2013-11-15T22:37:45-06:00 2012-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 770022591 990 2012-01-01 466029223 SSM HEALTH CARE CORPORATION SSMH 3145238759 477 N LINDBERGH BLVD ST LOUIS MO 63141 JUNE L PICKETT 3145238759 2013-11-15 1 BROOKE KITCHEN P00849302 7139822000 2012 2016-03-07 17:11:31Z SEE SCHEDULE O WILLIAM THOMPSON 477 N LINDBERGH BLVD ST LOUIS MO 63141 194068959 0 0928 X HTTP://WWW.SSMHC.COM X 1874 MO SEE SCHEDULE O 9 8 1404 8 149729 0 0 0 32097467 91422721 106502846 86376459 9772412 16098354 148372725 193897534 152060 62850 0 0 26437884 64361867 0 0 0 68942543 79256332 95532487 143681049 52840238 50216485 2089501611 2320835992 2274010034 2413305309 -184508423 -92469317 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 101508620 62850 91422721 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. 101508620 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 2405 0 1 1404 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X DONNA WALLACE 3145238793 12312 OLIVE BLVD SUITE 600 ST LOUIS MO 63141 SR ROSE DOWLING FSM 1.00 0.00 X 0 0 0 SR IRMA KENNEBECK FSM 1.00 0.00 X 0 0 0 JOHN MOTEN 1.00 0.00 X 0 0 0 THOMAS M NOONAN 1.00 0.00 X 0 0 0 SR MARGE O'GORMAN FSM 1.00 0.00 X 0 0 0 SR MARY JEAN RYAN FSM 40.00 0.00 X X 0 0 0 SR SUSAN SCHOLL FSM 1.00 0.00 X 0 0 0 SR SANDRA SCHWARTZ FSM 1.00 0.00 X 0 0 0 WILLIAM P THOMPSON 40.00 1.00 X X 2161601 0 1088396 KRIS A ZIMMER 40.00 1.00 X 837428 0 257469 JUNE L PICKETT 40.00 1.00 X 240525 0 353818 STEVEN BARNEY 40.00 1.00 X 779380 0 231364 CHRISTOPHER HOWARD 1.00 40.00 X 873195 0 368042 DIXIE PLATT 40.00 0.00 X 514403 0 242813 PHILIP GUSTAFSON 1.00 40.00 X 646285 0 156679 THOMAS LANGSTON 1.00 40.00 X 640985 0 293527 PAULA FRIEDMAN 40.00 1.00 X 598630 0 294336 JOE HODGES 1.00 40.00 X 705117 0 313970 SHERILYN HAILSTONE 1.00 40.00 X 640496 0 181620 FRANK BYRNE 1.00 40.00 X 614855 0 187531 GAUROV DAYAL 40.00 0.00 X 582134 0 61107 ROBERT PORTER 0.10 40.00 X 555984 0 245011 PATRICE KOMOROSKI 1.00 40.00 X 507529 0 66497 WILLIAM SCHOENHARD 0.10 0.00 X 274197 0 676363 11172744 0 5018543 90 1 1 0 CATHOLIC HEALTHCARE AUDIT NETWORK 231 S BEMISTON ST LOUIS MO 63105 INTERNAL AUDIT SERVICES 2341716 CONVERGENT REVENUE CYCLE 13575 HEATHCOTE BLVD STE 300 GAINESVILLE VA 20155 COLLECTION AGENCY 2197144 DELOITTE & TOUCHE LLP 100 S 4TH STREET SUITE 300 ST LOUIS MO 63102 CONSULTING AND AUDIT SERVICES 1995735 CYMETRIX CORP 2875 MICHELLE DRIVE STE 250 IRVINE CA 92606 COLLECTION AGENCY 1190066 MEDICAL REIMBURSEMENTS OF AMERICA LLC 7105 MOORES LANE BRENTWOOD TN 37027 COLLECTION AGENCY 1181316 50 CORPORATE FEES 561000 70822550 70822550 INSURANCE FEES 525100 15613431 15613431 OTHER OPERATING REV. 519100 2603479 2603479 MANAGEMENT FEES 561000 2383261 2383261 91422721 63967469 63967469 22213810 366605 0 171425 22213810 195180 22408990 22408990 JOINT VENTURE INCOME 900099 11481906 149729 11332177 OTHER INCOME 900099 4616448 4616448 16098354 193897534 91422721 149729 102325084 X 62850 62850 4794957 4794957 45262984 25869183 19393801 4563152 2693460 1869692 6486972 3913140 2573832 3253802 1984544 1269258 528119 528119 341288 341288 17778417 12800041 4978376 40900 40900 2661538 803458 1858080 4875259 2891622 1983637 2407055 1127211 1279844 1375331 243031 1132300 93021 13323 79698 42548164 42548164 1349275 625852 723423 25397 25397 BOND RELATED FEES 4094784 4094784 LOSS ON EARLY EXTINGUIS 1125229 1125229 LICENSES AND TAXES 12555 12555 143681049 101508620 42172429 0 66737404 3798052 7572171 782741318 866964292 896072 1069058 12327016 5357633 9312123 6969383 1201008487 1280374148 82490571 83380565 9254988 7768971 2089501611 2320835992 170878735 191071567 1141026088 1223194661 37000000 962105211 962039081 2274010034 2413305309 X -184526468 -92488802 1045 2485 17000 17000 -184508423 -92469317 2089501611 2320835992 X 50216485 62484713 -20662092 X 0 1 X 1 0 X X X 0 0 0 SSM HEALTH CARE ST LOUIS 431343281 3 1 0 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 430738490 3 1 0 SSM HEALTH CARE OF WISCONSIN INC 430688874 3 1 0 SSM HEALTH CARE OF OKLAHOMA INC 730657693 3 1 0 SSM REGIONAL HEALTH SERVICES 440579850 3 1 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 430653587 3 1 0 ST MARY'S HOSPITAL 370662580 3 1 0 ST ANTHONY SHAWNEE HOSPITAL INC 455055149 3 1 0 8 0 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SSM HEALTH CARE CORPORATION (SSMHC) IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED EXCLUSIVELY TO SUPPORT THE OPERATIONS OF ALL ITS RELATED ORGANIZATIONS LISTED ON SCHEDULE A, PART I, LINE 11(H). THE AMOUNT OF SUPPORT PROVIDED TO THESE ORGANIZATIONS, REPORTED ON SCHEDULE A, PART I, LINE 11(H)(VII), DOES NOT INCLUDE EXPENSES PAID ON BEHALF OF BUT NOT DIRECTLY TO THE ENTITIES SSMHC SUPPORTS. THESE EXPENSES TOTALED $143,681,048 DURING THE YEAR ENDED DECEMBER 31, 2012. 0 1 0 1 149232 0 0 1 157977 0 0 307209 0 18046 1439 19485 28289 1046 11289 18046 26092 2197 28289 22624 3468 26092 22624 22624 0.87000 0.13000 0 0 2014663 1605216 409447 5972146 3752417 2219729 4340207 4340207 6969383 CAPITAL LEASE OBLIGATION 17246204 DEFERRED COMPENSATION 74880623 SWAPS MARK TO MARKET LIABILITY 135154155 RABBI TRUST LIABILITY 34509497 PENSION LIABILITY 679820602 ESTIMATED HEALTH CARE CLAIMS 20428000 962039081 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SSMHC'S ENDOWMENT FUNDS ARE TO BE USED TO DEFRAY THE COSTS OF AN ANNUAL EXECUTIVE LEVEL MANAGEMENT MEETING. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: SSM HEALTH CARE CORPORATION 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 2012 OR 2011. 1 MALCOLM BALDRIGE NATIONAL QUALITY AWARD FOUNDATION 165 SUMMIT RIDGE MARYVILLE IL 62062 390912502 501(C)(3) 25000 TO SUPPORT THE QUALITY AWARD PROGRAM SSM CARDINAL GLENNON CHILDREN'S HOSPITAL FOUNDATION 1465 S GRAND ST LOUIS MO 63104 430738490 501(C)(3) 10000 TO SUPPORT THE BOB COSTAS CANCER CENTER URBAN LEAGUE OF METROPOLITAN ST LOUIS INC 3701 GRANDEL SQUARE ST LOUIS MO 63118 430653605 501(C)(3) 5000 TO SUPPORT ORGANIZATION'S ACTIVITIES 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION'S GRANTS WERE MADE TO ORGANIZATIONS TAX EXEMPT UNDER IRC SECTION 501 (C)(3). THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. X X 1 1 X X X 1 1 0 0 0 0 0 0 0 WILLIAM P THOMPSON 1321845 0 0 0 839756 0 1051531 0 36865 0 3249997 0 57960 0 KRIS A ZIMMER 737296 0 0 0 100132 0 227242 0 30227 0 1094897 0 43820 0 JUNE L PICKETT 220007 0 0 0 20518 0 331433 0 22385 0 594343 0 8280 0 STEVEN BARNEY 623277 0 0 0 156103 0 208024 0 23340 0 1010744 0 0 0 CHRISTOPHER HOWARD 735141 0 0 0 138054 0 337445 0 30597 0 1241237 0 37660 0 DIXIE PLATT 446837 0 0 0 67566 0 212494 0 30319 0 757216 0 29050 0 PHILIP GUSTAFSON 535571 0 0 0 110714 0 121551 0 35128 0 802964 0 35700 0 THOMAS LANGSTON 490608 0 0 0 150377 0 259942 0 33585 0 934512 0 31500 0 PAULA FRIEDMAN 479732 0 0 0 118898 0 277027 0 17309 0 892966 0 32340 0 JOE HODGES 621033 0 0 0 84084 0 286178 0 27792 0 1019087 0 29120 0 SHERILYN HAILSTONE 518118 0 0 0 122378 0 156452 0 25168 0 822116 0 35840 0 FRANK BYRNE 512174 0 0 0 102681 0 157533 0 29998 0 802386 0 32130 0 GAUROV DAYAL 456746 0 0 0 125388 0 45500 0 15607 0 643241 0 0 0 ROBERT PORTER 439830 0 0 0 116154 0 219237 0 25774 0 800995 0 29190 0 PATRICE KOMOROSKI 75945 0 0 0 431584 0 64189 0 2308 0 574026 0 27790 0 WILLIAM SCHOENHARD 0 0 0 0 274197 0 662169 0 14194 0 950560 0 0 0 SUPPLEMENTAL INFORMATION PART III PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2012. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. WILLIAM THOMPSON KRIS ZIMMER CHRISTOPHER HOWARD DIXIE PLATT THOMAS LANGSTON PAULA FRIEDMAN JOE HODGES SHERLYN HAILSTONE FRANK BYRNE ROBERT PORTER THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2012. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. FRANK BYRNE STEVEN BARNEY CHRISTOPHER HOWARD DIXIE PLATT JOE HODGES PATRICE KOMOROSKI ROBERT PORTER PART I, LINE 4A: 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 INDIVIDUALS RECEIVED PAYMENTS UNDER THE PLAN IN THE CURRENT YEAR: WILLIAM SCHOENHARD $277,333 PATRICE KOMOROSKI $365,500 PART I, LINE 4B: 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 2012. 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 2012. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. STEVEN BARNEY $74,677 PHILIP GUSTAFSON $73,610 WILLIAM THOMPSON $58,026 PATRICE KOMOROSKI $56,806 CHRISTOPHER HOWARD $48,612 KRIS ZIMMER $43,871 SHERLYN HAILSTONE $37,177 THOMAS LANGSTON $35,638 ROBERT PORTER $33,412 DIXIE PLATT $33,330 PAULA FRIEDMAN $32,376 FRANK BYRNE $32,167 JOE HODGES $29,154 JUNE PICKETT $8,289 A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635R2Z9 2008-05-15 100851259 TO FINANCE VARIOUS CAPITAL IMPROVEMENTS 0 0 0 B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635RV20 2005-07-21 555100000 SEE PART VI 0 0 0 C HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635R7B7 2010-05-13 450254794 SEE PART VI 0 0 0 D WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BUX8 2010-05-13 125000551 TO FINANCE VARIOUS CAPITAL IMPROVEMENTS 0 0 0 A 100851259 100851259 2009 0 0 1 1 B 321475000 629030476 6776384 122495329 499758763 2008 0 1 1 1 C 97455000 452649653 244374 165003260 287402019 2010 1 1 0 1 D 3080000 125438268 125438268 2011 0 0 0 1 A 0 1 1 1 1 1 0.00860 0.00860 0 0 1 B 0 1 1 1 1 1 0.01070 0.01070 0 0 1 C 0 1 1 1 1 1 0.01230 0.01230 0 0 1 D 0 1 1 1 1 1 0.03000 0.03000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 1 1 PNC UNION BANK & CITIBANK 27.900000000000 0 1 0 1 1 C 0 0 0 1 1 0 0 1 1 D 0 0 0 1 1 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K SUPPLENTAL INFORMATION PART II LINE 3: TOTAL PROCEEDS OF ISSUE EXCEED THE AMOUNT SHOWN IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS FROM THE PROJECT FUND AND/OR THE REFUNDING ESCROW. PART II LINE 11: OTHER SPENT PROCEEDS INCLUDE INVESTMENT EARNINGS IN THE REFUNDING ESCROW. PART IV LINE 3C: THE TERMS OF THE HEDGES SHOWN REFLECT THE ORIGINAL TERMS, NOT ADJUSTED FOR THE EARLY TERMINATION. PART IV LINE 5 COLUMN C: GROSS PROCEEDS WERE HELD IN A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW. SCHEDULE K, PART I, LINE B HEALTH & EDUCATION FACILITIES AUTHORITY OF THE STATE OF MISSOURI (1) TO FINANCE CAPITAL IMPROVEMENTS AND (2) TO REFUND SERIES 1998A BONDS, ISSUED 5/20/1998 AND SERIES 2001A BONDS, ISSUED 5/22/2001. SCHEDULE K, PART I, LINE C HEALTH & EDUCATION FACILITIES AUTHORITY OF THE STATE OF MISSOURI (1) TO FINANCE VARIOUS CAPITAL EQUIPMENT AND IMPROVEMENTS AND (2) TO REFUND SERIES 2001A BONDS ISSUED ON 5/22/2001, SERIES 2005AB BONDS ISSUED ON 7/21/2005, AND SERIES 2005CD BONDS ISSUED 7/21/2005. ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION'S MISSION: THE ORGANIZATION IS THE PARENT OF THE SSM HEALTH CARE SYSTEM. THE ORGANIZATION PROVIDES MANAGEMENT AND CENTRALIZED SUPPORT SERVICES TO THE HOSPITALS AND OTHER HEALTH CARE ORGANIZATIONS WITHIN THE SYSTEM. FORM 990, PART I, DOING BUSINESS AS: SSM HEALTH CARE CORPORATION CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES: SSM HEALTH CARE SSM HEALTH CARE CORPORATE ARCHIVES SSM SUPPORT SERVICES PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A: BRIEFLY DESCRIBE THE ORGANIZATION'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. SPONSORED BY THE FRANCISCAN SISTERS OF MARY AND HEADQUARTERED IN ST. LOUIS, MO, SSMHC OPERATES 18 HOSPITAL LOCATIONS, TWO SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES IN FOUR STATES (WISCONSIN, OKLAHOMA, ILLINOIS, AND MISSOURI). THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 25,600 PEOPLE AND IS AFFILIATED WITH MORE THAN 6,600 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. DESCRIBE THE TAX-EXEMPT PURPOSE ACHIEVEMENTS: SSMHC'S CORPORATE OFFICE PROVIDES SERVICES TO ALL SSMHC FACILITIES. THESE SERVICES INCLUDE THE FOLLOWING: IMPLEMENTATION AND OPTIMIZATION OF A COMMON PLATFORM OF CARE FOR SSMHC FACILITIES; SUPPORT AND IMPLEMENTATION OF THE ELECTRONIC HEALTH RECORDS AT SSMHC HOSPITALS AND FACILITIES; EVALUATION AND CONSULTATION OF NEW GROWTH STRATEGIES AND OPPORTUNITIES; COMMUNICATIONS COUNSEL, STRATEGY AND PLANNING; OVERSIGHT OF THE MISSION AWARENESS TEAMS AND SPIRITUAL CARE DEPARTMENTS; HIGH-LEVEL CORPORATE RESPONSIBILITY PROCESS OVERSIGHT TO ENSURE ETHICAL AND LEGAL COMPLIANCE; ORGANIZATIONAL AND CLINICAL ETHICS EDUCATION; AND POLICY WRITING AND REVIEW AND PATIENT BILLING SERVICES. OTHER SERVICES INCLUDE CAPITAL PLANNING AND ALLOCATION; STRATEGIC, FINANCIAL AND HUMAN RESOURCE PLAN PREPARATION; INVESTMENT MANAGEMENT AND DEBT FINANCING; SYSTEM-LEVEL INTERNAL AND EXTERNAL FINANCIAL REPORTING; TAX COMPLIANCE PROCESS MANAGEMENT; EMPLOYEE BENEFITS ADMINISTRATION; EDUCATIONAL PROGRAM OFFERINGS FOR LEADERSHIP DEVELOPMENT; AND RISK MANAGEMENT STRATEGIES. DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: SSM HEALTH CARE'S CORPORATE OFFICE OVERSEES COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM. THE 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 (HCIS). 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. COMMUNITY HEALTH IMPROVEMENT, WHICH WE PURSUE AS A SYSTEM PRIMARILY THROUGH HCIS UNDERTAKEN AT THE ENTITY LEVEL, IS FUNDAMENTAL TO OUR MISSION, VALUES, AND VISION. OVER THE YEARS MANY PEOPLE HAVE BENEFITED FROM OUR HCIS AND MUCH GOOD HAS COME FROM THEM. IN AN EFFORT TO BEST RESPOND TO COMMUNITY NEEDS, HCIS HAS REFOCUSED ITS EFFORTS TOWARD A NEW APPROACH TO COMMUNITY HEALTH, AS OUTLINED HERE. IN ADDITION TO THE HEALTHY COMMUNITIES' INITIATIVES, EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TO SUPPORT THE COMPLETION OF A CHNA IN ACCORDANCE WITH ESTABLISHED GUIDELINES, A SIX-STEP PROCESS WAS DEVELOPED. THE PROCESS DEFINES AN APPROACH THAT CAN BE USED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY SSM HEALTH CARE AND DEVELOP STRATEGIES FOR MEETING THOSE NEEDS. THE PROCESS INCLUDES: -DEVELOP A PLAN TO ADDRESS HEALTH REFORM MANDATES TO INCLUDE DEFINING HOW THE ASSESSMENT AND BY WHOM THE ASSESSMENT WILL BE COMPLETED; IDENTIFYING THE STAKEHOLDERS INVOLVED AND THE TIME FRAME FOR COMPLETION -PERFORM DATA COLLECTION INCLUDING IDENTIFYING THE GEOGRAPHIC AREA SERVED, ACCESSING SECONDARY DATA SOURCES AND COORDINATING INTERVIEWS, SURVEY AND/OR FOCUS GROUPS FOR PRIMARY DATA COLLECTION -PERFORM DATA ANALYSIS BY EVALUATING QUANTITATIVE AND QUALITATIVE DATA TO IDENTIFY AND PRIORITIZE HEALTH NEEDS AND OPPORTUNITIES -CREATE A PLAN WITH GOALS, STRATEGIES, ACTIONS, DUE DATES, AND RESOURCE REQUIREMENTS WHICH INCLUDES INPUT FROM CONSTITUENTS -OBTAIN APPROVAL FROM SYSTEM MANAGEMENT TO BE ADOPTED IN 2012 AND INCORPORATE THE CHNA INITIATIVES INTO THE STRATEGIC PLAN TO INCLUDE APPOINTING RESPONSIBILITY FOR IMPLEMENTING THE PLAN AND ASSIGNING A STEERING COMMITTEE TO MONITOR PROGRESS AS APPROPRIATE -COORDINATE COMMUNICATION TO THE PUBLIC, BOARDS, STAFF AND OTHER STAKEHOLDERS PROGRESS IN ADDRESSING TOP PRIORITIES IMPACTING COMMUNITY HEALTH IN COLLABORATION WITH OUR COMMUNITY PARTNERS, ALL SSM HEALTH CARE HOSPITAL FACILITIES COMPLETED THEIR CHNA IN 2012. THE ASSESSMENTS HAVE BEEN APPROVED BY SSMHC MANAGEMENT AND INCLUDED AS PART OF OUR STRATEGIC PLAN. 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 IT PARTICIPATES 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 IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. FORM 990, PART III, LINE 4A: 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 FLYERS 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: SSMHC HOSPITALS: -OPERATE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; -HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; -HAVE A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY; -ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS; -PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: 1. SSM'S CORPORATE OFFICE DEMONSTRATED ITS COMMITMENT TO PRESERVING THE ENVIRONMENT BY PARTICIPATING IN A COLLECTION/RECYCLING EVENT FOR COMPUTERS AND OTHER ELECTRONICS WHICH WERE DONATED TO WEB INNOVATIONS & TECHNOLOGY SERVICES, A LOCAL NON-PROFIT ORGANIZATION WHICH REPAIRS AND RECYCLES ELECTRONICS, AND PROVIDES EMPLOYMENT, EDUCATION AND FREE COMPUTERS TO SCHOOLS AND CHURCHES WHICH OTHERWISE COULD NOT AFFORD THESE ITEMS. 2. STAFF MEMBERS CONTRIBUTED THEIR TIME TO THE ST. LOUIS REGIONAL COMMERCE AND GROWTH ASSOCIATION, INCLUDING THEIR PUBLIC POLICY COMMITTEE. THE ORGANIZATION UNITES THE ST. LOUIS REGION'S BUSINESS COMMUNITY TO DEVELOP AND SUSTAIN A WORLD-CLASS ECONOMY AND COMMUNITY. 3. STAFF MEMBERS CONTRIBUTED THEIR TIME TO ASSOCIATED INDUSTRIES OF MISSOURI, A GROUP THAT BELIEVES THAT THE TRANSPORTATION SYSTEM IN MISSOURI DEMANDS CONTINUING CARE AND ATTENTION BECAUSE IT IS VITAL TO THE STATE'S ECONOMIC WELFARE AND QUALITY OF LIFE. 4. SSM STAFF SERVE ON THE BOARD OF LEADING AGE MISSOURI, AN ORGANIZATION THAT SERVES THE NEEDS OF PROVIDERS OF HEALTH CARE HOUSING AND SERVICES FOR MISSOURI'S ELDERLY. 5. STAFF MEMBERS CONTRIBUTE THEIR TIME TO THE LEADERSHIP COUNCIL SOUTHWESTERN ILLINOIS. THIS ORGANIZATION HAS BEEN THE PREMIER ECONOMIC DEVELOPMENT ORGANIZATION FOR MADISON AND ST CLAIR COUNTIES SINCE 1983. THEIR MISSION IS TO ATTRACT AND RETAIN JOBS, STIMULATE CAPITAL INVESTMENT, AND PROMOTE THE ECONOMIC DEVELOPMENT OF SOUTHWESTERN ILLINOIS BY BUILDING EFFECTIVE PARTNERSHIPS WITH LEADERS IN BUSINESS, INDUSTRY, GOVERNMENT, EDUCATION AND LABOR. 6. SSM'S CORPORATE OFFICE HELD A COMMUNITY BENEFIT FORUM TO BRING TOGETHER COMMUNITY BENEFIT PERSONNEL FOR TWO DAYS OF TRAINING ON COMMUNITY BENEFIT REPORTING. TOPICS INCLUDED HOW TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT, REPORTING COMMUNITY BENEFITS TO THE INTERNAL REVENUE SERVICE, THE NEW ERA OF COMMUNITY BENEFIT REPORTING, AND EMBRACING COMMUNITY BENEFIT REPORTING TO MAKE A REAL AND LASTING CHANGE. IN ADDITION, THE SSM CORPORATE OFFICE GATHERED VARIOUS RESOURCES TO PREPARE A COMMUNITY BENEFIT TOOL KIT AND ESTABLISHED A SHARE POINT SITE FOR THE DISSEMINATION OF COMMUNITY BENEFIT INFORMATION. 7. SSM SENIOR LEADERS PARTICIPATE IN VARIOUS ECONOMIC DEVELOPMENT COUNCILS OR CHAMBERS OF COMMERCE ON ISSUES IMPACTING THE COMMUNITY'S HEALTH AND SAFETY. SPECIFIC ORGANIZATIONS INCLUDE THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT, THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES, ST LOUIS METRO HOSPITAL COUNCIL, ST LOUIS ECONOMIC COUNCIL, MISSOURI STATE UNIVERSITY BOARD OF GOVERNORS, AREA AGENCIES ON AGING, OKLAHOMA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND OKLAHOMA STATE BOARD OF MEDICAL LICENSURE. 8. DURING 2012, THE SSM PATIENT BUSINESS SERVICES DEPARTMENT PROVIDED SERVICES TO INCREASE ACCESS AND QUALITY OF CARE IN HEALTH SERVICES TO INDIVIDUALS, ESPECIALLY PERSONS LIVING IN POVERTY AND THOSE IN OTHER VULNERABLE POPULATIONS. SERVICES INCLUDED FINANCIAL COUNSELING, MEDICAID ELIGIBILITY TEAMS, PROCESSING FINANCIAL APPLICATIONS FOR SELF- PAY PATIENTS AND CONTRACTING WITH VENDORS TO SUPPORT THE DEPARTMENT'S EFFORTS. 9. IN 2012, THE CORPORATE OFFICE HELD AN EVENT CALLED "HEARTFELT THANKS!" TO SHOW APPRECIATION TO THEIR COWORKERS BY SENDING THEM A CARNATION AND THANK YOU NOTE FOR $1.00 PER FLOWER. THE MONEY RAISED FROM THE EVENT WAS DONATED TO OPERATION FOOD SEARCH'S BACKPACK PROGRAM. EACH WEEK THE BACKPACK PROGRAM PROVIDES BACKPACKS FILLED WITH NUTRITIOUS, KID-FRIENDLY, EASY-TO-PREPARE FOODS TO ST. LOUIS PUBLIC SCHOOL CHILDREN WHO RELY ON FREE OR REDUCED-COST MEAL PROGRAMS. THE CHILDREN RECEIVE THE BACKPACKS ON FRIDAY AS SCHOOL DISMISSES. ON MONDAY, THEY RETURN THE EMPTY BACKPACK TO BE REFILLED FOR THE FOLLOWING WEEKEND. THE EMPLOYEES RAISED AND DONATED OVER $2,000 FOR OPERATION BACKPACK. SSM'S CORPORATE OFFICE STAFF SUPPORTED THE LOCAL UNITED WAY CAMPAIGN BY RAISING OVER $70,000 IN DONATIONS FROM STAFF. ADDITIONAL INFORMATION REGARDING SSMHC'S 2012 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHC.COM. QUANTIFIABLE COMMUNITY BENEFIT THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS COMMUNITY BENEFIT ACTIVITIES. COMMUNITY BENEFIT PROGRAMS $8,678,247 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERS. THESE MEMBERS CONSIST OF THE PRESIDENT AND COUNSELORS OF THE FRANCISCAN SISTERS OF MARY (FOUR INDIVIDUALS). THE VOTING RIGHTS, INTERESTS AND PRIVILEGES OF EACH MEMBER ARE EQUAL. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS HAVE THE POWER TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE, EXCEPT FOR THOSE WHO SERVE EX-OFFICIO. 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 CERTIFICATE OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO 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 SSMHC 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 AT THE CORPORATE OFFICE AND COORDINATED WITH 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 ITS NEXT SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY 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 B, LINE 15 ALL SSMHC EXECUTIVE SALARY/COMPENSATION INFORMATION IS BASED ON COMPARATIVE DATA WITH SIMILAR POSITIONS IN THE MARKET. THE COMPENSATION REVIEW PROCESS IS PERFORMED BY EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS. THE SALARY DATA AND POTENTIAL ADJUSTMENTS FOR THE PRESIDENT/CEO OF THE SYSTEM, THE SENIOR VICE PRESIDENTS AND REGIONAL VICE PRESIDENTS ARE PRESENTED TO THE SSMHC BOARD OF DIRECTORS BY THE SAME INDEPENDENT COMPENSATION CONSULTANTS TO APPROVE, DISAPPROVE, OR MODIFY. THE SAME COMPARATIVE COMPENSATION PROCESS USED FOR EXECUTIVE SALARY/COMPENSATION IS PERFORMED INTERNALLY FOR ALL EMPLOYEES. THE SSMHC BOARD OF DIRECTORS HAS DELEGATED SALARY APPROVAL FOR ALL OTHER POSITIONS TO THE COMPENSATION COMMITTEE. 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. OTHER FEES FORM 990, PART IX, LINE 11G PROFESSIONAL FEES (CONSULTING, RECRUITMENT): PROGRAM SERVICE EXPENSES 2,074,908. MANAGEMENT AND GENERAL EXPENSES 4,330,358. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,405,266. PURCHASED SERVICES (COLLECTION AGENCY FEES): PROGRAM SERVICE EXPENSES 8,268,116. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,268,116. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 2,457,017. MANAGEMENT AND GENERAL EXPENSES 648,018. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,105,035. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: FUND BALANCE TRANSFERS -20,662,092. SSM EMPLOYEE HEALTH CARE FUND 477 N LINDBERGH BLVD ST LOUIS MO 63141 431328934 BENEFIT PLANS MO 501(C)(9) SSM HEALTH CARE CORPORATION 1 SSMHC LIABILITY TRUST I 477 N LINDBERGH BLVD ST LOUIS MO 63141 436331003 INSURANCE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM CONSOLIDATED HEALTH SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431473657 HEALTH CARE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM POLICY INSTITUTE 477 N LINDBERGH BLVD ST LOUIS MO 63141 431788151 HEALTH CARE MO 501(C)(4) SSM HEALTH CARE CORPORATION 1 SSM PORTFOLIO MANAGEMENT CO 477 N LINDBERGH BLVD ST LOUIS MO 63141 431825256 MANAGEMENT MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 477 N LINDBERGH BLVD ST LOUIS MO 63141 430738490 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE ST LOUIS 0 CARDINAL GLENNON CHILDREN'S FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431754347 FUNDRAISING MO 501(C)(3) LINE 7 SSM CARDINAL GLENNONCHILDREN'S HOSPITAL 0 SSM DEPAUL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431776109 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST JOSEPH FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431591556 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST CLARE HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431273310 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431552945 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM HEALTH CARE OF OKLAHOMA INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 730657693 HEALTH CARE OK 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 ST ANTHONY HOSPITAL FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 736104300 FUNDRAISING OK 501(C)(3) LINE 7 SSM HEALTH CARE OF OKLAHOMA 0 SSM HEALTH CARE OF WISCONSIN INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 430688874 HEALTH CARE WI 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 DELLS MEDICAL BUILDING INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 391613292 MOB WI 501(C)(2) SSM HEALTH CARE OF WISCONSIN 0 ST MARY'S FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940686 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 ST CLARE HEALTH CARE FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940683 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 HOME HEALTH UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391539827 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HOME CARE UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391776340 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HHU XTRA CARE INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391705111 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 SSM REGIONAL HEALTH SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 440579850 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 ST FRANCIS HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431099253 FUNDRAISING MO 501(C)(3) LINE 7 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431575307 FUNDRAISING MO 501(C)(3) LINE 11B, II SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 477 N LINDBERGH BLVD ST LOUIS MO 63141 430653587 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S HOSPITAL CENTRALIA ILLINOIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 370662580 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S - GOOD SAMARITAN INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 364170833 HEALTH CARE IL 501(C)(3) LINE 11A, I SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 262884795 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 ST MARY'S HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 364636691 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 SSM HEALTH BUSINESSES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431333488 HEALTH CARE MO 501(C)(3) LINE 9 SSM HEALTH CARE CORPORATION 1 SSM HEALTH CARE ST LOUIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 431343281 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 CENTRALIA MEDICAL SERVICES BLDG ASSOC 477 N LINDBERGH BLVD ST LOUIS MO 63141 237408025 HEALTH CARE IL 501(C)(3) LINE 11A, I SSM REGIONAL HEALTH SERVICES 0 ST MARY'S JANESVILLE FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 273439133 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 FRANCISCAN SISTERS OF MARY 3221 MCKELVEY ROAD SUITE 107 BRIDGETON MO 63044 431012492 RELIGIOUS ORGANIZATION MO 501(C)(3) LINE 1 N/A 0 LEE DEWEY CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 731279603 MOB OK 501(C)(3) LINE 11A, I SSM HEALTH CARE OF OKLAHOMA 0 SSM HOSPICE & HOME CARE FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 300012246 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH BUSINESSES 0 ST MARY'S HOSPITAL AUXILIARY 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 436049878 FUNDRAISING MO 501(C)(3) LINE 11B, II N/A 0 GOOD SAMARITAN HOSPITAL AUXILIARY 605 NORTH 12TH STREET MT VERNON IL 62864 237049599 FUNDRAISING IL 501(C)(3) LINE 11C, III-FI 0 ST ANTHONY SHAWNEE HOSPITAL INC 1000 N LEE AVE OKLAHOMA CITY OK 73102 455055149 HEALTH CARE OK 501(C)(3) LINE 3 SSM HEALTH CARE OF OKLAHOMA 0 SSM SJ ENDOSCOPY 477 N LINDBERGH BLVD ST LOUIS MO 63141 270046559 SURGERY SERVICES MO N/A ST CLARE IMAGING SERVICES 707 14TH STREET SUITE A BARABOO WI 53913 200122365 DIAG. SERVICES WI N/A MT VERNON RADIATION THERAPY CENTER 477 N LINDBERGH BLVD ST LOUIS MO 63141 201382620 RADIATION THERAPY IL N/A SLEEPNEURO SO IL 477 N LINDBERGH BLVD ST LOUIS MO 63141 208468195 DIAG. 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