2020-11-04T15:32:32-06:00 2019-12-31 990 2019-01-01 431550298 SSM Audrain Health Care Inc SSMA 5735825000 10101 Woodfield Lane St Louis MO 63132 Doug Long Secretary 2020-11-04 2019 2021-01-29 14:40:06Z See Schedule O Donna Jacobs 10101 Woodfield Lane St Louis MO 63132 52444778 false X https://www.ssmhealth.com/locations/st-marys-hospital-audrain X 1990 MO Operates a community hospital offering a range of services including emergency care, cardiology services, medical imaging, women and child services and diabetes education. 4 0 439 50 63431 34132 98472 89130 58674713 52095204 26550 21675 354520 219138 59154255 52425147 2929 6043 0 28490384 26366147 0 44227 35070706 31658679 63564019 58030869 -4409764 -5605722 34696042 32771400 60955479 69576532 -26259437 -36805132 THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. false false 52580226 6043 52095204 Please see Schedule O for a complete description of program service accomplishments. 52580226 true true false true false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 0 0 439 true true true false false false false false false false false false false false X 4 0 false false false false true true true true false false false false true true true true true false false false X JOSEPH HENDERSON 5736813000 2505 MISSION DRIVE JEFFERSON CITY MO 65109 Doug Long Director, Secretary, General Counsel at SSM Health 1.0 65.2 X X 0 229550 471986 Kris Zimmer Director, Treasurer/Asst Sec, Chief Financial Officer at SSM Health 1.0 67.0 X X 0 1365634 813620 Laura Kaiser Director, President/CEO of SSM Health 1.0 47.0 X X 0 2153858 2027129 Paula Friedman Pt Yr Director/Vice President, Pt Yr Senior VP-Strategic Development SSM Health 1.0 58.0 X X 0 1384920 282580 Steven Smoot Director, Vice President, COO of SSM Health 1.0 50.0 X X 0 1066618 686232 Donna Jacobs President, SSM Health St. Mary's Hospital - Audrain 40.0 1.0 X 457451 0 82389 James Stratton Regional CFO-Mid Missouri 20.0 21.0 X 0 319266 87691 Romida Sison-Martinez VP-Patient Care Services/CNO 40.0 0 X 194864 0 28869 Diane Jacobi Physician 40.0 0 X 254861 0 38948 Eric Kondro Physician 40.0 0 X 251550 0 24370 Michael Quinlan Physician 40.0 0 X 291396 0 36561 N Eugene Thomas Physician 40.0 0 X 315874 0 35369 Shahid Waheed Physician 40.0 0 X 491863 0 57392 Christopher Howard Former Officer 0.0 0.0 X 0 566322 218976 2257858 7086169 4892112 25 true true false AMN HEALTHCARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 STAFFING SERVICES 1112054 Audrain Physician Services LLC PO Box 82368 Lafayette LA 70598 Physician services 690499 MID-MISSOURI ANESTHESIA CONSULTANTS PC 1445 CHRISTY DRIVE JEFFERSON CITY MO 65101 ANESTHESIOLOGY 673667 JACKSON AND COKER HOLDINGS LLC 3000 OLD ALABAMA ROAD ALPHARETTA GA 30022 EMPLOYMENT AGENCY 656372 AUDRAIN EMERGENCY GROUP LLC PO BOX 82368 LAFAYETTE LA 70598 EMERGENCY SERVICES 600000 13 69526 12927 6677 3177 89130 NET PATIENT REVENUE 622110 52095204 52095204 0 0 0 0 52095204 41306 41306 16259 16259 0 16259 16259 0 19631 0 -19631 -19631 -19631 Cafeteria 722514 136148 136148 Laboratory 621500 63431 63431 Medical staff dues 900099 3300 3300 0 0 0 0 202879 52425147 52095204 63431 177382 X 6043 6043 763573 738325 24170 1078 19249644 18613145 609332 27167 1518026 1467832 48052 2142 3465712 3351117 109704 4891 1369192 1323919 43341 1932 132896 132896 27411 27411 55300 55300 16604 16604 9713100 7837094 1875321 685 1684 1684 2820015 2544782 269227 6006 2449642 2440462 9180 1928249 1859383 68866 128927 109354 19247 326 71219 69148 2071 60 60 1563488 1563488 33208 33208 Medical supplies 7330441 7330441 Medicaid Provider Tax 3070900 3070900 Internal management fees 2226906 2226906 Licenses and taxes 88629 88629 0 0 0 0 58030869 52580226 5406416 44227 34296 34467 47363 8273 0 7074419 6804685 0 0 0 0 0 949861 938157 849934 688720 22357603 12125030 16281305 10232573 0 0 1037991 1173288 0 8420873 12891237 34696042 32771400 46234604 52431383 0 169 0 0 0 0 0 0 14720875 17144980 60955479 69576532 X -26988387 -37558663 728950 753531 -26259437 -36805132 34696042 32771400 X -5605722 -4939973 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 16604 16604 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 361547 361547 372541 -10994 361547 342786 29755 372541 326711 16075 342786 337840 -11129 326711 0.0 1.0 0.0 true false 247221 247221 6220931 2723509 3497422 810334 422176 388158 13804090 8979345 4824745 1275027 0 1275027 10232573 Due from Affiliates 10466071 Third-party receivable Operating right-of-use assets 879938 Other assets 1545228 12891237 ASSET RETIREMENT OBLIGATION 702029 DUE TO THIRD-PARTY PAYORS 1552333 DUE TO AFFILIATES 9808237 Third-party patient loans 140463 RETIREMENT FUNDING LIABILITY 4061804 Operating lease obligations 880114 17144980 X Schedule D, Part V, Line 4 Intended uses of endowment funds ALL FUNDS ARE USED TO PROVIDE HEALTH CARE SERVICES AND CAPITAL IMPROVEMENTS. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SSM AUDRAIN HEALTH CARE, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH (SSMH), A RELATED ORGANIZATION. 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 2019 OR 2018. true true true X true X true true false true true 2153602 2153602 0.0371 9256962 10317363 0 0.0 1089196 493864 595332 0.0103 0 0 12499760 10811227 2748934 0.0474 221795 2145 219650 0.0038 42347 42347 0.0007 0 0.0 0 0.0 9253 9253 0.0002 0 0 273395 2145 271250 0.0047 0 0 12773155 10813372 3020184 0.0520 0 0.0 0 0.0 45 45 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 45 0 45 0.0000 true 2533307 13142729 16361644 -3218915 X true true 1 1 SSM Health St Mary's Hospital - Audrain 620 E MONROE MEXICO MO 65265 https://www.ssmhealth.com/locations/st-marys-hospital-audrain 36-62 X X X A A 1 false false true X X X X X X X X X 18 true false true true X https://www.ssmhealth.com/locations/st-marys-hospital-audrain X https://www.ssmhealth.com/about/chna X true 19 true https://www.ssmhealth.com/about/chna false true X 200.0 400.0 X X X X X true true X X X true X https://www.ssmhealth.com/resources/for-patients/financial-assistance X https://www.ssmhealth.com/resources/for-patients/financial-assistance X https://www.ssmhealth.com/resources/for-patients/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E 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. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. SSM Health St. Mary's Hospital - Audrain conducted a community health needs assessment which included input from persons who represent the broad interest of the community served. Community discussion groups, much like town hall meetings, were organized and facilitated by members of the steering team where more than 85 individuals participated in discussion groups and consumer interview sessions. These discussions provided perspective on the health status of the community and enlightened the analysis of the secondary data relative to the most important health issues and challenges, key resources and advice on how to address the issues identified. To stimulate discussion, the community discussion group agenda included questions on observed community health, top health issues and challenges, what local resources exist, and what advice community members had. During the input sessions, participants were also asked to review a listing of key indicators, factors and or determinants of health that had previously been identified to have some degree of variance in the report area. In addition to the review of demographics and secondary data, and the aforementioned discussion groups with key stakeholders and community representatives, a community perception survey was conducted to assess the perception of health care and health status across the two-county region in the analysis. The survey was made available on social media and internet sites, in physician offices, medical clinics and public health departments and various other locations, yielding a total of 751 responses from residents. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. SSM Health St. Mary's Hospital - Audrain and its affiliate, SSM Health St. Mary's Hospital - Jefferson City, conducted research and prioritization of needs in cooperation with each other. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. The hospital conducted its 2018 CHNA in collaboration with the following groups: Arthur Center Community Health, Audrain County Commission, Audrain County Health Department, City of Vandalia, Mexico Area Chamber of Commerce, United Way of Audrain County, Mexico Area YMCA, Mexico Veterans Home, Mexico Parks & Recreation, and Montgomery County Health Department. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - SSM Health St. Mary's Hospital - Audrain. The hospital identified various health needs in the 2018 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: - Mental health/substance abuse - Access to health care - Chronic disease Mental health/substance abuse Mental health issues, such as anxiety, depression and risk of suicide, are prevalent concerns. There are limited mental health providers in the area in general but especially noted was the gap in providers for youth and families in distress. Additionally, mental health is intertwined with other key health issues such as substance abuse, addiction, and overall good physical health. It was noted that individuals may be using drugs/alcohol as a mechanism to cope with mental health issues stemming from toxic stress they have experienced. Community input also emphasized the impact of opioid abuse on the community, a lack of detox or substance abuse treatment options, as well as the economic burden it is placing on law enforcement, EMS, and hospital providers. Additionally, statistics show: - The Suicide Age-Adjusted Death rate for the report area per 100,000 population is 18.5%, compared to the US rate of 13% and the Missouri rate of 16.4% - According to the exploreMOhealth.org county and zip-code level study data, depression is the top health factor in Audrain and Montgomery counties - Alcohol-and Substance-Related Mental Health Disorders is ranked fifth among the top five chronic diseases and conditions in both counties included in the report area - 47% of the CHNA community health needs survey respondents said drug use was the top challenge facing their community - 28% of survey respondents indicated mental health disorders was the most important issue in the community The hospital's action plan includes the following initiatives to improve mental health and substance abuse in the community served: - Partner to provide Adult and Youth Mental Health First Aid education and Suicide Prevention and Awareness education - Provide leadership support and enroll primary care clinics in Missouri Child Psychiatry Access Project (MO-CPAP) which provides free, same-day expert child psychiatry phone consultation to primary care providers (PCPs) - Explore partnership and implementation of Missouri Hospital Association Engaging Patients In Care Coordination (EPICC) program in Emergency Department - Evaluate partnership with Council for Drug Free Youth to extend school-based education and increase availability of substance use prevention and early identification/ intervention initiatives in the report area - Participate and support SSM Opioid Stewardship Program and central Missouri opioid task force initiatives - Continue to offer the SSM Health Senior Care / Geriatric Psych specialty program - Continue to offer Tele-psychiatry services in the Emergency Department and Inpatient Geriatric Psych Unit Access to health care Access to specialty, primary and preventive health care services through a doctor's office, clinic or other appropriate provider is an important element of a community's health care system and is vital for helping the community's residents to be healthy. The ability to access care is influenced by many factors, including insurance coverage and the ability to afford services, long waits for appointments or treatments, the availability and hours of operation of health care providers, an understanding of where to find services when needed, a lack of providers and a lack of reliable transportation were frequently mentioned as concerns. Additionally, findings show: - Lack of access to OB physicians and services was of great concern, leading to lack of prenatal care during pregnancy, high risk deliveries, infant poor health and mortality. The infant mortality rate for Montgomery County was 10.7 per 1,000 births compared to the Missouri rate of 7.2 and the US rate of 6.5, per 1,000 births. The teen births (rate of total births to women age 15-19 per 1,000 female population) for the report area was 50.04 compared to the Missouri rate of 39.5 and the US rate of 36.6. These indicators may indicate the existence of broader issues pertaining to access to reproductive and maternal and child health and education - Lack of mental health providers and substance abuse services was mentioned most among input session participants. Community input emphasized the impact of mental health disorders and drug abuse on the community, a lack of mental health professionals and treatment options, as well as the economic burden it is placing on law enforcement, EMS, public health and hospital providers. Opioid use and alcohol overuse were mentioned more often, however, marijuana, and methamphetamines were also mentioned as top concerns - The percentage of population in the report area living in a designated Health Professional Shortage Area (HPSA) is 100%. A geographic area designated as a HPSA, is defined as having a shortage of primary medical care, dental or mental health professionals - Of the respondents to the 2018 community health assessment survey, who reported they did not see a doctor in the past 12 months, 40% said they could not afford and 12% reported lack of insurance and lack of transportation as a reason they didn't see a doctor - Survey respondents noted lack of affordable health insurance, lack of specialists, hours of operation, long-wait time for appointments and lack of health care professionals as the top five factors that impact access to health care in their community The hospital's action plan includes the following initiatives to address access to health care in the community served: - Implement Outpatient Perinatal Assessment Services - Explore collaboration with SSM Health Women's Health to implement Centering Pregnancy Model in Montgomery County - Partner with the Arthur Center to increase capacity and referrals for suicide evaluation of Emergency Department patients Chronic disease Chronic diseases, specifically Diabetes, Heart/Cardiovascular, Cancer and Lung/COPD are prevalent health issues in the report area. Diabetes and Heart Disease was the most frequently mentioned chronic disease and was often linked with discussion about obesity and overweight. Heart Disease is the leading cause of death in the report area. Obesity is often the driver of other chronic conditions, such as diabetes, heart disease and cancer. Additionally, statistics show: - The percent of adults with Heart Disease in the report area is 12.6%, nearly three times higher than Missouri (4.8%) and the United States (4.4%). The mortality rate for Heart Disease per 100,000 population is 209 for the report area, mostly attributable to Montgomery County's age-adjusted death rate of 242.7 per 100,000, which is significantly higher than the Missouri rate - Cancer and Lung/COPD were reported frequently among the top diseases for hospitalizations, ER visits and chronic disease deaths in the report area and are listed among the top causes of death, just behind Heart Disease. The Cancer mortality age-adjusted death rate per 100,000 population is 181.6 for the two-county report area, which is higher than the Missouri rate of 175.88 per 100,000 population - The Lung disease mortality, age-adjusted death rate per 100,000 population for the report area is 74.1 compared to the Missouri rate of 52.17 and the US rate of 41.3 The hospital's action plan includes the following initiatives to improve chronic disease in the community served: - Provide community and workplace health fairs and screenings - Provide annual Senior Expo to promote healthy living and preventative care - Provide community health education. Health literacy, including health risk prevention, chronic disease self-management, preventative care, and life skills education, stress management and coping are needed to improve health and wellness decisions - Evaluate implementation of evidenced-based Diabetes Prevention Program (DPP) in partnership with the YMCA - Explore partnership with Audrain and Montgomery County Health Departments to enhance community diabetes support and resources - Collaborate with Catholic Charities to enhance parish health ministry - Continue support and partnership with Audrain County YMCA - Continue to provide community and school-based health education classes The hospital has no plans to discontinue other community benefit efforts addressing the remaining CHNA-identified needs and address additional community needs within its efforts. The following community needs were identified but have not been prioritized due to the hospital's limited resources at this time (additional descriptions available in the 2018 CHNA): - Health literacy - Overweight/obesity & physical inactivity - Smoking & tobacco use 13 SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 111 WEST BATES WELLSVILLE MO 63384 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 1223 EAST MAIN STREET PERRY MO 63462 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 201 SOUTH MAIN STREET AUXVASSE MO 65231 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 204 WEST WASHINGTON VANDALIA MO 63382 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 240 NORTH PICKERING MONTGOMERY CITY MO 63361 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 350 COUNTRY MEADOWS LANE FULTON MO 65261 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH URGENT CARE 3626 SOUTH CLARK STREET SUITE C MEXICO MO 65265 URGENT CARE FACILITY SSM HEALTH MEDICAL GROUP - PAIN MANAGEMENT 515 EAST PROMENADE STREET MEXICO MO 65265 PAIN MANAGEMENT CLINIC SSM HEALTH MEDICAL GROUP - INTERNAL MEDICINE 600 MEDICAL PARK DRIVE MEXICO MO 65265 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH SLEEP CENTER 620 EAST MONROE STREET MEXICO MO 65265 SLEEP CENTER SSM HEALTH CANCER CENTER 713 EAST JACKSON STREET MEXICO MO 65265 CANCER CENTER SSM HEALTH MEDICAL GROUP - FAMILY MEDICINE 3626 SOUTH CLARK STREET SUITE A MEXICO MO 65265 OUTPATIENT PHYSICIAN CLINIC SSM HEALTH BEHAVIORAL HEALTH 620 EAST MONROE STREET MEXICO MO 65265 BEHAVIORAL HEALTH Schedule H, 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 health 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." Schedule H, Part I, Line 6a Community benefit report prepared by related organization SSM Health Care Corporation, 46-6029223 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance 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 7i 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. Schedule H, Part II Community Building Activities SSM AUDRAIN HEALTH CARE PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEALTH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE INVOLVEMENT WITH THE MEXICO, MISSOURI SUSTAINABILITY BOARD. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote SSM Health St. Mary's Hospital - Audrain 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, 2019 consolidated audit is contained on page 11 and 12 of the attached financial statements. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance SSM Health St. Mary's Hospital - Audrain 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 Audrain Health Care, Inc. collection and financial assistance policies. Schedule H, Part V, Section B, Line 16a FAP website A - SSM Health St. Mary's Hospital - Audrain: Line 16a URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - SSM Health St. Mary's Hospital - Audrain: Line 16b URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - SSM Health St. Mary's Hospital - Audrain: Line 16c URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment 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 SSM's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always our goal. To fulfill this commitment, SSM'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-health priorities: Establish strategies to address priorities; complete Strategic Implementation Plan; obtain Regional/Divisional 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 health priorities: Collect data and evaluate progress; report to Regional/Divisional 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 health 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. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance 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 counseling. The 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. Schedule H, Part VI, Line 4 Community information SSM Health St. Mary's Hospital - Audrain is located in Mexico, Missouri, in Audrain County. The hospital defines its primary service area as Audrain and Montgomery Counties in Missouri. As of 2016, the two-county area had a total population of 37,688 persons. Of this population, 31.5% were age 55 or above. This percentage of older adults, as well as the median age of the service area, are both higher than the same statistic for Missouri and the United States. Within Audrain and Montgomery Counties, 15.7% of the population age 25 or above has no high school diploma, while 19.7% has at least an Associate's degree. Unemployment measures fare better than state and national averages, reported at only 3.2% in 2018; however, per capita income falls below the state and national levels and rates of poverty are substantially higher. Rates of uninsured adults and children is higher in Audrain and Montgomery Counties than for Missouri and the United States and is key factor in the accessibility and affordability of health care. In these two counties, 14.9% of adults are uninsured, compared to 12.8% in Missouri and 12.1% nationally. For children, 6.4% of the two-county area are uninsured, higher than the Missouri rate of 4.8% and national rate of 4.7%. Additional demographic and statistical information on the hospital's community can be found throughout the 2018 CHNA. Schedule H, Part VI, Line 5 Promotion of community health SSM Health St. Mary's Hospital - Audrain 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 health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. Focusing on a broad definition of health, SSM Health St. Mary's hospital, clinics and programs provide medical and mental health services, health education, health management, prevention, referrals, insurance enrollment and in-home primary care services and support, while fostering collaboration and incorporating Community Benefit strategies. St. Mary's Hospital - Audrain promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. SSM Health St. Mary's Hospital - Audrain 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, * 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. Schedule H, Part VI, Line 6 Affiliated health care system SSM Audrain Health Care is a 501(c)(3) organization and is a member of the integrated health care system known as SSM Health. SSM Health is a 501(c)(3) organization headquartered in St. Louis, Missouri. Schedule H, Part VI, Line 7 State filing of community benefit report MO true true false false false false false false false Kris Zimmer Director, Treasurer/Asst Sec, Chief Financial Officer at SSM Health 0 887868 0 230489 0 247277 0 797538 0 16082 0 2179255 0 340596 Steven Smoot Director, Vice President, COO of SSM Health 0 882327 0 172763 0 11529 0 667250 0 18983 0 1752851 0 97763 Doug Long Director, Secretary, General Counsel at SSM Health 0 149400 0 0 0 80150 0 469438 0 2548 0 701536 0 0 Laura Kaiser Director, President/CEO of SSM Health 0 1591955 0 536550 0 25353 0 2013276 0 13853 0 4180987 0 536550 Paula Friedman Pt Yr Director/Vice President, Pt Yr Senior VP-Strategic Development SSM Health 0 270134 0 189852 0 924934 0 278843 0 3736 0 1667500 0 618871 Christopher Howard Former Officer 0 0 0 0 0 566322 0 214327 0 4649 0 785299 0 0 James Stratton Regional CFO-Mid Missouri 0 259935 0 41261 0 18071 0 67735 0 19956 0 406957 0 41028 Donna Jacobs President, SSM Health St. Mary's Hospital - Audrain 288305 0 57166 0 111980 0 78830 0 3559 0 539839 0 119384 0 Romida Sison-Martinez VP-Patient Care Services/CNO 170072 0 8750 0 16041 0 18267 0 10603 0 223733 0 0 0 Shahid Waheed Physician 457625 0 5164 0 29074 0 39700 0 17692 0 549255 0 0 0 Diane Jacobi Physician 228045 0 22391 0 4425 0 17658 0 21290 0 293809 0 0 0 N Eugene Thomas Physician 304175 0 0 0 11699 0 20259 0 15110 0 351243 0 0 0 Eric Kondro Physician 181280 0 64316 0 5955 0 16500 0 7870 0 275920 0 0 0 Michael Quinlan Physician 274509 0 13750 0 3137 0 14691 0 21870 0 327957 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization's top management official, the Hospital 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 4a Severance or change-of-control payment SSM Health has adopted a severance policy to provide a financial transition in the event of involuntary termination without cause for executive level positions. The amount of the compensation is based on the position held and length of service with SSMH. The following individuals listed in Part VII of the Form 990 received payments under the plan in the current year. Paula Friedman $470,555 Christopher Howard $564,308 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 2019. 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 2019: Steven Smoot $105,168 Laura Kaiser $314,000 Kris Zimmer $105,240 Donna Jacobs $22,800 James Stratton $10,400 Romida Sison-Martinez $7,000 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2019. All distributions received from the plan in the current year were included in the individual's taxable compensation. Paula Friedman $429,019 Kris Zimmer $111,962 Donna Jacobs $76,468 James Stratton $12,767 During 2019, the following individuals participated in a nonqualified retirement plan from the organization or a related organization. The amounts reported below represent the change in accrued benefit for each individual and also include amounts accrued under the pension restoration plan: Paula Friedman $9,691 Kris Zimmer $66,609 Form 990, Part III, Line 4a Description of Program Service Accomplishments Briefly describe the organization's mission: 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 300 physician offices and other outpatient and virtual care services, 10 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company, and an Accountable Care Organization. The health system employs nearly 40,000 people and is affiliated with 11,000 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 SSM Health St Mary's Hospital - Audrain: SSM Health St Mary's Hospital - Audrain is an acute-care hospital located in Mexico, Missouri. The hospital has a strong primary-care presence with several rural health clinics in Mexico and the neighboring communities. SSM Health St Mary's Hospital - Audrain's cancer program has earned the Commission on Cancer of the American College of Surgeons Accreditation Aware four times. The Hospital has also been recognized by the Joint Commission for attaining and sustaining excellence in accountability measures for performance for heart attack, heart failure, pneumonia, surgical care and venous thromboembolism. Other recognitions include the High-Value Health Care Citation of Merit and Guardian of Excellence for Clinical Quality. In 2018, the hospital earned a grade "A" from Leapfrog for safety. Since 1918, SSM Health St Mary's Hospital - Audrain has been providing for the health care needs of the citizens of Audrain County and surrounding communities. During its long history of service, the hospital has made many changes to better serve its patients. For instance, in 1991, SSM Health St Mary's Hospital - Audrain was the first community hospital in Missouri to lease its facilities and operations to a not-for-profit corporation to establish clinics in communities outside of Audrain County in order to improve patient access to primary-care services. SSM Health St Mary's Hospital - Audrain joined SSM Health in April 2013 as part of SSM's new Mid-Missouri Region. The region also consists of SSM Health St. Mary's Hospital - Jefferson City in Jefferson City, Mo. SSM Health St Mary's Hospital - Audrain provides the following services at its hospital: SSM Health Cancer Center, diabetes education, emergency department, Healthworks rehabilitation, Jordan-Waters heart center, lab services, medical imaging, sleep lab, and women's and children's services. A complete list of services the Hospital offers can be found at https://www.ssmhealth.com/locations/st-marys-hospital-audrain. SSM Health St Mary's Hospital - Audrain 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, * 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 $ 2,153,602 Unpaid Cost of Other Government Programs $ 595,332 Unpaid Cost of Medicare Services $ 3,218,915 Total Quantifiable Uncompensated Care $ 5,967,849 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, Line 15a Process of determining compensation 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, Line 15b Process of determining compensation 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, Line 6 Classes of members or stockholders THE SOLE MEMBER OF THE CORPORATION IS SSM REGIONAL HEALTH SERVICES. SSM REGIONAL HEALTH SERVICES IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH SSM AUDRAIN HEALTH CARE, INC. AND SSM REGIONAL HEALTH SERVICES ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND TO APPOINT AND REMOVE THE DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE 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 APPOINT 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 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 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 MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER OF THE MEMBER AS DETERMINED BY THE MEMBER OF THE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OR THE CORPORATION WHICH WILL NOT REQUIRE 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 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. Form 990, Part VI, 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, Line 11b Review of form 990 by 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 at the next regularly scheduled board meeting. Form 990, Part VI, 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 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, 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 ON THE MISSOURI 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 Medical and other professional fees - Total Expense: 9713100, Program Service Expense: 7837094, Management and General Expenses: 1875321, Fundraising Expenses: 685; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in beneficial interest in foundation - 140602; Actuarial change in defined benefit obligation - 1346864; LOSS ON IMPAIRED ASSETS - -6427439; Part I Doing Business As SSM Audrain Health Care, Inc. currently conducts business under the following registered names: Audrain Medical Center Healthworks Mexico Health Services Mexico Surgical Services Specialty Services of Mexico SSM Health Behavioral Health SSM Health Cancer Center SSM Health Medical Group SSM Health Medical Group - Family Medicine SSM Health Medical Group - General Surgery SSM Health Medical Group - Internal Medicine SSM Health Medical Group - Orthopedic Surgery SSM Health Medical Group - Pediatrics SSM Health Medical Group Pulmonary & Critical Care SSM Health Medical Group - Women's Health SSM Health Sleep Center SSM Health St. Mary's Hospital - Audrain SSM Health Urgent Care Jordan-Waters Heart Center SSM Health Care Corporation 10101 Woodfield Lane St Louis MO 63132 466029223 Health Care MO 501(c)(3) Type I SSM Health Ministries false SSMHC Liability Trust I 10101 Woodfield Lane St Louis MO 63132 436331003 Insurance MO 501(c)(3) Type I SSM Health Care Corporation false SSM Consolidated Health Services 10101 Woodfield Lane St Louis MO 63132 431473657 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Policy Institute 10101 Woodfield Lane St Louis MO 63132 431788151 Health Care MO 501(c)(4) SSM Health Care Corporation false SSM Health Care Portfolio Management Co 10101 Woodfield Lane St Louis MO 63132 431825256 Management MO 501(c)(3) Type I SSM Health Care Corporation false SSM Cardinal Glennon Children's Hospital 10101 Woodfield Lane St Louis MO 63132 430738490 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false Cardinal Glennon Children's Foundation 10101 Woodfield Lane St Louis MO 63132 431754347 Fundraising MO 501(c)(3) 7 SSM Cardinal Glennon Children's Hospital false SSM Health Foundation - St Louis 10101 Woodfield Lane St Louis MO 63132 431552945 Fundraising MO 501(c)(3) 7 SSM Health Care St Louis false SSM Health Care of Oklahoma Inc 10101 Woodfield Lane St Louis MO 63132 730657693 Health Care OK 501(c)(3) 3 SSM Health Care Corporation false The St Anthony Hospital Foundation Inc 10101 Woodfield Lane St Louis MO 63132 736104300 Fundraising OK 501(c)(3) 7 SSM Health Care of Oklahoma false SSM Health Care of Wisconsin Inc 10101 Woodfield Lane St Louis MO 63132 430688874 Health Care WI 501(c)(3) 3 SSM Health Care Corporation false Dells Medical Building Inc 10101 Woodfield Lane St Louis MO 63132 391613292 MOB WI 501(c)(2) SSM Health Care of Wisconsin false St Mary's Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940686 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false St Clare Health Care Foundation Inc 10101 Woodfield Lane St Louis MO 63132 431940683 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Home Health United Inc 2802 Walton Commons Lane Madison WI 53718 391539827 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false Home Care United Inc 2802 Walton Commons Lane Madison WI 53718 391776340 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false HHU Xtra Care Inc 2802 Walton Commons Lane Madison WI 53718 391705111 Health Care WI 501(c)(3) 10 SSM Health Care of Wisconsin false SSM Health at Home Foundation of Wisconsin Inc 2802 Walton Commons Lane Madison WI 53718 391839309 Fundraising WI 501(c)(3) Type I Home Health United Inc false SSM Regional Health Services 10101 Woodfield Lane St Louis MO 63132 440579850 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false St Mary's Health Center Jefferson City Missouri Foundation 10101 Woodfield Lane St Louis MO 63132 431575307 Fundraising MO 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center 10101 Woodfield Lane St Louis MO 63132 430653587 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's Hospital Centralia Illinois 10101 Woodfield Lane St Louis MO 63132 370662580 Health Care IL 501(c)(3) 3 SSM Regional Health Services false St Mary's - Good Samaritan Inc 10101 Woodfield Lane St Louis MO 63132 364170833 Health Care IL 501(c)(3) Type I SSM Regional Health Services false Good Samaritan Regional Health Center Foundation 10101 Woodfield Lane St Louis MO 63132 262884795 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Foundation 10101 Woodfield Lane St Louis MO 63132 364636691 Fundraising IL 501(c)(3) 7 St Mary's-Good Samaritan Inc false St Mary's Hospital Auxiliary 400 N Pleasant Centralia IL 62801 237126345 Fundraising IL 501(c)(3) 10 St Mary's Hospital Foundation false SSM Health Businesses 10101 Woodfield Lane St Louis MO 63132 431333488 Health Care MO 501(c)(3) 10 SSM Health Care Corporation false SSM Health Care St Louis 10101 Woodfield Lane St Louis MO 63132 431343281 Health Care MO 501(c)(3) 3 SSM Health Care Corporation false Centralia Medical Services Bldg Assoc 10101 Woodfield Lane St Louis MO 63132 237408025 MOB IL 501(c)(3) Type I SSM Regional Health Services false St Mary's Janesville Foundation Inc 10101 Woodfield Lane St Louis MO 63132 273439133 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false SSM Health Ministries 3221 McKelvey Road Suite 107 Bridgeton MO 63044 431012492 Religious Organization MO 501(c)(3) 1 NA false Lee Dewey Corporation 10101 Woodfield Lane St Louis MO 63132 731279603 MOB OK 501(c)(3) Type I SSM Health Care of Oklahoma false SSM Hospice & Home Care Foundation 10101 Woodfield Lane St Louis MO 63132 300012246 Fundraising MO 501(c)(3) 7 SSM Health Businesses false St Mary's Hospital Auxiliary 100 St Marys Medical Plaza Jefferson City MO 65101 436049878 Fundraising MO 501(c)(3) Type II NA false Good Samaritan Hospital Auxiliary 1 Good Samaritan Way Mount Vernon IL 62864 237049599 Fundraising IL 501(c)(3) Type III-FI NA false St Anthony Shawnee Hospital Inc 1000 N Lee Ave Oklahoma City OK 73102 455055149 Health Care OK 501(c)(3) 3 SSM Health Care of Oklahoma false Audrain Medical Center Foundation Inc 620 E Monroe St Mexico MO 65265 431265060 Fundraising MO 501(c)(3) Type I NA false SSM-SLUH Inc 10101 Woodfield Lane St Louis MO 63132 474196634 Health Care MO 501(c)(3) 3 SSM Health Care St Louis false SSM Health Plan 1277 Deming Way Madison WI 53717 831979548 Insurance MO 501(c)(4) SSM Health Businesses false Agnesian Healthcare Inc 430 E Division St Fond du Lac WI 54935 390807236 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Ripon Medical Center Inc 845 Parkside Street Ripon WI 54971 391101287 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc false Waupun Memorial Hospital Inc 620 West Brown Street Waupun WI 53963 390806265 Health Care WI 501(c)(3) 3 Agnesian Healthcare Inc false St Francis Home of Fond du Lac Wisconsin Inc 33 Everett Street Fond du Lac WI 54935 391029998 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Sister Servants of Christ the King Villa Loretto N8114 County WW Mount Calvary WI 53057 391022770 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false Villa Rosa Inc N8120 County WW Mount Calvary WI 53057 421670962 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Christian Home and Rehabilitation Center Incorporated 331 Bly Street Waupun WI 53963 390884514 Health Care WI 501(c)(3) 10 Agnesian Healthcare Inc false The Monroe Clinic Inc 515 22nd Avenue Monroe WI 53566 390808509 Health Care WI 501(c)(3) 3 SSM Health Care of Wisconsin false Monroe Clinic and Hospital Foundation Inc 515 22nd Avenue Monroe WI 53566 205769038 Fundraising WI 501(c)(3) 7 SSM Health Care of Wisconsin false Agnesian Healthcare Foundation Inc 430 E Division St Fond du Lac WI 54935 391684956 Fundraising WI 501(c)(3) Type I SSM Health Care of Wisconsin false Shared Magnetic Resonance Imaging Facility Inc 1104 John Nolen Drive Madison WI 53713 391534744 Health Care WI 501(c)(3) Type I SSM Health Care of Wisconsin false SSM St Joseph Endoscopy Center LLC 10101 Woodfield Lane St Louis MO 63132 270046559 Surgery Services MO NA N/A 0 0 0 St Clare Imaging Services LLC 707 14th Street Suite A Baraboo WI 53913 200122365 Diag. Services WI NA N/A 0 0 0 Mt Vernon Radiation Therapy Center LLC 10101 Woodfield Lane St Louis MO 63132 201382620 Radiation Therapy IL NA N/A 0 0 0 Sleep & Neurology Center of Southern Illinois LLC 10101 Woodfield Lane St Louis MO 63132 208468195 Diag. Services IL NA N/A 0 0 0 CHOWSMGSI Office Building LLC 10101 Woodfield Lane St Louis MO 63132 371383861 MOB IL NA N/A 0 0 0 Oza Cancer Center LLC 10101 Woodfield Lane St Louis MO 63132 201382727 MOB IL NA N/A 0 0 0 Shawnee Real Estate Holdings LLC 1000 N Lee Ave Oklahoma City OK 73102 455458304 MOB OK NA N/A 0 0 0 Dean Clinic & St Mary's Hospital Accountable Care Organization LLC 1808 West Beltline Highway Madison WI 53713 452995500 Accountable Care Organization WI NA N/A 0 0 0 Wisconsin Integrated Information Technology and Telemedicine Systems LLC 1808 West Beltline Highway Madison WI 53713 392016715 Information Technology Services WI NA N/A 0 0 0 Dean Health Holdings LLC 1277 Deming Way Madison WI 53717 261594709 Support Services WI NA N/A 0 0 0 Wingra Building Group 1808 West Beltline Highway Madison WI 53713 390237060 MOB WI NA N/A 0 0 0 Janesville Riverview Clinic Building Partnership 1808 West Beltline Highway Madison WI 53713 396220698 MOB WI NA N/A 0 0 0 1110 N Classen Blvd LLC 1110 N Classen Boulevard Oklahoma City OK 73106 731158158 MOB OK NA N/A 0 0 0 SSM St Clare Surgical Center LLC 10101 Woodfield Lane St Louis MO 63132 261439695 Surgery Services MO NA N/A 0 0 0 Windmill LLP 50 Village View Lane Chesterfield MO 63017 431804651 Investments MO NA N/A 0 0 0 SSM Managed Care Organization LLC 10101 Woodfield Lane St Louis MO 63132 431708511 Health Promotion MO NA C Corporation 0 0 false FPP INC & Subs 10101 Woodfield Lane St Louis MO 63132 431465174 Health Care MO NA C Corporation 0 0 false Diversified Health Services Corp 10101 Woodfield Lane St Louis MO 63132 431369305 Medical Equipment MO NA C Corporation 0 0 false SSM Properties Inc 10101 Woodfield Lane St Louis MO 63132 431462486 Property Services MO NA C Corporation 0 0 false HealthFirst Physician Management Services 10101 Woodfield Lane St Louis MO 63132 731534336 Medical Services OK NA C Corporation 0 0 false SSMHC Liability Trust II 10101 Woodfield Lane St Louis MO 63132 816128118 Insurance MO NA C Corporation 0 0 false SSM Medical Group Inc 10101 Woodfield Lane St Louis MO 63132 431664107 Physician Offices MO NA C Corporation 0 0 false SSMHC Insurance Company 10101 Woodfield Lane St Louis MO 63132 030310431 Insurance NA C Corporation 0 0 false Physicians Services Corp of Southern Illinois Inc 10101 Woodfield Lane St Louis MO 63132 364161526 Health Care IL NA C Corporation 0 0 false Dean Health Systems Inc 1808 West Beltline Highway Madison WI 53713 391128616 Physician Offices WI NA C Corporation 0 0 false Dean Health Insurance Inc PO Box 56099 Madison WI 53705 391830837 Insurance WI NA C Corporation 0 0 false Dean Health Plan Inc PO Box 56099 Madison WI 53705 391535024 Insurance WI NA C Corporation 0 0 false SMDV Office Building 1808 West Beltline Highway Madison WI 53713 391628491 Physician Offices WI NA C Corporation 0 0 false Dean Retail Services Inc 1808 West Beltline Highway Madison WI 53713 391717636 Property Services WI NA C Corporation 0 0 false Navitus Holdings LLC 1808 West Beltline Highway Madison WI 53713 800968174 Pharmacy Benefits WI NA C Corporation 0 0 false Oza Oncology Inc 4117 Veterans Memorial Drive Mt Vernon IL 62804 371343746 Physician Offices IL NA S Corporation 0 0 false SSM Health Janesville Campus Condominium Association Inc 1808 West Beltline Highway Madison WI 53713 832038674 Condo association WI NA C Corporation 0 0 false SSM Health Pharmacy LLC 10101 Woodfield Lane St Louis MO 63132 264031708 Pharmacy MO NA C Corporation 0 0 false Dane County Cytology Center Inc 2000 Engel Street Suite 201 Madison WI 53713 391414219 Medical Services WI NA C Corporation 0 0 false SSM Health Insurance Company 1277 Deming Way Madison WI 53717 834718249 Insurance MO NA C Corporation 0 0 false false true true false false false false false false false false false true true true true false false false