2025-11-17T19:02:22-06:00 2024-12-31 990 2024-01-01 273439133 ST MARY'S JANESVILLE FOUNDATION INC STMA 6183738015 3400 E RACINE ST JANESVILLE WI 53546 STEPHANIE KING VP FINANCE 6083738015 2025-11-17 0 2024 2025-03-06 01:10:19Z DONA HOHENSEE 3400 E RACINE ST JANESVILLE WI 53546 291137 0 0928 X WWW.GIVETOSSMHEALTH.ORG/FOUNDATIONS/WISCONSIN/SSM X 2010 WI TO ACTIVELY BUILD AND SUSTAIN COMMUNITY SUPPORT FOR THE HEALTH AND WELLNESS INITIATIVES OF SSM HEALTH ST. MARY'S HOSPITAL JANESVILLE. 9 7 0 7 0 0 274971 96698 0 145022 14339 43474 -5743 4315 283567 289509 4007 43403 0 0 142294 145023 0 0 160867 38283 16428 184584 204854 98983 84655 935252 1016738 16271 0 918981 1016738 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 43987 43403 145022 PROVIDED SUPPORT FOR THE HEALTH CARE INITIATIVES OF SSM HEALTH ST. MARY'S HOSPITAL - JANESVILLE AND OTHER COMMUNITY ORGANIZATIONS. PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF SUPPORT INITIATIVES. 43987 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 WI X DONA HOHENSEE 6083738015 3400 E RACINE STREET JANESVILLE WI 53546 JANE CURRAN-MEULI DIRECTOR & HOSPITAL PRESIDENT 1.00 50.00 X X 0 591941 178076 TIMOTHY AXE DIRECTOR & VICE CHAIRMAN 1.00 0.00 X X 0 252497 64025 MARY ARNDT DIRECTOR 1.00 0.00 X 0 0 0 KAREN CAIN DIRECTOR & CHAIR 1.00 0.00 X X 0 0 0 BETSY RIEMER DIRECTOR & TREASURER 1.00 0.00 X X 0 0 0 WILLIAM SCHENDT DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM SPRINGER DIRECTOR 1.00 0.00 X 0 0 0 A LASSE CULLUM DIRECTOR 1.00 0.00 X 0 0 0 BARBARA GEORGE DIRECTOR 1.00 0.00 X 0 0 0 DONA HOHENSEE EXECUTIVE DIRECTOR 40.00 0.00 X 0 136882 40855 0 981320 282956 0 0 1 0 0 96698 11375 96698 145022 145022 145022 18347 18347 25127 0 25127 25127 25127 5943 1628 4315 4315 289509 145022 0 47789 31119 31119 12284 12284 134323 134323 10700 10700 12857 12857 296 266 30 543 543 29 29 35 35 OTHER EXPENSES 1700 1700 BANK SERVICE CHARGES 968 318 650 204854 43987 0 160867 369758 392507 185 0 252680 565309 367077 0 4474 935252 1016738 221 16050 0 16271 0 X 182939 238242 736042 778496 918981 1016738 935252 1016738 X 84655 13101 1 X 0 1 X 1 0 X 75522 92816 197258 286741 96698 749035 75522 92816 197258 286741 96698 749035 749035 4494 4645 6134 10628 18347 44248 28068 16681 25205 33291 5943 109188 902471 0.83000 0.74980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 331358 47022 11741 402066 106517 213538 11303 331358 34171 72694 -348 106517 33823 348 34171 0.00000 1.00000 0.00000 0 1 1 0 SSM COMPREHENSIVE INVESTMENT PROGRAM 367077 F 367077 X PART X, LINE 2: SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE ST MARY'S JANESVILLE FOUNDATION INC'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). 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 RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2024 OR 2023. SCHEDULE D PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUNDS THE ENDOWMENT EXISTS TO SUPPORT CARE FOR CANCER PATIENTS. 0 SSM HEALTH CARE OF WISCONSIN INC 12800 CORPORATE HILL DRIVE ST LOUIS MO 63131 430688874 501(C)(3) 30985 0 SUPPORT OF HOSPITAL OPERATIONS 1 0 EMPLOYEE RELIEF GRANTS 5 8791 HOUSING AND UTLITIES EMERGENCY RELIEF CARDS AND CANCER CARE BAGS 27 3493 PATIENT CARE ASSISTANCE PART I, LINE 2: ALL GRANTS TO ORGANIZATIONS WERE MADE TO A RELATED ORGANIZATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3). THE ORGANIZATION HAS DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. 0 1 0 0 0 0 0 0 0 JANE CURRAN-MEULI DIRECTOR & HOSPITAL PRESIDENT 0 427455 0 114495 0 49991 0 145793 0 32283 0 770017 0 114495 TIMOTHY AXE DIRECTOR & VICE CHAIRMAN 0 236145 0 0 0 16352 0 20143 0 43882 0 316522 0 0 DONA HOHENSEE EXECUTIVE DIRECTOR 0 126508 0 9270 0 1104 0 14985 0 25870 0 177737 0 9270 PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, (EXECUTIVE DIRECTOR), 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 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 2024. 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 DISTRIBUTIONS FROM THIS PLAN IN 2024. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. TIMOTHY AXE $8,159 FORM 990 PART III, LINE 4A - PROGRAM SERVICE ACCOMPLISHMENTS FOUNDED IN 2011, THE SSM HEALTH ST. MARY'S FOUNDATION JANESVILLE EXISTS TO SUPPORT THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IN ROCK COUNTY, WISCONSIN. THE FOUNDATION ENGAGES WITH THE LOCAL COMMUNITY TO RAISE FUNDS TO SUPPORT THE HEALING MISSION OF SSM HEALTH ST. MARY'S HOSPITAL - JANESVILLE THROUGH PROGRAMS, SERVICES, AND CAPITAL PROJECTS THAT ENHANCE NOT ONLY PATIENT CARE, BUT THE HEALTH AND WELL-BEING OF OUR COMMUNITY. IN 2024, THE ST. MARY'S JANESVILLE FOUNDATION WAS PROUD TO PARTICIPATE IN THE FOLLOWING PROJECTS: RAISED OVER $97,198. THERE ARE CURRENTLY 9 VOLUNTEER BOARD MEMBERS LEADING THE FOUNDATION. ST. MARY'S JANESVILLE FOUNDATION ASSISTED WITH THE FOLLOWING IN 2024: O $20,000 HEALING GARDEN MAINTENANCE O $10,985 DOOR FOR CARDIAC REHAB DEPARTMENT O $8,791 EMPLOYEE EMERGENCY RELIEF O $3,393 CANCER CARE BAGS AND HOPE BLOOMS FOR CANCER PATIENTS O $500 CARDIAC REHAB GAS CARDS FOR PATIENTS FORM 990 PART V, LINE 1A ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE CORPORATE MEMBER IS SSM HEALTH CARE OF WISCONSIN, INC. SSM HEALTH CARE OF WISCONSIN, INC. IS A NONPROFIT 501(C)(3) ORGANIZATION THAT OPERATES EIGHT HOSPITALS AND ONE SKILLED NURSING FACILITY, BOTH THE FOUNDATION AND SSM HEALTH CARE OF WISCONSIN, INC. ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY THE MEMBER HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS, EXCEPT FOR ANY DIRECTOR WHO SERVES EX OFFICIO, AND TO REMOVE THE DIRECTORS WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE PHILOSOPHY OF THE CORPORATION B. TO APPOINT THE BOARD OF DIRECTORS, EXCEPT FOR ANY DIRECTOR WHO SERVES EX OFFICIO, AND TO REMOVE THE DIRECTORS WITH OR WITHOUT CAUSE C. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN D. TO APPROVE THE BYLAWS OF THE CORPORATION AND ANY AMENDMENTS THERETO E. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION F. TO APPROVE THE SALE, CONVEYANCE, ASSIGNMENT, TRANSFER, ALIENATION, PLEDGE, ENCUMBRANCE, MORTGAGE OR LEASE OF REAL PROPERTY OR ANY INTEREST THEREIN OF THE CORPORATION IN ACCORDANCE WITH THE POLICIES APPROVED BY THE MEMBER G. TO APPROVE I) THE ACQUISITION OF REAL PROPERTY OR ANY INTEREST THEREIN OR II) THE ACQUISITION OF STOCK OF A CORPORATION IF, AFTER THE ACQUISITION, THE CORPORATION WILL OWN A MAJORITY OF THE VOTING STOCK OF SUCH CORPORATION, IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBER H. TO APPROVE THE SALE, TRANSFER OR OTHER DISPOSITION ("DISPOSITION") OF THE VOTING STOCK OF A CORPORATION IF BEFORE THE DISPOSITION THE CORPORATION OWNED A MAJORITY OF THE VOTING STOCK OF THE CORPORATION AND AFTER SUCH DISPOSITION THE CORPORATION WOULD NOT OWN A MAJORITY OF THE VOTING STOCK OF THE CORPORATION, IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBER FROM TIME TO TIME I. TO APPROVE ANY BORROWING OR GUARANTEES OF THE CORPORATION IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBER J. TO APPROVE ANY BORROWING OR GUARANTEES OF THE CORPORATION IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBER K. 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 L. TO APPROVE THE ACCEPTANCE OF ANY GIFT OR CONTRIBUTION WHICH IN CONNECTION THEREWITH, WOULD IMPOSE A CONTINUING OBLIGATION UPON THE CORPORATION, INCLUDING, WITHOUT LIMITATION, THE OBLIGATION TO PROVIDE HEALTH CARE SERVICES, PAY AN ANNUITY OR UNDERTAKE ANY OTHER OBLIGATIONS, EXCEPT AS OTHERWISE DETERMINGED BY THE MEMBER PURSUANT TO POLICIES ADOPTED BY THE MEMBER FROM TIME TO TIME M. TO APPROVE OR REJECT PROPOSALS FOR EXPENDITURES OR GRANTS IN ACCORDANCE WITH THE BYLAWS IN THE EVENT THE PRESIDENT OF THE HOSPITAL AND THE BOARD OF DIRECTORS OF THE CORPORATION DO NOT AGREE WITH RESPECT TO THE APPROVAL OF SUCH PROPOSAL. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION OF MEETINGS HELD BY COMMITTEES OF GOVERNING BODY THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 BY THE GOVERNING BODY THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION. SSM HEALTH CARE CORPORATION (SSM). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SSM PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY OF 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 DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ONLINE. PERIODICALLY THROUGH THE YEAR, 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, SECTION C, LINE 19 THE YEAR-END AUDITED CONSOLIDATED FINANCE STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE WISCONSIN 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 VI, LINE 19 - REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE UPON REQUEST TO THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTION'S OFFICE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: ROUNDING 1. 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