2024-11-15T14:54:10-06:00 2023-12-31 990 2023-01-01 390808509 THE MONROE CLINIC INC MONR 6083242000 515 22ND AVENUE MONROE WI 53566 STEPHANIE KING VP-FINANCE 6083242000 2024-11-15 0 2023 2024-10-15 13:58:12Z JANE CURRAN-MEULI 515 22ND AVENUE MONROE WI 53566 219651140 0 0928 X WWW.SSMHEALTH.COM/LOCATIONS/LOCATION-DETAILS/MONR X 1963 WI THE MONROE CLINIC, INC. PROVIDES HEALTHCARE SERVICES TO THE COMMUNITIES IN AND SURROUNDING GREEN COUNTY, WI AND STEPHENSON COUNTY, IL. MEDICAL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. 12 9 1215 178 2040012 0 270327 428857 197834552 209989012 1227362 5907186 7171843 3178355 206504084 219503410 43429 319804 0 0 110769564 111525411 0 0 0 92882775 96524787 203695768 208370002 2808316 11133408 323716950 301884357 84849318 41462756 238867632 260421601 X WORKING TOGETHER TO ACHIEVE THE HIGHEST STANDARDS IN HEALTHCARE, WE CREATE HEALTHY COMMUNITIES THROUGH GOD'S HEALING SPIRIT. VISION: EXCEPTIONAL HEALTHCARE, AN EXCEPTIONAL EXPERIENCE. 0 0 193117132 319804 207949000 SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 650 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 12 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 13,900 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMH STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. ABOUT MONROE CLINIC:MONROE CLINIC IS A NOT-FOR-PROFIT HEALTH CARE FACILITY FEATURING A MULTI-SPECIALTY CLINIC AND HOSPITAL DEDICATED TO BRINGING THE BEST CARE TO THE COMMUNITIES WE SERVE. WORKING TOGETHER TO ACHIEVE THE HIGHEST STANDARDS OF HEALTH CARE, WE CREATE HEALTHY COMMUNITIES THROUGH GOD'S HEALING SPIRIT.IN 2018, MONROE CLINIC JOINED THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH AND CONTINUES TO OFFER COMPREHENSIVE HEALTH CARE WITH OVER 120 PROVIDERS, A 24-HOUR EMERGENCY DEPARTMENT, HOME CARE AND HOSPICE SERVICES, AS WELL AS MULTIPLE CLINIC LOCATIONS IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. IN ALL THAT WE DO, WE ARE DEDICATED TO HELPING OUR PATIENTS GET BETTER FASTER AND STAY HEALTHIER LONGER. AS A STATE-OF-THE-ART HEALTH SYSTEM, WE OFFER ADVANCED MEDICAL EQUIPMENT AND TECHNOLOGY COMBINED WITH CARE AND SENSITIVITY. PHYSICIANS AND STAFF ARE COMMITTED TO PROVIDING PERSONALIZED HEALTH CARE, EDUCATION AND PEACE OF MIND. OUR PATIENTS BENEFIT FROM EXCEPTIONAL PREVENTIVE AND REHABILITATION SERVICES AND MORE THAN 25 MEDICAL SPECIALTIES. WITH GOD'S BLESSING, MONROE CLINIC IS ABLE TO MEET THE NEEDS OF THOSE WE ARE PRIVILEGED TO SERVE.TO DATE WE HAVE BEEN AMONG THE HIGHEST PERFORMING HOSPITALS IN THE AREA. PATIENT SATISFACTION SCORES ARE SIGNIFICANTLY ABOVE THE AVERAGE OF OTHER HEALTHCARE FACILITIES. OUR HIGHLY TRAINED PHYSICIANS AND STAFF ARE READY TO PROVIDE BOTH EXCEPTIONAL HEALTHCARE AND AN EXCEPTIONAL EXPERIENCE TO THE PATIENTS AND COMMUNITIES WE SERVE. THE MONROE CLINIC 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- ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.QUANTIFIABLE UNCOMPENSATED CARE:THE FOLLOWING IS A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS UNCOMPENSATED CARE:TRADITIONAL CHARITY CARE $ 1,465,623 UNPAID COST OF MEDICAID $ 19,357,298 OTHER MEANS-TESTED PROGRAMS $ 246,949TOTAL QUANTIFIABLE UNCOMPENSATED CARE $ 21,069,870 193117132 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1215 1 1 1 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 1 1 WI X BRADLEY REACH 6082416949 1808 W BELTLINE HWY MADISON WI 53713 SUE ANDERSON DIRECTOR, REGIONAL PRESIDENT - WISCONSIN 1.00 55.00 X X 0 1428914 540322 JAMES BERBERET PT YR DIRECTOR 1.00 0.00 X 0 0 0 RHEA EMMER DIRECTOR 1.00 5.00 X 0 0 0 PATTY JAMES PT YR DIRECTOR 1.00 0.00 X 0 0 0 PAT LEITZEN FYE DIRECTOR, PT YR CHAIRPERSON 1.00 5.00 X X 0 0 0 PENG HER DIRECTOR 1.00 5.00 X 0 0 0 MARK HOLZMAN DIRECTOR 1.00 5.00 X 0 0 0 JOAN KARSTEN DIRECTOR 1.00 5.00 X 0 0 0 JENNIFER MASKEL DIRECTOR, PHYSICIAN 1.00 5.00 X 0 142795 14024 WAYNE MATZKE DIRECTOR, VICE CHAIRPERSON 1.00 5.00 X X 0 0 0 JANE CURRAN-MEULI PT YR DIRECTOR, PRESIDENT - MONROE CLINIC 40.00 0.00 X X 552926 0 201977 THEODORE MILLER DIRECTOR 1.00 5.00 X 0 0 0 JOSHUA MORRISON PT YR DIRECTOR, PHYSICIAN 40.00 0.00 X 719832 0 60874 OLIVIA OTTE DIRECTOR 1.00 5.00 X 0 0 0 DARREN PIPP PT YR DIRECTOR, VP MEDICAL AFFAIRS 40.00 0.00 X 493379 0 133862 MATTHEW POGODZINSKI DIRECTOR, PHYSICIAN 1.00 5.00 X 0 755367 62067 SISTER SUSAN STUCKI PT YR DIRECTOR 1.00 0.00 X 0 0 0 WESLEY SPARKMAN DIRECTOR, CHAIRPERSON 1.00 5.00 X X 0 0 0 MARK THOMPSON PT YR DIRECTOR, REGIONAL PRESIDENT-MEDICAL GROUPS- 1.00 0.00 X 0 37398 12674 SUNIL PENESETTI PT YR DIRECTOR, PHYSICIAN 40.00 0.00 X 1098546 0 32626 CRAIG HOESLY PT YR DIRECTOR, VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 SISTER DONNA INNES PT YR DIRECTOR 1.00 0.00 X 0 0 0 JOHN KING PT YR DIRECTOR 1.00 0.00 X 0 0 0 JUDY THOMPSON PT YR DIRECTOR 1.00 0.00 X 0 0 0 SISTER JOMARIE ZIELKE PT YR DIRECTOR 1.00 0.00 X 0 0 0 STEVE SMOOT VICE PRESIDENT, COO OF SSM HEALTH 1.00 55.00 X 0 2054358 1204489 RANDY COMBS TREASURER, CFO AT SSM HEALTH 1.00 55.00 X 0 2182354 1238074 DOUGLAS LONG SECRETARY, GENERAL COUNSEL AT SSM HEALTH 1.00 55.00 X 0 1425239 777013 THOMAS KIRSCHBAUM ASSISTANT SECRETARY 1.00 55.00 X 0 532265 210384 CHELSEA HARDACRE VP PATIENT CARE SERVICES, CNO 40.00 0.00 X 227050 0 78652 STEVE BREWER VP OPERATIONS 40.00 0.00 X 267561 0 92650 NICHOLAS MAXWELL PHYSICIAN 40.00 0.00 X 834901 0 90374 ARIF AHMAD PHYSICIAN 40.00 0.00 X 824901 0 71096 JONATHAN SWINDLE PHYSICIAN 40.00 0.00 X 811020 0 53180 GURMEET SINGH PHYSICIAN 40.00 0.00 X 805397 0 61958 MICHAEL NETZEL PHYSICIAN 40.00 0.00 X 740105 0 66631 7375618 8558690 5002927 168 0 1 0 TRIMEDX HOLDINGS LLC 5451 LAKEVIEW PARKWAY S DR INDIANAPOLIS IN 46268 CLINICAL ENGINEERING SERVICES 2099545 ASSOCIATED PATHOLOGISTS SC PO BOX 628215 MIDDLETON WI 53562 MEDICAL SERVICES 1219929 SOPHIA EDWARDS-BENNETT 17407 LOTINO PL LUTZ FL 33548 MEDICAL SERVICES 772600 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 MEDICAL SERVICES 706099 IMPACTLIFE 5500 LAKEVIEW PARKWAY DAVENPORT IL 52807 MEDICAL SERVICES 506411 28 156009 272848 15963 428857 NET PATIENT SERVICE RE 622110 200955674 200955674 PHARMACY REVENUE 456110 6300999 5280533 1020466 CORPORATE FEES 561000 468171 468171 MANAGEMENT FEES 561000 13328 13328 2250840 1231294 1019546 209989012 3151641 3151641 12190 0 12190 12190 12190 2715944 39601 0 0 2715944 39601 2755545 2755545 1081035 147730 933305 933305 JOINT VENTURE REVENUE 900099 1751857 1751857 CAFETERIA REVENUE 722514 481003 481003 2232860 219503410 207949000 2040012 9085541 318436 318436 1368 1368 3959546 3815897 143649 85504903 82402859 3102044 4467244 4305176 162068 12193519 11751149 442370 5400199 5204284 195915 63268 63268 37352 108 37244 10811780 10567014 244766 20214 17649 2565 2289772 2089750 200022 7100947 7100947 2901762 2406041 495721 441171 421112 20059 304869 286751 18118 20255862 15555050 4700812 9163586 8861940 301646 791684 12015 779669 MEDICAL SUPPLIES & EQUI 37537401 37516252 21149 MEDICAID PROVIDER TAX & 3928768 292 3928476 LICENSES, DUES & SUBSCR 526364 379955 146409 BANK FEES 310713 545 310168 39274 39274 208370002 193117132 15252870 0 8309 662261 974705 41429943 33246150 3592782 3364510 572018 378344 173727606 55106332 122589485 118621274 116841680 131710870 9969917 11629485 381119 27738111 1890344 323716950 301884357 16146989 16995506 21681 68702329 24445569 84849318 41462756 X 232719740 251320674 6147892 9100927 238867632 260421601 323716950 301884357 X 11133408 9071908 1348655 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6513 6513 0 PART II-B, LINE 1: THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES. 5893458 94138 1058980 175879 6870697 5168051 747841 137457 159891 5893458 5489706 252166 843308 1417129 5168051 4610640 29793 849273 5489706 3745187 127089 867013 128649 4610640 0.14310 0.38490 0.47200 0 1 1 3022692 3022692 122046753 29614040 92432713 8245776 3101534 5144242 38938428 22390758 16547670 1473957 1473957 118621274 LONG-TERM INVESTMENTS 131710870 F 131710870 THIRD PARTY PAYABLES 3932502 INTERCOMPANY PAYABLE 20466283 OPERATING RIGHT-OF-USE LIABILITIES 46784 24445569 X PART V, LINE 4: THE OPERATING ENDOWMENT HAS BEEN ESTABLISHED TO SUPPORT THE OPERATING COSTS OF THE MONROE CLINIC AND HOSPITAL FOUNDATION. THE FUTURE OF HEALTHCARE ENDOWMENT HAS BEEN ESTABLISHED TO PROVIDE FUNDING FOR GRANTS AND PROGRAMS THAT SUPPORT THE MONROE CLINIC AND HOSPITAL FOUNDATION MISSION. PART X, LINE 2: THE MONROE CLINIC, INC.'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). SSMH 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 2023 OR 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 1465623 0 1465623 0.00700 27609583 8252285 19357298 0.09290 1831295 1584346 246949 0.00120 30906501 9836631 21069870 0.10110 394048 0 394048 0.00190 77727 0 77727 0.00040 2274910 0 2274910 0.01090 0 0 812005 0 812005 0.00390 3558690 3558690 0.01710 34465191 9836631 24628560 0.11820 0 0 2571 0 2571 0.00000 0 0 1493 0 1493 0.00000 0 0 0 0 0 0 3083 0 3083 0.00000 0 0 7147 7147 0.00000 1 0 0 29486550 25381081 4105469 X 1 1 1 1 MONROE CLINIC 515 22ND AVENUE MONROE WI 53566 WWW.SSMHEALTH.COM/LOCATIONS/WISCONSIN/ 56 X X X X MONROE CLINIC 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH X 1 22 1 HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA X WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA X WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTA X X X X X X 1 X 0 X X X X 1 X 0 0 MONROE CLINIC PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. MONROE CLINIC PART V, SECTION B, LINE 5: THE GCHCC IS CO-CHAIRED BY REPRESENTATIVES FROM SSM HEALTH MONROE HOSPITAL & MONROE CLINIC MEDICAL GROUP AND GREEN COUNTY PUBLIC HEALTH. THE COALITION IS COMPRISED OF PUBLIC HEALTH, HEALTHCARE LEADERS AND REPRESENTATIVES OF THE UNDERSERVED POPULATION. THE COALITION DETERMINED OUR COMMUNITY HEAL TH PRIORITIES AFTER COLLECTING PRIMARY AND SECONDARY COMMUNITY HEALTH DATA. AN ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY IN ENGLISH AND SPANISH WAS AVAILABLE FOR COMMUNITY MEMBERS TO COMPLETE DURING FEBRUARY AND MARCH OF 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEALTH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND GAVE SPACE FOR PEOPLE TO PROVIDE SUGGESTIONS. IT TOOK APPROXIMATELY 10 MINUTES TO COMPLETE WITH 750 INDIVIDUALS FULLY COMPLETING THE SURVEY. COMMUNITY MEMBERS COULD SUBMIT A COMMENT AT THE END OF THE SURVEY. WHEN THESE COMMENTS WERE ANALYZED WE IDENTIFIED THE 10 MOST FREQUENT COMMENT TOPICS/SUGGESTIONS. FIVE COMMUNITY CONVERSATIONS WERE HELD IN SEVERAL COMMUNITIES WITHIN GREEN COUNTY TO LEARN ABOUT RESIDENTS' CONCERNS, SOLICIT THEIR IDEAS ON HEALTHCARE AND HOW IT COULD BE IMPROVED. THESE CONVERSATIONS GAVE US INSIGHT ON WHAT COMMUNITY PERCEPTION WAS AND OPENED-UP THE CONVERSATION FOR IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. APPROXIMATELY 30 INDIVIDUALS CONTRIBUTED COMMENTS ON A RANGE OF ISSUES THAT AFFECT POPULATION HEALTH AND WELL-BEING, BARRIERS FOR UNDERSERVED POPULATIONS AND OTHER COMMUNITY CONCERNS. EIGHT "KEY INFORMANT" INTERVIEWS WERE HELD WITH HEALTHCARE PROFESSIONALS FROM A VARIETY OF SETTINGS IN GREEN COUNTY. DURING THESE INTERVIEWS AND CONVERSATIONS WE ASKED QUESTIONS AND TOOK NOTES. AFTERWARDS THOSE RESPONSES WERE ANALYZED TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES AND ANALYZED AND REVEALED HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEALTH. DATA COLLECTION INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/ MORTALITY INFORMATION, HEAL TH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. THE COMMUNITY SURVEY AND SECONDARY DATA WERE PRESENTED TO THE COALITION. THE COMMITTEE IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND OUR ABILITY TO MAKE A SIGNIFICANT IMPACT. THE REQUIREMENT THAT THE HOSPITAL CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) ASKS HOSPITALS TO PAY SPECIFIC ATTENTION TO HEALTH CARE CONCERNS THAT AFFECT VULNERABLE POPULATIONS. THIS PRIORITIZED LIST WAS THEN PRESENTED TO SSM HEALTH MONROE HOSPITAL & MONROE CLINIC MEDICAL GROUPBOARD OF DIRECTORS AND GREEN COUNTY PUBLIC HEALTH BOARD FOR APPROVAL. MONROE CLINIC PART V, SECTION B, LINE 6B: THE FACILITY CONDUCTED ITS 2021 CHNA WITH GREEN COUNTY (WI) PUBLIC HEALTH. MONROE CLINIC PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES:- ADVERSE CHILDHOOD EXPERIENCES- HOUSING- MENTAL HEALTHADVERSE CHILDHOOD EXPERIENCES WHAT HAPPENS TO PEOPLE DURING THEIR CHILDHOOD IMPACTS THEM THROUGHOUT THEIR LIFE, AND NEGATIVE EXPERIENCES AT A YOUNG AGE CAN HAVE DETRIMENTAL CONSEQUENCES TO A PERSON'S HEALTH. ACES ARE TRAUMATIC EVENTS AND UNSAFE OR UNSTABLE ENVIRONMENTS EXPERIENCED BETWEEN THE AGES OF O THROUGH 17. ACES SIGNIFICANTLY AFFECT CHILDHOOD DEVELOPMENT, WELLBEING, ADULT HEALTH, AND SOCIAL PRODUCTIVITY. THE MORE ACES EXPERIENCED AS A CHILD, THE GREATER THE INDIVIDUAL'S RISK FOR CHRONIC DISEASE AND MENTAL ILLNESS THROUGHOUT LIFE. THE HOSPITAL'S VISION IS TO BREAK THE CYCLE OF ADVERSITY AND TRAUMA BY BUILDING HOPE, RESILIENCE AND GROWTH FOR THE CHILDREN AND FAMILIES OF GREEN COUNTY WITH THE FOLLOWING GOALS AND OBJECTIVES: GOAL #1: DEVELOP A CENTRALIZED WEBSITE DEDICATED TO BUILDING KNOWLEDGE, PREVENTION AND RESOURCES TOWARDS ADVERSE CHILDHOOD EXPERIENCES BY OCTOBER 2022.- OBJECTIVE 1A: DEVELOP EASILY UNDERSTOOD INFORMATION RELATED TO WHAT ADVERSE CHILDHOOD EXPERIENCES ARE AND WHY IT IS IMPORTANT WE PREVENT THEM (THE BUY IN) BY JULY 2022. - OBJECTIVE 1B: GATHER ALREADY AVAILABLE RESOURCES IN GREEN COUNTY THAT PROMOTE THE PREVENTION OF ADVERSE EXPERIENCES AND DEVELOP PROSOCIAL BEHAVIOR FOR CHILDREN AND FAMILIES BY APRIL 2023.- OBJECTIVE 1C: DEVELOPING A WEBSITE THROUGH THE GREEN COUNTY HEALTHY COMMUNITY COALITION BY OCTOBER 2022.- OBJECTIVE 1D: PROVIDE CONTENT FOR THE SOCIAL MEDIA PLATFORM RELATED TO ADVERSE CHILDHOOD EXPERIENCES AND RESOURCES AS AN ONGOING TASK.- OBJECTIVE 1E: MONITOR HOW FREQUENTLY THE WEB PAGE IS ACCESSED AND THE FACEBOOK INSIGHTS AS TO THE NUMBER OF PEOPLE CONTENT REACHES AND WEBPAGE ACCESSED AS AN ONGOING TASK.- OBJECTIVE 2A: RESEARCH AVAILABLE COMMUNITY EVIDENCE-BASED RESOURCES ALREADY AVAILABLE IN GREEN COUNTY BY JULY 2022. - OBJECTIVE 2B: DETERMINE WHAT COMMUNITY INTERVENTION OR MODEL FITS OUR MISSION AND VISION FOR THE RESILIENT CHILDREN, FAMILIES, AND COMMUNITY COMMITTEE BY DECEMBER 2022. - OBJECTIVE 2C: IDENTIFY A STEERING COMMITTEE INTERESTED IN THE DEVELOPMENT OF THE CHOSEN MODEL BY JANUARY 2023.- OBJECTIVE 2D: DEVELOP ACTION STEPS TO CARRY OUT THE IMPLEMENTATION OF THE IDENTIFIED RESOURCE BY FEBRUARY 2023. - OBJECTIVE 2E: DETERMINE A GENERAL BUDGET TO ACCESS TRAINING RESOURCE AND CARRY OUT THE ACTION STEPS FOR IMPLEMENTATION BY MARCH 2023.GOAL #3: INCREASE PUBLIC AWARENESS BY OFFERING ADVERSE CHILDHOOD EXPERIENCES EDUCATION GEARED TOWARDS ALL LEVELS OF THE COMMUNITY BY APRIL 2024. OBJECTIVE 3A: RESEARCH AVAILABLE TOOL KITS AND PREVENTION RECOMMENDATIONS FOR COMMUNITIES FOR THE PREVENTION OF ACES AND POSITIVE CHILDHOOD EXPERIENCES (PCES) BY JANUARY 2023. OBJECTIVE 3B: DEVELOP GOALS AND IMPLEMENTATION STEPS FOR A PUBLIC AWARENESS CAMPAIGN BASED ON THE TOOL KITS AND PREVENTION RECOMMENDATIONS BY APRIL 2023. HOUSING SAFE, AFFORDABLE HOUSING IS IMPERATIVE TO THE HEALTH OF AN INDIVIDUAL AND FOR A THRIVING COMMUNITY. EVIDENCE SHOWS HOUSING AND HEALTH CAN BE UNDERSTOOD AS SUPPORTING THE EXISTENCE OF FOUR PATHWAYS. FIRST, THE HEALTH IMPACTS OF NOT HAVING A STABLE HOME (THE STABILITY PATHWAY). SECOND, THE HEALTH IMPACTS OF CONDITIONS INSIDE THE HOME (THE SAFETY AND QUALITY PATHWAY), THIRD, THE HEALTH IMPACTS OF THE FINANCIAL BURDENS RESULTING FROM HIGHCOST HOUSING (THE AFFORDABILITY PATHWAY) AND LASTLY, THE HEALTH IMPACTS OF NEIGHBORHOODS, INCLUDING BOTH THE ENVIRONMENTAL AND SOCIAL CHARACTERISTICS OF WHERE PEOPLE LIVE (THE NEIGHBORHOOD PATHWAY). THE COMMITTEE PLANS TO WORK TO HAVE AVAILABLE, AFFORDABLE, ACCESSIBLE, AND SAFE HOUSING FOR ALL GREEN COUNTY RESIDENTS, AND TO BUILD AWARENESS OF HOUSING ISSUES THROUGH THE FOLLOWING GOALS AND OBJECTIVES: GOAL #1: OUR GROUP WILL CREATE AND DISTRIBUTE COMPREHENSIVE RESOURCES FOR HOUSING IN GREEN COUNTY BY DECEMBER 2022.- OBJECTIVE 1A: DETERMINE BEST LOCATIONS WHERE RESOURCES NEED TO BE DISTRIBUTED. - OBJECTIVE 1B: WILL DISTRIBUTE 20 FLYERS/PACKETS TO DETERMINED LOCATIONS. - OBJECTIVE 1C: DETERMINE HOW INFORMATION SHOULD BE PUBLISHED: PRINT, DIGITAL, SOCIAL MEDIA AND MULTL-LINGUAL.GOAL #2: PLAN AND HOST A HOUSING SUMMIT WITH STAKEHOLDERS BY JUNE 2023 IN GREEN COUNTY.- OBJECTIVE 2A: DETERMINE FORMAT OF SUMMIT AND LOCATION BY DECEMBER 2022.- OBJECTIVE 2B: DETERMINE CONTENT AND STAKEHOLDERS BY AUGUST 2022.- OBJECTIVE 2C: EVALUATE AND CREATE NEXT STEPS AFTER HOUSING SUMMIT BY AUGUST 2023.MENTAL HEALTH COMMUNITY EDUCATION, PREVENTION, ACCESS TO CARE, ADDRESSING BINGE DRINKING AND FIGHTING STIGMA ARE IMPORTANT IN SUSTAINING A COMMUNITY THAT SUPPORTS MENTAL HEALTH. ONE IN FOUR AMERICANS SUFFER FROM A MENTAL HEALTH ISSUE EACH YEAR. MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL AND SOCIAL WELL-BEING. IT IMPACTS GENERAL HEALTH AND QUALITY OF LIFE AT EVERY STAGE. THE PANDEMIC HAS NOT HELPED WITH THE ISOLATION PEOPLE HAVE FELT. NATIONWIDE AND LOCALLY, MENTAL HEALTH PROFESSIONALS ARE CHALLENGED BY A NEED FOR SERVICES THAT EXCEEDS AVAILABILITY. THE RESULT IS MENTAL HEALTH CARE IN GREEN COUNTY IS LARGELY FOCUSED ON PROVIDING CRISIS INTERVENTION AND FOLLOW-UP SERVICES. OUR FOCUS IS TO BUILD UPON THE EXISTING FOUNDATIONS TO EXPAND AND GROW BEHAVIORAL HEALTH RESOURCES IN AN INCLUSIVE AND NON-JUDGMENTAL MANNER BY EDUCATING, ADVOCATING FOR, AND SUPPORTING EVERYONE WHO LIVES, WORKS, OR LEARNS IN GREEN COUNTY. GOAL #1: MENTAL HEALTH MATTERS (MHM) WILL SUPPORT AND INCREASE THE AWARENESS OF THE SUBSTANCE ABUSE AND MENTAL WELLNESS NAVIGATOR POSITION.- OBJECTIVE 1A: MHM WILL SHARE ON MANY PLATFORMS THE JOB POSTING TO FIND A CANDIDATE. UPON HIRE, MHM WILL ASSIST WITH THE ONBOARDING PROCESS FOR THE CANDIDATE TO BE SUCCESSFUL TRANSITIONING INTO THE COMMUNITY. MHM WILL HELP THE CANDIDATE CONNECT WITH PROVIDERS AND RESOURCES. THIS WILL BE MEASURED BY THE CANDIDATE MEETING 80% OF IDENTIFIED PROVIDERS AND RESOURCES WITHIN FOUR MONTHS OF STARTING THE POSITION AND CONSISTENTLY ATTENDING THE MHM COMMITTEE MEETINGS. - OBJECTIVE 1B: MHM WILL PROMOTE AWARENESS IN THE COMMUNITY AND INCREASE WITH A GRAND REOPENING AND OTHER MEDIA PROMOTIONS. THIS WILL BE MEASURED BY AN INCREASE IN MONTHLY DATA OF THOSE BEING CONNECTED AND HELPED BY THE NAVIGATOR.GOAL #2: MHM WILL INCREASE MENTAL HEALTH EDUCATION, AWARENESS, AND OUTREACH IN GREEN COUNTY BY JUNE 2024. -OBJECTIVE 2A: MHM HAS FORMED A SUBCOMMITTEE TO DEVELOP A PLAN TO INCREASE AWARENESS, RESOURCES, AND ISSUES TO DETERMINE: A) THE NUMBER OF OPPORTUNITIES TO DEVELOP, OR B) THE NUMBER OF PEOPLE WE WOULD LIKE TO REACH IN THIS GOAL. THE SUBCOMMITTEE WILL COMPLETE THIS PLAN AND PRESENT IT AT THE JULY 2022 MHM COMMITTEE MEETING. GOAL #3: MHM WILL WORK ON PROMOTION AND EDUCATION TO DECREASE BINGE DRINKING IN GREEN COUNTY. -OBJECTIVE 3A: MHM WILL FORMULATE A SUBCOMMITTEE TO WORK THROUGH A STRATEGIC FRAMEWORK PROCESS TO IDENTIFY THE PREVENTION PRIORITIES. THIS WILL BE MEASURED BY THE STRATEGIC PROCESS TO BE COMPLETED AND PRESENTED AT THE SEPTEMBER 2022 MHM COMMITTEE MEETING. THE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING THE REMAINING CHNA-IDENTIFIED NEEDS. 10 1 - MONROE CLINIC - HIGHLAND WOMEN'S CARE 3103 W KUNKLE BLVD FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC 2 - MONROE CLINIC - FREEPORT 1301 S KIWANIS DRIVE FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC 3 - MONROE CLINIC - FREEPORT EYE CARE 1110 S PARK BLVD FREEPORT IL 61032 COMMUNITY-BASED OUTPATIENT CLINIC 4 - MONROE CLINIC - BRODHEAD 1904 FIRST CENTER AVENUE BRODHEAD WI 53520 COMMUNITY-BASED OUTPATIENT CLINIC 5 - MONROE CLINIC - LENA 214 SCHUYLER LENA IL 61048 COMMUNITY-BASED OUTPATIENT CLINIC 6 - MONROE CLINIC - NEW GLARUS 1800 SECOND STREET NEW GLARUS WI 53574 COMMUNITY-BASED OUTPATIENT CLINIC 7 - MONROE CLINIC - ALBANY 700 CAROLAN DRIVE ALBANY WI 53502 COMMUNITY-BASED OUTPATIENT CLINIC 8 - MONROE CLINIC - DURAND 400 S CENTER STREET DURAND IL 61024 COMMUNITY-BASED OUTPATIENT CLINIC 9 - MONROE CLINIC FASTCARE 405 W 8TH STREET MONROE WI 53566 COMMUNITY-BASED OUTPATIENT CLINIC 10 - MONROE CLINIC - BLANCHARDVILLE 309 S MAIN STRET BLANCHARDVILLE WI 53516 COMMUNITY-BASED OUTPATIENT CLINIC PART I, LINE 3C: PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF THE HOSPITAL; HOWEVER THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED TO COMMERCIALLY INSURED [OR MEDICARE] PATIENTS. IN SUCH CASES, OTHER FACTORS MAY BE CONSIDERED IN DETERMINING THEIR ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES, INCLUDING: *BANK ACCOUNTS, INVESTMENTS AND OTHER ASSETS*EMPLOYMENT STATUS AND EARNING CAPACITY*AMOUNT AND FREQUENCY OF BILLS FOR HEAL TH CARE SERVICES*OTHER FINANCIAL OBLIGATIONS AND EXPENSES*GENERALLY, FINANCIAL RESPONSIBILITY WILL BE NO MORE THAN 25% OF GROSS FAMILY INCOME. THE HOSPITAL MAY UTILIZE PREDICTIVE ANALYTICAL SOFTWARE OR OTHER CRITERIA TO ASSIST IN MAKING A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IN SITUATIONS WHERE THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE BUT HAS NOT PROVIDED THE NECESSARY DOCUMENTATION TO MAKE A DETERMINATION. THIS PROCESS IS CALLED "PRESUMPTIVE ELIGIBILITY." PART I, LINE 6A: SSM HEALTH CARE CORPORATION, 46-6029223 PART I, LINE 7: THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B, AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H, AND 71 ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE CALCULATION OF SCHEDULE H, PART I, LINE 7, COLUMN F UTILIZES 990, PART IX, LINE 25, COLUMN A, WHICH DOES NOT INCLUDE BAD DEBT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: THE MONROE CLINIC INC PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEAL TH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING: PHYSICAL IMPROVEMENTS/HOUSING: HABITAT FOR HUMANITY BUILDING; ECONOMIC DEVELOPMENT: HOSPITAL PRESIDENT VOLUNTEERS ON GREEN COUNTY DEVELOPMENT BOARD WORKING WITH 20+ COMMUNITY LEADERS; COMMUNITY SUPPORT: HOSPITAL PRESIDENT VOLUNTEERS WITH EXCELLENCE IN EDUCATION TO SUPPORT SPECIAL TEACHER/STUDENT PROJECTS ADVANCING EDUCATION; ENVIRONMENTAL IMPROVEMENTS: HOSPITAL STAFF ADOPTED PORTION OF HIGHWAY FOR ROUTINE CLEAN UP; COALITION BUILDING: HOSPITAL STAFF PARTICIPATION IN THE UNITED WAY; WORKFORCE DEVELOPMENT: ASSISTANCE WITH AREA HEALTH EDUCATION COLLEGE IN PRESENTATION VIDEO ON HEALTH CARE CAREERS. PART III, LINE 2: AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE. PART III, LINE 3: FOR FINANCIAL STATEMENT PURPOSES, SSM HEALTH HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THEREFORE, THERE IS NO AMOUNT REPORTED ON PART III, LINE 3 FOR THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER SSM HEALTH'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: THE MONROE CLINIC, INC. IS PART OF THE SSM HEALTH CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES THE TREATMENT OF UNCOLLECTIBLE ACCOUNTS AND IMPLICIT PRICE CONCESSIONS IN THE DECEMBER 31, 2023 CONSOLIDATED AUDIT IS CONTAINED ON PAGE 13 AND 14 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEAL TH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST. PART III, LINE 9B: THE MONROE CLINIC, INC. HAS ESTABLISHED A WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEAL TH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE, THE HEAL TH CENTER EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HEALTH CENTER'S BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RA TE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY. ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING: 1.THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT 2.EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS. 3.ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD. 4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL. 5.BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSM PRIOR TO ENGAGING IN ECAS. SSM WILL REVIEW THE ACCOUNTS AND VERIFY SATISFACTORY COMPLETION OF REASONABLE EFFORTS DURING THE NOTIFICATION AND APPLICATION PERIOD. A WAIVER IS NOT CONSIDERED REASONABLE EFFORTS. OBTAINING A SIGNED WAIVER THAT AN INDIVIDUAL DOES NOT WISH TO APPLY FOR FAP ASSISTANCE OR RECEIVE FAP APPLICATION INFORMATION WILL NOT MEET THE REQUIREMENT TO MAKE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN ECAS. 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 THE MONROE CLINIC, INC.'S COLLECTION AND FINANCIAL ASSISTANCE POLICIES. PART VI, LINE 2: SSM HEALTH (SSMH) PARTICIPATES IN COMMUNITY BENEFIT ACCORDING TO OUR VISION, 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. IN THE TRADITION OF OUR FOUNDERS, THE FRANCISCAN SISTERS OF MARY, CARING FOR THOSE IN GREATEST NEED REMAINS OUR ORGANIZATIONAL PRIORITY. TODAY OUR SYSTEM BOARD MONITORS COMMUNITY BENEFIT EFFORTS, AND VIEWS ACHIEVEMENT OF OUR VISION AS A PRIMARY RESPONSIBILITY. THE PURPOSE OF SSMH'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEAL TH NEEDS. MAKING OUR COMMUNITIES HEALTHIER IN MEASURABLE WAYS IS ALWAYS OUR GOAL. TO FULFILL THIS COMMITMENT, SSMH'S COMMUNITY BENEFIT IS DIVIDED INTO TWO PARTS: 1) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND 2) COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA). THE CHNA IS AN ASSESSMENT AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS AND THE ADOPTION AND IMPLEMENTATION OF STRATEGIES TO ADDRESS THOSE NEEDS. A CHNA IS CONDUCTED EVERY THREE YEARS BY EACH HOSPITAL ACCORDING TO THE FOLLOWING STEPS: *ASSESS AND PRIORITIZE COMMUNITY HEALTH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATA TO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA. *DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEAL TH PRIORITIES: ESTABLISH STRATEGIES TO ADDRESS PRIORITIES; COMPLETE STRATEGIC IMPLEMENTATION PLAN; OBTAIN REGIONAUDIVISIONAL BOARD APPROVAL; AND INTEGRATE STRATEGIES INTO OPERATIONAL PLAN. *MAKE CHNA WIDELY AVAILABLE TO THE PUBLIC: PUBLISH CHNA AND SUMMARY DOCUMENT ON HOSPITAL'S WEBSITE. *MONITOR, TRACK, AND REPORT PROGRESS ON TOP HEAL TH PRIORITIES: COLLECT DATA AND EVALUATE PROGRESS; REPORT TO REGIONAUDIVISIONAL BOARD EVERY SIX MONTHS AND SYSTEM BOARD EVERY YEAR; SHARE FINDINGS WITH COMMUNITY STAKEHOLDERS; AND SEND RESULTS TO FINANCE FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS). SYSTEM OFFICE STAFF AND LEADERS OVERSEE AND MONITOR SSMH'S COMMUNITY BENEFIT PROGRAM, AND ENSURE REPORTING IS IN COMPLIANCE WITH IRS REGULATIONS. IN COLLABORATION WITH COMMUNITY STAKEHOLDERS AND PARTNER ORGANIZATIONS, SSM HEALTH CARE CORPORATION ALSO IDENTIFIES NEEDS BASED ON ASSESSMENTS AND RESEARCH, AND SSMH FACILITIES ALSO INVOLVE CASE MANAGERS AND CARE TEAM STAFF TO PINPOINT CRITICAL HEAL TH ISSUES IN THE COMMUNITY. ALL HOSPITAL CHNAS ARE COMPLETED, APPROVED, AND INTEGRATED INTO THE ORGANIZATION'S STRATEGIC PLAN. WE CONTINUE TO MONITOR AND ASSESS THE PROGRESS OF OUR LOCAL EFFORTS IN THE SPIRIT OF CARING FOR OTHERS AND IMPROVING COMMUNITY HEALTH. PART VI, LINE 3: 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 COUNSELINGTHE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED: *SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS. *BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. *NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES. *APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES. PART VI, LINE 4: THE MONROE CLINIC IS LOCATED IN MONROE, WISCONSIN, IN GREEN COUNTY. THE COUNTY, AS WELL AS PORTIONS OF LAFAYETTE COUNTY, WISCONSIN, ACCOUNTS FOR 51% OF MONROE CLINIC'S PATIENTS. THE HOSPITAL ALSO SERVES STEPHENSON COUNTY, ILLINOIS, AND JO DAVIESS COUNTY, ILLINOIS.THE COMMUNITY IS OVERWHELMINGLY WHITE AT 96.8% FOR GREEN COUNTY, AND APPROXIMATELY 19.3% OF RESIDENTS ARE AGE 65 OR OLDER. MEDIAN HOUSEHOLD INCOME IS SLIGHTLY ABOVE THE STATE AVERAGE, AND RATES OF POVERTY ARE 6.4%, BELOW THE STATE RATE OF 10.4% AND NATIONAL RATE OF 10.5%. FOR THOSE UNDER 65, 5.4% OF GREEN COUNTY RESIDENTS ARE WITHOUT HEALTH INSURANCE, CONSIDERABLY LOWER THAN STATE AND NATIONAL PERCENTAGES. WHILE THERE IS A HIGHER PERCENTAGE OF COUNTY RESIDENTS GRADUATING HIGH SCHOOL THAN IN WISCONSIN AND THE U.S., THERE ARE LOWER RATES FOR THOSE WITH A BACHELOR'S DEGREE.ADDITIONAL DEMOGRAPHIC AND STATISTICAL INFORMATION ON THE HOSPITAL'S COMMUNITY CAN BE FOUND THROUGHOUT THE 2021 CHNA. PART VI, LINE 5: THE MONROE CLINIC PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEAL TH OF THE COMMUNITY. THE COMMUNITY INITIATIVES BUILD ON THE STRENGTHS OF OUR COMMUNITIES AND SYSTEMS TO IMPROVE THE QUALITY OF LIFE AND TO CREATE A SENSE OF HOPE. COMMUNITY BENEFIT INITIATIVES BUILD COMMUNITY CAPACITY AND INDIVIDUAL EMPOWERMENT THROUGH COMMUNITY ORGANIZING, LEADERSHIP DEVELOPMENT, PARTNERSHIPS, AND COALITION BUILDING. OUR COMMUNITY HEAL TH PROGRAMS PROVIDE COMPASSIONATE AND COMPETENT CARE WHILE THEY PROMOTE HEALTH IMPROVEMENT BY REACHING DIRECTLY INTO THE COMMUNITY TO ENSURE THAT LOW-INCOME AND UNDER-SERVED PERSONS CAN ACCESS HEALTH CARE SERVICES. IN RESPONSE TO THE GLOBAL CORONAVIRUS PANDEMIC, THE MONROE CLINIC, INC WORKED RELENTLESSLY TO RESPOND TO COMMUNITY NEEDS BY DEVELOPING AND IMPLEMENTING STRATE GIES TO ADDRESS SOCIAL NEEDS OF THOSE SERVED, PROVIDING SCREENING & TESTING SERVICES, PERSONAL PROTECTIVE EQUIPMENT AND EDUCATION THROUGHOUT THE COMMUNITY, AS WELL AS TREATMENT FOR THOSE WHO PRESENTED WITH COVID-19. THE MONROE CLINIC PROMOTES GRASSROOTS ADVOCACY AND ENGAGES PERSONS OF INFLUENCE TO AFFECT SOCIAL AND PUBLIC POLICY CHANGE IN ORDER TO PROMOTE COMMUNITY HEALTH. THE MONROE CLINIC 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,* ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS,* PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS * ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM. PART VI, LINE 6: THE MONROE CLINIC IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTHCARE SYSTEM KNOWN AS SSM HEALTH.SSM HEALTH (SSMH) IS A CENTRALLY MANAGED, FULLY INTEGRATED HEALTH CARE DELIVERY SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSM HEALTH CARE CORPORATION (SSMHCC) (DOING BUSINESS AS SSMH) IS THE PRINCIPAL NOT-FOR-PROFIT CORPORATION AND HAS BEEN ESTABLISHED AS THE PARENT CORPORATION. SSMH OWNS AND OPERATES 22 ADULT HOSPITALS, ONE PEDIATRIC HOSPITAL, THIRTEEN POST-ACUTE CARE FACILITIES, A NATIONAL PHARMACY BENEFIT MANAGEMENT COMPANY (PBM), AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEALTH CARE BUSINESSES. SSMH'S HOSPITAL OPERATIONS ARE LOCATED PRIMARILY IN MISSOURI, WISCONSIN, OKLAHOMA AND ILLINOIS, AND ITS RELATED BUSINESSES PROVIDE HEAL TH RELATED SERVICES IN 50 STATES. SSMH'S MISSION STATEMENT IS AS FOLLOWS: THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. SSMHCC AND MOST OF ITS AFFILIATED SUBSIDIARY CORPORATIONS HAVE BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). CERTAIN SUBSIDIARIES OF SSMH ARE FOR-PROFIT ENTITIES THAT ARE TAXABLE UNDER THE IRC. SSMH IS SPONSORED BY SSM HEALTH MINISTRIES, AN INDEPENDENT NINE-MEMBER BODY COMPOSED OF TWO FRANCISCAN SISTERS OF MARY, ONE SISTER OF ST. AGNES, ONE JESUIT PRIEST, AND FIVE LAY PERSONS WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMH. PART VI, LINE 7, REPORTS FILED WITH STATES IL,WI 1 FREEPORT MINISTRY FELLOWSHIP ALLIANCE 18 W STEPHENSON STREET STE 8 FREEPORT IL 61032 501(C)(3) 27800 0 GENERAL PURPOSE GREEN COUNTY YMCA 1307 2ND ST MONROE WI 53566 391405623 501(C)(3) 20200 0 GENERAL PURPOSE MONROE ARTS CENTER INC PO BOX 472 MONROE WI 53566 391209502 501(C)(3) 5792 0 GENERAL PURPOSE MONROE CLINIC AND HOSPITAL FOUNDATION 515 22ND AVENUE MONROE WI 53566 205769038 501(C)(3) 200909 0 GENERAL PURPOSE 4 0 PART I, LINE 2: GRANTS ARE MADE TO ORGANIZATIONS AND OFTEN MADE TO RELATED ORGANIZATIONS THAT ARE TAX EXEMPT UNDER SECTION 501(C)(3). THE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. ALL GRANTS TO INDIVIDUALS, WHEN APPLICABLE, INCLUDE A GRANT APPLICATION PROCESS THROUGH A PARTNER ORGANIZATION. APPROVED GRANT APPLICATIONS ARE FORWARDED TO THE MONROE CLINIC AND THE CLINIC PAYS THE REQUESTED EXPENDITURES. X 1 1 0 1 0 0 0 0 0 0 0 RANDY COMBS TREASURER, CFO AT SSM HEALTH 0 1242308 0 669269 0 270777 0 1203989 0 34085 0 3420428 0 669269 STEVE SMOOT VICE PRESIDENT, COO OF SSM HEALTH 0 1173646 0 737192 0 143520 0 1164125 0 40364 0 3258847 0 878090 DOUGLAS LONG SECRETARY, GENERAL COUNSEL AT SSM HE 0 759270 0 495539 0 170430 0 753634 0 23379 0 2202252 0 495539 SUE ANDERSON DIRECTOR, REGIONAL PRESIDENT - WISCO 0 765767 0 330759 0 332388 0 520449 0 19873 0 1969236 0 386663 SUNIL PENESETTI PT YR DIRECTOR, PHYSICIAN 1081836 0 15000 0 1710 0 18687 0 13939 0 1131172 0 0 0 NICHOLAS MAXWELL PHYSICIAN 799346 0 0 0 35555 0 45256 0 45118 0 925275 0 0 0 ARIF AHMAD PHYSICIAN 801170 0 0 0 23731 0 31730 0 39366 0 895997 0 16207 0 GURMEET SINGH PHYSICIAN 783257 0 21000 0 1140 0 19649 0 42309 0 867355 0 0 0 JONATHAN SWINDLE PHYSICIAN 798742 0 0 0 12278 0 11054 0 42126 0 864200 0 10568 0 MATTHEW POGODZINSKI DIRECTOR, PHYSICIAN 0 753607 0 0 0 1760 0 19050 0 43017 0 817434 0 0 MICHAEL NETZEL PHYSICIAN 620439 0 0 0 119666 0 35964 0 30667 0 806736 0 94207 0 JOSHUA MORRISON PT YR DIRECTOR, PHYSICIAN 712430 0 0 0 7402 0 18705 0 42169 0 780706 0 5692 0 JANE CURRAN-MEULI PT YR DIRECTOR, PRESIDENT - MONROE C 388761 0 118561 0 45604 0 171633 0 30344 0 754903 0 118561 0 THOMAS KIRSCHBAUM ASSISTANT SECRETARY 0 388964 0 99618 0 43683 0 172359 0 38025 0 742649 0 99618 DARREN PIPP PT YR DIRECTOR, VP MEDICAL AFFAIRS 421918 0 61066 0 10395 0 91127 0 42735 0 627241 0 69276 0 STEVE BREWER VP OPERATIONS 231300 0 33974 0 2287 0 56156 0 36494 0 360211 0 33974 0 CHELSEA HARDACRE VP PATIENT CARE SERVICES, CNO 199481 0 27179 0 390 0 45237 0 33415 0 305702 0 27179 0 JENNIFER MASKEL DIRECTOR, PHYSICIAN 0 142370 0 0 0 425 0 10628 0 3396 0 156819 0 0 PART I, LINE 1A SEVERAL INDIVIDUALS LISTED ON SCHEDULE J PART II RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2023. THE PAYMENT WAS INCLUDED IN THEIR TAXABLE COMPENSATION. PART I, LINE 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (HOSPITAL PRESIDENT) IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH 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 THE SSMH 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 SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. CAPITAL ACCUMULATION PLAN: SSMH 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 SSMH 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 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR 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 DEFERRALS FROM THIS PLAN IN 2023: STEVE SMOOT - $249,972 RANDY COMBS - $261,633 DOUGLAS LONG - $161,286 JANE CURRAN-MEULI - $38,469 JENNIFER MASKEL - $2,131 THOMAS KIRSCHBAUM - $37,511 CHELSEA HARDACRE - $9,318 STEVE BREWER - $10,880 NICHOLAS MAXWELL - $26,206 ARIF AHMAD - $12,858 MICHAEL NETZEL - $17,935 SUE ANDERSON - $153,458 DARREN PIPP - $19,253 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. STEVE SMOOT - $140,898 ARIF AHMAD - $16,207 JONATHAN SWINDLE - $10,568 MICHAEL NETZEL - $94,207 SUE ANDERSON - $132,843 JOSHUA MORRISON - $5,692 DARREN PIPP - $8,210 FORM 990, PART V, LINE 1A: ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS SSM HEALTH CARE OF WISCONSIN, INC. SSM HEALTH CARE OF WISCONSIN, INC, IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH THE MONROE CLINIC AND SSM HEALTH CARE OF WISCONSIN, INC. ARE PART OF THE INTEGRATED HEAL TH CARE SYSTEM KNOWN AS SSM HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO 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 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 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 SSMHCC OR TO ANY OTHER ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN 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 SSMHCC, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF SSMHCC AS DETERMINED BY SSMHCC; Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN SSMHCC, 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 SSMHCC 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 NONCONTROLLED SUBSIDIARY. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION (SSM). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SSM PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS. 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 OF 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 MUCH 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 A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 869,254. BENEFICIAL INTEREST IN FOUNDATION 479,401. 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