2014-11-17T15:03:10-06:00 2013-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 77002 990 2013-01-01 440579850 SSM REGIONAL HEALTH SERVICES SSMR 3149947800 10101 WOODFIELD LANE ST LOUIS MO 63132 JUNE L PICKETT SECRETARY 3149947800 2014-11-17 1 BROOKE KITCHEN P00849302 7139822000 2013 2015-11-30 17:44:51Z X SEE SCHEDULE O WILLIAM P THOMPSON 10101 WOODFIELD LANE ST LOUIS MO 63132 196958662 0 0928 X WWW.SSMHEALTH.COM X 2000 MO OPERATES TWO HOSPITALS AND HEALTH CENTERS IN JEFFERSON CITY, MISSOURI AND MARYVILLE, MISSOURI. 6 0 1722 142 7512213 0 507652 2057960 185435032 186188859 966180 1106844 7663843 7514630 194572707 196868293 151335 106562 0 0 101682295 98308747 0 0 113664 102983667 98897942 204817297 197313251 -10244590 -444958 153467018 208501302 59656856 112925343 93810162 95575959 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 171379409 106562 186188859 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICES ACCOMPLISHMENTS. 171379409 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1722 1 1 1 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 1 X DONNA WALLACE 3145238793 10101 WOODFIELD LANE ST LOUIS MO 63132 STEVEN BARNEY PT YR DIR & VICE PRES 1.00 40.00 X X 0 592443 -223953 LYNN BRUCHHOF PT YR DIRECTOR 1.00 40.00 X 0 469878 77344 GAUROV DAYAL MD DIRECTOR 1.00 40.00 X 0 775353 124266 MARGARET FOWLER PT YR DIRECTOR 1.00 40.00 X 0 374091 87201 PAULA FRIEDMAN DIRECTOR & VICE PRES 1.00 40.00 X X 0 596799 15489 PHILIP GUSTAFSON PT YR DIRECTOR 1.00 40.00 X X 0 640932 134043 THOMAS K LANGSTON PT YR DIRECTOR 1.00 40.00 X 0 664464 147214 JOE M HODGES PT YR DIRECTOR 1.00 40.00 X 0 690999 16679 CHRISTOPHER HOWARD DIRECTOR 1.00 40.00 X 0 893660 29906 MICHAEL R PANICOLA PT YR DIRECTOR 1.00 40.00 X 0 453857 43280 SHANE PENG MD DIRECTOR 1.00 40.00 X 0 674433 62843 DIXIE L PLATT PT YR DIRECTOR 1.00 40.00 X 0 590484 10096 WILLIAM P THOMPSON DIRECTOR & PRESIDENT 1.00 40.00 X X 0 2421072 841970 KRIS A ZIMMER DIRECTOR & TREASURER 1.00 40.00 X X 0 836253 68008 JUNE L PICKETT SECRETARY 1.00 40.00 X 0 256054 -96872 GRAY COX HOSPITAL PRESIDENT 40.00 0.00 X 0 359271 289547 R BRENT VANCONIA HOSPITAL CEO 40.00 0.00 X 0 488550 62199 JOCELYN SKIDMORE CFO 40.00 0.00 X 134997 0 18246 MARVIN KURTZ CFO 40.00 0.00 X 294085 0 -46448 SCOTT HOLMAN DO VP MEDICAL AFFAIRS 40.00 0.00 X 370648 0 17587 ANTHONY HOUSTON HOSPITAL COO 40.00 0.00 X 231646 0 37810 JOHN LUCIO DO VP MEDICAL AFFAIRS 40.00 0.00 X 159390 0 29198 SUSAN MANKOSKI HOSPITAL VP HR 40.00 0.00 X 190484 0 47799 THOMAS DISTEFANO PHYSICIAN 40.00 0.00 X 984325 0 -46279 JOHN CLEMENS PHYSICIAN 40.00 0.00 X 550232 0 134684 JANE DAWSON PHYSICIAN 40.00 0.00 X 470188 0 4829 COURTNYE WALKER PHYSICIAN 40.00 0.00 X 465914 0 51804 SHIRLEY HARRIS PHYSICIAN 40.00 0.00 X 457224 0 19293 4309133 11778593 1957783 95 0 1 0 ALBERICI CONSTRUCTORS INC 8800 PAGE AVE ST LOUIS MO 63114 CONSTRUCTION MANAGEMENT 60102189 LAWRENCE GROUP INC 319 N 4TH STREET ST LOUIS MO 63102 CONSTRUCTION MANAGEMENT 2252323 EMERGENCY PRACTICE ASSOCIATES INC 3840 W 9TH ST WATERLOO IA 50702 MEDICAL PHYSICIAN SERVICES 1483251 MID-MISSOURI ANESTHESIA 1445 CHRISTY DRIVE JEFFERSON CITY MO 65101 MEDICAL PHYSICIAN SERVICES 1201039 MORRISON MANAGEMENT SPECIALIST 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 NUTRITIONAL SERVICES 1125760 47 40100 2001753 15833 274 6688 2057960 NET PATIENT REV 621110 183600559 183600559 OTHER OPERATING REVENUE 621110 2588300 2588300 186188859 425874 425874 41812 53756 -11944 -11944 -11944 676104 23500 0 18634 676104 4866 680970 680970 14256 8883 5373 5373 18084 9096 8988 8988 PHARMACY REVENUE 446110 7068459 7068459 CHILD CARE CENTER 624410 399477 399477 LABORATORY REV 621500 22785 22785 21492 21492 7512213 196868293 186188859 7512213 1109261 106562 106562 2407819 2407819 70768227 59992676 10705607 69944 7776130 6420456 1346991 8683 12469719 10280704 2176927 12088 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DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 111000 2226 2226 111000 111000 1109 1109 111000 111000 1436 1436 111000 116307 2098 7405 111000 118719 1500 4614 8526 116307 1.00000 1 0 4715483 4715483 81006502 67296597 13709905 543967 478901 65066 55026483 44985480 10041003 94175660 785603 93390057 121921514 BENEFICIAL INTEREST IN FOUNDATIONS 14252064 F EQUITY IN JOINT VENTURES 332290 F SSM COMPREHENSIVE INVESTMENT PROGRAM 17994316 F 32578670 THIRD PARTY PAYOR 8678826 OTHER RECEIVABLES 831168 LONG TERM NOTES RECEIVABLE 78907 OTHER NON-CURRENT ASSETS 1228972 SOFTWARE 12934 10830807 PENSION FUNDING LIABILITY 15093134 RABBI TRUST LIABILITY 1585313 THIRD PARTY PAYOR 859418 ASSET RETIREMENT LIABILITY 932353 DEFERRED COMPENSATION LIABILITY 960160 DUE TO AFFILIATES 32363 ALLOCATED TAX EXEMPT BOND DEBT (ISSUED BY SSM HEALTH CARE) 79226263 98689004 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS AND THE MISSION OF ST. MARY'S HEALTH CENTER. PART X, LINE 2: SSM REGIONAL HEALTH SERVICES' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH CARE CORPORATION (SSMHC), A RELATED ORGANIZATION. SSMHC EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2013 OR 2012. 1 1 X 1 X 1 X 1 1 1 0 1 0 4953249 4953249 0.02510 31661256 30415808 1245448 0.00630 36614505 30415808 6198697 0.03140 300048 10900 289148 0.00150 87255 87255 0.00040 278668 50212 228456 0.00120 665971 61112 604859 0.00310 37280476 30476920 6803556 0.03450 24573 24573 0.00010 4147 4147 0.00000 189392 189392 0.00100 218112 218112 0.00110 0 7090602 49677788 65738532 -16060744 X 1 0 1 SMHC SURGICAL CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 2 SMHC MUSCULOSKELETAL CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 3 SMHC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 2 1 ST MARY'S HEALTH CENTER 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 WWW.LETHEALINGBEGIN.COM 455-14 X X X 2 ST FRANCIS HOSPITAL & HEALTH SERVICES 2015 S MAIN MARYVILLE MO 64468 WWW.STFRANCISMARYVILLE.COM 147-55 X X X ST MARY'S HEALTH CENTER 1 1 X X X X X X X X 12 1 1 1 X SEE PART V, SECTION C FOR FULL URL X WWW.SSMHEALTH.COM X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 ST FRANCIS HOSPITAL & HEALTH SERVICES 2 1 X X X X X X X X 12 1 0 1 X SEE PART V, SECTION C FOR FULL URL X WWW.SSMHEALTH.COM X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 ST MARY'S HEALTH CENTER PART V, SECTION B, LINE 3: THE CENTRAL MISSOURI COMMUNITY HEALTH ASSESSMENT PARTNERSHIP (CMCHAP) WORKED COLLABORATIVELY TO COLLECT AND ANALYZE HEALTH DATA AND GATHER INPUT FROM COMMUNITY MEMBERS TO AID IN ASSESSING AND PRIORITIZING NEEDS. COMMUNITY DISCUSSION GROUPS, MUCH LIKE TOWN HALL MEETINGS WERE ORGANIZED BY THE STEERING TEAM AND FACILITATED BY MICHAEL FELIX, A COMMUNITY HEALTH DEVELOPMENT SPECIALIST. THROUGHOUT THIS PROCESS, MORE THAN 150 INDIVIDUALS PARTICIPATED IN 12 DISCUSSION GROUPS AND CONSUMER INTERVIEW SESSIONS. ORGANIZATIONS PARTICIPATING IN THESE DISCUSSIONS CAN BE FOUND ON PAGE 6 OF THE CHNA: HTTP://WWW.LETHEALINGBEGIN.COM/PAGES/2012COMMUNITYBENEFITREPORT.ASPX ST FRANCIS HOSPITAL & HEALTH SERVICES PART V, SECTION B, LINE 3: ST FRANCIS CREATED AN INTERNAL STEERING TEAM WITH TRAINED STAFF MEMBERS AND STAFF THAT HAD SIGNIFICANT CONTACT WITH THE COMMUNITY THROUGH VARIOUS AVENUES. IN ADDITION, A HEALTH PARTNERS EXTERNAL COUNCIL WAS FORMED WITH MEMBERS FROM ST FRANCIS AND AREA AGENCIES INVOLVED IN THE CARE OF THE COMMUNITY. MEMBERS OF THIS COUNCIL INCLUDED:DELLA RHOADES NODAWAY COUNTY HEALTH CENTERDR JERRY WILMES NORTHWEST MISSOURI STATE UNIVERSITYDAVE WEICHINGER COMMUNITY SERVICETY PARSONS NWMO REGIONAL COUNCIL OF GOVERNMENTSTAMMY OLTMAN ACESLISA MACALI NODAWAY COUNTY ECONOMIC DEVELOPMENTLARRY LINTHICUM MARYVILLE SCHOOL DISTRICTDEAN SCHNEIDER HYVEE PHARMACYAMIE FIRAVICH SENIOR CENTER DIRECTORJONATHAN MITCHELL FIRST PRESBYTERIAN CHURCHIN ADDITION, ST FRANCIS SURVEYED THE COMMUNITY USING FOCUS GROUPS AND A DIRECT MAIL PAPER SURVEY. COMMUNITY GROUPS WERE ASKED THEIR THOUGHTS ON COMMUNITY HEALTH. THE PAPER SURVEY WAS SENT TO 979 RANDOM COMMUNITY MEMBERS. INFORMATION ON THE COMMUNITY SURVEY RESULTS CAN BE FOUND ON PAGES 31 THROUGH 39 OF THE CHNA: HTTP://WWW.STFRANCISMARYVILLE.COM/COMMUNITYWELLNESS/PAGES/CHNA.ASPX ST MARY'S HEALTH CENTER PART V, SECTION B, LINE 4: THE MEMBERS OF THE CMCHAP CAN BE FOUND ON PAGE 5 OF THE CHNA. ST MARY'S HEALTH CENTER PART V, SECTION B, LINE 7: THE PROCESS USED TO SCREEN AND PRIORITIZE THE IDENTIFIED COMMUNITY NEEDS CAN BE FOUND ON PAGE 20 OF THE CHNA. IN ADDITION TO IDENTIFYING ISSUES WITH ACCESS TO CARE, THE REPORT IDENTIFIED THE THREE MOST PREVALENT HEALTH PROBLEMS FACING PEOPLE IN THE REGION. ST MARY'S HEALTH CENTER HAS DEVELOPED A PLAN TO ADDRESS THESE PRESSING COMMUNITY HEALTH NEEDS. ST FRANCIS HOSPITAL & HEALTH SERVICES PART V, SECTION B, LINE 7: THE HEALTHY COMMUNITIES COUNCIL REVIEWED THE CHNA DATA, ENGAGED IN DISCUSSION, AND COMPLETED A MULTI-VOTING EXERCISE BASED ON THE FOLLOWING CRITERIA: SEVERITY, IMPORTANCE TO COMMUNITY, IMPACT, AND EXISTING COMMUNITY RESOURCES. THE RESULTS OF THIS PROCESS CAN BE FOUND ON PAGES 41 AND 42 OF THE CHNA. 25 ST FRANCIS FAMILY HEALTH CARE WEST 2016 S MAIN MARYVILLE MO 64468 PRIMARY CARE CLINIC ST MARY'S PEDIATRICS 3348 AMERICAN AVENUE JEFFERSON CITY MO 651091079 PEDIATRIC CLINIC ST MARY'S SPORTS MEDICINE & REHAB 1225 WEST STADIUM BLVD JEFFERSON CITY MO 65109 OUTPATIENT CLINIC ST MARY'S SLEEP DISORDERS CENTER 3348 AMERICAN AVENUE JEFFERSON CITY MO 65109 SLEEP DISORDERS CENTER ST MARY'S HOLTS SUMMIT PHARMACY 140 NORTHSTAR DRIVE HOLTS SUMMIT MO 650431123 RETAIL PHARMACY ST MARY'S TIPTON PHARMACY 875 STATE RT 5 PO BOX 667 TIPTON MO 650818411 RETAIL PHARMACY ST FRANCIS FAMILY HEALTH CARE - EAST 114 E SOUTH HILLS DR MARYVILLE MO 64468 PRIMARY CARE CLINIC ST MARY'S PLAZA PHARMACY 200 ST MARYS MEDICAL PLAZA SUITE 204 JEFFERSON CITY MO 65101 RETAIL PHARMACY ST MARY'S URGENT CARE - LAKE OZARK 2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 650498603 URGENT CARE CLINIC AND RURAL HEALTH CLINIC ST MARY'S CARDIOVASCULAR SURGERY 200 ST MARYS MEDICAL PLAZA SUITE 203 JEFFERSON CITY MO 651011604 CARDIOVASCULAR SERVICES ST MARY'S HEALTH PSYCHOLOGY 3702 W TRUMAN BLVD SUITE 115 JEFFERSON CITY MO 651096152 O/P PSYCHIATRIC SERVICES ST MARY'S URGENT CARE - JEFFERSON CITY 2511 W EDGEWOOD SUITE D JEFFERSON CITY MO 651095869 URGENT CARE CLINIC ST FRANCIS FAMILY LIFE SERVICES 114 EAST SOUTH HILLS DRIVE MARYVILLE MO 64468 MENTAL HEALTH OUTPATIENT ST MARY'S OUTPATIENT REHAB & SPINE CENTE 2511 W EDGEWOOD SUITE G JEFFERSON CITY MO 65109 OUTPATIENT CLINIC ST MARY'S MEDICAL CLINIC - BELLE 100 HIGHWAY 28 W BELLE MO 650133405 FAMILY PRACTICE CLINIC & RURAL HEALTH CLINIC ST MARY'S MEDICAL CLINIC - JEFFERSON 2511 W EDGEWOOD SUITE F JEFFERSON CITY MO 65109 FAMILY PRACTICE CLINIC ST MARY'S MEDICAL CLINIC - HOLTS SUMMIT 140 NORTHSTAR DRIVE HOLTS SUMMIT MO 650431123 FAMILY PRACTICE CLINIC ST MARY'S MEDICAL CLINIC - TIPTON 875 STATE RT 5 PO BOX 667 TIPTON MO 650818411 FAMILY PRACTICE CLINIC ST MARY'S OCCUPATIONAL MEDICINE 2511 W EDGEWOOD SUITE F JEFFERSON CITY MO 651095869 OCCUPATIONAL MEDICINE ST MARY'S MEDICAL CLINIC - VERSAILLES 801 KIDWELL DRIVE VERSAILLES MO 650841787 FAMILY PRACTICE CLINIC ST FRANCIS HOSPITAL - SAVANNAH CLINIC 301 E PRICE STREET SAVANNAH MO 64485 PRIMARY CARE CLINIC HARDIN MEDICAL CLINIC 408 SOUTH DODGE STREET BEDFORD IA 50833 PRIMARY CARE CLINIC ST FRANCIS GRANT CITY MEDICAL CLINIC 24 WEST 4TH STREET GRANT CITY MO 64456 PRIMARY CARE CLINIC WEST NODAWAY HEALTH CLINIC 221 EAST MAIN STREET BURLINGTON JUNCTION MO 64428 PRIMARY CARE CLINIC ST MARY'S MEDICAL CLINIC - LAKE OZARK 2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 650498603 FAMILY PRACTICE CLINIC & RURAL HEALTH CLINIC SCHEDULE H, PART I, QUESTION 3B SSM REGIONAL HEALTH SERVICES USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.THE APPLICABLE PERCENTAGE VARIES BASED ON HOW MUCH THE APPLICANT'S INCOME EXCEEDS FPG GUIDELINES. THE FOLLOWING SCHEDULE IS USED TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE:APPLICANT'S INCOME IS CHARITY CARE PERCENTAGELESS THAN OR EQUAL TO 2 TIMES FPG 100%MORE THAN 2 TIMES, LESS THAN 2.5 TIME FPG 80%MORE THAN 2.5 TIMES, LESS THAN 3 TIMES FPG 60%MORE THAN 3 TIMES, LESS THAN 3.5 TIMES FPG 40%MORE THAN 3.5 TIMES, LESS THAN 4 TIMES FPG 20%4 OR MORE TIMES FPG 0%SCHEDULE H, PART I, QUESTION 3CAN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT IF THEIR BALANCE DUE EXCEEDS 20% OF THEIR GROSS FAMILY INCOME. IN THIS SITUATION, THE BILL IS DISCOUNTED DOWN TO 20% OF THEIR FAMILY INCOME. TO FURTHER STREAMLINE AND AUTOMATE THE FINANCIAL ASSISTANCE PROCESS, SSM REGIONAL HEALTH SERVICES BUSINESS OFFICE PERSONNEL WILL AUTOMATICALLY CONSIDER 100% OF THE PATIENT ACCOUNT AS CHARITY CARE IF THE COMMERCIAL SOFTWARE SYSTEM (PASSPORT) INDICATES THAT THE PATIENT IS LIVING AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL). ADDITIONALLY, PRIOR TO CLASSIFYING THE BALANCE DUE AS A BAD DEBT, THE HOSPITAL REVIEWS ACCOUNTS WITH BALANCES OVER $10,000 AND APPLIES THE SAME ELIGIBILITY CRITERIA MENTIONED ABOVE. THIS PROCESS IS CALLED "PRESUMPTIVE ELIGIBILITY". SCHEDULE H, PART I, QUESTION 6ASSM REGIONAL HEALTH SERVICES IS PART OF THE INTEGRATED HEALTH SYSTEM KNOWN AS SSM HEALTH CARE. IN AN EFFORT TO STRENGTHEN ITS COMMUNITY BENEFIT PROGRAM, SSM HEALTH CARE PLANS FOR, MEASURES, AND COMMUNICATES, IN AN ANNUAL REPORT, CHARITY CARE PROVIDED TO PERSONS WHO ARE LOW INCOME, THE UNPAID COSTS OF PUBLIC PROGRAMS AND OTHER ACTIVITIES THAT RESPOND TO COMMUNITY NEED, IMPROVE COMMUNITY HEALTH, OR REACH OUT TO LOW INCOME AND VULNERABLE PERSONS.SCHEDULE H, PART I, QUESTION 7CHARITY CARE COSTING METHODOLOGY: THE COST OF CHARITY CARE IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES. A COST TO CHARGE RATIO CALCULATED USING THE IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGE, WAS USED TO COMPUTE CHARITY CARE AT COST. THIS IS THE RATIO OF TOTAL ADJUSTED OPERATING EXPENSE TO TOTAL GROSS PATIENT REVENUE. THE GROSS REVENUE AMOUNT IS A GROSS AMOUNT - PRIOR TO CONTRACTUAL ADJUSTMENTS AND BAD DEBTS. BOTH GROSS REVENUE AND COSTS ARE BASED ON CHARGES AT DATE/TIME OF SERVICE.UNREIMBURSED MEDICAID COSTING METHODOLOGY: THE COST OF UNREIMBURSED MEDICAID IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES. A COST TO CHARGE RATIO CALCULATED UTILIZING IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGE, WAS USED TO COMPUTE UNREIMBURSED MEDICAID COSTS. THIS IS THE RATIO OF TOTAL ADJUSTED OPERATING EXPENSE TO TOTAL GROSS PATIENT REVENUE. THE GROSS REVENUE AMOUNT IS A GROSS AMOUNT - PRIOR TO CONTRACTUAL ADJUSTMENTS AND BAD DEBTS. BOTH GROSS REVENUE AND COSTS ARE BASED ON CHARGES AT DATE/TIME OF SERVICE. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS COSTING METHODOLOGY: THE COSTS FOR THESE PROGRAMS WERE DERIVED FROM THE ACTUAL COSTS INCURRED IN THESE AREAS. THE EXPENDITURES ARE DETERMINED BASED ON ACTUAL INVOICES OR DOLLAR AMOUNTS SPENT AND CHARGED TO THESE DEPARTMENTS.HEALTH PROFESSIONAL EDUCATION COSTING METHODOLOGY: THE EXPENSES FOR HEALTH PROFESSION EDUCATION WERE TAKEN FROM THE DEPARTMENT'S INCOME AND EXPENSE STATEMENT, DERIVED FROM THE ACCOUNTING SYSTEM. AMOUNTS PAID FROM RESIDENT DEPARTMENTS WERE ALSO INCLUDED.CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS COSTING METHODOLOGY: CONTRIBUTION EXPENDITURES ARE BASED ON ACTUAL INVOICES THAT WERE CAPTURED AND REPORTED FOR THIS PROGRAM.SCHEDULE H, PART II, COMMUNITY BUILDING ACTIVITIESSSM REGIONAL HEALTH SERVICES 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 SUPPORT - PHYSICAL IMPROVEMENT AND HOUSING: ST FRANCIS HOSPITAL SPONSORED THE MARYVILLE TRAILS EXTENSION PROVIDING THE TRAILS EASEMENT, TEMPORARY CONSTRUCTION AND EASEMENT GRADING.COMMUNITY SUPPORT - ECONOMIC DEVELOPMENT: PARTICIPATION IN AN ORGANIZATION PROMOTING SMALL BUSINESS DEVELOPMENT INCLUDING PARTICIPATION IN THE SAVANNAH CHAMBER OF COMMERCE, GREATER MARYVILLE CHAMBER OF COMMERCE AND NODAWAY COUNTY ECONOMIC DEVELOPMENT COUNCIL.COMMUNITY BUILDING - COMMUNITY SUPPORT: PROVIDES DIRECT SUPPORT FOR UNDERFUNDED CHILD CARE CENTER TO COVER SALARY AND BENEFITS FOR CHILDREN AND FAMILY CENTER OF NORTHWEST MISSOURI; PARTICIPATES IN ACTIVITIES TO TAKE AN ACTIVE ROLE IN THE JEFFERSON CITY, MISSOURI COMMUNITY AND THE HEALTH OF ITS CITIZENS.SCHEDULE H, PART III, SECTION A, LINE 2BAD DEBT COSTING METHODOLOGY: BAD DEBT EXPENSE REPORTED IN THE ACCOUNTING SYSTEM, ADJUSTED FOR BAD DEBT RECOVERIES, WAS USED, MULTIPLIED BY THE COST TO CHARGE RATIO USING IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES.SCHEDULE H, PART III, SECTION A, LINE 3SSM REGIONAL HEALTH SERVICES 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, SECTION A, LINE 4SSM REGIONAL HEALTH SERVICES IS PART OF THE SSM HEALTH CARE CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES BAD DEBT EXPENSE IN THE DECEMBER 31, 2013 CONSOLIDATED AUDIT IS AS FOLLOWS:"IN LINE WITH ITS MISSION, SSMHC PROVIDES SERVICES TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR THOSE SERVICES. FOR SOME OF ITS PATIENT SERVICES, SSMHC RECEIVES NO PAYMENT OR PAYMENT THAT IS LESS THAN THE FULL COST OF PROVIDING THE SERVICES.SSMHC VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AS DETERMINED BY SSMHC'S CRITERIA FOR FINANCIAL ASSISTANCE. BECAUSE SSMHC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUES.IN SOME CASES, SSMHC DOES NOT RECEIVE THE AMOUNT BILLED FOR PATIENT SERVICES EVEN THOUGH IT DID NOT RECEIVE INFORMATION NECESSARY TO DETERMINE IF THE PATIENTS MET THE CRITERIA FOR FINANCIAL ASSISTANCE. THE ESTIMATED COST OF CHARITY AND THE COST OF DOUBTFUL ACCOUNTS ARE AS FOLLOWS: THE ESTIMATED COSTS ARE CALCULATED USING THE COSTS OF PROVIDING PATIENT CARE DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS RATIO IS THEN MULTIPLIED BY THE GROSS CHARITY AND DOUBTFUL CHARGES TO DETERMINE ESTIMATED COSTS." BAD DEBT EXPENSE REPORTED ON LINE 2 FOR THE YEAR ENDED DECEMBER 31, 2013 WAS $18,110,149 AT CHARGES AND $7,090,602 AT COST. SCHEDULE H, PART III, SECTION B, LINE 8 THE COST OF PROVIDING CARE TO MEDICARE ELIGIBLE PATIENTS IS GREATER THAN THE REIMBURSEMENT THAT MEDICARE ALLOWS ON THE MEDICARE COST REPORT. SSM REGIONAL HEALTH SERVICES CONSIDERS THIS SHORTFALL AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIATED AND SERVICES ARE PROVIDED REGARDLESS OF THE PATIENTS' ABILITY TO PAY. THE MEDICARE COSTS REPORTED ON LINE 6 WERE OBTAINED FROM THE 2013 MEDICARE COST REPORT.SCHEDULE H, PART III, SECTION C, LINE 9BSSM REGIONAL HEALTH SERVICES HAS ESTABLISHED WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEALTH CARE, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. THE HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE. 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 REGIONAL HEALTH SERVICES' COLLECTION AND CHARITY POLICIES.SCHEDULE H, PART IV, LINE 2: NEEDS ASSESSMENT PROCESSTHE ANNUAL STRATEGIC, FINANCIAL, AND HUMAN RESOURCES PLANNING PROCESS HAS INCLUDED AN ASSESSMENT OF THE COMMUNITY'S NEEDS TO INCLUDE THE IDENTIFICATION OF SPECIFIC AND MEASUREABLE HEALTHY COMMUNITIES' INITIATIVES. OUR SYSTEM VISION FOR IMPROVED COMMUNITY HEALTH IS PURSUED IN ALL OF OUR WORK AT SSM HEALTH CARE FROM STRATEGIC PLANNING, FINANCIAL MANAGEMENT, AND DIRECT PATIENT CARE TO ADVOCACY, COMMUNITY PARTNERSHIPS AND HEALTHY COMMUNITIES INITIATIVES. OVERALL EFFORTS IN THIS AREA ARE COORDINATED THROUGH SSM HEALTH CARE'S COMMUNITY BENEFIT PROGRAM, WHICH FOCUSES ON ASSESSING AND IMPLEMENTING STRATEGIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS.SSM HEALTH CARE'S COMMITMENT TO COMMUNITY BENEFIT IS DEEPLY EMBEDDED INTO OUR ORGANIZATIONAL CULTURE AS REFLECTED IN OUR SYSTEM VISION STATEMENT WHICH READS: 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 WITHIN THE FINANCIAL LIMITS OF THE SYSTEM.A COMMUNITY BENEFIT ACTIVITY IS IDENTIFIED AS A SERVICE RATHER THAN AS A MARKETING TOOL AND MEETS AT LEAST TWO OF THE FOLLOWING CRITERIA:- IT IS FINANCED BY PHILANTHROPIC CONTRIBUTIONS, VOLUNTEER EFFORTS, OR AN ENDOWMENT.- IT PROVIDES A RESPONSE TO A UNIQUE OR PARTICULAR HEALTH PROBLEM IN THE COMMUNITY.- IT GENERATES A LOW OR NEGATIVE MARGIN ON A FULLY ABSORBED COST BASIS.- IT RESPONDS TO THE NEEDS OF SPECIAL POPULATIONS SUCH AS MINORITIES, WOMEN AND CHILDREN, THE FRAIL ELDERLY, LOW INCOME PERSONS WITH DISABILITIES, THE MENTALLY ILL, OR THOSE LIVING WITH CHRONIC ILLNESS.- THE DECISION TO OFFER THE SERVICE OR PROGRAM IS NOT MADE ON A PURELY FINANCIAL BASIS.- IF NOT PROVIDED BY HEALTH CARE ORGANIZATION, THE SERVICE WOULD NO LONGER BE AVAILABLE IN THE COMMUNITY OR WOULD BE THE RESPONSIBILITY OF GOVERNMENT.THE COMMUNITY BENEFIT PLAN DETAILS THE PLANNING, MEASUREMENT AND COMMUNICATION OF ITS COMMUNITY BENEFITS. THE THREE-MAIN ASPECTS OF COMMUNITY BENEFIT BEING THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH DETERMINES THE COMMUNITY NEEDS TO BE ADDRESSED BY THE HOSPITAL, THE COMMUNITY BENEFIT PLAN WHICH DETAILS STEPS TO BE ACCOMPLISHED TO MEET IDENTIFIED NEEDS, AND THE CBISA DATABASE WHICH DOCUMENTS ALL OF THE COMMUNITY BENEFIT ACTIVITIES FOR EACH YEAR. AT THE END OF EACH YEAR, THE CBISA COMMUNITY BENEFIT REPORT IS GIVEN TO MANAGEMENT, ADMINISTRATION AND THE SSMHC BOARD OF DIRECTORS IN ORDER TO EVALUATE AND IMPROVE THE PROGRAM. ST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MO:ONE OF THE FIRST STEPS FOR IDENTIFYING THE HIGH-PRIORITY HEALTH NEEDS OF OUR COMMUNITY IS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A SUMMARY OF THE ST FRANCIS HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CAN BE FOUND ON PAGES 4 AND 5 OF ITS CHNA. THE TWO STRATEGIC PRIORITIES OF THE ST FRANCIS HOSPITAL COMMUNITY BENEFIT PLAN ARE: MENTAL HEALTH SERVICES FOR YOUTH AND ADOLESCENTS, AND OBESITY. DURING 2013, GOALS AND OBJECTIVES WERE ESTABLISHED TO CHANGE BEHAVIOR, PROVIDE METRICS TO MEASURE CHANGE, AND TO IMPACT THE OVERALL HEALTH OF THOSE WE SERVE. ALL OF THE COMMUNITY BENEFIT ACTIVITIES ARE DESIGNED TO MEET THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH WAS COMPLETED IN OCTOBER 2012. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO:ST. MARY'S HEALTH CENTER CO-SPONSORED A 2012 COMMUNITY HEALTH NEEDS ASSESSMENT FOR A FOUR-COUNTY REGION IN CENTRAL MISSOURI THAT INCLUDES COLE, MILLER, MONITEAU AND OSAGE COUNTIES. THE CENTRAL MISSOURI HEALTH ASSESSMENT PARTNERSHIP FORMULATES INITIATIVES WITH MEMBER ORGANIZATIONS, INCLUDING THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI (A FEDERALLY QUALIFIED HEALTH CENTER), COLE COUNTY HEALTH DEPARTMENT, THE UNITED WAY OF CENTER MISSOURI, SAMARITAN CENTER OF JEFFERSON CITY, AS WELL AS CAPITAL REGION MEDICAL CENTER. A SUMMARY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CAN BE FOUND ON PAGE 4 OF THE CHNA.THE THREE STRATEGIC PRIORITIES OF THE ST MARY'S HEALTH CENTER COMMUNITY BENEFIT PLAN ARE: DIABETES, CANCER AND HEART DISEASE. DURING 2013, GOALS AND OBJECTIVES WERE ESTABLISHED TO CHANGE BEHAVIOR, PROVIDE METRICS TO MEASURE CHANGE, AND TO IMPACT THE OVERALL HEALTH OF THOSE WE SERVE. ALL OF THE COMMUNITY BENEFIT ACTIVITIES ARE DESIGNED TO MEET THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH WAS COMPLETED IN AUGUST 2012. SCHEDULE H, PART IV LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEALL SSMHC FACILITIES WILL STRIVE TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. ALL BILLING AND COLLECTION POLICIES REFLECT THE MISSION AND VALUES OF SSMHC, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMHC FACILITIES OFFER DISCOUNTS FOR HOSPITAL SERVICES TO ALL UNINSURED PERSONS. SELF-PAY DISCOUNTS APPLY TO EVERYONE WHO DOES NOT HAVE HEALTH INSURANCE, NO MATTER THEIR ABILITY TO PAY.SSMHC APPLIES ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON IS TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMHC EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNT EXCEEDS 20% OF THEIR GROSS FAMILY INCOME. IN THIS SITUATION, THE BILL IS DISCOUNTED DOWN TO 20% OF THEIR FAMILY INCOME.EACH ENTITY PROVIDING MEDICAL SERVICES 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 INFORMATIONST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MO: ST FRANCIS HOSPITAL & HEALTH SERVICES IS LOCATED IN MARYVILLE, MISSOURI, IN RURAL NORTHWEST MISSOURI. THE SERVICE AREA FOR ST FRANCIS ENCOMPASSES NODAWAY COUNTY, MISSOURI AND ALL OF THE CONTIGUOUS SURROUNDING COUNTIES IN MISSOURI AND IOWA. THE ESTIMATED 2011 POPULATION OF NODAWAY COUNTY WAS 21,860 WITH A PROJECTED GROWTH RATE OF 0.2% FROM 2011 TO 2016. THE LARGEST AGE GROUP IN NODAWAY COUNTY IS THE 18 - 24 GROUP, WHICH MAKES UP ABOUT 27% OF THE TOTAL POPULATION. THE POPULATION OF NODAWAY COUNTY IS PREDOMINANTLY WHITE/NON-HISPANIC (94%). THE AVERAGE HOUSEHOLD INCOME IN NODAWAY COUNTY IS $46,895. THIS IS CONSIDERABLY LOWER THAN THE MISSOURI AVERAGE OF $58,797. IN 2010, THE POVERTY RATE WAS 17.0%, WHICH WAS HIGHER THAN THE MISSOURI AVERAGE OF 15.3%. THE POVERTY RATE FOR CHILDREN WAS 15.0% IN NODAWAY COUNTY. MOST OF THE ADULT POPULATION (AGE 25 OR OLDER) IN NODAWAY COUNTY HAVE A HIGH SCHOOL DEGREE OR HIGHER. ADDITIONAL DETAILED INFORMATION ON THE ST FRANCIS HOSPITAL AND HEALTH CENTER SERVICE AREA CAN BE FOUND ON PAGES 6 THROUGH 29 OF THE CHNA.AS A RURAL HOSPITAL, ST FRANCIS HOSPITAL & HEALTH SERVICES PROVIDES EMERGENCY TREATMENT, ACUTE CARE FOR PATIENTS WITH MEDICAL AND SURGICAL DIAGNOSIS, MENTAL HEALTH ILLNESSES, AND OBSTETRICAL NEEDS. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO:ST MARY'S HEALTH CENTER DEFINES ITS PRIMARY AND SECONDARY SERVICE AREAS AS THE FOUR COUNTIES OF COLE, MILLER, MONITEAU AND OSAGE LOCATED IN CENTRAL MISSOURI. THE TOTAL POPULATION OF THE SERVICE AREA, BASED ON THE 2010 CENSUS, WAS 130,223. THIS REGION IS EXPECTING AN INCREASE OF 1.8% FROM 2010 TO 2015 WITH COLE COUNTY EXPECTING THE PARGETS GROWTH AT 2.2%. THE AGE DISTRIBUTION CONTINUES TO SHIFT TOWARD A LARGER POPULATION OF OLDER ADULTS WITH ESTIMATES SUGGESTING THE 65+ COHORT WILL SEE THE LARGEST GROWTH FROM 2010 TO 2015 WITH A 13.4% INCREASE. THE MEDIAN AGE FOR THE REGION IS 38.4 WHICH IS SLIGHTLY HIGHER THAN THE MISSOURI AVERAGE OF 37.9. THE RACE/ETHNICITY DISTRIBUTION BASED ON THE 2010 CENSUS DATA SHOWS A POPULATION THAT IS PREDOMINATELY WHITE/CAUCASIAN (89.2%), WITH 7.1 PERCENT BLACK/AFRICAN AMERICAN. THE MAJORITY OF THE ADULT POPULATION IN THE REGION HAS AN EDUCATION LEVEL AT OR ABOVE THE HIGH SCHOOL LEVEL (85.4%). LOWER THAN AVERAGE POVERTY RATES PROVIDE EVIDENCE OF A HIGHER LEVEL OF ECONOMIC WELL-BEING IN THREE OF THE FOUR COUNTIES WITH ONLY MILLER COUNTY (16.8%) HAVING A PERCENTAGE HIGHER THAN THE MISSOURI AVERAGE (14%). MILLER COUNTY ALSO REPORTS A HIGHER PERCENTAGE OF CHILDREN IN POVERTY (31%) WHEN COMPARED TO 21 PERCENT IN MISSOURI. PER CAPITA INCOME RANGED FROM A LOW $18,202 IN MILLER COUNTY TO A HIGH OF $25,935 IN CLE COUNTY. THIS REGION CONTAINS 50,499 HOUSEHOLDS WITH AVERAGE HOUSEHOLD INCOMES RANGING FROM $43,839 IN MILLER COUNTY TO $65,254 IN COLE COUNTY. ADDITIONAL DETAILED INFORMATION ON THE ST MARY'S HEALTH CENTER SERVICE AREA CAN BE FOUND ON PAGES 8 THROUGH 17 OF THE CHNA.ST MARY'S HEALTH CENTER OFFERS A FULL RANGE OF HEALTH CARE SERVICES INCLUDING CARDIOVASCULAR, EMERGENCY, ORTHOPEDIC, CANCER, OUTPATIENT SURGICAL, AND WOMEN'S HEALTH SERVICES. IN ADDITION ST MARY'S EXTENDS ITS HEALTH CARE INTO THE REGION WITH THE FOLLOWING SERVICES: WOUND HEALING CENTER, MEDICAL CLINICS, URGENT CARE FACILITIES, RETAIL PHARMACIES, ST MARY'S PEDIATRICS, HEALTH PSYCHOLOGY, PAIN MANAGEMENT, ST MARY'S SLEEP CENTER, WOMEN'S IMAGING CENTER, OCCUPATION MEDICINE, OUTPATIENT PHYSICAL REHABILITATION AND DIABETES MANAGEMENT AND TRAINING.SCHEDULE H, PART VI LINE 5: PROMOTION OF COMMUNITY HEALTHSSM HEALTH CARE'S MISSION STATEMENT IS "THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD". SSM REGIONAL HEALTH SERVICES PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY. SOME EXAMPLES INCLUDE THE FOLLOWING:ST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MOIN NODAWAY COUNTY, THE RATE OF ER VISITS FOR STROKE OR OTHER CEREBROVASCULAR DISEASE SHOWED A SIGNIFICANT INCREASE IN RECENT YEARS BASED ON THE COMMUNITY ASSESSMENT. OF THE DATA STUDIED, 75% OF THE PATIENTS WERE FEMALE. EFFORTS WERE MADE TO IDENTIFY HIGH-RISK PATIENTS THROUGH INCREASED SCREENINGS IN THE AREA WITH SPECIAL EMPHASIS ON WOMEN IN THE AREA. HEALTH SCREENINGS INCLUDE BLOOD PRESSURE, BLOOD DRAWS, AND/OR ONE DENSITY TEST. THE HOSPITAL MAKES PRESENTATIONS ABOUT HEALTH RELATED-RELATED MATTERS SUCH AS DIABETES AND HEART DISEASE AND PARTICIPATES IN HEALTH FAIRS. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN JOB SHADOW OPPORTUNITIES FOR STUDENTS IN ELEMENTARY SCHOOL THROUGH COLLEGE. DURING 2013, THE HOSPITAL HELD 14 HEALTH SCREENING WITH OVER 750 PARTICIPANTS.DIABETES EDUCATION: DEB HULL, DIABETES EDUCATOR, CONTINUED HER EFFORTS TO INFORM AND RAISE AWARENESS ABOUT DIABETES. IN 2013, DEB PRESENTED INFORMATION TO OVER 350 SCHOOL AND COMMUNITY MEMBERS ABOUT THE RISK OF DEVELOPING TYPE 2 DIABETES AND HOW IT CAN BE SIGNIFICANTLY REDUCED THROUGH EXERCISE AND MODEST WEIGHT LOSS. PRESENTATIONS INCLUDED INFORMATION ABOUT THE DISEASE, PREVENTION, TREATMENT, SIGNS AND SYMPTOMS AND TIPS ON HANDLING THE DISEASE. IN ADDITION, THE HOSPITAL HOSTED MONTHLY DIABETES SUPPORT GROUP MEETINGS.HEALTH PROFESSIONALS EDUCATION: IN COLLABORATION WITH MISSOURI AREA HEALTH EDUCATION CENTERS AND THE UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE, ST. FRANCIS ACCOMMODATED MEDICAL STUDENTS IN AN OPPORTUNITY TO HELP THEM EXPLORE FIRST-HAND THE PROSPECTS AWAITING THEM IN A RURAL AND OUTREACH POPULATIONS. THE PROGRAM INCLUDED PHYSICIAN INVOLVEMENT TO OVERSEE THE STUDENT LEARNING AS WELL AS HOUSING WITH MAINTENANCE AND HOUSEKEEPING AND INTERNET-BASED EQUIPMENT AND FACILITIES TO CONDUCT CHATS WITH UNIVERSITY INSTRUCTORS ON A REGULAR BASIS. IN COLLABORATION WITH NORTH CENTRAL MISSOURI COLLEGE AND IOWA WESTERN COMMUNITY COLLEGE, ST FRANCIS HOSTED OVER 120 RN AND LPN STUDENTS DURING 2013. THE STUDENTS WERE PROVIDED MENTORING THROUGH A JOB SHADOW PROGRAM WITH HOSPITAL STAFF. IN ADDITION, THE HOSPITAL PROVIDED PROFESSIONAL EDUCATION TO SPECIALTY STUDENTS IN THE AREAS OF DIETICIANS, EMT, SURGERY TECHNICIANS, PHARMACY, SOCIAL WORK AND PHYSICAL THERAPY. HEALTH EDUCATION: TO PROVIDE BETTER HEALTH EDUCATION TO COMMUNITY MEMBERS, HOSPITAL EMPLOYEES PROVIDE CPR TRAINING AT VARIOUS EVENTS AND PROVIDED HEALTH LIFESTYLES FOLLOW-UP SESSIONS.ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MOST. MARY'S FINANCIAL ASSISTANCE PROGRAM: ST. MARY'S PROVIDED ASSISTANCE TO PATIENTS IN APPLYING FOR MEDICAID AND OTHER SERVICES.SMHC FOUNDATION MEDICATION ASSISTANCE FUND: THIS PROGRAM PROVIDES AID TO THOSE IN NEED BY OFFERING SHORT-TERM MEDICATION ASSISTANCE TO PATIENTS WHO CANNOT AFFORD PRESCRIPTION MEDICINE, AND CANNOT OBTAIN IT IN A TIMELY MANNER FROM ANOTHER AGENCY. THIS PROGRAM SUPPORTS THE POOR, UNINSURED AND IS AVAILABLE TO THE URBAN AND RURAL DEMOGRAPHIC.SPORTS MEDICINE OUTREACH PROGRAM: ST MARY'S HEALTH CENTER PROVIDES ATHLETIC TRAINERS TO SEVERAL AREA HIGH SCHOOL'S SPORTING EVENTS IN CASE OF INJURY.HEALTH PROFESSIONAL EDUCATION: ST MARY'S HEALTH CENTER PROVIDES LOCAL NURSING AND PHARMACY STUDENTS MENTORING OPPORTUNITIES IN VARIOUS CLINICAL DEPARTMENTS OF THE HOSPITAL.EDUCATION: ST MARY'S MISSION EFFECTIVENESS DEPARTMENT PROVIDES MONTHLY EDUCATION SESSIONS TO THE COMMUNITY ON END-OF-LIFE ISSUES. ST MARY'S PROVIDES BASIC LIFE SUPPORT OF ADULT, CHILD AND INFANTS, AND FAMILY AND FRIENDS WHICH IS A COURSE FOR LAYPERSONS TO KNOW WHAT TO DO UNTIL EMERGENCY HELP ARRIVES ON THE SCENE. ST MARY'S WOMEN'S SERVICES DEPARTMENT PROVIDES CHILDBIRTH EDUCATION CLASSES, REFRESHER CLASSES, SUPERSIBLING CLASSES AND BREASTFEEDING EDUCATION CLASSES.TRAINING RESOURCES FOR DISADVANTAGED YOUTH: THIS PROGRAM IS A TRAINING PROGRAM THAT PROVIDES LEARNING CHALLENGED HIGH SCHOOL STUDENTS AN OPPORTUNITY TO BUILD VALUABLE EXPERIENCE AND LIFE SKILLS BY WORKING AT THE HOSPITAL. THE PROGRAM SUPPORTS LEARNING DISADVANTAGED, OFTEN ECONOMICALLY CHALLENGED YOUTH IN OUR COMMUNITY, AS WELL AS SUPPORTS A COMMUNITY PARTNERSHIP WITH THE LOCAL HIGH SCHOOL. LINCOLN UNIVERSITY SCHOOL OF NURSING: ST. MARY'S PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $60,407 TO THE NURSING PROGRAM AS WELL AS PROVIDING A CLINICAL SETTING FOR THE RN STUDENTS TO LEARN. SSM REGIONAL HEALTH SERVICES ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES:- OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY,- HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA,- HAS A SOLE CORPORATE MEMBER WITH RESERVED POWERS WHICH 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,- SSM REGIONAL HEALTH SERVICES IS COMMITTED TO PROVIDING A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM WHICH INCLUDES THE REINVESTMENT OF SURPLUS FUNDS. A ST MARY'S HEALTH CENTER REPLACEMENT HOSPITAL IS UNDER CONSTRUCTION AND SCHEDULED TO OPEN IN 2014. SCHEDULE H, PART VI LINE 6: AFFILIATED HEALTH CARE SYSTEMSSM REGIONAL HEALTH SERVICES IS A HEALTH CARE NETWORK THAT THAT OPERATES ST MARY'S HEALTH CENTER IN JEFFERSON CITY MISSOURI AND ST FRANCIS HOSPITAL & HEALTH SERVICES IN MARYVILLE, MISSOURI. IT IS PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE. SSM HEALTH CARE IS A 501(C)(3) ORGANIZATION HEADQUARTERED IN ST LOUIS, MISSOURI.SCHEDULE H, PART VI LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORTTHE SSM HEALTH CARE'S ANNUAL CONSOLIDATED COMMUNITY BENEFIT REPORT IS FILED IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN. 1 LINCOLN UNIVERSITY 820 CHESTNUT JEFFERSON CITY MO 65101 446001089 501(C)(3) 60407 SUPPORT RN TRAINING PROGRAM CATHOLIC DIOCESE OF JEFFERSON CITY 2207 WEST MAIN STREET JEFFERSON CITY MO 65109 440612540 501(C)(3) 16000 PASTORAL CARE SERVICES GRANT MISSOURI HOSPITAL ASSOCIATION CENTER FOR EDUCATION 4712 COUNTRY CLUB DRIVE JEFFERSON CITY MO 65109 430898947 501(C)(3) 21655 SCHOLARSHIP FUNDING AMERICAN HEART ASSOCIATION PO BOX 4002902 DES MOINES IA 50340 135613797 501(C)(3) 8500 SUPPORT GENERAL OPERATIONS 4 PART I, LINE 2: THE ORGANIZATION'S GRANTS WERE MADE TO GOVERNMENTAL OR TAX EXEMPT, UNDER SECTION 501(C)(3), ORGANIZATIONS. THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. X X X 1 1 1 1 0 0 0 0 0 0 0 STEVEN BARNEY PT YR DIR & VICE PRES 0 354279 0 0 0 238164 0 -236820 0 12867 0 368490 0 0 LYNN BRUCHHOF PT YR DIRECTOR 0 426648 0 0 0 43230 0 44161 0 33183 0 547222 0 0 GAUROV DAYAL MD DIRECTOR 0 749382 0 0 0 25971 0 96224 0 28042 0 899619 0 0 MARGARET FOWLER PT YR DIRECTOR 0 324479 0 0 0 49612 0 58991 0 28210 0 461292 0 10592 PAULA FRIEDMAN DIRECTOR & VICE PRES 0 523635 0 0 0 73164 0 -2191 0 17680 0 612288 0 32970 PHILIP GUSTAFSON PT YR DIRECTOR 0 538937 0 0 0 101995 0 107724 0 26319 0 774975 0 0 THOMAS K LANGSTON PT YR DIRECTOR 0 502778 0 0 0 161686 0 112421 0 34793 0 811678 0 33880 JOE M HODGES PT YR DIRECTOR 0 633887 0 0 0 57112 0 -16778 0 33457 0 707678 0 31500 CHRISTOPHER HOWARD DIRECTOR 0 806003 0 0 0 87657 0 -1097 0 31003 0 923566 0 40320 MICHAEL R PANICOLA PT YR DIRECTOR 0 415203 0 0 0 38654 0 17361 0 25919 0 497137 0 9680 SHANE PENG MD DIRECTOR 0 520569 0 0 0 153864 0 39900 0 22943 0 737276 0 0 DIXIE L PLATT PT YR DIRECTOR 0 345892 0 0 0 244592 0 -19981 0 30077 0 600580 0 29890 WILLIAM P THOMPSON DIRECTOR & PRESIDENT 0 1404608 0 0 0 1016464 0 811381 0 30589 0 3263042 0 59150 KRIS A ZIMMER DIRECTOR & TREASURER 0 763126 0 0 0 73127 0 40169 0 27839 0 904261 0 45360 JUNE L PICKETT SECRETARY 0 226100 0 0 0 29954 0 -119886 0 23014 0 159182 0 8680 GRAY COX HOSPITAL PRESIDENT 0 285222 0 0 0 74049 260507 0 29040 0 289547 359271 19950 0 R BRENT VANCONIA HOSPITAL CEO 0 435074 0 0 0 53476 29877 0 32322 0 62199 488550 26810 0 JOCELYN SKIDMORE CFO 128338 0 0 0 6659 0 7622 0 10624 0 153243 0 4896 0 MARVIN KURTZ CFO 260000 0 0 0 34085 0 -46448 0 0 0 247637 0 0 0 SCOTT HOLMAN DO VP MEDICAL AFFAIRS 343844 0 0 0 26804 0 -7624 0 25211 0 388235 0 0 0 ANTHONY HOUSTON HOSPITAL COO 213186 0 0 0 18460 0 16087 0 21723 0 269456 0 0 0 JOHN LUCIO DO VP MEDICAL AFFAIRS 141650 0 0 0 17740 0 28100 0 1098 0 188588 0 0 0 SUSAN MANKOSKI HOSPITAL VP HR 179440 0 0 0 11044 0 34988 0 12811 0 238283 0 6640 0 THOMAS DISTEFANO PHYSICIAN 944117 0 0 0 40208 0 -63326 0 17047 0 938046 0 0 0 JOHN CLEMENS PHYSICIAN 464903 0 0 0 85329 0 102421 0 32263 0 684916 0 0 0 JANE DAWSON PHYSICIAN 462407 0 0 0 7781 0 -8360 0 13189 0 475017 0 0 0 COURTNYE WALKER PHYSICIAN 445033 0 0 0 20881 0 25745 0 26059 0 517718 0 0 0 SHIRLEY HARRIS PHYSICIAN 433039 0 0 0 24185 0 -15360 0 34653 0 476517 0 0 0 PART I, LINE 1A THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2013, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: SCOTT HOLMAN THOMAS DISTEFANO SHIRLEY HARRIS JOHN CLEMENS JANE DAWSON THE FOLLOWING INDIVIDUAL LISTED IN PART VII, SECTION A, RECEIVED HOUSING ALLOWANCE PAYMENTS IN 2013, WHICH WERE INCLUDED IN HIS TAXABLE COMPENSATION: MARVIN KURTZ THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A, RECEIVED REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2013, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: BRENT VANCONIA ANTHONY HOUSTON PART I, LINE 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, 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 SSMHC BOARD OF DIRECTORS. PART I, LINES 4A-B SEVERANCE PLAN: SSMHC 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 SSMHC. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENTS UNDER THE PLAN IN THE CURRENT YEAR. DIXIE PLATT $103,615 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: PENSION RESTORATION PLAN: SSM HEALTH CARE (SSMHC) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMHC 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 SSMHC'S 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 SSMHC OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMHC. NO REPORTABLE INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN DURING 2013. CAPITAL ACCUMULATION PLAN: SSMHC 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 SSMHC 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 2008 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF TWO 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 DISTRIBUTIONS FROM THIS PLAN IN 2013. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. STEVEN BARNEY $148,902 DIXIE PLATT $ 95,540 WILLIAM THOMPSON $ 59,209 CHRISTOPHER HOWARD $ 52,082 KRIS ZIMMER $ 45,405 GRAY COX $ 40,970 PHILIP GUSTAFSON $ 37,870 THOMAS LANGSTON $ 36,217 PAULA FRIEDMAN $ 33,003 JOE HODGES $ 31,531 BRENT VANCONIA $ 26,837 JUNE PICKETT $ 19,086 MICHAEL PANICOLA $ 12,277 SUSAN MANKOSKI $ 6,917 JOCELYN SKIDMORE $ 4,901 FORM 990, PART I, DOING BUSINESS AS: SSM REGIONAL HEALTH SERVICES CURRENTLY UTILIZES THE FOLLOWING FICTITIOUS NAMES: 1. ST. FRANCIS HOSPITAL & HEALTH SERVICES (EIN:44-0579850) A. ST. FRANCIS FAMILY HEALTH CARE - EAST B. ST. FRANCIS FAMILY HEALTH CARE - WEST C. ST. FRANCIS FAMILY LIFE SERVICES D. ST. FRANCIS GRANT CITY HEALTH CLINIC E. ST. FRANCIS HARDIN MEDICAL CLINIC F. ST. FRANCIS ORTHOPEDIC & SPORTS MEDICINE CLINIC G. ST. FRANCIS PRESCHOOL & CHILD CARE H. ST. FRANCIS WEST NODAWAY HEALTH CLINIC I. ST. FRANCIS HOSPITAL & HEALTH SERVICES - SAVANNAH CLINIC 2. ST. MARY'S HEALTH CENTER (EIN:44-0546097) A. COMPREHENSIVE WOUND HEALING CENTER AT ST. MARY'S B. ST. MARY'S CANCER SPECIALISTS C. ST. MARY'S HEALTH PSYCHOLOGY D. ST. MARY'S HOLTS SUMMIT PHARMACY E. ST. MARY'S MEDICAL CLINIC - BELLE F. ST. MARY'S MEDICAL CLINIC - HOLTS SUMMIT G. ST. MARY'S MEDICAL CLINIC - LINN H. ST. MARY'S MEDICAL CLINIC - TIPTON I. ST. MARY'S MEDICAL CLINIC - VERSAILLES J. ST. MARY'S MEDICAL PLAZA PHARMACY K. ST. MARY'S OCCUPATIONAL MEDICINE L. ST. MARY'S PEDIATRICS M. ST. MARY'S REHABILITATION N. ST. MARY'S SLEEP CENTER O. ST. MARY'S SPORTS MEDICINE & REHABILITATION CENTER P. ST. MARY'S TIPTON PHARMACY Q. ST. MARY'S URGENT CARE AT THE LAKE R. ST. MARY'S WESTPHALIA PHARMACY S. THE VASCULAR INSTITUTE AT ST. MARY'S T. SSM MID-MISSOURI FORM 990, PART III LINE 4A, DESCRIPTION OF PROGRAM SERVICE: BRIEFLY DESCRIBE THE CORPORATION'S MISSION: SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH CARE (SSMHC) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. AS OF NOVEMBER 15, 2013, WITH VATICAN APPROVAL, THE FRANCISCAN SISTERS OF MARY TRANSITIONED SPONSORSHIP OF SSMHC TO SSM HEALTH MINISTRIES. SSM HEALTH MINISTRIES IS AN INDEPENDENT 6-MEMBER BODY COMPRISED OF THREE FRANCISCAN SISTERS OF MARY AND THREE LAY PEOPLE WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMHC. HEADQUARTERED IN ST LOUIS, MISSOURI, SSMHC OWNS AND OPERATES 18 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, TWO LONG-TERM CARE FACILITIES, AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEALTH CARE BUSINESSES LOCATED PRIMARILY IN MISSOURI, OKLAHOMA, WISCONSIN, AND ILLINOIS. THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 30,000 PEOPLE AND IS AFFILIATED WITH MORE THAN 8,000 PHYSICIANS. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMHC STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. SSM REGIONAL HEALTH SERVICES INCLUDES ST FRANCIS HOSPITAL AND HEALTH SERVICES IN MARYVILLE, MISSOURI, ST. MARY'S HEALTH CENTER IN JEFFERSON CITY, MISSOURI AND A NETWORK OF PRIMARY CARE MEDICAL CLINICS AND SPECIALTY OFFERINGS SERVING JEFFERSON CITY AND SURROUNDING COMMUNITIES. DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: A COMMUNITY BENEFIT ACTIVITY IS IDENTIFIED AS A SERVICE RATHER THAN AS A MARKETING TOOL AND MEETS AT LEAST TWO OF THE FOLLOWING CRITERIA: - IT IS FINANCED BY PHILANTHROPIC CONTRIBUTIONS, VOLUNTEER EFFORTS, OR AN ENDOWMENT. - IT PROVIDES A RESPONSE TO A UNIQUE OR PARTICULAR HEALTH PROBLEM IN THE COMMUNITY. - IT GENERATES A LOW OR NEGATIVE MARGIN ON A FULLY ABSORBED COST BASIS. - IT RESPONDS TO THE NEEDS OF SPECIAL POPULATIONS SUCH AS MINORITIES, WOMEN AND CHILDREN, THE FRAIL ELDERLY, LOW INCOME PERSONS WITH DISABILITIES, THE MENTALLY ILL, OR THOSE LIVING WITH CHRONIC ILLNESS. - THE DECISION TO OFFER THE SERVICE OR PROGRAM IS NOT MADE ON A PURELY FINANCIAL BASIS. - IF NOT PROVIDED BY HEALTH CARE ORGANIZATION, THE SERVICE WOULD NO LONGER BE AVAILABLE IN THE COMMUNITY OR WOULD BE THE RESPONSIBILITY OF GOVERNMENT. THE COMMUNITY BENEFIT PLAN DETAILS THE PLANNING, MEASUREMENT AND COMMUNICATION OF ITS COMMUNITY BENEFITS. THE THREE-MAIN ASPECTS OF COMMUNITY BENEFIT BEING THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH DETERMINES THE COMMUNITY NEEDS TO BE ADDRESSED BY THE HOSPITAL, THE COMMUNITY BENEFIT PLAN WHICH DETAILS STEPS TO BE ACCOMPLISHED TO MEET IDENTIFIED NEEDS, AND THE CBISA DATABASE WHICH DOCUMENTS ALL OF THE COMMUNITY BENEFIT ACTIVITIES FOR EACH YEAR. AT THE END OF EACH YEAR, THE CBISA COMMUNITY BENEFIT REPORT IS GIVEN TO MANAGEMENT, ADMINISTRATION AND THE SSMHC BOARD OF DIRECTORS IN ORDER TO EVALUATE AND IMPROVE THE PROGRAM. ST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MO: ONE OF THE FIRST STEPS FOR IDENTIFYING THE HIGH-PRIORITY HEALTH NEEDS OF OUR COMMUNITY IS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A SUMMARY OF THE ST FRANCIS HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CAN BE FOUND ON PAGES 4 AND 5 OF ITS CHNA. THE TWO STRATEGIC PRIORITIES OF THE ST FRANCIS HOSPITAL COMMUNITY BENEFIT PLAN ARE: MENTAL HEALTH SERVICES FOR YOUTH AND ADOLESCENTS, AND OBESITY. DURING 2013, GOALS AND OBJECTIVES WERE ESTABLISHED TO CHANGE BEHAVIOR, PROVIDE METRICS TO MEASURE CHANGE, AND TO IMPACT THE OVERALL HEALTH OF THOSE WE SERVE. ALL OF THE COMMUNITY BENEFIT ACTIVITIES ARE DESIGNED TO MEET THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH WAS COMPLETED IN OCTOBER 2012. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO: ST. MARY'S HEALTH CENTER CO-SPONSORED A 2012 COMMUNITY HEALTH NEEDS ASSESSMENT FOR A FOUR-COUNTY REGION IN CENTRAL MISSOURI THAT INCLUDES COLE, MILLER, MONITEAU AND OSAGE COUNTIES. THE CENTRAL MISSOURI HEALTH ASSESSMENT PARTNERSHIP FORMULATES INITIATIVES WITH MEMBER ORGANIZATIONS, INCLUDING THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI (A FEDERALLY QUALIFIED HEALTH CENTER), COLE COUNTY HEALTH DEPARTMENT, THE UNITED WAY OF CENTER MISSOURI, SAMARITAN CENTER OF JEFFERSON CITY, AS WELL AS CAPITAL REGION MEDICAL CENTER. A SUMMARY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CAN BE FOUND ON PAGE 4 OF THE CHNA. THE THREE STRATEGIC PRIORITIES OF THE ST MARY'S HEALTH CENTER COMMUNITY BENEFIT PLAN ARE: DIABETES, CANCER AND HEART DISEASE. DURING 2013, GOALS AND OBJECTIVES WERE ESTABLISHED TO CHANGE BEHAVIOR, PROVIDE METRICS TO MEASURE CHANGE, AND TO IMPACT THE OVERALL HEALTH OF THOSE WE SERVE. ALL OF THE COMMUNITY BENEFIT ACTIVITIES ARE DESIGNED TO MEET THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH WAS COMPLETED IN AUGUST 2012. DESCRIBE THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICIES OR PROGRAMS (E.G., CHARITY CARE, DISCOUNTING) FOR LOW-INCOME PERSONS AND HOW THEY ARE COMMUNICATED TO THE PUBLIC. ALL SSMHC FACILITIES WILL STRIVE TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF SSMHC, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMHC FACILITIES OFFER DISCOUNTS FOR HOSPITAL SERVICES TO ALL UNINSURED PERSONS. SELF-PAY DISCOUNTS APPLY TO EVERYONE WHO DOES NOT HAVE HEALTH INSURANCE, NO MATTER THEIR ABILITY TO PAY. SSMHC WILL APPLY ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMHC EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT IF THEIR BALANCE DUE EXCEEDS 20% OF THEIR GROSS FAMILY INCOME. EACH ENTITY PROVIDING MEDICAL SERVICES 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 COMMUNICATIONS 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 WILL BE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. THEY WILL 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 - WHOM TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING. THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC SHALL BE 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 WILL ALSO BE PROVIDED TO PUBLIC AGENCIES. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION: EACH OF THE HOSPITALS OF SSM REGIONAL HEALTH SERVICES: - 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 DIVISIONAL BOARD OF DIRECTORS 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 GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. - SSM REGIONAL HEALTH SERVICES IS COMMITTED TO PROVIDING A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM WHICH INCLUDES THE REINVESTMENT OF SURPLUS FUNDS. A ST. MARY'S HEALTH CENTER REPLACEMENT HOSPITAL IS UNDER CONSTRUCTION AND IS SCHEDULED TO OPEN IN 2014. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: ST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MO DIABETES EDUCATION: DEB HULL, DIABETES EDUCATOR, CONTINUED HER EFFORTS TO INFORM AND RAISE AWARENESS ABOUT DIABETES. IN 2013, DEB PRESENTED INFORMATION TO OVER 350 SCHOOL AND COMMUNITY MEMBERS ABOUT THE RISK OF DEVELOPING TYPE 2 DIABETES AND HOW IT CAN BE SIGNIFICANTLY REDUCED THROUGH EXERCISE AND MODEST WEIGHT LOSS. PRESENTATIONS INCLUDED INFORMATION ABOUT THE DISEASE, PREVENTION, TREATMENT, SIGNS AND SYMPTOMS AND TIPS ON HANDLING THE DISEASE. IN ADDITION, THE HOSPITAL HOSTED MONTHLY DIABETES SUPPORT GROUP MEETINGS. HEALTH PROFESSIONALS EDUCATION: IN COLLABORATION WITH MISSOURI AREA HEALTH EDUCATION CENTERS AND THE UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE, ST. FRANCIS ACCOMMODATED MEDICAL STUDENTS IN AN OPPORTUNITY TO HELP THEM EXPLORE FIRST-HAND THE PROSPECTS AWAITING THEM IN A RURAL AND OUTREACH POPULATIONS. THE PROGRAM INCLUDED PHYSICIAN INVOLVEMENT TO OVERSEE THE STUDENT LEARNING AS WELL AS HOUSING WITH MAINTENANCE AND HOUSEKEEPING AND INTERNET-BASED EQUIPMENT AND FACILITIES TO CONDUCT CHATS WITH UNIVERSITY INSTRUCTORS ON A REGULAR BASIS. IN COLLABORATION WITH NORTH CENTRAL MISSOURI COLLEGE AND IOWA WESTERN COMMUNITY COLLEGE, ST FRANCIS HOSTED OVER 120 RN AND LPN STUDENTS DURING 2013. THE STUDENTS WERE PROVIDED MENTORING THROUGH A JOB SHADOW PROGRAM WITH HOSPITAL STAFF. IN ADDITION, THE HOSPITAL PROVIDED PROFESSIONAL EDUCATION TO SPECIALTY STUDENTS IN THE AREAS OF DIETICIANS, EMT, SURGERY TECHNICIANS, PHARMACY, SOCIAL WORK AND PHYSICAL THERAPY. COMMUNITY HEALTH SCREENINGS: IN RESPONSE TO THE HIGH DEATH RATE FOR STROKES IN NODAWAY COUNTY (70.7 PER 100,000) COMPARED TO THE STATE AVERAGE (62.6/100,000) PLUS A LOWER THAN AVERAGE HOSPITALIZATION RATE, ST. FRANCIS HOSPITAL AND HEALTH SERVICES DEVELOPED A COMMUNITY HEALTH SCREENINGS INITIATIVE IN COLLABORATION WITH THE NODAWAY COUNTY HEALTH DEPARTMENT, SCHOOLS AND OTHER HEALTH FAIR OR SCREENING PARTNERS. THE INITIATIVE IMPACTS THE HEALTH STATUS OF RESIDENTS AND PATIENTS BY INCREASING THE NUMBER OF COMMUNITY SCREENINGS TO IDENTIFY THE AT-RISK POPULATION FOR STROKE. IN 2013, THE HOSPITAL HELD 14 HEALTH SCREENINGS WITH OVER 725 PARTICIPANTS. HEALTH EDUCATION: TO PROVIDE BETTER HEALTH EDUCATION TO COMMUNITY MEMBERS, HOSPITAL EMPLOYEES PROVIDE CPR TRAINING AT VARIOUS EVENTS AND PROVIDED HEALTH LIFESTYLES FOLLOW-UP SESSIONS. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO ST. MARY'S FINANCIAL ASSISTANCE PROGRAM: ST. MARY'S PROVIDED ASSISTANCE TO PATIENTS IN APPLYING FOR MEDICAID AND OTHER SERVICES. SMHC FOUNDATION MEDICATION ASSISTANCE FUND: THIS PROGRAM PROVIDES AID TO THOSE IN NEED BY OFFERING SHORT-TERM MEDICATION ASSISTANCE TO PATIENTS WHO CANNOT AFFORD PRESCRIPTION MEDICINE, AND CANNOT OBTAIN IT IN A TIMELY MANNER FROM ANOTHER AGENCY. THIS PROGRAM SUPPORTS THE POOR, UNINSURED AND IS AVAILABLE TO THE URBAN AND RURAL DEMOGRAPHIC. SPORTS MEDICINE OUTREACH PROGRAM: ST MARY'S HEALTH CENTER PROVIDES ATHLETIC TRAINERS TO SEVERAL AREA HIGH SCHOOL'S SPORTING EVENTS IN CASE OF INJURY. HEALTH PROFESSIONAL EDUCATION: ST MARY'S HEALTH CENTER PROVIDES LOCAL NURSING AND PHARMACY STUDENTS MENTORING OPPORTUNITIES IN VARIOUS CLINICAL DEPARTMENTS OF THE HOSPITAL. EDUCATION: ST MARY'S MISSION EFFECTIVENESS DEPARTMENT PROVIDES MONTHLY EDUCATION SESSIONS TO THE COMMUNITY ON END-OF-LIFE ISSUES. ST MARY'S PROVIDES BASIC LIFE SUPPORT OF ADULT, CHILD AND INFANTS, AND FAMILY AND FRIENDS WHICH IS A COURSE FOR LAYPERSONS TO KNOW WHAT TO DO UNTIL EMERGENCY HELP ARRIVES ON THE SCENE. ST MARY'S WOMEN'S SERVICES DEPARTMENT PROVIDES CHILDBIRTH EDUCATION CLASSES, REFRESHER CLASSES, SUPERSIBLING CLASSES AND BREASTFEEDING EDUCATION CLASSES. TRAINING RESOURCES FOR DISADVANTAGED YOUTH: THIS PROGRAM IS A TRAINING PROGRAM THAT PROVIDES LEARNING CHALLENGED HIGH SCHOOL STUDENTS AN OPPORTUNITY TO BUILD VALUABLE EXPERIENCE AND LIFE SKILLS BY WORKING AT THE HOSPITAL. THE PROGRAM SUPPORTS LEARNING DISADVANTAGED, OFTEN ECONOMICALLY CHALLENGED YOUTH IN OUR COMMUNITY, AS WELL AS SUPPORTS A COMMUNITY PARTNERSHIP WITH THE LOCAL HIGH SCHOOL. LINCOLN UNIVERSITY SCHOOL OF NURSING: ST. MARY'S PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $60,407 TO THE NURSING PROGRAM AS WELL AS PROVIDING A CLINICAL SETTING FOR THE RN STUDENTS TO LEARN. QUANTIFIABLE COMMUNITY BENEFIT THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS COMMUNITY BENEFIT ACTIVITIES. TRADITIONAL CHARITY CARE $ 4,953,249 UNPAID COST OF MEDICARE $16,060,744 UNPAID COST OF MEDICAID $ 1,245,448 COST OF BAD DEBT $ 7,090,602 COMMUNITY BENEFIT PROGRAMS $ 604,859 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $29,954,902 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE CORPORATION. SSM HEALTH CARE CORPORATION IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH SSM REGIONAL HEALTH SERVICES AND SSM HEALTH CARE CORPORATION ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND APPOINT AND REMOVE THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE MEMBER OF THE MEMBER AS DETERMINED BY THE MEMBER OF THE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTING/FINANCE PERSONNEL AT EACH SSMHC (SSM HEALTH CARE SYSTEM) ENTITY, IN CONJUNCTION WITH SYSTEM FINANCE PERSONNEL, PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE SYSTEM OFFICE FOR FINAL REVIEW AND COORDINATION OF THE SYSTEM LEVEL FORM 990 INFORMATION. THE INFORMATION IS SUBMITTED TO AN OUTSIDE TAX CONSULTING FIRM WHO PREPARES AND SIGNS THE FORM 990 FROM THE SSMHC INFORMATION. PRIOR TO FINALIZING THE RETURN, A DRAFT IS SENT TO PERSONNEL AT SSMHC FOR REVIEW AND APPROVAL. UPON SSMHC APPROVAL, THE OUTSIDE PREPARER FORWARDS THE COMPLETED FORM 990 FOR THE APPROPRIATE SIGNATURES AND FILING ACTION. A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO 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, SECTION C, LINE 19 THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENT FOR THE SSM HEALTH CARE SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH CARE'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 XI, LINE 9: BENEFICIAL INTEREST IN FOUNDATION 1,139,400. TRANSFER TO AFFILIATES 304,774. 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