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Nonprofiteer
← SSM AUDRAIN HEALTH CARE INC

Form 990 for tax year 2022

Filed by SSM AUDRAIN HEALTH CARE INC.

Totals

Total revenue
$3,223,276
Total expenses
$1,833,766
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$3,223,276
Investment income
$0
Other revenue
$0
Total assets, end of year
$27,532
Total liabilities, end of year
$50,412,032
Net assets or fund balances, end of year
-$50,384,500
Program services expenses (Part IX)
$1,833,468
Management and general expenses
$298
Fundraising expenses
$0
Program service expenses (Part III)
$1,833,468

Program services were 100.0% 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.

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $3,217,658 · related or exempt $3,217,658

  • 2f · All other program service revenue

    total $5,618 · related or exempt $5,618 · unrelated business $0 · excluded $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $3,256 · program services $3,256

  • 8 · Pension plan contributions

    total $193,655 · program services $193,655

  • 10 · Payroll taxes

    total $290 · program services $290

  • 11b · Fees: legal

    total $119 · management and general $119

  • 11g · Fees: other

    total $10,555 · program services $10,436 · management and general $119 · fundraising $0

  • 14 · Information technology

    total $3,584 · program services $3,584

  • 24a · Other expenses: Medical supplies

    total $13,037 · program services $13,037

  • 24b · Other expenses: loss on impairment

    total $1,215,612 · program services $1,215,612

  • 24c · Other expenses: Licenses and taxes

    total $2,235 · program services $2,175 · management and general $60

  • 24d · Other expenses: Government grant revision

    total $391,423 · program services $391,423

  • 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 $14,330 · end of year $5,376

  • 4 · Accounts receivable

    beginning of year $246,867 · end of year $11,981

  • 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

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

    $0

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

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $10,175 · end of year $10,175

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $172,831 · end of year $432,648

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $53,559,889 · end of year $49,979,384

  • 27 · Net assets without donor restrictions

    beginning of year -$53,461,348 · end of year -$50,394,675

  • 28 · Net assets with donor restrictions

    end of year $10,175

Mission and programs · 2022

Mission

THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.

Activities or mission (Part I)

The Hospital's assets were sold in March of 2021. Prior to that date, it operated as a community hospital offering a range of services including emergency care, cardiology services, medical imaging, women and child services and diabetes education.

  • Effective March 15, 2021, SSM Audrain Health Care, Inc. sold substantially all of its assets and ceased hospital operations. Please see Schedule O for a complete description of program service accomplishments through March 15, 2021.

    Expenses $1,833,468 · Revenue $3,223,276

As filed on the 2022 return.

Listed in Part VII

  • Douglas Long

    Director, 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
    0 + 73.2 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

  • Laura Kaiser

    Director, President/CEO of SSM Health

    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

  • Steve Smoot

    Director, Vice President, COO of SSM Health

    Total calculated
    $2,904,291
    From this org
    $0
    From related orgs
    $1,870,292
    Other
    $1,033,999
    Hours/week
    0 + 66 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,084,584 related
    Bonus
    $0 + $672,081 related
    Other
    $0 + $113,627 related
    Deferred
    $0 + $995,370 related
    Nontaxable benefits
    $0 + $38,629 related
    Filer's total
    $0 + $2,904,291 related

  • Karen Rewerts

    Director, 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

  • Randy Combs

    Treasurer, Chief Financial Officer of SSM Health

    Total calculated
    $2,850,791
    From this org
    $0
    From related orgs
    $1,879,738
    Other
    $971,053
    Hours/week
    0 + 70 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

  • John Snodsmith

    FORMER OFFICER

    Total calculated
    $385,946
    From this org
    $0
    From related orgs
    $296,045
    Other
    $89,901
    Hours/week
    0 + 44 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

  • 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

  • Michael Baumgartner

    FORMER OFFICER

    Total calculated
    $1,161,282
    From this org
    $0
    From related orgs
    $805,707
    Other
    $355,575
    Hours/week
    0 + 44 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

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

  • 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 or compensation committee.
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: Karen Rewerts $57,962 Steve Smoot $240,329 Laura Kaiser $708,350 John Snodsmith $12,062 RANDALL COMBS $251,115 DOUGLAS LONG $159,815 MICHAEL BAUMGARTNER $86,821 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. Karen Rewerts $51,943 Laura Kaiser $1,488,789 STEVE SMOOT $111,005

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.

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
202323199349330352

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