Skip to content
Nonprofiteer
← CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION

Form 990 for tax year 2022

Filed by CENTRALIA MEDICAL SERVICES BUILDING ASSOCIATION.

Totals

Total revenue
$299,081
Total expenses
$325,665
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$311,516
Management and general expenses
$14,149
Fundraising expenses
$0
Program service expenses (Part III)
$311,516

Program services were 95.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Michael Baumgartner

    Director, Regional President-Southern Illinois

    Total calculated
    $1,161,282
    From this org
    $0
    From related orgs
    $805,707
    Other
    $355,575
    Hours/week
    1 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $429,527 related
    Bonus
    $0 + $281,574 related
    Other
    $0 + $94,606 related
    Deferred
    $0 + $337,942 related
    Nontaxable benefits
    $0 + $17,633 related
    Filer's total
    $0 + $1,161,282 related

  • Sr M Clarette Stryzewski CSSF

    Director, Chairperson

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Ben Houle MD

    Director

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Damon Harbison

    Director, Hospital President-SSM Health St. Mary's Hospital

    Total calculated
    $608,529
    From this org
    $0
    From related orgs
    $426,972
    Other
    $181,557
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $288,253 related
    Bonus
    $0 + $114,517 related
    Other
    $0 + $24,202 related
    Deferred
    $0 + $132,756 related
    Nontaxable benefits
    $0 + $48,801 related
    Filer's total
    $0 + $608,529 related

  • Erica Ibendahl MD

    Director, SSM Health Medical Group Physician

    Total calculated
    $779,803
    From this org
    $0
    From related orgs
    $714,363
    Other
    $65,440
    Hours/week
    1 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $675,815 related
    Bonus
    $0 + $37,487 related
    Other
    $0 + $1,061 related
    Deferred
    $0 + $11,867 related
    Nontaxable benefits
    $0 + $53,573 related
    Filer's total
    $0 + $779,803 related

  • Herb Williams

    Director

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Jeremy Bradford

    Director, Hospital President-SSM Health Good Samaritan Hospital

    Total calculated
    $557,749
    From this org
    $0
    From related orgs
    $457,250
    Other
    $100,499
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $348,491 related
    Bonus
    $0 + $96,657 related
    Other
    $0 + $12,101 related
    Deferred
    $0 + $53,463 related
    Nontaxable benefits
    $0 + $47,037 related
    Filer's total
    $0 + $557,749 related

  • Matthew Flanigan

    Director

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Patty Williams

    Director

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • Sr M Ramona Dombrowski CSSF

    Director

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Sudeep Nair MD

    Director, SSM Health Medical Group Physician

    Total calculated
    $611,024
    From this org
    $0
    From related orgs
    $530,032
    Other
    $80,992
    Hours/week
    1 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $518,132 related
    Bonus
    $0 + $8,863 related
    Other
    $0 + $3,036 related
    Deferred
    $0 + $29,166 related
    Nontaxable benefits
    $0 + $51,826 related
    Filer's total
    $0 + $611,024 related

  • Suzie Schmidt

    Director

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Tena Hoyt

    Director

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Timothy Carmody MD

    Director, SSM Health St. Mary's Hospital Physician

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Douglas Long

    Secretary, General Counsel at SSM Health

    Total calculated
    $2,040,754
    From this org
    $0
    From related orgs
    $1,354,027
    Other
    $686,727
    Hours/week
    1 + 72.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $724,576 related
    Bonus
    $0 + $460,492 related
    Other
    $0 + $168,959 related
    Deferred
    $0 + $664,054 related
    Nontaxable benefits
    $0 + $22,673 related
    Filer's total
    $0 + $2,040,753 related

  • John Snodsmith

    Regional VP, Finance

    Total calculated
    $385,946
    From this org
    $0
    From related orgs
    $296,045
    Other
    $89,901
    Hours/week
    1 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $256,300 related
    Bonus
    $0 + $38,894 related
    Other
    $0 + $852 related
    Deferred
    $0 + $61,875 related
    Nontaxable benefits
    $0 + $28,026 related
    Filer's total
    $0 + $385,946 related

  • Rachel Hall

    Assistant Secretary

    Total calculated
    $121,439
    From this org
    $0
    From related orgs
    $90,574
    Other
    $30,865
    Hours/week
    1 + 39 related

  • Randy Combs

    Treasurer, Chief Financial Officer at SSM Health

    Total calculated
    $2,850,791
    From this org
    $0
    From related orgs
    $1,879,738
    Other
    $971,053
    Hours/week
    1 + 69 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,144,254 related
    Bonus
    $0 + $475,226 related
    Other
    $0 + $260,259 related
    Deferred
    $0 + $938,234 related
    Nontaxable benefits
    $0 + $32,819 related
    Filer's total
    $0 + $2,850,792 related

  • Karen Rewerts

    VP-Financial Operations

    Total calculated
    $1,067,699
    From this org
    $0
    From related orgs
    $805,591
    Other
    $262,108
    Hours/week
    0 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $589,253 related
    Bonus
    $0 + $159,192 related
    Other
    $0 + $57,145 related
    Deferred
    $0 + $231,797 related
    Nontaxable benefits
    $0 + $30,312 related
    Filer's total
    $0 + $1,067,699 related

  • Kris Zimmer

    Pt Yr Treasurer, Pt Yr Chief Financial Officer at SSM Health

    Total calculated
    $135,402
    From this org
    $0
    From related orgs
    $135,402
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $135,402 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $135,402 related

  • Matt Kinsella

    Matthew Kinsella

    Total calculated
    $770,808
    From this org
    $0
    From related orgs
    $571,367
    Other
    $199,441
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $395,809 related
    Bonus
    $0 + $165,836 related
    Other
    $0 + $9,722 related
    Deferred
    $0 + $163,175 related
    Nontaxable benefits
    $0 + $36,266 related
    Filer's total
    $0 + $770,809 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
The organization's top management official, Regional 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 Board of Directors.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Pension Restoration Plan: SSM Health (SSMH) provides this supplemental defined benefit nonqualified retirement plan to any employee who is a participant in the SSMH qualified defined benefit plan who earns over the Internal Revenue Service compensation limit. The plan "restores" the benefits to these employees that would have been provided under the SSMH qualified plan if the regulations did not impose compensation limits. An individual can take a distribution from the plan at (1) age 65 or older if the individual is still employed by SSMH or (2) age 55 or older if the individual is no longer employed by SSMH. No individuals listed on Part VII of Form 990 received distributions from the plan in 2022. Capital Accumulation Plan: SSMH provides this supplemental nonqualified retirement plan to executive level employees. The organization contributed a percentage of the employee's base salary into their choice of a select list of investments. The deposits and earnings of the plan are owned by SSMH and are tax-deferred until a distribution is made to the employee. In addition, the plan has special safeguards in place to protect the funds from contingencies, other than insolvency. For contributions made to the plan in 2014 or after, the distribution will occur after the completion of four plan years for all executives that are still actively employed on the distribution date. Any active participant 65 years or older will receive the contribution in the current year. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM T HIS PLAN IN 2022: Michael Baumgartner $86,821 Jeremy Bradford $35,613 Damon Harbison $29,687 Sudeep Nair $8,433 Randall Combs $251,115 Douglas Long $159,815 Karen Rewerts - $57,962 John Snodsmith - $12,062 Matt Kinsella - $39,627 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2022. All distributions received from the plan in the current year were included in the individual's taxable compensation. Jeremy Bradford $10,916 Damon Harbison $23,551 Karen Rewerts - $51,943 Matt Kinsella - $8,819

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202303199349326965

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.