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        <NamePerson>JAMES M SANGER</NamePerson>
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        <NamePerson>WILLIAM P THOMPSON</NamePerson>
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        <NamePerson>KRIS A ZIMMER</NamePerson>
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        <NamePerson>MARY STARMANN-HARRISON</NamePerson>
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        <NamePerson>JUNE L PICKETT</NamePerson>
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        <NamePerson>ALISON RUEHL</NamePerson>
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        <NamePerson>JONATHAN KIMERLE</NamePerson>
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        <NamePerson>DAVID LUNDAL</NamePerson>
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        <NamePerson>MICHAEL PAASCH</NamePerson>
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        <NamePerson>KEVIN OLSON</NamePerson>
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        <NamePerson>KEVIN CROSS</NamePerson>
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      <Form990ScheduleJPartIII>
        <ReturnReference>PART I, LINE 1A</ReturnReference>
        <Explanation>PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2011, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: JONATHAN KIMERLE DAVID LUNDAL</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SUPPLEMENTAL INFORMATION</Identifier>
        <ReturnReference>PART III</ReturnReference>
        <Explanation>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) WRITTEN EMPLOYMENT CONTRACT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. 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. 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 2011. 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 2011. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. JAMES M SANGER $71,999 STEVEN BARNEY $66,707 PHIL GUSTAFSON $36,750 KEVIN OLSON $15,106</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>KRISTOPHER ZIMMER</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>FAMILY MEMBER OF KRIS ZIMMER</Relationship>
        <AmountOfTransaction>48797</AmountOfTransaction>
        <DescriptionOfTransaction>EMPLOYMENT</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>DOING BUSINESS AS:</Identifier>
        <ReturnReference>FORM 990, PART I</ReturnReference>
        <Explanation>SSM HEALTH BUSINESSES CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES: 1) SSM HOME CARE A)SSM HOME CARE AT ST. ANTHONY HOSPITAL B)SSM HOME CARE AT ST. FRANCIS HOSPITAL C)SSM HOME CARE AT ST. MARY'S HEALTH CENTER D)SSM HOME CARE OF ILLINOIS E)SSM HOME CARE OF ST. LOUIS F)SSM HOME CARE-PRIVATE DUTY G)SSM HOSPICE H)SSM HOSPICE AT ST. FRANCIS HOSPITAL I)SSM HOSPICE OF ILLINOIS 2) SSM HOME MEDICAL EQUIPMENT COMPANY 3) SSM INTEGRATED HEALTH TECHNOLOGIES</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROGRAM SERVICE STATEMENT</Identifier>
        <ReturnReference>FORM 990, PART III, LINE 4A</ReturnReference>
        <Explanation>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 17 HOSPITALS, TWO SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES IN FOUR STATES (WISCONSIN, ILLINOIS, OKLAHOMA AND MISSOURI). THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 24,000 PEOPLE AND IS AFFILIATED WITH MORE THAN 6,500 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: SSM INTEGRATED HEALTH TECHNOLOGIES DIVISION (SSMIHT) WORKS CLOSELY WITH OUR COLLEAGUES AT THE SSMHC HOSPITALS TO PROVIDE ASSISTANCE IN THEIR HEALTH CARE MINISTRY, INCLUDING PROVIDING TECHNOLOGY ASSISTANCE TO THEIR HEALTH COMMUNITY ACTIVITIES AS APPROPRIATE. SSMIHT HAS TWO PRIMARY, CLOSELY RELATED SERVICE SEGMENTS, CLINICAL ENGINEERING SERVICES (CES) AND INFORMATION TECHNOLOGY (IT). CES PROVIDES THE HIGHEST STANDARD OF MAINTENANCE, EQUIPMENT MANAGEMENT, AND TECHNOLOGY ASSESSMENT. THIS SERVICE ENABLES SSMHC CAREGIVERS TO PROVIDE SAFE AND RELIABLE SERVICE TO OUR PATIENTS. CES SERVICES ALSO REDUCE COST FOR HIGH QUALITY PERFORMANCE. IT SUPPORTS THE INFORMATION SYSTEMS, TELECOMMUNICATION AND NETWORK INFRASTRUCTURE FOR SSMHC ENTITIES. THIS INCLUDES SUPPORT OF A WIDE RANGE OF APPLICATIONS. CLINICAL APPLICATIONS PROVIDE THE INFORMATION SYSTEMS USED BY THE ACUTE CARE FACILITIES TO SERVE SSMHC'S CUSTOMERS AND INCLUDE A FULLY INTEGRATED ELECTRONIC HEALTH RECORD, PATIENT REGISTRATION, PATIENT ACCOUNTING, PHYSICIAN CONNECTIVITY, AND MULTIPLE OTHER APPLICATIONS. ALSO INCLUDED IN THE CLINICAL SYSTEMS GROUP ARE APPLICATIONS UTILIZED BY OUR NON-ACUTE CARE CUSTOMERS, AND INCLUDE A HOME HEALTH AND A PHYSICIAN PRACTICE MANAGEMENT SYSTEM. THE ADMINISTRATIVE APPLICATIONS PROVIDE THE BUSINESS INFORMATION SYSTEMS REQUIRED BY SSMHC TO EFFECTIVELY MANAGE OPERATIONS. INCLUDED IN THIS GROUP OF PRODUCTS IS AN ENTERPRISE RESOURCE PLANNING (ERP) SYSTEM, WHICH INCLUDES FINANCIAL, MATERIALS MANAGEMENT AND HR/PAYROLL COMPONENTS. SOME APPLICATIONS, SUCH AS DECISION SUPPORT MODELS AND BENCHMARKING SOFTWARE, ARE UTILIZED BY BOTH THE CLINICAL AND THE ADMINISTRATIVE APPLICATIONS. SUPPORT OF THESE SYSTEMS TAKES MANY FORMS. SSMIHT COORDINATES AND MANAGES ALL UPGRADES TO STANDARD APPLICATIONS, AS WELL AS NEW PRODUCT IMPLEMENTATIONS. OUR PRODUCT SPECIALISTS ARE KNOWLEDGEABLE IN ALL ASPECTS OF THE APPLICATION THEY SUPPORT AND PROVIDE CONSULTING SERVICES AS WELL AS PROBLEM RESOLUTION SERVICES TO THE SSMHC USER COMMUNITY. THE TECHNICAL SERVICE CENTER (TSC), SSMIHT'S CERTIFIED HELP DESK, HAS BEEN NATIONALLY RECOGNIZED FOR MULTIPLE BEST PRACTICES, AND PROVIDES THE FIRST LINE OF SUPPORT. APPLICATION DEVELOPMENT STAFF MODIFY AND ENHANCE APPLICATIONS TO MEET SPECIFIED USER NEEDS. SSMIHT ALSO ACTS AS A RESOURCE FOR PROJECT IMPLEMENTATION FOR PROJECTS THAT HAVE WIDESPREAD IMPACT TO THE ORGANIZATION, SUCH AS HIPAA. SSMIHT PROVIDES THE APPLICATION TECHNOLOGY AND HARDWARE INFRASTRUCTURE REQUIRED TO SUPPORT THESE APPLICATIONS. IN ADDITION TO MAINTAINING AND MONITORING COMPUTER OPERATIONS, THIS GROUP IS RESPONSIBLE FOR NETWORK MANAGEMENT AND CONSULTATION, AND ASSURING THE SECURITY AND INTEGRITY OF THE INFORMATION SYSTEMS. THESE SERVICES PROVIDE THE IT INFRASTRUCTURE AND OPERATIONS THAT ALLOW THE INFORMATION APPLICATIONS TO PROCESS AND FUNCTION OPTIMALLY. TECHNOLOGY CONSULTING IS ALSO A FUNCTION PROVIDED BY THE STAFF. SSMIHT'S SOLE PURPOSE IS PROVIDING SERVICE TO SSM FACILITIES TO CARRY OUT THE MISSION OF SSMHC. SSM HOME CARE STRIVES TO PROVIDE HOLISTIC AND FAMILY-CENTERED CARE. SSM HOME CARE PROVIDES A VARIETY OF HOME CARE SERVICES TO MEET A VARIETY OF NEEDS -WHEN EXTENDED CARE IS REQUIRED AFTER A HOSPITAL STAY, AS AN ALTERNATIVE TO A HOSPITAL ADMISSION, OR INSTEAD OF A NURSING HOME OR ALTERNATIVE CARE SETTING. OUR SERVICES CAN BE ARRANGED QUICKLY AND EFFICIENTLY BY A SINGLE PHONE CALL AND REFERRALS CAN BE MADE BY PHYSICIANS, CASE MANAGERS, SOCIAL WORKERS, FAMILY AND FRIENDS, OR BY REQUEST FROM THE PATIENT. THE HEALING SERVICES WE OFFER AT SSM HOME CARE INCLUDE SKILLED NURSING CARE, HOME HEALTH AIDES/NURSES ASSISTANTS, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH-LANGUAGE THERAPY, MATERNAL/CHILD/PEDIATRIC, NUTRITIONAL COUNSELING AND MEDICAL SOCIAL WORK. SSM HOSPICE PROVIDES HOSPICE CARE AT A TIME WHEN CARING, COMFORT, ASSISTANCE AND A SPECIAL KIND OF HEALING ARE NEEDED. IT IS A VERY SPECIAL WAY OF CARING FOR PEOPLE WITH A LIMITED LIFE EXPECTANCY. HOSPICE ALSO PROVIDES COMFORT AND GUIDANCE TO CARE GIVERS, FAMILIES AND FRIENDS OF THE PATIENT. HOSPICE CARE GIVES INDIVIDUALS AND THEIR CARE GIVERS A COMFORTING ALTERNATIVE TO THE TRADITIONAL HOSPITAL SETTING, MAKING IT POSSIBLE FOR THE TERMINALLY ILL PERSON TO REMAIN AT HOME OR IN OTHER FAMILIAR SURROUNDINGS. DESCRIBE THE CORPORATION'S FINANCIAL ASSISTANCE POLICIES OR PROGRAMS (E.G., CHARITY CARE, DISCOUNTING) FOR LOW-INCOME PERSONS AND HOW THEY ARE COMMUNICATED TO THE PUBLIC: SSM HOME CARE 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. SSM HOME CARE 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. SSM HOME CARE 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 NOT 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. SSM HOME CARE WILL PROVIDE INFORMATION ABOUT: A) THE PATIENT'S RESPONSIBILITY FOR PAYMENT; B) THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS; C) THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS AND D) WHOM TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING. SSM HOME CARE SHALL PROVIDE THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC: A) AT THE BEGINNING OF CARE, WHEN THE CAREGIVER FIRST GOES INTO THE HOME, THE PATIENT'S GUIDE TO FINANCIAL ASSISTANCE IS PROVIDED TO EACH PATIENT. B) NOTICES RELATED TO FINANCIAL ASSISTANCE ARE SENT TO PATIENTS: WHEN BILLED FOR THEIR PORTION OF THE BALANCE DUE C) IMMEDIATELY UPON REQUEST FROM THE PATIENT, PATIENT'S FAMILY, PATIENT'S PHYSICIAN OR SSM HOME CARE STAFF. D) ALL NOTICES WILL BE EASY TO UNDERSTAND BY THE GENERAL PUBLIC AND CULTURALLY APPROPRIATE. TRANSLATORS WILL BE AVAILABLE TO PROVIDE ASSISTANCE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. 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: THE DIVISIONS OF SSM HEALTH BUSINESS: - PROVIDE HOME HEALTH, HOSPICE AND TECHNICAL SUPPORT TO SSMHC HOSPITALS. IN ADDITION, SSM HOME CARE: A) PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. B) WORKS IN COOPERATION WITH SSMHC HOSPITALS AND PHYSICIANS TO PROVIDE A CONTINUUM OF CARE TO THE PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: SSM HOSPICE BEREAVEMENT PROGRAM - BEREAVEMENT COUNSELORS CONTINUE TO PROVIDE SUPPORTIVE SERVICES TO SURVIVORS FOR THIRTEEN MONTHS AFTER THE PATIENT HAS DIED. BEREAVEMENT SERVICES INCLUDE TELEPHONE CALLS, VISITS, LETTERS, SUPPORT GROUP MEETINGS AND INDIVIDUAL AND GROUP COUNSELING. BY RESPECTING INDIVIDUAL DIFFERENCES AND CULTURAL INFLUENCES THAT SURROUND GRIEVING, OUR TEAM PROMOTES A POSITIVE, HEALING EXPRESSION OF GRIEF CONSISTENT WITH SOCIAL AND RELIGIOUS EXPECTATIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>PART III, LINE 4A - DESCRIPTION OF PROGRAM SERVICE ACTIVITIES (CONTINUED)</ReturnReference>
        <Explanation>REDUCING HOSPITAL READMISSIONS INITIATIVE - THE INITIATIVE INCLUDES THE DEVELOPMENT OF SPECIFIC PROGRAMS AND STRATEGIES TO REDUCE HOSPITAL READMISSIONS WITHIN 30 DAYS OF DISCHARGE. HOME HEALTH DISEASE MANAGEMENT AND HOME CONNECTION PROGRAM HAVE BEEN DEVELOPED FOR PATIENTS WITH SPECIFIC DIAGNOSIS WITH SSMHC HOSPITALS WHOSE POST-HOSPITAL CARE IS PROVIDED BY SSM HOME CARE. BOTH PROGRAMS SUPPORT THE TRANSITION OF CARE FROM HOSPITAL TO HOME. SSM HOME CARE AND HOME CONNECTION PROGRAM TEACH PATIENTS HOW TO TAKE CARE OF THEMSELVES. THE PROGRAMS USE THE TECHNIQUES OF THE EVIDENCE-BASED CHRONIC CARE MODEL, WHICH HAS THE POTENTIAL TO IMPROVE PATIENT CARE AND CONTROL COTS. SSM HOME CARE STAFF CLARIFY HOSPITAL DISCHARGE MEDICATIONS IN THE HOME, MAKE SURE PATIENTS ARE TAKING MEDICATIONS AS PRESCRIBED AND ARE RESPONDING TO MEDICATIONS CORRECTLY; ASSESS HOME SAFETY; LOOK FOR OBSTACLES THAT MIGHT INTERFERE WITH HEALING AND TEACHING SIGNS AND SYMPTOMS OF EXACERBATIONS TO PREVENT HOSPITAL READMISSION. OTHER COMMUNITY BENEFIT ACTIVITIES - HOME CARE - STAFF MEMBERS PARTICIPATED IN THE UNITED WAY CAMPAIGN, THE BACK TO SCHOOL COLLECTION DRIVE, DOORWAYS "RED" GALA, HEALTH FAIR AND COMMUNITY RESOURCE EDUCATION PROGRAM. OTHER COMMUNITY BENEFIT ACTIVITIES - IHT - APPROXIMATELY 500 HOURS OF STAFF TIME WAS DEDICATED TO MEETINGS, TRAINING NEW TEAM MEMBERS, RUNNING REPORTS, DEVELOPING ONLINE COURSE, DEVELOPING PRESENTATION MATERIAL, AND FACILITATING BREAKOUT TRAINING SESSIONS ON COMMUNITY BENEFIT REPORTING. STAFF MEMBERS HELD THE REUSE, RECYCLE, REDECORATE SILENT AUCTION/SALE AND VOLUNTEERED AT THE ARBOR DAY TREE GIVEAWAY. STAFF MEMBERS PARTICIPATED IN VARIOUS COMMUNITY EVENTS INCLUDING VOLUNTEERING WITH THE HORIZON SCHOOL, RAINBOW PROJECT - CHILD AND FAMILY COUNSELING CLINIC, CIRCLE OF CONCERN, UNITED WAY, AND ST. LOUIS FOOD BANK VOLUNTEER DAY. THROUGH ITS CES DIVISION, SSM SSMIHT SAVES SSMHC APPROXIMATELY $11 MILLION ANNUALLY IN CLINICAL EQUIPMENT MAINTENANCE EXPENSES COMPARED TO OUTSOURCING ADDITIONAL INFORMATION REGARDING SSMHC'S 2011 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHC.COM. QUANTIFIABLE COMMUNITY BENEFIT THE FOLLOWING IS A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS COMMUNITY BENEFIT ACTIVITIES. TRADITIONAL CHARITY CARE $ 314,500 UNPAID COST OF MEDICARE $ 707,556 COST OF BAD DEBT $ 372,593 COMMUNITY BENEFIT PROGRAMS $ 13,214 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $ 1,407,863</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 6</ReturnReference>
        <Explanation>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 BUSINESSES AND SSM HEALTH CARE CORPORATION ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7A</ReturnReference>
        <Explanation>THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND APPOINT AND REMOVE DIRECTORS OF THE CORPORATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7B</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>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 SAME COMPARATIVE PROCESS IS PERFORMED INTERNALLY FOR EMPLOYEES. THE SALARY DATA AND POTENTIAL ADJUSTMENTS, FOR THE CEO OF THE SYTEM, THE PRESIDENT/COO AND THE SENIOR VICE PRESIDENTS ARE PRESENTED TO THE SSMHC BOARD OF DIRECTORS BY THE SAME INDEPENDENT COMPENSATION CONSULTANTS TO APPROVE, DISAPPROVE, MODIFY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>AVG HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED:</Identifier>
        <ReturnReference>FORM 990, PART VII:</ReturnReference>
        <Explanation>ALL INDIVIDUALS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION ARE EMPLOYED AND COMPENSATED BY THE ORGANIZATION OR BY A RELATED ORGANIZATION. IN ADDITION, ALL COMPENSATED REPORTABLE INDIVIDUALS LISTED ON FORM 990, PART VII WORK A MINIMUM OF 40 HOURS PER WEEK FOR SSMHC RELATED ORGANIZATIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>NET UNREALIZED LOSSES ON INVESTMENTS: -7,111,125. BENEFICIAL INTEREST IN FOUNDATION 97,576. TRANSFERS TO AFFILIATES 97,983. TOTAL TO FORM 990, PART XI, LINE 5: -6,915,566.</Explanation>
      </GeneralExplanation>
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