2014-11-17T15:24:45-06:00 2013-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 77002 990 2013-01-01 466029223 SSM HEALTH CARE CORPORATION SSMH 3145238759 10101 WOODFIELD LANE ST LOUIS MO 63132 JUNE L PICKETT SECRETARY 3145238759 2014-11-17 1 BROOKE KITCHEN P00849302 7139822000 2013 2015-11-30 17:44:51Z X SEE SCHEDULE O WILLIAM THOMPSON 10101 WOODFIELD LANE ST LOUIS MO 63132 414817743 0 0928 X WWW.SSMHEALTH.COM X 1874 MO 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. 13 12 1532 12 604814 603814 0 1500 91422721 302530357 86376459 96147362 16098354 16130682 193897534 414809901 62850 91575 0 0 64361867 86201257 0 0 0 79256332 323827598 143681049 410120430 50216485 4689471 2320835992 2342180230 2413305309 2472157898 -92469317 -129977668 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 1 0 282035411 91575 318056225 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. 282035411 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 0 0 1 X 2648 0 1 1532 1 1 1 1 CJ BR KS TW 0 0 0 0 0 0 0 0 X 13 12 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X DONNA WALLACE 3145238793 10101 WOODFIELD LANE ST LOUIS MO 63132 DAVID G COSBY DIRECTOR 1.00 0.00 X 0 0 0 SR ROSE DOWLING FSM DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER GRANTHAN-STEIN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS GUNN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS HILTON DIRECTOR 1.00 0.00 X 0 0 0 SR IRMA KENNEBECK FSM DIRECTOR 1.00 0.00 X 0 0 0 JOHN MOTEN DIRECTOR 1.00 0.00 X 0 0 0 THOMAS NOONAN DIRECTOR 1.00 0.00 X 0 0 0 SR MARGE O'GORMAN FSM DIRECTOR 1.00 0.00 X 0 0 0 SR MARY JEAN RYAN FSM CHAIRPERSON & DIRECTOR 1.00 0.00 X 0 0 0 SR SUSAN SCHOLL FSM DIRECTOR 1.00 0.00 X 0 0 0 SR SANDRA SCHWARTZ FSM DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM THOMPSON PRESIDENT & DIRECTOR 40.00 0.00 X X 2421072 0 841970 PAULA FRIEDMAN VICE PRESIDENT 40.00 0.00 X 596799 0 15489 KRIS ZIMMER TREASURER 40.00 0.00 X 836253 0 68008 JUNE PICKETT SECRETARY 40.00 0.00 X 256054 0 -96872 STEVEN BARNEY PT YR VICE PRESIDENT 40.00 0.00 X 592443 0 -223953 CHRISTOPHER HOWARD PRES - HOSP OPER 40.00 0.00 X 893660 0 29906 GAUROV DAYAL PRES - HEALTH CARE DEL 40.00 0.00 X 775353 0 124266 SHANE PENG PRES - PHYS & AMB CARE 40.00 0.00 X 674433 0 62843 DIXIE PLATT SENIOR VICE PRESIDENT 40.00 0.00 X 590484 0 10096 PHILIP GUSTAFSON REGIONAL PRESIDENT 0.00 40.00 X 640932 0 134043 THOMAS LANGSTON SENIOR VICE PRESIDENT 0.00 40.00 X 664464 0 147214 JOE HODGES REGIONAL VICE PRES 0.00 40.00 X 690999 0 16679 LYNN BRUCHOF SENIOR VICE PRESIDENT 40.00 0.00 X 469878 0 77344 SHERILYN HAILSTONE HOSPITAL PRESIDENT 0.00 40.00 X 630075 0 70593 FRANK BYRNE HOSPITAL PRESIDENT 0.00 40.00 X 601058 0 75664 MICHAEL WARREN HOSPITAL PRESIDENT 0.00 40.00 X 525198 0 159093 LEE BERNSTEIN REGIONAL EXECUTIVE VP 0.00 40.00 X 494330 0 64147 ROBERT VANCONIA HOSPITAL PRESIDENT 0.00 40.00 X 488550 0 62199 WILLIAM SCHOENHARD FORMER OFFICER 0.00 0.00 X 274359 0 -277636 ROBERT PORTER FORMER HIGHEST COMP 0.00 0.00 X 532567 0 -33023 PATRICE KOMOROSKI FORMER HIGHEST COMP 0.00 0.00 X 264315 0 -18492 13913276 0 1309578 95 1 1 0 HURON CONSULTING SERVICES LLC 3005 MOMENTUM PLACE CHICAGO IL 60689 CONSULTING SERVICES 9001651 MCKINSEY & COMPANY 55 E 52ND STREET NEW YORK NY 10022 CONSULTING SERVICES 5137500 GREENSFELDER HEMKER AND GALE PC 10 S BRAODWAY ST LOUIS MO 63102 LEGAL SERVICES 2523882 DELOITTE & TOUCHE LLC 100 S 4TH STREET ST LOUIS MO 63102 ACCOUNTING SERVICES 2197901 CATHOLIC HEALTHCARE AUDIT NETWORK 231 S BEMISTON ST LOUIS MO 63105 CONSULTING SERVICES 1461793 61 1500 1500 INSURANCE FEES 525100 213372961 213372961 CORPORATE FEES 561000 84881224 84881224 MANAGEMENT FEES 561000 2219838 2219838 OTHER OPERATING REVENUE 519100 2056334 2056334 302530357 60264008 60264008 35891196 0 7842 35891196 -7842 35883354 35883354 JOINT VENTURE INCOME 900099 13374847 13374847 OTHER INCOME 900099 2151021 2151021 INCOME FROM PARTNERSHIPS 900099 604814 604814 16130682 414809901 318056225 604814 96147362 X 91575 91575 7028394 4053408 2974986 57672132 39256479 18415653 7365448 4957594 2407854 9936826 6711034 3225792 4198457 2814842 1383615 2372617 2372617 2438270 2438270 45179696 7011288 38168408 50700 50700 3030983 893526 2137457 3636578 251272 3385306 2778871 1307346 1471525 1403779 289641 1114138 78713 17704 61009 43815757 43815757 1198628 489008 709620 41484 41484 MEDICAL CLAIMS EXPENSE 212593672 170074937 42518735 BOND RELATED FEES 3345004 3345004 FEDERAL INCOME TAXES 1603446 1603446 259400 259400 410120430 282035411 128085019 0 66737404 21119568 7572171 7949329 866964292 917795656 1069058 617860 13296659 4053312 6969383 9243347 1280374148 1364786073 83380565 15720407 7768971 4947990 2320835992 2342180230 191071567 214896769 597959 1223194661 1200964711 37000000 400000000 962039081 655698459 2413305309 2472157898 X -92488802 -129996835 2485 2167 17000 17000 -92469317 -129977668 2320835992 2342180230 X 4689471 138019202 -180217024 X 0 1 X 1 0 X X X 0 0 0 SSM HEALTH CARE ST LOUIS 431343281 3 1 0 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 430738490 3 1 0 SSM HEALTH CARE OF WISCONSIN INC 430688874 3 1 0 SSM HEALTH CARE OF OKLAHOMA INC 730657693 3 1 0 SSM REGIONAL HEALTH SERVICES 440579850 3 1 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 430653587 3 1 0 ST MARY'S HOSPITAL 370662580 3 1 0 ST ANTHONY SHAWNEE HOSPITAL INC 455055149 3 1 0 SSM AUDRAIN HEALTH CARE INC 431550298 3 1 0 9 0 PART I, LINE 11(H) SSM HEALTH CARE CORPORATION (SSMHC) IS A TYPE I SUPPORTING ORGANIZATION THAT IS OPERATED 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 $410,120,430 DURING THE YEAR ENDED DECEMBER 31, 2013. 0 1 0 1 105460 0 0 1 116922 0 0 222382 0 PART II-B, LINE 1: SSM HEALTH CARE CORPORATION EMPLOYS LOBBYISTS WHOSE ACTIVITIES INCLUDE SERVING AS LIAISONS TO CITY, STATE, AND FEDERAL OFFICIALS. THEY TRACK AND EVALUATE HEALTH CARE AND OTHER LEGISLATION THAT MAY HAVE AN IMPACT ON THE SYSTEM, EXPLORE AND EVALUATE POSSIBLE FUNDING OPPORTUNITIES FOR SSM HEALTH CARE CORPORATION, AND SERVE AS THE SPOKESPERSONS TO LEGISLATIVE COMMITTEES AND STATE AGENCIES FOR THE SYSTEM ON LEGISLATIVE ISSUES. THE LOBBYIST'S ACTIVITIES INCLUDE DIRECT MAILINGS, DIRECT CONTACT WITH LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS. 19485 -319 19166 18046 1439 19485 28289 1046 11289 18046 26092 2197 28289 22624 3468 26092 0.89000 0.11000 0 0 1885537 1681314 204223 4314404 2371998 1942406 7096718 7096718 9243347 CAPITAL LEASE OBLIGATION 9589288 DEFERRED COMPENSATION 91780590 SWAPS MARK TO MARKET LIABILITY 74642369 RABBI TRUST LIABILITY 37319930 PENSION LIABILITY 417087282 ESTIMATED HEALTH CARE CLAIMS 25279000 655698459 X PART V, LINE 4: SSMHC'S ENDOWMENT FUNDS ARE TO BE USED TO DEFRAY THE COSTS OF AN ANNUAL EXECUTIVE LEVEL MANAGEMENT MEETING. PART X, LINE 2: SSM HEALTH CARE CORPORATION EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2013 OR 2012. 1 MALCOLM BALDRIGE NATIONAL QUALITY AWARD FOUNDATION 165 SUMMIT RIDGE MARYVILLE IL 62062 390912502 501(C)(3) 12500 TO SUPPORT THE QUALITY AWARD PROGRAM ST ANTHONY HOSPITAL FOUNDATION 10101 WOODFIELD LANE ST LOUIS MO 63132 736104300 501(C)(3) 25000 TO ASSIST WITH TORNADO RELIEF CHADS COALITION FOR MENTAL HEALTH PO BOX 510528 ST LOUIS MO 63151 202172260 501(C)(3) 10000 TO SUPPORT GENERAL OPERATIONS CARDINAL GLENNON CHILDREN'S FOUNDATION 10101 WOODFIELD LANE ST LOUIS MO 63132 431754347 501(C)(3) 10000 TO SUPPORT THE BOB COSTAS CANCER CENTER COALITION TO PROTECT AMERICA'S HEALTH CARE PO BOX 30211 BETHESDA MD 20824 522253225 501(C)(4) 25000 TO SUPPORT GENERAL OPERATIONS 4 1 PART I, LINE 2: THE ORGANIZATION'S GRANTS WERE PRIMARILY 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 X 1 1 X X X X 1 1 0 0 0 0 0 0 0 WILLIAM THOMPSON PRESIDENT & DIRECTOR 1404608 0 0 0 1016464 0 811381 0 30589 0 3263042 0 59150 0 PAULA FRIEDMAN VICE PRESIDENT 523635 0 0 0 73164 0 -2191 0 17680 0 612288 0 32970 0 KRIS ZIMMER TREASURER 763126 0 0 0 73127 0 40169 0 27839 0 904261 0 45360 0 JUNE PICKETT SECRETARY 226100 0 0 0 29954 0 -119886 0 23014 0 159182 0 8680 0 STEVEN BARNEY PT YR VICE PRESIDENT 354279 0 0 0 238164 0 -236820 0 12867 0 368490 0 0 0 CHRISTOPHER HOWARD PRES - HOSP OPER 806003 0 0 0 87657 0 -1097 0 31003 0 923566 0 40320 0 GAUROV DAYAL PRES - HEALTH CARE DEL 749382 0 0 0 25971 0 96224 0 28042 0 899619 0 0 0 SHANE PENG PRES - PHYS & AMB CARE 520569 0 0 0 153864 0 39900 0 22943 0 737276 0 0 0 DIXIE PLATT SENIOR VICE PRESIDENT 345892 0 0 0 244592 0 -19981 0 30077 0 600580 0 29890 0 PHILIP GUSTAFSON REGIONAL PRESIDENT 538937 0 0 0 101995 0 107724 0 26319 0 774975 0 0 0 THOMAS LANGSTON SENIOR VICE PRESIDENT 502778 0 0 0 161686 0 112421 0 34793 0 811678 0 33880 0 JOE HODGES REGIONAL VICE PRES 633887 0 0 0 57112 0 -16778 0 33457 0 707678 0 31500 0 LYNN BRUCHOF SENIOR VICE PRESIDENT 426648 0 0 0 43230 0 44161 0 33183 0 547222 0 0 0 SHERILYN HAILSTONE HOSPITAL PRESIDENT 540980 0 0 0 89095 0 45395 0 25198 0 700668 0 36540 0 FRANK BYRNE HOSPITAL PRESIDENT 522629 0 0 0 78429 0 41956 0 33708 0 676722 0 35210 0 MICHAEL WARREN HOSPITAL PRESIDENT 370631 0 0 0 154567 0 125554 0 33539 0 684291 0 22470 0 LEE BERNSTEIN REGIONAL EXECUTIVE VP 444074 0 0 0 50256 0 36508 0 27639 0 558477 0 12360 0 ROBERT VANCONIA HOSPITAL PRESIDENT 435074 0 0 0 53476 0 29877 0 32322 0 550749 0 26810 0 WILLIAM SCHOENHARD FORMER OFFICER 0 0 0 0 274359 0 -296128 0 18492 0 -3277 0 0 0 ROBERT PORTER FORMER HIGHEST COMP 3609 0 0 0 528958 0 -51201 0 18178 0 499544 0 30660 0 PATRICE KOMOROSKI FORMER HIGHEST COMP 161 0 0 0 264154 0 -18760 0 268 0 245823 0 0 0 PART I, LINE 1A THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2013. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. WILLIAM THOMPSON KRIS ZIMMER CHRISTOPHER HOWARD DIXIE PLATT THOMAS LANGSTON PAULA FRIEDMAN JOE HODGES SHERILYN HAILSTONE FRANK BYRNE MICHAEL WARREN LEE BERNSTEIN ROBERT VANCONIA SHANE PENG PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED A REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2013. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. STEVEN BARNEY JOE HODGES MICHAEL WARREN ROBERT VANCONIA PAULA FRIEDMAN PART I, LINE 1A: THE FOLLOWING INDIVIDUAL LISTED ON PART VII, SECTION A RECEIVED A REIMBURSEMENT FOR HOUSING ALLOWANCE IN 2013. THIS PAYMENT WAS INCLUDED IN THEIR TAXABLE COMPENSATION. PHILIP GUSTAFSON PART I, LINE 4A: SEVERANCE PLAN: SSMHC HAS ADOPTED A SEVERANCE POLICY TO PROVIDE A FINANCIAL TRANSITION IN THE EVENT OF INVOLUNTARY TERMINATION WITHOUT CAUSE FOR EXECUTIVE LEVEL POSITIONS. THE AMOUNT OF THE COMPENSATION IS BASED ON THE POSITION HELD AND LENGTH OF SERVICE WITH SSMHC. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS UNDER THE PLAN IN THE CURRENT YEAR ROBERT PORTER $440,365 WILLIAM SCHOENHARD $274,359 PATRICE KOMOROSKI $260,780 DIXIE PLATT $103,615 PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS PENSION RESTORATION PLAN: SSM HEALTH CARE (SSMHC) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMHC QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER SSMHC'S QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMHC OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMHC. NO REPORTABLE INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN DURING 2013. 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 2013. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. STEVEN BARNEY $148,902 DIXIE PLATT $ 95,540 WILLIAM THOMPSON $ 59,209 CHRISTOPHER HOWARD $ 52,082 KRIS ZIMMER $ 45,405 SHERLYN HAILSTONE $ 43,212 THOMAS LANGSTON $ 36,217 PHILLIP GUSTAFSON $ 37,870 ROBERT PORTER $ 65,817 PAULA FRIEDMAN $ 33,003 FRANK BYRNE $ 43,031 MICHAEL WARREN $ 29,919 JOE HODGES $ 31,531 ROBERT VANCONIA $ 26,837 JUNE PICKETT $ 19,086 LEE BERNSTEIN $ 14,709 A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635R2Z9 2008-05-15 100851259 TO FINANCE VARIOUS CAPITAL IMPROVEMENTS 0 0 0 B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635RV20 2005-07-21 555100000 (1) FINANCE CAP. IMPROVEMENTS (2) REFUND SERIES 1998A & SERIES 2001A BONDS 1 0 0 C HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 60635R7B7 2010-05-13 450254794 (1) FINANCE CAP. IMPROVEMENTS (2) REFUND SERIES 2001A, 2005AB & 2005CD BONDS 1 0 0 D WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97710BUX8 2010-05-13 125000551 TO FINANCE VARIOUS CAPITAL IMPROVEMENTS 0 0 0 A 100851259 100851259 2009 0 0 1 1 B 43600000 277995000 557582390 6776384 122495329 428310677 2008 0 1 1 1 C 3845000 94805000 450254794 244374 165003260 285007161 2010 1 1 0 1 D 4430000 125436509 125436509 2011 0 0 0 1 A 0 1 1 1 1 1 0.00900 0.00900 0 0 1 B 0 1 1 1 1 1 0.00850 0.00850 0 0 1 C 0 1 1 1 1 1 0.01150 0.01150 0 0 1 D 0 1 1 1 1 1 0.03000 0.03000 0 0 1 A 0 0 1 0 0 1 0 0 0 0 1 B 0 0 0 1 1 1 PNC UNION & CITI 27.900000000000 1 1 0 1 1 C 0 0 0 1 1 1 0 0 0 1 1 D 0 0 0 1 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K SUPPLENTAL INFORMATION PART II LINE 3 - TOTAL PROCEEDS EXCEEDS AMOUNT SHOWN IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF THE STATE OF MISSOURI 431178966 NONEAVAIL 2012-07-26 183265000 TO REFUND SERIES 2005A BONDS, SERIES 2005C BONDS AND 2010C BONDS 0 0 0 A 1835000 100000 183265000 183265000 2012 1 0 1 1 A 0 1 1 1 1 1 0.00760 0.00760 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 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 FORM 990, PART III, LINE 2 SSM HEALTH CARE CORPORATION NOW PROVIDES HOSPITAL, MEDICAL CARE, ACCIDENT AND OTHER QUALIFIED INSURANCE BENEFITS FOR EMPLOYEES OF THE SSM HEALTH CARE SYSTEM. THIS ACTIVITY WAS PREVIOUSLY CONDUCTED THROUGH A SUBSIDIARY ENTITY. FORM 990, PART III LINE 4A, DESCRIPTION OF PROGRAM SERVICE: 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. AS OF NOVEMBER 15, 2013, WITH VATICAN APPROVAL, THE FRANCISCAN SISTERS OF MARY TRANSITIONED SPONSORSHIP OF SSMHC TO SSM HEALTH MINISTRIES. SSM HEALTH MINISTRIES IS AN INDEPENDENT 6-MEMBER BODY COMPRISED OF THREE FRANCISCAN SISTERS OF MARY AND THREE LAY PEOPLE WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMHC. HEADQUARTERED IN ST LOUIS, MISSOURI, SSMHC OWNS AND OPERATES 18 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, TWO LONG-TERM CARE FACILITIES, AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEALTH CARE BUSINESSES LOCATED PRIMARILY IN MISSOURI, OKLAHOMA, WISCONSIN, AND ILLINOIS. THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 30,000 PEOPLE AND IS AFFILIATED WITH MORE THAN 8,000 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 RECORD 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; POLICY WRITING AND REVIEW AND PATIENT BILLING SERVICES. OTHER SERVICES INCLUDE CAPITAL PLANNING AND ALLOCATION; STRATEGIC, FINANCIAL AND HUMAN RESOURCE PLAN PREPARATION; INVESTMENT MANAGEMENT AND DEBT FINANCING; SYSTEM-LEVEL INTERNAL AND EXTERNAL FINANCIAL REPORTING; TAX COMPLIANCE PROCESS MANAGEMENT; EMPLOYEE BENEFITS ADMINISTRATION; EDUCATIONAL PROGRAM OFFERINGS FOR LEADERSHIP DEVELOPMENT; AND RISK MANAGEMENT STRATEGIES. DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: SSM HEALTH CARE'S CORPORATE OFFICE OVERSEES COMMUNITY BENEFIT REPORTING FOR THE ENTIRE SYSTEM. THE ANNUAL STRATEGIC, FINANCIAL, AND HUMAN RESOURCES PLANNING PROCESS HAS INCLUDED AN ASSESSMENT OF THE COMMUNITY'S NEEDS TO INCLUDE THE IDENTIFICATION OF SPECIFIC AND MEASUREABLE HEALTHY COMMUNITIES' INITIATIVES. OUR SYSTEM VISION FOR IMPROVED COMMUNITY HEALTH IS PURSUED IN ALL OF OUR WORK AT SSM HEALTH CARE FROM STRATEGIC PLANNING, FINANCIAL MANAGEMENT, AND DIRECT PATIENT CARE TO ADVOCACY, COMMUNITY PARTNERSHIPS AND HEALTHY COMMUNITIES INITIATIVES (HCIS). OVERALL EFFORTS IN THIS AREA ARE COORDINATED THROUGH SSM HEALTH CARE'S COMMUNITY BENEFIT PROGRAM, WHICH FOCUSES ON ASSESSING AND IMPLEMENTING STRATEGIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. SSM HEALTH CARE'S COMMITMENT TO COMMUNITY BENEFIT IS DEEPLY EMBEDDED INTO OUR ORGANIZATIONAL CULTURE AS REFLECTED IN OUR SYSTEM VISION STATEMENT WHICH READS: THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT, AND ENVIRONMENT WITHIN THE FINANCIAL LIMITS OF THE SYSTEM. COMMUNITY HEALTH IMPROVEMENT, WHICH WE PURSUE AS A SYSTEM PRIMARILY THROUGH HCIS UNDERTAKEN AT THE ENTITY LEVEL, IS FUNDAMENTAL TO OUR MISSION, VALUES, AND VISION. OVER THE YEARS MANY PEOPLE HAVE BENEFITED FROM OUR HCIS AND MUCH GOOD HAS COME FROM THEM. IN AN EFFORT TO BEST RESPOND TO COMMUNITY NEEDS, HCIS HAS REFOCUSED ITS EFFORTS TOWARD A NEW APPROACH TO COMMUNITY HEALTH, AS OUTLINED HERE. IN ADDITION TO THE HEALTHY COMMUNITIES INITIATIVES, EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TO SUPPORT THE COMPLETION OF A CHNA IN ACCORDANCE WITH ESTABLISHED GUIDELINES, A SIX-STEP PROCESS WAS DEVELOPED. THE PROCESS DEFINES AN APPROACH THAT CAN BE USED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY SSM HEALTH CARE AND DEVELOP STRATEGIES FOR MEETING THOSE NEEDS. THE PROCESS INCLUDES: - DEVELOP A PLAN TO ADDRESS HEALTH REFORM MANDATES TO INCLUDE DEFINING HOW THE ASSESSMENT AND BY WHOM THE ASSESSMENT WILL BE COMPLETED; IDENTIFYING THE STAKEHOLDERS INVOLVED; AND THE TIME FRAME FOR COMPLETION - PERFORM DATA COLLECTION INCLUDING IDENTIFYING THE GEOGRAPHIC AREA SERVED, ACCESSING SECONDARY DATA SOURCES AND COORDINATING INTERVIEWS, SURVEY AND/OR FOCUS GROUPS FOR PRIMARY DATA COLLECTION - PERFORM DATA ANALYSIS BY EVALUATING QUANTITATIVE AND QUALITATIVE DATA TO IDENTIFY AND PRIORITIZE HEALTH NEEDS AND OPPORTUNITIES - CREATE A PLAN WITH GOALS, STRATEGIES, ACTIONS, DUE DATES, AND RESOURCE REQUIREMENTS WHICH INCLUDES INPUT FROM CONSTITUENTS - OBTAIN APPROVAL FROM SYSTEM MANAGEMENT TO BE ADOPTED AND INCORPORATE THE CHNA INITIATIVES INTO THE STRATEGIC PLAN TO INCLUDE APPOINTING RESPONSIBILITY FOR IMPLEMENTING THE PLAN AND ASSIGNING A STEERING COMMITTEE TO MONITOR PROGRESS AS APPROPRIATE - COORDINATE COMMUNICATION TO THE PUBLIC, BOARDS, STAFF AND OTHER STAKEHOLDERS PROGRESS IN ADDRESSING TOP PRIORITIES IMPACTING COMMUNITY HEALTH IN COLLABORATION WITH OUR COMMUNITY PARTNERS, ALL SSM HEALTH CARE HOSPITAL FACILITIES COMPLETED THEIR CHNA IN 2013. THE ASSESSMENTS HAVE BEEN APPROVED BY SSMHC MANAGEMENT AND INCLUDED AS PART OF OUR 2013 STRATEGIC PLAN. DURING 2013 EACH SSMHC HOSPITAL UTILIZED THEIR CHNA TO IDENTIFY VARIOUS UNMET COMMUNITY HEALTH NEEDS. OUR PRIMARY RESPONSIBILITY IS TO ADDRESS THOSE THAT WE CAN IMPACT THE MOST, THAT IS, THOSE ALIGNED WITH OUR CORE COMPETENCIES. WE COMMUNICATE THE NEEDS IDENTIFIED IN THE ASSESSMENT TO THE COMMUNITY THROUGH A VARIETY OF MEDIA, DEVELOP A PLAN FOR HOW TO ADDRESS THOSE NEEDS THAT WE CAN IMPACT, AND IMPLEMENT STRATEGIES TO ADDRESS THESE NEEDS. EACH PRIORITY AREA WAS ASSIGNED A CHAMPION AND PROGRAMS AND SERVICES WERE DESIGNED TO ADDRESS THE IDENTIFIED NEED. ADDITIONAL INFORMATION REGARDING IDENTIFIED NEEDS AND ACTIONABLE GOALS CAN BE FOUND AT WWW.SSMHEALTH.COM. 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 EXCEEDS 20% OF THEIR FAMILY GROSS INCOME. IN THIS SITUATION, THE BILL IS DISCOUNTED DOWN TO 20% OF THEIR FAMILY INCOME. 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. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: CONTINUED - 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. - ALL SURPLUS FUNDS GENERATED BY SSMHC ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM. OVER THE LAST SEVERAL YEARS, SSMHC HAS OPENED ONE NEW HOSPITAL AND CONSTRUCTED TWO NEW REPLACEMENT HOSPITALS. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: 1. 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. 2. 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. 3. 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. 4. SSM SENIOR LEADERS PARTICIPATE IN VARIOUS ECONOMIC DEVELOPMENT COUNCILS OR CHAMBERS OF COMMERCE ON ISSUES IMPACTING THE COMMUNITY'S HEALTH AND SAFETY. SPECIFIC ORGANIZATIONS INCLUDE THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT, THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES, ST LOUIS METRO HOSPITAL COUNCIL, ST LOUIS ECONOMIC COUNCIL, MISSOURI STATE UNIVERSITY BOARD OF GOVERNORS, AREA AGENCIES ON AGING, OKLAHOMA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND OKLAHOMA STATE BOARD OF MEDICAL LICENSURE. 5. SSM'S CORPORATE OFFICE EMPLOYEES PROVIDED SUPPORT FOR COMMUNITY BENEFIT REPORTING THROUGHOUT THE SYSTEM EMBRACING COMMUNITY BENEFIT REPORTING TO MAKE A REAL AND LASTING CHANGE. IN ADDITION, THE SSM CORPORATE OFFICE MAINTAINED A COMMUNITY BENEFIT TOOL KIT AND A SHARE POINT SITE FOR THE DISSEMINATION OF COMMUNITY BENEFIT INFORMATION. 6. SSM PUBLIC POLICY LEADERS PARTICIPATE IN VARIOUS DISCUSSIONS WITH LEGISLATORS ON NUMEROUS ISSUES IMPACTING THE COMMUNITY'S HEALTH AND SAFETY INCLUDING MEDICAID EXPANSION AND ACCESS TO CARE. 7. STAFF MEMBERS CONTRIBUTED THEIR TIME TO SUPPORT VARIOUS LEADERSHIP DEVELOPMENT PROGRAMS INCLUDING PROVIDING HUMAN RESOURCE COUNSELING TO UNEMPLOYED PROFESSIONALS AT ST PATRICK'S CENTER AND TO GUARD/RESERVE MEMBERS AND PROVIDING INFORMATION ON JOB SEEKING SKILLS TO ST LOUIS UNIVERSITY MHA STUDENTS. 8. IN SUPPORT OF SSMHC'S DIVERSITY STRATEGIC GOAL, IMPROVE AND SUPPORT ALLIANCES WITH ORGANIZATIONS WHOSE MISSION CALL FOR RIGOROUS PURSUIT OF FAIRNESS AND EQUALITY FOR ALL PEOPLE, SSMHC PROVIDED SUPPORT TO NUMEROUS COMMUNITY ACTIVITIES. 9. SSMHC PROVIDED SUPPORT TO VARIOUS COMMUNITY EVENTS IMPACTING THE COMMUNITY'S HEALTH AND SAFETY. SPECIFIC EVENTS INCLUDE UTILIZATION OF THE EDUCATION SERVICE CENTER FOR COMMUNITY GROUPS, SUPPORT OF CHAD'S COALITION FOR MENTAL HEALTH, HUMAN RESOURCE SUPPORT FOR THE ST LOUIS REGIONAL CHAMBER AND GROWTH ASSOCIATION, FURNITURE DONATIONS TO NEW HORIZONS, AND PRODUCTION OF A PROMOTIONAL VIDEO FOR WOMAN'S PLACE. 10. DURING 2013, THE SSM PATIENT BUSINESS SERVICES DEPARTMENT PROVIDED SERVICES TO INCREASE ACCESS AND QUALITY OF CARE IN HEALTH SERVICES TO INDIVIDUALS, ESPECIALLY PERSONS LIVING IN POVERTY AND THOSE IN OTHER VULNERABLE POPULATIONS. SERVICES INCLUDED FINANCIAL COUNSELING, MEDICAID ELIGIBILITY TEAMS, PROCESSING FINANCIAL APPLICATIONS FOR SELF- PAY PATIENTS AND CONTRACTING WITH VENDORS TO SUPPORT THE DEPARTMENT'S EFFORTS. IN ADDITION, THE DEPARTMENT PROVIDED COMPUTER LITERACY TRAINING TO PATIENTS. 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 $9,084,308 FORM 990, PART VI, SECTION A, LINE 4 DURING 2013, SSM HEALTH CARE CORPORATION'S GOVERNING DOCUMENTS WERE AMENDED TO REFLECT THE FOLLOWING PRIMARY CHANGES: - THE MEMBERS OF THE ORGANIZATION WILL CONSIST OF THE CURRENT MEMBERS OF SSM HEALTH MINISTRIES, A CANONICAL SUCCESSOR TO THE FRANCISCAN SISTERS OF MARY. - THE NUMBER OF POTENTIAL VOTING BOARD DIRECTORS WAS INCREASED TO 18, TWO OF WHOM MUST BE PHYSICIANS. - REVISED TERM LIMITATIONS WERE INSTITUTED FOR APPOINTED BOARD DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERS. THESE MEMBERS CONSIST OF THE INDIVIDUALS WHO ARE THE THEN-SERVING MEMBERS OF SSM HEALTH MINISTRIES, A PUBLIC JURIDIC PERSON AND CANONICAL SUCCESSOR TO THE RELIGIOUS INSTITUTE, THE FRANCISCAN SISTERS OF MARY (SIX 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 BOARD OF DIRECTOR MEMBERS, 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 THE BOARD OF DIRECTORS, EXCEPT FOR FOR DIRECTORS WHO SERVE EX OFFICIO AND, TO REMOVE THE APPOINTED DIRECTORS WITH OR WITHOUT CAUSE C. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN D. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION E. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION F. SEE BYLAWS FOR REMAINING RESERVED POWERS G. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY H. 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 I. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION J. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION K. 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 L. 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 FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTING/FINANCE PERSONNEL AT EACH SSMHC (SSM HEALTH CARE SYSTEM) ENTITY, IN CONJUNCTION WITH SYSTEM FINANCE PERSONNEL, PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE SYSTEM OFFICE FOR FINAL REVIEW AND COORDINATION OF THE SYSTEM LEVEL FORM 990 INFORMATION. THE INFORMATION IS SUBMITTED TO AN OUTSIDE TAX CONSULTING FIRM WHO PREPARES AND SIGNS THE FORM 990 FROM THE SSMHC INFORMATION. PRIOR TO FINALIZING THE RETURN, A DRAFT IS SENT TO PERSONNEL AT SSMHC FOR REVIEW AND APPROVAL. UPON SSMHC APPROVAL, THE OUTSIDE PREPARER FORWARDS THE COMPLETED FORM 990 FOR THE APPROPRIATE SIGNATURES AND FILING ACTION. A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. FORM 990, PART VI, SECTION B, LINE 15 ALL SSMHC EXECUTIVE SALARY/COMPENSATION INFORMATION IS BASED ON COMPARATIVE DATA WITH SIMILAR POSITIONS IN THE MARKET. THE COMPENSATION REVIEW PROCESS IS PERFORMED BY EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS. THE SALARY DATA AND POTENTIAL ADJUSTMENTS FOR THE PRESIDENT/CEO OF THE SYSTEM, VICE PRESIDENT, TREASURER, THE SENIOR VICE PRESIDENTS AND PRESIDENTS OF HOSPITAL OPERATIONS, HEALTH CARE DEVELOPMENT AND PHYS. AND AMBULATORY CARE ARE PRESENTED TO THE SSMHC BOARD OF DIRECTORS BY THE SAME INDEPENDENT COMPENSATION CONSULTANTS TO APPROVE, DISAPPROVE OR MODIFY. ALL DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED. 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. FORM 990, PART IX, LINE 11G PROFESSIONAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 6,893,346. MANAGEMENT AND GENERAL EXPENSES 22,530,652. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,423,998. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 117,942. MANAGEMENT AND GENERAL EXPENSES 15,637,756. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,755,698. FORM 990, PART XI, LINE 9: FUND BALANCE TRANSFERS -180,217,024. 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