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28 locations registered under this record — data as of November 6, 2026

Sole community hospital · FOND DU LAC, WI

SSM HEALTH ST AGNES HOSPITAL - FOND DU LAC

Taking partNoTermination date filedJuly 1, 2026Last certifiedAugust 18, 2025

  • 28Registered locations
  • 7Associated locations
  • 45Contract pharmacies
  • 0With no end date
  • October 1, 2023In 340B since

Every Medicare cost report this hospital has filed is on its cost-report record.

Finances, as filed

From this hospital’s Medicare cost report for the year ended December 31, 2025.

FigureAs filedWhere it comes from
Total patient revenue$1,291,340,102CMS-2552-10 worksheet G300000 line 100 column 100
Contractual allowances$821,687,654CMS-2552-10 worksheet G300000 line 200 column 100
Net patient revenue$469,652,448CMS-2552-10 worksheet G300000 line 300 column 100
Total operating expenses$400,856,942CMS-2552-10 worksheet G300000 line 400 column 100
Income from service to patients$68,795,506CMS-2552-10 worksheet G300000 line 500 column 100
Charity care, at charges$7,403,217CMS-2552-10 worksheet S100001 line 2000 column 300
Charity care, at cost$2,571,163CMS-2552-10 worksheet S100001 line 2300 column 300
Bad debt expense$9,153,749CMS-2552-10 worksheet S100001 line 2600 column 100
Bad debt other than Medicare, at cost$2,736,513CMS-2552-10 worksheet S100001 line 2900 column 100
Uncompensated care, at cost$5,307,676CMS-2552-10 worksheet S100001 line 3000 column 100
Total facility beds105CMS-2552-10 worksheet S300001 line 1400 column 200
Cost-to-charge ratio0.2957CMS-2552-10 worksheet S100001 line 100 column 100
Allowable disproportionate share percentage0.0686CMS-2552-10 worksheet E00A18A line 3300 column 100

Cost report filed under CMS certification number 520088 for January 1, 2025 to December 31, 2025, as submitted. The public file it was read from.

Community benefit, as filed

From IRS Form 990 Schedule H, Part I, filed by AGNESIAN HEALTHCARE INC (employer identification number 390807236) for tax year 2023. The return lists this hospital as its one hospital facility.

FigureAs filedWhere it comes from
Total community benefit expense (line 7k)$41,386,312IRS Form 990 Schedule H, Part I, <TotalCommunityBenefitsGrp><NetCommunityBenefitExpnsAmt>
Financial assistance at cost (line 7a)$4,390,412IRS Form 990 Schedule H, Part I, <FinancialAssistanceAtCostTyp><NetCommunityBenefitExpnsAmt>
Medicaid (line 7b)$31,040,178IRS Form 990 Schedule H, Part I, <UnreimbursedMedicaidGrp><NetCommunityBenefitExpnsAmt>
Financial assistance and means-tested government programs (line 7d)$37,145,173IRS Form 990 Schedule H, Part I, <TotalFinancialAssistanceTyp><NetCommunityBenefitExpnsAmt>
Other benefits (line 7j)$4,241,139IRS Form 990 Schedule H, Part I, <TotalOtherBenefitsGrp><NetCommunityBenefitExpnsAmt>
Total, fraction of total expense (line 7k, column f)0.0777IRS Form 990 Schedule H, Part I, <TotalCommunityBenefitsGrp><TotalExpensePct>

E-file object id 202423209349310802. The IRS archive it was read from.

Executive and director compensation, as filed

From IRS Form 990 Part VII, Section A, filed by AGNESIAN HEALTHCARE INC (employer identification number 390807236) for tax year 2023. The return lists this hospital as its one hospital facility.

NameTitleRoleReportable comp, from this organizationReportable comp, from related organizationsOther compensation
BRET PASIUK MDDIRECTORTrustee/director$0$0$0
DOUG FOWNES MDDIRECTORTrustee/director$0$0$0
DOUG LONGSECRETARY, GENERAL COUNSEL AT SSM HEALTHOfficer$0$1,425,239$777,013
EMMER RHEADIRECTORTrustee/director$0$0$0
JEFFREY STRONG MDDIRECTORTrustee/director$0$0$0
JENNIFER MASKEL MDDIRECTORTrustee/director$0$142,795$14,024
JOAN KARSTENDIRECTORTrustee/director$0$0$0
KATHERINE VERGOSPRESIDENT - ST. AGNES HOSPITALOfficer$674,601$0$242,929
KATIE KENNEDYDIRECTORTrustee/director$0$0$0
KRISTOF GEHRKEPHYSICIANHighest-compensated employee$659,537$0$58,792
MARCIO SHIOKAWAPHYSICIANHighest-compensated employee$600,929$0$57,978
MARK THOMPSON MDDIRECTOR, REGIONAL CHIEF MEDICAL OFFICERTrustee/director$0$37,398$12,674
MATT HANLEYDIRECTOR, INTERIM REGIONAL PRES - SSM WITrustee/director$0$974,654$0
MATTHEW POGODZINSKI MDDIRECTORTrustee/director$0$0$0
MICHAEL DREESVP - OPERATIONS, FOND DU LAC CLINICKey employee$363,052$0$62,834
MICHAEL VANDER KOOYRADIATION ONCOLOGISTHighest-compensated employee$661,704$0$67,567
NANCY A BIRSCHBACHFORMER KEY EMPLOYEEFormer$0$458,076$177,602
PAT LEITZEN FYEDIRECTORTrustee/director$0$0$0
RANDY COMBSTREASURER, CHIEF FINANCIAL OFFICER AT SSM HEALTHOfficer$0$2,182,354$1,238,074
SR DONNA INNESDIRECTORTrustee/director$0$0$0
SR HERTHA LONGODIRECTORTrustee/director$0$0$0
SR SUSAN M STUCKIDIRECTORTrustee/director$0$0$0
STEPHEN M PETERSONDIRECTOR, VICE CHAIRPERSONTrustee/director, Officer$0$0$0
STEVE SMOOTVICE PRESIDENT, COO OF SSM HEALTHOfficer$0$2,054,358$1,204,489
STEVEN FLURRYANESTHESIOLOGISTHighest-compensated employee$633,603$0$61,405
SUZANNE ANDERSONDIRECTOR, REGIONAL PRESIDENTTrustee/director, Officer$0$1,428,914$540,322
SYED MOHIUDDINDIRECTORHighest-compensated employee$666,956$0$55,922
TAMI SCHATTSCHNEIDERVP - PATIENT CARE SERVICES, CNOKey employee$288,633$0$100,264
TARA RHODESVP - OPERATIONS, ST. AGNES HOSPITALKey employee$252,246$0$92,166
THEODORE MILLER MDDIRECTORTrustee/director$0$0$0
THOMAS SCHUESSLERDIRECTORTrustee/director$0$0$0
THOR H GILBERTSONDIRECTOR, CHAIRPERSONTrustee/director, Officer$0$0$0
WAYNE MATZKEDIRECTORTrustee/director$0$0$0
WESLEY SPARKMANDIRECTORTrustee/director$0$0$0

E-file object id 202423209349310802. The IRS archive it was read from.

The full report for SSM HEALTH ST AGNES HOSPITAL - FOND DU LAC

Every figure on this page as a document you can keep, file or send on: the finances as filed with the worksheet, line and column each one came from, five hospitals of a similar size in the same state, the contract-pharmacy network year by year, and what changed on the record.

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Where this hospital sits among its peers

A position, not a grade. Each line names the figure, how it is measured, and the hospitals it is placed among: short-term acute care hospitals in the same state and the same bed-size band, each on its latest filed year. Under it, the same figure across every hospital that filed for the year — a larger set, and a different one.

  • 89thpercentile of 18 hospitals in WI, same facility class, 100 to 199 bedsNet patient revenue, in dollars, as filed

Net patient revenue across every hospital that filed for 2025, in every state and of every size, with this one marked.

Net patient revenue (CMS-2552-10 worksheet G300000 line 300 column 100)

This hospital$13,421,290$688,185,845

Middle half between $26,780,592 and $275,353,989, median $73,049,131, across 5,659 hospitals that filed for 2025, in every state and of every size.

  • 78thpercentile of 18 hospitals in WI, same facility class, 100 to 199 bedsTotal operating expenses, in dollars, as filed

Total operating expenses across every hospital that filed for 2025, in every state and of every size, with this one marked.

Total operating expenses (CMS-2552-10 worksheet G300000 line 400 column 100)

This hospital$15,363,143$674,207,581

Middle half between $27,953,478 and $268,914,289, median $72,935,955, across 5,819 hospitals that filed for 2025, in every state and of every size.

  • 33rdpercentile of 15 hospitals in WI, same facility class, 100 to 199 bedsCharity care, at cost, in dollars, as filed
  • 50thpercentile of 16 hospitals in WI, same facility class, 100 to 199 bedsUncompensated care, at cost, in dollars, as filed
  • 28thpercentile of 18 hospitals in WI, same facility class, 100 to 199 bedsTotal facility beds, a count of beds, as filed

Total facility beds across every hospital that filed for 2025, in every state and of every size, with this one marked.

Total facility beds (CMS-2552-10 worksheet S300001 line 1400 column 200)

This hospital18338

Middle half between 25 and 168, median 64, across 5,777 hospitals that filed for 2025, in every state and of every size.

  • 69thpercentile of 16 hospitals in WI, same facility class, 100 to 199 bedsCost-to-charge ratio, the ratio, as filed

Cost-to-charge ratio across every hospital that filed for 2025, in every state and of every size, with this one marked.

Cost-to-charge ratio (CMS-2552-10 worksheet S100001 line 100 column 100)

This hospital0.12330.6732

Middle half between 0.1809 and 0.4503, median 0.2651, across 4,413 hospitals that filed for 2025, in every state and of every size.

Changes recorded

Nothing on this record has moved since it was first read here on September 6, 2026.

Every Medicare cost report this hospital has filed, every change this record has shown since it was first read here, and five hospitals of its own size in Wisconsin beside it — each figure with the cell it came from — are in the report above.

Register detail and identifiers

Participation, as filed

Participating
FALSE
Participation start date
October 1, 2023
Termination date
July 1, 2026
Termination reason
DSH percentage below statutory minimum
Certification date
August 18, 2025
Record last edited
July 1, 2026

Identifiers

340B ID
SCH520088-00
Entity type as filed
SCH
CMS certification number
520088
Rural
No

430 EAST DIVISION STREET, FOND DU LAC WI 54935

Locations registered under this record

Browse all of them as a list →

SCH520088-01AGNESIAN HEALTHCARE INC - OT/Speech TherapySCHFOND DU LAC, WINo
SCH520088-02AGNESIAN HEALTHCARE INC - Hand ClinicSCHFOND DU LAC, WINo
SCH520088-03AGNESIAN HEALTHCARE - Physical TherapySCHMAYVILLE, WINo
SCH520088-04AGNESIAN HEALTHCARE INC - Physical TherapySCHBEAVER DAM, WINo
SCH520088-05Agnesian Healthcare - Physical TherapySCHFond du Lac, WINo
SCH520088-06AGNESIAN HEALTHCARE INC - Sport and SpineSCHFOND DU LAC, WINo
SCH520088-07AGNESIAN HEALTHCARE INC - Pain MedicineSCHFOND DU LAC, WINo
SCH520088-08AGNESIAN HEALTHCARE INC - RadiologySCHFOND DU LAC, WINo
SCH520088-09AGNESIAN HEALTHCARE INC - Surgery CenterSCHFOND DU LAC, WINo
SCH520088-10FOND DU LAC REG CLINIC - Radiation TherapySCHFOND DU LAC, WINo
SCH520088-11Agnesian Healthcare - Home Health CareSCHFond du Lac, WINo
SCH520088-12Hospice FDL - HospiceSCHFond du Lac, WINo
SCH520088-13Hospice House - HospiceSCHFond du Lac, WINo
SCH520088-14Agnesian Healthcare Inc - Vascular SurgerySCHFond du Lac, WINo
SCH520088-15Agnesian Healthcare Inc - NeurologySCHFond du Lac, WINo
SCH520088-16Agnesian Healthcare Inc - CardiologySCHFond du Lac, WINo
SCH520088-17Agnesian Healthcare Inc - IM/IM Peds/RheumatologySCHFond du Lac, WINo
SCH520088-18Agnesian Healthcare Inc - Infusion OncologySCHFond du Lac, WINo
SCH520088-19Agnesian Healthcare Inc - NephrologySCHFond du Lac, WINo
SCH520088-20Agnesian Healthcare Inc - Cardiac SurgerySCHFond du Lac, WINo
SCH520088-21Agnesian Healthcare Inc - OncologySCHFond du Lac, WINo
SCH520088-22Agnesian Healthcare Inc - UrologySCHFond du Lac, WINo
SCH520088-23Agnesian Healthcare Inc-Gastro - GastroenterologySCHFond du Lac, WINo
SCH520088-24Agnesian Healthcare Inc-Family Med Main - Family MedicineSCHFond du Lac, WINo
SCH520088-25Agnesian Healthcare Inc-Surgery Clinic - SurgerySCHFond du Lac, WINo
SCH520088-26Agnesian Healthcare Inc-OBGYN - OBGYNSCHFond du Lac, WINo
SCH520088-27Agnesian Healthcare Inc-OBGYN Ultrasound - UltrasoundSCHFond du Lac, WINo
SCH520088-28Agnesian Healthcare Inc-Pulmonary - PulmonologySCHFond du Lac, WINo

Associated locations

SSM Health Medication Purchasing2201 W Badger RdMadison WI 53713
SSM Health Pharmacy912 S Hickory StFond du Lac WI 54935
SSM Health Pharmacy145 N main StFond du Lac WI 54935
SSM Health Pharmacy420 East Division StreetFond du Lac WI 54935
SSM Health Pharmacy904 W Main StWaupun WI 53963
SSM HEALTH ST AGNES HOSPITAL - FOND DU LAC430 EAST DIVISION STREETFOND DU LAC WI 54935
SSM HEALTH ST AGNES HOSPITAL - FOND DU LAC430 East Division StreetFond du Lac WI 54935

Pharmacy contracts

No end date filed0

No arrangement with no end date filed matches that.

An end date is filed45

An end date still in the future is a termination already filed, not one that has happened. Both are printed here as the file carries them.

ACCREDO HEALTH GROUP INCMEMPHIS, TNJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP INCTEMPE, AZJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP INCWARRENDALE, PAJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP, INC.ORLANDO, FLJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP, INC.WHITESTOWN, INJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP, INC.NEWARK, DEJanuary 1, 2024July 1, 2026
ACCREDO HEALTH GROUP, INC.INDIANAPOLIS, INJanuary 1, 2024October 1, 2024
AGNESIAN HEALTHCARE INC.FOND DU LAC, WIJanuary 1, 2024January 1, 2025
AGNESIAN HEALTHCARE INC.WAUPUN, WIJanuary 1, 2024January 1, 2025
AGNESIAN HEALTHCARE INC.FOND DU LAC, WIJanuary 1, 2024January 1, 2025
AGNESIAN HEALTHCARE INC.FOND DU LAC, WIJanuary 1, 2024January 1, 2025
AGNESIAN HEALTHCARE INC.FOND DU LAC, WIJanuary 1, 2024January 1, 2025
CAREMARK ILLINOIS SPECIALTY PHARMACY, LLMOUNT PROSPECT, ILApril 1, 2025July 1, 2026
CAREMARK KANSAS SPECIALTY PHARMACYLENEXA, KSApril 1, 2025July 1, 2026
CVS CAREMARKWILKES BARRE, PAJanuary 1, 2024July 1, 2026
CVS CAREMARK ADVANCED TECHNOLOGY PHARMACMT PROSPECT, ILJanuary 1, 2024July 1, 2026
ESI MAIL PHARMACY SERVICETEMPE, AZJanuary 1, 2024July 1, 2026
EXPRESS SCRIPTSSAINT LOUIS, MOJanuary 1, 2024July 1, 2026
EXPRESS SCRIPTS PHARMACY, INC.BURLINGTON, NJJanuary 1, 2024July 1, 2026
EXPRESS SCRIPTS PHARMACY, INC.WHITESTOWN, INJanuary 1, 2024July 1, 2026
MAH PHARMACY LLCFAIRFIELD, OHJanuary 1, 2026July 1, 2026
OPTUM PHARMACY 701, LLCFLINT, MIJanuary 1, 2024July 1, 2026
OPTUM PHARMACY 701, LLCMESA, AZApril 1, 2024July 1, 2026
OPTUM PHARMACY 702, LLCJEFFERSONVILLE, INOctober 1, 2023July 1, 2026
OPTUM PHARMACY 705, LLCBIRMINGHAM, ALJanuary 1, 2024July 1, 2026
OPTUM PHARMACY 705, LLCCOLUMBUS, MSJanuary 1, 2024July 1, 2026
OPTUM PHARMACY 707, INCIRWINDALE, CAJanuary 1, 2025July 1, 2026
OPTUMRXOVERLAND PARK, KSOctober 1, 2023July 1, 2026
PROCARE PHARMACY DIRECT, L.L.C.MONROEVILLE, PAApril 1, 2025July 1, 2026
SSM HEALTH PHARMACYMADISON, WIJanuary 1, 2024July 1, 2026
SSM HEALTH PHARMACYMARKESAN, WIJanuary 1, 2024September 14, 2024
SSM HEALTH SPECIALTY PHARMACYSAINT LOUIS, MOJanuary 1, 2024July 1, 2026
Walgreen COBolingbrook, ILJanuary 1, 2024July 1, 2026
WALGREEN CO.HARTFORD, WIOctober 1, 2023July 1, 2026
WALGREEN CO.OSHKOSH, WIOctober 1, 2023July 1, 2026
WALGREEN CO.WAUPUN, WIOctober 1, 2023July 1, 2026
WALGREEN CO.FOND DU LAC, WIOctober 1, 2023July 1, 2026
WALGREEN CO.BEAVER DAM, WIOctober 1, 2023July 1, 2026
WALGREEN CO.CHILTON, WIOctober 1, 2023July 1, 2026
WALGREEN CO.FOND DU LAC, WIOctober 1, 2023July 1, 2026
WALGREEN CO.FOND DU LAC, WIOctober 1, 2023July 1, 2026
WALGREEN CO.RIPON, WIOctober 1, 2023July 1, 2026
WALGREEN CO.WAUWATOSA, WIJanuary 1, 2024July 1, 2026
WALGREEN CO.WEST BEND, WIOctober 1, 2023July 1, 2026
WISCONSIN CVS PHARMACY, L.L.C.FOND DU LAC, WIJanuary 1, 2024July 1, 2026

How this page is built

What is counted
One row per registration in the register. This page is the row for this 340B ID; a figure that reads across a record and its locations counts the rows the register lists under this record as well.
As of
November 6, 2026 — the date of the register file this record was last listed in.
Contract-pharmacy arrangements
Each arrangement the register files between a covered entity and a pharmacy counts once. An arrangement counts among those with no end date where the register prints no termination date for it, and among the rest where it prints one.

Every figure on this page comes from HRSA 340B OPAIS Covered Entity Daily Report.

Every figure on this page is printed as it appears in the HRSA 340B OPAIS Covered Entity Daily Report, file 340B_CoveredEntity_Daily_20261106_071011.xlsx, stamped by its publisher November 6, 2026. This record has been read here since September 6, 2026.

How this page was built: the HRSA 340B OPAIS Covered Entity Daily Report, file 340B_CoveredEntity_Daily_20261106_071011.xlsx, read November 6, 2026.

What this page shows

SSM Health St Agnes Hospital - Fond du Lac is a sole community hospital located in Fond du Lac, WI. The entity began participation in 2023 and received certification in 2025.