2020-11-05T10:30:54-06:00 2019-12-31 350921680 Crowe LLP 9600 Brownsboro Road Suite 400 Louisville KY 402411122 990 2019-01-01 431343281 SSM Health Care St Louis SSMH 3149947800 10101 Woodfield Lane St Louis MO 63132 Doug Long Secretary 2020-11-05 true Kim Scifres P01316095 5023263996 2019 2021-01-29 14:40:06Z See Schedule O Candace Jennings 10101 Woodfield Lane St Louis MO 63132 1636600308 false 0928 X www.ssmhealth.com X 2000 MO OPERATES SEVEN HOSPITALS AND HEALTH CARE CENTERS UNDER SIX SEPARATE HOSPITAL LICENSES IN THE GREATER ST. LOUIS METROPOLITAN AREA. 7 4 11518 1341 6012965 97109 1086157 1829682 1598605230 1619640552 2911591 2853625 12786337 10251992 1615389315 1634575851 458989 413759 0 607365749 612989708 0 0 846988201 896736537 1454812939 1510140004 160576376 124435847 1255842672 1651343422 781284676 1161540281 474557996 489803141 THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. false false 1346312802 413759 1619640552 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. 1346312802 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 true true true false false false false false false true false true false false false true true true true false false true X 0 0 11518 true true true false false false false false false false false false false false X 7 4 false false false false true true true true false false false false true true true true true false false true true X Bonnie Thorn 3149893640 1195 Corporate Lake Drive St Louis MO 63132 Candace Jennings Chair, President, Regional President-St Louis 40.0 10.0 X X 1336265 0 538244 Laura Kaiser Vice Chair, President/CEO at SSM Health 1.0 47.0 X X 0 2153858 2027129 Dee Joyner Director 1.0 2.0 X 0 0 0 Jan Cerny Director 1.0 2.0 X 0 0 0 Robert Wilmott Director 1.0 2.0 X 0 0 0 Snehal Gandhi Director 1.0 2.0 X 0 0 0 Steven Smoot Director, COO of SSM Health 1.0 50.0 X 0 1066618 686232 Doug Long Secretary, General Counsel at SSM Health 1.0 65.2 X 0 229550 471986 Karen Rewerts System VP, Finance (MO/ILL) 25.0 21.0 X 0 714136 175222 Kris Zimmer Treasurer, Chief Financial Officer at SSM Health 1.0 67.0 X 0 1365634 813620 Omolola Vinson Assistant Secretary 25.0 15.0 X 16739 0 0 Paula Friedman Pt Yr Vice President, Pt Yr Senior VP-Strategic Development SSM Health 1.0 58.0 X 0 1384920 282580 Dang Tran President, Physicians Org/Ambulatory Services 40.0 0 X 524277 0 195714 Ellis Hawkins Hospital President - SSM Health DePaul Hospital 40.0 1.0 X 560251 0 166266 Hsieng-Teh Su Regional VP, Medical Affairs 40.0 0 X 508510 0 155675 Kathleen Bonser Regional VP, Nursing/CNO 40.0 0 X 415493 0 111062 Lee Bernstein Regional VP, Hospital Operations 40.0 0 X 0 590108 22746 Lisle Wescott Hospital President - SSM Health St. Joseph - St. Charles, SSM Health St. Joseph - Lake St. Louis 40.0 1.0 X 527295 0 162276 Michael Bowers Chief Operating Officer - SSM Health Care St. Louis 40.0 1.0 X 656563 0 203040 Rachel Donlan System VP - Strategic Development 40.0 0 X 0 241148 91349 Renee Roach System VP, Human Resources - St. Louis 40.0 0 X 0 433335 150646 Tina Garrison Hospital President - SSM Health St. Clare Hospital 40.0 1.0 X 359824 0 119692 Travis Capers Hospital President - SSM Health St. Mary's Hospital 40.0 1.0 X 587496 0 176316 Andrew Karanas Physician 40.0 0 X 517649 0 21809 David McCollister Physician 40.0 0 X 468861 0 18916 Joseph Attewell Physician 40.0 0 X 618181 0 27209 Timothy Pratt VP - Medical Affairs 40.0 0 X 526921 0 74086 William Holcomb Physician 40.0 0 X 476248 0 36153 Alexander Garza Former Key Employee 0.0 40.0 X 0 616202 228090 Christopher Howard Former Director & Officer 0.0 0.0 X 0 566322 218976 Margaret Fowler Former Key Employee 40.0 X 0 784531 173221 8100573 10146363 7348255 632 true true false INTERFACE CONSTRUCTION GROUP 8401 WABASH BERKELEY MO 63134 CONSTRUCTION SERVICES 17537628 ST LOUIS UNIVERSITY 1402 S GRAND BLVD ST LOUIS MO 63104 MEDICAL SERVICES 16884779 ALBERICI CONSTRUCTORS INC 8800 PAGE AVE ST LOUIS MO 63114 CONSTRUCTION SERVICES 13191918 AMN HEALTHCARE INC 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 STAFFING SERVICES 11769433 SSM SELECT REHAB OF ST LOUIS LLC 4714 GETTYSBURG ROAD MECHANICSBURG PA 17055 MEDICAL SERVICES 10198168 105 0 0 0 1363273 400444 65965 31618 1829682 NET PATIENT SERVICE REVENUE 621110 1619640552 1619640552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1619640552 2524914 0 0 2524914 0 0 0 0 0 0 0 0 3530889 0 1844981 1685908 0 1685908 1685908 508186 179476 508186 -179476 328711 328711 0 0 0 0 0 0 0 0 0 LABORATORY SERVICES 621500 2965385 2965385 0 LTACH/SELECT REHAB 622310 2416299 2416299 PHARMACY SERVICES 446110 581882 581882 0 2602518 0 49399 2553119 8566084 1634575851 1619640552 6012965 7092652 X 350529 350529 63230 63230 7320998 6893522 427476 99753 99753 458211283 431577162 26634121 35404370 33337094 2067276 78346485 73771802 4574683 33606819 31644503 1962316 15235535 15235535 147817 147817 504685 504685 206843 206843 197120740 142711734 54409006 0 56517 56517 55768869 53122149 2646720 77540601 75851462 1689139 32453106 29087685 3365421 2029840 1065276 964564 565515 483022 82493 12052069 12052069 58453935 58453935 10300886 10300886 Medical supplies 288416944 288416944 Medicaid Provider Tax 79952897 79952897 Internal management fees 61307218 61307218 Licenses and taxes 992763 992763 3629757 948603 2681154 0 1510140004 1346312802 163827202 0 837206 960247 157213694 528629225 0 212970320 224579877 0 0 0 0 0 33250903 33381428 10635664 9077926 1450216824 797751423 629368214 652465401 0 28321547 73415877 18600167 20241091 16567899 16567748 148077058 92024602 1255842672 1651343422 145728852 171234233 0 693742 670742 0 0 0 0 0 0 634862082 989635306 781284676 1161540281 X 461681134 476472237 12876862 13330904 474557996 489803141 1255842672 1651343422 X 124435847 1074219 -110264921 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 206843 206843 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The organization paid dues to various national and local hospital associations and a portion of these dues was allocated to lobbying activities. 3332047 1502500 502477 333513 5003511 3635052 -283932 19073 3332047 3349246 2500 335306 52000 3635052 3223619 156025 30398 3349246 3232137 -8233 285 3223619 0.0 1.0 0.0 true true true 58165541 58165541 895205256 465876686 429328570 33817318 21441750 12375568 419519367 310432987 109086380 43509342 0 43509342 652465401 DUE FROM AFFILIATES 42500885 OTHER ASSETS 19311709 OPERATING RIGHT-OF-USE ASSETS 30212008 92024602 PAYABLE TO THIRD-PARTY PAYORS 64208677 DUE TO AFFILIATES 171557633 OTHER LIABILITIES 304477 ASSET RETIREMENT LIABILITY 2573462 ALLOCATED TAX-EXEMPT DEBT (ISSUED BY SSM HEALTH CARE) 704123560 CAPITAL LEASE OBLIGATION 256281 Rabbi Trust Liability 3790953 Third-party patient loans 5628761 RETIREMENT OBLIGATIONS 3349352 OPERATING LEASE OBLIGATIONS 33842150 989635306 X Schedule D, Part V, Line 4 Intended uses of endowment funds ALL ENDOWMENT FUNDS WILL BE USED TO SUPPORT HEALTH CARE SERVICES. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SSM HEALTH CARE ST LOUIS' 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 X true X true X true true true false true true 48313911 48313911 0.0320 255570892 232471946 23098946 0.0153 16443705 14619268 1824437 0.0012 0 0 320328508 247091214 73237294 0.0485 5408751 10350 5398401 0.0036 28671077 12597419 16073658 0.0106 0 0.0 2488 2488 0.0000 33867 33867 0.0000 0 0 34116183 12607769 21508414 0.0142 0 0 354444691 259698983 94745708 0.0627 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 124311 124311 0.0001 401327 210189 191138 0.0001 0 0.0 0 0 525638 210189 315449 0.0002 true 90513721 334391152 346570930 -12179778 X true true SSM ST JOSEPH ENDOSCOPY CENTER LLC OPERATE AN ENDOSCOPY CENTER 0.5 0.0 0.5 ST LOUIS CYBERKNIFE LLC OPERATE A CANCER TREATMENT CENTER 0.44 0.0 0.56 6 1 SSM Health DePaul Hospital - St Louis 12303 DePaul Drive St Louis MO 63044 https://www.ssmhealth.com/locations/depaul-hospital-st-louis 414-18 X X X A 2 SSM Health St Mary's Hospital - St Louis 6420 Clayton Road St Louis MO 63117 https://www.ssmhealth.com/locations/st-marys-hospital-st-louis 383-21 X X X X A 3 SSM Health St Joseph Hospital - St Charles 300 First Capitol Drive St Charles MO 63301 https://www.ssmhealth.com/locations/st-joseph-hospital-st-charles 494-8 X X X A 4 SSM Health St Clare Hospital - Fenton 1015 Bowles Avenue Fenton MO 63026 https://www.ssmhealth.com/locations/st-clare-hospital-fenton 456-14 X X X A 5 SSM Health St Joseph Hospital - Lake Saint Louis 100 Medical Drive Lake St Louis MO 63367 https://www.ssmhealth.com/locations/st-joseph-hospital-lake-saint-louis 381-21 X X X A 6 SSM Health Rehabilitation Hospital 12380 DePaul Drive Bridgeton MO 63044 HTTPS://WWW.SSM-REHAB.COM/ 522-4 X A false false true X X X X X X X X X 18 true true false true 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 SSM Health Rehabilitation Hospital 6 false false true X X X X X X X X X 18 true true false true X https://www.ssm-rehab.com/about/community-health-needs-assessment/ 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.ssm-rehab.com/referral-sources/financial-assistance/ X https://www.ssm-rehab.com/referral-sources/financial-assistance/ X https://www.ssm-rehab.com/referral-sources/financial-assistance/ X X X X X X true X false 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 - Facility Group A. THE PRIMARY DATA CONSISTED OF COMMUNITY FOCUS GROUPS THAT INCLUDED KEY STAKEHOLDERS WITHIN THE HOSPITALS' SERVICE AREAS. FOCUS GROUP PARTICIPANTS INCLUDED REPRESENTATION FROM THE ST. LOUIS COUNTY AND ST. CHARLES COUNTY DEPARTMENTS OF HEALTH, ST. LOUIS CITY, ST. LOUIS COUNTY, AND ST. CHARLES COUNTY COMMUNITIES, COLLABORATING HOSPITALS, AND LOCAL PUBLIC SCHOOL DISTRICTS. IN ADDITION TO A REVIEW OF DEMOGRAPHICS, THE HOSPITALS' GATHERED AND REVIEWED DATA FROM BROAD SOURCES. THE SECONDARY DATA WAS DERIVED FROM A VARIETY OF SOURCES INCLUDING THINK HEALTH ST. LOUIS - ST. LOUIS PARTNERSHIP FOR A HEALTH COMMUNITY, WHICH INCLUDES DATA PULLS FROM HEALTH COMMUNITIES INSTITUTE COVERING TOPICS IN AREAS OF HEALTH, DETERMINANTS OF HEALTH AND QUALITY OF LIFE, AS WELL AS COUNTY HEALTH RANKINGS. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - SSM Health DePaul Hospital - St. Louis. THE HOSPITAL CONDUCTED AND COMPLETED ITS 2018 CHNA JOINTLY WITH SSM HEALTH REHABILITATION NETWORK. THE HOSPITAL ALSO COLLABORATED WITH BJC HEALTHCARE'S CHRISTIAN HOSPITAL. Schedule H, Part V, Section B, Line 6a Facility A, 2 Facility A, 2 - SSM Health St. Mary's Hospital - St. Louis. THE HOSPITAL CONDUCTED AND COMPLETED ITS 2018 CHNA JOINTLY WITH SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL AND SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL. THE HOSPITAL ALSO COLLABORATED WITH MEMBERS OF BJC HEALTHCARE, ST. LOUIS CHILDREN'S HOSPITAL AND BARNES JEWISH HOSPITAL, AND SHRINER'S CHILDREN'S HOSPITAL. Schedule H, Part V, Section B, Line 6a Facility A, 3 Facility A, 3 - SSM Health St. Joseph Hospital - St. Charles and SSM Health St. Joseph Hospital - Lake Saint Louis. BOTH HOSPITALS CONDUCTED AND COMPLETED A JOINT 2018 CHNA. THE HOSPITALS ALSO COLLABORATED WITH MEMBER HOSPITALS OF BJC HEALTHCARE. Schedule H, Part V, Section B, Line 6a Facility A, 4 Facility A, 4 - SSM Health St. Clare Hospital - Fenton. SSM HEALTH ST. CLARE HOSPITAL - FENTON DID NOT COLLABORATE WITH OTHER HOSPITAL FACILITIES TO COMPLETE THEIR 2018 CHNA. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - SSM Health DePaul Hospital - St. Louis. 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: - Substance abuse/mental health - Access to care - Chronic disease-Hepatitis C Substance abuse/mental health Substance abuse is a major public health issue in the community, having a strong impact on individuals, families, and communities. The use of illicit drugs, abuse of alcohol, and addiction to pharmaceuticals is linked to serious health conditions such as heart disease, cancer, and liver diseases. Substance abuse also contributes to a wide range of social, physical, mental, and public health problems. Because of these far-reaching consequences of substance abuse, treatment programs have been developed to counter addiction. Additional facts and figures that relate to substance abuse and mental health show: - ER visits related to substance abuse per 10,000 persons over 18 years is 17.9 in St. Louis County - Nationally, the incidence of drug-poisoning deaths involving natural and semisynthetic opioids, which include drugs such as oxycodone and hydrocodone, increased from 1.0 in 1999 to 4.4 in 2016 - The incidence of drug-poisoning deaths involving methadone increased from 0.3 in 1999 to 1.8 in 2006, then declined to 1.0 in 2016 - The incidence of drug-poisoning deaths involving heroin increased from 0.7 in 1999, to 1.0 in 2010, to 4.9 in 2016 - Missouri is statistically higher than the US average of 19.8 drug-poisoning deaths per 100,000 people (age-adjusted). In 2017, Missouri averaged 23.4 drug-poisoning deaths per 100,000 people - In 2017, the peak age group in Missouri for heroin and non-heroin opioid deaths is 25-34 The hospital is involved in the following initiatives to improve substance abuse and mental health in the community served: - Provide education to physicians for opioid tapering, monitor to ensure a decrease in the opioid/opiate prescribing rates within SSM Health DePaul Hospital - Advocate for a state-wide Prescription Drug Monitoring Program in Missouri - Increase the number of North St. Louis County residents able to access appropriate, quality substance use treatment - Prescription Take Back Day(s) -in collaboration with local law enforcement, establish/support programs that accept expired, unwanted, or unused medicines from designated users and dispose of them responsibly - Expand SSM Health DePaul Hospital's LAI (long-acting injection) clinic to treat 300 patients per month with readmissions for these under 10% - Partner with local civic and social organizations to educate the community on LAI options for treatment - In partnership with Behavioral Health Network and other non-profit organizations, address the social determinants of health and develop a behavioral health walk-in clinic Access to Care Access to primary care providers is a key priority for the hospital. Improvements will increase the likelihood that community members will have routine check-ups and screenings. Moreover, those with access to primary care are more likely to know where to go for treatment in acute situations. Communities that lack sufficient access to primary care, regardless of insurance, typically have members who delay necessary care until they are more ill than those that have greater access. Statistical data on access to care shows the following: - Per 100,000 persons, there are 123 providers in St. Louis County - St. Louis County ranks number 11 in the morbidity ranking. This indicator shows the ranking of the county in overall quality of life according to the County Health Rankings. The ranking is based on a summary composite score calculated from the following measures: poor or fair health, poor physical health days, poor mental health days, and low birthweight - 43% of St. Louis County residents have a bachelor's degree or greater 21% of St. Louis County residents have a high school graduation degree - Approximately 10% of St. Louis County residents don't have health insurance - 6.7% of St. Louis County families live below the poverty line - 82.5% of St. Louis County expecting mothers receive prenatal care and the infant mortality rate for St. Louis County is 7.7 out of 1,000 live births The hospital is implementing the following measures to improve access to care: - In partnership with the Integrated Health Network, utilize community referral coordinators to ensure continuity of care for patients and timely access to primary care follow-up - Evaluate opportunities to provide mobile health services through partnerships with philanthropic groups, local school districts, local municipalities, and Just Moms STL - Evaluate opportunity to partner with PattonvilleFire Protection District to provide community paramedicine / mobile integrated health program - Increase patients' health-related knowledge via efforts to simplify health education materials, improve patient-provider communication, and increase overall literacy - Provide health insurance outreach and support to assist individuals whose employers do not offer affordable coverage, who are self-employed, or who are unemployed - Partner with community groups to educate residents regarding the importance of prenatal care and the services available regardless of health insurance at OB Care Center at SSM Health DePaul Hospital - Expand the capacity of the Transitional Care Clinic, with the goal of reducing readmissions of participants by 40% Chronic disease-Hepatitis C Hepatitis C is a major concern in the hospital's service area. Chronic forms can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Certain types of hepatitis are extremely contagious; some are spread via blood or sexual contact, while others are spread via fecal-oral contact. Additional data on hepatitis C report that: - Per 10,000 St. Louis adults ages 45-64, 3.6 will be hospitalized for Hepatitis C - St. Louis County and St. Louis City have the highest rates of Hepatitis C in the state - Once diagnosed, highly effective treatment options are now available for Hepatitis C that have fewer side effects than earlier treatments. These new medication options have 95% cure rates and reduce the risk of death from liver cancer and cirrhosis The hospital has the following action plan in place to improve the community measures on Hepatitis C: - Evaluate partnership opportunities within the community to serve as referral and educational resources to residents that could benefit from the SSM Health DePaul Hospital Hepatitis C clinic - Partner with SUD (substance abuse disorder) treatment centers to provide screenings for at-risk patients - Increase clinic capacity by 33% (to 16 patients per month) 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: - Obesity, inactivity and nutrition - Medication management - Economic issues, poverty, unemployment - Violence - Smoking and tobacco use - Cerebrovascular disease Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - SSM Health St. Mary's Hospital - St. Louis. 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: - Access to care - High risk pregnancy - Chronic disease-diabetes Access to care Access to primary care providers is a key priority for the hospital. Improvements will increase the likelihood that community members will have routine check-ups and screenings. Moreover, those with access to primary care are more likely to know where to go for treatment in acute situations. Communities that lack sufficient access to primary care, regardless of insurance, typically have members who delay necessary care until they are more ill than those that have greater access. Additional facts and figures on access to care show: - Provider Care Rate-Per 100,000 persons, there are 123 providers in St. Louis County and 85 providers in St. Louis City. Primary care providers include practicing physicians specializing in general practice medicine, family medicine, internal medicine, and pediatrics - Clinical Care Ranking -The quality and accessibility of clinical care heavily impacts the health of a community. Without a sufficient number of providers or adequate insurance coverage, people often do not seek care services and are thus at higher risk of developing preventable illnesses or chronic conditions. People with access to high-quality care are more likely to receive effective treatment for their conditions and enjoy better health. St. Louis County is ranked at 2, St. Louis City is ranked at 27 (1-2 is healthiest). The ranking is based on a summary composite score calculated from the following measures: uninsured, primary care physicians, mental health providers, dentists, preventable hospital stays, diabetic monitoring, and mammography screening - 43% of St. Louis County residents and 34% of St. Louis City residents have a bachelor's degree or greater. 21% of St. Louis County residents and 23% of St. Louis City residents have a high school graduation degree - Approximately 10% of St. Louis County residents and 15% of St. Louis City resident don't have health insurance - 6.7% of St. Louis County families and 19.94% of St. Louis City families live below the poverty line The hospital is involved in the following initiatives to improve access to care in the community served: - Increase the number of lives cared for in the Internal Medicine Clinic to 1000 by 2021 through partnering with community agencies to promote the services available to the underserved population of the community - In partnership with the Integrated Health Network, utilize community referral coordinators to ensure continuity of care for patients and timely access to primary care follow up - Increase patients' health-related knowledge via efforts to simplify health education materials, improve patient-provider communication, and increase overall literacy - Provide health insurance outreach and support to assist individuals whose employers do not offer affordable coverage, who are self-employed, or who are unemployed High Risk Pregnancy High risk pregnancy is a key priority for the hospital. Increasing the number of women who receive prenatal care, and who do so early in their pregnancies, can improve birth outcomes and lower health care costs by reducing the likelihood of complications during pregnancy and childbirth. Statistical data on high risk pregnancy shows the following: - 82.5% of St. Louis County mothers received prenatal care compared to 73.2% of St. Louis City mothers. Babies born to mothers who do not receive prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care - Infant mortality rate continues to be one of the most widely used indicators of the overall health status of a community. The leading causes of death among infants are birth defects, preterm delivery, low birth weight, Sudden Infant Death Syndrome (SIDS), and maternal complications during pregnancy. St. Louis City has a rate of 11.2 per 1,000 live births compared to St. Louis County at 7.7. The Healthy People 2020 national health target is to reduce the infant mortality rate to 6 deaths per 1,000 live births The hospital is implementing the following measures to improve high risk pregnancy for the community: - Attain a threshold of 50% of patients illicit-drug free, at the time of delivery, for those enrolled in the WISH program. Develop outreach strategies to community organizations working in the substance abuse space for patient referral to WISH services - Continue to actively participate in the Generate Health Build Grant focusing on improving maternal and infant health outcomes by targeting transportation access for pregnant women and new parents in two contiguous zip codes of 63106 and 63107 in the City of St. Louis - Work with FLOURISH St. Louis, a diverse community partnership designed to work in a new way to achieve large-scale, lasting improvements in the health and well-being of St. Louis babies and families - Through Thrive St. Louis, establish seamless referral process for women needing prenatal care Chronic disease-Diabetes Diabetes is the third priority for the hospital and is also a leading cause of death in the United States. This disease can have a harmful effect on most of the organ systems in the human body; it is a frequent cause of end-stage renal disease, non-traumatic lower-extremity amputation, and a leading cause of blindness among working age adults. Persons with diabetes are also at increased risk for ischemic heart disease, neuropathy, and stroke. Additional data on diabetes report that: - 11.6% of adults (20+ years of age) in St. Louis County and 12.6% of adults in St. Louis City have been diagnosed with Diabetes - Diabetes is the leading cause of death in United State disproportionately affecting minority populations and the elderly, and its incidence is likely to increase as minority populations grow and the U.S. population ages - The percentage of obese adults is an indicator of the overall health and lifestyle of a community. 31.1% of St. Louis City residents and 282% of St. Louis County residents are obese based on a BMI greater than or equal to 30 - Age-adjusted death rate due to Diabetes per population of 100,000 persons is 30.3 in St. Louis City and 15.7 in St. Louis County - Annual age-adjusted emergency room visit rate due to diabetes per 10,000 population aged 18 years and older is 35.3 in St. Louis City and 17.9 in St. Louis County. Both Type 1 and Type 2 are included - Grocery store density in is St. Louis County is .34 and .18 in St. Louis City. This indicator shows the number of supermarkets and grocery stores per 1,000 population The hospital has the following action plan in place to improve the community measures on diabetes: - Utilize Diabetic Educators in the most optimal manner while meeting the needs of the inpatient and outpatient services' patients - Determine if there is a way to extend the reach of Diabetic Educators beyond inpatient and outpatient services and into the community, including the Internal Medicine Clinic, Wound Clinic and community events - Increase the number of patients served at the SSM Pharmacy on the hospital's campus by 5% each year moving forward so that patients are receiving the medications they need to effectively manage their diabetes - Engage community agencies and church groups to evaluate partnership opportunities to address diabetes management 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: - Continuity of care - Price/quality transparency - Trauma/stress care - Obesity - Cardiovascular disease - Sexually-transmitted disease - Violence - Pediatric neglect/abuse - Emergency department visits/capacity - Cancer - Dental health Schedule H, Part V, Section B, Line 11 Facility A, 3 Facility A, 3 - SSM Health St. Joseph Hospital - St. Charles and SSM Health St. Joseph Hospital - Lake Saint Louis. The hospitals identified various health needs in their jointly-completed 2018 CHNA. In order to make meaningful impact, and to use its finances most effectively and efficiency, the hospitals will place primary focus on the following key priorities: - Substance abuse - Access to care - Chronic disease-obesity Substance abuse Substance abuse is a major public health issue that has a strong impact on individuals, families, and communities. The use of illicit drugs, abuse of alcohol, and addiction to pharmaceuticals is linked to serious health conditions such as heart disease, cancer, and liver diseases, as well as lost work productivity, healthcare, and crime. Substance abuse also contributes to a wide range of social, physical, mental, and public health problems. Because of these far-reaching consequences of substance abuse, treatment programs have been developed to counter addiction. Additional facts and figures on substance abuse show: - Nationally, the incidence of drug-poisoning deaths involving natural and semisynthetic opioids, which include drugs such as oxycodone and hydrocodone, increased from 1.0 in 1999 to 4.4 in 2016 - The incidence of drug-poisoning deaths involving methadone increased from 0.3 in 1999 to 1.8 in 2006, then declined to 1.0 in 2016 - The incidence of drug-poisoning deaths involving heroin increased from 0.7 in 1999, to 1.0 in 2010, to 4.9 in 2016 - Missouri is statistically higher than the US average of 19.8 drug-poisoning deaths per 100,000 people (age-adjusted). In 2017, Missouri averaged 23.4 drug-poisoning deaths per 100,000 people - In 2017, the peak age group in Missouri for heroin and non-heroin opioid deaths is 25-34 - 2.8% of St. Charles County emergency room visits are related to substance abuse. The hospitals are involved in the following initiatives to improve substance abuse in the community served: - Provide education to physicians for opioid tapering, monitor to ensure a decrease in the opioid/opiate prescribing rates within SSM Health St. Charles hospitals and clinics - Advocate for a state-wide prescription drug monitoring program in Missouri - Increase the number of St. Charles County residents able to access appropriate, quality substance use treatment - Support educational efforts in our community and schools - Prescription Take Back Day(s) - establish/support programs that accept expired, unwanted, or unused medicines from designated users and dispose of them responsibly Access to care Access to primary care providers is a key priority for the hospitals. Improvements will increase the likelihood that community members will have routine check-ups and screenings. Moreover, those with access to primary care are more likely to know where to go for treatment in acute situations. Communities that lack sufficient access to primary care, regardless of insurance, typically have members who delay necessary care until they are more ill than those that have greater access. Statistical data on access to care shows the following: - St. Charles County ranks number 1 in the state in quality of life - St. Charles is the wealthiest county in the state by household income standards - Over 30% of residents have a bachelor's degree or greater - Approximately 7% of St. Charles County residents don't have health insurance - 5.3% of St. Charles residents live below the poverty line - 12% of St. Charles County residents are considered to be in fair or poor health - There are 123 primary care providers per 100,000 residents The hospitals are implementing the following measures to improve access to care in the community: - Improve access to care in St. Charles County by increasing annual utilization of Volunteers in Medicine clinics - Evaluate opportunities to expand/provide mobile health services for patients who live in areas with limited access to care - Establish transportation services for areas with low population densities using publicly funded buses and vans on a set schedule, dial-a-ride transit, volunteer ridesharing, etc. - Increase patients' health-related knowledge via efforts to simplify health education materials, improve patient-provider communication, and increase overall literacy - Provide health insurance outreach and support to assist individuals whose employers do not offer affordable coverage, who are self-employed, or who are unemployed Chronic disease-Obesity Obesity is the third priority for the hospitals. The percentage of obese adults is an indicator of the overall health and lifestyle of a community. Obesity increases the risk of many diseases and health conditions, including heart disease, type 2 diabetes, cancer, hypertension, stroke, liver and gallbladder disease, respiratory problems, and osteoarthritis. Losing weight and maintaining a healthy weight may help to prevent and control these diseases, as well as reduce economic costs of increased healthcare spending and lost earnings. Additional data on obesity report that: - 26% of adults in St. Charles County are obese - 24% of residents are physically inactive - 12% of residents don't have access to exercise opportunities - In 2017, St. Charles had a diabetes rate of 8.4% The hospitals have the following action plan in place to improve the community measures on obesity: - Use educational, environmental, and behavioral strategies to improve food choices and physical activity opportunities in worksite settings, also called workplace wellness programs - Deliver educational, behavioral, environmental, and other obesity prevention efforts (e.g., education classes, enhanced physical education, healthy food promotion, family outreach, etc.) in schools - Arrange active transportation with a fixed route, designated stops, and pick up times when children can walk to school with adult chaperones - Combine educational, environmental, and behavioral activities that increase physical activity and improve nutrition (e.g., nutrition education, aerobic/strength training, dietary prescriptions, etc.) in various settings - Build, strengthen, and maintain social networks that provide supportive relationships for behavior change through walking groups or other community-based interventions - Establish and support land that is gardened or cultivated by community members via community land trusts, gardening education, zoning regulation changes, or service provision (e.g., water or waste disposal) - Provide prescriptions with healthy eating and exercise plans for patients and families, often accompanied by progress checks at office visits The hospitals have 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 hospitals' limited resources at this time: - Pediatric health - Health literacy - Senior care - Diabetes - Public safety - Cancer - Smoking cessation and respiratory diseases Schedule H, Part V, Section B, Line 11 Facility A, 4 Facility A, 4 - SSM St. Clare Hospital - Fenton. 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: - Substance abuse - Access to care - Health behavior awareness Substance abuse Substance abuse is a key priority for the hospital. The Centers for Disease Control and Prevention (CDC) ranks drug poisoning as the number one cause of injury-related deaths in the US, with 63,632 deaths in 2016. Rates have more than tripled from 1999-2016 and have increased for all age groups. The rate of drug-poisoning deaths involving synthetic opioids other than methadone, which includes drugs such as fentanyl, fentanyl analogs, and tramadol, doubled from 2015 to 2016. Additional facts and figures on substance abuse show: - Nationally, the rate of drug-poisoning deaths involving natural and semisynthetic opioids, which include drugs such as oxycodone and hydrocodone, increased from 1.0 in 1999 to 4.4 in 2016 - The rate of drug-poisoning deaths involving methadone increased from 0.3 in 1999 to 1.8 in 2006, then declined to 1.0 in 2016 - The rate of drug-poisoning deaths involving heroin increased from 0.7 in 1999, to 1.0 in 2010, to 4.9 in 2016 - Missouri is statistically higher than the US average of 19.8 drug-poisoning deaths per 100,000 people (age-adjusted) - In 2017, Missouri averaged 23.4 drug-poisoning deaths per 100,000 people - The top 3 counties in Missouri for opioid-poisoning deaths are all in the St. Louis metropolitan region (Jefferson, Franklin & St. Louis City) - St. Louis County had 931 opioid deaths from 2013-2017 - In the same time span, St. Louis County had 481 heroin overdoses - In 2017, the peak age group in Missouri for heroin and non-heroin opioid deaths is 25-34 - The average prescription of opioids in St. Louis County was 15.6 days in 2018 The hospital is involved in the following initiatives to improve substance abuse in the community served: - Reduce the number of drug poisonings in St. Louis County through community collaborations - identify and develop partnerships - Achieve medical stabilization goal at hospital by discharging 80% of patients that complete the program with a plan for behavioral health and/or substance abuse treatment - Provide education to physicians for opioid tapering, monitor to ensure a decrease in the opioid/opiate prescribing rates within SSM Health St. Clare hospitals and clinics - Advocate for a state-wide Prescription Drug Monitoring Program in Missouri - Prescription Take Back Day(s) -establish/support programs that accept expired, unwanted, or unused medicines from designated users and dispose of them responsibly - Continue to grow the stabilization services program. This program helps individuals overcome their opiate or alcohol withdrawal symptoms, providing them with the resources to prevent relapse. In addition, the hospital plans to continue partnerships with COMTREA (Community Treatment, Inc.) and our first responders in dealing with substance abuse disorders. Partners in our school are extremely important and we will work alongside school districts as well as other educational entities to educate our youth on emotional well-being, mental illness and substance abuse Access to care Access to care is a top community health need for the hospital. Improvements will increase the likelihood that community members will have routine check-ups and screenings. Moreover, those with access to primary care are more likely to know where to go for treatment in acute situations. The hospital will continue to invest in primary and specialty healthcare providers in the region. We will also continue working on initiatives and partnerships to help address the convenience, value and quality of care we provide to the communities we serve. Statistical data on access to care shows the following: - Approximately 10% of adults in St. Louis County have no health insurance - There are 123 primary care physicians per 100,000 people in St. Louis County - St. Louis has a 15% food insecurity rate - As of 2017, there were 258 mental health providers per 100,000 people - There are 84 dentists per 100,000 people in St. Louis - Median household incomes are higher in St. Louis County than in Missouri or the United States - 7.4% of households live below the poverty level in St. Louis County - Access to Care exercise opportunities are higher in St. Louis than in Missouri or the United States - Farmers Market density is lower, on average, in St. Louis than in the United States - 6.0% of St. Louis County residents have no car and low access to a grocery store - St. Louis County has a higher rate of single parent households than the US average - 7.2% of St. Louis County households do not have a vehicle The hospital is implementing the following measures to improve access to care for the community: - Improve access to care in St. Louis County by increasing annual utilization of Volunteers in Medicine clinics - Evaluate opportunity to expand/provide mobile health services for patients who live in areas with limited access to care - Establish transportation services for areas with low population densities using publicly funded buses and vans on a set schedule, dial-a-ride transit, volunteer ridesharing, etc. - Increase patients' health-related knowledge via efforts to simplify health education materials, improve patient-provider communication, and increase overall literacy - Provide health insurance outreach and support to assist individuals whose employers do not offer affordable coverage, who are self-employed, or who are unemployed Health behavior awareness Educating the community on healthy behaviors and lifestyles is a key priority for the hospital. Health awareness is a multi-faceted topic that illustrates the extent to which an individual is aware of what constitutes a healthy lifestyle, community resources available to increase their health knowledge and the avoidance of risky behaviors that can lead to chronic disease development and/or premature death. SSM Health will continue to offer a wide scope of resource to help individuals understand how to maintain a healthy lifestyle, ultimately reducing the risk of chronic disease in our communities. Additional data on health behavior awareness is as follows: - St. Louis County ranks 2ndin Missouri in health behaviors - St. Louis County ranks 112 out of 114 counties in physical environment rankings - 11.7% of adults in St. Louis County have diabetes - 13.3% of adults in St. Louis County regularly consume fruits and vegetables - 28.2% of adults in St. Louis County are obese - In the US, 38% of adults lack sufficient sleep - Deaths due to stroke are higher in St. Louis County than the United States, on average - 8.3% of adults smoked during pregnancy in St. Louis County - Premature deaths are higher than the U.S. average but lower than the Missouri average in the County - As of 2016, 18.4% of adults in St. Louis County smoke - St. Louis County has higher access to recreation and fitness facilities than Missouri or the US, on average The hospital has the following action plan in place to improve the community awareness of healthy behaviors: - Partner with local St. Louis County and Jefferson County schools to increase awareness of healthy lifestyles - Partner with health-related community organizations - Decrease the readmission rate through health education with patients and families 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: - Cancer - Motor vehicle accidents Schedule H, Part V, Section B, Line 11 Facility A, 5 Facility A, 5 - Facility Group A. During 2019, the following activities were performed to help address the issues identified in the CHNA: SSM Health St. Louis offered free flu vaccinations across the St. Louis region ministries in 2019, in an effort to reduce influenza risk for children, adults, and their families. According to the Centers for Disease Control, an annual seasonal flu vaccination is the best way to reduce chances of being diagnosed with influenza or spreading it to others. Flu Clinic were "walk-ins" and community members were provided flu injections as well as a preservative-free option. Community members who were unable to make the walk-in clinic days were provided options to visit SSM providers or other SSM affiliate sites. SSM Health St. Mary's Hospital's participated in two collaborative initiatives to improve women's health across the St. Louis region.SSM Health St. Mary's Hospital Centering Pregnancy program recently participated in a regional initiative, led by the St. Louis Integrated Health Network, that won first place in the Council on Patient Safety in Women's Health Care's 2019 National Improvement Challenge on Reduction of Peripartum Racial and Ethnic Disparities. CenteringPregnancy is a group model of prenatal care that is offered across the country and has been offered at the Maternal and Fetal Care Center at St. Mary's Hospital since 2014. The program provides supportive prenatal care to expecting families at no additional cost with a focus on wellness, personal agency, self-care and community care. Thanks to the efforts of the Enhanced CenteringPregnancy Collaborative, SSM St. Mary's has seen improvements in preterm birth rate, lower rates of perinatal depression and higher birth weights. Gateway to Better Health (GBH) is a temporary health care program for uninsured adults in St. Louis City and County. The organization serves individuals from some of St. Louis City and County's highest need zip codes. Patients served are at or below 100 % of the federal poverty level, seventy percent of clients are African American and 40% have a chronic health conditions. SSM Health collaborates with other area health systems and community health centers to provide comprehensive health services for this underserved population. Schedule H, Part V, Section B, Line 3E THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS 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 , 1 Facility , 1 - SSM Health Rehabilitation Hospital. THE PRIMARY DATA CONSISTED OF COMMUNITY FOCUS GROUPS THAT INCLUDED KEY STAKEHOLDERS WITHIN THE HOSPITALS' SERVICE AREAS. FOCUS GROUP PARTICIPANTS INCLUDED REPRESENTATION FROM THE ST. LOUIS COUNTY DEPARTMENT OF HEALTH, THE NORTH ST. LOUIS COUNTY COMMUNITY, AND COLLABORATING HOSPITALS. THE SECONDARY DATA WAS DERIVED FROM A VARIETY OF SOURCES INCLUDING THINK HEALTH ST. LOUIS - ST. LOUIS PARTNERSHIP FOR A HEALTH COMMUNITY, WHICH INCLUDES DATA PULLS FROM HEALTH COMMUNITIES INSTITUTE COVERING TOPICS IN AREAS OF HEALTH, DETERMINANTS OF HEALTH AND QUALITY OF LIFE. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - SSM Health Rehabilitation Hospital. THE HOSPITAL CONDUCTED AND COMPLETED ITS 2018 CHNA JOINTLY WITH SSM HEALTH DEPAUL HOSPITAL - ST. LOUIS. THE HOSPITAL ALSO COLLABORATED WITH BJC HEALTHCARE'S CHRISTIAN HOSPITAL. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - SSM Health Rehabilitation 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: - Access to care - Chronic disease - Heart and Vascular disease - Chronic disease - Cerebrovascular disease Access to care Access to primary care providers is a key priority for the hospital. Improvements will increase the likelihood that community members will have routine check-ups and screenings. Moreover, those with access to primary care are more likely to know where to go for treatment in acute situations. Communities that lack a sufficient number of primary care providers typically have members who delay necessary care when sick and conditions can become more severe and complicated. Additional facts and figures that relate to access to care show: - Per 100,000 persons, there are 123 providers in St. Louis County - Clinical Care Ranking - the quality and accessibility of clinical care heavily impacts the health of a community. Without a sufficient number of providers or adequate insurance coverage, people often do not seek care services and are thus at higher risk of developing preventable illnesses or chronic conditions. People with access to high-quality care are more likely to receive effective treatment for their conditions and enjoy better health. St. Louis County is ranked at 2 (1-2 is healthiest). The ranking is based on a summary composite score calculated from the following measures: uninsured, primary care physicians, mental health providers, dentists, preventable hospital stays, diabetic monitoring, and mammography screening - 43% of St. Louis County residents have a bachelor's degree or greater 21% of St. Louis County residents have a high school graduation degree - Approximately 10% of St. Louis County residents don't have health insurance - 6.7% of St. Louis County families live below the poverty line - 82.5% of St. Louis County expecting mothers receive prenatal care and the infant mortality rate for St. Louis County is 7.7 out of 1,000 live births The hospital is involved in the following initiatives to improve access to care in the community served: - Partner with SSM Health Care St. Louis ministries and community collaborators to address access to care barriers, provide screenings and health education materials - Monitor durability of outcomes post-discharge through IT HealthTrack and create action plans, if appropriate - Utilize Care Partner Program to increase community discharges from 70.6% in 2018 to 73.6% by 2021 - Partner with Emergency rooms at other SSM Health hospitals to prevent unnecessary admissions to acute care from the hospital - Transition to Medical Model at the hospital in 2019 to enhance medical management coverage and increase in-house physician presence - Develop Meds to Beds Program to increase access to prescribed medications at time of patients' discharge from inpatient rehabilitation stay Chronic disease - Heart and Vascular disease Heart and vascular disease is a key priority for the hospital. Heart disease is a term that encompasses a variety of different diseases affecting the heart and is the leading cause of death in the United States, accounting for 25.4% of total deaths. The most common type in the US is coronary artery disease, which can cause heart attack, angina, heart failure, and arrhythmias. Coronary artery disease occurs when plaque builds up in the arteries that supply blood to the heart and the arteries narrow (atherosclerosis). There are many modifiable risk factors for atherosclerosis, including tobacco smoking, obesity, and a sedentary lifestyle. Heart disease is the number one killer of women in the United States. Statistical data on heart and vascular disease shows the following: - According to the Centers for Disease Control and Prevention, approximately round 5.7 million people in the United States have heart failure, and about half of people who develop heart failure will die within five years of diagnosis - Age-adjusted ER rate due to heart failure is 3.5 per 10,000 persons in St. Louis County compared to 5.9 in St. Louis City - The percentage of overweight adults is an indicator of the overall health and lifestyle of a community. Being overweight affects quality of life and puts individuals at risk for developing many diseases, especially heart disease, stroke, diabetes, and cancer. 32.6% of St. Louis County adults are overweight - High blood pressure is the number one modifiable risk factor for stroke. In addition to stroke, high blood pressure also contributes to heart attacks, heart failure, kidney failure, and atherosclerosis. The higher your blood pressure, the greater your risk of heart attack, heart failure, stroke, and kidney disease. In the United States, one in three adults has high blood pressure, and nearly one-third of these people are not aware that they have it. 31.9% of St. Louis County adults have high blood pressure. The hospital is implementing the following measures to improve Heart and vascular disease: - Partner with SSM Health Care St. Louis ministries and community collaborators to provide screenings and health education materials - Reduce cardiac-related acute care transfers from 12.5% in 2018 to 10% in 2021 - Monitor durability of outcomes post-discharge through IT HealthTrack and create action plans, if appropriate - Utilize Care Partner Program to increase community discharges from 70.6% in 2018 to 73.6% by 2021 - Partner with Emergency rooms at other SSM Health hospitals to prevent unnecessary admissions to acute care from the hospital - Transition to Medical Model at the hospital in 2019 to enhance medical management coverage and increase in-house physician presence - Develop Meds to Beds Program to increase access to prescribed medications at time of patients' discharge from inpatient rehabilitation stay Chronic disease - Cerebrovascular disease Cerebrovascular disease is a major concern in the hospital's service area. Cerebrovascular disease refers to conditions, including stroke, caused by problems with the blood vessels supplying the brain with blood. A stroke occurs when blood vessels carrying oxygen to the brain burst or become blocked, thereby cutting off the brain's supply of oxygen and other nutrients. Cerebrovascular disease is a leading cause of death in the United States and can also lead to brain damage and disability. The most important modifiable risk factor for cerebrovascular disease and stroke is high blood pressure. Other risk factors include high cholesterol, heart disease, diabetes mellitus, physical inactivity, obesity, excessive alcohol use, and tobacco use. Additional data on cerebrovascular disease report that: - The age-adjusted death rate due to Cerebrovascular Disease is 38 adults out of 100,000 persons in St. Louis County - 32.6% of St. Louis County adults are overweight - In the United States, one in three adults has high blood pressure, and nearly one-third of these people are not aware that they have it. 31.9% of St. Louis County adults have high blood pressure - Nearly three-quarters of all strokes occur in people over the age of 65. The Centers for Disease Control and Prevention (CDC) states that stroke is the fourth leading cause of death in the United States, is a leading cause of long-term disability, and is the cause of almost 133,000 deaths annually. According to the CDC, strokes cost the United States an estimated $38.6 billion each year. 4.4% of the Medicare population in St. Louis County were treated for a stroke The hospital has the following action plan in place to improve the community measures on cerebrovascular disease: - Partner with SSM Health Care St. Louis ministries and community collaborators to provide screenings and health education materials - Increase stroke community discharges from 67% in 2018 to 70% in 2021 - Utilize the Stroke Program Team to monitor durability of outcomes post-discharge through IT HealthTrack and create action plans, if appropriate - Decrease stroke fall rate per 1000 patient days by 10% - Participate in community events - Improve stroke patients' self-care and mobility activities from admission to discharge change to meet national average - Host stroke support group monthly 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: - Mental health/geriatric psychology and substance abuse - Smoking and tobacco use - Obesity - Care coordination - Health literacy 44 SSM Health Medical Group 1011 Bowles Avenue Fenton MO 63026 Outpatient clinic SSM Health Medical Group 1035 Bellevue St Louis MO 63117 Outpatient clinic SSM Health Medical Group 12266 DePaul Drive Bridgeton MO 63044 Outpatient clinic SSM Health Medical Group 12277 DePaul Drive Bridgeton MO 63044 Outpatient clinic SSM Health Medical Group 1475 Kisker Road St Charles MO 63304 Outpatient clinic SSM Health Medical Group 400 First Capitol Drive St Charles MO 63301 Outpatient clinic SSM Health Medical Group 6400 Clayton Road St Louis MO 63117 Outpatient clinic SSM Health Express Clinic 2 Cottonwood Rd Glen Carbon IL 62034 Express clinic SSM Health Medical Group 30 Ronnies Plaza Sappington MO 63126 Outpatient clinic SSM Health Medical Group 100 N Kingshighway St Charles MO 63301 Outpatient clinic SSM Health Express Clinic 441 N Kirkwood Rd Kirkwood MO 63122 Express clinic SSM Health Express Clinic 500 Howdershell Rd St Louis MO 63031 Express clinic SSM Health Medical Group 816 S Kirkwood Rd Kirkwood MO 63122 Outpatient clinic SSM Health Medical Group 900 East Walnut Carbondale IL 62901 Outpatient clinic SSM Health Express Clinic 917 Chesterfield Pkwy E Chesterfield MO 63017 Express clinic SSM Health Express Clinic 920 N Main St Louis MO 63044 Express clinic SSM Health Express Clinic 1000 Crossroads Place High Ridge MO 63049 Express clinic SSM Health Express Clinic 1001 Bowles St Louis MO 63026 Express clinic SSM Health Medical Group 1034 South Brentwood St Louis MO 63117 Outpatient clinic SSM Health Medical Group 1185 Fortune Blvd Shiloh IL 62269 Outpatient clinic SSM Health Medical Group 1345 Smizer Mill Road Fenton MO 63026 Outpatient clinic SSM Health Express Clinic 1650 Washington Alton IL 62002 Express clinic SSM Health Express Clinic 1718 Catlin Road Barnhart MO 63012 Express clinic SSM Health Medical Group 1821 Sherman St Charles MO 63303 Outpatient clinic SSM Health Express Clinic 1993 Wentzville Parkway Wentzville MO 63385 Express clinic SSM Health Medical Group 2133 Vadalabene Drive Maryville IL 62062 Outpatient clinic SSM Health Express Clinic 2310 S Old Highway 94 St Charles MO 63303 Express clinic SSM Health Express Clinic 2401 S Brentwood Blvd Brentwood MO 63144 Express clinic SSM Health Express Clinic 2920 Highway K OFallon MO 63368 Express clinic SSM Health Medical Group 3555 Sunset Office Drive Sunset Hills MO 63127 Outpatient clinic SSM Health Express Clinic 3732 Nameoki Granite City IL 62040 Express clinic SSM Health Express Clinic 3920 Hampton Ave St Louis MO 63109 Express clinic SSM Health Express Clinic 3937 Vogel Rd Arnold MO 63010 Express clinic SSM Health Express Clinic 6505 N Illinois Fairview Heights IL 62208 Express clinic SSM Health Medical Group 8086 Natural Bridge Road Bel Nor MO 63121 Outpatient clinic SSM Health Express Clinic 8571 Watson Rd Webster Groves MO 63119 Express clinic SSM Health Express Clinic 12098 Lusher Rd St Louis MO 63138 Express clinic SSM Health Express Clinic 12345 St Charles Rock Rd Bridgeton MO 63044 Express clinic SSM Health Express Clinic 12509 Dorsett Rd Maryland Heights MO 63043 Express clinic SSM Health Medical Group 13303 Tesson Ferry Road St Louis MO 63128 Outpatient clinic SSM Health Express Clinic 13992 Manchester Rd Manchester MO 63011 Express clinic SSM Health Medical Group 14309 Manchester Rd Ballwin MO 63011 Outpatient clinic SSM Health Express Clinic 16105 Manchester Rd St Louis MO 63011 Express clinic SSM Health Express Clinic 6071 Telegraph Rd St Louis MO 63129 Express 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 CARE ST. LOUIS 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: COMMUNITY HEALTH IMPROVEMENT ADVOCACY: HOSPITAL EMPLOYEES WORK WITH PRIVATE ORGANIZATIONS AND GOVERNMENT TO ADVOCATE ON PUBLIC POLICY ISSUES INCLUDING HEALTH CARE, HOUSING, SAFETY AND EDUCATION. SPONSORSHIP OF LOCAL BOYS AND GIRLS CLUB, SUPPORT FOR ST. CHARLES COUNTY ECONOMIC DEVELOPMENT CENTER. WORKFORCE DEVELOPMENT: PARTICIPATION IN REGIONAL EMPLOYMENT PROGRAM AND IN-SCHOOL PROGRAMS FOR HEALTH CARE CAREERS AND EDUCATION. 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 3 Bad Debt Expense Methodology SSM Health Care St. Louis did not make an estimate of the organization's bad debt attributable to patients eligible under the organization's financial assistance policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote SSM Health Care St. Louis 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 Care St. Louis 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. SSM Health Care St. Louis embraces its responsibility to serve the communities in which it participates by establishing sound business practices. SSM Health Care St. Louis' 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 SSMH prior to engaging in ECAs. SSMH will review the accounts and verify satisfactory completion of reasonable efforts during the notification and application period. A waiver is not considered reasonable efforts. Obtaining a signed waiver that an individual does not wish to apply for FAP assistance or receive FAP application information will not meet the requirement to make "reasonable efforts" to determine whether the individual is FAP-eligible before engaging in ECAs. All outside collection agencies must comply with state and federal laws, comply with the association of credit and collection professional's code of ethics and professional responsibility and comply with SSM Health Care St. Louis' collection and financial assistance policies. Schedule H, Part V, Section B, Line 16a FAP website A - SSM Health DePaul Hospital - St. Louis: Line 16a URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; - SSM Health Rehabilitation Hospital: Line 16a URL: https://www.ssm-rehab.com/referral-sources/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website A - SSM Health DePaul Hospital - St. Louis: Line 16b URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; - SSM Health Rehabilitation Hospital: Line 16b URL: https://www.ssm-rehab.com/referral-sources/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - SSM Health DePaul Hospital - St. Louis: Line 16c URL: https://www.ssmhealth.com/resources/for-patients/financial-assistance; - SSM Health Rehabilitation Hospital: Line 16c URL: https://www.ssm-rehab.com/referral-sources/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 Care St Louis defines its primary service area as the St Louis metropolitan statistical area (MSA), which includes the Missouri Counties of St. Louis, St. Charles, Jefferson, Franklin, Lincoln, and Warren and St. Louis City. Because we support a wide range of local markets and constituencies, demographics are also evaluated for our individual hospital service areas, service lines and clinical departments to ensure we focus on specific community health needs. The total population for the MSA is estimated at 2.8 million, making the area the 21st largest metropolitan area in the United States, and is enjoying consistent population growth. Of the total, nearly 30% of individuals are 55 years old or over. The poverty rate for the MSA was reported at 11.6% in 2017, while the national rate for the same year was 12.3 percent. The median household income continues to steadily rise, too, to $61,751, while income per capita is $33,987. More detailed statistics for each hospital's community is as follows: SSM Health St. Mary's Hospital is geographically located in mid -St. Louis County, however the primary service area and the secondary service area include zip codes in both St. Louis County and St. Louis City. There are 28 zip codes that are contained within or overlap the service area. In 2018, the population for St. Louis County is estimated at 997,087 persons. In St. Louis County, the average household income is $42,035, while in St. Louis City, the average is $67,173. In the County, over 42% of individuals have at least a Bachelor's degree, compared to 33.8% in the City. SSM Health St. Joseph - St. Charles and SSM Health St. Joseph Hospital - Lake Saint Louis hospitals are located in St. Charles County, Missouri, and serve that region as well as parts of Lincoln and Warren Counties. This tri-county area makes up 80% of the hospitals' patients served. In addition to the locations in historic downtown St. Charles and Lake Saint Louis, the hospital has a location in Wentzville that provides emergency, outpatient, and behavioral medicine services. The service area had an estimated population of 487,000 persons in 2017. The community is largely white, accounting for nearly 88% of the population. Nearly 13% of households earned less than $25,000 in 2018. SSM Health St. Clare Hospital - Fenton serves Southwest St. Louis and Jefferson Counties, which accounts for 85% of their total patients. There are 18 zip codes contained within or overlapping the service area. In 2017, the primary service area had an estimated population of 483,610 persons. Approximately 13.6% of the community population had a household income of less than $25,000 in 2017, and over 31% of the population is over the age of 55. SSM Health DePaul Hospital - St. Louis defines its service area as North St. Louis County, which accounts for 80% of the total patients served by the hospital. There are 20 zip codes within or that overlap the service area. In 2017, North St. Louis County had an estimated population of 350,000 persons. The community served is also very diverse, with over 52% of the population as black/non-Hispanic, and another nearly 9% comprised of other minorities. Approximately 22% of the population has at least a Bachelor's Degree. Schedule H, Part VI, Line 5 Promotion of community health SSM Health Care St. Louis 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 Care St. Louis' hospitals, 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. SSM Health Care St. Louis promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote community health. SSM Health Care St. Louis 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 Health Care St Louis is a 501(c)(3) organization and is a member of the integrated health care system know as SSM Health. SSM Health Care St Louis is one of the largest, full-service health care networks in the St Louis, Missouri area. SSM Health Care St Louis includes the following operating hospitals: SSM Health DePaul Hospital - St. Louis SSM Health St. Joseph Hospital - St. Charles SSM Health St. Joseph Hospital - Wentzville (remote location of St. Joseph Hospital) SSM Health St. Joseph Hospital - Lake Saint Louis SSM Health St. Mary's Hospital - St. Louis SSM Health St. Clare Hospital - Fenton. Schedule H, Part VI, Line 7 State filing of community benefit report MO true American Cancer Society 250 Williams Street NW Suite 400 Atlanta GA 30303 131788491 501(c)(3) 10000 Support operations and programs Archdiocese of St Louis 20 Archbishop May Drive St Louis MO 63119 430653244 501(c)(3) 52086 Support priest wellness program Helping Hand Me Downs PO Box 11385 St Louis MO 63105 800752179 501(c)(3) 6667 Support programs that assist families in need Karen Weidinger Foundation 2025 Zumbehl Road Suite 47 St Charles MO 63303 205501259 501(c)(3) 7534 Support operations and programs Northwest RI School 4290 Gravois Road House Springs MO 63051 436000854 Government 10000 Support educational programs Pink Ribbon Girls Inc 15 S Second Street Tipp City OH 45371 320020270 501(c)(3) 25000 Support for Ignite the Fight event St Louis Regional Chamber & Growth Association One Metropolitan Square Suite 1300 St Louis MO 63102 430975222 501(c)(6) 64470 Support businesses and economic growth in the area St Charles County Economic Development Council 5988 Mid Rivers Mall Drive St Peters MO 63304 431545618 501(c)(4) 55000 Support economic growth in the region STL Youth Jobs 4818 Washington Blvd St Louis MO 63108 832759267 501(c)(3) 30000 Support for at-risk youth job programs Tiffany Community Association 3811 Blaine Avenue St Louis MO 63110 431209674 501(c)(3) 6000 Support neighborhood programs Youth In Need 1815 Boones Lick Road St Charles MO 63301 431033862 501(c)(3) 7500 Support youth outreach programs 9 2 MEDICAL SUPPLIES ASSISTANCE 6916 63230 Book Medical Supplies Assistance Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT. IN CERTAIN CIRCUMSTANCES, QUALIFYING EXPENSES MAY BE PAID ON BEHALF OF SYSTEM EMPLOYEES BASED UPON DEMONSTRATED FINANCIAL HARDSHIP CAUSED BY NATURAL DISASTERS, ILLNESS, OR OTHER UNFORESEEN TRAGEDY. X true true true true false false false false false false false Christopher Howard Former Director & Officer 0 0 0 0 0 566322 0 214327 0 4649 0 785299 0 0 Candace Jennings Chair, President, Regional President-St Louis 679152 0 137790 0 519324 0 518845 0 19400 0 1874510 0 515924 0 Laura Kaiser Vice Chair, President/CEO at SSM Health 0 1591955 0 536550 0 25353 0 2013276 0 13853 0 4180987 0 536550 Steven Smoot Director, COO of SSM Health 0 882327 0 172763 0 11529 0 667250 0 18983 0 1752851 0 97763 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 Karen Rewerts System VP, Finance (MO/ILL) 0 540461 0 65545 0 108129 0 156482 0 18740 0 889358 0 122739 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 Margaret Fowler Former Key Employee 0 421037 0 64906 0 298587 0 155111 0 18109 0 957751 0 190888 Alexander Garza Former Key Employee 0 530533 0 82777 0 2893 0 205081 0 23009 0 844292 0 82777 Michael Bowers Chief Operating Officer - SSM Health Care St. Louis 514488 0 77638 0 64437 0 182856 0 20185 0 859603 0 120607 0 Travis Capers Hospital President - SSM Health St. Mary's Hospital 477576 0 76704 0 33216 0 168953 0 7363 0 763812 0 76704 0 Tina Garrison Hospital President - SSM Health St. Clare Hospital 310239 0 32232 0 17353 0 105284 0 14407 0 479516 0 39849 0 Ellis Hawkins Hospital President - SSM Health DePaul Hospital 430449 0 63104 0 66698 0 145031 0 21235 0 726516 0 97258 0 Lisle Wescott Hospital President - SSM Health St. Joseph - St. Charles, SSM Health St. Joseph - Lake St. Louis 419071 0 62767 0 45457 0 140767 0 21509 0 689571 0 89948 0 Lee Bernstein Regional VP, Hospital Operations 0 88767 0 71400 0 429942 0 7032 0 15715 0 612854 0 273791 Renee Roach System VP, Human Resources - St. Louis 0 355081 0 42964 0 35290 0 134512 0 16135 0 583981 0 71315 Hsieng-Teh Su Regional VP, Medical Affairs 477576 0 28764 0 2170 0 148312 0 7363 0 664185 0 28764 0 Kathleen Bonser Regional VP, Nursing/CNO 307558 0 36893 0 71042 0 92487 0 18575 0 526555 0 45917 0 Rachel Donlan System VP - Strategic Development 0 209169 0 25225 0 6754 0 71346 0 20003 0 332498 0 38051 Dang Tran President, Physicians Org/Ambulatory Services 474099 0 37536 0 12641 0 174136 0 21578 0 719991 0 37536 0 David McCollister Physician 415423 0 50000 0 3438 0 3391 0 15524 0 487776 0 0 0 Timothy Pratt VP - Medical Affairs 374598 0 41250 0 111073 0 58004 0 16082 0 601007 0 111913 0 Joseph Attewell Physician 476091 0 16667 0 125424 0 4200 0 23009 0 645390 0 0 0 William Holcomb Physician 467841 0 0 0 8408 0 23200 0 12953 0 512402 0 0 0 Andrew Karanas Physician 477991 0 18008 0 21651 0 3250 0 18559 0 539458 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments The following individuals listed on Part VII, Section A received a tax indemnification/gross up payment in 2019. These payments were included in their taxable compensation. Lisle Wescott Ellis Hawkins Tina Garrison Kathy Bonser Timothy Pratt Joseph Attewell Andrew Karanas Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization's top management official, Regional 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 President. 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 Lee Bernstein $224,131 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 Candace Jennings $81,053 Kris Zimmer $105,240 Karen Rewerts $42,840 Michael Bowers $41,000 Lisle Wescott $33,600 Travis Capers $37,600 Ellis Hawkins $34,440 Renee Roach $28,220 Tina Garrison $24,720 Hsieng-Teh Su $37,600 Kathleen Bonser $24,837 Rachel Donlan $16,983 Dang Tran, MD $37,904 Timothy Pratt $13,480 Alexander Garza, MD $42,400 Margaret Fowler $33,698 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. Candace Jennings $378,134 Paula Friedman $429,019 Kris Zimmer $111,962 Karen Rewerts $57,194 Michael Bowers $42,969 Lisle Wescott $27,181 Ellis Hawkins $34,154 Lee Bernstein $202,391 Renee Roach $28,350 Tina Garrison $7,617 Kathleen Bonser $9,023 Rachel Donlan $5,819 Timothy Pratt $70,663 Margaret Fowler $125,982 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 Karen Rewerts $24,629 Lisle Wescott $5,751 Ellis Hawkins $13,936 Tina Garrison $1,552 Kathleen Bonser $29,471 Timothy Pratt $12,531 Joseph Attewell $66,240 Andrew Karanas $10,739 Margaret Fowler $67,380 KRISTOPHER ZIMMER FAMILY MEMBER OF KRIS ZIMMER, OFFICER OF ORGANIZATION 87935 EMPLOYMENT false X VARIOUS MEDICAL ITEMS 2 31618 Cost 0 false true false Doing Business As SSM Health Care St. Louis currently conducts business under the following registered names. Clayton Health Services Pharmacy West East Central Missouri Area Health Education Center Maryville Pediatrics SSM Breast Care SSM Breast Care - DePaul Health Center SSM Breast Care - St. Clare Health Center SSM Breast Care - St. Joseph Health Center SSM Breast Care - St. Joseph Hospital West SSM Breast Care - St. Joseph Medical Park SSM Breast Care - St. Mary's Health Center SSM Cancer Care SSM Cancer Care - DePaul Health Center SSM Cancer Care - St. Clare Health Center SSM Cancer Care - St. Joseph Health Center SSM Cancer Care - St. Joseph Hospital West SSM Cancer Care - St. Joseph Medical Park SSM Cancer Care - St. Mary's Health Center SSM Care Management Company SSM Center for Sleep Disorders SSM Health Behavioral Health SSM Health DePaul Hospital - Anna House SSM Health DePaul Hospital - St. Louis SSM Health DePaul Hospital Surgery Center SSM Health Foundations St. Louis SSM Health Imaging Services SSM Health Outpatient Center SSM Health Pain Care SSM Health Sleep Services SSM Health St. Clare Hospital - Fenton SSM Health St. Joseph Hospital - Lake Saint Louis SSM Health St. Joseph Hospital - Lake Saint Louis Physician Billing SSM Health St. Joseph Hospital - St. Charles SSM Health St. Joseph Hospital - St. Charles Physician Billing SSM Health St. Joseph Hospital - Wentzville SSM Health St. Joseph Hospital - Wentzville Physician Billing SSM Health St. Joseph Hospital Wentzville Outpatient Pharmacy SSM Health St. Mary's Hospital - St. Louis SSM Health Treatment & Recovery SSM Health Urgent Care SSM Health Vascular Services SSM Health Weight Management Services SSM Health Women's Health SSM Heart Institute SSM Integrated Distribution & Services Center SSM St. Joseph Health Center SSM St. Joseph Health Center - Wentzville Outpatient Pharmacy SSM St. Joseph Hospital West SSM St. Joseph Medical Park Form 990, Part III, Line 4a Program Service Accomplishments Briefly describe the corporation'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 Care St Louis: SSM Health Care St Louis provides health care services at six wholly-owned acute care hospitals: SSM Health DePaul Hospital-St Louis, SSM Health St Mary's Hospital-St Louis, SSM Health St Joseph Hospital - St Charles, SSM Health St Clare Hospital-Fenton, SSM Health St Joseph Hospital-Lake St Louis, and SSM Health St Joseph Hospital - Wentzville. SSM Health Care St Louis is also the sole corporate member of SSM Health Cardinal Glennon Children's Hospital and SSM Health Saint Louis University Hospital. Since SSM Health's founding sisters began their ministry in St. Louis with just $5 among them more than 145 years ago, it has grown into one of the largest integrated delivery systems in the nation. In the St. Louis region, SSM Health operates eight hospitals, as well as numerous urgent care locations, SSM Health Express Clinics at Walgreens, SSM Health Medical Group offices, pediatric-specific locations, outpatient rehab centers, occupational health locations and hospice and home health services. SSM Health Care St. Louis also is partial owner of SSM Health Rehabilitation Hospital, a specialty rehabilitation hospital that offers care and advanced treatment for individuals with stroke, brain injury, spinal cord injury, neurological disorders, amputation, joint replacement and other orthopedic trauma, as well as general medical rehabilitation needs. SSM Health DePaul Hospital-St Louis opened in 1828, was the first hospital west of the Mississippi River and remains the oldest continuously existing business in St Louis. Today SSM Health DePaul Hospital-St Louis offers the only Level II Trauma Center in North St. Louis County and serves patients from across the St. Louis metropolitan area, with concentration in the surrounding communities of Bridgeton, Florissant, Hazelwood, St Ann, St John, Maryland Heights and Overland in Missouri. SSM Health DePaul Hospital-St Louis offers a wide range of comprehensive medical care including inpatient and outpatient surgeries using state-of-the-art technology and facilities. We offer the most advanced technology and procedures available including minimally invasive heart, spine, knee, hip and weight loss surgery. The Joint Commission has also designated the hospital as a Joint Commission Certified Primary Stroke Center, distinguishing it from other stroke centers, for meeting the highest standards of care established by the Joint Commission to receive and treat the most complex stroke cases, as a Certified Hip Replacement Center, a Certified Knee Replacement Center, and is designated as a Level I Time Critical Diagnosis STEMI Center. It is also a Bariatric Surgery Center of Excellence as endorsed by the American Society for Metabolic and Bariatric Surgery. SSM Health St. Mary's Hospital is a two-time winner of the Premier Award for Quality and a Level II Time Critical Diagnosis STEMI Center. The Hospital has distinctive capabilities in heart attack care, high-risk pregnancies, and fetal surgery. Additionally, the hospital has a chest pain center, advanced stroke care clinic and the latest imaging and outpatient services. A teaching hospital, SSM Health St. Mary's offers an independent, accredited internal medicine residency program and is the primary location for St. Louis University School of Medicine's Department of Obstetrics and Gynecology and its Family Practice residency programs. SSM Health St. Joseph Hospital-St Charles is located in a historic downtown district and has been serving the needs of the community since 1885. SSM St. Joseph Hospital-St Charles has grown structurally and technologically throughout the past 125 years to meet the needs of an ever-growing and changing population. Today, the acute care hospital offers highly-specialized care for critically ill patients. The hospital excels in many areas, including open-heart surgery, cardiac catheterizations, trauma and emergency services, sleep medicine, obstetrics, surgical services, oncology, vascular surgery, orthopedics and gastroenterology. The facility is designated as a Level II Trauma Center, A Joint Commission-certified Primary Stroke Center and the only Level I Time Critical Diagnosis STEMI Center in St. Charles County. SSM Health St. Joseph Hospital - Lake Saint Louis is the leading provider of health care services for western St. Charles, Warren and Lincoln Counties. The hospital is a state-designated Level III trauma center, a Level II Time Critical Diagnosis STEMI Center and specializes in obstetric and pediatric care. It also offers inpatient and outpatient health care services. In 2014 it was named one of the nation's Top 100 Hospitals by Truven Health Analytics and made Becker's Hospital Review's list of 100 Great Community Hospitals. SSM Health St. Joseph Hospital - Wentzville has been providing high quality health care to residents in western St. Charles, Warren, Lincoln, and Montgomery counties since 1987. Operating under the SSM Health St. Joseph Hospital - St. Charles hospital license, the facility currently offers patients in Wentzville and surrounding communities a 24-hour emergency department and ambulatory services, as well as convenient access to outpatient programs, including diagnostic, cardiology, pulmonary and rehab services. Behavioral health inpatient and outpatient care also is an integral part of the services offered at the hospital. The hospital offers inpatient psychiatric care on campus with close supervision, with the goal of stabilizing patients and helping them understand their condition and develop coping strategies to manage their emotions and behaviors. SSM Health St. Clare Hospital-Fenton is a Level I Time Critical Diagnosis STEMI Center and a Level I Stroke Center, serves the medical needs of the expanding community in southwest St. Louis County. Specializing in heart and vascular, neurosciences, cancer care, maternity and other medical services. The hospital also received the Healthgrades Outstanding Patient Experience Award in 2019. SSM Health Care St Louis furthers its exempt purpose with the following activities: - Operates an emergency room that is open to all persons regardless of ability to pay, - Has an open medical staff with privileges available to all qualified physicians in the area, - Has a governing body in which independent persons representative of the community comprise a majority - Engages in the training and education of health care professionals, - Participates in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs - All surplus funds generated by SSMH entities are reinvested in improving our patient care delivery system. Quantifiable Uncompensated Care: The following is a list of the types of programs and services that could be included as uncompensated care: Traditional Charity Care $ 48,313,911 Unpaid Cost of Medicaid $ 23,098,946 Unpaid Cost of Medicare $ 12,179,778 Unpaid Cost of Other Means-Tested Programs $ 1,824,437 Total Quantifiable Uncompensated Care $85,417,072 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 members of the corporation are SSM Health Care Corporation and Saint Louis University. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body SSM Health Care Corporation (SSMHCC), as one of the members, has the power to appoint additional, successor or replacement members of the Corporation, provided that any appointment or removal requiring the written consent of SLU has received that approval. SSMHCC has the power to appoint and remove the individuals serving on the Board, other than the SLU appointed directors. SLU retains power to appoint and remove individuals serving on the Board who have been appointed by SLU. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders SSM Health Care Corporation 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 of the Corporation, provided, that any member requiring the approval of SLU receives that approval according to the Bylaws, (c) to appoint and remove the individuals serving on the Board, other than the SLU Appointed Directors who will be subject to appointment and removal by SLU; provided, however, that SSMHCC may remove SLU Appointed Directors who violate conflict of interest policy and other policies of the Corporation, as the same may be amended from time to time, upon prior written notice to SLU pursuant to the Members' Agreement, (d) to appoint and remove the President of the Corporation and the chief executive officer of any Company Subsidiary and any Health Care Operating Division, provided, that SSMHCC shall (i) obtain the written consent of SLU before appointing any chief executive officer of SLUH, (ii) consult with the Board and SLU before exercising its reserved power to remove the chief executive officer of SLUH and (iii) consult with SLU in connection with hiring certain senior employees, (e) to approve amendments to the Articles of Incorporation of the Corporation, as provided therein, but subject to SLU's prior written consent, (f) to approve amendments to these Bylaws, but subject to SLU's prior written consent is not required for (i) non-material changes required by applicable law, regulation or any applicable accrediting entity, (g) to approve the merger or consolidation of the Corporation; provided, that (i) SLU's prior written consent shall be required in the event such transaction constitutes a Prohibited Change of Control, and (ii) with respect to a Permitted Change of Control that is a Permitted Affiliate Change of Control, SSMHCC shall provide SLU with written notice not less than thirty days prior to the effective date of such change of control, and with respect to any other Permitted Change of Control, SSMHCC shall provide SLU with written notice within thirty (30) days after the signing of a letter of intent, in both cases, with no separate SLU approval right, (h) to approve the dissolution of the Corporation, but subject to SLU's prior written consent, (i) to approve the formation of a Controlled Subsidiary or a Remotely Controlled Subsidiary, provided that certain deviations from protocol require the approval of SLU, (j) to approve the acquisition or disposition by the Corporation of another legal entity or an interest in another legal entity, provided, that the Corporation shall obtain the written consent of SLU before divesting of, or admitting another Person, (k) to authorize or approve the acquisition or disposition by the Corporation of real property or any interest in real property, provided, that the Corporation shall obtain the written consent of SLU before disposing of any real property or any interest in real property comprising a substantial portion of the operating assets, (l) to (i) establish centralized employee benefit, insurance, investment, financing, corporate responsibility, performance assessment and improvement and other operational and support programs; (ii) require the participation of the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary in such programs; and (iii) authorize the opening and closing of bank accounts and investment accounts in the name of the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary in connection with such programs; provided that SSMHCC has determined in its reasonable discretion that such actions are not inconsistent with and do not violate the terms of the Members' Agreement, the Master Agreement, the Academic Affiliation Agreement and the Bylaws, (m) to approve the strategic, financial and human resources plan of the Corporation, subject to SLU's rights set forth in the bylaws and approval of the Academic Program Strategic Plan, (n) to appoint the auditor and corporate counsel for the Corporation, (o) subject to SLU's rights, to authorize and approve borrowing money and entering into financial guaranties by the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary, 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 and any Controlled Subsidiary or Remotely Controlled Subsidiary; provided, that SSMHCC has determined in its reasonable discretion that such actions are not inconsistent with and do not violate the terms of the Members' Agreement, the Master Agreement, the Academic Affiliation Agreement and the Bylaws, (p) to require the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary to transfer assets, including but not limited to cash, to SSMHCC or to any entity exempt from federal income tax as an organization described in Section 501(c)(3) of the Internal Revenue Code, or the corresponding provision of any future United States Internal Revenue Law, which is controlled by SSMHCC, to the extent necessary to accomplish the mission, goals and objectives of SSMHCC as determined by SSMHCC; provided, that SSMHCC has determined in its reasonable discretion that any such transfer would not reasonably be likely to result in a failure of the Corporation or such subsidiary to fulfill its commitments under the Members' Agreement, the Master Agreement or the Academic Affiliation Agreement, (q) subject to SLU's rights, to approve the transfer of assets by the Corporation to any entity other than SSMHCC (other than transfers made in the ordinary course of operations of the Corporation, which will not require approval by the Members, and (r) to determine the extent to which and the manner in which the powers described in this section which are reserved to SSMHCC 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; provided, that SSMHCC has determined in its reasonable discretion that any such determination or action is not inconsistent with and does not violate the terms of the Members' Agreement or the terms of the Master Agreement or the Academic Affiliation Agreement. Saint Louis University (SLU) has the following powers: (a) The appointment and removal of the SLU Appointed Directors to the Board consistent with such standards for Board service as appear in the Bylaws, the conflict of interest policy and other Board policies of the Corporation, as the same may be amended from time to time, upon prior written notice to SLU pursuant to the Members' Agreement, (b) The right to make recommendations and provide meaningful input regarding the strategic, financial and human resources plans for the Corporation, (c) Approval of any guaranty by SLU of Corporation debt, and (d) In accordance with the Master Agreement, establishing payor contracting parameters for SLUCare. 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 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 statement for the SSM Health 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 VIII, Line 11d Other Miscellaneous Revenue All other revenue - Total Revenue: 2602518, Related or Exempt Function Revenue: , Unrelated Business Revenue: 49399, Revenue Excluded from Tax Under Sections 512, 513, or 514: 2553119; Form 990, Part IX, Line 11g Other Fees MEDICAL AND OTHER PROFESSIONAL FEES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 54409006, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFERS TO AFFILIATES - -XXX-XX-XXXX; BENEFICIAL INTEREST IN FOUNDATION - 1897172; SSM ACO LLC 10101 Woodfield Lane St Louis MO 63132 900986282 HEALTH PROMOTION MO 1631502 6397693 SSM Health Care St Louis 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 true 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 true 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 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 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 true 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 3123818 1795886 false 0 false 0.50 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 81731 1.00 true 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 true true false true false true true false false false SSM Health Foundation - St Louis C 1326944 Cash SSM Health Foundation - St Louis P 2597257 Cash