ST ANTHONY SHAWNEE HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ST ANTHONY SHAWNEE HOSPITAL INC (EIN 45-5055149)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-18
IRS object ID
201503229349300205
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-18T09:00:20-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11111 Bagby Street Suite 4500AddressLine1Txt
CityHoustonCityNm
State AbbreviationTXStateAbbreviationCd
ZIP77002ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN455055149EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Anthony Shawnee Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTANBusinessNameControlTxt
Phone4053955626PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 Woodfield LaneAddressLine1Txt
CitySt LouisCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63132ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJune L PickettPersonNm
Person TitleSecretaryPersonTitleTxt
Signature2015-11-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrooke Kitchen McNeilPreparerPersonNm
PTINP00849302PTIN
Phone7139822000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1William ThompsonBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110101 Woodfield LaneAddressLine1Txt
CitySt LouisCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63132ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$70,724,300GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ssmhealth.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateOKLegalDomicileStateCd
Activity Or MissionTO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACH.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee674TotalEmployeeCnt
Total Volunteers48TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$36,027PYContributionsGrantsAmt
CY Contributions Grants$17,110CYContributionsGrantsAmt
PY Program Service Revenue$71,878,172PYProgramServiceRevenueAmt
CY Program Service Revenue$69,314,842CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income-$17,767CYInvestmentIncomeAmt
PY Other Revenue$969,234PYOtherRevenueAmt
CY Other Revenue$1,145,972CYOtherRevenueAmt
PY Total Revenue$72,883,433PYTotalRevenueAmt
CY Total Revenue$70,460,157CYTotalRevenueAmt
PY Grants And Similar Paid$11,600PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$50,268CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$37,496,075PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$31,706,432CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$33,123,519PYOtherExpensesAmt
CY Other Expenses$33,680,990CYOtherExpensesAmt
PY Total Expenses$70,631,194PYTotalExpensesAmt
CY Total Expenses$65,437,690CYTotalExpensesAmt
PY Revenues Less Expenses$2,252,239PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,022,467CYRevenuesLessExpensesAmt
Total Assets BOY$78,147,476TotalAssetsBOYAmt
Total Assets EOY$88,959,523TotalAssetsEOYAmt
Total Liabilities BOY$54,848,248TotalLiabilitiesBOYAmt
Total Liabilities EOY$60,637,828TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,299,228NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,321,695NetAssetsOrFundBalancesEOYAmt
MissionTHROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$54,900,832ExpenseAmt
Grant$50,268GrantAmt
Revenue$69,314,842RevenueAmt
DescPlease see Schedule O for a complete description of program service accomplishments.Desc
Total Program Service Expenses$54,900,832TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee674EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOKStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jennifer PierceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4053955626PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11102 W McArthurAddressLine1Txt
CityShawneeCityNm
State AbbreviationOKStateAbbreviationCd
ZIP74801ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
William Thompson
Director & Vice Chair1.0055.00Yes (X)Yes (X)$0$3,248,929$2,256,052
Sr Mary Jean Ryan FSM
Director & Chairperson1.009.00Yes (X)Yes (X)$0$0$0
Joe Hodges
Director & President1.0043.00Yes (X)Yes (X)$0$713,630$399,333
MT Berry
Director1.002.00Yes (X)$0$0$0
Martha Burger
Director1.002.00Yes (X)$0$0$0
Mike Collison
Director1.002.00Yes (X)$0$0$0
David Harlow
Director1.002.00Yes (X)$0$0$0
Jenee Lister
Director1.003.00Yes (X)$0$0$0
Judith Love
Director1.003.00Yes (X)$0$0$0
John Richels
Director1.002.00Yes (X)$0$0$0
Kersey Winfree MD
Director1.0043.00Yes (X)$0$505,310$164,600
Margaret Salyer
Director1.002.00Yes (X)$0$0$0
Georgette Toma MD
Director1.0011.00Yes (X)$0$107,700$0
Marion McMillan
Director1.001.00Yes (X)$0$0$0
Natalie Shirley
Director1.001.00Yes (X)$0$0$0
June Pickett
Secretary0.1042.70Yes (X)$0$253,530$146,963
Kris Zimmer
Treasurer1.0056.00Yes (X)$0$956,951$412,836
Ramona Carey
Assistant Secretary1.0041.00Yes (X)$0$75,328$88,359
Paula Friedman
Vice President1.0053.00Yes (X)$0$729,173$396,619
Shasta Manuel
Regional VP Finance/CFO10.0031.00Yes (X)$0$363,653$82,462
Charles Skillings
Hospital President40.000Yes (X)$0$356,189$104,270
Angela Mohr
Executive Vice President40.000$165,206$0$35,366Yes (X)
David Heon
Physician40.000$314,362$0$48,636Yes (X)
Gaynell Anderson
Physician40.000$339,566$0$37,630Yes (X)
David Hadley
Physician40.000$317,843$0$30,169Yes (X)
Kenneth Darvin
Physician40.000$301,654$0$45,964Yes (X)
Lara Mashek
Physician40.000$250,558$0$32,509Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,689,189TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,310,393TotReportableCompRltdOrgAmt
Total Other Compensation$4,281,768TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K18IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
CLINICAL PARTNERS PA
7032 COLLECTION CENTER DRIVECHICAGOIL60693ANESTHESIA BILLING$1,823,857
SODEXO MANAGEMENT INC
PO BOX 536922ATLANTAGA303536922DIETARY AND ENVIRO SERVICES$1,017,020
SHAWNEE SURGICAL SERVICES LLC
PO BOX 68SHAWNEEOK74802SURGERY CENTOR DIRECTOR/MANAGEMENT FEES$585,012
SLEEPELITE OF SHAWNEE LLC
BMB 444MIDWEST CITYOK73130SLEEP LAB STUDIES$472,5002150 S DOUGLAS BLVD STE C
SODEXO INC AND AFFILIATES
500 ROSS ST 154-0455PITTSBURGPA152620001DIETARY AND ENVIRO SERVICES$325,777
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K20CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Government Grants$10,760GovernmentGrantsAmt
All Other Contributions$6,350AllOtherContributionsAmt
Total Contributions$17,110TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$67,179,494TotalRevenueColumnAmt
Related Or Exempt Func Income$67,179,494RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,135,348TotalRevenueColumnAmt
Related Or Exempt Func Income$2,135,348RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$69,314,842TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$603,578RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$80,637RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$522,941RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$522,941TotalRevenueColumnAmt
Exclusion$522,941ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$17,767OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$17,767OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$17,767TotalRevenueColumnAmt
Exclusion-$17,767ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$153,060GrossSalesOfInventoryAmt
Cost Of Goods Sold$165,739CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$12,679TotalRevenueColumnAmt
Exclusion-$12,679ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA REVENUE722320$535,772$535,772
JOINT VENTURE INCOME900099$99,938$99,938

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$635,710OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,460,157TotalRevenueColumnAmt
Related Or Exempt Func Income$69,314,842RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,128,205ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$50,268TotalAmt
Program Services$50,268ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$561,108TotalAmt
Management And General$561,108ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$22,494,013TotalAmt
Program Services$17,925,761ProgramServicesAmt
Management And General$4,568,252ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,298,587TotalAmt
Program Services$1,019,035ProgramServicesAmt
Management And General$279,552ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,743,074TotalAmt
Program Services$4,502,741ProgramServicesAmt
Management And General$1,240,333ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,609,650TotalAmt
Program Services$1,251,917ProgramServicesAmt
Management And General$357,733ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$323,000TotalAmt
Management And General$323,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,695TotalAmt
Management And General$1,695ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$141,168TotalAmt
Management And General$141,168ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,684,409TotalAmt
Program Services$6,082,147ProgramServicesAmt
Management And General$1,602,262ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$136TotalAmt
Management And General$136ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,576,975TotalAmt
Program Services$4,461,379ProgramServicesAmt
Management And General$115,596ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,419,424TotalAmt
Program Services$1,390,022ProgramServicesAmt
Management And General$29,402ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,108,043TotalAmt
Program Services$1,063,463ProgramServicesAmt
Management And General$44,580ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$91,233TotalAmt
Program Services$62,012ProgramServicesAmt
Management And General$29,221ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$11,791TotalAmt
Program Services$1,449ProgramServicesAmt
Management And General$10,342ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,263,128TotalAmt
Program Services$2,263,128ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,416,353TotalAmt
Program Services$4,042,395ProgramServicesAmt
Management And General$373,958ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$832,920TotalAmt
Management And General$832,920ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$8,564,909$8,564,909
MEDICAID PROVIDER TAX$1,953,393$1,953,393
LICENSES AND TAXES$56,134$53,560$2,574
MIscellaneous$236,279$213,253$23,026

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$65,437,690TotalAmt
Program Services$54,900,832ProgramServicesAmt
Management And General$10,536,858ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$209,723BOYAmt
EOY$558,782EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,221,211BOYAmt
EOY$12,538,661EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,079,677BOYAmt
EOY$2,473,871EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$631,226BOYAmt
EOY$848,654EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$59,756,683LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,891,307LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,783,838BOYAmt
EOY$47,865,376EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$21,933,262BOYAmt
EOY$21,933,262EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,288,539BOYAmt
EOY$2,740,917EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$78,147,476BOYAmt
EOY$88,959,523EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,508,734BOYAmt
EOY$15,008,837EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,339,514BOYAmt
EOY$45,628,991EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$54,848,248BOYAmt
EOY$60,637,828EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,299,228BOYAmt
EOY$28,321,695EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,299,228BOYAmt
EOY$28,321,695EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$78,147,476BOYAmt
EOY$88,959,523EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,022,467ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$2,662GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$2,662TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYFormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND PORTIONS OF THE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,000,668OtherCostOrOtherBasisAmt
Book Value$2,000,668BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,286,171OtherCostOrOtherBasisAmt
Depreciation$1,336,274DepreciationAmt
Book Value$13,949,897BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,432,502OtherCostOrOtherBasisAmt
Depreciation$10,555,033DepreciationAmt
Book Value$6,877,469BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,037,342OtherCostOrOtherBasisAmt
Book Value$25,037,342BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$47,865,376TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DUE TO AFFILIATES
INTERCO LOANS PAYABLE$40,780,002
PENSION FUNDING LIABILITY$913,132
CAPITAL LEASE OBLIGATION$3,935,857
FieldValueIRS element (for citing)
Total Liability$45,628,991TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationST. ANTHONY SHAWNEE HOSPITAL, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH (SSMH), A RELATED ORGANIZATION. SSMH EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS IN 2014 OR 2013.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailablefalseReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$423,588TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$423,588NetCommunityBenefitExpnsAmt
Total Expense0.0065TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,739,631TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,359,145DirectOffsettingRevenueAmt
Net Community Benefit Expns-$619,514NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$11,163,219TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,359,145DirectOffsettingRevenueAmt
Net Community Benefit Expns-$195,926NetCommunityBenefitExpnsAmt
Total Expense0.0065TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$30,917TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,620DirectOffsettingRevenueAmt
Net Community Benefit Expns$27,297NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$193,800TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$200DirectOffsettingRevenueAmt
Net Community Benefit Expns$193,600NetCommunityBenefitExpnsAmt
Total Expense0.0030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$224,717TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,820DirectOffsettingRevenueAmt
Net Community Benefit Expns$220,897NetCommunityBenefitExpnsAmt
Total Expense0.0034TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$11,387,936TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,362,965DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,971NetCommunityBenefitExpnsAmt
Total Expense0.0098TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$4,647,469BadDebtExpenseAmt
Reimbursed By Medicare$20,309,863ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,108,040CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,798,177MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1SHAWNEE SURGICAL REALTY LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMEDICAL BUILDINGPrimaryActivitiesTxt
Org Profit Or Ownership0.25OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.75PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST ANTHONY SHAWNEE HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11102 W MCARTHURAddressLine1Txt
CitySHAWNEECityNm
State AbbreviationOKStateAbbreviationCd
ZIP74801ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SSMHEALTH.COMWebsiteAddressTxt
State License2162StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST ANTHONY SHAWNEE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.stanthonyshawnee.com/pages/chna.aspxOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.SSMHEALTH.COM/SYSTEM/EXCEPTIONAL-CARE/WHAT-WE-MEAN/CHNA/OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.stanthonyshawnee.com/Pages/CHNA.aspxStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care2.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care4.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - St Anthony Shawnee Hospital. The participation by a largely diverse group of community leaders who shared their time and expertise in regard to the health status of the community contributed to the overall strength of the CHNA. Community partners were identified that are knowledgeable about the state of Pottawatomie County, as well as the City of Shawnee. Those identified included: Pottawatomie County Health Department, the Oklahoma Department of Human Services, the United Way of Pottawatomie County, Gateway to Prevention and Recovery, Growthlines, and COEDD Area Agency on Aging. A complete list of organizations and individuals participating can be found in Appendix 1 of the CHNA. A list of interview questions used to gather information from the community partners can be found in Appendix 2 of the CHNA. After the completion of the data analysis, a web-based survey tool was utilized that allowed for ranking and prioritization of the identified needs. The survey was distributed to close to 100 participants through an email mechanism including participating community partners and representatives in the medical and nursing field, the faith community, case management, hospital/practice management, public health, school officials, as well as patient and family advocates.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - St Anthony Shawnee Hospital. SSM Health's mission statement is "Through our exceptional health care services, we reveal the healing presence of God." The strategic priorities of the community benefit plan as identified in the most recent community health needs assessment (CHNA) are: obesity, heart disease, and prescription drug abuse. Our needs assessment was completed June 2012 and adopted as part of our strategic plan in November 2012 and adopted as part of our strategic plan. Goals and objectives were established to change behavior, provide metrics to measure change, and to impact the overall health of those we serve. All of the community benefit activities are designed to meet the needs identified in the CHNA. The St Anthony Shawnee 2012 - 2015 CHNA showed that in Pottawatomie County, 34% of the adult residents are identified as obese, with only 15% (1 in 7) reporting eating fruits and vegetables five times a day. This places Oklahoma at 51st in the nation. A myriad of social, economic, and environmental factors combine to discourage the efforts of monitoring calorie intake, choosing healthy foods, and increasing physical activity. The Nutritional Services Department of the hospital not only provides meals for hospitalized patients, but operates a full service cafe for employees and visitors. Increasing the availability of healthy options, with a focus on increasing fruits and vegetables in the diet, as well as educating employees, will not only affect their health but make an impact on their families as well. The Cafe, operated by the Nutritional Services Department, was instrumental in making an impact on the employees (and subsequently their families) through healthy options by increasing the visibility of fruits and vegetables in The Cafe, providing nutritional snacks at meetings, providing educational offerings on importance of fruits and vegetables, and implementing alternatives for fried foods. Marketing assisted with this initiative by providing information through the email and MyNews, as well as publishing the weekly menu with the healthier options highlighted. The following goals were established in 2014 to address obesity: * Goal: Increase the contribution and variety of fruits and vegetables sold in the cafe by 10%, the hospital will continue to monitor sales to determine the percentage increase in sales; healthy options in the cafe were increased * Goal: Decrease the number of admitted diabetic patients with a body mass index greater than 30, established a program to insure eligible patients receive counseling and instruction from a dietician The St Anthony Shawnee 2012 - 2015 CHNA indicated Heart Disease is the leading cause of death for Pottawatomie County, with 242.3/10,000 compared to the national average of 190.1. In addition, Oklahoma ranked 49th worst in the nation for lack of physical activity at 31% (as reported by the 2011 State of the State's Health Report). Heart Disease alone accounts for over $90 million a year in medical cost for Pottawatomie County and is the number one cause of death for all ages. Not only has the hospital provided medical care and treatment of patients with heart disease, there has been a focus on education to recognize symptoms of heart attack, as well as care for prevention of heart disease. St Anthony Shawnee Hospital will strive to increase educational initiatives and opportunities for heart disease awareness, In 2014, educational opportunities were the focus for the importance placed on "movement" as a positive term versus the sometimes negative connotation of "exercise" with emphasis in everyday life. This was seen in the February Heart Month awareness as well as the development of the first annual walk/run and educational expo for employees and the community. * Goal: sponsor the first ever employee/community walk/run, 65 registered participants in the 5K Harvest Health Hustle and 5 in the family walk * Goal: Reduce the readmissions rate for Congestive Heart Failure (CHF) patients, established a baseline percentage of 22% and developed a program for a follow-up clinic that will see patients within five business days of discharge to supplement current discharge phone calls The St Anthony Shawnee 2012 - 2015 CHNA indicated many societal and health factors have influenced the increase in the use and ease of availability of prescription pain medication. The ten-year trend for deaths due to drug overdose has been on a significant upward trend for the state of Oklahoma with a greater than 100% increase. According to the Oklahoma Bureau of Narcotics State Medical Examiner, three fourths of drug overdose deaths are attributable to prescription drugs. In Pottawatomie County, 17.9-21.0% of drug overdose deaths are attributable to prescription drug abuse ranking the County 25th in the state. While the specific numbers were not available for Pottawatomie County, it is interesting to note that the ten year trend for deaths due to drug overdose has been on a significant upward trend for the state of Oklahoma, with a greater than 100% increase. According to the Oklahoma Bureau of Narcotics: Oklahoma State Medical Examiner, three-fourths of these deaths are attributable to prescription drugs. St Anthony Shawnee Hospital has identified several avenues to impact the use of prescription pain medication, such as offering a variety of alternative methods for chronic and acute pain treatment. Having knowledgeable medical staff in regard to opiate use and alternative options further enhances the health benefits of the community. In addition, creating mechanisms to removed unused and expired drugs in a home creates a safer, healthier community. * Goal: After completion of training during the year on pain medications and alternative therapies, one-third of the physicians will indicate a change in their current practice, after completion of the Prescription Drug Abuse training 31% indicated they would make a change to current practice. * Goal: Decrease deaths in Pottawatomie County attributable to prescription drug abuse, established a baseline percentage of 800 To determine the community needs the hospital could address, the hospital used a point rating system to identify the top ten community needs. A full list of needs and points totals can be found in Appendix 4 of the CHNA. St. Anthony Shawnee's internal work group further refined the list to determine which of the top ten identified needs would develop into strategic action plans. This was done by using an internal rating scale that considered: the number of people in the PSA that are affected by the problem; how well the concern aligns with the hospital's mission and strategies, what resources are required to address the issue; and could the health need be measurably impacted. This process resulted in four needs being prioritized. Even though there was an extensive list of identified community health needs, there are existing that include services and agencies that work to meet those needs. See pages 25 and 26 of the CHNA for a list of existing community resources.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
FAMILY HEALTHCARE ASSOCIATES
3204 MEDICAL PARKSHAWNEEOK74804PHYSICIAN - FAMILY HEALTH
HEART CENTER AT ST ANTHONY SHAWNEE
3208 MEDICAL PARK DRIVESHAWNEEOK74804CARDIOLOGIST
URGENT CARE CLINIC
1900 GORDIN COOPERSHAWNEEOK74804URGENT CARE CLINIC
MULTISPECIALTY CLINIC AT ST ANTHONY
3200 MEDICAL PARKSHAWNEEOK74804PHYSICIAN - SPECIALTY
SURGERY CENTER AT ST ANTHONY SHAWNEE
1106 W MCARTHURSHAWNEEOK74804OUTPATIENT SURGERY

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3b ELIGIBILITY FOR DISCOUNTED CAREServices eligible under the financial assistance policy will be made available to the patient on a sliding fee scale, in accordance with financial need, as determined in reference to Federal Poverty Levels (FPL) in effect at the time of the determination. The basis for the amounts the hospital will charge patients qualifying for financial assistance is as follows: Patients whose family income is above 200% but not more than 400% of the FPL are eligible to receive discounted services at amounts no greater than the amounts generally billed to the hospital's commercially insured or Medicare patients.
Schedule H, Part I, Line 3c DISCOUNTED CARE EXCEPTIONSPatients whose family income exceeds 400% of the 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; however the discounted rates shall not be greater than the amounts generally billed to commercially insured [or Medicare] patients. 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. The hospital may utilize predictive analytical software or other criteria to assist in making a determination of financial assistance eligibility in situations where the patient qualifies for financial assistance but has not provided the necessary documentation to make a determination. This process is called "presumptive eligibility."
Schedule H, Part I, Line 6a COMMUNITY BENEFIT ANNUAL REPORTSt. Anthony Shawnee Hospital, Inc. is part of the integrated health system known as SSM Health. In an effort to strengthen its community benefit program, SSM Health plans for, measures, and communicates community benefits provided to persons who are low income, the unpaid costs of public programs and other activities that respond to community need, improve community health, or reach out to low income and vulnerable persons.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceFinancial Assistance Methodology: The cost of financial assistance is calculated in compliance with catholic health association (CHA) guidelines. A cost to charge ratio calculated using the IRS worksheet 2, ratio of patient care cost to charges, was used to compute financial assistance at cost. This is the ratio of total adjusted operating expense to total gross patient revenue. The gross revenue amount is a gross amount - prior to contractual adjustments and bad debts. Both gross revenue and costs are based on charges at date/time of service. Unreimbursed Medicaid Costing Methodology: The cost of unreimbursed Medicaid is calculated in compliance with Catholic Health Association(CHA) guidelines. A cost to charge ratio calculated utilizing IRS Worksheet 2, Ratio of patient care cost to charges, was used to compute unreimbursed Medicaid costs. This is the ratio of total adjusted operating expenses to total gross patient revenue. The gross revenue amount is gross amount - prior to contractual adjustments and bad debts. Both gross revenue and costs are based on charges at date/time of service. Community health improvement services and community benefit operations costing methodology: The costs for these programs were derived from the actual costs incurred in these areas. Subsidized health services costing methodology: The expenditures are determined based on actual invoices or dollar amounts spent and charged to these departments, reduced by any grant revenues restricted for these services, if any. Research costing methodology: Research expenses were taken from the income and expense statements for the research departments, derived from the accounting system. Cash and In-Kind contributions to community groups costing methodology: Contribution expenditures are based on actual invoices that were captured and reported for this program, derived from the accounting system.
Schedule H, Part II Community Building ActivitiesSt Anthony Shawnee Hospital participates in a wide array of community and civic organizations in the promotion of health care and community building activities. Specific activities reported in Part II of Schedule H include the following: Community Support - Coalition Building: Hospital representation at community coalition of Local Emergency Planning Committee for community health and safety which enhances health and advances knowledge. Hospital representation on the local United Way Board of Directors and participation in the United Way campaign. Hospital representation on the local YMCA Board of Directors.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountBad debt expense reported in the accounting system, adjusted for bad debt recoveries, was used, multiplied by the cost to charge ratio using IRS Worksheet 2, Ratio of patient costs to charges.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologySt. Anthony Shawnee Hospital, Inc. did not make an estimate of the organization's bad debt attributable to patients eligible under the organization's financial assistance policy.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteSt. Anthony Shawnee Hospital, nc. is part of the SSM Health consolidated audit. The footnote that references bad debt expense in the December 31, 2014 consolidated audit is contained on page 16 and 17 of the attached financial statements.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsThe cost of providing care to Medicare eligible patients is greater than the reimbursement that Medicare allows on the Medicare cost report. St. Anthony Shawnee Hospital, Inc. considers this shortfall as a component of community benefit because the reimbursement is not negotiated and services are provided regardless of the patients' ability to pay. The Medicare costs reported on Line 6 were obtained from the 2014 Medicare cost report.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceSt. Anthony Hospital Shawnee, Inc. has 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 Health Center embraces its responsibility to serve the communities in which it participates by establishing sound business practices. The Health Center's 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 statement 2. Extraordinary Collection Activity (ECAs) may not occur until bad debt placement and only after the expiration of the notification period. 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 St. Anthony Hospital Shawnee, Inc. collection and financial assistance policies.
Schedule H, Part V, Section B, Line 16a FAP website- ST ANTHONY SHAWNEE HOSPITAL: Line 16a URL: WWW.SSMHEALTH.COM/SYSTEM/EXCEPTIONAL-CARE/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16b FAP Application website- ST ANTHONY SHAWNEE HOSPITAL: Line 16b URL: WWW.SSMHEALTH.COM/SYSTEM/EXCEPTIONAL-CARE/FINANCIAL-ASSISTANCE;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- ST ANTHONY SHAWNEE HOSPITAL: Line 16c URL: WWW.SSMHEALTH.COM/SYSTEM/EXCEPTIONAL-CARE/FINANCIAL-ASSISTANCE;
Schedule H, Part VI, Line 2 Needs assessmentSSM Health (SSM) 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 SSM'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, SSM'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 the following 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 data to 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 community stakeholders; and send results to finance for submission to the Internal Revenue Service (IRS). CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: * Collect and enter data: Send out emails reminding staff to submit activities; enter data into Lyon; and run reports to share with leaders. * Finalize and report on prior year: Enter all prior year data into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. System Office staff and leaders oversee and monitor SSM's Community Benefit Program, and ensure reporting is in compliance with IRS regulations. In collaboration with community stakeholders and partner organizations, all hospital CHNAs were completed, approved, and integrated into the organization's strategic plan. We continue to monitor and assess the progress of our local efforts in the spirit of caring for others and improving community health.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceAll SSMH facilities will strive to provide exceptional health care services to all persons in need regardless of their ability to pay. All billing and collection policies reflect the mission and values of SSMH, including our special concern for people who are poor and vulnerable. SSMH facilities offer discounts for hospital services to all uninsured persons. Self-pay discounts apply to everyone who does not have health insurance, no matter their ability to pay. SSMH applies its charity care policies fairly and consistently. Each person is treated as an individual with specific needs for assistance without regard to payment. SSMH embraces its responsibility to serve the communities in which we participate by establishing sound business practices. Charity care is provided to patients based on a sliding scale for household incomes up to four times the federal poverty level. Patients whose household income is no more than two times the federal poverty level are eligible for free hospital services. In addition, an exception to the sliding scale is provided for a patient's balance due if the amount is too large to be reasonably paid through an installment plan over four years given the family income and expenses. 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
Schedule H, Part VI, Line 4 Community informationSt Anthony Shawnee Hospital is located in Shawnee, Oklahoma, in the northern section of Pottawatomie County. Pottawatomie County, with a population of 70,424 is considered the Primary Service area (PSA). The Pottawatomie County is predicted to experience a projected growth rate of 3.16% by 2016. This is only slightly higher than the projected growth rate for the state of Oklahoma, at 3%, and lower than the national projection of 4%. When comparing 2011 data and projections for 2016, it shows a negative growth rate for the 15 - 17 and 25 - 54 age groups. Estimates suggest that the largest growing segment of the population from 2011 to 2016 will be the 65+ cohort, with an estimated increase of 1.3% to reach 16% of the county's population by 2016. Additional detailed information concerning the demographic data of the St Anthony Shawnee service area can be found on pages 12 through 19 of the CHNA. St Anthony Shawnee Hospital is a 114 bed facility providing health care services for close to 50 years to Shawnee and the surrounding communities of Pottawatomie County. To address the healthcare needs, St Anthony Shawnee Hospital is comprised of two campus locations with acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, heart cath lab, diagnostic imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services.
Schedule H, Part VI, Line 5 Promotion of community healthSt. Anthony Shawnee Hospital, Inc. participates 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. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. Focusing on a broad definition of health, St. Anthony Shawnee Hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Anthony Hospital Shawnee, Inc. promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. St. Anthony Shawnee Hospital, Inc. also furthers its 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, * Has a governing body in which independent persons representative of the community comprise a majority * 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.
Schedule H, Part VI, Line 6 Affiliated health care systemST. ANTHONY SHAWNEE HOSPITAL IS A 501(C) (3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE. ALONG WITH SSM HEALTH CARE OF OKLAHOMA, INC. THE HOSPITAL IS PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE FOR THE CENTRAL OKLAHOMA REGION.
Schedule H, Part VI, Line 7 State filing of community benefit reportIL, MO, OK, WI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST GREGORY'S UNIVERSITYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 W MacArthur StreetAddressLine1Txt
CityShawneeCityNm
State AbbreviationOKStateAbbreviationCd
ZIP74804ZIPCd
FieldValueIRS element (for citing)
Recipient EIN730685198RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$40,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantNURSING PROGRAMPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant FundsThe organization's grants were made to organizations tax exempt under IRC Section 501(c)(3). These organizations have developed internal controls procedures for the use of grant funds.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.The organization's grants were made to organizations tax exempt under IRC Section 501(c)(3). These organizations have developed internal controls procedures for the use of grant funds.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William Thompson
Director & Vice Chair$0$1,807,984$0$0$0$1,440,945$0$2,228,684$0$27,368$0$5,504,981$0$90,580
Joe Hodges
Director & President$0$633,413$0$0$0$80,217$0$364,886$0$34,447$0$1,112,963$0$42,700
Kersey Winfree MD
Director$0$461,752$0$0$0$43,558$0$138,540$0$26,060$0$669,910$0$14,320
June Pickett
Secretary$0$230,695$0$0$0$22,835$0$130,612$0$16,351$0$400,493$0$8,960
Kris Zimmer
Treasurer$0$853,676$0$0$0$103,275$0$382,451$0$30,385$0$1,369,787$0$50,610
Ramona Carey
Assistant Secretary$0$72,979$0$0$0$2,349$0$71,192$0$17,167$0$163,687$0$0
Paula Friedman
Vice President$0$640,295$0$0$0$88,878$0$377,167$0$19,452$0$1,125,792$0$33,950
Shasta Manuel
Regional VP Finance/CFO$0$344,482$0$0$0$19,171$0$60,675$0$21,787$0$446,115$0$12,520
Charles Skillings
Hospital President$0$319,825$0$0$0$36,364$0$77,840$0$26,430$0$460,459$0$21,350
Angela Mohr
Executive Vice President$158,165$0$0$0$7,041$0$14,196$0$21,170$0$200,572$0$5,400$0
David Heon
Physician$311,200$0$0$0$3,162$0$18,465$0$30,171$0$362,998$0$0$0
Gaynell Anderson
Physician$336,643$0$0$0$2,923$0$14,684$0$22,946$0$377,196$0$0$0
David Hadley
Physician$316,584$0$0$0$1,259$0$7,449$0$22,720$0$348,012$0$0$0
Kenneth Darvin
Physician$300,100$0$0$0$1,554$0$17,043$0$28,921$0$347,618$0$0$0
Lara Mashek
Physician$249,934$0$0$0$624$0$10,719$0$21,790$0$283,067$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up paymentsThe following individuals listed on Part VII, Section A received a tax indemnification/gross up payment in 2014. The payment was included in their taxable compensation. Gaynell Anderson Kenneth Darvin Lara Mashek
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationThe 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 SSM Health (SSMH) President.
Schedule J, Part I, Line 4a Severance or change-of-control paymentSSMH has adopted a severance policy to provide a financial transition in the event of involuntary termination without cause for executive level positions. The amount of the compensation is based on the position held and length of service with SSMH. No reportable individuals listed on Part VII of Form 990 received payments from this plan during 2014.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planPension 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 SSMH's 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 reportable individuals listed on Part VII of Form 990 received distributions from this plan during 2014. 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 2008 or after, the distribution will occur after the completion of two 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 2014. All distributions received from the plan in the current year were included in the individuals' taxable compensation. William Thompson $ 90,701 Kris Zimmer $ 50,811 Joe Hodges $ 42,757 Paula Friedman $ 39,621 Charles Skillings $ 21,378 Kersey Winfree, MD $ 17,589 Shasta Manuel $ 12,537 June Pickett $ 11,398 Angela Mohr $ 5,407

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a Description of Program ServiceBriefly describe the organization's mission: Since it was founded in 1872 by catholic sisters, SSM Health (SSM) has existed to meet the health needs of the communities it serves. SSM is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through one of the largest integrated delivery systems in the nation. With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSM includes 18 acute care hospitals, one children's hospital, more than 60 outpatient care sites, a pharmacy benefit company, an insurance company, two long-term care facilities, comprehensive home care and hospice services, a technology company, and two Accountable Care Organizations. The health system employs approximately 30,000 people and is affiliated with more than 8,000 physicians making it one of the largest employers in every community it serves. SSM is sponsored by SSM Health Ministries, an independent 6-member body comprised of three Franciscan Sisters of Mary and three lay people who collectively hold certain reserved powers over SSM. In the tradition of its founding sisters, SSM strives to fulfill its mission by providing exceptional health care to everyone who comes to its hospitals, regardless of their ability to pay. About St. Anthony Shawnee Hospital: St. Anthony Shawnee Hospital is a 114-bed facility providing health care services for over 50 years to Shawnee and the surrounding communities of Pottawatomie County to address the healthcare needs. St Anthony Shawnee Hospital along with SSM Health Care of Oklahoma comprise the Oklahoma region of SSMH. St Anthony Shawnee Hospital is comprised of two campus locations with acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, heart cath lab, diagnostic imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services. According to the 2014 Hospital Consumer Assessment of Healthcare Providers and Systems, St. Anthony Shawnee Hospital scored above both the national average and average for Oklahoma hospitals in nine out of eleven patient satisfaction categories, demonstrating the hospital's continued commitment to high-quality care. The Women's Center at St. Anthony Shawnee Hospital has been recognized by the Immunization Action Coalition (IAC) for achieving one of the highest rankings in the nation for its work to immunize newborns against the hepatitis B virus. St. Anthony Shawnee Hospital is the only hospital in Oklahoma on the Immunization Action Coalition's Hepatitis B Honor Roll, with a coverage rate of 97 percent. Describe the organization's approach to providing community benefit: SSM Health (SSM) 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 SSM'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, SSM'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 the following 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 data to 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 community stakeholders; and send results to finance for submission to the Internal Revenue Service (IRS). CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: * Collect and enter data: Send out emails reminding staff to submit activities; enter data into Lyon; and run reports to share with leaders. * Finalize and report on prior year: Enter all prior year data into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. System Office staff and leaders oversee and monitor SSM's Community Benefit Program, and ensure reporting is in compliance with IRS regulations. In collaboration with community stakeholders and partner organizations, all hospital CHNAs were completed, approved, and integrated into the organization's strategic plan. We continue to monitor and assess the progress of our local efforts in the spirit of caring for others and improving community health. Description of CHNA Community Benefit Programs: For more information on CHNA Community Benefit Programs provided by St. Anthony Shawnee Hospital, please see Schedule H, Part V. Organizational description for tax exemption: In addition to its CHNA community benefit activities, St. Anthony Hospital Shawnee, Inc. participates 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. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. Focusing on a broad definition of health, St. Anthony Shawnee Hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Anthony Hospital Shawnee, Inc. promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. St Anthony Shawnee, along with three Catholic healthcare systems, is partnering with St Gregory University in Shawnee to establish a Catholic nursing program. The program will offer the traditional Bachelor of Nursing degree and a bridge program to the Bachelor of Science in Nursing, The program will provide new nurses with significant clinical experience and help meet the needs for current and future nurses. St. Anthony Hospital Shawnee, Inc. also furthers its exempt purpose with the following activities: * Operates a Level III Trauma 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, * Has a governing body in which independent persons representative of the community comprise a majority * 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.
Form 990, Part III, Line 4b Description of Program Service (Continued)Describe the organization's financial assistance policies or programs (e.g., charity care, discounting) for low-income persons and how they are communicated to the public: For information on the financial assistance policies provided by St. Anthony Shawnee Hospital, please see Schedule H. Quantifiable Community Benefit: This section includes a list of the types of programs and services that could be included as community benefit activities: Traditional Charity Care $ 423,588 Unpaid Cost of Medicare $ 2,798,177 Cost of Bad Debt $ 4,647,469 Community Benefit Programs $ 220,897 Total Quantifiable Community Benefit $ 8,090,131
Form 990, Part VI, Line 6 Classes of members or stockholdersTHE SOLE CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF OKLAHOMA, INC. SSM HEALTH CARE OF OKLAHOMA, INC. IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH ST. ANTHONY SHAWNEE HOSPITAL, INC. AND SSM HEALTH CARE OF OKLAHOMA, INC. ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE MEMBER HAS THE POWER TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO DIRECTORS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE 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 APPOINTED DIRECTORS AND THE EX-OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE Certificate 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 AUTHORIZE OR 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 STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN 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 INTERESTS 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 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 member, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER of the member AS DETERMINED BY THE MEMBER of the member. Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER of the member, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE 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 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.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyACCOUNTING/FINANCE PERSONNEL AT EACH SSMH (SSM HEALTH SYSTEM) ENTITY, IN CONJUNCTION WITH SYSTEM FINANCE PERSONNEL, PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE SYSTEM OFFICE FOR FINAL REVIEW AND COORDINATION OF THE SYSTEM LEVEL FORM 990 INFORMATION. SSMH PERSONNEL PREPARE THE FORM 990 AND SUBMIT THE COMPLETED FORM 990 TO AN OUTSIDE TAX CONSULTING FIRM WHO REVIEWS THE FORM 990 AND SIGNS AS PAID PREPARER. A COMPLETE COPT OF THE RETURN IS PROVIDED TO THE BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
Form 990, Part VI, Line 12c Conflict of interest policyBOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO 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 DECISION ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END.
Form 990, Part VI, Line 19 Required documents available to the publicTHE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR SSM HEALTH ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE OKLAHOMA 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 VIII, Line 2f Other Program Service RevenueOTHER PROGRAM SERVICE REVENUE - Total Revenue: 2135348, Related or Exempt Function Revenue: 2135348, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other FeesMedical Physician, Practitioner, Psychiatrist, Resident, and Therapist - Total Expense: 1610011, Program Service Expense: 1609961, Management and General Expenses: 50, Fundraising Expenses: 0; Recruitment, Consulting, Administrative, and PBS Fees - Total Expense: 3950102, Program Service Expense: 2371264, Management and General Expenses: 1578838, Fundraising Expenses: 0; Medical Lab, Radiology, Transportation - Total Expense: 2124296, Program Service Expense: 2100922, Management and General Expenses: 23374, Fundraising Expenses: 0;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (41 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
SSM Health Care Corporation
10101 Woodfield LaneSt LouisMO63132466029223Health CareMO501(c)(3Type ISSM Health Ministriesfalse
SSMHC Liability Trust I
10101 Woodfield LaneSt LouisMO63132436331003InsuranceMO501(c)(3Type ISSM Health Care Corporationfalse
SSM Consolidated Health Services
10101 Woodfield LaneSt LouisMO63132431473657Health CareMO501(c)(3Type ISSM Health Care Corporationfalse
SSM Policy Institute
10101 Woodfield LaneSt LouisMO63132431788151Health CareMO501(c)(4SSM Health Care Corporationfalse
SSM Health Care Portfolio Management Co
10101 Woodfield LaneSt LouisMO63132431825256ManagementMO501(c)(3Type ISSM Health Care Corporationfalse
SSM Cardinal Glennon Children's Hospital
10101 Woodfield LaneSt LouisMO63132430738490Health CareMO501(c)(33SSM Health Care St Louisfalse
Cardinal Glennon Children's Foundation
10101 Woodfield LaneSt LouisMO63132431754347FundraisingMO501(c)(37SSM Cardinal Glennon Hospitalfalse
SSM DePaul Health Center Foundation
10101 Woodfield LaneSt LouisMO63132431776109FundraisingMO501(c)(37SSM Health Care St Louisfalse
SSM St Joseph Foundation
10101 Woodfield LaneSt LouisMO63132431591556FundraisingMO501(c)(37SSM Health Care St Louisfalse
SSM St Clare Health Center Foundation
10101 Woodfield LaneSt LouisMO63132431273310FundraisingMO501(c)(37SSM Health Care St Louisfalse
SSM St Mary's Health Center Foundation
10101 Woodfield LaneSt LouisMO63132431552945FundraisingMO501(c)(37SSM Health Care St Louisfalse
SSM Health Care of Oklahoma Inc
10101 Woodfield LaneSt LouisMO63132730657693Health CareOK501(c)(33SSM Health Care Corporationfalse
St Anthony Hospital Foundation Inc
10101 Woodfield LaneSt LouisMO63132736104300FundraisingOK501(c)(37SSM Health Care of Oklahomafalse
Dells Medical Building Inc
10101 Woodfield LaneSt LouisMO63132391613292MOBWI501(c)(2SSM Health Care of Wisconsinfalse
St Mary's Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940686FundraisingWI501(c)(37SSM Health Care of Wisconsinfalse
St Clare Health Care Foundation Inc
10101 Woodfield LaneSt LouisMO63132431940683FundraisingWI501(c)(37SSM Health Care of Wisconsinfalse
Home Health United Inc
2802 Walton Commons LaneMadisonWI53718391539827Health CareWI501(c)(39SSM Health Care of Wisconsinfalse
Home Care United Inc
2802 Walton Commons LaneMadisonWI53718391776340Health CareWI501(c)(39SSM Health Care of Wisconsinfalse
HHU Xtra Care Inc
2802 Walton Commons LaneMadisonWI53718391705111Health CareWI501(c)(39SSM Health Care of Wisconsinfalse
Home Health United - VNS Foundation Inc
2802 Walton Commons LaneMadisonWI53718391839309FundraisingWI501(c)(3Type IINAfalse
SSM Regional Health Services
10101 Woodfield LaneSt LouisMO63132440579850Health CareMO501(c)(33SSM Health Care Corporationfalse
St Francis Hospital Foundation
10101 Woodfield LaneSt LouisMO63132431099253FundraisingMO501(c)(37SSM Regional Health Servicesfalse
St Mary's Health Center Jefferson City Missouri Foundation
10101 Woodfield LaneSt LouisMO63132431575307FundraisingMO501(c)(3Type IISSM Regional Health Servicesfalse
Good Samaritan Regional Health Center
10101 Woodfield LaneSt LouisMO63132430653587Health CareIL501(c)(33SSM Regional Health Servicesfalse
St Mary's Hospital Centralia Illinois
10101 Woodfield LaneSt LouisMO63132370662580Health CareIL501(c)(33SSM Regional Health Servicesfalse
St Mary's - Good Samaritan Inc
10101 Woodfield LaneSt LouisMO63132364170833Health CareIL501(c)(3Type ISSM Regional Health Servicesfalse
Good Samaritan Regional Health Center Foundation
10101 Woodfield LaneSt LouisMO63132262884795FundraisingIL501(c)(37St Mary's - Good Samaritan Incfalse
St Mary's Hospital Foundation
10101 Woodfield LaneSt LouisMO63132364636691FundraisingIL501(c)(37St Mary's - Good Samaritan Incfalse
St Mary's Hospital Auxiliary
400 N PleasantCentraliaIL62801237126345FundraisingIL501(c)(39St Mary's Hospital Foundationfalse
SSM Health Businesses
10101 Woodfield LaneSt LouisMO63132431333488Health CareMO501(c)(39SSM Health Care Corporationfalse
SSM Health Care St Louis
10101 Woodfield LaneSt LouisMO63132431343281Health CareMO501(c)(33SSM Health Care Corporationfalse
Centralia Medical Services Bldg Assoc
10101 Woodfield LaneSt LouisMO63132237408025MOBIL501(c)(3Type ISSM Regional Health Servicesfalse
St Mary's Janesville Foundation Inc
2901 Landmark PL Ste 300MadisonWI53713273439133FundraisingWI501(c)(37SSM Health Care of Wisconsinfalse
Franciscan Sisters of Mary
3221 McKelvey Road Suite 107St LouisMO63044431012492Religious OrganizationMO501(c)(1NAfalse
Lee Dewey Corporation
10101 Woodfield LaneSt LouisMO63132731279603MOBOK501(c)(3Type ISSM Health Care of Oklahomafalse
SSM Hospice and Home Care Foundation
10101 Woodfield LaneSt LouisMO63132300012246FundraisingMO501(c)(37SSM Health Businessesfalse
St Mary's Hospital Auxiliary
100 St Marys Medical PlazaJefferson CityMO65101436049878FundraisingMO501(c)(3Type IINAfalse
Good Samaritan Hospital Auxiliary
605 North 12th StreetMt VernonIL62864237049599FundraisingIL501(c)(3Type III-FINAfalse
SSM Health Care of Wisconsin Inc
10101 Woodfield LaneSt LouisMO63132430688874Health CareWI501(c)(33SSM Health Care Corporationfalse
SSM Audrain Health Care Inc
10101 Woodfield LaneSt LouisMO63132431550298Health CareMO501(c)(33SSM Regional Health Servicesfalse
Audrain Medical Center Foundation Inc
620 E Monroe StreetMexicoMO65265431265060FundraisingMO501(c)(3Type ISSM Audrain Health Care Incfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
SSM St Joseph Endoscopy Center LLC
10101 Woodfield LaneSt LouisMO63132270046559Surgery ServicesMONAN/A
St Clare Imaging Services
707 14th Street Suite ABarabooWI53913200122365Diag ServicesWINAN/A
Mt Vernon Radiation Therapy Center LLC
10101 Woodfield LaneSt LouisMO63132201382620Radiation TherapyILNAN/A
Sleep & Neurology Center of S Illinois LLC
10101 Woodfield LaneSt LouisMO63132208468195Diag ServicesILNAN/A
SMHC Surgical Co-Mgmt Company LLC
100 St Marys Medical PlazaJefferson CityMO65101208929305ManagementMONAN/A
SMHC Cardiovascular Co-Mgmt Company LLC
100 St Marys Medical PlazaJefferson CityMO65101208929381ManagementMONAN/A
SMHC Musculoskeletal Co-Mgmt Company LLC
100 St Marys Medical PlazaJefferson CityMO65101208929237ManagementMONAN/A
ChowSMGSI Office Building LLC
10101 Woodfield LaneSt LouisMO63132371383861MOBILNAN/A
Center for Comprehensive Cancer Care LLC
10101 Woodfield LaneSt LouisMO63132201382727MOBILNAN/A
Shawnee Real Estate Holdings LLC
1000 N Lee AveOklahoma CityOK73102455458304MOBOKNAN/A
SSM RX Express LLC
10101 Woodfield LaneSt LouisMO63132264031708PharmacyMONAN/A
Dean Clinic & St Marys Hospital Accountable Care Organization LLC
1808 West Beltline HighwayMadisonWI53713452995500Accountable Care OrganizationWINAN/A
Wisconsin Integrated Information Technology and Telemedicine Systems LLC
1808 West Beltline HighwayMadisonWI53713392016715Information Technology ServicesWINAN/A
Dean Health Holdings LLC
1277 Deming WayMadisonWI53717261594709Support ServicesWINAN/A
Wingra Building Group
1808 West Beltline HighwayMadisonWI53713390237060MOBWINAN/A
Janesville Riverview Clinic Building Partnership
1808 West Beltline HighwayMadisonWI53713396220698MOBWINAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (22 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SSM Managed Care Organization LLC
10101 Woodfield LaneSt LouisMO63132431708511Health PromotionMONAC Corporationfalse
FPP Inc
10101 Woodfield LaneSt LouisMO63132431465174Health CareMONAC Corporationfalse
Diversified Health Services Corp
10101 Woodfield LaneSt LouisMO63132431369305Medical EquipmentMONAC Corporationfalse
SSM Cardio and Thoracic Services Inc
10101 Woodfield LaneSt LouisMO63132260286559Health CareMONAC Corporationfalse
SSM Properties Inc
10101 Woodfield LaneSt LouisMO63132431462486Property ServicesMONAC Corporationfalse
SSM Depaul Medical Group Inc
10101 Woodfield LaneSt LouisMO63132431715106Health CareMONAC Corporationfalse
SSM St Charles Clinic Med Group Inc
10101 Woodfield LaneSt LouisMO63132430626408Physician OfficesMONAC Corporationfalse
Health First Phys Management
10101 Woodfield LaneSt LouisMO63132731534336Medical ServicesOKNAC Corporationfalse
SSMHCS Liability Trust II
10101 Woodfield LaneSt LouisMO63132816128118InsuranceMONAC Corporationfalse
SSM Neurosciences Inc
10101 Woodfield LaneSt LouisMO63132263413981Health CareMONAC Corporationfalse
SSM Medical Group Inc
10101 Woodfield LaneSt LouisMO63132431664107Physician OfficesMONAC Corporationfalse
SSMHC Insurance Company
10101 Woodfield LaneSt LouisMO63132030310431InsuranceCANAC Corporationfalse
SSM Orthopedic Inc
10101 Woodfield LaneSt LouisMO63132271557033Health CareMONAC Corporationfalse
SSM Cancer Care Inc
10101 Woodfield LaneSt LouisMO63132271557324Health CareMONAC Corporationfalse
Physicians Services Corp of Southern Illinois
10101 Woodfield LaneSt LouisMO63132364161526Health CareILNAC Corporationfalse
Dean Health Systems Inc
1808 West Beltline HighwayMadisonWI53713391128616Physician OfficesWINAC Corporationfalse
Dean Health Insurance Inc
PO Box 56099MadisonWI53705391830837InsuranceWINAC Corporationfalse
Dean Health Plan Inc
PO Box 56099MadisonMO53705391535024InsuranceWINAC Corporationfalse
St Marys Dean Ventures Inc
1808 West Beltline HighwayMadisonWI53713391628491Physician OfficesWINAC Corporationfalse
Dean Retail Services Inc
1808 West Beltline HighwayMadisonWI53713391717636Property ServicesWINAC Corporationfalse
Navitus Holdings LLC
1808 West Beltline HighwayMadisonWI53713800968174Pharmacy BenefitsWINAC Corporationfalse
Yagnesh V Oza MD Inc
4117 Veterans Memorial DriveMt VernonIL62804Physician OfficesILNAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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