2024-11-15T14:38:12-06:00 2023-12-31 990 2023-01-01 370662580 ST MARY'S HOSPITAL CENTRALIA ILLINOIS STMA 6184368000 12800 CORPORATE HILL DRIVE ST LOUIS MO 63131 STEPHANIE KING VP-FINANCE 6184368000 2024-11-15 0 X 2023 2024-10-15 13:58:12Z X SSM HEALTH ST MARY'S HOSPITAL - CEN DAMON HARBISON 12800 CORPORATE HILL DRIVE ST LOUIS MO 63131 131368786 0 X WWW.SSMHEALTH.COM/LOCATIONS/ILLINOIS/ST-MARYS-HOS X 1947 MO 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. 13 11 703 49 0 0 6407452 6468846 120802670 123978437 51283 436024 471501 485479 127732906 131368786 21161 134691 0 0 44319842 46320637 0 0 0 61948252 55474830 106289255 101930158 21443651 29438628 132060450 135782680 74255762 40782611 57804688 95000069 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 84742949 134691 123978437 SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 650 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 12 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 13,900 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMH STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. ABOUT ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, OPERATING IN PARTNERSHIP WITH THE FELICIAN SISTERS, IS A 125-BED HOSPITAL WITH A STRONG HISTORY OF OVER 100 YEARS OF COMMUNITY ENGAGEMENT. ST. MARY'S HOSPITAL DELIVERS HOSPITAL SERVICES IN INPATIENT, AMBULATORY SURGERY, OUTPATIENT, AND EMERGENCY ROOM SETTINGS. KEY SERVICE LINES INCLUDE BEHAVIORAL HEALTH, CANCER, MATERNITY, OCCUPATIONAL MEDICINE, WEIGHT MANAGEMENT SERVICES, WOUND CARE, AND MANY MORE. THE HOSPITAL'S SURGERY CENTERS ARE EQUIPPED WITH THE LATEST INNOVATIONS IN TECHNOLOGY ENSURING OUR PATIENTS HAVE ACCESS TO THE MOST ADVANCED TREATMENT WHILE STAYING CLOSE TO HOME. TO PROVIDE COMPLETE NEUROLOGICAL CARE, OUR SPECIALISTS ARE SUPPORTED BY BOARD CERTIFIED NEURORADIOLOGISTS, A FULL-SERVICE REHABILITATION UNIT, A HOME HEALTH DEPARTMENT, 24-HOUR MRI SERVICE, NEURODIAGNOSTIC EQUIPMENT, AND CARDIAC CATHETERIZATION LABORATORIES. SSM HEAL TH ST. MARY'S HOSPITAL - CENTRALIA ALSO OPERATES THE LITTLE EGYPT BREAST AND CERVICAL CANCER PROGRAM AND HAS BEEN A LEAD AGENCY FOR THIS ILLINOIS PUBLIC HEALTH PROGRAM SINCE 1998. THE PROGRAM OFTEN SERVES AS A LAST RESORT FOR BREAST AND CERVICAL CANCER SCREENINGS AND EDUCATION FOR WOMEN WHO ARE UNINSURED. FOR SEVEN CONSECUTIVE YEARS, HEAL THGRADES HAS PRESENTED ST. MARY'S HOSPITAL THE OUTSTANDING PATIENT EXPERIENCE AND CRITICAL CARE EXCELLENCE AWARDS. IN 2014, QUEST BY PREMIER INC. RECOGNIZED ST. MARY'S HOSPITAL-CENTRALIA WITH THE CITATION OF MERIT AWARD FOR HIGH-VALUE HEALTHCARE. IN 2016, SSM HEALTH ANNOUNCED A $20 MILLION RENOVATION PLAN FOR ST. MARY'S HOSPITAL CENTRALIA, WHICH WILL INCLUDE INTERIOR AND EXTERIOR UPGRADES, INCLUDING EXPANSION OF THE SURGERY DEPARTMENT AND IMPROVEMENTS TO THE EMERGENCY DEPARTMENT. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: - OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY - HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA - HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY- ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS- PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS - ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.QUANTIFIABLE UNCOMPENSATED CARE: THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE QUANTIFIED AS UNCOMPENSATED CARE: TRADITIONAL CHARITY CARE$ 605,655 UNPAID COST OF MEDICARE SERVICES$ 6,767,110 UNPAID COST OF OTHER GOVERNMENT PROGRAMS$ 1,157,502 TOTAL QUANTIFIABLE UNCOMPENSATED CARE$ 8,530,267 SCHEDULE H, PART VI, QUESTION 4: COMMUNITY INFORMATION: DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. UPDATED 7/18/2022 SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, IN PARTNERSHIP WITH SSM HEALTH GOOD SAMARITAN HOSPITAL - MOUNT VERNON, DEFINES ITS PRIMARY SERVICE AREA AS MARION AND JEFFERSON COUNTIES IN ILLINOIS. THERE ARE 23 ZIP CODES THAT ARE LOCATED WITHIN OR PARTIALLY WITHIN THE COMMUNITY. THIS AREA HAD AN ESTIMATED POPULATION OF 81,171 PEOPLE IN 2020 AND ACCOUNTS FOR 54% OF THE TOTAL PATIENTS SERVED BY THE HOSPITALS. THE SECONDARY SERVICE AREA IS ANOTHER 84,000 PEOPLE AND 17% OF INPATIENT-CARE PATIENTS SERVED. THE MEDIAN AGE IN THE COMMUNITY IS 41.0 YEARS OLD, WHICH IS OLDER THAN THE U.S. MEDIAN AGE OF 38.1 YEARS. THE POPULATION HAS ALSO DECREASED ABOUT 3.7% IN THE LAST 10 YEARS. IN THE AREA SERVED, THE POVERTY LEVEL IS 18.0%, SIGNIFICANTLY MORE THAN THE 13% RATES FOR BOTH ILLINOIS AND THE U.S. AS A WHOLE. MEDIAN FAMILY INCOME IS $60,361, COMPARED TO $83,279 FOR ILLINOIS AND $77,263 FOR THE NATION. LIFE EXPECTANCY ALSO FALLS BEHIND STATE AND U.S. RATES FOR THIS AREA. ADDITIONAL INFORMATION CONCERNING THE SERVICE AREA CAN BE FOUND STARTING ON PAGE 6 OF THE 2021 CHNA. 84742949 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 703 1 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X MARK STOVER 6184367545 400 N PLEASANT AVENUE CENTRALIA IL 62801 MICHAEL BAUMGARTNER DIRECTOR, REGIONAL PRESIDENT-SOUTHERN ILLINOIS 1.00 40.00 X X 0 563577 295955 MATTHEW FLANIGAN DIRECTOR 1.00 0.00 X 0 0 0 JEREMY FOTHERINGHAM DIRECTOR, CHAIRPERSON, REGIONAL PRESIDENT 0.00 40.00 X 0 1125814 687586 PAULA FRIEDMAN DIRECTOR, VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 DAMON HARBISON DIRECTOR, HOSPITAL PRESIDENT-SSM HEALTH ST. MARY'S 40.00 0.00 X X 478548 0 228496 DR JEAN BENOIT-HOULE DIRECTOR, SSM HEALTH GOOD SAMARITAN HOSPITAL PHYSI 1.00 0.00 X 0 0 0 TENA HOYT DIRECTOR 1.00 0.00 X 0 0 0 DR ERICA IBENDAHL DIRECTOR, SSM HEALTH MEDICAL GROUP PHYSICIAN 1.00 0.00 X 0 0 0 JEREMY MIDURA DIRECTOR 1.00 0.00 X 0 0 0 DR SUDEEP NAIR DIRECTOR, SSM HEALTH MEDICAL GROUP PHYSICIAN 1.00 0.00 X 0 0 0 SUZIE SCHMIDT DIRECTOR 1.00 0.00 X 0 0 0 RAJENDRA SHROFF MD DIRECTOR 1.00 0.00 X 0 0 0 PATRICIA WILLIAMS DIRECTOR 1.00 0.00 X 0 0 0 RANDY COMBS TREASURER, CHIEF FINANCIAL OFFICER AT SSM HEALTH 0.00 40.00 X 0 2182354 1238074 DOUGLAS LONG SECRETARY, GENERAL COUNSEL AT SSM HEALTH 0.00 40.00 X 0 1425239 777013 RACHEL HALL ASSISTANT SECRETARY 40.00 0.00 X 0 88558 30654 JOHN SNODSMITH REGIONAL VP, FINANCE 0.00 40.00 X 0 292287 99350 JULIE LONG VP - STRATEGIC PLANNING 0.00 40.00 X 0 417253 178318 JOHN KOHLER SR CHIEF MEDICAL OFFICER 0.00 40.00 X 0 334507 64243 HOLLIE COLLE VP HOSPITAL OPERATIONS 40.00 0.00 X 184039 0 62133 MATTHEW SCOTT DIRECTOR - PHARMACY 40.00 0.00 X 172469 0 72131 MARLA SMITH DIRECTOR - NURSING 40.00 0.00 X 168807 0 55883 MAAMOUN JUNIDI PHYSICIAN 40.00 0.00 X 337461 0 4942 TRACY FISCUS ADMINISTRATIVE DIRECTOR - NURSING 40.00 0.00 X 213193 0 50621 CHRISTY DETERING NURSE PRACTITIONER 40.00 0.00 X 169869 0 9963 AMBER WENNERSTROM NURSE PRACTITIONER 40.00 0.00 X 186153 0 37432 TODD DAVIS PHARMACIST 40.00 0.00 X 168178 0 42730 LAURA KAISER PRESIDENT/CEO OF SSM HEALTH 0.00 40.00 X 0 4644135 3002313 MATT KINSELLA PT YR REGIONAL VP FINANCE 0.00 40.00 X 0 532042 201905 KAREN REWERTS SYSTEM VP, FINANCE (MO/ILL) 0.00 40.00 X 0 801331 287514 GEORGE DANEKER INTERIM CHIEF MEDICAL OFFICER - SOUTHERN ILLINOIS 40.00 0.00 X 0 443773 58437 MELISSA KARAFFA NURSE PRACTITIONER 40.00 0.00 X 161335 0 45077 2240052 12850870 7530770 81 1 1 0 ANESTHESIA ASSOCIATES OF SOUTHERN ILLINO 2700 TURNBERRY DRIVE MARION IL 62959 MEDICAL SERVICES 3252083 VAYA WORKFORCE SOLUTIONS 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 STAFFING SERVICES 2430154 TRIMEDX HOLDINGS LLC 5451 LAKEVIEW PARKWAY S DR INDIANAPOLIS IN 46268 CLINICAL ENGINEERING SERVICES 1166796 SODEXO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY SERVICES 1026989 MIDWEST EMERGENCY DEPARTMENT SERVICES IN 320 E US HWY 50 OFALLON IL 62269 MEDICAL SERVICES 831574 24 3528149 2940697 6468846 NET PATIENT SERVICE REVENUE 622110 123745072 123745072 340B PHARMACY REVENUE 446110 61256 61256 CORPORATE FEES 561000 38972 38972 MANAGEMENT FEES 561000 36000 36000 97137 97137 123978437 271403 271403 226984 0 226984 226984 226984 164621 0 164621 164621 164621 CAFETERIA REVENUE 722210 258394 258394 BEAUTY SHOP REVENUE 812900 101 101 258495 131368786 123978437 0 921503 X 134691 134691 2672931 2509024 163907 31497412 29565957 1931455 1771285 1662668 108617 7903070 7418445 484625 2475939 2324112 151827 1332168 817138 515030 126616 126616 14196443 13548644 647799 26729 7876 18853 1581697 1494614 87083 3167566 3167566 2427810 2427810 235475 212933 22542 24310 20614 3696 11620074 150595 11469479 4131192 3866688 264504 889875 6763 883112 MEDICAL SUPPLIES & EQUI 10596690 10553763 42927 TAXES 4766172 4766172 LICENSES, DUES, SUBSCRI 228712 71845 156867 BANK FEES 108270 108270 15031 15031 101930158 84742949 17187209 0 122942 129870 17025888 24491034 2337462 1953230 664628 395075 91092828 54654272 37797529 36438556 894437 1153383 630679 512199 72586885 70709333 132060450 135782680 8796683 10215840 53034000 21872788 0 279490 12425079 8414493 74255762 40782611 X 57047129 94161504 757559 838565 57804688 95000069 132060450 135782680 X 29438628 7756753 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3998 3998 0 PART II-B, LINE 1: THE ORGANIZATION PAID DUES TO VARIOUS STATE AND NATIONAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 1302150 1302150 47293918 23979040 23314878 787310 677522 109788 41410032 29982620 11427412 299418 15090 284328 36438556 DUE FROM AFFILIATES 69040380 OPERATING RIGHT OF USE ASSETS 1668953 70709333 DEFERRED COMPENSATION 369673 ASSET RETIREMENT OBLIGATION 90101 OTHER LONG TERM LIABILITIES 1164114 THIRD PARTY PAYORS 3975866 OPERATING LEASE OBLIGATIONS 558596 INTERCOMPANY PAYABLES 2256143 8414493 X PART X, LINE 2: ST MARY'S HOSPITAL, CENTRALIA, ILLINOIS' 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 2022 OR 2023. 1 1 X 1 X 1 X 1 1 1 0 1 1 978585 0 978585 0.00960 31756564 31627218 129346 0.00130 2343483 1605725 737758 0.00720 35078632 33232943 1845689 0.01810 104253 0 104253 0.00100 291982 0 291982 0.00290 0 0 0 0 58825 0 58825 0.00060 455060 455060 0.00450 35533692 33232943 2300749 0.02260 1 3029143 0 20103307 27781957 -7678650 X 1 1 1 1 SSM HEALTH ST MARY'S HOSPITAL - CENTRALIA 400 N PLEASANT AVENUE CENTRALIA IL 62801 HTTPS://WWW.SSMHEAL TH.COM/LOCATIONS/S 0002642 X X X SSM HEALTH ST MARY'S HOSPITAL - CENTRAL 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/COMMUNITY-HEALTH X 1 22 1 HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/COMMUNITY-HEALTH 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIA X HTTPS://WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL X HTTPS://WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL X X X X X X 1 X 0 X X X X 1 X 0 0 SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PART V, SECTION B, LINE 5: IN CONDUCTING THIS ASSESSMENT, THE SSM HEALTH COMMUNITY HEAL TH TEAM SOUGHT INPUT FROM THE COMMUNITY THROUGH A COMMUNITY WIDE HEALTH SURVEY, HOSTED FOCUS GROUPS, AND CONDUCTED KEY INFORMANT INTERVIEWS. NO GROUPS IN THE COMMUNITY WERE EXCLUDED FROM PARTICIPATING IN THE ASSESSMENT. SECONDARY DATA WAS COLLECTED FROM VARIOUS ORGANIZATIONS, SUCH AS THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEAL TH RANKINGS, SPARKMAP, BROADSTREET.IQ, AND THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH. EACH OF THESE SOURCES OF PRIMARY DATA (COMMUNITY INPUT) WAS ANALYZED ALONG ASIDE SECONDARY DATA. NO WRITTEN COMMENTS WERE RECEIVED ON THE SSM HEALTH SOUTHERN ILLINOIS 2019- 2021 COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY HEALTH SURVEY FROM MARCH 15, 2021, TO MAY 24, 2021, INDIVIDUALS WITHIN THE COMMUNITY WERE INVITED TO COMPLETE A THIRTY NINE QUESTION COMMUNITY HEALTH SURVEY. THE ONLINE SURVEY WAS PROMOTED THROUGH SOCIAL MEDIA, PRESS RELEASES, COUNTY AND CITY CHAMBERS OF COMMERCE, E MAIL INVITATIONS TO SSM HEAL TH PHYSICIANS, STAFF, AND VOLUNTEER BOARDS AS WELL AS EMAIL INVITATIONS TO PUBLIC OFFICIALS, COMMUNITY ORGANIZATIONS, AND CHURCHES. PAPER SURVEYS WERE AVAILABLE AT THE HOSPITAL ENTRANCES AND LOCAL PUBLIC LIBRARIES. 577 RESIDENTS OF THE 23 ZIP CODES OF THE DEFINED COMMUNITIES COMPLETED SURVEYS; 3 OF THE 577 SURVEYS WERE COMPLETED USING A PAPER SURVEY. FOCUS GROUPS FOCUS GROUPS WERE MODERATED, CONDUCTED, AND ANALYZED BY THE COMPANY, STEFANIE SANTOS MCLEESE: PR AND BRAND STRATEGY. AS PART OF THE BROADER COMMUNITY HEAL TH NEEDS ASSESSMENT (CHNA) DATA GATHERING PROCESS, THREE AUDIENCES WERE IDENTIFIED AS PRIORITIES FOR FURTHER INVESTIGATION, EITHER DUE TO STATISTICAL UNDER REPRESENTATION IN THE 2021 CHNA SURVEY OR GENERAL URGENCY AS INDICATED IN SURVEY RESULTS. ONE GROUP WAS ASSIGNED TO REPRESENT EACH OF THESE AUDIENCES. WHEN POSSIBLE, CHNA INITIATIVES FOCUS ON THE COLLECTION OF HEAL TH NEEDS FROM A REPRESENTATIVE MIX OF FIRST PERSON PERSPECTIVES. HOWEVER, CERTAIN GROUPS MAY BE MORE RELUCTANT OR SIMPLY LESS LIKELY TO SHARE THEIR DIRECT FEEDBACK FOR A VARIETY OF REASONS. IN CASES LIKE THESE, IT CAN BE APPROPRIATE TO ENGAGE INDIVIDUALS WITH DIRECT CONTACT WITH THESE POPULATIONS TO PROVIDE THE NECESSARY STORY, POINT OF VIEW, AND CONTEXT, HELPING TO ENSURE THE CHNA INCORPORATES THE NEEDS OF THESE GROUPS. THE SSM HEALTH COMMUNITY HEALTH TEAM CONDUCTED A RIGOROUS, BEST PRACTICE NETWORK RECRUIT FOR EACH OF THE THREE GROUPS, BEGINNING WITH KNOWN STAKEHOLDERS WITH APPROPRIATE CONTEXT BEFORE BRANCHING OUT TO RECRUIT STAKEHOLDERS SUGGESTED AS IDEAL FOR REPRESENTING THE POPULATIONS IN QUESTION BY THOSE KNOWN STAKEHOLDERS. GROUP EMPHASIS AND PARTICIPANT SUMMARY - INDIVIDUALS EXPERIENCING HOUSING INSTABILITY OR HOMELESSNESS: SEVEN PARTICIPANTS REPRESENTING LOCAL COMMUNITY SERVICES ORGANIZATIONS; TWO OF THESE PARTICIPANTS HAD PERSONALLY EXPERIENCED HOUSING INSTABILITY - BLACK COMMUNITY MEMBERS : THREE CHURCH LEADERS SERVING PREDOMINANTLY BLACK CONGREGATIONS - INDIVIDUALS EXPERIENCING MENTAL HEALTH DIFFICULTIES: NINE PARTICIPANTS REPRESENTING LOCAL COMMUNITY SERVICE ORGANIZATIONS WHICH ON FOCUS MENTAL HEALTH SERVICES KEY INFORMANT INTERVIEWS THE COMMUNITY HEALTH TEAM INTERVIEWED 28 KEY COMMUNITY MEMBERS HEALTH CARE ADMINISTRATIONS, SOCIAL SERVICE ORGANIZATION LEADERS, LAW ENFORCEMENT, EDUCATIONAL LEADERS, CIVIC ORGANIZATIONAL LEADERS, AND KEY COMMUNITY LEADERS TO GATHER INPUT ON THE HEAL TH NEEDS, STRENGTHS, CONCERNS, AND AREAS OF IMPROVEMENT NEEDED IN OUR COMMUNITY. SEVERAL OF THE INTERVIEWS INVOLVED MORE THAN ONE PERSON FROM THE ORGANIZATION. INTERVIEWS WERE CONDUCTED IN PERSON OR VIA VIRTUAL VIDEO MEETING SOFTWARE DEPENDING ON THE INDIVIDUAL'S PREFERENCES. ALL INTERVIEWS WERE RECORDED AND TRANSCRIBED VIA AUTO TRANSCRIPTION SOFTWARE. SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PART V, SECTION B, LINE 6A: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA CONDUCTED ITS 2021 CHNA IN COOPERATION WITH SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON. SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - SUBSTANCE ABUSE- MENTAL HEALTH- NUTRITION, WEIGHT, AND EXERCISESUBSTANCE ABUSE ACCORDING TO THE CDC'S NATIONAL CENTER FOR HEALTH STATISTICS PROVISIONAL, DRUG OVERDOSE DEATHS HAVE INCREASED FROM 78,056 IN 2019/2020 TO 100,306 IN 2020/2021. IN ILLINOIS, THE OVERALL AGE ADJUSTED DRUG OVERDOSE MORTALITY RATE IN 2019 WAS 21.9 PER 100,000 POPULATION. ILLINOIS HAS ALSO BEEN RANKED 24TH IN THE COUNTRY FOR OVERALL DRUG OVERDOSE FATALITY RATE. ACCORDING TO THE CDC'S CENTER FOR VITALS STATISTICS, MORTALITY RATES DUE TO POISONING WERE 26 PER 100,000 POPULATION FOR MARION COUNTY AND 22 PER 100,000 FOR JEFFERSON COUNTY. TOBACCO USE IS THE LEADING CAUSE OF PREVENTABLE DISEASE, DISABILITY, AND DEATH IN THE UNITED STATES. CIGARETTE SMOKING CAUSES MORE THAN 480,000 DEATHS ANNUALLY, INCLUDING 41,000 DEATHS FROM SECONDHAND SMOKE. FOR EVERY AMERICAN WHO DIES BECAUSE OF SMOKING, AT LEAST 30 ARE LIVING WITH A SERIOUS SMOKING RELATED ILLNESS. ACCORDING TO CDC'S BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, OVER 15% OF RESIDENTS IN ILLINOIS WERE CURRENT SMOKERS IN 2019. ADDITIONALLY, IN 2019, 22.7% OF ILLINOIS HIGH SCHOOL YOUTH REPORTED CURRENTLY USING ANY TOBACCO PRODUCT, INCLUDING E CIGARETTES. AMONG ILLINOIS HIGH SCHOOL YOUTH, 4.7% REPORTED CURRENTLY SMOKING CIGARETTES. THE PERCENT OF ADULTS WHO REGULARLY SMOKE IN BOTH MARION AND JEFFERSON COUNTY IS APPROXIMATELY 20%, HIGHER THAN THE STATE AVERAGE. THE HOSPITAL HAS THE FOLLOWING STRATEGIES ADDRESSING SUBSTANCE ABUSE IN ITS COMMUNITY: - PROVIDE OPPORTUNITIES FOR PROPER DRUG DISPOSAL FOR OTC AND CONTROLLED SUBSTANCES - INSTALL COMPREHENSIVE MEDICATION COLLECTION KIOSKS, PENDING DEA APPROVAL, AT EACH HOSPITAL - CREATE AND DISTRIBUTE EDUCATION REGARDING AT HOME DRUG DISPOSAL BEST PRACTICES - DISTRIBUTE "AT-HOME" DISPOSAL KITS TO HIGH RISK POPULATIONS - PROVIDE EDUCATION ON OPIOID MISUSE AND PROVIDE NALOXONE TO COMMUNITY MEMBERS - APPLY FOR A STATE OF ILLINOIS NALOXONE STANDING ORDER FOR SSM HEALTH PHARMACY AND ENSURE LISTING ON STATE AND NATIONAL WEBSITES- IDENTIFY ELIGIBLE ORGANIZATIONS WILLING TO PARTICIPATE IN THE ILLINOIS DRUG OVERDOSE PREVENTION PROGRAM (DOPP)- PROMOTE NARCAN PICK-UP AVAILABILITY AT SPECIFIED COMMUNITY-BASED LOCATIONS- PROVIDE EDUCATION OPPORTUNITIES ON NARCAN ADMINISTRATION AND DISPERSE NARCAN FOR HOUSEHOLDS TO HAVE ON-HAND IN AN EMERGENCY - PROVIDE PREVENTION AND CESSATION EDUCATION ON TOBACCO AND VAPING USE- INITIATE THE IMPLEMENTATION OF CATCH MY BREATH PROGRAM IN LOCAL SCHOOLS- PROVIDE RESOURCES AND EDUCATIONAL OPPORTUNITIES FOR TOBACCO AND VAPING CESSATION IN THE COMMUNITY - PROVIDE INCENTIVE OPPORTUNITIES FOR LOCAL SCHOOLS TO PARTICIPATE IN SMOKING PREVENTION EDUCATION GOALS FOR THE SUBSTANCE ABUSE HEALTH PRIORITY ARE:- DECREASE INCIDENCE OF IMPROPER DRUG USE - DECREASE INCIDENCE OF PRESCRIPTION DRUG DEPENDENCE- REDUCE EMERGENCY HOSPITAL VISITS DUE TO DRUG-RELATED INCIDENTS - DECREASE RATE OF OPIOID OVERDOSE - REDUCE PREVALENCE OF TOBACCO RELATED HEALTH DISPARITIES MENTAL HEALTH MARION AND JEFFERSON COUNTIES ARE RANKED AMONG THE LOWEST QUARTILE OF ADULTS REPORTING POOR MENTAL HEALTH DAYS, WITH AN AVERAGE OF OVER 5 POOR MENTAL HEALTH DAYS PER MONTH. ACCORDING TO UNITED HEALTH FOUNDATION'S US HEALTH RANKINGS, OVER 14% OF ILLINOIS RESIDENTS HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER. THE RATE OF SUICIDE IN ILLINOIS IS 11.3 PER 100,000 POPULATION. ADDITIONALLY, THE RATE OF SUICIDE IN MARION COUNTY IS 26 PER 100,000 POPULATION, AND JEFFERSON COUNTY IS 15 PER 100,000 POPULATION. BOTH RATES OF SUICIDE ARE HIGHER THAN THE AVERAGE RATE OF SUICIDE IN THE STATE. THE HOSPITAL'S ACTION PLAN INCLUDES THE FOLLOWING INITIATIVES TO ADDRESS MENTAL HEALTH IN THE REGION SERVED: - PROVIDE EDUCATIONAL OPPORTUNITIES FOR COMMUNITY MEMBERS- OFFER QUESTION, PERSUADE, REFER (QPR) GATEKEEPER TRAINING - IMPLEMENT ADULT AND YOUTH MENTAL HEALTH FIRST AID TRAININGS - PROVIDE RESOURCES TO INCREASE KNOWLEDGE OF ACCESSIBLE MENTAL HEALTH SERVICES - INCREASE DISTRIBUTION OF COMMUNITY MENTAL HEALTH RESOURCE GUIDE - BEGIN DISTRIBUTING THE NATIONAL SUICIDE PREVENTION LIFELINE TO COMMUNITY MEMBERS AND PARTNERING ORGANIZATIONS- ENHANCE COLLABORATIVE EFFORTS WITH COMMUNITY PARTNERS - DEVELOP RELATIONSHIPS WITH NEW AND EXISTING COMMUNITY PARTNERS - SPONSOR COMMUNITY EVENTS AND INITIATIVES HOSTED BY PARTNERS - PROVIDE EDUCATIONAL OPPORTUNITIES ON TRAUMA INFORMED CARE - PROVIDE CME OPPORTUNITIES TO SSM HEALTH AND COMMUNITY CLINICIANS ON TRAUMA INFORMED CARE -PROVIDE GENERAL EDUCATION WORKSHOPS ON TRAUMA INFORMED COMMUNITY BUILDING AND RESILIENCE EXPECTED OUTCOMES OF THESE STRATEGIES INCLUDE THE FOLLOWING: - REDUCE NUMBER OF REPORTED MENTALLY UNHEALTHY DAYS- INCREASE PERCENTAGE OF INDIVIDUALS RECEIVING TREATMENT FOR CHRONIC MENTAL ILLNESS- REDUCE PREVALENCE OF UNTREATED DEPRESSION/ANXIETY- DECREASE SUICIDE RATE- DECREASE EMERGENCY DEPARTMENT VISITS FOR NONFATAL INTENTIONAL INJURYNUTRITION, WEIGHT AND EXERCISE OBESITY IS A SERIOUS CHRONIC DISEASE THAT CONTINUES TO INCREASE IN THE UNITED STATES AND CAN LEAD TO OTHER SERIOUS ILLNESSES LIKE TYPE II DIABETES, HEART DISEASE, AND CANCER. IN JEFFERSON AND MARION COUNTIES, OVER 30% OF ADULTS LIVING IN THE COMMUNITY ARE OBESE (BML=30+), WHICH IS SLIGHTLY LOWER THAN THE STATE AVERAGE PERCENTAGE OF ADULTS WITH OBESITY, AT 32%. COMMUNITY REPRESENTATIVES WHO PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT HAVE IDENTIFIED OBESITY AS A SIGNIFICANT NEED TO BE ADDRESSED IN THE AREA. ACCESS TO NUTRITIOUS FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY PLAYS A VITAL ROLE IN REDUCING THE PREVALENCE OF OBESITY AND CHRONIC DISEASE. WITHIN THE JEFFERSON AND MARION COUNTY AREAS, 14% OF THE POPULATION EXPERIENCE FOOD INSECURITY, OR A LACK OF RESOURCES TO FEED ALL MEMBERS OF THEIR HOUSEHOLD. ADDITIONALLY, THE RATE OF AVAILABLE FITNESS AND RECREATION FACILITIES PER 100,000 POPULATION IS APPROXIMATELY 15 IN BOTH JEFFERSON AND MARION COUNTY. THE RATE IN ILLINOIS FOR RECREATION AND FITNESS FACILITIES IS ONLY 12.5 PER 100,000 POPULATION. MANY TIMES, THESE FACILITIES HAVE A COST FOR MEMBERSHIP, WHICH CAN ALSO POSE A BARRIER TO MANY COMMUNITY MEMBERS. COSTS FOR FITNESS CENTER MEMBERSHIPS TYPICALLY RANGE FROM $10 TO $100 EACH MONTH. THE HOSPITAL HAS OUTLINED THE STRATEGIES BELOW TO IMPROVE COMMUNITY HEALTH RELATED TO NUTRITION, WEIGHT AND EXERCISE: - PROMOTE ACCESS TO NUTRITIOUS FOOD FOR THOSE EXPERIENCING FOOD INSECURITY - PROVIDE SUPPORT FOR MOBILE MARKETS AND TO LOCAL COMMUNITY FOOD PANTRIES- IDENTIFY LOCATIONS FOR LITTLE FOOD PANTRY BOX INSTALLATION - SUPPORT EXISTING AND ESTABLISH ADDITIONAL COMMUNITY GARDENS AND THE TRAINING OF MASTER GARDENERS - PROVIDE OPPORTUNITIES FOR EDUCATION AND ENGAGEMENT REGARDING NUTRITION, WEIGHT AND EXERCISE- FUND SCHOLARSHIPS FOR IDENTIFIED VULNERABLE POPULATIONS TO PARTICIPATE IN FELICIAN WELLNESS CENTERS' NEXT (NUTRITION, EXERCISE, AND PHYSICAL ACTIVITY) PROGRAM- PROVIDE EVIDENCE-BASED CHRONIC DISEASE/DIABETES SELF-MANAGEMENT COURCES- PROVIDE SUPPORT IN OFFERING ACCESSIBLE COMMUNITY FITNESS COURSES- BUILD PARTNERSHIPS WITH OUTSIDE ORGANIZATIONS TO BUILD COMMUNITY PROGRAMS- PARTNER WITH LOCAL SCHOOLS TO PROMOTE THE USDA'S TEAM NUTRITION PROGRAM- DEVELOP RELATIONSHIPS WITH NEW AND EXISTING COMMUNITY PARTNERS- SPONSOR COMMUNITY EVENTS AND INITIATIVES HOSTED BY PARTNERSLONG-TERM, THE HOSPITAL HOPES FOR THESE OUTCOMES:- REDUCE PERCENTAGE OF ADULTS WITH OBESITY- REDUCE PERCENTAGE OF INDIVIDUALS WITH TYPE II DIABETES- REDUCE PERCENTAGE OF INDIVIDUALS WITH CHRONIC DISEASE- DECREASE POPULATION WHO EXPERIENCE FOOD INSECURITY - REDUCE OBESITY-RELATED DISABILITY- IMPROVE QUALITY OF LIFE THE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS TO ADDRESS OTHER NEEDS NOTED IN ITS 2021 CHNA. 8 1 - SSM HEALTH MEDICAL GROUP 1054 MARTIN LUTHER KING CENTRALIA IL 62801 OUTPATIENT CLINIC 2 - SSM HEALTH MEDICAL GROUP 432 N PLEASANT AVE CENTRALIA IL 62801 OUTPATIENT CLINIC 3 - SSM HEALTH MEDICAL GROUP 1050 MARTIN LUTHER KING SUITE 104 CENTRALIA IL 62801 OUTPATIENT CLINIC 4 - SSM HEALTH MEDICAL GROUP 402 N PLEASANT AVE CENTRALIA IL 62801 OUTPATIENT CLINIC 5 - SSM HEALTH MEDICAL GROUP 1250 W WHITTAKER ST STE B SALEM IL 628811902 OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT 6 - SSM MEDICAL GROUP 1445 W BROADWAY CENTRALIA IL 628815613 OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT PHYSICIAN OFFICES 7 - SSM HEALTH BEHAVIORAL HEALTH 444 N PLEASANT AVE CENTRALIA IL 628013006 OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT BEHAVIORAL HEALTH 8 - SSM HEALTH CANCER CARE 1052 MARTIN LUTHER KING DR STE 100 CENTRALIA IL 628013002 OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT CANCER CENTER PART I, LINE 3C: PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF THE HOSPITAL; HOWEVER THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED TO COMMERCIALLY INSURED [OR MEDICARE] PATIENTS. IN SUCH CASES, OTHER FACTORS MAY BE CONSIDERED IN DETERMINING THEIR ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES, INCLUDING: BANK ACCOUNTS, INVESTMENTS AND OTHER ASSETS EMPLOYMENT STATUS AND EARNING CAPACITY AMOUNT AND FREQUENCY OF BILLS FOR HEAL TH CARE SERVICES OTHER FINANCIAL OBLIGATIONS AND EXPENSES GENERALLY, FINANCIAL RESPONSIBILITY WILL BE NO MORE THAN 25% OF GROSS FAMILY INCOME. THE HOSPITAL MAY UTILIZE PREDICTIVE ANALYTICAL SOFTWARE OR OTHER CRITERIA TO ASSIST IN MAKING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IN SITUATIONS WHERE THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE BUT HAS NOT PROVIDED THE NECESSARY DOCUMENTATION TO MAKE A DETERMINATION. THIS PROCESS IS CALLED "PRESUMPTIVE ELIGIBILITY." PART I, LINE 6A: SSM HEALTH CARE CORPORATION, 46-6029223 PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B, AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H, AND 71 ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE CALCULATION OF SCHEDULE H, PART I, LINE 7, COLUMN F UTILIZES 990, PART IX, LINE 25, COLUMN A, WHICH DOES NOT INCLUDE BAD DEBT EXPENSE. PART III, LINE 2: AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. PART III, LINE 3: FOR FINANCIAL STATEMENT PURPOSES, SSM HEALTH HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THEREFORE, THERE IS NO AMOUNT REPORTED ON PART III, LINE 3 FOR THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER SSM HEALTH'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: SSM HEAL TH ST. MARY'S HOSPITAL - CENTRALIA IS PART OF THE SSM HEALTH CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES THE TREATMENT OF UNCOLLECTIBLE ACCOUNTS AND IMPLICIT PRICE CONCESSIONS IN THE DECEMBER 31, 2023 CONSOLIDATED AUDIT IS CONTAINED ON PAGE 13 AND 14 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST. PART III, LINE 9B: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA HAS ESTABLISHED A WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEALTH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE, THE HEALTH CENTER EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HEALTH CENTER'S BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RATE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY. ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING: 1.THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT 2.EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS. 3.ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD. 4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL. 5.BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSM PRIOR TO ENGAGING IN ECAS. SSM WILL REVIEW THE ACCOUNTS AND VERIFY SATISFACTORY COMPLETION OF REASONABLE EFFORTS DURING THE NOTIFICATION AND APPLICATION PERIOD. A WAIVER IS NOT CONSIDERED REASONABLE EFFORTS. OBTAINING A SIGNED WAIVER THAT AN INDIVIDUAL DOES NOT WISH TO APPLY FOR FAP ASSISTANCE OR RECEIVE FAP APPLICATION INFORMATION WILL NOT MEET THE REQUIREMENT TO MAKE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN ECAS. ALL OUTSIDE COLLECTION AGENCIES MUST COMPLY WITH STATE AND FEDERAL LAWS, COMPLY WITH THE ASSOCIATION OF CREDIT AND COLLECTION PROFESSIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY AND COMPLY WITH SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA'S COLLECTION AND FINANCIAL ASSISTANCE POLICIES. PART VI, LINE 2: SSM HEALTH (SSMH) PARTICIPATES IN COMMUNITY BENEFIT ACCORDING TO OUR VISION, THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY, AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT AND ENVIRONMENT. IN THE TRADITION OF OUR FOUNDERS, THE FRANCISCAN SISTERS OF MARY, CARING FOR THOSE IN GREATEST NEED REMAINS OUR ORGANIZATIONAL PRIORITY. TODAY OUR SYSTEM BOARD MONITORS COMMUNITY BENEFIT EFFORTS, AND VIEWS ACHIEVEMENT OF OUR VISION AS A PRIMARY RESPONSIBILITY. THE PURPOSE OF SSMH'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEAL TH NEEDS. MAKING OUR COMMUNITIES HEALTHIER IN MEASURABLE WAYS IS ALWAYS OUR GOAL. TO FULFILL THIS COMMITMENT, SSMH'S COMMUNITY BENEFIT IS DIVIDED INTO TWO PARTS: 1) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND 2) COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA). THE CHNA IS AN ASSESSMENT AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS AND THE ADOPTION AND IMPLEMENTATION OF STRATEGIES TO ADDRESS THOSE NEEDS. A CHNA IS CONDUCTED EVERY THREE YEARS BY EACH HOSPITAL ACCORDING TO THE FOLLOWING STEPS: *ASSESS AND PRIORITIZE COMMUNITY HEALTH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATA TO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA. *DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEAL TH PRIORITIES: ESTABLISH STRATEGIES TO ADDRESS PRIORITIES; COMPLETE STRATEGIC IMPLEMENTATION PLAN; OBTAIN REGIONAUDIVISIONAL BOARD APPROVAL; AND INTEGRATE STRATEGIES INTO OPERATIONAL PLAN. *MAKE CHNA WIDELY AVAILABLE TO THE PUBLIC: PUBLISH CHNA AND SUMMARY DOCUMENT ON HOSPITAL'S WEBSITE. *MONITOR, TRACK, AND REPORT PROGRESS ON TOP HEAL TH PRIORITIES: COLLECT DATA AND EVALUATE PROGRESS; REPORT TO REGIONAUDIVISIONAL BOARD EVERY SIX MONTHS AND SYSTEM BOARD EVERY YEAR; SHARE FINDINGS WITH COMMUNITY STAKEHOLDERS; AND SEND RESULTS TO FINANCE FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS). SYSTEM OFFICE STAFF AND LEADERS OVERSEE AND MONITOR SSMH'S COMMUNITY BENEFIT PROGRAM, AND ENSURE REPORTING IS IN COMPLIANCE WITH IRS REGULATIONS. IN COLLABORATION WITH COMMUNITY STAKEHOLDERS AND PARTNER ORGANIZATIONS, SSM HEALTH CARE CORPORATION ALSO IDENTIFIES NEEDS BASED ON ASSESSMENTS AND RESEARCH, AND SSMH FACILITIES ALSO INVOLVE CASE MANAGERS AND CARE TEAM STAFF TO PINPOINT CRITICAL HEAL TH ISSUES IN THE COMMUNITY. ALL HOSPITAL CHNAS ARE COMPLETED, APPROVED, AND INTEGRATED INTO THE ORGANIZATION'S STRATEGIC PLAN. WE CONTINUE TO MONITOR AND ASSESS THE PROGRESS OF OUR LOCAL EFFORTS IN THE SPIRIT OF CARING FOR OTHERS AND IMPROVING COMMUNITY HEALTH. PART VI, LINE 3: EACH ENTITY PROVIDING MEDICAL SERVICE SHALL PROVIDE INFORMATION TO THE PUBLIC REGARDING ITS CHARITY CARE POLICIES AND THE QUALIFICATION REQUIREMENTS FOR EACH OF ITS FACILITIES. WHEN STANDARD SYSTEM NOTICES AND COMMUNICATION REGARDING CHARITY CARE ARE AVAILABLE, THESE MUST BE USED. MODIFICATIONS TO THE STANDARD MAY BE MADE TO COMPLY WITH STATE AND LOCAL LAWS, AS WELL AS REFLECT CULTURALLY SENSITIVE TERMINOLOGY FOR THE POLICY. ALL NOTICES ARE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. THEY PROVIDE INFORMATION ABOUT: * THE PATIENT'S RESPONSIBILITY FOR PAYMENT,* THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS* THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS, AND* WHO TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELINGTHE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED: *SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS. *BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. *NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES. *APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES. PART VI, LINE 4: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, IN PARTNERSHIP WITH SSM HEAL TH GOOD SAMARITAN HOSPITAL - MOUNT VERNON, DEFINES ITS PRIMARY SERVICE AREA AS MARION AND JEFFERSON COUNTIES IN ILLINOIS. THERE ARE 23 ZIP CODES THAT ARE LOCATED WITHIN OR PARTIALLY WITHIN THE COMMUNITY. THIS AREA HAD AN ESTIMATED POPULATION OF 81,171 PEOPLE IN 2020 AND ACCOUNTS FOR 54% OF THE TOTAL PATIENTS SERVED BY THE HOSPITALS. THE SECONDARY SERVICE AREA IS ANOTHER 84,000 PEOPLE AND 17% OF INPATIENT-CARE PATIENTS SERVED. THE MEDIAN AGE IN THE COMMUNITY IS 41.0 YEARS OLD, WHICH IS OLDER THAN THE U.S. MEDIAN AGE OF 38.1 YEARS. THE POPULATION HAS ALSO DECREASED ABOUT 3.7% IN THE LAST 10 YEARS. IN THE AREA SERVED, THE POVERTY LEVEL IS 18.0%, SIGNIFICANTLY MORE THAN THE 13% RATES FOR BOTH ILLINOIS AND THE U.S. AS A WHOLE. MEDIAN FAMILY INCOME IS $60,361, COMPARED TO $83,279 FOR ILLINOIS AND $77,263 FOR THE NATION. LIFE EXPECTANCY ALSO FALLS BEHIND STATE AND U.S. RATES FOR THIS AREA. ADDITIONAL INFORMATION CONCERNING THE SERVICE AREA CAN BE FOUND STARTING ON PAGE 6 OF THE 2021 CHNA. PART VI, LINE 5: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY. THE COMMUNITY INITIATIVES BUILD ON THE STRENGTHS OF OUR COMMUNITIES AND SYSTEMS TO IMPROVE THE QUALITY OF LIFE AND TO CREATE A SENSE OF HOPE. COMMUNITY BENEFIT INITIATIVES BUILD COMMUNITY CAPACITY AND INDIVIDUAL EMPOWERMENT THROUGH COMMUNITY ORGANIZING, LEADERSHIP DEVELOPMENT, PARTNERSHIPS, AND COALITION BUILDING. OUR COMMUNITY HEALTH PROGRAMS PROVIDE COMPASSIONATE AND COMPETENT CARE WHILE THEY PROMOTE HEAL TH IMPROVEMENT BY REACHING DIRECTLY INTO THE COMMUNITY TO ENSURE THAT LOW-INCOME AND UNDER-SERVED PERSONS CAN ACCESS HEAL TH CARE SERVICES. IN RESPONSE TO THE GLOBAL CORONAVIRUS PANDEMIC, ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS WORKED RELENTLESSLY TO RESPOND TO COMMUNITY NEEDS BY DEVELOPING AND IMPLEMENTING STRATEGIES TO ADDRESS SOCIAL NEEDS OF THOSE SERVED, PROVIDING SCREENING & TESTING SERVICES, PERSONAL PROTECTIVE EQUIPMENT AND EDUCATION THROUGHOUT THE COMMUNITY, AS WELL AS TREATMENT FOR THOSE WHO PRESENTED WITH COVID-19. SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA ADVOCATES FOR VULNERABLE POPULATIONS BY DEVELOPING RELATIONSHIPS WITH POLICY MAKERS AND THROUGH TARGETED EDUCATION EFFORTS. ALL PROJECTS INCLUDE MEASURABLE OBJECTIVES WITH A SPECIFIC TIME FRAME AND HAVE ACTIVITIES THAT WILL FAVORABLY AFFECT HEALTH STATUS INDICATORS. PROJECTS TO ACCOMPLISH HEALTH STATUS OBJECTIVES MAY INCLUDE: DISEASE PREVENTION PROGRAMS; HEALTH EDUCATION PROGRAMS; HEALTH CARE PROGRAMS FOR INDIVIDUALS WITH SPECIAL HEALTH CONCERNS; AND OTHER PROJECTS THAT IMPROVE COMMUNITY HEAL TH STATUS. PROJECTS TO ADDRESS THE HEAL TH PROBLEMS OF MINORITIES, THE POOR, AND OTHER MEDICALLY UNDERSERVED POPULATIONS MAY INCLUDE: IMPROVING ACCESSIBILITY AND CONTINUITY OF CARE; WORKING TO REDUCE DISPARITIES IN HEALTH STATUS; AND SPONSORING EFFORTS TO INCREASE THE NUMBER OF MINORITIES, THE POOR, AND UNDERSERVED WHO ENTER HEALTH PROFESSIONS AND WORK IN MEDICALLY UNDERSERVED COMMUNITIES. PROJECTS DESIGNED TO CONTAIN THE GROWTH OF COMMUNITY HEAL TH CARE COSTS MAY INCLUDE: IMPROVING EFFICIENCY OF SERVICES; IMPROVING CASE MANAGEMENT AND CONTINUITY OF CARE; SPONSORING HEALTH PROMOTION, DISEASE PREVENTION, AND SELFCARE ACTIVITIES; CONTAINING HEALTH CARE COSTS; AND REDUCING REDUNDANCIES. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: *OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, *HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, *HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY *ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, *PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEAL TH CARE PROGRAMS *ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM. PART VI, LINE 6: ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH GOOD SAMARITAN REGIONAL HEALTH CENTER, IT IS PART OF A JOINT OPERATING AGREEMENT BETWEEN SSM HEALTH BASED IN ST LOUIS, MISSOURI, AND FELICIAN SISTERS, INC. OF CHICAGO. TOGETHER THE HOSPITALS ARE PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE COVERING A NINE COUNTY AREA IN SOUTH CENTRAL ILLINOIS. SSM HEALTH (SSMH) IS A CENTRALLY MANAGED, FULLY INTEGRATED HEAL TH CARE DELIVERY SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSM HEAL TH CARE CORPORATION (SSMHCC) (DOING BUSINESS AS SSMH) IS THE PRINCIPAL NOT-FOR-PROFIT CORPORATION AND HAS BEEN ESTABLISHED AS THE PARENT CORPORATION. SSMH OWNS AND OPERATES 22 ADULT HOSPITALS, ONE PEDIATRIC HOSPITAL, THIRTEEN POST-ACUTE CARE FACILITIES, A NATIONAL PHARMACY BENEFIT MANAGEMENT COMPANY (PBM), AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEALTH CARE BUSINESSES. SSMH'S HOSPITAL OPERATIONS ARE LOCATED PRIMARILY IN MISSOURI, WISCONSIN, OKLAHOMA AND ILLINOIS, AND ITS RELATED BUSINESSES PROVIDE HEALTH RELATED SERVICES IN 50 STATES. SSMH'S MISSION STATEMENT IS AS FOLLOWS: THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. SSMHCC AND MOST OF ITS AFFILIATED SUBSIDIARY CORPORATIONS HAVE BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). CERTAIN SUBSIDIARIES OF SSMH ARE FOR-PROFIT ENTITIES THAT ARE TAXABLE UNDER THE IRC. SSMH IS SPONSORED BY SSM HEALTH MINISTRIES, AN INDEPENDENT NINE-MEMBER BODY COMPOSED OF TWO FRANCISCAN SISTERS OF MARY, ONE SISTER OF ST. AGNES, ONE JESUIT PRIEST, AND FIVE LAY PERSONS WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMH. PART VI, LINE 7, REPORTS FILED WITH STATES IL 0 ST MARY'S HOSPITAL FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS MO 63131 364636691 501(C)(3) 127595 0 GENERAL SUPPORT 1 0 PART I, LINE 2: THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT. IN CERTAIN CIRCUMSTANCES, QUALIFYING EXPENSES MAY BE PAID ON BEHALF OF SYSTEM EMPLOYEES BASED UPON DEMONSTRATED FINANCIAL HARDSHIP CAUSED BY NATURAL DISASTERS, ILLNESS, OR OTHER UNFORESEEN TRAGEDY. X 1 1 0 1 0 0 0 0 0 0 0 LAURA KAISER PRESIDENT/CEO OF SSM HEALTH 0 2047588 0 1868164 0 728383 0 2978810 0 23503 0 7646448 0 1868164 RANDY COMBS TREASURER, CHIEF FINANCIAL OFFICER A 0 1242308 0 669269 0 270777 0 1203989 0 34085 0 3420428 0 669269 DOUGLAS LONG SECRETARY, GENERAL COUNSEL AT SSM HE 0 759270 0 495539 0 170430 0 753634 0 23379 0 2202252 0 495539 JEREMY FOTHERINGHAM DIRECTOR, CHAIRPERSON, REGIONAL PRES 0 789865 0 334239 0 1710 0 648534 0 39052 0 1813400 0 334239 KAREN REWERTS SYSTEM VP, FINANCE (MO/ILL) 0 589021 0 154022 0 58288 0 253200 0 34314 0 1088845 0 207408 MICHAEL BAUMGARTNER DIRECTOR, REGIONAL PRESIDENT-SOUTHER 0 236516 0 233270 0 93791 0 285804 0 10151 0 859532 0 233270 MATT KINSELLA PT YR REGIONAL VP FINANCE 0 405421 0 105716 0 20905 0 160100 0 41805 0 733947 0 125530 DAMON HARBISON DIRECTOR, HOSPITAL PRESIDENT-SSM HEA 366317 0 85494 0 26737 0 178768 0 49728 0 707044 0 111394 0 JULIE LONG VP - STRATEGIC PLANNING 0 319559 0 76123 0 21571 0 147362 0 30956 0 595571 0 96034 GEORGE DANEKER INTERIM CHIEF MEDICAL OFFICER - SOUT 0 373699 0 46272 0 23802 0 35172 0 23265 0 502210 0 46272 JOHN KOHLER SR CHIEF MEDICAL OFFICER 0 273681 0 60259 0 567 0 36472 0 27771 0 398750 0 60259 JOHN SNODSMITH REGIONAL VP, FINANCE 0 257255 0 34175 0 857 0 69162 0 30188 0 391637 0 34175 MAAMOUN JUNIDI PHYSICIAN 330013 0 526 0 6922 0 0 0 4942 0 342403 0 0 0 TRACY FISCUS ADMINISTRATIVE DIRECTOR - NURSING 194909 0 15030 0 3254 0 31870 0 18751 0 263814 0 15030 0 HOLLIE COLLE VP HOSPITAL OPERATIONS 170413 0 13270 0 356 0 36882 0 25251 0 246172 0 13270 0 MATTHEW SCOTT DIRECTOR - PHARMACY 158006 0 0 0 14463 0 21481 0 50650 0 244600 0 0 0 MARLA SMITH DIRECTOR - NURSING 155236 0 12146 0 1425 0 25850 0 30033 0 224690 0 12146 0 AMBER WENNERSTROM NURSE PRACTITIONER 117129 0 68694 0 330 0 11204 0 26228 0 223585 0 0 0 TODD DAVIS PHARMACIST 166319 0 1000 0 859 0 9989 0 32741 0 210908 0 0 0 MELISSA KARAFFA NURSE PRACTITIONER 124654 0 36294 0 387 0 10179 0 34898 0 206412 0 0 0 CHRISTY DETERING NURSE PRACTITIONER 149658 0 20181 0 30 0 1183 0 8780 0 179832 0 0 0 PART I, LINE 1A SEVERAL INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2023. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. PART I, LINE 3 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 HEAL TH PRESIDENT. 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 INDIVIDUALS 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: JEREMY FOTHERINGHAM $158,615 DAMON HARBISON $37,247 RANDALL COMBS $261,633 DOUGLAS LONG $161,286 JOHN SNODSMITH $11,873 JULIE LONG $31,049 JOHN KOHLER, SR $21,610 HOLLIE COLLIE $6,962 LAURA KAISER $720,859 MATT KINSELLA $39,596 KAREN REWERTS $56,755 GEORGE DANEKER $17,035 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. DAMON HARBISON $25,899 JULIE LONG $19,911 MATT KINSELLA $19,814 KAREN REWERTS $53,386 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION SHALL HAVE TWO (2) MEMBERS: THE CORPORATE MEMBER, WHICH SHALL BE SSM REGIONAL HEALTH SERVICES, A MISSOURI NONPROFIT CORPORATION, AND THE MANAGING MEMBER, WHICH SHALL BE ST. MARY'S - GOOD SAMARITAN, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS, SSM REGIONAL HEALTH SERVICES, AND ST. MARY'S - GOOD SAMARITAN, INC., ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND ELECT AND REMOVE DIRECTORS EXCEPT EX OFFICIO DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL SUCCESSOR OR REPLACEMENT MEMBERS C. TO ELECT AND REMOVE THE DIRECTORS D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. 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 M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTEREST IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE CORPORATE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE CORPORATE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER OF THE CORPORATE MEMBER AS DETERMINED BY THE MEMBER OF THE CORPORATE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE CORPORATE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE CORPORATE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE CORPORATE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. THE MANAGING MEMBER HAS THE FOLLOWING POWERS: CERTAIN POWERS ARE RESERVED TO THE MANAGING MEMBER, INCLUDING THE AUTHORITY TO TAKE SUCH ACTIONS ON BEHALF OF THE CORPORATION AS ARE VESTED IN THE MANAGING MEMBER UNDER THE JOINT OPERATING AGREEMENT (JOA), SUBJECT TO THE LIMITATIONS OF APPLICABLE LAW. THE MANNER TO WHICH THE MANAGING MEMBER EXERCISES SUCH RESERVED POWERS SHALL BE DETERMINED PURSUANT TO THE PROVISIONS OF THE JOA AND THE BYLAWS OF THE MANAGING MEMBERS. IN ADDITION, THE MANAGING MEMBER SHALL PARTICIPATE IN THE ELECTION OF THE DIRECTORS TO THE EXTENT OUTLINED IN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 8B 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 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 AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C 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 CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF 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 B, LINE 15 A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 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 ON THE ILLINOIS 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 IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 13,548,644. MANAGEMENT AND GENERAL EXPENSES 647,799. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,196,443. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 7,756,753. 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