2012-11-15T17:01:45-06:00 2011-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 770022591 990 2011-01-01 466029223 SSM HEALTH CARE CORPORATION SSMH 3145238759 477 N LINDBERGH BLVD ST LOUIS MO 63141 JUNE L PICKETT 3145238759 2012-11-15 1 SRIRAM SRINIVASAN P00654717 7139822000 2011 2016-02-24 21:20:13Z SEE SCHEDULE O WILLIAM THOMPSON 477 N LINDBERGH BLVD ST LOUIS MO 63141 148372725 0 0928 X HTTP://WWW.SSMHC.COM X 1874 MO SEE SCHEDULE O 9 8 512 10 -56983 0 0 0 29724949 32097467 86078417 106502846 14554039 9772412 130357405 148372725 84900 152060 0 0 29478408 26437884 0 0 0 61725540 68942543 91288848 95532487 39068557 52840238 2185155989 2089501611 2159233931 2274010034 25922058 -184508423 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 152060 152060 32097467 SEE SCHEDULE O 152060 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 611 0 1 512 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X DONNA WALLACE 3145238793 12312 OLIVE BLVD SUITE 600 ST LOUIS MO 63141 SR ROSE DOWLING FSM 1.00 X 0 0 0 SR MARITA ANNE MARRAH FSM 1.00 X 0 0 0 SR IRMA KENNEBECK FSM 1.00 X 0 0 0 JOHN MOTEN 1.00 X 0 0 0 THOMS M NOONAN 1.00 X 0 0 0 SR MARGE O'GORMAN FSM 1.00 X 0 0 0 SR MARY JEAN RYAN FSM 40.00 X X 0 0 0 SR SUSAN SCHOLL FSM 1.00 X 0 0 0 SR SANDRA SCHWARTZ FSM 1.00 X 0 0 0 WILLIAM P THOMPSON 40.00 X X 1518393 0 741005 KRIS A ZIMMER 40.00 X 708536 0 189289 JUNE L PICKETT 40.00 X 224061 0 185772 STEVEN BARNEY 40.00 X 677427 0 38184 JAMES SANGER 40.00 X 842896 0 24901 MARY STARMANN-HARRISON 40.00 X 198348 0 124522 CHRISTOPHER HOWARD 40.00 X 822289 0 217130 DIXIE PLATT 40.00 X 465606 0 187812 PHILIP GUSTAFSON 40.00 X 593241 0 116181 THOMAS LANGSTON 40.00 X 581866 0 308345 PAULA FRIEDMAN 40.00 X 540978 0 207654 JOE HODGES 40.00 X 520135 0 176152 SHERLYN HAILSTONE 40.00 X 598587 0 160443 FRANK BYRNE 40.00 X 558918 0 156710 STEVEN JOHNSON 40.00 X 539699 0 229061 ROBERT PORTER 40.00 X 510511 0 216201 PATRICE KOMOROSKI 40.00 X 508298 0 169142 WILLIAM C SCHOENHARD 0.00 X 283017 0 109779 10692806 0 3558283 79 1 1 0 DELOITTE & TOUCHE LLP 100 S 4TH ST SUITE 300 ST LOUIS MO 63102 CONSULTING AND AUDIT SERVICES 5588358 CATHOLIC HEALTHCARE AUDIT NETWORK 231 S BEMISTON ST LOUIS MO 63105 INTERNAL AUDIT SERVICES 2258970 LOCKTON COMPANIES LLC 3 CITY PLACE DRIVE SUITE 900 ST LOUIS MO 63141 INSURANCE 1826949 INTERIOR CONSTRUCTION SERVICES LTD 2930 MARKET ST ST LOUIS MO 63103 CONSTRUCTION SERVICES 1469107 FRANCISCAN SISTERS OF MARY 3221 MCKELVEY RD SUITE 107 BRIDGETON MO 63044 MANAGEMENT SERVICES 1462410 31 CORPORTE FEES 561000 28179469 28179469 MANAGEMENT FEES 561000 2348708 2348708 OTHER OPERATING REV. 519100 1569290 1569290 32097467 58697245 58697245 47784905 20696 0 0 47784905 20696 47805601 47805601 JOINT VENTURE INCOME 900099 7180674 -56983 7237657 OTHER INCOME 900099 2591738 2591738 9772412 148372725 32097467 -56983 116332241 152060 152060 5107894 5107894 18822845 18822845 239232 239232 977418 977418 1290495 1290495 416817 416817 136047 136047 11649843 11649843 78932 78932 1201961 1201961 2316790 2316790 1300914 1300914 1269523 1269523 145357 145357 42186996 42186996 1100989 1100989 18647 18647 BOND RELATED FEES 5815768 0 5815768 0 LOSS ON EARLY EXTINGUIS 887425 0 887425 0 MISCELLANEOUS EXPENSES 314422 0 314422 0 UBI TAX 102112 0 102112 0 95532487 152060 95380427 0 282883 9146606 4318245 3798052 773626786 782741318 645651 896072 13839198 4527075 5361629 9312123 1300633343 1201008487 81932230 82490571 9208616 9254988 2185155989 2089501611 140621883 170878735 1157876734 1141026088 860735314 962105211 2159233931 2274010034 X 25893770 -184526468 1045 28288 17000 25922058 -184508423 2185155989 2089501611 X 52840238 -263270719 X 0 1 1 X 0 X X X 0 0 0 SSM HEALTH CARE ST LOUIS 431343281 3 1 0 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 430738490 3 1 0 SSM HEALTH CARE OF WISCONSIN INC 430688874 3 1 0 SSM HEALTH CARE OF OKLAHOMA INC 730657693 3 1 0 SSM REGIONAL HEALTH SERVICES 440579850 3 1 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 430653587 3 1 0 ST MARY'S HOSPITAL 370662580 3 1 0 7 0 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SSM HEALTH CARE CORPORATION (SSMHC) IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED EXCLUSIVELY TO SUPPORT THE OPERATIONS OF ALL ITS RELATED ORGANIZATIONS LISTED ON SCHEDULE A, PART I, LINE 11(H). THE AMOUNT OF SUPPORT PROVIDED TO THESE ORGANIZATIONS, REPORTED ON SCHEDULE A, PART I, LINE 11(H)(VII), DOES NOT INCLUDE EXPENSES PAID ON BEHALF OF BUT NOT DIRECTLY TO THE ENTITIES SSMHC SUPPORTS. THESE EXPENSES TOTALED $95,380,427 DURING THE YEAR ENDED DECEMBER 31, 2011. 0 1 0 1 136451 0 0 1 138161 0 0 274612 0 28289 1046 11289 18046 26092 2197 28289 22624 3468 26092 22624 22624 0.94000 0.06000 0 0 3438472 1259319 2179153 5882956 3267756 2615200 4517770 4517770 9312123 CAPITAL LEASE OBLIGATION 26331258 DEFERRED COMPENSATION 66706771 SWAPS MARK TO MARKET LIABILITY 135459790 RABBI TRUST LIABILITY 30954780 PENSION LIABILITY 702652612 962105211 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SSMHC'S ENDOWMENT FUNDS ARE TO BE USED TO DEFRAY THE COSTS OF AN ANNUAL EXECUTIVE LEVEL MANAGEMENT MEETING. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: SSM HEALTH CARE CORPORATION EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2011 OR 2010. 1 ST MARY'S FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940686 501(C)(3) 125000 ESTABLISH A NURSING ENDOWMENT MIGRANT HEALTH PROMOTIONS 224 W MICHIGAN AVE SALINE MI 48176 383092194 501(C)(3) 15000 GENERAL PROGRAM SUPPORT URBAN LEAGUE OF METROPOLITAN STLOUIS 3701 GRANDEL SQUARE ST LOUIS MO 63118 430653605 501(C)(3) 5500 GENERAL PROGRAM SUPPORT 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION'S GRANTS WERE MADE TO ORGANIZATIONS TAX EXEMPT UNDER IRC SECTION 501 (C)(3). THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 WILLIAM P THOMPSON 1013217 0 0 0 505176 0 725268 0 15737 0 2259398 0 0 0 KRIS A ZIMMER 661311 0 0 0 47225 0 162685 0 26604 0 897825 0 0 0 JUNE L PICKETT 217587 0 0 0 6474 0 169142 0 16630 0 409833 0 0 0 STEVEN BARNEY 539974 0 0 0 137453 0 16752 0 21432 0 715611 0 0 0 JAMES SANGER 702345 0 0 0 140551 0 6130 0 18771 0 867797 0 0 0 MARY STARMANN-HARRISON 152328 0 0 0 46020 0 119274 0 5248 0 322870 0 0 0 CHRISTOPHER HOWARD 768126 0 0 0 54163 0 190088 0 27042 0 1039419 0 0 0 DIXIE PLATT 433470 0 0 0 32136 0 161029 0 26783 0 653418 0 0 0 PHILIP GUSTAFSON 520187 0 0 0 73054 0 86661 0 29520 0 709422 0 0 0 THOMAS LANGSTON 474427 0 0 0 107439 0 277310 0 31035 0 890211 0 0 0 PAULA FRIEDMAN 466031 0 0 0 74947 0 191795 0 15859 0 748632 0 0 0 JOE HODGES 484905 0 0 0 35230 0 146883 0 29269 0 696287 0 0 0 SHERLYN HAILSTONE 550227 0 0 0 48360 0 136938 0 23505 0 759030 0 0 0 FRANK BYRNE 496667 0 0 0 62251 0 138295 0 18415 0 715628 0 0 0 STEVEN JOHNSON 404986 0 0 0 134713 0 212190 0 16871 0 768760 0 0 0 ROBERT PORTER 445542 0 0 0 64969 0 192832 0 23369 0 726712 0 0 0 PATRICE KOMOROSKI 412374 0 0 0 95924 0 157337 0 11805 0 677440 0 0 0 WILLIAM C SCHOENHARD 0 0 0 0 283017 0 94615 0 15164 0 392796 0 0 0 PART I, LINES 4A-B PART I, LINES 4A-B SUPPLEMENTAL INFORMATION PART III PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2011. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. WILLIAM THOMPSON KRIS ZIMMER CHRISTOPHER HOWARD DIXIE PLATT THOMAS LANGSTON PAULA FRIEDMAN STEVEN JOHNSON SHERLYN HAILSTONE FRANK BYRNE JOE HODGES PATRICE KOMOROSKI ROBERT PORTER THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2011. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. JAMES SANGER FRANK BYRNE PHILIP GUSTAFSON STEVEN BARNEY CHRISTOPHER HOWARD PAULA FRIEDMAN SHERLYN HAILSTONE STEVEN JOHNSON PATRICE KOMOROSKI ROBERT PORTER PART I, LINE 4A: SEVERANCE PLAN: SSMHC HAS ADOPTED A SEVERANCE POLICY TO PROVIDE A FINANCIAL TRANSITION IN THE EVENT OF INVOLUNTARY TERMINATION WITHOUT CAUSE FOR EXECUTIVE LEVEL POSITIONS. THE AMOUNT OF THE COMPENSATION IS BASED ON THE POSITION HELD AND LENGTH OF SERVICE WITH SSMHC. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENTS UNDER THE PLAN IN THE CURRENT YEAR 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 SSMHCS 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 PHILIP GUSTAFSON $ 36,750 STEVEN BARNEY $ 66,707 PATRICE KOMOROSKI $ 19,155 HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI HEALTH 431178966 60635R2Z9 2008-05-15 100851259 TO FINANCE / REFINANCE CAPITAL IMPROVEMENTS 0 0 0 HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI HEALTH 431178966 60635RU70 2005-07-21 198800000 SEE PART VI 0 0 0 HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI HEALTH 431178966 60635RV20 2005-07-21 555100000 SEE PART VI 0 0 0 WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BUX8 2010-05-13 125000551 TO FINANCE / REFINANCE CAPITAL IMPROVEMENTS 0 0 0 100851259 100851259 2009 0 0 1 1 134200000 204402773 1729412 165864999 36808362 2008 1 0 1 1 295675000 557582390 6776384 122495329 428310677 2008 0 1 1 1 920000 125438268 125438268 2011 0 0 0 1 0 1 1 1 1 1 0.00860 0.00860 1 0 1 1 1 1 1 0.01980 0.01980 1 0 1 1 1 1 1 0.01980 0.01980 1 0 1 1 1 1 1 0.01390 0.01390 1 0 0 0 0 0 1 1 1 1 UBS AG & CITIBANK NA 29.900000000000 0 1 0 0 1 0 1 1 UBS AG & CITIBANK NA 27.900000000000 0 1 0 1 0 0 1 0 0 0 0 SCHEDULE K SUPPLENTAL INFORMATION PART II LINE 3: TOTAL PROCEEDS OF ISSUE EXCEED THE AMOUNT SHOWN IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS FROM THE PROJECT FUND. PART IV LINE 3C: THE TERMS OF THE HEDGES SHOWN REFLECT THE ORIGINAL TERMS, NOT ADJUSTED FOR THE EARLY TERMINATION. PART IV LINE 5 COLUMN C: GROSS PROCEEDS WERE HELD IN A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW. PART IV LINE 5 COLUMN A OF THE SECOND PAGE (2010 MISSOURI BONDS): GROSS PROCEEDS WERE HELD IN A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW. PART IV, COLUMN B, LINE 1 COMPARED TO LINE 6: THE CURRENT REFUNDING PORTION OF THESE BONDS QUALIFIED FOR A SPENDING EXCEPTION, BUT THE PROJECT PORTION OT THESE BONDS DID NOT QUALIFY FOR THE EXCEPTION. SSM MADE A REBATE PAYMENT AND FILED IRS FORM 8038-T FOR THIS ISSUE. PART IV LINE 6 OF THE SECOND PAGE (2010 MISSOURI BONDS): THE CURRENT REFUNDING PORTION OF THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION, BUT THE PROJECT PORTION DID NOT. SCHEDULE K, PART I, LINE B HEALTH & EDUCATION FACILITIES AUTHORITY OF THE STATE OF MISSOURI (2005A-B) (1) TO FINANCE VARIOUS CAPITAL IMPROVEMENTS AND (2) TO REFUND SERIES 1995A OKLAHOMA BONDS, SERIES 1995A WISCONSIN BONDS, AND SERIES 1995A ILLINOIS BONDS, ALL ISSUED 7/12/1995. REFUNDED BONDS COMPRISE (A) $10,015,000 ORIGINAL PRINCIPAL AMOUNT HEALTH FACILITIES REVENUE BONDS (SSM HEALTH CARE PROJECTS) SERIES 1995A, ISSUED BY THE ILLINOIS FINANCE AUTHORITY (SUCCESSOR TO THE ILLINOIS HEALTH FACILITIES AUTHORITY) (THE "SERIES 1995A ILLINOIS BONDS"); (B) $15,055,000 ORIGINAL PRINCIPAL AMOUNT HEALTH FACILITIES REVENUE BONDS (ST. ANTHONY HOSPITAL PROJECT) SERIES 1995A, ISSUED BY THE OKLAHOMA CITY INDUSTRIAL AND CULTURAL FACILITIES TRUST (THE "SERIES 1995A OKLAHOMA BONDS"); AND (C) $21,605,000 ORIGINAL PRINCIPAL AMOUNT HEALTH FACILITIES REFUNDING REVENUE BONDS (SSM HEALTH CARE PROJECTS) SERIES 1995A, ISSUED BY THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY (THE "SERIES 1995A WISCONSIN BONDS"). SCHEDULE K, PART I, LINE C HEALTH & EDUCATION FACILITIES AUTHORITY OF THE STATE OF MISSOURI (2005CD) (1) TO FINANCE CAPITAL IMPROVEMENTS AND (2) TO REFUND SERIES 1998A BONDS, ISSUED 5/20/1998 AND SERIES 2001A BONDS, ISSUED 5/22/2001. REFUNDED BONDS COMPRISE (A) $179,030,000 ORIGINAL PRINCIPAL AMOUNT REVENUE BONDS (SSM HEALTH CARE ) SERIES 1998A, ISSUED BY THE HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI ("MOHEFA") (THE "SERIES 1998A BONDS" ) AND (B) $220,360,000 ORIGINAL PRINCIPAL AMOUNT REVENUE BONDS (SSM HEALTH CARE) SERIES 2001A ISSUED BY MOHEFA (THE "SERIES 2001A BONDS"). SCHEDULE K, PART I, LINE A OF THE SECOND PAGE HEALTH & EDUCATION FACILITIES AUTHORITY OF THE STATE OF MISSOURI (2010BCDE) (1) TO FINANCE VARIOUS CAPITAL EQUIPMENT AND IMPROVEMENTS AND (2) TO REFUND SERIES 2001A BONDS ISSUED ON 5/22/2001, SERIES 2005AB BONDS ISSUED ON 7/21/2005, AND SERIES 2005CD BONDS ISSUED 7/21/2005. SCHEDULE K, PART V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION DUE TO SOFTWARE LIMITATIONS, THIS QUESTION HAS BEEN ANSWERED "NO" ON SCHEDULE K, AS THE SOFTWARE DOES NOT PROVIDE A MECHANISM TO ENTER A YES RESPONSE. HOWEVER, FOR THE YEAR ENDED DECEMBER 31, 2011, TEH ORGANIZATION HAS ESTABLISHED WRITTEN PROCEDURES TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDICATION IS NOT AVAILABLE UNDER APPLICABLE REGULATIONS. HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI HEALTH 431178966 60635R7B7 2010-05-13 450254794 SEE PART VI 0 0 0 1450000 450254795 244374 165003260 285007161 2010 1 1 0 1 0 1 1 1 1 1 0.03130 0.03130 1 0 1 0 0 1 0 ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION'S MISSION: THE ORGANIZATION IS THE PARENT OF THE SSM HEALTH CARE SYSTEM. THE ORGANIZATION PROVIDES MANAGEMENT AND CENTRALIZED SUPPORT SERVICES TO THE HOSPITALS AND OTHER HEALTH CARE ORGANIZATIONS WITHIN THE SYSTEM. FORM 990, PART I, DOING BUSINESS AS: SSM HEALTH CARE CORPORATION CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES: SSM HEALTH CARE SSM HEALTH CARE CORPORATE ARCHIVES SSM SUPPORT SERVICES PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A: HOSPITAL COMMUNITY BENEFIT REPORT 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 HOSPITAL LOCATIONS, TWO SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES IN FOUR STATES (WISCONSIN, OKLAHOMA, ILLINOIS, 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: SSMHC'S CORPORATE OFFICE PROVIDES SERVICES TO ALL SSMHC FACILITIES. THESE SERVICES INCLUDE THE FOLLOWING: IMPLEMENTATION AND OPTIMIZATION OF A COMMON PLATFORM OF CARE FOR SSMHC FACILITIES; SUPPORT AND IMPLEMENTATION OF THE ELECTRONIC HEALTH RECORDS AT SSMHC HOSPITALS AND FACILITIES; EVALUATION AND CONSULTATION OF NEW GROWTH STRATEGIES AND OPPORTUNITIES; COMMUNICATIONS COUNSEL, STRATEGY AND PLANNING; OVERSIGHT OF THE MISSION AWARENESS TEAMS AND SPIRITUAL CARE DEPARTMENTS; HIGH-LEVEL CORPORATE RESPONSIBILITY PROCESS OVERSIGHT TO ENSURE ETHICAL AND LEGAL COMPLIANCE; ORGANIZATIONAL AND CLINICAL ETHICS EDUCATION; AND POLICY WRITING AND REVIEW. OTHER SERVICES INCLUDE CAPITAL PLANNING AND ALLOCATION; STRATEGIC, FINANCIAL AND HUMAN RESOURCE PLAN PREPARATION; INVESTMENT MANAGEMENT AND DEBT FINANCING; SYSTEM-LEVEL INTERNAL AND EXTERNAL FINANCIAL REPORTING; TAX COMPLIANCE PROCESS MANAGEMENT; EMPLOYEE BENEFITS ADMINISTRATION; EDUCATIONAL PROGRAM OFFERINGS FOR LEADERSHIP DEVELOPMENT; AND RISK MANAGEMENT STRATEGIES. DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: SSM HEALTH CARE'S CORPORATE OFFICE OVERSEES COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM. THE ANNUAL STRATEGIC, FINANCIAL, AND HUMAN RESOURCES PLANNING PROCESS HAS INCLUDED AN ASSESSMENT OF THE COMMUNITY'S NEEDS TO INCLUDE THE IDENTIFICATION OF SPECIFIC AND MEASUREABLE HEALTHY COMMUNITIES' INITIATIVES. OUR SYSTEM VISION FOR IMPROVED COMMUNITY HEALTH IS PURSUED IN ALL OF OUR WORK AT SSM HEALTH CARE FROM STRATEGIC PLANNING, FINANCIAL MANAGEMENT, AND DIRECT PATIENT CARE TO ADVOCACY, COMMUNITY PARTNERSHIPS AND HEALTHY COMMUNITIES INITIATIVES. 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 WITH THE FINANCIAL LIMITS OF THE SYSTEM. AS OF JANUARY 2011, THE PRIMARY FOCUS OF SSM HEALTH CARE'S HEALTHY COMMUNITIES INITIATIVES (HCIS) HAS BEEN ON ONE OF THE TOP-THREE CHRONIC DISEASES IN EACH ENTITY'S/NETWORK'S RESPECTIVE MARKET (E.G., CHF, DIABETES, ASTHMA) AS IDENTIFIED THROUGH, AMONG OTHER DATA SOURCES, COMMUNITY NEEDS ASSESSMENTS, CONSUMER/PUBLIC HEALTH STUDIES AND STATE/LOCAL HEALTH DEPARTMENT INFORMATION. COMMUNITY HEALTH IMPROVEMENT, WHICH WE PURSUE AS A SYSTEM PRIMARILY THROUGH HCIS UNDERTAKEN AT THE ENTITY LEVEL, IS FUNDAMENTAL TO OUR MISSION, VALUES, AND VISION. OVER THE YEARS MANY PEOPLE HAVE BENEFITED FROM OUR HCIS AND MUCH GOOD HAS COME FROM THEM. IN AN EFFORT TO BEST RESPOND TO COMMUNITY NEEDS, HCIS HAS REFOCUSED ITS EFFORTS TOWARD A NEW APPROACH TO COMMUNITY HEALTH, AS OUTLINED HERE. CHRONIC DISEASE IS RAMPANT THROUGHOUT THE U.S WHERE ROUGHLY HALF OF ALL ADULTS AND 10% OF CHILDREN/ADOLESCENTS LIVE WITH AT LEAST ONE CHRONIC DISEASE. OF THESE AN ESTIMATED 13 MILLION LACK HEALTH INSURANCE AND THEREBY HAVE POORER ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES THAN THEIR INSURED COUNTERPARTS AND EXPERIENCE WORSE HEALTH-RELATED OUTCOMES, INCLUDING PREMATURE DEATH. IN RESPONSE TO THIS GROWING NATIONAL HEALTH CRISIS, SYSTEM MANAGEMENT HAS SET THE EXPECTATION THAT ALL SSM OPERATING ENTITIES, WORKING INDIVIDUALLY OR COLLECTIVELY AS NETWORKS, IN COLLABORATION WITH COMMUNITY PARTNERS, WILL DEVELOP HCIS FOCUSED ON THE CHRONIC DISEASE SELECTED THAT ADDRESSES THREE PILLARS THAT STRETCH ACROSS THE CARE CONTINUUM: - PREVENTION THROUGH COMMUNITY EDUCATION IN PARTNERSHIP WITH COMMUNITY HEALTH ORGANIZATIONS, LOCAL HEALTH AGENCIES, CHURCHES, CIVIC CENTERS, SCHOOLS, INSURANCE COMPANIES AND OTHER COMMUNITY PARTNERS -ACCESS TO PRIMARY CARE SERVICES AND NECESSARY MEDICATIONS IN CONJUNCTION WITH COMMUNITY HEALTH ORGANIZATIONS, LOCAL HEALTH AGENCIES AND CLINICS, EMPLOYED COMMUNITY PHYSICIANS AND PHARMACEUTICAL COMPANIES. -INPATIENT CARE INCLUDING PATIENT EDUCATION, COMPREHENSIVE DISCHARGE PLANNING, MEDICATION RECONCILIATION, COORDINATION OF CARE ACROSS SETTINGS AND POST-DISCHARGE FOLLOW-UP. INITIALLY, THE STRATEGIC GOAL WILL BE TO REDUCE THE 30-DAY HOSPITAL READMISSION RATE FOR THE CHRONIC DISEASE SELECTED. THIS HAS THE MOST IMMEDIATE IMPACT. AS WE DEVELOP OUR COMMUNITY PARTNERSHIPS AND BEGIN TO IMPACT THE WHOLE CASE CONTINUUM, ADDITIONAL GOALS CAN BE ADDED THAT ADDRESS KEY INDICATORS OF COMMUNITY/POPULATION HEALTH (E.G., PREVALENCE AND INCIDENCE RATES, SCREENING RATES, HOSPITAL ADMISSION RATES, BEHAVIORAL AND LIFESTYLE FACTORS). ENTITIES MUST ESTABLISH SPECIFIC STRATEGIES AND DEVELOP CLEAR INDICATORS OR MEASURES OF SUCCESS TO TRACK PROGRESS. IN ADDITION TO THE HEALTHY COMMUNITIES, EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TO SUPPORT THE COMPLETION OF A CHNA IN ACCORDANCE WITH ESTABLISHED GUIDELINES, A SIX-STEP PROCESS WAS DEVELOPED. THE PROCESS DEFINES AN APPROACH THAT CAN BE USED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY SSM HEALTH CARE AND DEVELOP STRATEGIES FOR MEETING THOSE NEEDS. THE PROCESS INCLUDES: -DEVELOP A PLAN TO ADDRESS HEALTH REFORM MANDATES TO INCLUDE DEFINING HOW THE ASSESSMENT AND BY WHOM THE ASSESSMENT WILL BE COMPLETED; IDENTIFYING THE STAKEHOLDERS INVOLVED; AND THE TIME FRAME FOR COMPLETION -PERFORM DATA COLLECTION INCLUDING IDENTIFYING THE GEOGRAPHIC AREA SERVED, ACCESSING SECONDARY DATA SOURCES AND COORDINATING INTERVIEWS, SURVEY AND/OR FOCUS GROUPS FOR PRIMARY DATA COLLECTION -PERFORM DATA ANALYSIS BY EVALUATING QUANTITATIVE AND QUALITATIVE DATE 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 DESCRIBE THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICIES OR PROGRAMS (E.G., CHARITY CARE, DISCOUNTING) FOR LOW-INCOME PERSONS AND HOW THEY ARE COMMUNICATED TO THE PUBLIC. ALL SSMHC FACILITIES WILL STRIVE TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF SSMHC, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMHC FACILITIES OFFER DISCOUNTS FOR HOSPITAL SERVICES TO ALL UNINSURED PERSONS. SELF-PAY DISCOUNTS APPLY TO EVERYONE WHO DOES NOT HAVE HEALTH INSURANCE, NO MATTER THEIR ABILITY TO PAY. SSMHC WILL APPLY ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMHC EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNT IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. FORM 990, PART III, LINE 4A: HOSPITAL COMMUNITY BENEFIT REPORT - CONTINUED EACH ENTITY PROVIDING MEDICAL SERVICES SHALL PROVIDE INFORMATION TO THE PUBLIC REGARDING ITS CHARITY CARE POLICIES AND THE QUALIFICATION REQUIREMENTS FOR EACH OF ITS FACILITIES. WHEN STANDARD SYSTEM NOTICES AND COMMUNICATIONS REGARDING CHARITY CARE ARE AVAILABLE, THESE MUST BE USED. MODIFICATIONS TO THE STANDARD MAY BE MADE TO COMPLY WITH STATE AND LOCAL LAWS, AS WELL AS REFLECT CULTURALLY SENSITIVE TERMINOLOGY FOR THE POLICY. ALL NOTICES WILL BE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY. THEY WILL PROVIDE INFORMATION ABOUT: -THE PATIENT'S RESPONSIBILITY FOR PAYMENT; -THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS; -THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS: AND -WHOM TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING. THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC SHALL BE PROVIDED: -SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS. -BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. -NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES. -APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES WILL ALSO BE PROVIDED TO PUBLIC AGENCIES. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION: SSMHC HOSPITALS: -OPERATE AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; -HAVE AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; -HAVE A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY; -ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS; -PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: 1. SSM'S CORPORATE OFFICE DEMONSTRATED ITS COMMITMENT TO PRESERVING THE ENVIRONMENT BY PARTICIPATING IN A COLLECTION/RECYCLING EVENT FOR COMPUTERS AND OTHER ELECTRONICS WHICH WERE DONATED TO WEB INNOVATIONS & TECHNOLOGY SERVICES, A LOCAL NON-PROFIT ORGANIZATION WHICH REPAIRS AND RECYCLES ELECTRONICS, AND PROVIDES EMPLOYMENT, EDUCATION AND FREE COMPUTERS TO SCHOOLS AND CHURCHES WHICH OTHERWISE COULD NOT AFFORD THESE ITEMS. 2. STAFF MEMBERS CONTRIBUTED THEIR TIME TO THE ST. LOUIS REGIONAL COMMERCE AND GROWTH ASSOCIATION, INCLUDING THEIR PUBLIC POLICY COMMITTEE. THE ORGANIZATION UNITES THE ST. LOUIS REGION'S BUSINESS COMMUNITY TO DEVELOP AND SUSTAIN A WORLD-CLASS ECONOMY AND COMMUNITY. 3. STAFF MEMBERS CONTRIBUTED THEIR TIME TO ASSOCIATED INDUSTRIES OF MISSOURI, A GROUP THAT BELIEVES THAT THE TRANSPORTATION SYSTEM IN MISSOURI DEMANDS CONTINUING CARE AND ATTENTION BECAUSE IT IS VITAL TO THE STATE'S ECONOMIC WELFARE AND QUALITY OF LIFE. 4. SSM STAFF SERVE ON THE BOARD OF LEADING AGE MISSOURI, AN ORGANIZATION THAT SERVES THE NEEDS OF PROVIDERS OF HEALTH CARE HOUSING AND SERVICES FOR MISSOURI'S ELDERLY. 5. STAFF MEMBERS CONTRIBUTE THEIR TIME TO THE LEADERSHIP COUNCIL SOUTHWESTERN ILLINOIS. THIS ORGANIZATION HAS BEEN THE PREMIER ECONOMIC DEVELOPMENT ORGANIZATION FOR MADISON AND ST CLAIR COUNTIES SINCE 1983. THEIR MISSION IS TO ATTRACT AND RETAIN JOBS, STIMULATE CAPITAL INVESTMENT, AND PROMOTE THE ECONOMIC DEVELOPMENT OF SOUTHWESTERN ILLINOIS BY BUILDING EFFECTIVE PARTNERSHIPS WITH LEADERS IN BUSINESS, INDUSTRY, GOVERNMENT, EDUCATION AND LABOR. 6. SSM'S CORPORATE OFFICE HELD A COMMUNITY BENEFIT FORUM TO BRING TOGETHER COMMUNITY BENEFIT PERSONNEL FOR TWO DAYS OF TRAINING ON COMMUNITY BENEFIT REPORTING. TOPICS INCLUDED HOW TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT, REPORTING COMMUNITY BENEFITS TO THE INTERNAL REVENUE SERVICE, THE NEW ERA OF COMMUNITY BENEFIT REPORTING, AND EMBRACING COMMUNITY BENEFIT REPORTING TO MAKE A REAL AND LASTING CHANGE. IN ADDITION, THE SSM CORPORATE OFFICE GATHERED VARIOUS RESOURCES TO PREPARE A COMMUNITY BENEFIT TOOL KIT AND ESTABLISHED A SHARE POINT SITE FOR THE DISSEMINATION OF COMMUNITY BENEFIT INFORMATION. 7. IN 2011, THE CORPORATE OFFICE HELD AN EVENT CALLED "HEARTFELT THANKS!" TO SHOW APPRECIATION TO THEIR COWORKERS BY SENDING THEM A CARNATION AND THANK YOU NOTE FOR $1.00 PER FLOWER. THE MONEY RAISED FROM THE EVENT WAS DONATED TO OPERATION FOOD SEARCH'S BACKPACK PROGRAM. EACH WEEK THE BACKPACK PROGRAM PROVIDES BACKPACKS FILLED WITH NUTRITIOUS, KID-FRIENDLY, EASY-TO-PREPARE FOODS TO ST. LOUIS PUBLIC SCHOOL CHILDREN WHO RELY ON FREE OR REDUCED-COST MEAL PROGRAMS. THE CHILDREN RECEIVE THE BACKPACKS ON FRIDAY AS SCHOOL DISMISSES. ON MONDAY, THEY RETURN THE EMPTY BACKPACK TO BE REFILLED FOR THE FOLLOWING WEEKEND. THE EMPLOYEES RAISED AND DONATED OVER $727.00 FOR OPERATION BACKPACK. SSM'S CORPORATE OFFICE STAFF SUPPORTED THE LOCAL UNITED WAY CAMPAIGN BY RAISING OVER $58,000 IN DONATIONS FROM STAFF. ADDITIONAL INFORMATION REGARDING SSMHC'S 2011 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHC.COM. QUANTIFIABLE COMMUNITY BENEFIT THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS COMMUNITY BENEFIT ACTIVITIES. COMMUNITY BENEFIT PROGRAMS $358,487 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERS. THESE MEMBERS CONSIST OF THE PRESIDENT AND COUNSELORS OF THE FRANCISCAN SISTERS OF MARY (FOUR INDIVIDUALS). THE VOTING RIGHTS, INTERESTS AND PRIVILEGES OF EACH MEMBER ARE EQUAL. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS HAVE THE POWER TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE, EXCEPT FOR THOSE WHO SERVE EX-OFFICIO. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE CERTIFICATE OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE MEMBER OF THE MEMBER AS DETERMINED BY THE MEMBER OF THE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTING/FINANCE PERSONNEL AT SSMHC PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AT THE CORPORATE OFFICE AND COORDINATED WITH THE SYSTEM LEVEL FORM 990 INFORMATION. THE INFORMATION IS SUBMITTED TO AN OUTSIDE TAX CONSULTING FIRM WHO PREPARES AND SIGNS THE FORM 990 FROM THE SSMHC INFORMATION. PRIOR TO FINALIZING THE RETURN, A DRAFT IS SENT TO PERSONNEL AT SSMHC FOR REVIEW AND APPROVAL. UPON SSMHC APPROVAL, THE OUTSIDE PREPARER FORWARDS THE COMPLETED FORM 990 FOR THE APPROPRIATE SIGNATURES AND FILING ACTION. A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE BOARD AT ITS NEXT SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. FORM 990, PART VI, SECTION B, LINE 15 ALL SSMHC EXECUTIVE SALARY/COMPENSATION INFORMATION IS BASED ON COMPARATIVE DATA WITH SIMILAR POSITIONS IN THE MARKET. THE COMPENSATION REVIEW PROCESS IS PERFORMED BY EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS. THE SAME COMPARATIVE PROCESS IS PERFORMED INTERNALLY FOR EMPLOYEES. THE SALARY DATA AND POTENTIAL ADJUSTMENTS, FOR THE CEO OF THE SYSTEM, 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, OR MODIFY. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -150,059,397. TRANSFER TO AFFILIATES 844,011. NET PENSION LIABILITY -114,055,333. TOTAL TO FORM 990, PART XI, LINE 5: -263,270,719. SSM EMPLOYEE HEALTH CARE FUND 477 N LINDBERGH BLVD ST LOUIS MO 63141 431328934 BENEFIT PLANS MO 501(C)(9) SSM HEALTH CARE CORPORATION 1 SSHCS LIABILITY TRUST I 477 N LINDBERGH BLVD ST LOUIS MO 63141 436331003 INSURANCE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM CONSOLIDATED HEALTH SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431473657 HEALTH CARE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM POLICY INSTITUTE 477 N LINDBERGH BLVD ST LOUIS MO 63141 431788151 HEALTH CARE MO 501(C)(4) SSM HEALTH CARE CORPORATION 1 SSM PORTFOLIO MANAGEMENT CO 477 N LINDBERGH BLVD ST LOUIS MO 63141 431825256 MANAGEMENT MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 1 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 477 N LINDBERGH BLVD ST LOUIS MO 63141 430738490 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE ST LOUIS 0 GLENNON HOSPITAL GUILD 477 N LINDBERGH BLVD ST LOUIS MO 63141 431030299 FUNDRAISING MO 501(C)(3) LINE 9 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 0 CARDINAL GLENNON CHILDREN'S FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431754347 FUNDRAISING MO 501(C)(3) LINE 7 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 0 SSM DEPAUL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431776109 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST JOSEPH FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431591556 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST CLARE HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431273310 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431552945 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM HEALTH CARE OF OKLAHOMA INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 730657693 HEALTH CARE OK 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 ST ANTHONY HOSPITAL FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 736104300 FUNDRAISING OK 501(C)(3) LINE 7 SSM HEALTH CARE OF OKLAHOMA 0 SSM HEALTH CARE OF WISCONSIN INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 430688874 HEALTH CARE WI 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 DELLS MEDICAL BUILDING INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 391613292 MOB WI 501(C)(2) SSM HEALTH CARE OF WISCONSIN 0 ST MARY'S FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940686 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 ST CLARE HEALTH CARE FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940683 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 HOME HEALTH UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391539827 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HOME CARE UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391776340 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HHU XTRA CARE INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391705111 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 SSM REGIONAL HEALTH SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 440579850 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 1 ST FRANCIS HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431099253 FUNDRAISING MO 501(C)(3) LINE 7 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431575307 FUNDRAISING MO 501(C)(3) LINE 11B, II SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 477 N LINDBERGH BLVD ST LOUIS MO 63141 430653587 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S HOSPITAL CENTRALIA ILLINOIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 370662580 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S - GOOD SAMARITAN INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 364170833 HEALTH CARE IL 501(C)(3) LINE 11A, I SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 262884795 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 ST MARY'S HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 364636691 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 SSM HEALTH BUSINESSES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431333488 HEALTH CARE MO 501(C)(3) LINE 3 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 1 CENTRALIA MEDICAL SERVICES BLDG ASSOC 477 N LINDBERGH BLVD ST LOUIS MO 63141 237408025 HEALTH CARE IL 501(C)(3) LINE 11B, II 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 1100 BELLEVUE AVE ST LOUIS MO 63117 431012492 RELIGIOUS ORGANIZATION MO 501(C)(3) LINE 1 N/A 0 LEE DEWEY CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 731279603 MOB OK 501(C)(3) LINE 11A, I SSM HEALTH CARE OF OKLAHOMA 0 HEALTH CARE FOR KIDS 4055 LINDELL BLVD ST LOUIS MO 63141 431620093 HEALTH CARE MO 501(C)(3) LINE 3 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 0 SSM HOSPICE & HOME CARE FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 300012246 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH BUSINESSES 0 ST MARY'S HOSPITAL AUXILIARY 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 436049878 FUNDRAISING MO 501(C)(3) LINE 11B, II N/A 0 GOOD SAMARITAN HOSPITAL AUXILIARY 605 NORTH 12TH STREET MT VERNON IL 62864 237049599 FUNDRAISING IL 501(C)(3) LINE 11C, III-FI N/A 0 HHU-VNS FOUNDATION 4639 HAMMERSLEY ROAD MADISON WI 53713 391839309 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 ST MARY'S HOSPITAL AUXILIARY 400 N PLEASANT CENTRALIA IL 62801 237126345 FUNDRAISING IL 501(C)(3) LINE 9 N/A 0 SSM SJ ENDOSCOPY 477 N LINDBERGH BLVD ST LOUIS MO 63141 270046559 SURGERY SERVICES MO N/A SSMCDI IMAGING 3440 DEPAUL LN STE 100 BRIDGETON MO 63044 263791858 IMAGING SERVICES MO N/A SA MT AMB SURG 110 N LEE OKLAHOMA CITY OK 73103 731528341 SURGERY SERVICES OK N/A ST CLARE IMAGING SERVICES 707 14TH STREET SUITE A BARABOO WI 53913 200122365 DIAG. 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