2020-11-04T15:34:00-06:00 2019-12-31 990 2019-01-01 455055149 St Anthony Shawnee Hospital Inc STAN 4053955626 10101 Woodfield Lane St Louis MO 63132 Doug Long Secretary 2020-11-04 2019 2021-01-29 14:40:06Z SSM Health St Anthony Hospital - Shawnee Charles Skillings 10101 Woodfield Lane St Louis MO 63132 143061672 false 0928 X https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital X 2012 OK TO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACH. 10 7 955 89 0 0 678286 138876 133059904 142088740 13568 9421 607071 670502 134358829 142907539 109098 118023 0 51438905 55024197 0 0 71955870 78408514 123503873 133550734 10854956 9356805 245166332 303635734 145421672 194534269 99744660 109101465 THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. false false 126943675 118023 142088740 Please see Schedule O for a complete description of program service accomplishments. 126943675 true true false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true X 0 0 955 true false false false false false false false false false false false false X 10 7 false false false false true true true true false false false false true true true true true false false true true OK X Jennifer Pierce 4053955626 1102 W McArthur Shawnee OK 74801 Joe Hodges Director, Chairperson, Regional President - SSM Health Care of Oklahoma 1.0 42.0 X X 0 926611 523258 Patrick Mccruden Director, Vice Chair, Chief Mission Integration Officer-SSM Health 1.0 42.0 X X 0 416432 294191 Duke Ligon Director 1.0 2.0 X 0 0 0 Gregory McKinnis Director, Physician at SSM Health St. Anthony Hospital 1.0 2.0 X 0 1181 0 Iftikhar Ahmad Director, Physician at SSM Health St. Anthony Hospital 1.0 41.0 X 0 0 0 Margaret Salyer Director 1.0 2.0 X 0 0 0 Marion McMillan Director 1.0 2.0 X 0 0 0 Natalie Shirley Director 1.0 2.0 X 0 0 0 Paige Bass Director 1.0 2.0 X 0 0 0 Teresa Rose-Crook Director 1.0 2.0 X 0 0 0 Charles Skillings Hospital President, SSM Health St. Anthony Hospital - Shawnee 40.0 0 X 563967 0 166430 Doug Long Secretary, General Counsel at SSM Health 1.0 65.2 X 0 229550 471986 Kris Zimmer Treasurer, Chief Financial Officer at SSM Health 1.0 67.0 X 0 1365634 813620 Paula Friedman Pt Yr Vice President, Pt Yr Senior VP-Strategic Development SSM Health 1.0 58.0 X 0 1384920 282580 Ramona Carey Assistant Secretary 1.0 41.0 X 0 73615 22600 Shasta Manuel System Vice President-Finance 10.0 32.0 X 0 423343 141324 Angela Mohr Executive Vice President/COO/CNO 40.0 0 X 247026 0 78047 Cathy Broome Administrative Director - Nursing 40.0 0 X 137097 0 17306 Gaynell Anderson Chief Medical Officer 40.0 0 X 320776 0 40201 Adam Hogue Physician Assistant 40.0 0 X 344740 0 41913 Manikumar Bheemarasetti Physician 40.0 0 X 455383 0 31376 Sailaja Adari Physician 40.0 0 X 358457 0 54678 Troy Norred Physician 40.0 0 X 867858 0 24400 Venkata Damera Physician 40.0 0 X 506707 0 42636 Christopher Howard Former Officer 0.0 0.0 X 0 566322 218976 Laura Kaiser Former Officer 0.0 48.0 X 0 2153858 2027129 Linda Brown Former Key Employee 40.0 0 X 164050 0 43858 3966061 7541468 5336509 50 true true false Shawnee Medical Center Clinic 1501 N Airport Drive Shawnee OK 74804 Clinical services 13071920 CLINICAL PARTNERS PA 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ANESTHESIA BILLING 927380 Shawnee Surgical Services LLC PO Box 68 Shawnee OK 74802 Surgical services 453384 AMN Healthcare Inc 12400 HIGH BLUFF DRIVE San Diego CA 92130 Staffing services 398089 Comprehensive Pharmacy Services LLC 6409 QUAIL HOLLOW ROAD Memphis TN 38120 Pharmacy services 391663 17 138876 138876 NET PATIENT REVENUE 621110 142088740 142088740 0 0 0 0 142088740 9421 9421 113551 51440 62111 0 62111 62111 0 0 89773 102693 -12920 -12920 CAFETERIA REVENUE 722320 555955 555955 JOINT VENTURE INCOME 900099 65356 65356 0 0 0 0 621311 142907539 142088740 0 679923 X 118023 118023 1570850 1541431 29419 41119033 40370189 748844 1923217 1887199 36018 7493341 7353005 140336 2917756 2863112 54644 389699 389699 9841 9841 4800 4800 11120 11120 24684553 22097515 2587038 0 57398 57398 5867350 5688102 179248 5327988 5327988 3125493 3069372 56121 207643 119711 87932 31682 15072 16610 3014616 3014616 7422658 7422658 608436 608436 Medical supplies 22370608 22370608 Medicaid Provider Tax 2626044 2626044 Internal management fees 2587690 2587690 Licenses and taxes 60895 60895 0 0 0 0 133550734 126943675 6607059 0 200427 106276 0 0 16463051 19322546 0 0 0 0 0 2179685 2306527 422708 367328 115305071 39479712 80424226 75825359 0 541761 497498 678286 21933262 21933262 122322926 183276938 245166332 303635734 47187651 61169278 0 0 0 0 0 0 0 0 98234021 133364991 145421672 194534269 X 99066374 109101465 678286 0 0 99744660 109101465 245166332 303635734 9356805 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11120 11120 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL AND STATE HOSPITAL ASSOCIATIONS AND PORTIONS OF THE DUES WERE ALLOCATED TO LOBBYING ACTIVITIES. 2000668 2000668 70081070 8755447 61325623 396778 86467 310311 42640889 30637798 12003091 185666 0 185666 75825359 OTHER ASSETS 108189 DUE FROM AFFILIATES 180877307 THIRD-PARTY RECEIVABLE 751116 OPERATING RIGHT-OF-USE ASSETS 1540326 183276938 DUE TO AFFILIATES 129074209 CAPITAL LEASE OBLIGATION 2079965 Third-party payable 361434 RETIREMENT LIABILITIES 306720 OPERATING LEASE OBLIGATIONS 1542663 133364991 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote ST. ANTHONY SHAWNEE HOSPITAL, 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 RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS IN 2019 OR 2018. true true true X true X true true true false true true 4197621 0 4197621 0.0314 15347676 17898230 0 0.0 2507923 3143933 0 0.0 0 0 22053220 21042163 4197621 0.0314 76447 0 76447 0.0006 154620 0 154620 0.0012 0 0 0 0.0 0 0 0 0.0 291437 0 291437 0.0022 0 0 522504 0 522504 0.0039 0 0 22575724 21042163 4720125 0.0353 0 0.0 14730 14730 0.0001 5066 5066 0.0000 0 0.0 0 0.0 141 141 0.0000 2197 2197 0.0000 0 0.0 0 0.0 0 0 22134 0 22134 0.0002 true 6168968 33433752 33791781 -358029 X true true SHAWNEE SURGICAL REALTY LLC MEDICAL BUILDING 0.2806 0.7194 1 1 ST ANTHONY SHAWNEE HOSPITAL 1102 W MCARTHUR SHAWNEE OK 74801 https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital 2162 X X X A A 1 false false true X X X X X X X X X 18 true false false true X https://www.ssmhealth.com/locations/st-anthony-shawnee-hospital 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 - St Anthony Shawnee Hospital. The hospital took into account input from persons who represent the broad interests of the community served when conducting its most recent CHNA. The hospital conducted an online community survey which was reviewed by community partners. The process benefited from input from several individual community leaders representing diverse constituencies. Additionally, the hospital looked at its community profile, its consistent health needs, and the associated social determinants of health. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - St. Anthony Shawnee Hospital. 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: - Chronic disease prevention and management - Substance abuse - Food scarcity Chronic disease prevention and management Six in ten Americans live with at least one chronic disease, like heart disease and obesity. These contribute to the leading causes of death and disability in the United States, and the leading driver of healthcare costs. Healthy lifestyle is a key component for better management and even prevention of chronic disease. Making healthier choices easier is a major contributor to assisting individuals in resulting with healthier lifestyles, and as a result living healthier longer. Additionally, statistics show: - Obesity is a risk factor that is commonly associated with heart disease. It is defined as a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health - Obesity has been found to reduce life expectancy, and it is one of the leading preventable causes of death worldwide - There is convincing evidence that the consumption of high levels of processed foods, which are high in fats and sugars, promotes obesity as compared to whole foods - In Pottawatomie County, heart disease is still the leading cause of death for all ages combined, at 240.1 deaths per 100,000 population (2011-2015). The rate increased from the previous 2008-2012 data at 236.2 deaths per 100,000 population - Obesity / overweight was selected by the focus group as the #1 health challenge for the community - 70.7% of Shawnee residents are obese / overweight The hospital's action plan includes the following initiatives to improve chronic disease in the community served: - Ensure the Fruit and VeggieRx Pilot Program is affective with at least 50 participants in its first campaign - The overarching vision for the Fruit and VeggieRX Pilot Program is to broadly integrate fruit and vegetable prescription programs into the SSM St. Anthony Hospital -Shawnee healthcare system as a powerful tool for combating diet-related chronic disease - The Fruit and VeggieRX Pilot Program aims to initiate and strengthen conversations between healthcare providers and patients to provide education for the benefits of fresh fruits and vegetables in relationship to heart disease and obesity, increase access to fresh foods, and reduce obstacles of nourishment - Participants are recruited through a screening process for readiness by physician and/or care managers - Participants receive required program elements for participation to include check-ins, educational cooking classes, grocery store tours, and 12-week follow-up visit - Each participant receives a packet of vouchers dependent on family size equivalent to $120 for single/couple or $240 for families, to be redeemed for fresh fruits and vegetables at the local participating grocery store Substance abuse Utilization of addictive substances, including tobacco/vape use and prescription drug misuse remain high in Pottawatomie County. Tobacco use has predominantly negative effects on human health and concern about health effects of tobacco has a long history, which can lead to lung cancer, and increases the risk of heart disease and strokes. Research has focused primarily on cigarette tobacco smoking. Tobacco smoke contains more than fifty chemicals that cause cancer as well as nicotine, which is a highly addictive psychoactive drug. In addition, the effects of vaping include a toxic aerosol that is found to be highly detrimental to the lungs and body. Opioid use and addiction have negative physical and mental effects on the body and subsequent health risks, including overdose and death. Additionally, statistics show: - Tobacco use is high in Pottawatomie County, with 24.5% of adults smoking compared to the state's average of 23.3% - Unintentional Poisoning Death Rates involved at least one prescription opioid at a rate higher for Pottawatomie County compared to the state rate - In 2016, there were 444 opioid related overdose deaths in Oklahoma -a rate of 11.6 deaths per 100,000 persons -compared to the national rate of 13.3 deaths per 100,000 - There is a culture of tobacco use in the community, especially in the manufacturing sector and among low-income populations - Oklahoma has strong pre-emption laws that restrict what city governments can do with regards to tobacco policy. Only recently were cities allowed to enact tobacco-free policies for city property - Focus-group participants stated that older smokers tend to ignore tobacco-free signage and some adults continue to smoke on school property during sporting events despite signage - There is an abundance of tobacco retailers through the city of Shawnee, many with drive-thru windows, which are so popular that they cause traffic issues with waiting line queues The hospital's action plan includes the following initiatives to address substance abuse in the community served: - SSM Health St Anthony Hospital -Shawnee leadership serves as key stakeholders on the Well-Being Coalition to facilitate completion of the four components of the designated Well-Being District, which encompasses approximately one-third of the city - To facilitate District Tobacco Enforcement, comply with district certification criteria and support other businesses in the district through the following: - Have and enforce a Tobacco free policy - Eliminate sales of tobacco products in all grocers in district - All public parks in district posted as Tobacco Free, with implementation of signage for enforcement - Facilitate opportunities for smoking cessation to current tobacco users through the following: - Provide referral to Oklahoma Quit Line to all inpatients identified on admission as users of tobacco products - Supply activity kits for hands-on education - Facilitate opportunities for smoking-prevention education by assisting employers seeking resources for tobacco cessation and partnering with schools to create after-school programs for prevention education Food scarcity In 2017 it was estimated that 1 in 8 Americans were food insecure, equating to 40 million Americans including more than 12 million children. In Oklahoma, one in six people struggle with hunger with one in four children being food insecure. Hospitals are uniquely positioned to address hunger issues and boost resource utilization because of the link between food insecurity, nutrition, obesity, and overall health. Additionally, statistics show: - Nearly half of the households that receive SNAP (Supplemental Nutrition Assistance Program) benefits in Oklahoma have children - Over 16% of residents are food insecure - Food Insecurity leads to negative health implications including the following: - Increased incidence of chronic conditions including diabetes, cardiovascular disease, and poverty-related obesity - Exacerbation of existing health issues, particularly for elderly patients with chronic and acute diseases, which can also speed the onset of degenerative diseases - Poor maternal and infant health linked to higher rates of infant mortality and low birthweight babies - Fragile pediatric health associated with two to four times as any individual health problems in children, including weight loss, fatigue, headaches, stomach aches, and frequent colds - Psycho-social deficiencies linked to developmental delays, learning and behavioral problems The hospital's action plan includes the following initiatives to improve food scarcity in the community served: - Establish the hospital as a resource and community partner to address food scarcity, reframing hunger as a health issues and leveraging trusted health care provider relationships - Implement routine screening for food insecurity to identify what may otherwise be an invisible need - Secure food resources for immediate need, working with local experts and identifying the hospital as a stocked source for food items - Educate employees on issues of food scarcity in the community and resources available - Increase employee volunteer hours donated to identified agencies (such as Community Market of Pottawatomie County, Community Renewal, Kickapoo Park Community Garden) from 24 in 2018 to 48 in 2019 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): - Mental health - Health care access and medication cost - Health literacy - Transportation limitations - Exercise/physical activity Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - St. Anthony Shawnee Hospital (continued). During 2019, the following activities were performed to help address the issues identified in the CHNA: Chronic disease prevention and management * Launch of the VeggieRx program, the overarching vision of which is to broadly integrate fruit and vegetable prescription programs into the SSM St. Anthony Hospital -Shawnee healthcare system as a powerful tool for combating diet-related chronic disease. * The VeggieRx Pilot Program aims to initiate and strengthen conversations between healthcare providers and patients to provide education for the benefits of fresh fruits and vegetables in relationship to heart disease and obesity, increase access to fresh foods and reduce obstacles of nourishment. * Participants are recruited through a screening process for readiness by physician and/or care managers. Enrollment includes Baseline Program Survey with required health metrics of height, weight, BMI, circumference Blood pressure, and blood sugar. * Participants receive required program elements for participation to include check-ins, educational cooking classes, grocery store tours, and 12 week follow-up visit. * Each participant receives a packet of vouchers dependent on family size equivalent to $120 for single/couple or $240 for families, to be redeemed for fresh fruits and vegetables at the local participating grocery store. * At the completion of the program the data is collected to provide a de-identified file of participant pre-and post-metrics. * 54 patients enrolled in the program's pilot cohort in 2019 In addition to VeggieRx, the hospital participated in the following activities to promote chronic disease and management: * Consumer health information shared on social media about chronic disease and information about how to live a healthy lifestyle. * Promoted internally and externally National Walking Day- Wednesday, April 3, 2019. * Offered the Roadmap to Living with COPD program throughout 2019. The program is led by the hospital's Respiratory Therapy and Palliative Care teams, and provides education and encouragement to patients, caregivers and family members. * Developed for our staff and visitors a Blue Zones Shawnee campus walking map that gave different options (distance) for walking around campus, whether inside or outside. * Promoted Blue Zones inspired meals that were prepared in Cafe Substance Abuse * Ministry leadership served as a stakeholder on the Well-Being Coalition to facilitate completion of the four components of the designated Well-Being District, which encompasses approximately one-third of the city. This district includes the hospital. * To facilitate tobacco enforcement in the Well-Being District, the hospital complied with certification criteria and supported other businesses in the district: Had and enforced a tobacco free policy, Eliminated the sale of tobacco products at all grocers in the district, All public parks in the district received signage indicating its status as a tobacco free area and an enforcement phone number * Provided referrals to the Oklahoma Quit Line for all patients who requested a referral for tobacco cessation support * Hospital participated in the statewide OK to Quit Week through internal and external promotion of the program * Hospital participated in #KickButtsDay, a campaign for tobacco-free children, through internal and external promotion Food scarcity * Implemented routine screening for food insecurity for hospital patients: Incorporated short, validated screening questions into patient assessment tool upon admission and deployed social worker/case manager to confirm food insecurity * Provided immediate follow-up referrals to Community Market of Pottawatomie County (CMPC) for patients identified as food insecure * Referred patients identified as receiving inadequate healthy food consumption to the VeggieRx program * Ministry associates toured CMPC to increase awareness of food insecurity issues and availability of resources in the community * Mission Awareness Team led annual Feed a Family Campaign, raising funds to feed 100 families through CMPC * One ministry executive served on the CMPC board * Hospital donated fruit trees to the community garden at Kickapoo Park * Adopted a classroom at Jefferson Elementary, a public school where the majority of students are eligible for free lunches. When hospital leadership provide "party days" for the classroom, they made sure to provide enough food for the party and provided food for the students to take home after school. 3 SURGERY CENTER AT ST ANTHONY SHAWNEE 1106 W MCARTHUR SHAWNEE OK 74804 OUTPATIENT SURGERY FAMILY HEALTHCARE ASSOCIATES 3204 MEDICAL PARK SHAWNEE OK 74804 PHYSICIAN - FAMILY HEALTH URGENT CARE CLINIC 3200 MEDICAL PARK SHAWNEE OK 74804 URGENT CARE CLINIC Schedule H, Part I, Line 3c DISCOUNTED CARE EXCEPTIONS 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 HEALTH ST. ANTHONY HOSPITAL - SHAWNEE 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 THE FOLLOWING: ECONOMIC DEVELOPMENT: PARTICIPATION WITH THE CHAMBER OF COMMERCE AND SHAWNEE FORWARD, COMMUNITY SUPPORT: INVOLVEMENT WITH BLUE ZONES PROJECT, a community-wide well-being improvement initiative to help make healthy choices easier for everyone in THE community, COALITION BUILDING: PARTNERING WITH LOCAL SCHOOLS AND THE FAMILY JUSTICE CENTER BOARD, COMMUNITY HEALTH IMPROVEMENT ADVOCACY: VARIOUS HEALTH ALLIANCES INCLUDING THE POTTAWATOMIE COUNTY ALLIANCE TOWARD COMMUNITY AND REGIONAL EPIDEMIOLOGICAL OUTCOMES WORKGROUP. 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 St. Anthony Shawnee Hospital, Inc. 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 St. Anthony Shawnee Hospital 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 St. Anthony Shawnee Hospital collection and financial assistance policies. Schedule H, Part V, Section B, Line 16a FAP website A - ST ANTHONY SHAWNEE HOSPITAL: Line 16a URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - ST ANTHONY SHAWNEE HOSPITAL: 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 - ST ANTHONY SHAWNEE HOSPITAL: 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. Anthony Hospital - Shawnee is located in Shawnee, Oklahoma and defines its primary service area as in Pottawatomie County, which according to 2017 population estimates, has a population of 72,226 persons. Residents of the county account for nearly 70% of the total patients served by the hospital. Of the hospital's community, only 16.2% have a Bachelor's degree and almost 15% do not have a High School diploma. Rates of individuals in poverty are higher in the county, at 18.2%, as compared to state and national rates. Additionally, median household income was reported at $44,688 in 2015, significantly lower than Oklahoma and U.S. medians. Thirty percent of the Pottawatomie County population is age 55 and over. County-wide smoking rates for adults is 24.5%, while excessive drinking is reported at 13%. Nearly 40 percent of Pottawatomie County residents are obese. Additional detailed information on the SSM Health St Anthony Hospital - Shawnee service area can be found in the 2018 CHNA. Schedule H, Part VI, Line 5 Promotion of community health St. Anthony Shawnee Hospital, Inc. 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, St. Anthony Shawnee 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. Anthony Hospital Shawnee, Inc. 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. St. Anthony Shawnee Hospital, Inc. 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 ST. ANTHONY SHAWNEE HOSPITAL IS A 501(C) (3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH SSM HEALTH CARE OF OKLAHOMA, INC. THE HOSPITAL IS PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE FOR THE CENTRAL OKLAHOMA REGION. Schedule H, Part VI, Line 7 State filing of community benefit report OK true Oklahoma Baptist University 500 W University Box 61027 Shawnee OK 74804 730579264 501(c)(3) 90000 General support Shawnee Forward Inc 231 N Bell Shawnee OK 74801 823127939 501(c)(3) 12873 General support 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE ORGANIZATION'S GRANTS WERE MADE TO TAX- EXEMPT, UNDER SECTION 501(C)(3), ORGANIZATIONS. THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. true true false false false false false false false Joe Hodges Director, Chairperson, Regional President - SSM Health Care of Oklahoma 0 647086 0 145302 0 134224 0 497073 0 26185 0 1449869 0 225568 Patrick Mccruden Director, Vice Chair, Chief Mission Integration Officer-SSM Health 0 344641 0 59744 0 12047 0 270850 0 23341 0 710623 0 59744 Christopher Howard Former Officer 0 0 0 0 0 566322 0 214327 0 4649 0 785299 0 0 Laura Kaiser Former Officer 0 1591955 0 536550 0 25353 0 2013276 0 13853 0 4180987 0 536550 Kris Zimmer Treasurer, Chief Financial Officer at SSM Health 0 887868 0 230489 0 247277 0 797538 0 16082 0 2179255 0 340596 Doug Long Secretary, General Counsel at SSM Health 0 149400 0 0 0 80150 0 469438 0 2548 0 701536 0 0 Paula Friedman Pt Yr Vice President, Pt Yr Senior VP-Strategic Development SSM Health 0 270134 0 189852 0 924934 0 278843 0 3736 0 1667500 0 618871 Shasta Manuel System Vice President-Finance 0 340783 0 46367 0 36194 0 114585 0 26739 0 564667 0 76273 Charles Skillings Hospital President, SSM Health St. Anthony Hospital - Shawnee 347194 0 62209 0 154563 0 147062 0 19368 0 730397 0 174104 0 Linda Brown Former Key Employee 111278 0 19643 0 33129 0 16464 0 27394 0 207908 0 43507 0 Angela Mohr Executive Vice President/COO/CNO 211819 0 26498 0 8710 0 53774 0 24273 0 325074 0 33926 0 Cathy Broome Administrative Director - Nursing 135387 0 0 0 1710 0 7342 0 9964 0 154403 0 0 0 Gaynell Anderson Chief Medical Officer 315077 0 0 0 5699 0 14965 0 25236 0 360977 0 0 0 Venkata Damera Physician 386009 0 111784 0 8914 0 15200 0 27436 0 549342 0 0 0 Adam Hogue Physician Assistant 182738 0 151663 0 10339 0 14364 0 27550 0 386653 0 0 0 Troy Norred Physician 604648 0 260890 0 2320 0 0 0 24400 0 892258 0 0 0 Manikumar Bheemarasetti Physician 311123 0 143787 0 474 0 31131 0 246 0 486760 0 0 0 Sailaja Adari Physician 357701 0 0 0 756 0 25792 0 28886 0 413136 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, 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 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: Patrick McCruden $42,132 Joe Hodges $76,879 Kris Zimmer $105,240 Shasta Manuel $27,254 Charles Skillings $27,420 Angela Mohr $8,652 Laura Kaiser $314,000 Linda Brown $5,946 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. Joe Hodges $80,266 Paula Friedman $429,019 Kris Zimmer $111,962 Shasta Manuel $29,906 Charles Skillings $111,895 Angela Mohr $7,428 Linda Brown $23,863 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: Joe Hodges $23,497 Paula Friedman $9,691 Kris Zimmer $66,609 Shasta Manuel $2,439 Form 990, Part III, Line 4a 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 St. Anthony Shawnee Hospital: SSM Health St. Anthony Hospital - Shawnee has been providing health care services for over 50 years to Shawnee and the surrounding communities of Pottawatomie County. St Anthony Shawnee along with SSM Health Care of Oklahoma comprise the Oklahoma region of SSMH. St Anthony Shawnee also includes an urgent care facility, with services including acute care, newborn deliveries, Intensive Care, Emergency department, orthopedics, cardiology, diagnostic laboratory and imaging, sleep lab, physical therapy, occupational therapy, speech therapy, cancer center and rehabilitation services, respiratory care, and women's services. In 2018, the hospital earned the Guardian of Excellence - Clinical Quality award from Press Ganey, and also the Premier Award for Quality, High-Value Health Care Citation of Merit in 2017. SSM Health St. Anthony Hospital - Shawnee has received an 'A' Leapfrog Hospital Safety Grade annually since 2016. St. Anthony Shawnee Hospital 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 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 $ 4,197,621 Unpaid Cost of Medicare $ 358,029 Total Quantifiable Uncompensated Care $ 4,555,650 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 for 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 for 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 CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF OKLAHOMA, INC. SSM HEALTH CARE OF OKLAHOMA, INC. IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH ST. ANTHONY SHAWNEE HOSPITAL, INC. AND SSM HEALTH CARE OF OKLAHOMA, INC. 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 AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO 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 ELECT AND REMOVE THE APPOINTED DIRECTORS AND THE EX-OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE Certificate 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 AUTHORIZE OR 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 INTERESTS 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 OF 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 DECISION ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. 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 SSM HEALTH ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE OKLAHOMA 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: 24684553, Program Service Expense: 22097515, Management and General Expenses: 2587038, Fundraising Expenses: ; 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 SSM Audrain Health Care Inc 10101 Woodfield Lane St Louis MO 63132 431550298 Health Care MO 501(c)(3) 3 SSM Regional Health Services 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 0 St Clare Imaging Services LLC 707 14th Street Suite A Baraboo WI 53913 200122365 Diag. Services WI NA N/A 0 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 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 0 CHOWSMGSI Office Building LLC 10101 Woodfield Lane St Louis MO 63132 371383861 MOB IL NA N/A 0 0 0 0 Oza Cancer Center LLC 10101 Woodfield Lane St Louis MO 63132 201382727 MOB IL NA N/A 0 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 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 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 0 Dean Health Holdings LLC 1277 Deming Way Madison WI 53717 261594709 Support Services WI NA N/A 0 0 0 0 Wingra Building Group 1808 West Beltline Highway Madison WI 53713 390237060 MOB WI NA N/A 0 0 0 0 Janesville Riverview Clinic Building Partnership 1808 West Beltline Highway Madison WI 53713 396220698 MOB WI NA N/A 0 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 0 SSM St Clare Surgical Center LLC 10101 Woodfield Lane St Louis MO 63132 261439695 Surgery Services MO NA N/A 0 0 0 0 Windmill LLP 50 Village View Lane Chesterfield MO 63017 431804651 Investments MO NA N/A 0 0 0 0 SSM Managed Care Organization LLC 10101 Woodfield Lane St Louis MO 63132 431708511 Health Promotion MO NA C Corporation 0 0 0 false FPP INC & Subs 10101 Woodfield Lane St Louis MO 63132 431465174 Health Care MO NA C Corporation 0 0 0 false Diversified Health Services Corp 10101 Woodfield Lane St Louis MO 63132 431369305 Medical Equipment MO NA C Corporation 0 0 0 false SSM Properties Inc 10101 Woodfield Lane St Louis MO 63132 431462486 Property Services MO NA C Corporation 0 0 0 false HealthFirst Physician Management Services 10101 Woodfield Lane St Louis MO 63132 731534336 Medical Services OK NA C Corporation 0 0 0 false SSMHC Liability Trust II 10101 Woodfield Lane St Louis MO 63132 816128118 Insurance MO NA C Corporation 0 0 0 false SSM Medical Group Inc 10101 Woodfield Lane St Louis MO 63132 431664107 Physician Offices MO NA C Corporation 0 0 0 false SSMHC Insurance Company 10101 Woodfield Lane St Louis MO 63132 030310431 Insurance NA C Corporation 0 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 0 false Dean Health Systems Inc 1808 West Beltline Highway Madison WI 53713 391128616 Physician Offices WI NA C Corporation 0 0 0 false Dean Health Insurance Inc PO Box 56099 Madison WI 53705 391830837 Insurance WI NA C Corporation 0 0 0 false Dean Health Plan Inc PO Box 56099 Madison WI 53705 391535024 Insurance WI NA C Corporation 0 0 0 false SMDV Office Building 1808 West Beltline Highway Madison WI 53713 391628491 Physician Offices WI NA C Corporation 0 0 0 false Dean Retail Services Inc 1808 West Beltline Highway Madison WI 53713 391717636 Property Services WI NA C Corporation 0 0 0 false Navitus Holdings LLC 1808 West Beltline Highway Madison WI 53713 800968174 Pharmacy Benefits WI NA C Corporation 0 0 0 false Oza Oncology Inc 4117 Veterans Memorial Drive Mt Vernon IL 62804 371343746 Physician Offices IL NA S Corporation 0 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 0 false SSM Health Pharmacy LLC 10101 Woodfield Lane St Louis MO 63132 264031708 Pharmacy MO NA C Corporation 0 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 0 false SSM Health Insurance Company 1277 Deming Way Madison WI 53717 834718249 Insurance MO NA C Corporation 0 0 0 false false false true false false false false false false false true false true true true false false false false