2013-11-15T20:53:17-06:00 2012-12-31 861065772 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 77002 990 2012-01-01 440579850 SSM REGIONAL HEALTH SERVICES SSMR 3149947800 477 NORTH LINDBERGH BLVD ST LOUIS MO 63141 JUNE PICKETT 3149947800 2013-11-15 1 BROOKE KITCHEN P00849302 7139822000 2012 2016-03-07 17:11:31Z SEE SCHEDULE O WILLIAM P THOMPSON 477 NORTH LINDBERGH BLVD ST LOUIS MO 63141 194624963 0 0928 X WWW.SSMHC.COM X 2000 MO OPERATES TWO HOSPITALS AND HEALTH CENTERS IN JEFFERSON CITY, MISSOURI AND MARYVILLE, MISSOURI. 12 0 1760 232 7566349 56676 221302 507652 205595229 185435032 1778178 966180 8294803 7663843 215889512 194572707 166441 151335 0 0 103722671 101682295 0 0 130446 117947530 102983667 221836642 204817297 -5947130 -10244590 136505568 153467018 57319302 59656856 79186266 93810162 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 180519787 151335 185511391 PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS. 180519787 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 0 0 1 1760 1 1 1 0 0 0 0 0 0 0 0 0 0 X 12 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X DONNA WALLACE 3145238793 477 NORTH LINDBERGH BLVD ST LOUIS MO 63141 STEVEN BARNEY 1.00 40.00 X X 0 779380 231364 JOAN BEGLINGER 1.00 40.00 X 0 261146 153306 LYNN BRUCHHOF 1.00 40.00 X 0 154856 772 GAUROV DAYAL MD 1.00 40.00 X 0 582134 61107 PAULA FRIEDMAN 1.00 40.00 X 0 598630 294336 PHILIP GUSTAFSON 1.00 40.00 X 0 646285 156679 THOMAS K LANGSTON 1.00 40.00 X 0 640985 293527 JOE M HODGES 1.00 40.00 X 0 705117 313970 CHRISTOPHER HOWARD 1.00 40.00 X 0 873195 368042 MICHAEL R PANICOLA 1.00 40.00 X 0 384415 150918 DIXIE L PLATT 1.00 40.00 X 0 514403 242813 WILLIAM P THOMPSON 1.00 40.00 X X 0 2161601 1088396 KRIS A ZIMMER 1.00 40.00 X X 0 837428 257469 JUNE L PICKETT 1.00 40.00 X 0 240525 353818 GRAY COX 40.00 1.00 X 0 372041 69905 R BRENT VANCONIA 40.00 1.00 X 0 464768 202414 JOCELYN SKIDMORE 40.00 1.00 X 135275 0 84386 MARVIN KURTZ 40.00 1.00 X 291511 0 46448 SCOTT HOLMAN DO 40.00 1.00 X 371360 0 118971 PATRICK HARR 40.00 1.00 X 224037 0 127729 ANTHONY HOUSTON 40.00 1.00 X 271438 0 65825 JOHN LUCIO DO 40.00 1.00 X 168271 0 36337 SUSAN MANKOSKI 40.00 1.00 X 177758 0 61268 THOMAS DISTEFANO 40.00 1.00 X 946240 0 391027 GARRY PEARSON 40.00 1.00 X 625196 0 288244 JANE DAWSON 40.00 1.00 X 460013 0 113725 SHIRLEY HARRIS 40.00 1.00 X 439970 0 143068 AMRIT SINGH 40.00 1.00 X 427306 0 119933 CATHERINE ABRAMS 0.00 0.00 X 195616 0 34107 4733991 10216909 5869904 96 1 1 0 ALBERICI CONSTRUCTORS 8800 PAGE AVE ST LOUIS MO 631146106 CONSTRUCTION 10053413 LAWRENCE GROUP 319 N 4TH STREET STE 1000 ST LOUIS MO 63102 CONSTRUCTION MANAGEMENT/CONSULTING 2234774 EMERGENCY PRACTICE ASSOCIATES INC 3840 W 9TH ST WATERLOO IA 50702 MEDICAL PHYSICIAN SERVICES 1352733 CAPITAL EMERGENCY PHYSICIANS 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 MEDICAL PHYSICIAN SERVICES 1323055 MID MISSOURI ANESTHESIA CONSULTANTS 1445 CHRISTY DRIVE JEFFERSON CITY MO 65101 MEDICAL PHYSICIAN SERVICES 1255000 45 47018 405801 31727 23106 16030 507652 NET PATIENT REV 621110 182657800 182657800 OTHER OPERATING REVENUE 621110 2777232 2777232 185435032 537280 537280 41444 39339 2105 2105 2105 428589 8133 0 7822 428589 311 428900 428900 13138 5095 8043 8043 10987 0 10987 10987 PHARMACY REVENUE 446110 7104172 7104172 CHILD CARE CENTER 624410 395407 395407 LABORATORY REV 621500 40664 40664 102465 76359 26106 7642708 194572707 185511391 7566349 987315 151335 151335 2681277 2681277 73138697 63031775 10029379 77543 7801506 6512499 1279391 9616 13047491 10916049 2117791 13651 5013324 4167812 839842 5670 4470143 958384 3511759 441106 441106 97125 97125 15968821 14954028 1014793 845165 845165 7809825 7226814 567165 15846 11149477 11129436 20041 5014751 4779633 235118 521500 333905 184558 3037 191666 167389 24277 345463 345463 9258067 9073618 183457 992 644608 769296 -124688 MEDICAL SUPPLIES 34476098 34435326 40694 78 MEDICARE PROVIDER TAX 11109487 11109487 0 0 LICENSES 228033 227466 567 0 BOND RELATED FEES 209756 194044 15712 0 202576 36028 162535 4013 204817297 180519787 24167064 130446 1054845 2467752 13689469 17424932 29574252 30006433 20000 4312181 4324851 2010395 1202633 163951938 104674663 50630288 59277275 27050825 29973869 8163313 8789273 136505568 153467018 15604606 15940078 41714696 43716778 57319302 59656856 X 76400877 89381941 2674389 4317221 111000 111000 79186266 93810162 136505568 153467018 X -10244590 1084217 9877 23774392 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 52751 0 0 0 52751 0 111000 1109 1109 111000 111000 1436 1436 111000 116307 2098 7405 111000 118719 1500 4614 8526 116307 173727 -55008 118719 0.00000 1.00000 0.00000 0 0 4715483 4715483 80363933 61836802 18527131 537755 458078 79677 52015456 41618402 10397054 26319311 761381 25557930 59277275 BENEFICIAL INTEREST IN FOUNDATIONS 13112661 F EQUITY IN JOINT VENTURES 531121 F SSM COMPREHENSIVE INVESTMENT PROGRAM 16330087 F 29973869 THIRD PARTY PAYOR 7222001 OTHER RECEIVABLES 225834 LONG TERM NOTES RECEIVABLE 181135 OTHER NON CURRENT ASSETS 1160303 8789273 PENSION FUNDING LIABILITY 13210134 RABBI TRUST LIABILITY 1504633 THIRD PARTY PAYOR 1712499 ASSET RETIREMENT LIABILITY 908281 DEFERRED COMPENSATION LIABILITY 962051 DUE TO AFFILIATES 291049 ALLOCATED TAX EXEMPT BOND DEBT (ISSUED BY SSM HEALTH CARE) 25128131 43716778 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS AND THE MISSION OF ST. MARY'S HEALTH CENTER. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: SSM REGIONAL HEALTH SERVICES' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH CARE CORPORATION (SSMHC), A RELATED ORGANIZATION. SSMHC EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2012 OR 2011. 1 1 X 1 X 1 X 1 1 0 1 1 4440317 4440317 0.02170 32629659 29293180 3336479 0.01630 37069976 29293180 7776796 0.03800 367995 9398 358597 0.00180 95882 95882 0.00050 358377 23467 334910 0.00160 822254 32865 789389 0.00390 37892230 29326045 8566185 0.04190 343 343 0.00000 1050 1050 0.00000 201366 201366 0.00100 202759 202759 0.00100 0 7103893 52183060 65406424 -13223364 X 1 0 1 SMHC SURGICAL CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 2 SMHC MUSCULOSKELETAL CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 3 SMHC CARDIOVASCULAR CO-MANAGEMENT COMPANY LLC MANAGEMENT 0.50000 0.50000 2 1 ST MARY'S HEALTH CENTER

100 ST MARYS MEDICAL PLAZA JEFFESON CITY MO 65101

X X X A 2 ST FRANCIS HOSPITAL & HEALTH SERVICES

2015 S MAIN MARYVILLE MO 64468

X X X A FACILITY REPORTING GROUP - A 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 27 ST FRANCIS FAMILY HEALTH CARE WEST

2016 S MAIN MARYVILLE MO 64468

PRIMARY CARE CLINIC ST MARY'S PEDIATRICS

3348 AMERICAN AVENUE JEFFERSON CITY MO 651091079

PEDIATRIC CLINIC ST MARY'S SPORTS MEDICINE & REHAB

1225 WEST STADIUM BLVD JEFFERSON CITY MO 65109

OUTPATIENT CLINIC ST MARY'S SLEEP DISORDERS CENTER

3348 AMERICAN AVENUE JEFFERSON CITY MO 65109

SLEEP DISORDERS CENTER ST MARY'S HOLTS SUMMIT PHARMACY

140 NORTHSTAR DRIVE HOLTS SUMMIT MO 650431123

RETAIL PHARMACY ST MARY'S TIPTON PHARMACY

875 STATE RT 5 PO BOX 667 TIPTON MO 650818411

RETAIL PHARMACY ST MARY'S PLAZA PHARMACY

200 ST MARYS MEDICAL PLAZA SUITE 204 JEFFERSON CITY MO 65101

RETAIL PHARMACY ST FRANCIS FAMILY HEALTH CARE - EAST

114 E SOUTH HILLS DR MARYVILLE MO 64468

PRIMARY CARE CLINIC ST MARY'S URGENT CARE - JEFFERSON CITY

2511 W EDGEWOOD SUITE D JEFFERSON CITY MO 651095869

URGENT CARE CLINIC ST MARY'S CARDIOVASCULAR SURGERY

200 ST MARYS MEDICAL PLAZA SUITE 203 JEFFERSON CITY MO 651011604

CARDIOVASCULAR SERVICES ST MARY'S HEALTH PSYCHOLOGY

3702 W TRUMAN BLVD SUITE 115 JEFFERSON CITY MO 651096152

O/P PSYCHIATRIC SERVICES ST FRANCIS FAMILY LIFE SERVICES

114 EAST SOUTH HILLS DRIVE MARYVILLE MO 64468

MENTAL HEALTH OUTPATIENT ST MARY'S URGENT CARE - LAKE OZARK

2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 650498603

URGENT CARE CLINIC AND RURAL HEALTH CLINIC ST MARY'S OUTPATIENT REHAB & SPINE CENTE

2511 W EDGEWOOD SUITE G JEFFERSON CITY MO 65109

OUTPATIENT CLINIC ST MARY'S MEDICAL CLINIC - TIPTON

875 STATE RT 5 PO BOX 667 TIPTON MO 650818411

FAMILY PRACTICE CLINIC ST MARY'S MEDICAL CLINIC - BELLE

100 HIGHWAY 28 W BELLE MO 650133405

FAMILY PRACTICE CLINIC & RURAL HEALTH CLINIC ST MARY'S OCCUPATIONAL MEDICINE

2511 W EDGEWOOD SUITE F JEFFERSON CITY MO 651095869

OCCUPATIONAL MEDICINE ST MARY'S MEDICAL CLINIC - HOLTS SUMMIT

140 NORTHSTAR DRIVE HOLTS SUMMIT MO 650431123

FAMILY PRACTICE CLINIC ST MARY'S MEDICAL CLINIC - VERSAILLES

801 KIDWELL DRIVE VERSAILLES MO 650841787

FAMILY PRACTICE CLINIC ST MARY'S MEDICAL CLINIC - LAKE OZARK

2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 650498603

FAMILY PRACTICE CLINIC & RURAL HEALTH CLINIC HARDIN MEDICAL CLINIC

408 SOUTH DODGE STREET BEDFORD IA 50833

PRIMARY CARE CLINIC ST MARY'S MEDICAL CLINIC - JEFFERSON

2511 W EDGEWOOD SUITE F JEFFERSON CITY MO 65109

FAMILY PRACTICE CLINIC ST FRANCIS GRANT CITY MEDICAL CLINIC

24 WEST 4TH STREET GRANT CITY MO 64456

PRIMARY CARE CLINIC WEST NODAWAY HEALTH CLINIC

221 EAST MAIN STREET BURLINGTON JUNCTION MO 64428

PRIMARY CARE CLINIC ST MARY'S CANCER SPECIALIST

200 ST MARYS MEDICAL PLAZA SUITE 202 JEFFERSON CITY MO 651011604

OUTPATIENT ONCOLOGY ST MARY'S MEDICAL CLINIC - WESTPHALIA

1875 HWY 63 WESTPHALIA MO 65085

FAMILY PRACTICE CLINIC ST MARY'S WESTPHALIA PHARMACY

1875 HWY 63 WESTPHALIA MO 65085

RETAIL PHARMACY FORM 990, SCHEDULE H, PART I PART I, QUESTION 3BSSM REGIONAL HEALTH SERVICES USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.THE APPLICABLE PERCENTAGE VARIES BASED ON HOW MUCH THE APPLICANT'S INCOME EXCEEDS FPG GUIDELINES. THE FOLLOWING SCHEDULE IS USED TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE:APPLICANT'S INCOME IS CHARITY CARE PERCENTAGELESS THAN OR EQUAL TO 2 TIMES FPG 100%MORE THAN 2 TIMES, LESS THAN 2.5 TIME FPG 80%MORE THAN 2.5 TIMES, LESS THAN 3 TIMES FPG 60%MORE THAN 3 TIMES, LESS THAN 3.5 TIMES FPG 40%MORE THAN 3.5 TIMES, LESS THAN 4 TIMES FPG 20%4 OR MORE TIMES FPG 0%PART I, QUESTION 3CAN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNT IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. TO FURTHER STREAMLINE AND AUTOMATE THE FINANCIAL ASSISTANCE PROCESS, SSM REGIONAL HEALTH SERVICES BUSINESS OFFICE PERSONNEL WILL AUTOMATICALLY CONSIDER 100% OF THE PATIENT ACCOUNT AS CHARITY IF THE COMMERCIAL SOFTWARE SYSTEM (SEARCHAMERICA) INDICATES THAT THE PATIENT IS LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL). THIS PROCESS IS CALLED "PRESUMPTIVE ELIGIBILITY". PART I, QUESTION 6ASSM REGIONAL HEALTH SERVICES IS PART OF THE INTEGRATED HEALTH SYSTEM KNOWN AS SSM HEALTH CARE. IN AN EFFORT TO STRENGTHEN ITS COMMUNITY BENEFIT PROGRAM, SSM HEALTH CARE PLANS FOR, MEASURES, AND COMMUNICATES IN AN ANNUAL REPORT CHARITY CARE PROVIDED TO PERSONS WHO ARE LOW INCOME, THE UNPAID COSTS OF PUBLIC PROGRAMS AND OTHER ACTIVITIES THAT RESPOND TO COMMUNITY NEED, IMPROVE COMMUNITY HEALTH, OR REACH OUT TO LOW INCOME AND VULNERABLE PERSONS. SSM HEALTH CARE'S 2012 ANNUAL COMMUNITY BENEFIT REPORT FOR THE SYSTEM CAN BE FOUND AT WWW.SSMHC.COM.PART I, QUESTION 7CHARITY CARE COSTING METHODOLOGY: THE COST OF CHARITY CARE IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES. A COST TO CHARGE RATIO CALCULATED USING THE IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGE, WAS USED TO COMPUTE CHARITY CARE AT COST. THIS IS THE RATIO OF TOTAL ADJUSTED OPERATING EXPENSE TO TOTAL GROSS PATIENT REVENUE. THE GROSS REVENUE AMOUNT IS A GROSS AMOUNT PRIOR TO CONTRACTUAL ADJUSTMENTS AND BAD DEBTS. BOTH GROSS REVENUE AND COST ARE BASED ON CHARGES AT DATE/TIME OF SERVICE.UNREIMBURSED MEDICAID COSTING METHODOLOGY: THE COST OF UNREIMBURSED MEDICAID IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES. A COST TO CHARGE RATIO CALCULATED UTILIZING IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGE, WAS USED TO COMPUTE UNREIMBURSED MEDICAID COSTS. THIS IS THE RATIO OF TOTAL ADJUSTED OPERATING EXPENSE TO TOTAL GROSS PATIENT REVENUE. THE GROSS REVENUE AMOUNT IS A GROSS AMOUNT PRIOR TO CONTRACTUAL ADJUSTMENTS AND BAD DEBTS. BOTH GROSS REVENUE AND COST ARE BASED ON CHARGES AT DATE/TIME OF SERVICE. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS COSTING METHODOLOGY: THE COSTS FOR THESE PROGRAMS WERE DERIVED FROM THE ACTUAL COSTS INCURRED IN THESE AREAS. THE EXPENDITURES ARE DETERMINED BASED ON ACTUAL INVOICES OR DOLLAR AMOUNTS SPENT AND CHARGED TO THESE DEPARTMENTS.HEALTH PROFESSIONAL EDUCATION COSTING METHODOLOGY: THE EXPENSES FOR HEALTH PROFESSION EDUCATION WERE TAKEN FROM THE DEPARTMENT'S INCOME AND EXPENSE STATEMENT, DERIVED FROM THE ACCOUNTING FORM 990, SCHEDULE H, PART II PART II, COMMUNITY BUILDING ACTIVITIESSSM REGIONAL HEALTH SERVICES PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEALTH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING: COMMUNITY SUPPORT PHYSICAL IMPROVEMENT AND HOUSING: HOSPITAL STAFF SET A GOAL TO SECURE FUNDING FOR A NU-STEP MACHINE FOR THE MARYVILLE SENIOR CENTER. THE HOSPITAL SUCCESSFULLY RESEARCHED AND SUBMITTED A GRANT FROM THE GLADYS RICKER TRUST TO FUND THE ACQUISITION.COMMUNITY SUPPORT ECONOMIC DEVELOPMENT: PARTICIPATION IN AN ORGANIZATION PROMOTING SMALL BUSINESS DEVELOPMENT INCLUDING PARTICIPATION IN THE GRANT CITY CHAMBER OF COMMERCE AND NODAWAY COUNTY ECONOMIC DEVELOPMENT COUNCIL.COMMUNITY BUILDING COMMUNITY SUPPORT: PROVIDES DIRECT SUPPORT FOR UNDERFUNDED CHILD CARE CENTER TO COVER SALARY AND BENEFITS FOR CHILDREN AND FAMILY CENTER OF NORTHWEST MISSOURI; PARTICIPATES IN ACTIVITIES TO TAKE AN ACTIVE ROLE IN THE JEFFERSON CITY, MISSOURI COMMUNITY AND THE HEALTH OF ITS CITIZENS. FORM 990, SCHEDULE H, PART III PART III, SECTION A, LINE 2BAD DEBT COSTING METHODOLOGY: BAD DEBT EXPENSE REPORTED IN THE ACCOUNTING SYSTEM, ADJUSTED FOR BAD DEBT RECOVERIES, WAS USED, MULTIPLIED BY THE COST TO CHARGE RATIO USING IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES.PART III, SECTION A, LINE 3SSM REGIONAL HEALTH SERVICES DID NOT MAKE AN ESTIMATE OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.PART III, SECTION A, LINE 4SSM REGIONAL HEALTH SERVICES IS PART OF THE SSM HEALTH CARE CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES BAD DEBT EXPENSE IN THE DECEMBER 31, 2012 CONSOLIDATED AUDIT IS AS FOLLOW:"IN LINE WITH ITS MISSION, SSMHC PROVIDES SERVICES TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR THOSE SERVICES. FOR SOME OF ITS PATIENT SERVICES, SSMHC RECEIVES NO PAYMENT OR PAYMENT THAT IS LESS THAN THE FULL COST OF PROVIDING THE SERVICES.SSMHC VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AS DETERMINED BY SSMHC'S CRITERIA FOR FINANCIAL ASSISTANCE. BECAUSE SSMHC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUES.IN SOME CASES, SSMHC DOES NOT RECEIVE THE AMOUNT BILLED FOR PATIENT SERVICES EVEN THOUGH IT DID NOT RECEIVE INFORMATION NECESSARY TO DETERMINE IF THE PATIENTS MET THE CRITERIA FOR FINANCIAL ASSISTANCE. THE ESTIMATED COST OF CHARITY AND THE COST OF DOUBTFUL ACCOUNTS ARE AS FOLLOWS. THE ESTIMATED COSTS ARE CALCULATED USING THE COSTS OF PROVIDING PATIENT CARE DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS RATIO IS THEN MULTIPLIED BY THE GROSS CHARITY AND DOUBTFUL CHARGES TO DETERMINE ESTIMATED COSTS." BAD DEBT EXPENSE REPORTED ON LINE 2 FOR THE YEAR ENDED DECEMBER 31, 2012 WAS $18,015,207 AT CHARGES AND $7,103,893 AT COST.PART III, SECTION B, LINE 8 THE COST OF PROVIDING CARE TO MEDICARE ELIGIBLE PATIENTS IS GREATER THAN THE REIMBURSEMENT THAT MEDICARE ALLOWS ON THE MEDICARE COST REPORT. SSM REGIONAL HEALTH SERVICES CONSIDERS THIS SHORTFALL AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIATED AND SERVICES ARE PROVIDED REGARDLESS OF THE PATIENTS ABILITY TO PAY. THE MEDICARE COSTS REPORTED ON LINE 6 WERE OBTAINED FROM THE 2012 MEDICARE COST REPORT.PART III, SECTION C, LINE 9BSSM REGIONAL HEALTH SERVICES HAS ESTABLISHED WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEALTH CARE, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. THE HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIR AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE. ALL OUTSIDE COLLECTION AGENCIES MUST COMPLY WITH STATE AND FEDERAL LAWS, COMPLY WITH THE ASSOCIATION OF CREDIT AND COLLECTION PROFESSIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY AND COMPLY WITH SSM REGIONAL HEALTH SERVICES' COLLECTION AND CHARITY POLICIES. FORM 990, SCHEDULE H, PART IV PART IV, LINE 2: NEEDS ASSESSMENT PROCESSTHE ANNUAL STRATEGIC, FINANCIAL, AND HUMAN RESOURCES PLANNING PROCESS HAS INCLUDED AN ASSESSMENT OF THE COMMUNITY'S NEEDS TO INCLUDE THE IDENTIFICATION OF SPECIFIC AND MEASUREABLE HEALTHY COMMUNITIES' INITIATIVES. OUR SYSTEM VISION FOR IMPROVED COMMUNITY HEALTH IS PURSUED IN ALL OF OUR WORK AT SSM HEALTH CARE FROM STRATEGIC PLANNING, FINANCIAL MANAGEMENT, AND DIRECT PATIENT CARE TO ADVOCACY, COMMUNITY PARTNERSHIPS AND HEALTHY COMMUNITIES INITIATIVES. OVERALL EFFORTS IN THIS AREA ARE COORDINATED THROUGH SSM HEALTH CARE'S COMMUNITY BENEFIT PROGRAM, WHICH FOCUSES ON ASSESSING AND IMPLEMENTING STRATEGIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS.SSM HEALTH CARE'S COMMITMENT TO COMMUNITY BENEFIT IS DEEPLY EMBEDDED INTO OUR ORGANIZATIONAL CULTURE AS REFLECTED IN OUR SYSTEM VISION STATEMENT WHICH READS: THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT, AND ENVIRONMENT WITH THE FINANCIAL LIMITS OF THE SYSTEM.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 2011 AND INCORPORATE THE CHNA INITIATIVES INTO THE STRATEGIC PLAN TO INCLUDE APPOINTING RESPONSIBILITY FOR IMPLEMENTING THE PLAN AND ASSIGNING A STEERING COMMITTEE TO MONITOR PROGRESS AS APPROPRIATE-COORDINATE COMMUNICATION TO THE PUBLIC, BOARDS, STAFF AND OTHER STAKEHOLDERS PROGRESS IN ADDRESSING TOP PRIORITIES IMPACTING COMMUNITY HEALTHUTILIZING THIS PLAN, SSM REGIONAL HEALTH SERVICES' HOSPITALS HAVE COMPLETED THEIR CHNA IN 2012 AND IT WAS ADOPTED AS PART OF OUR STRATEGIC PLAN.ST. FRANCIS HOSPITAL AND HEALTH SERVICES MARYVILLE, MO:A COMMUNITY BENEFIT ACTIVITY IS IDENTIFIED AS A SERVICE RATHER THAN AS A MARKETING TOOL AND MEETS AT LEAST TWO OF THE FOLLOWING CRITERIA:-IT IS FINANCED BY PHILANTHROPIC CONTRIBUTIONS, VOLUNTEER EFFORTS, OR AN ENDOWMENT.-IT PROVIDES A RESPONSE TO A UNIQUE OR PARTICULAR HEALTH PROBLEM IN THE COMMUNITY.-IT GENERATES A LOW OR NEGATIVE MARGIN ON A FULLY ABSORBED COST BASIS.-IT RESPONDS TO THE NEEDS OF SPECIAL POPULATIONS SUCH AS MINORITIES, WOMEN AND CHILDREN, THE FRAIL ELDERLY, LOW INCOME PERSONS WITH DISABILITIES, THE MENTALLY ILL, OR THOSE LIVING WITH CHRONIC ILLNESS.-THE DECISION TO OFFER THE SERVICE OR PROGRAM IS NOT MADE ON A PURELY FINANCIAL BASIS.-IF NOT PROVIDED BY HEALTH CARE ORGANIZATION, THE SERVICE WOULD NO LONGER BE AVAILABLE IN THE COMMUNITY OR WOULD BE THE RESPONSIBILITY OF GOVERNMENT.HEALTHY COMMUNITIES' INITIATIVES ARE A COMPONENT OF THE OVERALL COMMUNITY BENEFIT PROGRAM. HEALTHY COMMUNITIES' INITIATIVES DEMONSTRATE THE LEADERSHIP ROLE THAT ST. FRANCIS IS TAKING IN IDENTIFYING, COMMUNICATING AND DEVELOPING RESPONSES TO HEALTH-RELATED NEEDS IN THE COMMUNITY. THESE INITIATIVES ARE UNDERTAKEN IN COLLABORATION WITH OTHER COMMUNITY PARTNERS. HEALTHY COMMUNITIES' INITIATIVES ARE SPECIFICALLY IDENTIFIED IN THE STRATEGIC AND FINANCIAL PLAN. SPECIFIC AND MEASURABLE GOALS AND OBJECTIVES ARE ESTABLISHED FOR EACH INITIATIVE IN ORDER TO DETERMINE ITS EFFECTIVENESS IN RESPONDING TO THE IDENTIFIED COMMUNITY NEED.ONE OF THE FIRST STEPS FOR IDENTIFYING A HEALTHY COMMUNITIES' PROJECT IS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT TO DETERMINE TOP CHRONIC DISEASES IN THE AREA. COMMUNITY PARTNERS ARE IDENTIFIED IN ORDER TO ADDRESS KEY INDICATORS OF COMMUNITY/POPULATION HEALTH (E.G., PREVALENCE AND INCIDENCE RATES, SCREENING RATES, HOSPITAL ADMISSION RATES, BEHAVIORAL AND LIFESTYLE FACTORS). STRATEGIES ARE FOCUSED AROUND PREVENTION, ACCESS, AND INPATIENT CARE TO REDUCE READMISSIONS AND DEVELOP CLEAR INDICATORS OR MEASURES OF SUCCESS TO TRACK PROGRESS.ST. MARY'S HEALTH CENTER JEFFERSON CITY, MO:ST. MARY'S USES PRIMARY AND SECONDARY DATA, AS WELL AS VITAL MARKET STUDIES, TO ASSESS MARKET UTILIZATION, VOLUME TRENDS AND SERVICE NEEDS ON AN ANNUAL BASIS. FOR INSTANCE, ST. MARY'S UTILIZES THE MISSOURI HOSPITAL ASSOCIATION'S HIDI MARKET DATA TO ASSESS PREVALENT DISEASE CATEGORIES BY AGE AND GENDER AND GEOGRAPHIC ORIGINATION WITHIN OUR NINE COUNTY SERVICE AREA TO DETERMINE THE NEEDS AND MOST EFFECTIVE OUTREACH FOR THE UNDERSERVED. FOCUS GROUPS ARE ALSO USED FOR BETTER UNDERSTANDING DISPARITIES AND ACCESS TO HEALTH CARE SERVICES. IN ADDITION, ST. MARY'S COMPLETES A COMPREHENSIVE COMMUNITY NEEDS EVERY THREE YEARS. ST. MARY'S PARTICIPATES AS A MEMBER OF THE CENTRAL MISSOURI HEALTH ASSESSMENT PARTNERSHIP AND FORMULATES INITIATIVES WITH MEMBER ORGANIZATIONS, INCLUDING THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI (A FEDERALLY QUALIFIED HEALTH CENTER), COLE COUNTY DEPARTMENT OF HEALTH, THE UNITED WAY OF CENTRAL MISSOURI, THE SAMARITAN CENTER OF JEFFERSON CITY, AS WELL AS CAPITAL REGION MEDICAL CENTER. PART IV LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEALL SSMHC FACILITIES WILL STRIVE TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. ALL BILLING AND COLLECTION POLICIES REFLECT THE MISSION AND VALUES OF SSMHC, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. SSMHC FACILITIES OFFER DISCOUNTS FOR HOSPITAL SERVICES TO ALL UNINSURED PERSONS. SELF-PAY DISCOUNTS APPLY TO EVERYONE WHO DOES NOT HAVE HEALTH INSURANCE, NO MATTER THEIR ABILITY TO PAY.SSMHC APPLIES ITS CHARITY CARE POLICIES FAIRLY AND CONSISTENTLY. EACH PERSON IS TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. SSMHC EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNT IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES.EACH ENTITY PROVIDING MEDICAL SERVICE SHALL PROVIDE INFORMATION TO THE PUBLIC REGARDING ITS CHARITY CARE POLICIES AND THE QUALIFICATION REQUIREMENTS FOR EACH OF ITS FACILITIES. WHEN STANDARD SYSTEM NOTICES AND COMMUNICATION REGARDING CHARITY CARE ARE AVAILABLE, THESE MUST BE USED. MODIFICATIONS TO THE STANDARD MAY BE MADE TO COMPLY WITH STATE AND LOCAL LAWS, AS WELL AS REFLECT CULTURALLY SENSITIVE TERMINOLOGY FOR THE POLICY. ALL NOTICES ARE EASY TO UNDERSTAND BY THE GENERAL PUBLIC, CULTURALLY APPROPRIATE AND AVAILABLE IN THOSE LANGUAGES THAT ARE PREVALENT IN THE COMMUNITY.THEY PROVIDE INFORMATION ABOUT:-THE PATIENT'S RESPONSIBILITY FOR PAYMENT,-THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND ENTITY CHARITY CARE AND PAYMENT ARRANGEMENTS,-THE ENTITY'S CHARITY POLICY AND APPLICATION PROCESS, AND-WHO TO CONTACT TO GET ADDITIONAL INFORMATION OR FINANCIAL COUNSELING.THE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED:-SIGNS IN THE EMERGENCY DEPARTMENT, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS.-BROCHURES OR FLYERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS.-NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES.-APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION.THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES. FORM 990, SCHEDULE H, PART VI PART VI LINE 4: COMMUNITY INFORMATIONST MARY'S HEALTH CENTER DEFINES ITS PRIMARY AND SECONDARY SERVICE AREAS AS THE FOUR COUNTIES OF COLE, MILLER, MONITEAU AND OSAGE LOCATED IN CENTRAL MISSOURI. THE TOTAL POPULATION OF THE SERVICE AREA, BASED ON THE 2010 CENSUS, WAS 130,223. THIS REGION IS EXPECTING AN INCREASE OF 1.8% FROM 2010 TO 2015 WITH COLE COUNTY EXPECTING THE PARGETS GROWTH AT 2.2%. THE AGE DISTRIBUTION CONTINUES TO SHIFT TOWARD A LARGER POPULATION OF OLDER ADULTS WITH ESTIMATES SUGGESTING THE 65+ COHORT WILL SEE THE LARGEST GROWTH FROM 2010 TO 2015 WITH A 13.4% INCREASE. THE MEDIAN AGE FOR THE REGION IS 38.4 WHICH IS SLIGHTLY HIGHER THAN THE MISSOURI AVERAGE OF 37.9. THE RACE/ETHNICITY DISTRIBUTION BASED ON THE 2010 CENSUS DATA SHOWS A POPULATION THAT IS PREDOMINATELY WHITE/CAUCASIAN (89.2%), WITH 7.1 PERCENT BLACK/AFRICAN AMERICAN. THE MAJORITY OF THE ADULT POPULATION IN THE REGION HAS AN EDUCATION LEVEL AT OR ABOVE THE HIGH SCHOOL LEVEL (85.4%). LOWER THAN AVERAGE POVERTY RATES PROVIDE EVIDENCE OF A HIGHER LEVEL OF ECONOMIC WELL-BEING IN THREE OF THE FOUR COUNTIES WITH ONLY MILLER COUNTY (16.8%)HAVING A PERCENTAGE HIGHER THAN THE MISSOURI AVERAGE (14%). MILLER COUNTY ALSO REPORTS A HIGHER PERCENTAGE OF CHILDREN IN POVERTY (31%) WHEN COMPARED TO 21 PERCENT IN MISSOURI. PER CAPITA INCOME RANGED FROM A LOW $18,202 IN MILLER COUNTY TO A HIGH OF $25,935 IN CLE COUNTY. THIS REGION CONTAINS 50,499 HOUSEHOLDS WITH AVERAGE HOUSEHOLD INCOMES RANGING FROM $43,839 IN MILLER COUNTY TO $65,254 IN COLE COUNTY. ST FRANCIS HOSPITAL & HEALTH SERVICES IS LOCATED IN MARYVILLE, MISSOURI, IN RURAL NORTHWEST MISSOURI. THE SERVICE AREA FOR ST FRANCIS ENCOMPASSES NODAWAY COUNTY, MISSOURI AND ALL OF THE CONTIGUOUS SURROUNDING COUNTIES IN MISSOURI AND IOWA. THE ESTIMATED 2011 POPULATION OF NODAWAY COUNTY WAS 21,860 WITH A PROJECTED GROWTH RATE OF 0.2% FROM 2011 TO 2016. THE LARGEST AGE GROUP IN NODAWAY COUNTY IS THE 18 24 GROUP, WHICH MAKES UP ABOUT 27% OF THE TOTAL POPULATION. THE POPULATION OF NODAWAY COUNTY IS PREDOMINANTLY WHITE/NON-HISPANIC (94%). THE AVERAGE HOUSEHOLD INCOME IN NODAWAY COUNTY IS $46,895. THIS IS CONSIDERABLY LOWER THAN THE MISSOURI AVERAGE OF $58,797. IN 2010, THE POVERTY RATE WAS 17.0%, WHICH WAS HIGHER THAN THE MISSOURI AVERAGE OF 15.3%. THE POVERTY RATE FOR CHILDREN WAS 15.0% IN NODAWAY COUNTY. MOST OF THE ADULT POPULATION (AGE 25 OR OLDER) IN NODAWAY COUNTY HAVE A HIGH SCHOOL DEGREE OR HIGHER.ST MARY'S HEALTH CENTER OFFERS A FULL RANGE OF HEALTH CARE SERVICES INCLUDING CARDIOVASCULAR, EMERGENCY, ORTHOPEDIC, CANCER, OUTPATIENT SURGICAL, AND WOMEN'S HEALTH SERVICES. IN ADDITION ST MARY'S EXTENDS ITS HEALTH CARE INTO THE REGION WITH THE FOLLOWING SERVICES: WOUND HEALING CENTER, MEDICAL CLINICS, URGENT CARE FACILITIES, RETAIL PHARMACIES, ST MARY'S PEDIATRICS, HEALTH PSYCHOLOGY, PAIN MANAGEMENT, ST MARY'S SLEEP CENTER, WOMEN'S IMAGING CENTER, OCCUPATION MEDICINE, OUTPATIENT PHYSICAL REHABILITATION AND DIABETES MANAGEMENT AND TRAINING.AS A RURAL HOSPITAL, ST FRANCIS HOSPITAL & HEALTH SERVICES PROVIDES EMERGENCY TREATMENT, ACUTE CARE FOR PATIENTS WITH MEDICAL AND SURGICAL DIAGNOSIS, MENTAL HEALTH ILLNESSES, AND OBSTETRICAL NEEDS. PART VI LINE 5: PROMOTION OF COMMUNITY HEALTHSSM HEALTH CARE'S MISSION STATEMENT IS "THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD." SSM REGIONAL HEALTH SERVICES PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY. SOME EXAMPLES INCLUDE THE FOLLOWING:ST. FRANCIS HOSPITAL AND HEALTH SERVICES MARYVILLE, MOIN NODAWAY COUNTY, THE RATE OF ER VISITS FOR STROKE OR OTHER CEREBROVASCULAR DISEASE SHOWED A SIGNIFICANT INCREASE IN RECENT YEARS BASED ON THE COMMUNITY ASSESSMENT. OF THE DATA STUDIED, 75% OF THE PATIENTS WERE FEMALE. EFFORTS WERE MADE TO IDENTIFY HIGH-RISK PATIENTS THROUGH INCREASED SCREENINGS IN THE AREA WITH SPECIAL EMPHASIS ON WOMEN IN THE AREA. HEALTH SCREENINGS INCLUDE BLOOD PRESSURE, BLOOD DRAWS, AND/OR ONE DENSITY TEST. THE HOSPITAL MAKES PRESENTATIONS ABOUT HEALTH RELATED-RELATED MATTERS SUCH AS DIABETES AND HEART DISEASE AND PARTICIPATES IN HEALTH FAIRS. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN JOB SHADOW OPPORTUNITIES FOR STUDENTS IN ELEMENTARY SCHOOL THROUGH COLLEGE. DURING 2012, THE HOSPITAL HELD 18 HEALTH SCREENING WITH 1090 PARTICIPANTS.THROUGH ITS COMMUNITY OUTREACH, THE HOSPITAL IDENTIFIED OBESITY AS A HIGH PRIORITY INITIATIVE IN ITS SERVICE AREA. IN CONJUNCTION WITH LOCAL PARTNERS, THE HOSPITAL DEVELOPED A HEALTHY LIFESTYLES PROGRAM TO PROVIDE EDUCATION AND PRIMARY CARE FOR THOSE WHO STRUGGLE WITH OBESITY WHILE SIMULTANEOUSLY PREVENTING THE CONDITION IN THE YOUNG THROUGH EDUCATION AND ENCOURAGEMENT OF ACTIVITY. DURING 2012, THE HOSPITAL HELD 12 HOSPITAL SPONSORED COMMUNITY ACTIVITY EVENTS AND REGISTERED 20 PATIENTS IN THE PROGRAM.A SECOND COMMUNITY IDENTIFIED PRIORITY WAS ADOLESCENT MENTAL HEALTH CARE. THE HOSPITAL INITIATIVE STRIVES TO INCREASE ACCESS TO CARE FOR ADOLESCENTS AFFECTED BY MENTAL HEALTH ISSUES AND INCREASING AWARENESS OF MENTAL HEALTH ISSUES IN THE COMMUNITY. DURING 2012, THE HOSPITAL PROVIDED 1,100 ADOLESCENT OUTPATIENT MENTAL HEALTH APPOINTMENTS.ST. MARY'S HEALTH CENTER JEFFERSON CITY, MOST. MARY'S FINANCIAL ASSISTANCE PROGRAM: ST. MARY'S PROVIDED IN-HOUSE AND NOW CONTRACTS WITH A COMPANY THAT SCREENS AND ASSISTS ALL PATIENTS WHO HAVE NO INSURANCE TO HELP THEM APPLY FOR MEDICARE, MEDICAID, OR OTHER FORMS OF ASSISTANCE.SMHC FOUNDATION MEDICATION ASSISTANCE FUND: THIS PROGRAM PROVIDES AID TO THOSE IN NEED BY OFFERING SHORT-TERM ASSISTANCE TO PATIENTS WHO CANNOT AFFORD PRESCRIPTION MEDICINE, AND CANNOT OBTAIN IT IN A TIMELY MANNER FROM ANOTHER AGENCY. THIS PROGRAM SUPPORTS THE POOR, UNINSURED AND IS AVAILABLE TO BOTH THE URBAN AND RURAL DEMOGRAPHIC.TRAINING RESOURCES FOR DISADVANTAGED YOUTH: THIS PROGRAM IS A TRAINING PROGRAM THAT PROVIDES LEARNING CHALLENGED HIGH SCHOOL STUDENTS AN OPPORTUNITY TO BUILD VALUABLE EXPERIENCE AND LIFE SKILLS BY WORKING AT THE HOSPITAL. THE PROGRAM SUPPORTS LEARNING DISADVANTAGED, OFTEN ECONOMICALLY CHALLENGED YOUTH IN OUR COMMUNITY, AS WELL AS SUPPORTS A COMMUNITY PARTNERSHIP WITH THE LOCAL HIGH SCHOOL.LINCOLN UNIVERSITY SCHOOL OF NURSING: ST. MARY'S PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $63,507 TO THE NURSING PROGRAM AS WELL AS PROVIDING A CLINICAL SETTING FOR THE RN STUDENTS TO LEARN.SSM REGIONAL HEALTH SERVICES ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES:-OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY,-HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA,-HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY,-ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS,-PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. PART VI LINE 6: AFFILIATED HEALTH CARE SYSTEMSSM REGIONAL HEALTH SERVICES IS A HEALTH CARE NETWORK THAT THAT OPERATES ST MARY'S HEALTH CENTER IN JEFFERSON CITY MISSOURI AND ST FRANCIS HOSPITAL & HEALTH SERVICES IN MARYVILLE, MISSOURI. IT IS PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE. SSM HEALTH CARE IS A 501(C)(3) ORGANIZATION HEADQUARTERED IN ST LOUIS, MISSOURI.PART VI LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORTTHE SSM HEALTH CARE'S ANNUAL CONSOLIDATED COMMUNITY BENEFIT REPORT IS FILED IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN. PART V, LINE 8 FACILITY REPORTING GROUP A SEE BELOW FACILITY 2 -- ST. FRANCIS HOSPITAL & HEALTH SERVICES PART V, SECTION B, LINE 20D: 1 LINCOLN UNIVERSITY FOUNDATION INC 820 CHESTNUT STREET JEFFERSON CITY MO 65101 237325582 501(C)(3) 63507 SUPPORT OF THE NURSING PROGRAM AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135616797 501(C)(3) 11250 JC HEART BALL AND HEART WALK SPONSORSHIPS ROMAN CATHOLIC DIOCESE OF JEFFERSON CITY PO BOX 104900 JEFFERSON CITY MO 65110 440612540 501(C)(3) 12000 GENERAL SUPPORT HEARTLAND FOUNDATION 518 SOUTH 6TH STREET ST JOSEPH MO 64501 431262768 501(C)(3) 18910 GENERAL SUPPORT 4 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 GOVERNMENTAL OR TAX EXEMPT, UNDER SECTION 501(C(3), ORGANIZATIONS. THESE ORGANIZATIONS HAVE DEVELOPED INTERNAL CONTROL PROCEDURES FOR THE USE OF GRANT FUNDS. X X X 1 1 1 1 0 0 0 0 0 0 0 STEVEN BARNEY 0 623277 0 0 0 156103 0 208024 0 23340 0 1010744 0 0 JOAN BEGLINGER 0 248059 0 0 0 13087 0 134024 0 19282 0 414452 0 8848 LYNN BRUCHHOF 0 67452 0 0 0 87404 0 0 0 772 0 155628 0 0 GAUROV DAYAL MD 0 456746 0 0 0 125388 0 45500 0 15607 0 643241 0 0 PAULA FRIEDMAN 0 479732 0 0 0 118898 0 277027 0 17309 0 892966 0 32340 PHILIP GUSTAFSON 0 535571 0 0 0 110714 0 121551 0 35128 0 802964 0 35700 THOMAS K LANGSTON 0 490608 0 0 0 150377 0 259942 0 33585 0 934512 0 31500 JOE M HODGES 0 621033 0 0 0 84084 0 286178 0 27792 0 1019087 0 29120 CHRISTOPHER HOWARD 0 735141 0 0 0 138054 0 337445 0 30597 0 1241237 0 37660 MICHAEL R PANICOLA 0 360517 0 0 0 23898 0 123673 0 27245 0 535333 0 8560 DIXIE L PLATT 0 446837 0 0 0 67566 0 212494 0 30319 0 757216 0 29050 WILLIAM P THOMPSON 0 1321845 0 0 0 839756 0 1051531 0 36865 0 3249997 0 57960 KRIS A ZIMMER 0 737296 0 0 0 100132 0 227242 0 30227 0 1094897 0 43820 JUNE L PICKETT 0 220007 0 0 0 20518 0 331433 0 22385 0 594343 0 8280 GRAY COX 0 276484 0 0 0 95557 0 43043 0 26862 0 441946 0 19390 R BRENT VANCONIA 0 397780 0 0 0 66988 0 171017 0 31397 0 667182 0 26040 JOCELYN SKIDMORE 125694 0 0 0 9581 0 73279 0 11107 0 219661 0 4780 0 MARVIN KURTZ 255000 0 0 0 36511 0 46448 0 0 0 337959 0 0 0 SCOTT HOLMAN DO 339872 0 0 0 31488 0 92852 0 26119 0 490331 0 0 0 PATRICK HARR 187356 0 0 0 36681 0 113444 0 14285 0 351766 0 0 0 ANTHONY HOUSTON 192777 0 0 0 78661 0 42782 0 23043 0 337263 0 0 0 JOHN LUCIO DO 146108 0 0 0 22163 0 35338 0 999 0 204608 0 8631 0 SUSAN MANKOSKI 166857 0 0 0 10901 0 47578 0 13690 0 239026 0 6260 0 THOMAS DISTEFANO 910429 0 0 0 35811 0 373386 0 17641 0 1337267 0 0 0 GARRY PEARSON 530643 0 0 0 94553 0 253258 0 34986 0 913440 0 0 0 JANE DAWSON 439647 0 0 0 20366 0 108320 0 5405 0 573738 0 0 0 SHIRLEY HARRIS 406642 0 0 0 33328 0 104187 0 38881 0 583038 0 0 0 AMRIT SINGH 382346 0 0 0 44960 0 92945 0 26988 0 547239 0 0 0 CATHERINE ABRAMS 0 0 0 0 195616 0 17524 0 16583 0 229723 0 0 0 PART I, LINE 1A THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2012, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: SCOTT HOLMAN THOMAS DISTEFANO GARRY PEARSON JANE DAWSON SHIRLEY HARRIS AMRIT SINGH THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A, RECEIVED HOUSING ALLOWANCE PAYMENTS IN 2012, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: ANTHONY HOUSTON MARVIN KURTZ THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A, RECEIVED REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2012, WHICH WERE INCLUDED IN THEIR TAXABLE COMPENSATION: ANTHONY HOUSTON PART I, LINE 3 THE ORGANIZATION'S CEO IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SUPPLEMENTAL INFORMATION PART III 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. CATHERINE ABRAMS $195,817 PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS PENSION RESTORATION PLAN: SSM HEALTH CARE (SSMHC) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMHC QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER SSMHC'S QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMHC OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMHC. NO REPORTABLE INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN DURING 2012. CAPITAL ACCUMULATION PLAN: SSMHC PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMHC AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2008 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF TWO PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2012. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. STEVEN BARNEY $74,677 PHILIP GUSTAFSON $73,610 WILLIAM THOMPSON $58,026 CHRISTOPHER HOWARD $48,612 KRIS ZIMMER $43,871 THOMAS LANGSTON $35,638 DIXIE PLATT $33,330 PAULA FRIEDMAN $32,376 JOE HODGES $29,154 BRENT VANCONIA $26,070 GRAY COX $19,412 MICHAEL PANICOLA $10,928 JOAN BEGLINGER $10,615 JOHN LUCIO $8,641 JOCELYN SKIDMORE $8,444 JUNE PICKETT $8,289 SUSAN MANKOSKI $6,768 TERI HARR FAMILY MEMBER OF KEY EMPLOYEE 64143 EMPLOYMENT 0 NICOLE MAUGHAN FAMILY MEMBER OF KEY EMPLOYEE 5225 EMPLOYMENT 0 FORM 990, PART I, DOING BUSINESS AS: SSM REGIONAL HEALTH SERVICES CURRENTLY UTILIZES THE FOLLOWING FICTITIOUS NAMES: 1. ST. FRANCIS HOSPITAL & HEALTH SERVICES (EIN:44-0579850) A. ST. FRANCIS FAMILY HEALTH CARE - EAST B. ST. FRANCIS FAMILY HEALTH CARE - WEST C. ST. FRANCIS FAMILY LIFE SERVICES D. ST. FRANCIS GRANT CITY HEALTH CLINIC E. ST. FRANCIS HARDIN MEDICAL CLINIC F. ST. FRANCIS ORTHOPEDIC & SPORTS MEDICINE CLINIC G. ST. FRANCIS PRESCHOOL & CHILDCARE H. ST. FRANCIS WEST NODAWAY HEALTH CLINIC 2. ST. MARY'S HEALTH CENTER (EIN:44-0546097) A. COMPREHENSIVE WOUND HEALTH CENTER AT ST. MARY'S B. ST. MARY'S CANCER SPECIALISTS C. ST. MARY'S HEALTH PSYCHOLOGY D. ST. MARY'S HOLTS SUMMIT PHARMACY E. ST. MARY'S MEDICAL CLINIC - BELLE F. ST. MARY'S MEDICAL CLINIC - HOLTS SUMMIT G. ST. MARY'S MEDICAL CLINIC - LINN H. ST. MARY'S MEDICAL CLINIC - TIPTON I. ST. MARY'S MEDICAL CLINIC - VERSAILLES J. ST. MARY'S MEDICAL PLAZA PHARMACY K. ST. MARY'S OCCUPATIONAL MEDICINE L. ST. MARY'S PEDIATRICS M. ST. MARY'S REHABILITATION N. ST. MARY'S SLEEP CENTER O. ST. MARY'S SPORTS MEDICINE & REHABILITATION CENTER P. ST. MARY'S TIPTON PHARMACY Q. ST. MARY'S URGENT CARE AT THE LAKE R. ST. MARY'S WESTPHALIA PHARMACY S. THE VASCULAR INSTITUTE AT ST. MARY'S PROGRAM SERVICE STATEMENT FORM 990, PART III LINE 4A, DESCRIPTION OF PROGRAM SERVICE: BRIEFLY DESCRIBE THE CORPORATION'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 18 HOSPITALS, TWO SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES IN FOUR STATES: WISCONSIN, ILLINOIS, MISSOURI AND OKLAHOMA. THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 25,600 EMPLOYEES AND IS AFFILIATED WITH MORE THAN 6,600 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. SSM REGIONAL HEALTH SERVICES INCLUDES ST FRANCIS HOSPITAL AND HEALTH SERVICES IN MARYVILLE, MISSOURI, ST. MARY'S HEALTH CENTER IN JEFFERSON CITY, MISSOURI AND A NETWORK OF PRIMARY CARE MEDICAL CLINICS AND SPECIALTY OFFERINGS SERVING JEFFERSON CITY AND SURROUNDING COMMUNITIES DESCRIBE THE ORGANIZATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT: ST. FRANCIS HOSPITAL AND HEALTH SERVICES MARYVILLE, MO: A COMMUNITY BENEFIT ACTIVITY IS IDENTIFIED AS A SERVICE RATHER THAN AS A MARKETING TOOL AND MEETS AT LEAST TWO OF THE FOLLOWING CRITERIA: -IT IS FINANCED BY PHILANTHROPIC CONTRIBUTIONS, VOLUNTEER EFFORTS, OR AN ENDOWMENT. -IT PROVIDES A RESPONSE TO A UNIQUE OR PARTICULAR HEALTH PROBLEM IN THE COMMUNITY. -IT GENERATES A LOW OR NEGATIVE MARGIN ON A FULLY ABSORBED COST BASIS. -IT RESPONDS TO THE NEEDS OF SPECIAL POPULATIONS SUCH AS MINORITIES, WOMEN AND CHILDREN, THE FRAIL ELDERLY, LOW INCOME PERSONS WITH DISABILITIES, THE MENTALLY ILL, OR THOSE LIVING WITH CHRONIC ILLNESS. -THE DECISION TO OFFER THE SERVICE OR PROGRAM IS NOT MADE ON A PURELY FINANCIAL BASIS. -IF NOT PROVIDED BY HEALTH CARE ORGANIZATION, THE SERVICE WOULD NO LONGER BE AVAILABLE IN THE COMMUNITY OR WOULD BE THE RESPONSIBILITY OF GOVERNMENT. HEALTHY COMMUNITIES' INITIATIVES ARE A COMPONENT OF THE OVERALL COMMUNITY BENEFIT PROGRAM. HEALTHY COMMUNITIES' INITIATIVES DEMONSTRATE THE LEADERSHIP ROLE THAT ST. FRANCIS IS TAKING IN IDENTIFYING, COMMUNICATING AND DEVELOPING RESPONSES TO HEALTH-RELATED NEEDS IN THE COMMUNITY. THESE INITIATIVES ARE UNDERTAKEN IN COLLABORATION WITH OTHER COMMUNITY PARTNERS. HEALTHY COMMUNITIES' INITIATIVES ARE SPECIFICALLY IDENTIFIED IN THE STRATEGIC AND FINANCIAL PLAN. SPECIFIC AND MEASURABLE GOALS AND OBJECTIVES ARE ESTABLISHED FOR EACH INITIATIVE IN ORDER TO DETERMINE ITS EFFECTIVENESS IN RESPONDING TO THE IDENTIFIED COMMUNITY NEED. ONE OF THE FIRST STEPS FOR IDENTIFYING A HEALTHY COMMUNITIES' PROJECT IS TO CONDUCT A COMMUNITY NEEDS ASSESSMENT TO DETERMINE TOP CHRONIC DISEASES IN THEAREA. COMMUNITY PARTNERS ARE IDENTIFIED IN ORDER TO ADDRESS KEY INDICATORS OF COMMUNITY/POPULATION HEALTH (E.G., PREVALENCE AND INCIDENCE RATES, SCREENING RATES, HOSPITAL ADMISSION RATES, BEHAVIORAL AND LIFESTYLE FACTORS). STRATEGIES ARE FOCUSED AROUND PREVENTION, ACCESS, AND INPATIENT CARE TO REDUCE READMISSIONS AND DEVELOP CLEAR INDICATORS OR MEASURES OF SUCCESS TO TRACK PROGRESS. ST. MARY'S HEALTH CENTER JEFFERSON CITY, MO: ST. MARY'S USES PRIMARY AND SECONDARY DATA, AS WELL AS VITAL MARKET STUDIES, TO ASSESS MARKET UTILIZATION, VOLUME TRENDS AND SERVICE NEEDS ON AN ANNUAL BASIS. FOR INSTANCE, ST. MARY'S UTILIZES THE MISSOURI HOSPITAL ASSOCIATION'S HIDI MARKET DATA TO ASSESS PREVALENT DISEASE CATEGORIES BY AGE AND GENDER AND GEOGRAPHIC ORIGINATION WITHIN OUR NINE COUNTY SERVICE AREA TO DETERMINE THE NEEDS AND MOST EFFECTIVE OUTREACH FOR THE UNDERSERVED. FOCUS GROUPS ARE ALSO USED FOR BETTER UNDERSTANDING DISPARITIES AND ACCESS TO HEALTH CARE SERVICES. IN ADDITION, ST. MARY'S COMPLETES A COMPREHENSIVE COMMUNITY NEEDS EVERY THREE YEARS. ST. MARY'S PARTICIPATES AS A MEMBER OF THE CENTRAL MISSOURI HEALTH ASSESSMENT PARTNERSHIP AND FORMULATES INITIATIVES WITH MEMBER ORGANIZATIONS, INCLUDING THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI (A FEDERALLY QUALIFIED HEALTH CENTER), COLE COUNTY DEPARTMENT OF HEALTH, THE UNITED WAY OF CENTRAL MISSOURI, THE SAMARITAN CENTER OF JEFFERSON CITY, AS WELL AS CAPITAL REGION MEDICAL CENTER. 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 WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. CHARITY CARE IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE FOR HOUSEHOLD INCOMES UP TO FOUR TIMES THE FEDERAL POVERTY LEVEL. PATIENTS WHOSE HOUSEHOLD INCOME IS NO MORE THAN TWO TIMES THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR FREE HOSPITAL SERVICES. IN ADDITION, AN EXCEPTION TO THE SLIDING SCALE IS PROVIDED FOR A PATIENT'S BALANCE DUE IF THE AMOUNT IS TOO LARGE TO BE REASONABLY PAID THROUGH AN INSTALLMENT PLAN OVER FOUR YEARS GIVEN THE FAMILY INCOME AND EXPENSES. EACH ENTITY PROVIDING MEDICAL 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: EACH OF THE HOSPITALS OF SSM REGIONAL HEALTH SERVICES: -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 DIVISIONAL BOARD OF DIRECTORS 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. FORM 990, PART III LINE 4A, DESCRIPTION OF PROGRAM SERVICE: DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS: ST. FRANCIS HOSPITAL AND HEALTH SERVICES MARYVILLE, MO DIABETES EDUCATION: DEB HULL, DIABETES EDUCATOR, CONTINUED HER EFFORTS TO INFORM AND RAISE AWARENESS ABOUT DIABETES. IN 2012, DEB PRESENTED INFORMATION TO OVER 200 SCHOOL AND COMMUNITY MEMBERS ABOUT THE RISK OF DEVELOPING TYPE 2 DIABETES AND HOW IT CAN BE SIGNIFICANTLY REDUCED THROUGH EXERCISE AND MODEST WEIGHT LOSS. IN CONJUNCTION WITH THE ST. FRANCIS HOSPITAL FOUNDATION, A DVD HAS BEEN PRODUCED AND DISTRIBUTED TO FIFTH AND SIXTH GRADERS THROUGHOUT THE AREA TEACHING CHILDREN ABOUT DIABETES AND HOW IT CAN BE PREVENTED. HEALTH PROFESSIONALS EDUCATION: IN COLLABORATION WITH MISSOURI AREA HEALTH EDUCATION CENTERS AND THE UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE, ST. FRANCIS ACCOMMODATED MEDICAL STUDENTS IN AN OPPORTUNITY TO HELP THEM EXPLORE FIRST-HAND THE PROSPECTS AWAITING THEM IN A RURAL AND OUTREACH POPULATIONS. THE PROGRAM INCLUDED PHYSICIAN INVOLVEMENT TO OVERSEE THE STUDENT LEARNING AS WELL AS HOUSING WITH MAINTENANCE AND HOUSEKEEPING AND INTERNET-BASED EQUIPMENT AND FACILITIES TO CONDUCT CHATS WITH UNIVERSITY INSTRUCTORS ON A REGULAR BASIS. COMMUNITY HEALTH SCREENINGS: IN RESPONSE TO THE HIGH DEATH RATE FOR STROKES IN NODAWAY COUNTY (70.7 PER 100,000) COMPARED TO THE STATE AVERAGE (62.6/100,000) PLUS A LOWER THAN AVERAGE HOSPITALIZATION RATE, ST. FRANCIS HOSPITAL AND HEALTH SERVICES DEVELOPED A COMMUNITY HEALTH SCREENINGS INITIATIVE IN COLLABORATION WITH THE NODAWAY COUNTY HEALTH DEPARTMENT, SCHOOLS AND OTHER HEALTH FAIR OR SCREENING PARTNERS. THE INITIATIVE IMPACTS THE HEALTH STATUS OF RESIDENTS AND PATIENTS BY INCREASING THE NUMBER OF COMMUNITY SCREENINGS TO IDENTIFY THE AT-RISK POPULATION FOR STROKE. IN 2012, THE HOSPITAL HELD 18 HEALTH SCREENINGS WITH 1090 PARTICIPANTS. ST. MARY'S HEALTH CENTER JEFFERSON CITY, MO ST. MARY'S FINANCIAL ASSISTANCE PROGRAM: ST. MARYS PROVIDED IN-HOUSE AND NOW CONTRACTS WITH A COMPANY THAT SCREENS AND ASSISTS ALL PATIENTS WHO HAVE NO INSURANCE TO HELP THEM APPLY FOR MEDICARE, MEDICAID, OR OTHER FORMS OF ASSISTANCE. SMHC FOUNDATION MEDICATION ASSISTANCE FUND: THIS PROGRAM PROVIDES AID TO THOSE IN NEED BY OFFERING SHORT-TERM MEDICATION ASSISTANCE TO PATIENTS WHO CANNOT AFFORD PRESCRIPTION MEDICINE, AND CANNOT OBTAIN IT IN A TIMELY MANNER FROM ANOTHER AGENCY. THIS PROGRAM SUPPORTS THE POOR, UNINSURED AND IS AVAILABLE TO THE URBAN AND RURAL DEMOGRAPHIC. TRAINING RESOURCES FOR DISADVANTAGED YOUTH: THIS PROGRAM IS A TRAINING PROGRAM THAT PROVIDES LEARNING CHALLENGED HIGH SCHOOL STUDENTS AN OPPORTUNITY TO BUILD VALUABLE EXPERIENCE AND LIFE SKILLS BY WORKING AT THE HOSPITAL. THE PROGRAM SUPPORTS LEARNING DISADVANTAGED, OFTEN ECONOMICALLY CHALLENGED YOUTH IN OUR COMMUNITY, AS WELL AS SUPPORTS A COMMUNITY PARTNERSHIP WITH THE LOCAL HIGH SCHOOL. LINCOLN UNIVERSITY SCHOOL OF NURSING: ST. MARY'S PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $63,507 TO THE NURSING PROGRAM AS WELL AS PROVIDING A CLINICAL SETTING FOR THE RN STUDENTS TO LEARN. ADDITIONAL INFORMATION REGARDING SSMHC'S 2012 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. TRADITIONAL CHARITY CARE $ 4,440,317 UNPAID COST OF MEDICARE $ 13,223,364 UNPAID COST OF MEDICAID $ 3,336,479 COST OF BAD DEBT $ 7,103,893 COMMUNITY BENEFIT PROGRAMS $ 789,389 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $ 28,893,442 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE CORPORATION IS SSM HEALTH CARE CORPORATION. SSM HEALTH CARE CORPORATION IS A NONPROFIT 501(C)(3) ORGANIZATION. BOTH SSM REGIONAL HEALTH SERVICES AND SSM HEALTH CARE CORPORATION ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH CARE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND APPOINT AND REMOVE THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE FOLLOWING POWERS: A. TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION B. TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE MEMBER OF THE MEMBER AS DETERMINED BY THE MEMBER OF THE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTING/FINANCE PERSONNEL AT EACH SSMHC (SSM HEALTH CARE SYSTEM) ENTITY, IN CONJUNCTION WITH CORPORATE FINANCE PERSONNEL, PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE CORPORATE OFFICE FOR FINAL REVIEW AND COORDINATION OF THE SYSTEM LEVEL FORM 990 INFORMATION. THE INFORMATION IS SUBMITTED TO AN OUTSIDE TAX CONSULTING FIRM WHO PREPARES AND SIGNS THE FORM 990 FROM THE SSMHC INFORMATION. PRIOR TO FINALIZING THE RETURN, A DRAFT IS SENT TO PERSONNEL AT SSMHC FOR REVIEW AND APPROVAL. UPON SSMHC APPROVAL, THE OUTSIDE PREPARER FORWARDS THE COMPLETED FORM 990 FOR THE APPROPRIATE SIGNATURES AND FILING ACTION. A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. FORM 990, PART VI, SECTION B, LINE 15 ALL SSMHC EXECUTIVE SALARY/COMPENSATION INFORMATION IS BASED ON COMPARATIVE DATA WITH SIMILAR POSITIONS IN THE MARKET. THE COMPENSATION REVIEW PROCESS IS PERFORMED BY EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS. THE SALARY DATA AND POTENTIAL ADJUSTMENTS, FOR THE PRESIDENT/CEO OF THE SYSTEM, THE SENIOR VICE PRESIDENTS AND THE REGIONAL PRESIDENTS ARE PRESENTED TO THE SSMHC BOARD OF DIRECTORS BY THE SAME INDEPENDENT COMPENSATION CONSULTANTS TO APPROVE, DISAPPROVE, MODIFY. THE SAME COMPARATIVE PROCESS USED FOR EXECUTIVE SALARY/COMPENSATION IS PERFORMED INTERNALLY FOR OTHER EMPLOYEES. THE SSMHC BOARD OF DIRECTORS HAS DELEGATED SALARY APPROVAL FOR ALL OTHER POSITIONS TO THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENT FOR THE SSM HEALTH CARE SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH CARE'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: BENEFICIAL INTEREST IN FOUNDATION 3,773,757. TRANSFERS FROM AFFLIATES 20,000,635. SSM HEALTH CARE CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 466029223 HEALTH CARE MO 501(C)(3) LINE 11A, I FRANCISCAN SISTERS OF MARY 0 SSM EMPLOYEE HEALTH CARE FUND 477 N LINDBERGH BLVD ST LOUIS MO 63141 431328934 BENEFIT PLANS MO 501(C)(9) SSM HEALTH CARE CORPORATION 0 SSMHC LIABILITY TRUST I 477 N LINDBERGH BLVD ST LOUIS MO 63141 436331003 INSURANCE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 0 SSM CONSOLIDATED HEALTH SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431473657 HEALTH CARE MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 0 SSM POLICY INSTITUTE 477 N LINDBERGH BLVD ST LOUIS MO 63141 431788151 HEALTH CARE MO 501(C)(4) SSM HEALTH CARE CORPORATION 0 SSM PORTFOLIO MANAGEMENT CO 477 N LINDBERGH BLVD ST LOUIS MO 63141 431825256 MANAGEMENT MO 501(C)(3) LINE 11A, I SSM HEALTH CARE CORPORATION 0 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 477 N LINDBERGH BLVD ST LOUIS MO 63141 430738490 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE ST LOUIS 0 CARDINAL GLENNON CHILDREN'S FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431754347 FUNDRAISING MO 501(C)(3) LINE 7 SSM CARDINAL GLENNONCHILDREN'S HOSPITAL 0 SSM DEPAUL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431776109 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST JOSEPH FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431591556 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST CLARE HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431273310 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 SSM ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431552945 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH CARE ST LOUIS 0 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 0 ST ANTHONY HOSPITAL FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 736104300 FUNDRAISING OK 501(C)(3) LINE 7 SSM HEALTH CARE OF OKLAHOMA 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 0 DELLS MEDICAL BUILDING INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 391613292 MOB WI 501(C)(2) SSM HEALTH CARE OF WISCONSIN 0 ST MARY'S FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940686 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 ST CLARE HEALTH CARE FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 431940683 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 HOME HEALTH UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391539827 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HOME CARE UNITED INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391776340 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 HHU XTRA CARE INC 4639 HAMMERSLEY ROAD MADISON WI 53713 391705111 HEALTH CARE WI 501(C)(3) LINE 9 SSM HEALTH CARE OF WISCONSIN 0 ST FRANCIS HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431099253 FUNDRAISING MO 501(C)(3) LINE 7 SSM REGIONAL HEALTH SERVICES 1 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 1 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 1 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 1 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 1 GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 262884795 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 ST MARY'S HOSPITAL FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 364636691 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S-GOOD SAMARITAN INC 0 SSM HEALTH BUSINESSES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431333488 HEALTH CARE MO 501(C)(3) LINE 9 SSM HEALTH CARE CORPORATION 0 SSM HEALTH CARE ST LOUIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 431343281 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 0 CENTRALIA MEDICAL SERVICES BLDG ASSOC 477 N LINDBERGH BLVD ST LOUIS MO 63141 237408025 HEALTH CARE IL 501(C)(3) LINE 11A, I SSM REGIONAL HEALTH SERVICES 1 ST MARY'S JANESVILLE FOUNDATION INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 273439133 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 FRANCISCAN SISTERS OF MARY 3221 MCKELVEY ROAD SUITE 107 BRIDGETON MO 63044 431012492 RELIGIOUS ORGANIZATION MO 501(C)(3) LINE 1 N/A 0 LEE DEWEY CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 731279603 MOB OK 501(C)(3) LINE 11A, I SSM HEALTH CARE OF OKLAHOMA 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 0 ST ANTHONY SHAWNEE HOSPITAL INC 1000 N LEE AVE OKLAHOMA CITY OK 73102 455055149 HEALTH CARE OK 501(C)(3) LINE 3 SSM HEALTH CARE OF OKLAHOMA 0 SSM SJ ENDOSCOPY 477 N LINDBERGH BLVD ST LOUIS MO 63141 270046559 SURGERY SERVICES MO N/A ST CLARE IMAGING SERVICES 707 14TH STREET SUITE A BARABOO WI 53913 200122365 DIAG. SERVICES WI N/A MT VERNON RADIATION THERAPY CENTER 477 N LINDBERGH BLVD ST LOUIS MO 63141 201382620 RADIATION THERAPY IL N/A SLEEPNEURO SO IL 477 N LINDBERGH BLVD ST LOUIS MO 63141 208468195 DIAG. SERVICES IL N/A SMHC SURG CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929305 MANAGEMENT MO SSM REGIONAL HEALTH SERVICES RELATED 210013 215887 0 1 0.50000 SMHC CARD CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929381 MANAGEMENT MO SSM REGIONAL HEALTH SERVICES RELATED 144002 160498 0 1 0.50000 SMHC MUSC CO-MGMT 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 208929237 MANAGEMENT MO SSM REGIONAL HEALTH SERVICES RELATED 231497 154743 0 1 0.50000 CHOWSMGSI 477 N LINDBERGH BLVD ST LOUIS MO 63141 371383861 MOB IL N/A COMP CANCER CARE 477 N LINDBERGH BLVD ST LOUIS MO 63141 201382727 MOB IL N/A SHAWNEE REAL ESTATE HOLDINGS LLC 1000 N LEE AVE OKLAHOMA CITY OK 73102 455458304 MOB OK N/A SSM RX EXPRESS 477 N LINDBERGH BLVD ST LOUIS MO 63141 264031708 PHARMACY MO N/A SSM MANAGED CARE ORGANIZATION LLC 477 N LINBERGH BLVD ST LOUIS MO 63141 431708511 HEALTH PROMOTION MO N/A C 0 FPP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431465174 HEALTH CARE MO N/A C 0 DIVERSIFIED HEALTH SERVICES CORP 477 N LINBERGH BLVD ST LOUIS MO 63141 431369305 MEDICAL EQUIPMENT MO N/A C 0 SSM CARDIO AND THORACIC SERVICES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 260286559 HEALTH CARE MO N/A C 0 SSM PROPERTIES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431462486 PROPERTY SERVICES MO N/A C 0 SSM DEPAUL MEDICAL GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431715106 HEALTH CARE MO N/A C 0 SSM ST CHARLES CLINIC MED GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 430626408 PHYSICIAN OFFICES MO N/A C 0 HEALTH FIRST PHYS MANAGEMENT 477 N LINBERGH BLVD ST LOUIS MO 63141 731534336 MEDICAL SERVICES OK N/A C 0 SSMHCS LIABILITY TRUST II 477 N LINBERGH BLVD ST LOUIS MO 63141 816128118 INSURANCE MO N/A C 0 SSM NEUROSCIENCES INC 477 N LINBERGH BLVD ST LOUIS MO 63141 263413981 HEALTH CARE MO N/A C 0 SSM MEDICAL GROUP INC 477 N LINBERGH BLVD ST LOUIS MO 63141 431664107 PHYSICIAN OFFICES MO N/A C 0 SSMHC INSURANCE COMPANY 477 N LINBERGH BLVD ST LOUIS MO 63141 030310431 INSURANCE CA N/A C 0 SSM ORTHOPEDIC INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 271557033 HEALTH CARE MO N/A C 0 SSM CANCER CARE 477 N LINDBERGH BLVD ST LOUIS MO 63141 271557324 HEATH CARE MO N/A C 0 PHYSCIAN SERVICES CORP OF SOUTHERN ILLINOIS 477 N LINDBERGH BLVD ST LOUIS MO 63141 364161526 HEATH CARE IL N/A C 0 0 1 1 0 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 SSM EMPLOYEE HEALTH CARE FUND Q 14692457 COST OF SERVICES ST FRANCIS HOSPITAL FOUNDATION C 310005 CASH TRANSFER ST MARY'S HEALTH CENTER JEFFERSON CITY MISSOURI FOUNDATION C 65596 CASH TRANSFER