2013-11-15T20:00:08-06:00 2012-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 770022591 990 2012-01-01 730657693 SSM HEALTH CARE OF OKLAHOMA INC SSMH 3149947800 477 N LINDBERGH ST LOUIS MO 63141 JUNE PICKETT 3149947800 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 454010742 0 0928 X WWW.SAINTSOK.COM X 1995 OK SEE SCHEDULE O 15 12 3989 49 4735220 -605282 2426444 1263156 379793735 434932080 599331 104246 10360774 15553020 393180284 451852502 415000 334365 0 0 182129789 206954480 0 0 0 225438294 249191673 407983083 456480518 -14802799 -4628016 246076422 321014505 213689768 291550907 32386654 29463598 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 408995195 334365 444678224 SEE SCHEDULE O 408995195 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 1 1 1 1 1 0 1 0 0 3989 1 1 1 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X LEAH HODGES 4052727499 PO BOX 205 OKLAHOMA CITY OK 73101 CHAD ADUDDELL 40.00 X 0 221941 65033 MT BERRY 1.00 1.00 X 0 0 0 JAMES BRINKWORTH MD 1.00 1.00 X 0 0 0 MARTHA BURGER 1.00 1.00 X 0 0 0 MIKE COLLISON 1.00 1.00 X 0 0 0 CLAY FARHA 1.00 1.00 X 0 0 0 GLORIA GRIFFIN 1.00 1.00 X 0 0 0 DAVID HARLOW 1.00 1.00 X 0 0 0 JOE HODGES 40.00 2.00 X X 0 705117 313970 JENEE LISTER 1.00 1.00 X 0 0 0 JUDY LOVE 1.00 1.00 X 0 0 0 JOHN RICHELS 1.00 1.00 X 0 0 0 MARGARET SALYER 1.00 1.00 X 0 0 0 KERSEY WINFREE MD 40.00 1.00 X 462842 0 87730 SR MARY JEAN RYAN FSM 1.00 40.00 X X 0 0 0 WILLIAM THOMPSON 1.00 40.00 X X 0 2161601 1088396 KRIS ZIMMER 1.00 40.00 X 0 837428 257469 JUNE PICKETT 1.00 40.00 X 0 240525 353818 RAMONA CAREY 40.00 1.00 X 70277 0 67747 SHASTA R MANUEL 40.00 2.00 X 326790 0 73375 STEVEN BARNEY 1.00 40.00 X 0 779380 231364 TAMARA L POWELL 40.00 X 318393 0 157620 STEPHEN D POWELL 40.00 X 278105 0 94338 CYNTHIA L BRUNDIGE 40.00 X 231073 0 117853 MARTI F JOURDEN 40.00 X 182701 0 147626 JOHN R MOBLEY 40.00 X 176925 0 109413 JASON EMERSON 40.00 X 1133235 0 284781 AVINIASH VYAS 40.00 X 1077088 0 103066 LEONARD BOWEN 40.00 X 1062407 0 123397 BASSAM HADI 40.00 X 1011814 0 188520 RALPH GANICK 40.00 X 984461 0 32586 WILLIAM SCHOENHARD 0.00 X 0 274197 676363 CHRISTOPHER HOWARD 0.00 40.00 X 0 873195 368042 7316111 6093384 4942507 177 1 1 0 SODEXO MARRIOTT SERVICES 1000 NORTH LEE STREET OKLAHOMA CITY OK 73101 FOOD SERVICES 11343198 EMERGENCY MANAGEMENT MIDWEST PO BOX 634850 CINCINNATI OH 45263 PHYSICIAN SERVICES 9236279 SHAWNEE MEDICAL CENTER CLINIC PO BOX 959 SHAWNEE OK 74802 PHYSICIAN SERVICES 6370227 RICHEY-ZINK & ASSOCIATES 330 NE 38TH STREET OKLAHOMA CITY OK 73105 CONSTRUCTION SERVICES 2936526 INSIGHT CREATIVE GROUP INC 19 NE 9TH STREET OKLAHOMA CITY OK 73104 ADVERTISING CONSULTANTS 1924571 83 1093282 169874 1263156 NET PATIENT REVENUE 621950 422762985 422762985 OTHER REVENUE 900099 12169095 7433875 4735220 434932080 108481 108481 2384438 1621799 762639 762639 762639 4235 -4235 -4235 -4235 841223 532206 309017 309017 MANAGEMENT FEES 541610 8088697 8088697 CAFETERIA REVENUE 722320 4149192 4149192 JV REVENUE 900099 1121654 1121654 1121821 1121821 14481364 451852502 444678224 4735220 1175902 X 334365 334365 3319410 3319410 157395704 140577400 16818304 10511025 9353437 1157588 25120128 22172663 2947465 10608213 9296502 1311711 10500657 4125292 6375365 1682293 1682293 232628 232628 64453919 59514289 4939630 1773224 1648 1771576 24076950 22913372 1163578 19781069 19600197 180872 14000835 13695906 304929 1167886 406208 761678 491511 402767 88744 7782397 7782397 15670219 14641254 1028965 4539198 1878121 2661077 MEDICAL SUPPLIES 70063941 70063941 0 0 MEDICARE PROVIDER TAX 11195678 11195678 0 0 BAD DEBT 687299 687299 0 0 BOND RELATED FEES 657036 0 657036 0 434933 352459 82474 456480518 408995195 47485323 0 -4469289 67364159 102874381 6055290 6421166 2447322 4272677 394108990 239665101 139669099 154443889 19371567 28154316 15638274 24848076 246076422 321014505 31033455 37488517 182656313 254062390 213689768 291550907 X 26928214 23687466 5382867 5700559 75573 75573 32386654 29463598 246076422 321014505 X -4628016 149078 1555882 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 32083 0 1 9463 1 32083 0 0 73629 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: TAXPAYER HAS HIRED A PAID LOBBYIST WHOSE ACTIVITIES INCLUDE SERVING AS LIAISON TO CITY, STATE AND FEDERAL OFFICIALS. HE TRACKS AND EVALUATES HEALTH CARE AND OTHER LEGISLATION THAT MAY HAVE AN IMPACT ON THE SYSTEM, EXPLORES AND EVALUATES POSSIBLE FUNDING OPPORTUNITIES FOR SSM OKLAHOMA, AND SERVES AS THE SPOKESPERSON TO LEGISLATIVE COMMITTEES AND STATE AGENCIES FOR THE SYSTEM ON LEGISLATIVE ISSUES. THE LOBBYIST'S ACTIVITIES INCLUDE DIRECT MAILINGS, DIRECT CONTACT WITH LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS. MAJOR ISSUES ADDRESSED INCLUDE MEDICAID FUNDING AND REIMBURSEMENTS, DSH PAYMENTS, NICHE HOSPITALS, AND OTHER VARIOUS MATTERS. HE HAS ALSO WORKED WITH CITY, COUNTY, AND STATE OFFICIALS REGARDING MEDICAID FUNDING, PATIENT SAFETY, INMATE CARE AND OTHER LEGISLATIVE MATTERS. HIS SALARY AND EXPENSES WERE $64,166 WITH NO BENEFITS. 75573 3313 3313 75573 75573 7000 7000 75573 75573 14500 14500 75573 75573 13499 13168 331 75573 75573 75573 1.00000 0 1 1 6212015 6212015 204894316 124868507 80025809 3132265 2745704 386561 142303907 109960722 32343185 37566487 2090168 35476319 154443889 BENEFICIAL INTEREST IN FOUNDATION 18626745 F INVESTMENT IN JOINT VENTURES 9120699 F SSM COMPREHENSIVE INVESTMENT PROGRAM 406872 F 28154316 LONG TERM NOTES RECEIVABLE 409697 OTHER RECEIVABLES 4347273 DUE FROM THIRD PARTY PAYOR 105078 GOODWILL 1034810 INTANGLIBLE ASSETS 121986 DUE FROM AFFILIATES 18829232 24848076 THIRD PARTY PAYOR 7972535 PENSION FUNDING LIABILITY 14038494 ASSET RETIREMENT OBLIGATION 189705 DEFERRED COMPENSATION LIABLITY 1539779 ALLOCATED TAX EXEMPT BOND DEBT (ISSUED BY SSM HEALTH CARE) 156160133 CASH OVERDRAFT 74161744 254062390 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PERMANENT ENDOWMENT FUNDS ARE HELD FOR THE PURPOSE OF PROVIDING NURSING SCHOLARSHIPS TO NURSING STUDENTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: SSM HEALTH CARE OF OKLAHOMA'S 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 RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS IN 2012 OR 2011. 1 1 1 X 1 X 1 1 0 1 1 7150816 7150816 0.01570 77296793 90102864 -12806071 0.00000 84447609 90102864 -5655255 0.01570 219518 5515 214003 0.00050 7183141 7183141 0.01570 475014 475014 0.00100 7877673 5515 7872158 0.01720 92325282 90108379 2216903 0.03290 4980 4980 0.00000 9982 9982 0.00000 14962 14962 0 14683029 687299 102944365 102208733 735632 X 1 1 1 ST ANTHONY HOSPITAL CARDIOVASCULAR SERVICES INSTITUTE LLC MANAGEMENT SERVICES 0.20000 0.80000 2 BONE AND JOINT MANAGEMENT COMPANY MANAGEMENT SERVICES 0.29700 0.70300 3 B&JMCBRIDE OFFICE BUILDING LLC MEDICAL OFFICE BUILDING 0.50000 0.50000 4 CLASSEN ASSOCIATES MEDICAL OFFICE BUILDING 0.20140 0.79860 5 SHAWNEE REAL ESTATE HOLDINGS LLC MEDICAL OFFICE BUILDING 0.50000 0.50000 6 MEDICAL PROPERTIES DEVELOPMENT LLC MEDICAL OFFICE BUILDING 0.05000 0.95000 1 1 ST ANTHONY HOSPITAL

1000 N LEE OKLAHOMA CITY OK 73103

X X X ST ANTHONY HOSPITAL 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X 1 0 1 X 0 0 39 BONE AND JOINT HOSPITAL AT ST ANTHONY

111 BN DEWEY AVE OKLAHOMA CITY OK 73102

ORTHOPEDIC SERVICES ST ANTHONY PHYSICIANS SHAWNEE

3315 KETHLEY RD SHAWNEE OK 74804

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS DERMATOLOGY CENTER

9720 N BROADWAY EXT OKLAHOMA CITY OK 73114

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS FAMILY MEDICINE CE

608 NW 9TH ST SUITE 1100 OKLAHOMA CITY OK 73102

PRIMARY CARE CLINIC ST ANTHONY PHYISICIANS NEUROLOGY AND NEU

535 NW 9TH STREET SUITE 235 OKLAHOMA CITY OK 73102

NEUROLOGY CLINIC ST ANTHONY PHYSICIANS INTERVENTIONAL PAI

535 NW 9TH STREET SUITE 205 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS HERITAGE FAMILY ME

6908 E RENO AVE MIDWEST CITY OK 73110

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS CENTER FOR INTEGRA

535 NW 9TH SUITE 220 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS HEMATOLOGYONCOLOG

1011 N DEWEY AVE OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC SAINT ANTHONY PHYSICIANS NORTH

6201 NORTH SANTA FE SUITE 2010 OKLAHOMA CITY OK 73118

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS HEALTHPLEX - EAST

3400 S DOUGLAS BLVD OKLAHOMA CITY OK 73150

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS CHOCTAW

15679 NE 23RD STREET CHOCTAW OK 73020

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS MIDTOWN ORTHOPEDIC

400 NW 13TH OKLAHOMA CITY OK 73103

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS CARDIOVASCULAR INS

608 NW 9TH STREET SUITE 4000 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS METRO MEDICAL ASSO

120 N ROBINSON SUITE 153W OKLAHOMA CITY OK 73102

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS CARDIOVASCULAR SPE

608 NW 9TH ST SUITE 2200 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS HEALTHPLEX - SOUTH

13500 S TULSA DRIVE OKLAHOMA CITY OK 73170

PRIMARY CARE CLINIC SAINTS FAMILY HEALTHCARE AND GYNECOLOGY

220 SW 89TH SUITE D OKLAHOMA CITY OK 73139

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS VASCULAR ASSOCIATE

608 NW 9TH ST SUITE 5204 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PULMONARY SPECIALITY CLINIC

608NW 9TH STREET SUITE 3110 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS DERMATOLOGY ENID

330 S 5TH ST STE 400 ENID OK 73701

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS GENERAL SURGERY

535 NW 9TH SUITE 330 OKLAHOMA CITY OK 73102

SURGERY CENTER ST ANTHONY PHYSICIANS MEDICINE ASSOCIATE

6205 N SANTA FE SUITE 201 OKLAHOMA CITY OK 73118

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS MUSTANG

120 N CHISHOLM TRAIL WAY MUSTANG OK 73064

PRIMARY CARE CLINIC ST ANTHONY CARDIOVASCULAR CARE

608 NW 9TH SUITE 4106 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS DERMATOLOGY MIDTOW

608 NW 9TH STREET SUITE 3206 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS STROUD

2308 B HWY 66 STROUD OK 74079

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS FAMILY MEDICINE M

10002 SE 15TH STREET MIDWEST CITY OK 73130

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS BLANCHARD

2002 N COUNCIL AVENUE BLANCHARD OK 73010

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS THORACIC AND CARDI

608 NW 9TH ST SUITE 2110 OKLAHOMA CITY OK 73102

SURGERY CENTER ST ANTHONY PHYSICIANS PULMONARY & WELLNE

608 NW 9TH ST STE 6200 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS PRIMARY CARE NORTH

6201 NORTH SANTA FE SUITE 2020 OKLAHOMA CITY OK 73118

PRIMARY CARE CLINIC ST ANTHONY PHYSICIANS ENDOCRINOLOGY ASSO

608 NW 9TH ST STE 5000 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS DERMATOLOGY MIDWES

9020 E RENO STE 100 MIDWEST CITY OK 73130

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS BREAST CARE SERVIC

535 NW 9TH ST SUITE 100 OKLAHOMA CITY OK 73102

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS MIDTOWN RENAL CARE

810 NW 10TH ST STE A OKLAHOMA CITY OK 73106

SPECIALTY CARE CLINIC ST ANTHONY PHYSICIANS MCLOUD

704 S 8TH ST MCLOUD OK 74851

PRIMARY CARE CLINIC ST ANTHONY HEALTHPLEX SOUTH

13500 S TULSA DR OKLAHOMA CITY OK 73170

HEALTHPLEX ST ANTHONY HEALTHPLEX EAST

3400 S DOUGLAS BLVD OKLAHOMA CITY OK 73150

HEALTHPLEX SCHEDULE H, PART I, QUESTION 3BSSM HEALTH CARE OF OKLAHOMA 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 TIMES 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%PART I, QUESTION 3CAN 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. TO FURTHER STREAMLINE AND AUTOMATE THE FINANCIAL ASSISTANCE PROCESS, SSM HEALTH CARE OF OKLAHOMA WILL AUTOMATICALLY CONSIDER 100% OF THE PATIENT ACCOUNT AS CHARITY IF THE COMMERCIAL SOFTWARE SYSTEM (SEARCHAMERICA) INDICATES THAT THE PATIENT IS LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL). THIS PROCESS IS CALLED "PRESUMPTIVE ELIGIBILITY". PART I, QUESTION 6ASSM HEALTH CARE OF OKLAHOMA 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. SSM HEALTH CARE'S 2012 ANNUAL COMMUNITY BENEFIT REPORT FOR THE SYSTEM CAN BE FOUND AT WWW.SSMHC.COM.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 COST 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 COST 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.RESEARCH COSTING METHODOLOGY: RESEARCH EXPENSES WERE TAKEN FROM THE INCOME AND EXPENSE STATEMENT FOR THE RESEARCH DEPARTMENTS, DERIVED FROM THE ACCOUNTING SYSTEM.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 IICOMMUNITY BUILDING ACTIVITIESSSM HEALTH CARE OF OKLAHOMA 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 BUILDING - PHYSICAL IMPROVEMENTS: PARTICIPATE IN REBUILDING TOGETHER WITH USE OF STAFF TO IMPROVE/REPAIR HOMES OF LOW INCOME ELDERLY PERSONS IN THE COMMUNITY; PARTICIPATE IN THE OKLAHOMA CITY LITTER BLITZ A NEIGHBORHOOD IMPROVEMENT AND REVITALIZATION PROJECT.COMMUNITY BUILDING - COMMUNITY HEALTH IMPROVEMENT ADVOCACY - STAFF MEMBERS PARTICIPATE IN VARIOUS CIVIC ORGANIZATIONS INCLUDING MARCH OF DIMES, REDBUD BOARD, OKLAHOMA QUALITY FOUNDATION, MIDTOWN DEVELOPMENT, SOUTH ROTARY CLUB, NATIONAL ALLIANCE OF MENTAL ILLNESS, COMMUNITY ARTS ASSESSMENT FOR THE ARTS COUNCIL, ALLIED ARTS, OKLAHOMA BLOOD INSTITUTE, EXECUTIVE WOMEN INTERNATIONAL, CASA OF OKLAHOMA COUNTY AND OKLAHOMA QUALITY AWARD. SCHEDULE H, PART III, SECTION A, LINE 2 BAD 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.PART III, SECTION A, LINE 3SSM HEALTH CARE OF OKLAHOMA DID NOT MAKE AN ESTIMATE OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.PART III, SECTION A, LINE 4SSM HEALTH CARE OF OKLAHOMA IS PART OF THE SSM HEALTH CARE CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES BAD DEBT EXPENSE IN THE DECEMBER 31, 2012 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, 2012 WAS $11,891,623 AT CHARGES AND $4,036,017 AT COST.PART III, SECTION B, LINE 8THE COST OF PROVIDING CARE TO MEDICARE ELIGIBLE PATIENTS IS GREATER THAN THE REIMBURSEMENT THAT MEDICARE ALLOWS ON THE MEDICARE COST REPORT. GOOD SAMARITAN REGIONAL HEALTH CENTER 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 2012 MEDICARE COST REPORT.PART III, SECTION C, LINE 9BSSM HEALTH CARE OF OKLAHOMA 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 FAIR 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 HEALTH CARE OF OKLAHOMA' COLLECTION AND CHARITY POLICIES.SCHEDULE H, PART VI, LINE 2NEEDS 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.EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ONCE EVERY THREE YEARS. 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 HEALTHUTILIZING THIS PLAN, SSM HEALTH CARE OF OKLAHOMA HAS COMPLETED ITS CHNA IN 2012 AND IT WAS ADOPTED AS PART OF OUR STRATEGIC PLAN. PART VI, 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 IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES.EACH ENTITY PROVIDING MEDICAL SERVICE SHALL PROVIDE INFORMATION TO THE PUBLIC REGARDING ITS CHARITY CARE POLICIES AND THE QUALIFICATION REQUIREMENTS FOR EACH OF ITS FACILITIES. WHEN STANDARD SYSTEM NOTICES AND COMMUNICATION REGARDING CHARITY CARE ARE AVAILABLE, THESE MUST BE USED. MODIFICATIONS TO THE STANDARD MAY BE MADE TO COMPLY WITH STATE AND LOCAL LAWS, AS WELL AS REFLECT CULTURALLY SENSITIVE TERMINOLOGY FOR THE POLICY. ALL NOTICES ARE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY.THEY PROVIDE INFORMATION ABOUT: - THE PATIENT'S RESPONSIBILITY FOR PAYMENT, - THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS, - THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS, AND - WHO TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING.THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED: - SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS. - BROCHURES OR 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 IS ALSO PROVIDED TO PUBLIC AGENCIES.PART VI LINE 4COMMUNITY INFORMATIONST. ANTHONY HOSPITAL IS LOCATED IN OKLAHOMA CITY, OKLAHOMA IN THE CENTER OF OKLAHOMA COUNTY. IN ADDITION TO OKLAHOMA COUNTY, ST ANTHONY HOSPITAL'S PRIMARY SERVICE AREA (PSA) INCLUDES CANADIAN, CLEVELAND AND POTTAWATOMIE COUNTIES. THE 2011 ESTIMATED POPULATION OF THE FOUR-COUNTY PSA IS 1,186,563. THE FOUR-COUNTY PSA HAS AN EXPECTED GROWTH RATE OF 5.0% FROM 2011 TO 2016. THE 2011 PROJECTED POPULATION FOR THE PSA IS SLIGHTLY YOUNGER THAN THE NATIONAL AVERAGE, WITH 51.1% UNDER AGE 35. ALL FOUR PSA COUNTIES ARE PROJECTED TO SEE AN INCREASE IN THE NUMBER OF INFANTS AND YOUTH UNDER AGE 18 FROM 2011 TO 2016. FOR THIS SAME PERIOD, THE TOTAL PSA IS ALSO PROJECTED TO SEE A GROWTH RATE OF 16.0% FOR SENIORS AGE 65 AND ABOVE. DISTRIBUTION OF RACE/ETHNICITY IN OUR COMMUNITY IS WHITE/CAUCASIAN: 68%; BLACK/AFRICAN-AMERICAN: 11%; HISPANIC: 11%; OTHER: 10%. ST. ANTHONY PROVIDES GENERAL, TERTIARY ACUTE CARE SERVICES INCLUDING CARDIOLOGY, ONCOLOGY, BEHAVIORAL MEDICINE, SURGERY, KIDNEY TRANSPLANTATION, AND A VARIETY OF OTHER DISCIPLINES. ST. ANTHONY HAS BROUGHT MANY "FIRSTS" TO HEALTH CARE IN OKLAHOMA (FIRST ICU, FIRST KIDNEY TRANSPLANT, FIRST NEUROSURGICAL INSTITUTE), INCLUDING BRINGING THE STATE'S ONLY CYBERKNIFE TECHNOLOGY TO OKLAHOMANS. BONE AND JOINT HOSPITAL AT ST. ANTHONY IS UNIQUE IN THAT THE HOSPITAL, PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS ARE COMMITTED SOLELY TO ORTHOPEDIC CARE. OUR STAFF OFFERS A RANGE OF ORTHOPEDIC SERVICES INCLUDING HIP AND KNEE REPLACEMENT, SPINE SURGERY, PAIN MANAGEMENT, SPORTS MEDICINE, ARTHROSCOPIC PROCEDURES, FOOT AND ANKLE SURGERY, HAND SURGERY, AND ROBOTIC SURGERY.THROUGH SAINTS MEDICAL GROUP, SSM HEALTH CARE OF OKLAHOMA PROVIDES PRIMARY CARE PHYSICIANS IN FAMILY MEDICINE, INTERNAL MEDICINE AND PEDIATRICS. SPECIALTY SERVICE LINES INCLUDE CARDIOLOGY, DERMATOLOGY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, PULMONARY, THORACIC SURGERY, VASCULAR SURGERY, DIAGNOSTIC/MEDICAL TESTING SERVICES, AND A OCCUPATIONAL HEALTH NETWORK.PART VI LINE 5PROMOTION OF COMMUNITY HEALTHSSM HEALTH CARE'S MISSION STATEMENT IS "THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD." SSM HEALTH CARE OF OKLAHOMA 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. ANTHONY HOSPITAL AND BONE AND JOINT HOSPITAL AT ST. ANTHONY PARTICIPATE IN CENTRAL OKLAHOMA TURNING POINT, A NATIONAL PROGRAM TO PROMOTE LOCAL HEALTH INITIATIVES BY BUILDING HEALTHY COMMUNITIES THROUGH PUBLIC/PRIVATE PARTNERSHIPS. ST. ANTHONY COMMUNITY HEALTH FELLOW, A ST. ANTHONY HOSPITAL EMPLOYEE, IS A MEMBER OF THE CENTRAL OKLAHOMA TURNING POINT EXECUTIVE COMMITTEE. FOR 2012, THESE EFFORTS RESULTED IN A STATE HEALTH RANKING (PER UHF) OF 43RD, AN OBESITY RATE OF 31.1%, 19 SCHOOL DISTRICTS THAT ARE TOBACCO FREE AND A SMOKING RATE OF 26.1%.ST. ANTHONY HOSPITAL AND BONE AND JOINT HOSPITAL AT ST. ANTHONY ALSO COLLABORATE WITH STATE AGENCIES, HEALTHCARE PROVIDERS, AND EDUCATION AND BUSINESS LEADERS. BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS COMMUNITY EDUCATION AND SCREENING OPPORTUNITIES TO AREA ORGANIZATIONS AND THE GENERAL PUBLIC. SPECIAL ATTENTION IS GIVEN TO ENSURE THAT DIVERSE GROUPS OF THE LOCAL POPULATION ARE IDENTIFIED AND PROVIDED WITH EDUCATIONAL/SCREENING OPPORTUNITIES.BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS ONGOING COMMUNITY EDUCATION REGARDING OSTEOARTHRITIS, OSTEOPOROSIS, SPINE PAIN AND OTHER ORTHOPEDIC-RELATED TOPICS. THE CLASSES ARE FREE OF CHARGE AND FEATURE A BONE AND JOINT HOSPITAL AT ST. ANTHONY PHYSICIAN WHO DONATES HIS TIME FOR THE SEMINARS. BONE AND JOINT HOSPITAL AT ST. ANTHONY ALSO PARTICIPATES IN HEALTH FAIRS WHERE FREE BONE DENSITY SCREENINGS ARE OFFERED. IN 2012, THESE EFFORTS RESULTED IN 204 PEOPLE ATTENDING AN EDUCATIONAL PROGRAM ON OSTEOPOROSIS OR ARTHRITIS HOSTED THE BONE AND JOINT HOSPITAL AT ST. ANTHONY AND 133 PEOPLE WHO PARTICIPATED IN OSTEOPOROSIS SCREENINGS. THE SCREENING RESULTED IN 38% OF THE PEOPLE IDENTIFIED WITH OSTEOPENIA AND 8% WITH OSTEOPOROSIS. 27% OF THE PEOPLE IDENTIFIED WERE NOT PREVIOUSLY AWARE OF THE CONDITION.THROUGH THE FREE CLINIC, CROSS AND CROWN, BONE AND JOINT HOSPITAL AT ST. ANTHONY PROVIDED FREE X-RAY SERVICES TO 10 UNINSURED INDIVIDUALS REFERRED TO US BY THE CLINIC IN 2012. FURTHER, BONE AND JOINT HOSPITAL AT ST. ANTHONY SUPPORTS THE EFFORTS OF THE ARTHRITIS FOUNDATION BY SUPPORTING FUNDRAISING AND AWARENESS EFFORTS INCLUDING BEING THE TITLE SPONSOR OF THE LOCAL CHAPTER'S ANNUAL ARTHRITIS WALK.ST. ANTHONY HOSPITAL SPONSORED VARIOUS EDUCATIONAL EVENTS INCLUDING ITS ANNUAL STROKE OF COURAGE PROGRAM TO RAISE STROKE AWARENESS AND ITS CELEBRITY CHEF EVENT TO PROMOTE HEART HEALTHY EATING. PHYSICIAN SPEAKERS PRESENT AT AREA BUSINESSES TO PROVIDE ADDITIONAL HEALTH EDUCATION TO THEIR WORKFORCE.ST ANTHONY HOSPITAL IN COLLABORATION WITH 61 OKLAHOMA SCHOOLS, THE UNIVERSITY OF OKLAHOMA AND VARIOUS STATE AGENCIES HAS ESTABLISHED A COMMUNITY HEALTH INITIATIVE TO SUPPORT PROGRAMS AND CURRICULUM IN OKLAHOMA SCHOOLS TO PROMOTE HEALTHY LIFESTYLES. IN 2012, THESE EFFORTS RESULTED IN THE FOLLOWING PRE- AND POST-TEST:- 32% INCREASE IN MEETING FITNESS STANDARDS (FITNESSGRAM STANDARD) - 35% INCREASE IN FOOD LABEL KNOWLEDGE - 52% INCREASE IN NUTRITIONAL FATS, - 48% INCREASE IN CONSUMPTION OF FRUITS AND VEGETABLES- 40% INCREASE IN LEVELS OF PHYSICAL ACTIVITY THE PROGRAM ALSO RESULTED IN A 11.9% INCREASE IN THE ACADEMIC PERFORMANCE INDEX (API) FOR PARTICIPATING SCHOOLS.THE HOSPITAL AND ITS EMPLOYEES PARTICIPATE IN REBUILDING TOGETHER TO REHABILITATE A HOME FOR AN INDIVIDUAL WITHIN THE COMMUNITY WHO DOES NOT HAVE THE MEANS TO MAKE NECESSARY REPAIRS TO ENSURE A SAFE, WARM HOME. ADDITIONALLY, NUMEROUS SUPPORT GROUPS, CHILDBIRTH CLASSES, MEDIA HEALTH INFORMATION STORIES, SEMINARS ON A RANGE OF HEALTHY TOPICS, HEALTH FAIRS AND HEALTH PROFESSIONALS EDUCATION PROVIDE SUBSTANTIAL BENEFIT TO THE COMMUNITY. IN 2012, THE HOSPITAL CONTINUED ITS MIDTOWN MARKET AT SAINTS, A COMMUNITY LOCAL FOOD FARMERS' MARKET HOSTED WEEKLY ON THE HOSPITAL CAMPUS FROM MAY THROUGH OCTOBER. IT ALSO SPONSORED OTHER EVENTS TO SUPPORT COMMUNITY HEALTH AND FITNESS INCLUDING THE DOWNTOWN DASH (4TH YEAR TO SPONSOR ON ITS CAMPUS) AND REDBUD CLASSIC (THE 30TH YEAR TO SPONSOR) AS WELL AS THE AMERICAN HEART ASSOCIATION HEART WALK.THE HOSPITAL WEBSITE, SAINTSOK.COM, PROVIDES HEALTH INFORMATION USEFUL TO THE COMMUNITY THROUGH A COMPILATION OF HEALTH EDUCATION TOPICS, HEALTH RISK APPRAISALS, AND OTHER TOOLS DESIGNED TO ASSIST INDIVIDUALS WITH HEALTH CONCERNS AND ENCOURAGE A HEALTHIER LIFESTYLE. THESE SERVICES ARE IN ADDITION TO THE TRADITIONAL CHARITY CARE PROVIDED CONSISTENT WITH THE HOSPITAL'S MISSION. SSM HEALTH CARE OF OKLAHOMA 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 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 PART VI LINE 6:AFFILIATED HEALTH CARE SYSTEMSSM HEALTH CARE OF OKLAHOMA IS A HEALTH CARE NETWORK THAT ENCOMPASSES SSM HEALTH CARE FACILITIES IN OKLAHOMA. THIS CONSISTS OF TWO HOSPITALS IN OKLAHOMA CITY, BONE AND JOINT HOSPITAL AT ST ANTHONY AND ST ANTHONY HOSPITAL AND A PHYSICIAN ORGANIZATION, SAINTS MEDICAL GROUP SSM HEALTH CARE OF OKLAHOMA ALSO OPERATES A HOSPITAL IN SHAWNEE, OKLAHOMA, ST ANTHONY SHAWNEE HOSPITAL. SSM HEALTH CARE OF OKLAHOMA, WITH HEADQUARTERS IN OKLAHOMA CITY, OK, IS SPONSORED BY THE FRANCISCAN SISTERS OF MARY AND IS OWNED AND OPERATED BY SSM HEALTH CARE (SSMHC) BASED IN ST. LOUIS, MISSOURIPART VI LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORTTHE SSM HEALTH CARE ANNUAL CONSOLIDATED COMMUNITY BENEFIT REPORT IS FILED IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN. 1 AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 20000 GENERAL SUPPORT ARTHRITIS FOUNDATION 710 W WILSHIRE STE 101 OKLAHOMA CITY OK 73116 943454386 501(C)(3) 25000 GENERAL SUPPORT CANTERBURY CHORAL SOCIETY 428 W CALIFORNIA STE 100 OKLAHOMA CITY OK 730125454 237282541 501(C)(3) 7500 GENERAL SUPPORT UNITED WAY OF CENTRAL OKLAHOMA INC 1444 NW 28TH STREET OKLAHOMA CITY OK 73106 730589829 501(C)(3) 12726 GENERAL SUPPORT ALLIED ARTS FOUNDATION 1015 N BROADWAY STE 200 OKLAHOMA CITY OK 73102 730804291 501(C)(3) 15000 GENERAL SUPPORT ARTS COUNCIL OF OKLAHOMA CITY INC 400 W CALIFORNIA AVENUE OKLAHOMA CITY OK 73102 736112471 501(C)(3) 12500 GENERAL SUPPORT CATHOLIC CHARITIES 3577 HIGH POINT ROAD MADISON WI 53744 390807067 501(C)(3) 10700 GENERAL SUPPORT CIVIC CENTER FOUNDATION 201 N WALKER OKLAHOMA CITY OK 73012 731603622 501(C)(3) 25000 GENERAL SUPPORT JASMINE MORAN CHILDRENS MUSEUM PO BOX 1828 SEMINOLE OK 748181828 731335990 501(C)(3) 10000 GENERAL SUPPORT GNAMI OKLAHOMA 4200 PERIMETER CENTER DR STE 150 OKLAHOMA CITY OK 73112 731248588 501(C)(3) 5500 GENERAL SUPPORT OKLAHOMA CITY NATIONAL MEMORIAL FOUNDATION PO BOX 323 OKLAHOMA CITY OK 73101 731472725 501(C)(3) 5500 GENERAL SUPPORT OKLAHOMA CITY UNIVERSITY 2501 N BLACKWELDER AVE OKLAHOMA CITY OK 73106 730579265 501(C)(3) 140000 GENERAL SUPPORT SHARTEL BLVD DEVELOPMENT AUTHORITY INC 301 NW 18TH STREET OKLAHOMA CITY OK 73103 731572000 501(C)(3) 5000 GENERAL SUPPORT 13 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 1 1 1 1 0 0 0 0 0 0 0 CHAD ADUDDELL 0 186973 0 0 0 34968 0 53153 0 11880 0 286974 0 0 JOE HODGES 0 621033 0 0 0 84084 0 286178 0 27792 0 1019087 0 29120 KERSEY WINFREE MD 446416 0 0 0 16426 0 66043 0 21687 0 550572 0 0 0 WILLIAM THOMPSON 0 1321845 0 0 0 839756 0 1051531 0 36865 0 3249997 0 57960 KRIS ZIMMER 0 737296 0 0 0 100132 0 227242 0 30227 0 1094897 0 43820 JUNE PICKETT 0 220007 0 0 0 20518 0 331433 0 22385 0 594343 0 8280 SHASTA R MANUEL 307486 0 0 0 19304 0 44625 0 28750 0 400165 0 10400 0 STEVEN BARNEY 0 623277 0 0 0 156103 0 208024 0 23340 0 1010744 0 0 TAMARA L POWELL 284411 0 0 0 33982 0 151793 0 5827 0 476013 0 10200 0 STEPHEN D POWELL 264046 0 0 0 14059 0 64382 0 29956 0 372443 0 9984 0 CYNTHIA L BRUNDIGE 209648 0 0 0 21425 0 100864 0 16989 0 348926 0 7880 0 MARTI F JOURDEN 170363 0 0 0 12338 0 119600 0 28026 0 330327 0 6624 0 JOHN R MOBLEY 165518 0 0 0 11407 0 73056 0 36357 0 286338 0 6624 0 JASON EMERSON 1053932 0 0 0 79303 0 252818 0 31963 0 1418016 0 0 0 AVINIASH VYAS 953040 0 0 0 124048 0 71244 0 31822 0 1180154 0 0 0 LEONARD BOWEN 965217 0 0 0 97190 0 92587 0 30810 0 1185804 0 0 0 BASSAM HADI 993340 0 0 0 18474 0 152925 0 35595 0 1200334 0 0 0 RALPH GANICK 897901 0 0 0 86560 0 3750 0 28836 0 1017047 0 0 0 WILLIAM SCHOENHARD 0 0 0 0 0 274197 0 662169 0 14194 0 950560 0 0 CHRISTOPHER HOWARD 0 735141 0 0 0 138054 0 337445 0 30597 0 1241237 0 37660 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. TAMARA POWELL STEPHEN POWELL AVINIASH VYAS JASON EMERSON LEONARD BOWEN RALPH GANICK SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: COMPENSATION TO CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S CEO IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE SSM HEALTH CARE (SSMHC) BOARD OF DIRECTORS. 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 THIS PLAN. WILLIAM SCHOENHARD $277,333 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 WILLIAM THOMPSON $58,026 KRIS ZIMMER $43,871 JOE HODGES $29,154 CHAD ADUDDELL $18,992 SHASTA MANUEL $10,411 TAMARA POWELL $10,212 STEPHEN POWELL $9,940 JUNE PICKETT $8,289 CYNTHIA BRUNDIGE $7,889 MARTI JOURDEN $6,632 JOHN MOBLEY $6,632 ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: SSM HEALTH CARE OF OKLAHOMA (SSMOK) IS A HEALTH CARE NETWORK THAT ENCOMPASSES THE OKLAHOMA FACILITIES OF SSM HEALTH CARE (SSMHC). FORM 990, PART I, DOING BUSINESS AS: SSM HEALTH CARE OF OKLAHOMA, INC. CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES 1) BONE & JOINT HOSPITAL 2) BONE & JOINT HOSPITAL AT ST. ANTHONY 3) ST. ANTHONY HOSPITAL 4) ST. ANTHONY CENTER FOR BEHAVIORAL MEDICINE AT ST. MICHAEL PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: SSM HEALTH CARE OF OKLAHOMA (SSMOK) IS A HEALTH CARE NETWORK THAT ENCOMPASSES THE OKLAHOMA FACILITIES OF SSM HEALTH CARE (SSMHC). BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION: SSMHC IS ONE OF THE LARGEST CATHOLIC HEALTH SYSTEMS IN THE COUNTRY AND IS DEDICATED TO QUALITY AND COMPASSIONATE CARE FOR ANYONE IN NEED, REGARDLESS OF ABILITY TO PAY. THE SYSTEM BEGAN WITH FIVE RELIGIOUS SISTERS WHO JOURNEYED TO ST. LOUIS IN 1872 FROM GERMANY TO BE OF SERVICE TO PEOPLE IN NEED. IN THEIR EARLY LEDGERS, THE SISTERS LISTED PATIENTS WHO COULD NOT PAY FOR THEIR CARE AS "OUR DEAR LORD'S." SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, 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 HOSPITALS, 2 SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES IN FOUR STATES: WISCONSIN, ILLINOIS, MISSOURI AND OKLAHOMA. SSM HAS NEARLY 25,600 EMPLOYEES, MORE THAN 6,600 PHYSICIANS. IT IS THE FIRST HEALTH-CARE RECIPIENT OF THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD AND THE FIRST LARGE HEALTH SYSTEM TO GO SMOKELESS INSIDE AND OUT. SSMOK INCLUDES ST. ANTHONY HOSPITAL, BONE AND JOINT HOSPITAL AT ST. ANTHONY AND ST. ANTHONY PHYSICIANS GROUP. IN JUNE 2012, SSMOK COMPLETED THE ACQUISITION OF ST ANTHONY SHAWNEE HOSPITAL IN SHAWNEE, OKLAHOMA. IN ADDITION TO THE MAIN HOSPITAL CAMPUSES, THE REGION ALSO ENCOMPASSES ST ANTHONY NORTH, LOCATED IN NORTH OKLAHOMA CITY, AND ST ANTHONY SOUTH, LOCATED IN SOUTH OKLAHOMA CITY. TWO NEW THREE-STORY FACILITIES, ST ANTHONY HEALTHPLEX EAST AND ST ANTHONY HEALTHPLEX SOUTH, ARE NOW OPEN IN EAST AND SOUTH OKLAHOMA CITY. THESE STATE-OF-THE-ART CAMPUSES FEATURE FREESTANDING EMERGENCY ROOMS, AMBULATORY SERVICES AND PHYSICIANS. SSMOK ALSO INCLUDES THE ST. ANTHONY AFFILIATE HEALTH NETWORK THAT ENCOMPASSES 19 AFFILIATE HOSPITALS, FOUR TIER ONE AFFILIATE HOSPITALS, AND ONE MANAGED HOSPITAL. IN TOTAL, SSMOK HAS A NETWORK OF 23 HOSPITALS. PHYSICIAN SPECIALTY CLINICS, MOBILE DIAGNOSTICS AND TELEHEALTH CAPABILITIES ARE OFFERED TO COMMUNITIES THROUGHOUT THE NETWORK, THUS IMPROVING ACCESS TO HEALTH CARE IN THE COMMUNITIES LOCATED SOME DISTANCE FROM A METROPOLITAN AREA. INSPIRED BY OUR FOUNDING RELIGIOUS SISTERS, SSMOK VALUES THE SACREDNESS AND DIGNITY OF EACH PERSON. THEREFORE, SSMOK FINDS THESE FIVE VALUES CONSISTENT WITH ITS HERITAGE AND MINISTRY: COMPASSION: WE REACH OUT WITH OPENNESS, KINDNESS AND CONCERN. RESPECT: WE HONOR THE WONDER OF THE HUMAN SPIRIT. EXCELLENCE: WE EXPECT THE BEST OF OURSELVES AND ONE ANOTHER. STEWARDSHIP: WE USE OUR RESOURCES RESPONSIBLY. COMMUNITY: WE CULTIVATE RELATIONSHIPS THAT INSPIRE US TO SERVE. DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: SSMOK WILL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN EARLY 2012. 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 SSMOK 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 UPON APPROVAL BY THE BOARD IN 4TH QUARTER 2012, SSMOK WILL COMMUNICATE THE RESULTS OF THE CHNA TO ITS STAKEHOLDERS. BECAUSE OF ITS SPECIALTY HOSPITAL STATUS, BONE AND JOINT HOSPITAL AT ST. ANTHONY FOCUSES ON AREAS WHERE IT CAN MAKE AN IMPACT AND AS A RESULT, HAS CHOSEN OSTEOPOROSIS PREVENTION AS ITS COMMUNITY INITIATIVE. 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, INCLUDING SSMOK, 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 REFLECT THE MISSION AND VALUES OF SSMOK, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMOK 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. SSMOK APPLIES ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON IS TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMOK 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 IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. EACH SSMHC 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: SSMHC HOSPITALS, INCLUDING ST. ANTHONY HOSPITAL AND BONE AND JOINT HOSPITAL: - 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 OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: SSM HEALTH CARE OF OKLAHOMA 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. ANTHONY HOSPITAL AND BONE AND JOINT HOSPITAL AT ST. ANTHONY PARTICIPATE IN CENTRAL OKLAHOMA TURNING POINT, A NATIONAL PROGRAM TO PROMOTE LOCAL HEALTH INITIATIVES BY BUILDING HEALTHY COMMUNITIES THROUGH PUBLIC/PRIVATE PARTNERSHIPS. ST. ANTHONY COMMUNITY HEALTH FELLOW, A ST. ANTHONY HOSPITAL EMPLOYEE, IS A MEMBER OF THE CENTRAL OKLAHOMA TURNING POINT EXECUTIVE COMMITTEE. FOR 2012, THESE EFFORTS RESULTED IN A STATE HEALTH RANKING (PER UHF) OF 43RD, AND OBESITY RATE OF 31.1%, 19 SCHOOL DISTRICTS THAT ARE TOBACCO FREE AND A SMOKING RATE OF 26.1% ST. ANTHONY HOSPITAL AND BONE AND JOINT HOSPITAL AT ST. ANTHONY ALSO COLLABORATE WITH STATE AGENCIES, HEALTHCARE PROVIDERS, AND EDUCATION AND BUSINESS LEADERS. BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS COMMUNITY EDUCATION AND SCREENING OPPORTUNITIES TO AREA ORGANIZATIONS AND THE GENERAL PUBLIC. SPECIAL ATTENTION IS GIVEN TO ENSURE THAT DIVERSE GROUPS OF THE LOCAL POPULATION ARE IDENTIFIED AND PROVIDED WITH EDUCATIONAL/SCREENING OPPORTUNITIES BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS ONGOING COMMUNITY EDUCATION REGARDING OSTEOARTHRITIS, OSTEOPOROSIS, SPINE PAIN AND OTHER ORTHOPEDIC-RELATED TOPICS. THE CLASSES ARE FREE OF CHARGE AND FEATURE A BONE AND JOINT HOSPITAL AT ST. ANTHONY PHYSICIAN WHO DONATES HIS TIME FOR THE SEMINARS. BONE AND JOINT HOSPITAL AT ST. ANTHONY ALSO PARTICIPATES IN HEALTH FAIRS WHERE FREE BONE DENSITY SCREENINGS ARE OFFERED. IN 2012, THESE EFFORTS RESULTED IN 204 PEOPLE ATTENDING AN EDUCATIONAL PROGRAM ON OSTEOPOROSIS OR ARTHRITIS HOSTED THE BONE AND JOINT HOSPITAL AT ST. ANTHONY AND 133 PEOPLE WHO PARTICIPATED IN OSTEOPOROSIS SCREENINGS. THE SCREENING RESULTED IN 38% OF THE PEOPLE IDENTIFIED WITH OSTEOPENIA AND 8% WITH OSTEOPOROSIS. 27% OF THE PEOPLE IDENTIFIED WERE NOT PREVIOUSLY AWARE OF THE CONDITION. THROUGH THE FREE CLINIC, CROSS AND CROWN, BONE AND JOINT HOSPITAL AT ST. ANTHONY PROVIDED FREE X-RAY SERVICES TO 10 UNINSURED INDIVIDUALS REFERRED TO US BY THE CLINIC IN 2012. FURTHER, BONE AND JOINT HOSPITAL AT ST. ANTHONY SUPPORTS THE EFFORTS OF THE ARTHRITIS FOUNDATION BY SUPPORTING FUNDRAISING AND AWARENESS EFFORTS INCLUDING BEING THE TITLE SPONSOR OF THE LOCAL CHAPTER'S ANNUAL ARTHRITIS WALK. ST. ANTHONY HOSPITAL SPONSORED VARIOUS EDUCATIONAL EVENTS INCLUDING ITS ANNUAL STROKE OF COURAGE PROGRAM TO RAISE STROKE AWARENESS AND ITS CELEBRITY CHEF EVENT TO PROMOTE HEART HEALTHY EATING. PHYSICIAN SPEAKERS PRESENT AT AREA BUSINESSES TO PROVIDE ADDITIONAL HEALTH EDUCATION TO THEIR WORKFORCE. ST ANTHONY HOSPITAL IN COLLABORATION WITH 61 OKLAHOMA SCHOOLS, THE UNIVERSITY OF OKLAHOMA AND VARIOUS STATE AGENCIES HAS ESTABLISHED A COMMUNITY HEALTH INITIATIVE TO SUPPORT PROGRAMS AND CURRICULUM IN OKLAHOMA SCHOOLS TO PROMOTE HEALTHY LIFESTYLES. IN 2012, THESE EFFORTS RESULTED IN THE FOLLOWING PRE- AND POST-TEST: - 32% INCREASE IN MEETING FITNESS STANDARDS (FITNESSGRAM STANDARD) - 35% INCREASE IN FOOD LABEL KNOWLEDGE - 52% INCREASE IN NUTRITIONAL FATS, - 48% INCREASE IN CONSUMPTION OF FRUITS AND VEGETABLES - 40% INCREASE IN LEVELS OF PHYSICAL ACTIVITY THE PROGRAM ALSO RESULTED IN A 11.9% INCREASE IN THE ACADEMIC PERFORMANCE INDEX (API) FOR PARTICIPATING SCHOOLS. THE HOSPITAL AND ITS EMPLOYEES PARTICIPATE IN REBUILDING TOGETHER TO REHABILITATE A HOME FOR AN INDIVIDUAL WITHIN THE COMMUNITY WHO DOES NOT HAVE THE MEANS TO MAKE NECESSARY REPAIRS TO ENSURE A SAFE, WARM HOME. ADDITIONALLY, NUMEROUS SUPPORT GROUPS, CHILDBIRTH CLASSES, MEDIA HEALTH INFORMATION STORIES, SEMINARS ON A RANGE OF HEALTHY TOPICS, HEALTH FAIRS AND HEALTH PROFESSIONALS EDUCATION PROVIDE SUBSTANTIAL BENEFIT TO THE COMMUNITY. IN 2012, THE HOSPITAL CONTINUED ITS MIDTOWN MARKET AT SAINTS, A COMMUNITY LOCAL FOOD FARMERS' MARKET HOSTED WEEKLY ON THE HOSPITAL CAMPUS FROM MAY THROUGH OCTOBER. IT ALSO SPONSORED OTHER EVENTS TO SUPPORT COMMUNITY HEALTH AND FITNESS INCLUDING THE DOWNTOWN DASH (4TH YEAR TO SPONSOR ON ITS CAMPUS) AND REDBUD CLASSIC (THE 30TH YEAR TO SPONSOR) AS WELL AS THE AMERICAN HEART ASSOCIATION HEART WALK. THE HOSPITAL WEBSITE, SAINTSOK.COM, PROVIDES HEALTH INFORMATION USEFUL TO THE COMMUNITY THROUGH A COMPILATION OF HEALTH EDUCATION TOPICS, HEALTH RISK APPRAISALS, AND OTHER TOOLS DESIGNED TO ASSIST INDIVIDUALS WITH HEALTH CONCERNS AND ENCOURAGE A HEALTHIER LIFESTYLE. THESE SERVICES ARE IN ADDITION TO THE TRADITIONAL CHARITY CARE PROVIDED CONSISTENT WITH THE HOSPITAL'S MISSION. ADDITIONAL INFORMATION REGARDING SSMHC'S 2012 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHC.COM AND ON WWW.SAINTSOK.COM. 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 $ 7,150,816 UNPAID COST OF MEDICAID $ (12,806,071) UNPAID COST OF MEDICARE $ (735,632) COST OF BAD DEBT $ 14,683,029 COMMUNITY BENEFIT PROGRAMS $ 7,872,158 -------------------- TOTAL QUANTIFIABLE COMMUNITY BENEFIT $ 16,164,300 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 HEALTH CARE OF OKLAHOMA 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 CORPORATE 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 CORPORATE 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 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 THE REGIONAL 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 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 MEDICAL PHYSICIAN, PRACTITIONER, PSYCHAITRIST, RESIDENT, AND THERAPIST FEES: PROGRAM SERVICE EXPENSES 27,109,992. MANAGEMENT AND GENERAL EXPENSES 531,350. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,641,342. RECRUITMENT, CONSULTING, ADMINISTRATIVE, AND PBS FEES: PROGRAM SERVICE EXPENSES 22,009,316. MANAGEMENT AND GENERAL EXPENSES 4,235,874. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,245,190. MEDICAL LAB, RADIOLOGY, TRANSPORTATION: PROGRAM SERVICE EXPENSES 10,394,981. MANAGEMENT AND GENERAL EXPENSES 172,406. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,567,387. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: BENEFICIAL INTEREST IN FOUNDATION 1,982,286. TRANSFERS TO AFFILIATES -426,404. SAINTS MEDICAL GROUP 477 N LINDBERGH BLVD ST LOUIS MO 63141 760825755 MEDICAL SERVICES OK 17083844 7813277 SSM HEALTH CARE OF OKLAHOMA SSM HEALTH CARE CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 466029223 HEALTH CARE MO 501(C)(3) LINE 11A, I FRANCISCAN SISTERS OF MARY 0 SSM EMPLOYEE HEALTH CARE FUND 477 N LINDBERGH BLVD ST LOUIS MO 63141 431328934 BENEFIT PLANS MO 501(C)(9) SSM HEALTH CARE CORPORATION 0 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 0 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 0 SSM POLICY INSTITUTE 477 N LINDBERGH BLVD ST LOUIS MO 63141 431788151 HEALTH CARE MO 501(C)(4) SSM HEALTH CARE CORPORATION 0 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 0 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 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 1 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 0 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 0 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 0 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 0 CENTRALIA MEDICAL SERVICES BLDG ASSOC 477 N LINDBERGH BLVD ST LOUIS MO 63141 237408025 MOB 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 1 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 N/A 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 1 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. SERVICES IL N/A SMHC SURG CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929305 MANAGEMENT MO N/A SMHC CARD CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929381 MANAGEMENT MO N/A SMHC MUSC CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929237 MANAGEMENT MO N/A CHOWSMGSI 477 N LINDBERGH BLVD ST LOUIS MO 63141 371383861 MOB IL N/A COMP CANCER CARE 477 N LINDBERGH BLVD ST LOUIS MO 63141 201382727 MOB IL N/A SHAWNEE REAL ESTATE HOLDINGS LLC 1000 N LEE AVE OKLAHOMA CITY OK 73102 455458304 MOB OK N/A EXCLUDED 187266 7213166 0 0 SSM RX EXPRESS 477 N LINDBERGH BLVD ST LOUIS MO 63141 264031708 PHARMACY MO N/A B&JMCBRIDE OFFICE BUILDING LLC 1000 N LEE AVE OKLAHOMA CITY OK 73102 731533449 MOB OK N/A EXCLUDED 173200 1292108 0 0 SSM MANAGED CARE ORGANIZATION LLC 477 N LINBERGH BLVD ST LOUIS MO 63141 431708511 HEALTH PROMOTION MO N/A C 0 FPP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431465174 HEALTH CARE MO N/A C 0 DIVERSIFIED HEALTH SERVICES CORP 477 N LINBERGH BLVD ST LOUIS MO 63141 431369305 MEDICAL EQUIPMENT MO N/A C 0 SSM CARDIO AND THORACIC SERVICES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 260286559 HEALTH CARE MO N/A C 0 SSM PROPERTIES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431462486 PROPERTY SERVICES MO N/A C 0 SSM DEPAUL MEDICAL GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431715106 HEALTH CARE MO N/A C 0 SSM ST CHARLES CLINIC MED GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 430626408 PHYSICIAN OFFICES MO N/A C 0 HEALTH FIRST PHYS MANAGEMENT 477 N LINBERGH BLVD ST LOUIS MO 63141 731534336 MEDICAL SERVICES OK N/A C 0 SSMHCS LIABILITY TRUST II 477 N LINBERGH BLVD ST LOUIS MO 63141 816128118 INSURANCE MO N/A C 0 SSM NEUROSCIENCES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 263413981 HEALTH CARE MO N/A C 0 SSM MEDICAL GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431664107 PHYSICIAN OFFICES MO N/A C 0 SSMHC INSURANCE COMPANY 477 N LINBERGH BLVD ST LOUIS MO 63141 030310431 INSURANCE CA N/A C 0 SSM ORTHOPEDIC INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 271557033 HEALTH CARE MO N/A C 0 SSM CANCER CARE 477 N LINDBERGH BLVD ST LOUIS MO 63141 271557324 HEATH CARE MO N/A C 0 PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 364161526 HEATH CARE IL N/A C 0 1 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 SSM EMPLOYEE HEALTH CARE FUND R 27514574 COST ST ANTHONY HOSPITAL FOUNDATION C 1093282 CASH CONTRIBUTION ST ANTHONY HOSPITAL FOUNDATION P 793718 COST OF SERVICES LEE DEWEY CORPORATION K 1056117 RENTAL AGREEMENT LEE DEWEY CORPORATION P 369648 REIMBURSE EXPENSES