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Nonprofiteer
← ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC

Form 990 for tax year 2023

Filed by ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC.

Totals

Total revenue
$14,030,240
Total expenses
$15,966,674
Contributions and grants received
$10,990
Grants paid
$793
Program services expenses (Part IX)
$14,240,563
Management and general expenses
$1,726,111
Fundraising expenses
$0
Program service expenses (Part III)
$14,240,563

Program services were 89.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • CAROL HYLAND

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • STEVE FRANKE

    PT YR DIRECTOR, ASST SEC/TREAS

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • SR STEPHEN BLOESL

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • DAVE KUSEK

    PT YR DIRECTOR, CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • BARB SENN

    PT YR DIRECTOR, VICE CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • DG GLOEDE

    DIRECTOR, PRESIDENT-POST ACUTE

    Total calculated
    $533,829
    From this org
    $0
    From related orgs
    $352,791
    Other
    $181,038
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $307,772 related
    Bonus
    $0 + $43,403 related
    Other
    $0 + $1,616 related
    Deferred
    $0 + $151,034 related
    Nontaxable benefits
    $0 + $30,004 related
    Filer's total
    $0 + $533,829 related

  • SUE BUWALDA

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • RICK VANT HOFF

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • JENNY KNUTH

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • MARILYN MULDER

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • CHRIS THORNOCK

    PT YR DIRECTOR, VP MEDICAL GROUP

    Total calculated
    $847,024
    From this org
    $0
    From related orgs
    $583,387
    Other
    $263,637
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $466,669 related
    Bonus
    $0 + $112,038 related
    Other
    $0 + $4,680 related
    Deferred
    $0 + $228,224 related
    Nontaxable benefits
    $0 + $35,413 related
    Filer's total
    $0 + $847,024 related

  • RANDY COMBS

    TREASURER, CFO OF SSM HEALTH

    Total calculated
    $3,420,428
    From this org
    $0
    From related orgs
    $2,182,354
    Other
    $1,238,074
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,242,308 related
    Bonus
    $0 + $669,269 related
    Other
    $0 + $270,777 related
    Deferred
    $0 + $1,203,989 related
    Nontaxable benefits
    $0 + $34,085 related
    Filer's total
    $0 + $3,420,428 related

  • DOUGLAS LONG

    SECRETARY, GENERAL COUNSEL AT SSM HEALTH

    Total calculated
    $2,202,252
    From this org
    $0
    From related orgs
    $1,425,239
    Other
    $777,013
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $759,270 related
    Bonus
    $0 + $495,539 related
    Other
    $0 + $170,430 related
    Deferred
    $0 + $753,634 related
    Nontaxable benefits
    $0 + $23,379 related
    Filer's total
    $0 + $2,202,252 related

  • STEVE SMOOT

    VICE PRESIDENT, COO OF SSM HEALTH

    Total calculated
    $3,258,847
    From this org
    $0
    From related orgs
    $2,054,358
    Other
    $1,204,489
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,173,646 related
    Bonus
    $0 + $737,192 related
    Other
    $0 + $143,520 related
    Deferred
    $0 + $1,164,125 related
    Nontaxable benefits
    $0 + $40,364 related
    Filer's total
    $0 + $3,258,847 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

  • 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)

PART I, LINE 1A
SEVERAL INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2023, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION.
PART I, LINE 3
THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (PRESIDENT-POST ACUTE) IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER THE SSMH QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUAL LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. 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 2023: STEVE SMOOT - $249,972 RANDALL COMBS $261,633 DOUGLAS LONG $161,286 DG GLOEDE $28,146 CHRIS THORNOCK $45,375 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. STEVE SMOOT $140,898

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
2023
Filed
15 November 2024
IRS schema version
2023v5.1
Source object
202443209349317569

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