $253,962,490 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $5,777,559 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,634,996 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,667 | TotalAmt |
| Program Services | $223,667 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $861,804 | TotalAmt |
| Management And General | $861,804 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,958,206 | TotalAmt |
| Program Services | $60,093,654 | ProgramServicesAmt |
| Management And General | $864,552 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,423,228 | TotalAmt |
| Program Services | $3,337,296 | ProgramServicesAmt |
| Management And General | $85,932 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,598,846 | TotalAmt |
| Program Services | $14,232,375 | ProgramServicesAmt |
| Management And General | $366,471 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,459,728 | TotalAmt |
| Program Services | $4,347,777 | ProgramServicesAmt |
| Management And General | $111,951 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,470,727 | TotalAmt |
| Program Services | $7,042,399 | ProgramServicesAmt |
| Management And General | $428,328 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,561 | TotalAmt |
| Program Services | $7,729 | ProgramServicesAmt |
| Management And General | $181,832 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,156,179 | TotalAmt |
| Program Services | $22,856,648 | ProgramServicesAmt |
| Management And General | $1,295,706 | ManagementAndGeneralAmt |
| Fundraising | $3,825 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,347 | TotalAmt |
| Program Services | $20,524 | ProgramServicesAmt |
| Management And General | $14,823 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,062,174 | TotalAmt |
| Program Services | $1,953,185 | ProgramServicesAmt |
| Management And General | $108,680 | ManagementAndGeneralAmt |
| Fundraising | $309 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,339,122 | TotalAmt |
| Program Services | $7,339,122 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,490,377 | TotalAmt |
| Program Services | $5,490,363 | ProgramServicesAmt |
| Management And General | $14 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,602 | TotalAmt |
| Program Services | $330,714 | ProgramServicesAmt |
| Management And General | $20,888 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,436 | TotalAmt |
| Program Services | $97,057 | ProgramServicesAmt |
| Management And General | $19,379 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $976,069 | TotalAmt |
| Program Services | $976,069 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,675,639 | TotalAmt |
| Program Services | $730,309 | ProgramServicesAmt |
| Management And General | $23,945,330 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,911,805 | TotalAmt |
| Program Services | $9,367,883 | ProgramServicesAmt |
| Management And General | $4,543,922 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & EQUI | $40,868,514 | $40,868,514 | |
| MEDICAID PROVIDER TAX & | $7,378,015 | $7,378,015 | |
| LICENSES, DUES & SUBSCR | $364,267 | $133,480 | $230,787 |
| BANK FEES | $1,856 | $1,856 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,913,169 | TotalAmt |
| Program Services | $186,826,780 | ProgramServicesAmt |
| Management And General | $33,082,255 | ManagementAndGeneralAmt |
| Fundraising | $4,134 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,169 | BOYAmt |
| EOY | $3,638 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,812,187 | BOYAmt |
| EOY | $31,716,699 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,762,396 | BOYAmt |
| EOY | $5,139,410 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $784,065 | BOYAmt |
| EOY | $1,126,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $281,188,143 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $158,747,125 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,030,425 | BOYAmt |
| EOY | $122,441,018 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,550 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,930,012 | BOYAmt |
| EOY | $3,100,949 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,308,281 | BOYAmt |
| EOY | $4,142,088 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,650,030 | BOYAmt |
| EOY | $2,273,245 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,544,115 | BOYAmt |
| EOY | $169,943,814 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,903,520 | BOYAmt |
| EOY | $16,509,225 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,439,630 | BOYAmt |
| EOY | $1,293,175 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,755,463 | BOYAmt |
| EOY | $10,061,370 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $794,278 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,259,581 | BOYAmt |
| EOY | $58,595,010 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,152,472 | BOYAmt |
| EOY | $86,458,780 | 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 | $84,542,140 | BOYAmt |
| EOY | $83,485,034 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,849,503 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,391,643 | BOYAmt |
| EOY | $83,485,034 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,544,115 | BOYAmt |
| EOY | $169,943,814 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $44,630,618 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$47,537,227 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $20,720 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $20,720 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL, STATE AND LOCAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $27,448 | BeginningYearBalanceAmt |
| Contributions | $113,350 | ContributionsAmt |
| Investment Earnings Or Losses | $3,647 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,000 | OtherExpendituresAmt |
| End Year Balance | $143,445 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,714 | BeginningYearBalanceAmt |
| Contributions | $1,000 | ContributionsAmt |
| Investment Earnings Or Losses | $1,734 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $27,448 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $27,995 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$3,281 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $24,714 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $25,000 | BeginningYearBalanceAmt |
| Contributions | $2,995 | ContributionsAmt |
| End Year Balance | $27,995 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $25,000 | ContributionsAmt |
| End Year Balance | $25,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $590,251 | OtherCostOrOtherBasisAmt |
| Book Value | $590,251 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $161,277,248 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,817,028 | DepreciationAmt |
| Book Value | $91,460,220 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,480,397 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,197,173 | DepreciationAmt |
| Book Value | $9,283,224 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,003,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $63,752,856 | DepreciationAmt |
| Book Value | $15,250,609 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,836,782 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,980,068 | DepreciationAmt |
| Book Value | $5,856,714 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $122,441,018 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY PAYABLES | $551,481 |
| INTERCOMPANY PAYABLE | $55,760,757 |
| OPERATING RIGHT-OF-USE LIABILITIES | $2,282,772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $58,595,010 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GOOD SAMARITAN REGIONAL HEALTH CENTER'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 2024. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,484,700 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,484,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,585,800 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $41,047,928 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,537,872 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02060 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,060,552 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,203,780 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,856,772 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $55,131,052 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $46,251,708 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,879,344 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $173,406 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $173,406 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $678,040 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $678,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,770 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,770 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,293 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $89,293 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $988,509 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $988,509 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,119,561 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $46,251,708 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,867,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04480 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,511,084 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $53,115,529 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $87,274,088 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$34,158,559 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 2 MT VERNON RADIATION THERAPY CENTER LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | RADIATION THERAPY SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.51000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.49000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSM HEALTH GOOD SAMARITAN HOSPITAL-MT VERNON | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 GOOD SAMARITAN WAY | AddressLine1Txt |
| City | MT VERNON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62864 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SSMHEALTH.COM/LOCATIONS/ILLINOIS/G | WebsiteAddressTxt |
| State License | 0005850 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSM HEALTH GOOD SAMARITAN HOSPITAL - MT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON | PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. |
| SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON | PART V, SECTION B, LINE 5: SSM HEALTH ILLINOIS COMMITTED ITSELF TO A CHNA PROCESS CENTERED AROUND ACTIVELY ENGAGING AND LISTENING TO THE LIVED EXPERIENCE OF OUR MARION AND JEFFERSON COUNTY RESIDENTS AND LEADERS THROUGH A COMMUNITY HEALTH SURVEY, KEY INFORMANT INTERVIEWS AND COMMUNITY CONVERSATIONS. PUBLICLY AVAILABLE SECONDARY DATA WAS ALSO INCORPORATED IN THE CHNA PROCESS TO ENHANCE AND FURTHER ILLUMINATE LEARNINGS FROM THE COMMUNITY. IT IS WITH THIS COMMITMENT TO EQUITY-FOCUSED COLLABORATION THAT SSM HEALTH ILLINOIS ENGAGED MEMBERS OF THE COMMUNITY, AS WELL AS COMMUNITY STAKEHOLDERS (THOSE THAT DO COMMUNITY WORK PROFESSIONALLY SUCH AS PUBLIC HEALTH, EDUCATORS, NONPROFIT LEADERS, COMMUNITY-BASED SERVICE PROVIDERS, ETC.) IN OUR CHNA PROCESS. OUR GOAL WAS TO DEEPEN OUR UNDERSTANDING OF THE STRENGTHS AND CHALLENGES WITHIN THE COMMUNITY AND PRIORITIZE COLLABORATION, DIRECT COMMUNITY MEMBER ENGAGEMENT AND ANCHORING OUR PROCESS IN COMMUNITY VOICE. THE DIRECT LIVED EXPERIENCE OF COMMUNITY MEMBERS AND PROFESSIONALS ARE THE DRIVING VOICE IN OUR CHNA PROCESS.SSM HEALTH ILLINOIS FACILITATED A 13-QUESTION COMMUNITY HEALTH NEEDS SURVEY FROM MARCH 2024 THROUGH JULY 2024. THE SURVEY WAS DEVELOPED AFTER REVIEWING PREVIOUS SURVEYS AND TAKING INTO ACCOUNT FACTORS SUCH ENSURING QUESTIONS WERE ALIGNED WITH OUR PROCESS GOALS, ENSURING HEALTH LITERACY, AND KEEPING IT BRIEF TO PROMOTE COMPLETION. THE SURVEY WAS PRIMARILY AVAILABLE ELECTRONICALLY; HOWEVER, PAPER COPIES WERE AVAILABLE IN CERTAIN LOCATIONS. THE SURVEY WAS OPEN TO ANYONE WHO CALLED THE SSM HEALTH ILLINOIS REGION HOME AND EFFORTS TO INVITE PARTICIPATION IN THE SURVEY INCLUDED DIRECT OUTREACH TO STAKEHOLDERS AND COMMUNITY ORGANIZATIONS, PRESENCE AT COMMUNITY EVENTS, AND THE USE OF VARIOUS SOCIAL AND NEWS MEDIA OPTIONS. IN TOTAL 459 SURVEY RESPONSES WERE COLLECTED FROM ACROSS THE REGION.FOLLOWING THE COMMUNITY SURVEY, DATA WAS DISAGGREGATED AND ANALYZED WITHIN SSM HEALTH ILLINOIS FOCUS GEOGRAPHIES. USING THE DATA COLLECTED FROM THE COMMUNITY SURVEY TO GUIDE CONVERSATIONS WITH STAKEHOLDERS THROUGH 60-MINUTE KEY INFORMANT INTERVIEWS. SSM HEALTH ILLINOIS FACILITATED 9 KEY INFORMANT INTERVIEWS.ALIGNING WITH OUR COMMITMENT TO ANCHORING OUR CHNA EFFORTS IN COMMUNITY VOICE, SSM HEALTH ILLINOIS FACILITATED CONVERSATIONS DIRECTLY WITH COMMUNITY MEMBERS ASKING FOR THEIR REACTIONS TO SURVEY DATA RESULTS AND FOR THEIR OWN LIVED EXPERIENCE AND PERSPECTIVES ON IDENTIFYING RELEVANT COMMUNITY HEALTH PRIORITIES. IN TOTAL, 18 COMMUNITY MEMBERS ENGAGED WITH COMMUNITY HEALTH STAFF IN 4 COMMUNITY CONVERSATIONS. COMMUNITY CONVERSATIONS ARE INTENDED TO BE AN ON-GOING PROCESS AND SSM ILLINOIS IS COMMITTED TO CONTINUING TO GROW AND DEVELOP COMMUNITY RELATIONSHIPS TO FURTHER ENGAGE STAKEHOLDERS IN FACILITATING STRATEGIES TO IMPROVE THE IDENTIFIED COMMUNITY HEALTH PRIORITIES. |
| SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON | PART V, SECTION B, LINE 6A: THE 2024 CHNA WAS COMPLETED COLLABORATIVELY COMPLETED WITH THE FOLLOWING OTHER HOSPITALS:* SSM HEALTH ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS |
| SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON | PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2024 CHNA. IN ORDER TO MAKE A MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES:* BEHAVIORAL HEALTH: MENTAL HEALTH/WELLBEING & SUBSTANCE ABUSE* FOOD & NUTRITION SECURITY BEHAVIORAL HEALTH: MENTAL HEALTH/WELLBEING & SUBSTANCE ABUSE* MENTAL HEALTH WAS DEFINITIVELY DEFINED AS THE TOP HEALTH PROBLEM THROUGH THE COMMUNITY SURVEY AND UNANIMOUSLY CONFIRMED IN STAKEHOLDER AND COMMUNITY CONVERSATIONS.* DATA FROM THE SSM HEALTH ILLINOIS' COMMUNITY HEALTH NEEDS SURVEY RANKED SUBSTANCE USE AS THE 3RD HIGHEST RATED HEALTH PROBLEM IN BOTH ADULTS AND YOUTH.PROGRESS MADE SINCE 2021* INTENSIVE OUTPATIENT PROGRAM: SSM ST. MARY'S HOSPITAL IN CENTRALIA IL REIMPLEMENTED THE INTENSIVE OUTPATIENT PROGRAM IN MARCH 2024. WITH A TAILORED CURRICULUM INVOLVING INDIVIDUAL AND GROUP-BASED THERAPY, THE ST. MARY'S IOP PROGRAM PROVIDES MORE RIGOROUS SUPPORT THAN TYPICAL OUTPATIENT MENTAL HEALTH SERVICES. THE PROGRAM OFFERS PATIENTS UP TO NINE HOURS OF THERAPEUTIC SERVICES PER WEEK. IN ADDITION TO THERAPY, PATIENTS HAVE ACCESS TO SEVERAL PSYCHIATRIC PROVIDERS WHO ARE SPECIFICALLY TRAINED TO PRESCRIBE AND MANAGE MEDICATIONS FOR MENTAL HEALTH-RELATED ISSUES.MEDICATION DISPOSAL KIOSKS: SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON AND SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PARTNERED WITH STERICYCLE, INC. TO OFFER THEIR COMMUNITIES MEDDROP. MEDICATION COLLECTION KIOSKS. ACCESSIBLE YEARROUND AND LOCATED IN THE HOSPITALS' EMERGENCY DEPARTMENT ENTRANCES, THE KIOSKS PROVIDE A SAFE, SECURE, AND CONVENIENT WAY TO DISPOSE OF UNUSED OR EXPIRED HOUSEHOLD MEDICATIONS THAT COULD OTHERWISE HAVE BEEN DIVERTED OR ABUSED. THEY ALSO PROTECT THE ENVIRONMENT BY MITIGATING THE CONTAMINATION OF WATERWAYS AND DRINKING WATER SYSTEMS BECAUSE OF IMPROPER DISPOSAL FROM FLUSHING. SINCE ITS IMPLEMENTATION IN 2023, 991 POUNDS OF UNUSED OR EXPIRED MEDICATION HAVE BEEN SAFELY DISPOSED.GOALS * IMPROVE MENTAL HEALTH AND WELL-BEING WITHIN JEFFERSON AND MARION COUNTIES THROUGH INCREASED EDUCATION/COMMUNITY AWARENESS AND ENSURE THE AVAILABILITY, ACCESSIBILITY, AND AFFORDABILITY OF INTEGRATED AND CONSISTENT, COORDINATED, PATENT-CENTERED CARE FOR OUR MOST IMPACTED POPULATIONS. * INCREASE EDUCATION/COMMUNITY AWARENESS OF THE DANGERS OF SUBSTANCE USE WITHIN JEFFERSON AND MARION COUNTIES AND ENSURE THE AVAILABILITY, ACCESSIBILITY, AND AFFORDABILITY OF INTEGRATED AND CONSISTENT, COORDINATED, PATENT-CENTERED CARE FOR OUR MOST IMPACTED POPULATIONS.OBJECTIVES * OPTIMIZE PARTNERSHIPS WITH PUBLIC HEALTH INSTITUTIONS, COMMUNITY ORGANIZATIONS AND REGIONAL COLLABORATIVES TO EXPAND COMMUNITY EDUCATION EFFORTS AND INCREASE SERVICES FOR MENTAL AND EMOTIONAL WELLNESS.* INCREASE COMMUNITY AWARENESS AND UTILIZATION OF SSM HEALTH BEHAVIORAL HEALTH OUTPATIENT PROGRAMS LOCATED AT SSM HEALTH ST. MARY'S HOSPITAL IN CENTRALIA IL THROUGH ACTIVE ENGAGEMENT AND INFORMATION SHARING WITH COMMUNITY, COMMUNITY PROVIDERS AND REGIONAL COLLABORATIONS.* INCREASE BEHAVIORAL HEALTH SUPPORTS WITHIN SSM HEALTH PRIMARY CARE SETTINGS THROUGH THE SSM HEALTH VIRTUAL BEHAVIORAL HEALTH INTEGRATION PROGRAM. EXPLORE EXPANSION FROM ADULT PRIMARY SETTINGS TO ADDITIONAL SPECIALTY CARE SETTINGS INCLUDING BUT NOT LIMITED TO: PEDIATRICS, OBSTETRICS & GYNECOLOGY, AND ONCOLOGY.* OPTIMIZE PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND REGIONAL COLLABORATIVES TO EXPAND SUBSTANCE USE PREVENTION INITIATIVES AND INCREASE SERVICES FOR THOSE WITH SUBSTANCE USE DISORDERS.* INCREASE COMMUNITY KNOWLEDGE AND UTILIZATION OF DRUG TAKE BACK BINS LOCATED THROUGHOUT THE COMMUNITY AND AT SSM HEALTH ILLINOIS HOSPITALS.* EXPLORE OPPORTUNITIES TO ENHANCE TOBACCO AND VAPING PREVENTION EFFORTS IN THE COMMUNITY.FOOD & NUTRITION SECURITY * NEITHER FOOD NOR NUTRITION WERE IDENTIFIED HEALTH PROBLEMS ON THE COMMUNITY HEALTH SURVEY. THEY WERE NOT CHOICES ON THE SURVEY AT ALL YET WHEN ACTIVELY LISTENING TO COMMUNITY STAKEHOLDERS AND MEMBERS THROUGHOUT THE CHNA PROCESS, FOOD INSECURITY AND LACK OF KNOWLEDGE ON NUTRITION CAME UP AS ROOT CAUSE FACTORS FOR MULTIPLE IDENTIFIED TOP HEALTH PROBLEMS INCLUDING OBESITY & MAINTAINING HEALTHY WEIGHT, HEART CONDITIONS, DIABETES, AND CHRONIC DISEASES IN GENERAL. FUNDAMENTALLY, COMMUNITY LOUDLY STATED THAT "FOOD IS MEDICINE AND NEEDS TO BE A FOCUSED CHNA PRIORITY.* A 2019 STUDY BY FEEDING AMERICA ESTIMATED THAT FOOD INSECURITY COSTS THE US HEALTH CARE SYSTEM AN ADDITIONAL $53 BILLION ANNUALLY.PROGRESS MADE SINCE 2021* IN JULY 2024, SSM ILLINOIS IMPLEMENTED THE BREAD BASKET PROGRAM AT GOOD SAMARITAN HOSPITAL AND ST. MARY'S HOSPITAL- CENTRALIA. THROUGH A PARTNERSHIP WITH CENTRAL ILLINOIS AREA FOOD BANK AND FEEDING AMERICA, SSM HEALTH'S BREAD BASKET PROGRAM IN SOUTHERN ILLINOIS PROVIDES A SHORT-TERM SUPPLY OF NUTRITIONALLY DENSE SHELF-STABLE FOOD ITEMS TO QUALIFYING PATIENTS, ALONG WITH A LIST OF COMMUNITY RESOURCES FOR LONGER TERM FOOD ACCESS. THROUGH THIS COLLABORATIVE EFFORT WITH SEVERAL HOSPITAL DEPARTMENTS, INCLUDING NURSING, SOCIAL WORK, AND GUEST RELATIONS, SSM HEALTH GOOD SAMARITAN AND ST. MARY HOSPITALS ENSURE ELIGIBLE PATIENTS EASILY RECEIVE NEEDED NUTRITION WITH INFORMATION ON ADDITIONAL FOOD RESOURCES FOR THEMSELVES AND THEIR FAMILIES.* MOBILE MARKETS: SSM HEALTH PARTNERS WITH THE UNITED WAY OF SOUTH-CENTRAL ILLINOIS AND UNIVERSITY OF ILLINOIS EXTENSION TO PROVIDE MOBILE MARKETS IN JEFFERSON AND MARION COUNTY. FOOD IS PURCHASED THROUGH LOCAL FOOD VENDORS, INCLUDING CUSUMANO AND SONS AND PRAIRIE FARMS TO PROVIDE NUTRIENT DENSE FOOD OPTIONS TO COMMUNITY MEMBERS. THROUGH THE 2021-2024 CHNA CYCLE, $160,000 HAS BEEN CONTRIBUTED TO PURCHASING FOOD FOR THE MOBILE MARKET PROGRAM. IN 2023, APPROXIMATELY 6,900 HOUSEHOLDS WERE SERVED ACROSS OUR COMMUNITIES.GOAL* INCREASE HEALTHY/NUTRITIOUS FOOD AVAILABILITY, ACCESSIBILITY AND CONSUMPTION IN JEFFERSON AND MARION COUNTIES THROUGH COMMUNITY NUTRITION EDUCATION AND THE CONTINUED DEVELOPMENT OF PROGRAMS AND PARTNERSHIPS FOCUSED ON PROVIDING OR CONNECTING COMMUNITY MEMBER TO DIRECT FOOD ASSISTANCE AND/OR FOOD ASSISTANCE PROGRAMS.OBJECTIVES * OPTIMIZE SSM HEALTH ILLINOIS REGIONAL FOOD INSECURITY INITIATIVE KNOWN AS THE BREAD BASKET. THIS PROGRAM SEEKS TO PROVIDE DIRECT FOOD ASSISTANCE AND REFERRAL FOR ONGOING SUPPORT TO SSM HEALTH INPATIENTS.* CONTINUE SUPPORT FOR MOBILE MARKET AND OTHER FOOD DISTRIBUTION OPPORTUNITIES IN JEFFERSON AND MARION COUNTY, IL.* OPTIMIZE PARTNERSHIPS WITH FOOD AND NUTRITION SUPPORT ORGANIZATIONS TO INCREASE FOOD SECURITY AND NUTRITIONAL EDUCATION FOR SPECIFIC POPULATIONS SUCH AS THOSE WITH CHRONIC DISEASE, CANCER OR DURING PREGNANCY.* EXPLORE COLLABORATIVE OPPORTUNITIES AND SUPPORT FOR FOCUSED NUTRITION EDUCATION PROGRAMMING. |
| SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON | PART V, SECTION B, LINE 13H: SSM HEALTH MAY UTILIZE PREDICTIVE ANALYTICAL SOFTWARE OR OTHER CRITERIA TO ASSIST IN MAKING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IN SITUATIONS, INCLUDING BUT NOT LIMITED TO THE HOMELESS POPULATION, WHERE THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE BUT HAS NOT PROVIDED THE NECESSARY DOCUMENTATION TO MAKE A DETERMINATION. IRREGULARLY, IN THE ABSENCE OF USING THE PREDICTIVE ANALYTICAL SOFTWARE, PRESUMPTIVE CHARITY MAY BE AUTHENTICATED BY THE PATIENT CARE TEAM AS REPRESENTED AS CHARITY OR UNINSURED DISCOUNTS TO THE PATIENTS' FINANCIAL OBLIGATION.ADDITIONALLY, PATIENTS MAY BE ELIGIBLE TO RECEIVE A DISCOUNT ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SSM HEALTH MEDICAL GROUP | ||||
| 4117 VETERANS MEMORIAL DRIVE | MT VERNON | IL | 62864 | OUTPATIENT CLINIC |
| 2 - SSM HEALTH MEDICAL GROUP | ||||
| 602 S 42ND STREET | MT VERNON | IL | 62864 | OUTPATIENT CLINIC |
| 3 - SSM HEALTH MEDICAL GROUP | ||||
| 2 GOOD SAMARITAN WAY | MT VERNON | IL | 62864 | OUTPATIENT CLINIC |
| 4 - SSM HEALTH MEDICAL GROUP | ||||
| 5 GOOD SAMARITAN WAY | MT VERNON | IL | 62864 | OUTPATIENT CLINIC |
| 5 - SSM HEALTH MEDICAL GROUP | ||||
| 4106 S WATER TOWER PL | MT VERNON | IL | 62864 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR THOSE INDIVIDUALS WHO:* HAVE LIMITED OR NO HEALTH INSURANCE;* COOPERATE WITH SSM HEALTH'S POLICIES AND PROCEDURES;* DEMONSTRATE FINANCIAL NEED;* SUPPLY ALL REQUIRED INFORMATION TO PROCESS THE APPLICATION; AND * REIMBURSES THE HOSPITAL FOR ANY MONIES PAID DIRECTLY TO PATIENT BY INSURANCE. PATIENTS WHOSE FAMILY INCOME EXCEED 400% OF THE FEDERAL POVERTY GUIDELINES (FPL) MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF THE HOSPITAL. IN SUCH CASES, OTHER FACTORS MAY BE CONSIDERED IN DETERMINING THEIR ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES, INCLUDING:*BANK ACCOUNTS, INVESTMENTS AND OTHER ASSETS*EMPLOYMENT STATUS AND EARNING CAPACITY*AMOUNT AND FREQUENCY OF BILLS FOR HEALTH CARE SERVICES*OTHER FINANCIAL OBLIGATIONS AND EXPENSES*GENERALLY, FINANCIAL RESPONSIBILITY WILL BE NO MORE THAN 25% OF GROSS FAMILY INCOME.SSM HEALTH MAY UTILIZE PREDICTIVE ANALYTICAL SOFTWARE OR OTHER CRITERIA TO ASSIST IN MAKING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IN SITUATIONS, INCLUDING BUT NOT LIMITED TO THE HOMELESS POPULATION, WHERE THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE BUT HAS NOT PROVIDED THE NECESSARY DOCUMENTATION TO MAKE A DETERMINATION. IRREGULARLY, IN THE ABSENCE OF USING THE PREDICTIVE ANALYTICAL SOFTWARE, PRESUMPTIVE CHARITY MAY BE AUTHENTICATED BY THE PATIENT CARE TEAM AS REPRESENTED AS CHARITY OR UNINSURED DISCOUNTS TO THE PATIENTS' FINANCIAL OBLIGATION. |
| PART I, LINE 6A: | SSM HEALTH CARE CORPORATION FILES A COMBINED COMMUNITY BENEFIT REPORT FOR ALL ITS AFFILIATES. THE COMMUNITY BENEFIT REPORT CAN BE FOUND ON SSM'S WEBSITE AT: HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH. |
| PART I, LINE 7: | THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B, AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H, AND 71 ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE CALCULATION OF SCHEDULE H, PART I, LINE 7, COLUMN F UTILIZES 990, PART IX, LINE 25, COLUMN A, WHICH DOES NOT INCLUDE BAD DEBT EXPENSE. |
| PART III, LINE 2: | AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. |
| PART III, LINE 3: | FOR FINANCIAL STATEMENT PURPOSES, SSM HEALTH HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDE BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THEREFORE, THERE IS NO AMOUNT REPORTED ON PART III, LINE 3 FOR THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER SSM HEALTH'S FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 4: | GOOD SAMARITAN REGIONAL HEALTH CENTER IS PART OF THE SSM HEALTH CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES THE TREATMENT OF UNCOLLECTIBLE ACCOUNTS AND IMPLICIT PRICE CONCESSIONS IN THE DECEMBER 31, 2024 CONSOLIDATED AUDIT IS CONTAINED ON PAGE 13 AND 14 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COSTS REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST. |
| PART III, LINE 9B: | THE HOSPITALS HAVE ESTABLISHED A WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEALTH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE, THE HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HOSPITALS' BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED.ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY, REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE.ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RATE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY.ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY, THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING:1. THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT2. EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS.3. ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD.4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL.5. BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSM PRIOR TO ENGAGING IN ECAS. SSM WILL REVIEW THE ACCOUNTS AND VERIFY SATISFACTORY COMPLETION OF REASONABLE EFFORTS DURING THE NOTIFICATION AND APPLICATION PERIOD.A WAIVER IS NOT CONSIDERED REASONABLE EFFORTS. OBTAINING A SIGNED WAIVER THAT AN INDIVIDUAL DOES NOT WISH TO APPLY FOR FAP ASSISTANCE OR RECEIVE FAP APPLICATION INFORMATION WILL NOT MEET THE REQUIREMENT TO MAKE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN ECAS.ALL OUTSIDE COLLECTION AGENCIES MUST COMPLY WITH STATE AND FEDERAL LAWS, COMPLY WITH THE ASSOCIATION OF CREDIT AND COLLECTION PROFESSIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY AND COMPLY WITH THE HOSPITAL'S COLLECTION AND FINANCIAL ASSISTANCE POLICIES. |
| PART VI, LINE 2: | SSM HEALTH (SSMH) PARTICIPATES IN COMMUNITY BENEFIT ACCORDING TO OUR VISION, THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY, AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT AND ENVIRONMENT. IN THE TRADITION OF OUR FOUNDERS, THE FRANCISCAN SISTERS OF MARY, CARING FOR THOSE IN GREATEST NEED REMAINS OUR ORGANIZATIONAL PRIORITY. TODAY OUR SYSTEM BOARD MONITORS COMMUNITY BENEFIT EFFORTS, AND VIEWS ACHIEVEMENT OF OUR VISION AS A PRIMARY RESPONSIBILITY.THE PURPOSE OF SSMH'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEALTH NEEDS. MAKING OUR COMMUNITIES HEALTHIER IN MEASURABLE WAYS IS ALWAYS OUR GOAL. TO FULFILL THIS COMMITMENT, SSMH'S COMMUNITY BENEFIT IS DIVIDED INTO TWO PARTS: 1) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND 2) COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA).THE CHNA IS AN ASSESSMENT AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS AND THE ADOPTION AND IMPLEMENTATION OF STRATEGIES TO ADDRESS THOSE NEEDS. A CHNA IS CONDUCTED EVERY THREE YEARS BY EACH HOSPITAL ACCORDING TO THEFOLLOWING STEPS:*ASSESS AND PRIORITIZE COMMUNITY HEALTH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATATO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA.*DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEALTH PRIORITIES: ESTABLISH STRATEGIES TO ADDRESS PRIORITIES; COMPLETE STRATEGIC IMPLEMENTATION PLAN; OBTAIN REGIONAL/DIVISIONAL BOARD APPROVAL; AND INTEGRATE STRATEGIES INTO OPERATIONAL PLAN.*MAKE CHNA WIDELY AVAILABLE TO THE PUBLIC: PUBLISH CHNA AND SUMMARY DOCUMENT ON HOSPITAL'S WEBSITE.*MONITOR, TRACK, AND REPORT PROGRESS ON TOP HEALTH PRIORITIES: COLLECT DATA AND EVALUATE PROGRESS; REPORT TO REGIONAL/DIVISIONAL BOARD EVERY SIX MONTHS AND SYSTEM BOARD EVERY YEAR; SHARE FINDINGS WITH COMMUNITYSTAKEHOLDERS; AND SEND RESULTS TO FINANCE FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS).SYSTEM OFFICE STAFF AND LEADERS OVERSEE AND MONITOR SSMH'S COMMUNITY BENEFIT PROGRAM, AND ENSURE REPORTING IS IN COMPLIANCE WITH IRS REGULATIONS. IN COLLABORATION WITH COMMUNITY STAKEHOLDERS AND PARTNER ORGANIZATIONS, SSM HEALTH CARE CORPORATION ALSO IDENTIFIES NEEDS BASED ON ASSESSMENTS AND RESEARCH, AND SSMH FACILITIES ALSO INVOLVE CASE MANAGERS AND CARE TEAM STAFF TO PINPOINT CRITICAL HEALTH ISSUES IN THE COMMUNITY. ALL HOSPITAL CHNAS ARE COMPLETED, APPROVED, AND INTEGRATED INTO THE ORGANIZATION'S STRATEGIC PLAN. WE CONTINUE TO MONITOR AND ASSESS THEPROGRESS OF OUR LOCAL EFFORTS IN THE SPIRIT OF CARING FOR OTHERS AND IMPROVING COMMUNITY HEALTH. |
| PART VI, LINE 3: | EACH ENTITY PROVIDING MEDICAL SERVICE SHALL PROVIDE INFORMATION TO THE PUBLIC REGARDING ITS CHARITY CARE POLICIES AND THE QUALIFICATION REQUIREMENTS FOR EACH OF ITS FACILITIES. WHEN STANDARD SYSTEM NOTICES AND COMMUNICATION REGARDING CHARITY CARE ARE AVAILABLE, THESE MUST BE USED. MODIFICATIONS TO THE STANDARD MAY BE MADE TO COMPLY WITH STATE AND LOCAL LAWS, AS WELL AS REFLECT CULTURALLY SENSITIVE TERMINOLOGY FOR THE POLICY. ALL NOTICES ARE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. THEY PROVIDE INFORMATION ABOUT:* THE PATIENT'S RESPONSIBILITY FOR PAYMENT,* THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS* THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS, AND* WHO TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED:*SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS.*BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS.*NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES.*APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION.THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES. |
| PART VI, LINE 4: | THE SSM HEALTH SOUTHERN ILLINOIS MARKET IS COMPRISED OF JEFFERSON AND MARION COUNTY, ILLINOIS. JEFFERSON COUNTY HOSTS SSM HEALTH GOOD SAMARITAN HOSPITAL IN MOUNT VERNON, IL. MARION COUNTY HOSTS SSM HEALTH ST. MARY'S HOSPITAL IN CENTRALIA, IL. BOTH COUNTIES MAKE UP THE PRIMARY SERVICE AREA FOR THE PATIENTS OF SSM ILLINOIS' MINISTRIES. THERE ARE 30 ZIP CODES THAT ARE CONTAINED WITHIN OR OVERLAP THE SERVICE AREA. IN 2023, THE SOUTHERN ILLINOIS MARKET HAD AN ESTIMATED POPULATION OF 95,295 PERSONS.THE SOUTHERN ILLINOIS MARKET INCLUDES:* AGE OVER 50% OF THE RESIDENTS ARE 20-64 YEARS, APPROXIMATELY 25% ARE OVER 65, APPROXIMATELY 25% ARE 5-19* RACE/ETHNICITY 82.2% WHITE COMPARED TO 62.7% FOR ILLINOIS AS A WHOLE AND 62.3% FOR THE U.S. AS A WHOLE. 7.4% BLACK/AFRICAN AMERICAN COMPARED TO 14.7% FOR ILLINOIS AS A WHOLE AND 13.7% FOR THE U.S. AS A WHOLE. 2.6% HISPANIC COMPARED TO 18.7% FOR ILLINOIS AS A WHOLE AND 18.1% FOR THE U.S. AS A WHOLE. 4.3% OTHER COMPARED TO 22.5% FOR ILLINOIS AS A WHOLE AND 23.9% FOR THE U.S. AS A WHOLE.* SEX 51% MALE AND 49% FEMALE* EDUCATIONAL ATTAINMENT 32.8% HAVE ATTAINED A HIGH SCHOOL DIPLOMA COMPARED TO 24.9% FOR ILLINOIS AS A WHOLE AND 26.1% FOR THE U.S. AS A WHOLE. 12.7% HAVE ATTAINED A BACHELOR'S DEGREE COMPARED TO 22.5% FOR ILLINOIS AS A WHOLE AND 21.6% FOR THE U.S. AS A WHOLE. 5.9% HAVE ATTAINED A MATER'S DEGREE OR HIGHER COMPARED TO 15.3% FOR ILLINOIS AS A WHOLE AND 14% FOR THE U.S. AS A WHOLE.* MEDIAN HOUSEHOLD INCOME UNDER $60,000 COMPARED TO OVER $80,000 FOR ILLINOIS AS A WHOLE AND 80,000 FOR THE U.S. AS A WHOLE.* UNEMPLOYMENT RATE THE UNEMPLOYMENT RATE IN JEFFERSON AND MARION COUNTIES HAS DECREASED SINCE 2010. IT WAS APPROXIMATELY 5% FOR BOTH COUNTIES, WHICH IS SIMILAR TO THE UNEMPLOYMENT RATE FOR ILLINOIS AS A WHOLE.* POVERTY RATE 21% OF THE OVERALL POPULATION OF JEFFERSON COUNTY LIVES IN POVERTY AND 24% OF THE OVERALL POPULATION OF MARION COUNTY LIVES IN POVERTY COMPARED TO 15% FOR ILLINOIS AS A WHOLE. 14.1% OF THE CHILDREN OF JEFFERSON COUNTY LIVE IN POVERTY AND 17% OF THE CHILDREN OF MARION COUNTY LIVE IN POVERTY COMPARED TO 11.6% FOR ILLINOIS AS A WHOLE. * POPULATION CHANGE JEFFERSON COUNTY'S POPULATION DECREASED 4.4% AND MARION COUNTY'S POPULATION DECREASED 4.3% FROM 2000 TO 2010 COMPARED TO A DECREASE OF .14% FOR ILLINOIS AS A WHOLE AND AN INCREASE OF 7.4% FOR THE U.S. AS A WHOLE FROM 2000 TO 2010.* UNINSURED POPULATION APPROXIMATELY 8% AND 9% OF THE ADULT POPULATION IN JEFFERSON AND MARION COUNTIES, RESPECTIVELY, ARE UNINSURED COMPARED TO 10% FOR ILLINOIS AS A WHOLE. APPROXIMATELY 4% AND 3% OF THE CHILD POPULATION IN JEFFERSON AND MARION COUNTIES, RESPECTIVELY, ARE UNINSURED COMPARED TO 3% FOR ILLINOIS AS A WHOLE.* ADULT OBESITY 35% FOR JEFFERSON COUNTY AND 40% FOR MARION COUNTY COMPARED TO 34% FOR ILLINOIS AS A WHOLE AND 34% FOR THE U.S. AS A WHOLE. |
| PART VI, LINE 5: | SSM HEALTH AND ITS AFFILIATES PARTICIPATE IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY. THE COMMUNITY INITIATIVES BUILD ON THE STRENGTHS OF OUR COMMUNITIES AND SYSTEMS TO IMPROVE THE QUALITY OF LIFE AND TO CREATE A SENSE OF HOPE.COMMUNITY BENEFIT INITIATIVES BUILD COMMUNITY CAPACITY AND INDIVIDUAL EMPOWERMENT THROUGH COMMUNITY ORGANIZING, LEADERSHIP DEVELOPMENT, PARTNERSHIPS, AND COALITION BUILDING.SSM HEALTH AND ITS AFFILIATES PROMOTE GRASSROOTS ADVOCACY AND ENGAGES PERSONS OF INFLUENCE TO AFFECT SOCIAL AND PUBLIC POLICY CHANGE IN ORDER TO PROMOTE COMMUNITY HEALTH.THE HOSPITALS ALSO FURTHER THEIR EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES:*OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY,*HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA,*ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS,*PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS*ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM. |
| PART VI, LINE 6: | SSM HEALTH GOOD SAMARITAN REGIONAL HEALTH CENTER IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH SSM HEALTH ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS, IT IS PART OF A JOINT OPERATING AGREEMENT BETWEEN SSM HEALTH, BASED IN ST. LOUIS, MISSOURI AS MANAGING PARTNER, AND FELICIAN SISTERS, INC. OF CHICAGO. TOGETHER THE HOSPITALS ARE PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE COVERING A NINE-COUNTY AREA IN SOUTH CENTRAL ILLINOIS. SSM HEALTH CARE CORPORATION (SSMHCC), A MISSOURI NONPROFIT CORPORATION, IS THE ULTIMATE PARENT ENTITY OF A FULLY INTEGRATED HEALTH SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSMHCC AND ITS CONSOLIDATED SUBSIDIARIES (DOING BUSINESS AS SSM HEALTH (SSMH) OWNS AND OPERATES 23 ACUTE CARE HOSPITALS, ONE OF WHICH SPECIALIZES IN PEDIATRICS, TWELVE POST-ACUTE CARE FACILITIES, A NATIONAL PHARMACY BENEFIT MANAGEMENT COMPANY (PBM), AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, OTHER HEALTH CARE BUSINESSES AND SEVERAL FOUNDATIONS. SSMH'S HOSPITAL OPERATIONS ARE LOCATED PRIMARILY IN MISSOURI, WISCONSIN, OKLAHOMA AND ILLINOIS, AND ITS RELATED BUSINESSES PROVIDE HEALTH RELATED SERVICES IN 50 STATES. SSMH'S MISSION STATEMENT IS AS FOLLOWS:THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.SSMHCC AND MOST OF ITS AFFILIATED SUBSIDIARY CORPORATIONS HAVE BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). CERTAIN SUBSIDIARIES OF SSMH ARE FOR-PROFIT ENTITIES THAT ARE TAXABLE UNDER THE IRC.SSMH IS SPONSORED BY SSM HEALTH MINISTRIES, A MINISTERIAL JURIDIC PERSON, WHICH IS CURRENTLY COMPOSED OF ONE FRANCISCAN SISTER OF MARY (FSM), ONE SISTER OF ST. AGNES, ONE JESUIT PRIEST, ONE FRANCISCAN PRIEST, AND FOUR LAY PERSONS WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMH. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION | ||||||||
| 1 GOOD SAMARITAN WAY | MT VERNON | IL | 62864 | 262884795 | 501(C)(3) | $142,794 | $0 | GENERAL SUPPORT |
| JOHN R AND ELEANOR R MITCHELL FOUNDATION | ||||||||
| 2600 E RICHVIEW RD | MT VERNON | IL | 62864 | 376053100 | 501(C)(3) | $15,400 | $0 | GENERAL SUPPORT |
| JEFFERSON COUNTY CEO | ||||||||
| PO BOX 905 | MT VERNON | IL | 62864 | 475039390 | 501(C)(3) | $7,500 | $0 | GENERAL SUPPORT |
| MT VERNON TOWNSHIP HIGH SCHOOL | ||||||||
| 11101 N WLS BYP RD | MT VERNON | IL | 62864 | GOVERNMENT | $7,350 | $0 | GENERAL SUPPORT | |
| GREATER JEFFERSON COUNTY CHAMBER OF COMMERCE | ||||||||
| 123 S 10TH ST | MT VERNON | IL | 62864 | 370430860 | 501(C)(6) | $6,070 | $0 | GENERAL SUPPORT |
| MT VERNON FESTIVALS INC | ||||||||
| PO BOX 1708 | MT VERNON | IL | 62864 | 455380442 | 501(C)(3) | $6,000 | $0 | GENERAL SUPPORT |
| THE AMY SCHULZ CHILD ADVOCACY CENTER | ||||||||
| 500 FAIRFIELD ROAD | MT VERNON | IL | 62864 | 371260968 | 501(C)(3) | $5,100 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S GRANTS WERE MADE TO GOVERNMENTAL OR TAX-EXEMPT ORGANIZATIONS, UNDER IRC SECTION 501(C)(3). THESE ORGANIZATIONS ARE EXPECTED TO MAINTAIN ADEQUATE CONTROLS REGARDING THE USE OF GRANT FUNDS FOR THEIR INTENDED PURPOSE. | 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 (23 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN SMOOT | ||||||||||||||
| VICE PRESIDENT, COO AT SSM HEALTH | $0 | $1,305,272 | $0 | $895,103 | $0 | $164,560 | $0 | $1,075,677 | $0 | $44,021 | $0 | $3,484,633 | $0 | $1,036,001 |
| DOUGLAS LONG | ||||||||||||||
| SECRETARY, CLO AT SSM HEALTH | $0 | $813,979 | $0 | $583,198 | $0 | $189,973 | $0 | $676,547 | $0 | $24,224 | $0 | $2,287,921 | $0 | $583,198 |
| JEREMY FOTHERINGHAM | ||||||||||||||
| DIRECTOR, CHAIR, REGIONAL PRESIDENT | $0 | $837,601 | $0 | $470,869 | $0 | $1,710 | $0 | $589,116 | $0 | $41,042 | $0 | $1,940,338 | $0 | $470,869 |
| KEVIN SMITH | ||||||||||||||
| TREASURER, CFO AT SSM HEALTH | $0 | $1,034,519 | $0 | $0 | $0 | $15,958 | $0 | $586,407 | $0 | $40,674 | $0 | $1,677,558 | $0 | $0 |
| RANDALL COMBS | ||||||||||||||
| FORMER OFFICER | $0 | $323,766 | $0 | $923,306 | $0 | $206,949 | $0 | $13,881 | $0 | $15,625 | $0 | $1,483,527 | $0 | $923,306 |
| KAREN REWERTS | ||||||||||||||
| FMR OFF, VP FINANCIAL OPS | $0 | $601,026 | $0 | $176,014 | $0 | $68,440 | $0 | $198,391 | $0 | $36,452 | $0 | $1,080,323 | $0 | $229,400 |
| ERICA IBENDAHL | ||||||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | $0 | $713,041 | $0 | $71,766 | $0 | $1,179 | $0 | $22,666 | $0 | $56,633 | $0 | $865,285 | $0 | $0 |
| DAMON HARBISON | ||||||||||||||
| DIRECTOR, HOSPITAL PRESIDENT | $0 | $420,997 | $0 | $122,672 | $0 | $31,827 | $0 | $166,694 | $0 | $53,879 | $0 | $796,069 | $0 | $148,571 |
| MATTHEW KINSELLA | ||||||||||||||
| FMR OFF, REGIONAL VP FINANCE WI | $0 | $417,285 | $0 | $101,437 | $0 | $42,609 | $0 | $132,986 | $0 | $42,091 | $0 | $736,408 | $0 | $121,251 |
| FAISAL RASHID | ||||||||||||||
| PHYSICIAN | $597,351 | $0 | $28,000 | $0 | $4,941 | $0 | $17,844 | $0 | $57,353 | $0 | $705,489 | $0 | $0 | $0 |
| BROOKE WILLOWS | ||||||||||||||
| PHYSICIAN | $537,271 | $0 | $60,000 | $0 | $1,381 | $0 | $8,360 | $0 | $18,616 | $0 | $625,628 | $0 | $0 | $0 |
| JULIE LONG | ||||||||||||||
| VP - STRATEGIC PLANNING | $0 | $344,171 | $0 | $94,612 | $0 | $23,784 | $0 | $123,736 | $0 | $32,516 | $0 | $618,819 | $0 | $114,523 |
| JIGGAR HINDIA | ||||||||||||||
| PHYSICIAN | $555,927 | $0 | $0 | $0 | $1,131 | $0 | $3,583 | $0 | $53,953 | $0 | $614,594 | $0 | $0 | $0 |
| SUDEEP NAIR | ||||||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | $0 | $494,951 | $0 | $20,942 | $0 | $2,206 | $0 | $35,958 | $0 | $55,640 | $0 | $609,697 | $0 | $0 |
| MARCIA LYSAGHT | ||||||||||||||
| VP PATIENT CARE SERVICES, CNO | $0 | $343,591 | $0 | $45,000 | $0 | $22,743 | $0 | $94,442 | $0 | $6,496 | $0 | $512,272 | $0 | $0 |
| JOHN FLICK | ||||||||||||||
| PHYSICIAN | $406,702 | $0 | $6,000 | $0 | $1,209 | $0 | $19,035 | $0 | $33,878 | $0 | $466,824 | $0 | $0 | $0 |
| TRENTON GRIMM | ||||||||||||||
| PHYSICIAN | $374,216 | $0 | $4,500 | $0 | $698 | $0 | $15,631 | $0 | $54,915 | $0 | $449,960 | $0 | $0 | $0 |
| JAYANTHI SUPPIAH | ||||||||||||||
| CHIEF MEDICAL OFFICER | $360,773 | $0 | -$15,386 | $0 | $2,017 | $0 | $24,954 | $0 | $39,488 | $0 | $411,846 | $0 | $0 | $0 |
| JOHN SNODSMITH | ||||||||||||||
| REGIONAL VP, FINANCE | $0 | $264,636 | $0 | $40,328 | $0 | $15,163 | $0 | $59,973 | $0 | $30,146 | $0 | $410,246 | $0 | $40,328 |
| MONICA HEINZMAN | ||||||||||||||
| DIRECTOR, VP-OPS AT SSM HEALTH | $215,583 | $0 | $25,532 | $0 | $1,090 | $0 | $51,769 | $0 | $30,191 | $0 | $324,165 | $0 | $25,532 | $0 |
| HOLLIE COLLE | ||||||||||||||
| VP HOSPITAL OPERATIONS | $0 | $202,702 | $0 | $21,496 | $0 | $654 | $0 | $44,939 | $0 | $26,385 | $0 | $296,176 | $0 | $21,496 |
| MICHAEL BAUMGARTNER | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $182,141 | $0 | $0 | $0 | $11,296 | $0 | $0 | $0 | $193,437 | $0 | $182,141 |
| RAJENDRA SHROFF | ||||||||||||||
| DIRECTOR, PHYSICIAN AT SSM HEALTH | $0 | $139,645 | $0 | $0 | $0 | $188 | $0 | $8,702 | $0 | $31,113 | $0 | $179,648 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | SEVERAL INDIVIDUALS LISTED ON SCHEDULE J PART II RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2024. THE PAYMENT WAS INCLUDED IN THEIR TAXABLE COMPENSATION. |
| PART I, LINE 3 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (HOSPITAL PRESIDENT) 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. STEVE SMOOT - $159,608 JOHN SNODSMITH - $14,284 KAREN REWERTS - $60,917 DAMON HARBISON - $30,371 JULIE LONG - $21,682 MATT KINSELLA - $41,165 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATTHEW FLANIGAN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $22,272 | TransactionAmt |
| Transaction | SPOUSE IS EMPLOYEE OF GOOD SAMARITAN, KATHRYN FLANIGAN | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, ITEM C | DBA: SSM HEALTH BREAST CARE DBA: SSM HEALTH CHILD CARE CENTER DBA: SSM HEALTH CANCER CARE DBA: SSM HEALTH SCHOOL OF MEDICAL LABORATORY DBA: SSM HEALTH PHARMACY |
| 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 CORPORATION SHALL HAVE TWO (2) MEMBERS: THE CORPORATE MEMBER, WHICH SHALL BE SSM REGIONAL HEALTH SERVICES, A MISSOURI NONPROFIT CORPORATION, AND THE MANAGING MEMBER, WHICH SHALL BE ST. MARY'S-GOOD SAMARITAN, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION. GOOD SAMARITAN REGIONAL HEALTH CENTER, SSM REGIONAL HEALTH SERVICES, AND ST. MARY'S-GOOD SAMARITAN, INC., ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND ELECT AND REMOVE DIRECTORS EXCEPT EX-OFFICIO DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL SUCCESSOR OR REPLACEMENT MEMBERS C. TO ELECT AND REMOVE THE DIRECTORS D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTEREST IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE CORPORATE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE CORPORATE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER OF THE CORPORATE MEMBER AS DETERMINED BY THE MEMBER OF THE CORPORATE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE CORPORATE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE CORPORATE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE CORPORATE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. THE MANAGING MEMBER HAS THE FOLLOWING POWERS: CERTAIN POWERS ARE RESERVED TO THE MANAGING MEMBER, INCLUDING THE AUTHORITY TO TAKE SUCH ACTIONS ON BEHALF OF THE CORPORATION AS ARE VESTED IN THE MANAGING MEMBER UNDER THE JOINT OPERATING AGREEMENT (JOA), SUBJECT TO THE LIMITATIONS OF APPLICABLE LAW. THE MANNER TO WHICH THE MANAGING MEMBER EXERCISES SUCH RESERVED POWERS SHALL BE DETERMINED PURSUANT TO THE PROVISIONS OF THE JOA AND THE BYLAWS OF THE MANAGING MEMBERS. IN ADDITION, THE MANAGING MEMBER SHALL PARTICIPATE IN THE ELECTION OF THE DIRECTORS TO THE EXTENT OUTLINED IN THE ORGANIZATION'S BYLAWS. |
| 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. |
| FORM 990, PART VI, SECTION B, LINE 12C | 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 MUCH 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, 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 FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,503,292. MANAGEMENT AND GENERAL EXPENSES 141,908. FUNDRAISING EXPENSES 419. TOTAL EXPENSES 2,645,619. MEDICAL PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 12,051,459. MANAGEMENT AND GENERAL EXPENSES 704,733. FUNDRAISING EXPENSES 2,082. TOTAL EXPENSES 12,758,274. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 590,544. MANAGEMENT AND GENERAL EXPENSES 33,477. FUNDRAISING EXPENSES 99. TOTAL EXPENSES 624,120. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 282,452. MANAGEMENT AND GENERAL EXPENSES 16,012. FUNDRAISING EXPENSES 47. TOTAL EXPENSES 298,511. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,382,913. MANAGEMENT AND GENERAL EXPENSES 226,904. FUNDRAISING EXPENSES 669. TOTAL EXPENSES 4,610,486. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 2,984,545. MANAGEMENT AND GENERAL EXPENSES 169,189. FUNDRAISING EXPENSES 499. TOTAL EXPENSES 3,154,233. RECRUITMENT: PROGRAM SERVICE EXPENSES 61,443. MANAGEMENT AND GENERAL EXPENSES 3,483. FUNDRAISING EXPENSES 10. TOTAL EXPENSES 64,936. |
| FORM 990, PART XI, LINE 9: | TRANSFERS WITH CONSOLIDATED ENTITIES -46,055,066. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -1,824,503. BENEFICIAL INTEREST IN FOUNDATION 342,347. ROUNDING -5. |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 | SSM HEALTH MINISTRIES | |
| SSMHC LIABILITY TRUST I | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 436331003 | INSURANCE | MO | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE CORPORATION | |
| SSM CONSOLIDATED HEALTH SERVICES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431473657 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | 0 | SSM HEALTH CARE CORPORATION | |
| SSM POLICY INSTITUTE | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431788151 | HEALTH CARE | MO | 501(C)(4) | 0 | SSM HEALTH CARE CORPORATION | ||
| SSM HEALTH CARE PORTFOLIO MANAGEMENT CO | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431825256 | MANAGEMENT | MO | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE CORPORATION | |
| SSM HEALTH FOUNDATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 874109859 | FUNDRAISING | MO | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE CORPORATION | |
| SSM HEALTH CARE ST LOUIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431343281 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE CORPORATION | |
| SSM-SLUH INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 474196634 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE ST LOUIS | |
| SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430738490 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE ST LOUIS | |
| CARDINAL GLENNON CHILDREN'S FOUNDATION | |||||||||||
| 3800 PARK AVE | ST LOUIS | MO | 63110 | 431754347 | FUNDRAISING | MO | 501(C)(3) | LINE 7 | 0 | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | |
| SSM HEALTH CARDINAL GLENNON TRANSPORT | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 863519607 | HEALTH CARE | MO | 501(C)(3) | LINE 12A, I | 0 | SSM CARDINAL GLENNON CHILDREN'S HOSPITAL | |
| SSM HEALTH CARE GROUP | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 880988603 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | 0 | SSM HEALTH CARE ST LOUIS | |
| SSM HEALTH FOUNDATION - ST LOUIS | |||||||||||
| 12312 OLIVE BLVD STE 100 | ST LOUIS | MO | 63141 | 431552945 | FUNDRAISING | MO | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE ST LOUIS | |
| SSM HEALTH CARE OF OKLAHOMA INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 730657693 | HEALTH CARE | OK | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE CORPORATION | |
| LEE DEWEY CORPORATION | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 731279603 | MOB | OK | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE OF OKLAHOMA INC | |
| ST ANTHONY SHAWNEE HOSPITAL INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 455055149 | HEALTH CARE | OK | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE OF OKLAHOMA INC | |
| THE ST ANTHONY HOSPITAL FOUNDATION INC | |||||||||||
| 601 NW 11TH STREET | OKLAHOMA CITY | OK | 73101 | 736104300 | FUNDRAISING | OK | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE OF OKLAHOMA INC | |
| SSM HEALTH CARE OF WISCONSIN INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430688874 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE CORPORATION | |
| DELLS MEDICAL BUILDING INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 391613292 | MOB | WI | 501(C)(2) | 0 | SSM HEALTH CARE OF WISCONSIN INC | ||
| ST MARY'S FOUNDATION INC | |||||||||||
| 700 SOUTH PARK STREET | MADISON | WI | 53715 | 431940686 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| ST CLARE HEALTH CARE FOUNDATION INC | |||||||||||
| 707 14TH STREET | BARABOO | WI | 53913 | 431940683 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| ST MARY'S JANESVILLE FOUNDATION INC | |||||||||||
| 3400 E RACINE ST | JANESVILLE | WI | 53546 | 273439133 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| AGNESIAN HEALTHCARE FOUNDATION INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 391684956 | FUNDRAISING | WI | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| MONROE CLINIC AND HOSPITAL FOUNDATION INC | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 205769038 | FUNDRAISING | WI | 501(C)(3) | LINE 7 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| SHARED MAGNETIC RESONANCE IMAGING FACILITY INC | |||||||||||
| 1104 JOHN NOLEN DRIVE | MADISON | WI | 53713 | 391534744 | HEALTH CARE | WI | 501(C)(3) | LINE 12A, I | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| AGNESIAN HEALTHCARE INC | |||||||||||
| 430 E DIVISION ST | FOND DU LAC | WI | 54935 | 390807236 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| RIPON MEDICAL CENTER INC | |||||||||||
| 845 PARKSIDE STREET | RIPON | WI | 54971 | 391101287 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | 0 | AGNESIAN HEALTHCARE INC | |
| WAUPUN MEMORIAL HOSPITAL INC | |||||||||||
| 620 WEST BROWN STREET | WAUPUN | WI | 53963 | 390806265 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | 0 | AGNESIAN HEALTHCARE INC | |
| 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 | 0 | AGNESIAN HEALTHCARE INC | |
| SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO | |||||||||||
| N8114 COUNTY WW | MOUNT CALVARY | WI | 53057 | 391022770 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | AGNESIAN HEALTHCARE INC | |
| VILLA ROSA INC | |||||||||||
| N8120 COUNTY WW | MOUNT CALVARY | WI | 53057 | 421670962 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | AGNESIAN HEALTHCARE INC | |
| THE CHRISTIAN HOME AND REHABILITATION CENTER INCORPORATED | |||||||||||
| 452 FOX LAKE ROAD | WAUPUN | WI | 53963 | 390884514 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | AGNESIAN HEALTHCARE INC | |
| THE MONROE CLINIC INC | |||||||||||
| 515 22ND AVENUE | MONROE | WI | 53566 | 390808509 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE OF WISCONSIN INC | |
| SSM HEALTH AT HOME FOUNDATION OF WISCONSIN INC | |||||||||||
| 4639 HAMMERSLEY ROAD | MADISON | WI | 53711 | 391839309 | FUNDRAISING | WI | 501(C)(3) | LINE 12A, I | 0 | HOME HEALTH UNITED INC | |
| SSM REGIONAL HEALTH SERVICES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 440579850 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | 0 | SSM HEALTH CARE CORPORATION | |
| ST MARY'S HEALTH CENTER JEFFERSON CITY MISSOURI FOUNDATION | |||||||||||
| 2505 MISSION DRIVE | JEFFERSON CITY | MO | 65109 | 431575307 | FUNDRAISING | MO | 501(C)(3) | LINE 12A, I | 0 | SSM REGIONAL HEALTH SERVICES | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 2505 MISSION DRIVE | JEFFERSON CITY | MO | 65109 | 436049878 | FUNDRAISING | MO | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| SSM AUDRAIN HEALTH CARE INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431550298 | HEALTH CARE | MO | 501(C)(3) | LINE 3 | 0 | SSM REGIONAL HEALTH SERVICES | |
| ST MARY'S - GOOD SAMARITAN INC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 364170833 | HEALTH CARE | IL | 501(C)(3) | LINE 12A, I | 0 | SSM REGIONAL HEALTH SERVICES | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 400 N PLEASANT | CENTRALIA | IL | 62801 | 364636691 | FUNDRAISING | IL | 501(C)(3) | LINE 7 | 0 | ST MARY'S-GOOD SAMARITAN INC | |
| ST MARY'S HOSPITAL AUXILIARY | |||||||||||
| 400 N PLEASANT | CENTRALIA | IL | 62801 | 237126345 | FUNDRAISING | IL | 501(C)(3) | LINE 10 | 0 | ST MARY'S HOSPITAL FOUNDATION | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION | |||||||||||
| 1 GOOD SAMARITAN WAY | MOUNT VERNON | IL | 62864 | 262884795 | FUNDRAISING | IL | 501(C)(3) | LINE 7 | 0 | ST MARY'S-GOOD SAMARITAN INC | |
| GOOD SAMARITAN HOSPITAL AUXILIARY | |||||||||||
| 1 GOOD SAMARITAN WAY | MOUNT VERNON | IL | 62864 | 237049599 | FUNDRAISING | IL | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| GOOD SAMARITAN REGIONAL HEALTH CENTER | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430653587 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | 0 | SSM REGIONAL HEALTH SERVICES | |
| ST MARY'S HOSPITAL CENTRALIA ILLINOIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 370662580 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | 0 | SSM REGIONAL HEALTH SERVICES | |
| CENTRALIA MEDICAL SERVICES BLDG ASSOC | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 237408025 | MOB | IL | 501(C)(3) | LINE 12A, I | 0 | SSM REGIONAL HEALTH SERVICES | |
| SSM HEALTH BUSINESSES | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431333488 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | 0 | SSM HEALTH CARE CORPORATION | |
| THE SARAH COMMUNITY | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 431784657 | HEALTH CARE | MO | 501(C)(3) | LINE 10 | 0 | SSM HEALTH BUSINESSES | |
| VISITING NURSE ASSOCIATION OF GREATER ST LOUIS | |||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 430567000 | HEALTH CARE | MO | 501(C)(3) | LINE 7 | 0 | SSM HEALTH BUSINESSES | |
| HOME HEALTH UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391539827 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | SSM HEALTH BUSINESSES | |
| HHU XTRA CARE INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391705111 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | SSM HEALTH BUSINESSES | |
| HOME CARE UNITED INC | |||||||||||
| 2802 WALTON COMMONS LANE | MADISON | WI | 53718 | 391776340 | HEALTH CARE | WI | 501(C)(3) | LINE 10 | 0 | SSM HEALTH BUSINESSES | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (19 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSM ST JOSEPH ENDOSCOPY CENTER LLC | ||||||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 270046559 | SURGERY SERVICES | MO | N/A | 0 | Yes (1) | |||||
| ST LOUIS HEALTHCARE SUPPORT SERVICES LLC | ||||||||||||||
| 4901 FOREST PARK AVENUE STE 1140 | ST LOUIS | MO | 63108 | 372121486 | LAUNDRY SERVICES | MO | N/A | 0 | Yes (1) | |||||
| 1110 N CLASSEN BLVD LLC | ||||||||||||||
| 1110 N CLASSEN BOULEVARD | OKLAHOMA CITY | OK | 73106 | 731158158 | MOB | OK | N/A | 0 | Yes (1) | |||||
| MT VERNON RADIATION THERAPY CENTER LLC | ||||||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 201382620 | RADIATION THERAPY | IL | 0 | Yes (1) | GOOD SAMARITAN REGIONAL HEALTH CENTER | EXCLUDED | -$184,060 | $3,598,455 | 0.51000 | |
| CHOWSMGSI OFFICE BUILDING LLC | ||||||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 371383861 | MOB | IL | N/A | 0 | 0 | |||||
| OZA CANCER CENTER LLC | ||||||||||||||
| 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | 201382727 | MOB | IL | N/A | 0 | 0 | |||||
| WINGRA BUILDING GROUP | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 390237060 | MOB | WI | N/A | 0 | 0 | |||||
| JANESVILLE RIVERVIEW CLINIC BUILDING PARTNERSHIP | ||||||||||||||
| 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | 396220698 | MOB | WI | 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 | |||||
| ST CLARE IMAGING SERVICES LLC | ||||||||||||||
| 707 14TH STREET SUITE A | BARABOO | WI | 53913 | 200122365 | DIAG. SERVICES | WI | N/A | 0 | Yes (1) | |||||
| NAVITUS HEALTH SOLUTIONS LLC | ||||||||||||||
| 361 INTEGRITY DRIVE | MADISON | WI | 53717 | 043608530 | PHARMACY BENEFIT MANAGEMENT | WI | N/A | 0 | 0 | |||||
| EPIPHANY RX LLC | ||||||||||||||
| 361 INTEGRITY DRIVE | MADISON | WI | 53717 | 364855405 | PHARMACY BENEFIT MANAGEMENT | DE | N/A | 0 | 0 | |||||
| RXPRECHECK LL | ||||||||||||||
| 278 FRANKLIN RD | BRENTWOOD | TN | 37027 | 812842151 | PHARMACY BENEFIT MANAGEMENT | TN | N/A | 0 | 0 | |||||
| ARCHIMEDES LLC | ||||||||||||||
| 278 FRANKLIN RD | BRENTWOOD | TN | 37027 | 811158028 | PHARMACY BENEFIT MANAGEMENT | TN | N/A | 0 | 0 | |||||
| M&C REALTY LLC | ||||||||||||||
| 343 DUENKE RD | FORISTELL | MO | 63348 | 621851447 | MOB | MO | N/A | 0 | Yes (1) | |||||
| 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 (18 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SSMHC INSURANCE COMPANY | |||||||||||||||||
| PO BOX 1051 GT | GRAND CAYMAN | CJ | 030310431 | INSURANCE | CJ | N/A | C | 0 | |||||||||
| OMNINHEALTH HOLDINGS | |||||||||||||||||
| 884144276 | HEALTH CARE CONSULTING | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | DE | ||||||||
| SSM MANAGED CARE ORGANIZATION LLC | |||||||||||||||||
| 431708511 | HEALTH PROMOTION | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| ST MARY'S HOSPITAL CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC | |||||||||||||||||
| 000000000 | CONDO ASSOCIATION | N/A | C | 0 | 707 SOUTH MILLS STREET | MADISON | WI | 53715 | WI | ||||||||
| PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS INC | |||||||||||||||||
| 364161526 | HEALTH CARE | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | IL | GOOD SAMARITAN REGIONAL HEALTH CENTER | -$25,545,684 | $6,374,563 | 1.00000 | |||||
| FPP INC & SUBS | |||||||||||||||||
| 431465174 | HEALTH CARE | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| SSM MEDICAL GROUP INC | |||||||||||||||||
| 431664107 | PHYSICIAN OFFICES | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| SSM HEALTH PHARMACY LLC | |||||||||||||||||
| 264031708 | PHARMACY | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| SSMHC LIABILITY TRUST II | |||||||||||||||||
| 816128118 | INSURANCE | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| HEALTHFIRST PHYSICIAN MANAGEMENT SERVICES | |||||||||||||||||
| 731534336 | MEDICAL SERVICES | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | OK | ||||||||
| DIVERSIFIED HEALTH SERVICES CORP | |||||||||||||||||
| 431369305 | MEDICAL EQUIPMENT | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| SSM PROPERTIES INC | |||||||||||||||||
| 431462486 | PROPERTY SERVICES | N/A | C | 0 | 12800 CORPORATE HILL DRIVE | ST LOUIS | MO | 63131 | MO | ||||||||
| DEAN HEALTH SYSTEMS INC | |||||||||||||||||
| 391128616 | PHYSICIAN OFFICES | N/A | C | 0 | 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | WI | ||||||||
| DEAN RETAIL SERVICES INC | |||||||||||||||||
| 391717636 | PROPERTY SERVICES | N/A | C | 0 | 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | WI | ||||||||
| NAVITUS HOLDINGS LLC | |||||||||||||||||
| 800968174 | PHARMACY | N/A | C | 0 | 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | WI | ||||||||
| SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM ASSOCIATION INC | |||||||||||||||||
| 832038674 | CONDO ASSOCIATION | N/A | C | 0 | 1808 WEST BELTLINE HIGHWAY | MADISON | WI | 53713 | WI | ||||||||
| QUALITY DRUG CORPORATION | |||||||||||||||||
| 330644268 | PHARMACY BENEFITS | N/A | C | 0 | 239 BROADWAY | LAGUNA BEACH | CA | 92651 | CA | ||||||||
| PARTNERS GROUP PMC PRIVATE CREDIT LP | |||||||||||||||||
| C/O MAPLES CORPORATE SERVICES LTD | GRAND CAYMAN | CJ | 981439264 | INVESTMENT | CJ | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION | ||
| B | $142,794 | CASH |
| GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION | ||
| C | $151,568 | BOOK |
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