Skip to content
Nonprofiteer
← GOOD SAMARITAN REGIONAL HEALTH CENTER

Form 990 for tax year 2022

Filed by GOOD SAMARITAN REGIONAL HEALTH CENTER.

Totals

Total revenue
$230,838,321
Total expenses
$211,708,381
Contributions and grants received
$1,559,845
Grants paid
$59,116
Program service revenue
$221,267,035
Investment income
$1,061,623
Other revenue
$6,949,818
Total assets, end of year
$398,383,512
Total liabilities, end of year
$248,738,113
Net assets or fund balances, end of year
$149,645,399
Program services expenses (Part IX)
$191,529,204
Management and general expenses
$20,123,410
Fundraising expenses
$55,767
Program service expenses (Part III)
$191,529,204

Program services were 90.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $115,257

  • 1e · Government grants (contributions)

    $1,444,588

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $209,391,953 · related or exempt $209,391,953

  • 2b · Program service revenue: 340B PHARMACY REVENUE

    total $1,516,608 · related or exempt $1,516,608

  • 2f · All other program service revenue

    total $10,358,474 · related or exempt $10,358,474 · unrelated business $0 · excluded $0

  • 6a · Gross rents

    real property $358,450

  • 6c · Rental income or loss

    real property $358,450 · personal property $0

  • 6d · Net rental income or loss

    total $358,450 · excluded $358,450

  • 7a · Gross sales of assets other than inventory

    securities $973,566 · other assets $88,057

  • 7c · Gain or loss

    securities $973,566 · other assets $88,057

  • 7d · Net gain or loss

    total $1,061,623 · excluded $1,061,623

  • 11a · Other revenue: RETAIL PHARMACY

    total $5,364,079 · unrelated business $5,364,079

  • 11b · Other revenue: MANAGEMENT FEES

    total $203,736 · excluded $203,736

  • 11c · Other revenue: CAFETERIA

    total $499,799 · excluded $499,799

  • 11d · All other revenue

    total $523,754 · related or exempt $523,126 · unrelated business $628 · excluded $0

  • 11e · Other revenue, total

    $6,591,368

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $57,116 · program services $57,116

  • 2 · Grants to domestic individuals

    total $2,000 · program services $2,000

  • 5 · Compensation of officers, directors and key employees

    total $1,585,060 · program services $1,507,327 · management and general $77,733

  • 7 · Other salaries and wages

    total $57,270,678 · program services $56,323,244 · management and general $947,434

  • 8 · Pension plan contributions

    total $3,318,233 · program services $3,155,502 · management and general $162,731

  • 9 · Other employee benefits

    total $14,268,030 · program services $13,568,307 · management and general $699,723

  • 10 · Payroll taxes

    total $4,291,543 · program services $4,081,080 · management and general $210,463

  • 11a · Fees: management

    total $862,108 · program services $444,569 · management and general $417,539

  • 11b · Fees: legal

    total $325,097 · management and general $325,097

  • 11d · Fees: lobbying

    total $6,414 · management and general $6,414

  • 11g · Fees: other

    total $35,337,037 · program services $29,916,206 · management and general $5,399,419 · fundraising $21,412

  • 12 · Advertising and promotion

    total $17,012 · management and general $17,012

  • 13 · Office expenses

    total $6,459,404 · program services $6,384,730 · management and general $74,674

  • 14 · Information technology

    total $8,088,736 · program services $8,056,000 · management and general $2,179 · fundraising $30,557

  • 16 · Occupancy

    total $4,861,429 · program services $4,860,689 · management and general $468 · fundraising $272

  • 17 · Travel

    total $330,304 · program services $310,727 · management and general $16,051 · fundraising $3,526

  • 19 · Conferences, conventions and meetings

    total $69,495 · program services $68,662 · management and general $833

  • 20 · Interest

    total $5,864,914 · program services $5,864,914

  • 22 · Depreciation, depletion and amortization

    total $12,838,526 · program services $12,838,526

  • 23 · Insurance

    total $3,148,290 · program services $3,148,290

  • 24a · Other expenses: Medical supplies

    total $35,009,185 · program services $35,009,185

  • 24b · Other expenses: Medicaid Provider Tax

    total $5,833,559 · program services $5,833,559

  • 24c · Other expenses: Internal management fees

    total $11,765,640 · management and general $11,765,640

  • 24d · Other expenses: Licenses and taxes

    total $98,571 · program services $98,571

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $976,564 · end of year $232,584

  • 4 · Accounts receivable

    beginning of year $29,103,387 · end of year $21,722,343

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $4,111,398 · end of year $4,373,617

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,464,436 · end of year $2,874,179

  • 10a · Land, buildings and equipment: cost or other basis

    $271,095,826

  • 10b · Land, buildings and equipment: accumulated depreciation

    $75,455,121

  • 10c · Land, buildings and equipment, net

    beginning of year $141,995,213 · end of year $195,640,705

  • 12 · Investments: other securities

    beginning of year $108,544,457 · end of year $98,060,531

  • 13 · Investments: program-related

    beginning of year $5,869,118 · end of year $4,472,408

  • 14 · Intangible assets

    beginning of year $3,087,199 · end of year $3,176,064

  • 15 · Other assets

    beginning of year $48,607,243 · end of year $67,831,081

  • 17 · Accounts payable and accrued expenses

    beginning of year $17,702,485 · end of year $16,283,805

  • 19 · Deferred revenue

    beginning of year $1,768,689 · end of year $1,604,160

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $182,611,772 · end of year $230,850,148

  • 27 · Net assets without donor restrictions

    beginning of year $141,252,916 · end of year $148,222,246

  • 28 · Net assets with donor restrictions

    beginning of year $1,423,153 · end of year $1,423,153

Mission and programs · 2022

Mission

Through our exceptional health care services, we reveal the healing presence of God.

Activities or mission (Part I)

To continue the healing ministry of Jesus Christ by improving & providing regional, cost effective quality health services for everyone, with a special concern for the poor and vulnerable.

  • See Schedule O for a complete description of program service accomplishments.

    Expenses $191,529,204 · Grants $59,116 · Revenue $221,790,161

As filed on the 2022 return.

Listed in Part VII

  • Jeremy Bradford

    Director, Hospital President-SSM Health Good Samaritan Hospital

    Total calculated
    $557,749
    From this org
    $457,250
    From related orgs
    $0
    Other
    $100,499
    Hours/week
    40 + 3 related

    Schedule J breakdown matched by us

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

  • 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-St. Mary's Centralia

    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

  • Matthew Flanigan

    Director

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • 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

  • 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

    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
    10 + 34 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

  • George Daneker MD

    Interim Chief Medical Officer - Southern Illinois

    Total calculated
    $573,535
    From this org
    $0
    From related orgs
    $471,789
    Other
    $101,746
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $388,005 related
    Bonus
    $0 + $59,354 related
    Other
    $0 + $24,430 related
    Deferred
    $0 + $80,896 related
    Nontaxable benefits
    $0 + $20,850 related
    Filer's total
    $0 + $573,535 related

  • Hollie Colle

    Director - Administrative Services/Operations

    Total calculated
    $200,747
    From this org
    $0
    From related orgs
    $155,405
    Other
    $45,342
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $155,087 related
    Bonus
    $0
    Other
    $0 + $318 related
    Deferred
    $0 + $19,912 related
    Nontaxable benefits
    $0 + $25,430 related
    Filer's total
    $0 + $200,747 related

  • John Kohler Sr

    chief medical officer

    Total calculated
    $651,665
    From this org
    $521,446
    From related orgs
    $0
    Other
    $130,219
    Hours/week
    40 + 20 related

    Schedule J breakdown matched by us

    Base
    $440,383
    Bonus
    $0
    Other
    $81,063
    Deferred
    $87,947
    Nontaxable benefits
    $42,272
    Filer's total
    $651,665

  • Julie Long

    VP - Strategic Planning

    Total calculated
    $533,926
    From this org
    $0
    From related orgs
    $391,408
    Other
    $142,518
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $297,159 related
    Bonus
    $0 + $77,364 related
    Other
    $0 + $16,884 related
    Deferred
    $0 + $125,957 related
    Nontaxable benefits
    $0 + $16,561 related
    Filer's total
    $0 + $533,926 related

  • Lisa Dimarco

    Regional VP, Patient Care Services/CNO

    Total calculated
    $375,645
    From this org
    $332,389
    From related orgs
    $0
    Other
    $43,256
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $146,975
    Bonus
    $41,357
    Other
    $144,057
    Deferred
    $26,040
    Nontaxable benefits
    $17,216
    Filer's total
    $375,645

  • Faisal Rashid

    Physician

    Total calculated
    $694,481
    From this org
    $622,138
    From related orgs
    $0
    Other
    $72,343
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $577,200
    Bonus
    $40,000
    Other
    $4,938
    Deferred
    $17,850
    Nontaxable benefits
    $54,493
    Filer's total
    $694,481

  • John Flick

    Physician

    Total calculated
    $491,147
    From this org
    $415,435
    From related orgs
    $0
    Other
    $75,712
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $414,265
    Bonus
    $0
    Other
    $1,170
    Deferred
    $17,850
    Nontaxable benefits
    $57,862
    Filer's total
    $491,147

  • Muhammad Talha Khalid

    physician

    Total calculated
    $466,565
    From this org
    $397,325
    From related orgs
    $0
    Other
    $69,240
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $396,781
    Bonus
    $0
    Other
    $544
    Deferred
    $17,322
    Nontaxable benefits
    $51,918
    Filer's total
    $466,565

  • Shamlan Sheikh

    Physician

    Total calculated
    $479,050
    From this org
    $433,680
    From related orgs
    $0
    Other
    $45,370
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $433,294
    Bonus
    $0
    Other
    $386
    Deferred
    $14,055
    Nontaxable benefits
    $31,315
    Filer's total
    $479,050

  • Thomas Smith

    Physician

    Total calculated
    $468,885
    From this org
    $401,954
    From related orgs
    $0
    Other
    $66,931
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $400,911
    Bonus
    $0
    Other
    $1,043
    Deferred
    $15,002
    Nontaxable benefits
    $51,929
    Filer's total
    $468,885

  • Karen Rewerts

    Former Officer

    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

    Former Officer

    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

  • Laura Kaiser

    Former Officer

    Total calculated
    $8,384,492
    From this org
    $0
    From related orgs
    $5,770,684
    Other
    $2,613,808
    Hours/week
    0 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,929,589 related
    Bonus
    $0 + $1,636,383 related
    Other
    $0 + $2,204,713 related
    Deferred
    $0 + $2,594,363 related
    Nontaxable benefits
    $0 + $19,444 related
    Filer's total
    $0 + $8,384,492 related

  • Matt Kinsella

    Former Officer

    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, and on a Form 990-PF Part VIII's — 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

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1a Tax indemnification and gross-up payments
Several individuals listed on Part VII, Section A received a tax indemnification/gross up payment in 2022. These payments were included in their taxable compensation.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
The organization's top management official (Hospital President) has compensation that is determined by a related organization. The related organization utilized the following to determine compensation: (1) independent compensation consultant; (2) compensation survey or study; (3) approval by the SSM Health President.
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 THIS PLAN IN 2022: Michael Baumgartner $86,821 Damon Harbison $29,687 Sudeep Nair $8,433 Randall Combs $251,115 Douglas Long $159,815 John Snodsmith $12,062 Julie Long $29,180 George Daneker $17,559 Laura Kaiser $708,350 Matt Kinsella $39,627 Karen Rewerts $57,962 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. Damon Harbison $23,551 Julie Long $15,364 Laura Kaiser $1,488,789 Matt Kinsella $8,819 Karen Rewerts $51,943

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

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
16 November 2023
IRS schema version
2022v5.0
Source object
202323209349300622

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.