2011-11-15T11:23:38-06:00 2010-12-31 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 77002 990 2010-01-01 431343281 SSM HEALTH CARE ST LOUIS SSMH 3145238700 477 NORTH LINDBERGH ST LOUIS MO 63141 JUNE L PICKETT 3145238700 2011-11-15 1 NANCY Z EVETTS 7139822000 2010 2016-03-07 17:11:31Z SEE SCHEDULE O WILLIAM P THOMPSON 477 NORTH LINDBERGH ST LOUIS MO 63141 1125395792 0 0928 X WWW.SSMHC.COM X 2000 MO SEE SCHEDULE O 13 9 11991 965 11902645 -714724 2295549 1688852 1005695149 1095846232 16373341 9613026 18741411 17385746 1043105450 1124533856 183589 350386 0 0 483541158 493172183 0 0 140774 552017535 587781449 1035742282 1081304018 7363168 43229838 787534843 761528745 613131128 448051749 174403715 313476996 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 996737131 350386 1096690700 SEE SCHEDULE O 996737131 1 1 0 1 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 715 0 1 11991 1 1 1 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 X KELLY THOMPSON 3149893610 1195 CORPORATE LAKE DRIVE ST LOUIS MO 63132 X SHEILA BADER 1.00 X 0 0 0 DANIEL BAUMANN MD 1.00 X 0 282086 22768 DONALD BINZ II MD 1.00 X 0 363544 25571 DAVID CROSBY 1.00 X 0 0 0 MARY T MCLENNAN MD 1.00 X 0 0 0 BRENDA D NEWBERRY 1.00 X 0 0 0 RUDOLPH W NICKENS JR 1.00 X 0 0 0 TIKA NAZARETH DMD 1.00 X 0 0 0 JAMES A SANDFORT EDD 1.00 X 0 0 0 KARL WILSON PHD 1.00 X 0 0 0 SR MARY JEAN RYAN FSM 1.00 X X 0 0 0 JAMES SANGER 40.00 X X 0 914911 40252 WILLIAM THOMPSON 1.00 X X 0 1188452 605422 KRIS ZIMMER 1.00 X 0 723982 180212 JUNE L PICKETT 1.00 X 0 220736 179387 JUDY GARTLAND 40.00 X 66164 0 45540 KAREN REWERTS 40.00 X 365914 0 121672 MARY SUE EMBERTSON 40.00 X 0 270134 57895 STEVEN JOHNSON 40.00 X 0 704668 237862 WILLIAM JENNINGS 40.00 X 0 370387 77411 GASPARE CALVARUSO 40.00 X 0 439647 147173 PATRICE KOMOROSKI 40.00 X 0 502278 157205 SHERRY HAUSMANN 40.00 X 0 347304 109547 SHERLYN HAILSTONE 40.00 X 0 662469 143891 DREW RECTOR 40.00 X 0 327400 59279 SHARON E DUDLEY 40.00 X 300478 0 24556 LEE BERNSTEIN 40.00 X 305198 0 67763 DEBORAH WALKENHORST 40.00 X 335000 0 94668 LYNN LENKER 40.00 X 353604 0 138714 KEVIN TODD JOHNSON 40.00 X 520731 0 134714 MARGARET FOWLER 40.00 X 275819 0 150825 LORRAINE MAE YEHLEN 40.00 X 249673 0 138391 ROBERT PORTER 40.00 X 0 494589 213235 SEAN HOGAN 40.00 X 0 331089 96617 JAMES SCOTT 40.00 X 738160 0 130854 WILLIAM HOLCOMB 40.00 X 470287 0 116980 MARIO MORALES 40.00 X 409526 0 35105 ANDREW KARANAS 40.00 X 397390 0 63040 MARK RENKEN 40.00 X 346291 0 48361 WILLIAM SCHOENHARD X 0 282789 130820 5134235 8426465 3795730 223 1 1 0 ST LOUIS UNIVERSITY 1402 S GRAND BLVD ST LOUIS MO 63104 MEDICAL SERVICES 9281772 SELECT REHAB ST LOUIS 3572 SOLUTIONS CENTER CHICAGO IL 60677 MEDICAL SERVICES 6470568 SODEXO OPERATIONS 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICES 3837357 PINSTRIPE INC 200 S EXECUTIVE DR 400 BROOKFIELD WI 53005 RECRUITMENT 3573278 CDI IMAGING CENTERS 5775 WAYZATA BLVD 400 ST LOUIS MO 55416 MEDICAL SERVICES 3092376 142 11602 1420884 223872 32494 30663 1688852 NET PATIENT REVENUE 621110 1072556041 1072556041 OTHER REVENUE 621110 23290191 21703984 1586207 1095846232 2212696 2212696 5071076 520731 4550345 4550345 4550345 6913260 215326 -702396 -215326 7615656 7400330 7400330 52119 11602 43638 8481 8481 864444 784637 79807 79807 PHARMACY 446110 6479647 6479647 PHYSICIAN CATH LAB 621500 2624795 2624795 LABORATORY SERVICES 621500 722966 722966 2919705 2430675 489030 12747113 1124533856 1096690700 11902645 14251659 350386 350386 7004650 2902346 4102304 377562342 349439224 28123118 28599557 26455844 2143713 56339200 52580616 3758584 23666434 21693056 1973378 20364576 9381152 10983424 1452474 1452474 486710 486710 82310722 81710952 537453 62317 3363090 61975 3300701 414 229325276 224498913 4761690 64673 47022407 43961046 3061361 26291285 22296440 3994805 40 1732746 320491 1407316 4939 284727 136691 147262 774 18031789 18012750 19039 46791984 41656787 5133120 2077 6369190 232599 6136591 MEDICARE PROVIDER TAX 56110861 56110861 BAD DEBT 43801482 43801482 BOND RELATED FEES 1871237 1871237 MISCELLANEOUS EXPENSES 1534899 774990 754369 5540 LICENSES AND TAXES 635994 358530 277464 1081304018 996737131 84426113 140774 28826594 124604353 132995355 4437422 1779430 16953808 17466193 7816476 5449596 1071362709 557976327 517721568 513386382 22401038 27703405 1386012 4601411 92214166 29320379 787534843 761528745 87160461 92909211 1649589 948173 524321078 354194365 613131128 448051749 X 166160389 304792866 5748218 6189825 2495108 2494305 174403715 313476996 787534843 761528745 X 43229838 95843443 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 27804 0 0 0 27804 0 2635031 14648 135542 130572 2654649 2565757 163187 44663 138576 2635031 2623975 3000 -55299 5919 2565757 0.04000 0.96000 0 1 1 39879099 39879099 622220201 280945357 341274844 11642614 6532509 5110105 379956987 270498461 109458526 17663808 17663808 513386382 PAYABLE TO THIRD-PARTY PAYORS 6920284 DUE TO RELATED PARTIES 8305609 OTHER LIABILITIES 5363265 ASSET RETIREMENT LIABILITY 3527151 CAPITAL LEASES 117555 PENSION FUNDING LIABILITY 42398240 ALLOCATED TAX EXEMPT DEBT (ISSUED BY SSM HEALTH CARE) 287562261 354194365 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ALL ENDOWMENT FUNDS WILL BE USED TO PROVIDE HEALTH CARE SERVICES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: SSM HEALTH CARE ST LOUIS' 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 2010 OR 2009. JEWELRY SALE 17388 17388 13409 TRIVIA NIGHT 11624 4777 6847 1538 1531 315 3 34709 6825 27884 26845 63721 11602 52119 1538 1531 40569 43638 8481 1 1 X 1 X 1 X 0.0 1 1 0 1 1 34270155 751666 33518489 0.03230 195733447 208870083 -13136636 0.00000 230003602 209621749 20381853 0.01960 586680 15410 571270 0.00060 10144680 3425100 6719580 0.00650 1649 1649 0.00000 244620 244620 0.00020 10977629 3440510 7537119 0.00730 240981231 213062259 27918972 0.02690 958 958 0.00000 88490 88490 0.00010 33320 33320 0.00000 414 414 0.00000 123182 123182 0.00010 1 15173748 304725414 323628542 -18903128 X 1 0 1 SSM ST JOSEPH ENDOSCOPY CTRLLC OPERATE AN ENDOSCOPY CENTER 0.50000 0.50000 6 1 DEPAUL HEALTH CENTER

12303 DEPAUL DRIVE ST LOUIS MO 63044

X X X 2 ST JOSEPH HEALTH CARE

300 FIRST CAPITOL DRIVE ST CHARLES MO 63301

X X X 3 ST JOSEPH HEALTH CENTER - WENTZVILLE

500 MEDICAL DRIVE WENTZVILLE MO 63385

X X 4 SSM ST JOSEPH HOSPITAL WEST

100 MEDICAL DRIVE LAKE ST LOUIS MO 63367

X X X 5 ST MARY'S HEALTH CENTER

6420 CLAYTON ROAD ST CHARLES MO 63117

X X X X 6 ST CLARE HEALTH CENTER

1015 BOWLES AVENUE FENTON MO 63026

X X X NOT APPLICABLE FOR THIS TAX YEAR 1 28 ST JOSEPH SURGERY CENTER

1475 KISKER ROAD ST CHARLES MO 63385

GENERAL MEDICAL & SURGICAL SSM REHAB

300 FIRST CAPITOL DRIVE ST CHARLES MO 63301

REHABILITATION CLINIC SSM REHAB

100 MEDICAL PLAZA LAKE ST LOUIS MO 63367

REHABILITATION CLINIC SSM REHAB

525 COUCH AVENUE KIRKWOOD MO 63122

REHABILITATION CLINIC SSM REHAB

12303 DEPAUL DRIVE BRIDGETON MO 63044

REHABILITATION CLINIC SSM REHAB

500 MEDICAL DRIVE WENTZVILLE MO 63385

REHABILITATION CLINIC SSM REHAB

1 VILLAGE SQUARE DRIVE HAZELWOOD MO 63042

REHABILITATION CLINIC SSM REHAB

4 ARNOLD PARK MALL ARNOLD MO 63010

PHYSICAL THERAPY CENTER SSM REHAB

1551 WALL STREET ST CHARLES MO 63301

PHYSICAL THERAPY CENTER SSM REHAB

201 SOUTH KIRKWOOD KIRKWOOD MO 63122

PHYSICAL THERAPY CENTER SSM REHAB

2730 W OSAGE PACIFIC MO 63069

PHYSICAL THERAPY CENTER SSM REHAB

511 ASHLAND WARRENTON MO 63069

PHYSICAL THERAPY CENTER SSM REHAB

1704 BROADWAY ST LOUIS MO 63104

PHYSICAL THERAPY CENTER SSM REHAB

8793 WATSON ROAD ST LOUIS MO 63119

PHYSICAL THERAPY CENTER SSM REHAB

1475 KISKER ROAD ST CHARLES MO 63304

PHYSICAL THERAPY CENTER SSM REHAB

6555 CHIPPEWA SUITE 150 ST LOUIS MO 63109

PHYSICAL THERAPY CENTER SSM REHAB

3789 NEW TOWN BLVD ST CHARLES MO 63301

PHYSICAL THERAPY CENTER SSM REHAB

600 MEDICAL DRICE SUITE 109 WENTZVILLE MO 63385

PHYSICAL THERAPY CENTER SSM REHAB

100 BREVCO PLAZA SUITE 106 LAKE ST LOUIS MO 63367

PHYSICAL THERAPY CENTER SSM REHAB

1027 BELLEVUE SUITE 15 ST LOUIS MO 63117

PHYSICAL THERAPY CENTER SSM REHAB

2 HARBOR BEND COURT LAKE ST LOUIS MO 63367

PHYSICAL THERAPY CENTER SSM REHAB

400 1ST CAPITOL DRIVE SUITE 101 ST CHARLES MO 63301

PHYSICAL THERAPY CENTER SSM REHAB

20 THE LEGENDS PKWY SUITE 130 EUREKA MO 63025

PHYSICAL THERAPY CENTER SSM REHAB

300 ST PETERS CENTER BLVD SUITE 150 ST PETERS MO 63376

WORKHEALTH/OCCUPATIONAL THERAPY SSM REHAB

2321B MCCAUSLAND ST LOUIS MO 63143

WORKHEALTH/OCCUPATIONAL THERAPY SSM REHAB

7421 HIGHWAY N SUITE B DARDENNE PRAIRIE MO 63368

PHYSICAL THERAPY CENTER SSM REHAB

12266 DEPAUL DRIVE SUITE 115 BRIDGETON MO 63044

PHYSICAL THERAPY CENTER ST JOSEPH MEDICAL PARK

1475 KISKER ROAD ST CHARLES MO 63304

OUTPATIENT PROCEDURE FOR RADIATION ONCOL, RADIOLOGY/IMAGING PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 43801482. PART I, QUESTION 3B SSM HEALTH CARE ST LOUIS 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 TIMES 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 HEALTH CARE ST LOUIS 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 HEALTH CARE ST LOUIS 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 2010 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. THE UNREIMBURSED COST OF MEDICAID IS NEGATIVE DUE TO THE FACT THAT FEDERAL REIMBURSEMENT ALLOWANCE (FRA) RECEIPTS ARE INCLUDED IN THE CALCULATION. THROUGH THE FRA PROGRAM, MISSOURI'S MEDICAID PROGRAM USES FUNDS THAT HAVE BEEN ASSESSED FROM HOSPITALS TO EARN MATCHING FEDERAL DOLLARS, ALLOWING MISSOURI'S GENERAL REVENUE FUNDS TO BE USED FOR OTHER STATE PRIORITIES. THESE FUNDS ARE PROVIDED AS REIMBURSEMENT TO HOSPITALS FOR THE COST OF TREATING THE UNINSURED, MEDICAID RECIPIENTS AND PROVIDING GRADUATE MEDICAL EDUCATION. THE PROGRAM ENABLES OUR HOSPITALS TO PROVIDE SAFETY NET SERVICES FOR THE POOR AND UNINSURED OF THE COMMUNITY. 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 SYSTEM. AMOUNTS PAID FROM RESIDENT DEPARTMENTS WERE ALSO INCLUDED.RESEARCH COSTING METHODOLOGY: RESEARCH EXPENSES WERE TAKEN FROM THE INCOME AND EXPENSE STATEMENT FOR THE RESEARCH DEPARTMENTS, DERIVED FROM THE ACCOUNTING SYSTEM.CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS COSTING METHODOLOGY: CONTRIBUTION EXPENDITURES ARE BASED ON ACTUAL INVOICES THAT WERE CAPTURED AND REPORTED FOR THIS PROGRAM.PART I, LINE 7B, COLUMN FDUE TO SOFTWARE LIMITATIONS RELATED TO ELECTRONICALLY FILING THIS TAX RETURN, THE CALCULATED AMOUNT ON LINE 7B, COLUMN F SHOULD BE -1.27%. HOWEVER, THE SOFTWARE WOULD NOT ACCEPT A NEGATIVE PERCENTAGE, AND THEREFORE, LINE 7B IS ZERO.PART II, COMMUNITY BUILDING ACTIVITIESSSM HEALTH CARE ST LOUIS 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 BUILDING - COALITION BUILDING: PARISH NURSE SERVICES PROVIDE NURSING SERVICES TO AREA PARISHIONERS TO ENABLE THEM TO BE A PART OF THE COMMUNITY AND HELP MEET THEIR NEEDS.COMMUNITY BUILDING - WORKFORCE DEVELOPMENT: PROVIDE JOB SKILL TRAINING TO SPECIAL NEEDS STUDENTS IN COLLABORATION WITH THE SPECIAL SCHOOL DISTRICT OF ST LOUIS COUNTY AND THE URBAN LEAGUE. TEN STUDENTS PER YEAR, AGED 17 TO 21 PARTICIPATE IN THIS PROGRAM.PART III, SECTION A, LINE 4SSM HEALTH CARE ST LOUIS IS PART OF THE SSM HEALTH CARE (SSMHC) CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES BAD DEBT EXPENSE IN THE DECEMBER 31, 2010 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. BAD DEBTS EXPENSE IS THE ESTIMATED AMOUNT OF PATIENT SERVICE REVENUES THAT SSMHC WILL NOT COLLECT."BAD DEBT COSTING METHODOLOGY: BAD DEBT EXPENSE REPORTED IN THE 2010 ANNUAL LICENSING SURVEY OF MISSOURI HOSPITALS WAS USED, MULTIPLIED BY THE COST TO CHARGE RATIO USING IRS WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES.BAD DEBT EXPENSE REPORTED ON LINE 2 FOR THE YEAR ENDED DECEMBER 31, 2010 WAS $43,801,482 AT CHARGES AND $15,173,748 AT COST.SSM HEALTH CARE ST LOUIS 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 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 HEALTH CARE ST LOUIS 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 2010 MEDICARE COST REPORT.PART III, SECTION C, LINE 9BSSM HEALTH CARE ST LOUIS 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 HEALTH CARE ST LOUIS' COLLECTION AND CHARITY POLICIES. PART IV, LINE 2: NEEDS ASSESSMENT PROCESS 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. HEALTHY COMMUNITIES' INITIATIVES DEMONSTRATE THE LEADERSHIP ROLE THAT SSM HEALTH CARE ST LOUIS IS TAKING IN IDENTIFYING, COMMUNICATING AND DEVELOPING RESPONSES TO HEALTH RELATED NEEDS IN THE COMMUNITY. AS OF JANUARY 2010, THE PRIMARY FOCUS OF SSM HEALTH CARE'S HEALTHY COMMUNITIES INITIATIVES (HCIS) HAS BEEN ON ONE OF THE TOP-THREE CHRONIC DISEASES IN EACH ENTITY'S/NETWORK'S RESPECTIVE MARKET (E.G., CHF, DIABETES, ASTHMA) AS IDENTIFIED THROUGH, AMONG OTHER DATA SOURCES, COMMUNITY NEEDS ASSESSMENTS, CONSUMER/PUBLIC HEALTH STUDIES AND STATE/LOCAL HEALTH DEPARTMENT INFORMATION.COMMUNITY HEALTH IMPROVEMENT, WHICH WE PURSUE AS A SYSTEM PRIMARILY THROUGH HCIS UNDERTAKEN AT THE ENTITY LEVEL, IS FUNDAMENTAL TO OUR MISSION, VALUES, AND VISION. OVER THE YEARS MANY PEOPLE HAVE BENEFITED FROM OUR HCIS AND MUCH GOOD HAS COME FROM THEM. IN AN EFFORT TO BEST RESPOND TO COMMUNITY NEEDS, HCIS WILL REFOCUS ITS EFFORTS TOWARD A NEW APPROACH TO COMMUNITY HEALTH, AS OUTLINED HERE.CHRONIC DISEASE IS RAMPANT THROUGHOUT THE U.S WHERE ROUGHLY HALF OF ALL ADULTS AND 10% OF CHILDREN/ADOLESCENTS LIVE WITH AT LEAST ONE CHRONIC DISEASE. OF THESE, AN ESTIMATED 13 MILLION LACK HEALTH INSURANCE AND THEREBY HAVE POORER ACCESS TO PREVENTIVE AND PRIMARY CARE SERVICES THAN THEIR INSURED COUNTERPARTS AND EXPERIENCE WORSE HEALTH-RELATED OUTCOMES, INCLUDING PREMATURE DEATH.IN RESPONSE TO THIS GROWING NATIONAL HEALTH CRISIS, SYSTEM MANAGEMENT HAS SET THE EXPECTATION THAT ALL SSM OPERATING ENTITIES, WORKING INDIVIDUALLY OR COLLECTIVELY AS NETWORKS, IN COLLABORATION WITH COMMUNITY PARTNERS, WILL DEVELOP HCIS FOCUSED ON THE CHRONIC DISEASE SELECTED THAT ADDRESSES THREE PILLARS THAT STRETCH ACROSS THE CARE CONTINUUM:- PREVENTION THROUGH COMMUNITY EDUCATION IN PARTNERSHIP WITH COMMUNITY HEALTH ORGANIZATIONS, LOCAL HEALTH AGENCIES, CHURCHES, CIVIC CENTERS, SCHOOLS, INSURANCE COMPANIES AND OTHER COMMUNITY PARTNERS.- ACCESS TO PRIMARY CARE SERVICES AND NECESSARY MEDICATIONS IN CONJUNCTION WITH COMMUNITY HEALTH ORGANIZATIONS, LOCAL HEALTH AGENCIES AND CLINICS, EMPLOYED COMMUNITY PHYSICIANS AND PHARMACEUTICAL COMPANIES.- INPATIENT CARE INCLUDING PATIENT EDUCATION, COMPREHENSIVE DISCHARGE PLANNING, MEDICATION RECONCILIATION, COORDINATION OF CARE ACROSS SETTINGS AND POST-DISCHARGE FOLLOW-UP.INITIALLY, THE STRATEGIC GOAL WILL BE TO REDUCE THE 30-DAY HOSPITAL READMISSION RATE FOR THE CHRONIC DISEASE SELECTED. THIS HAS THE MOST IMMEDIATE IMPACT. AS WE DEVELOP OUR COMMUNITY PARTNERSHIPS AND BEGIN TO IMPACT THE WHOLE CARE CONTINUUM, ADDITIONAL GOALS CAN BE ADDED THAT ADDRESS KEY INDICATORS OF COMMUNITY/POPULATION HEALTH (E.G., PREVALENCE AND INCIDENCE RATES, SCREENING RATES, HOSPITAL ADMISSION RATES, BEHAVIORAL AND LIFESTYLE FACTORS). ENTITIES MUST ESTABLISH SPECIFIC STRATEGIES AND DEVELOP CLEAR INDICATORS OR MEASURES OF SUCCESS TO TRACK PROGRESS. IN ADDITION TO THE HEALTHY COMMUNITIES, EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TO SUPPORT THE COMPLETION OF A CHNA IN ACCORDANCE WITH ESTABLISHED GUIDELINES, A SIX-STEP PROCESS WAS DEVELOPED. THE PROCESS DEFINES AN APPROACH THAT CAN BE USED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY SSM HEALTH CARE AND DEVELOP STRATEGIES FOR MEETING THOSE NEEDS. THE PROCESS INCLUDES:- DEVELOP A PLAN TO ADDRESS HEALTH REFORM MANDATES TO INCLUDE DEFINING HOW THE ASSESSMENT AND BY WHOM THE ASSESSMENT WILL BE COMPLETED; IDENTIFYING THE STAKEHOLDERS INVOLVED; AND THE TIME FRAME FOR COMPLETION- PERFORM DATA COLLECTION INCLUDING IDENTIFYING THE GEOGRAPHIC AREA SERVED, ACCESSING SECONDARY DATA SOURCES AND COORDINATING INTERVIEWS, SURVEY AND/OR FOCUS GROUPS FOR PRIMARY DATA COLLECTION- PERFORM DATA ANALYSIS BY EVALUATING QUANTITATIVE AND QUALITATIVE 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 IN 2012 AND INCORPORATE THE CHNA INITIATIVES INTO THE STRATEGIC PLAN TO INCLUDE APPOINTING RESPONSIBILITY FOR IMPLEMENTING THE PLAN AND ASSIGNING A STEERING COMMITTEE TO MONITOR PROGRESS AS APPROPRIATE- COORDINATE COMMUNICATION TO THE PUBLIC, BOARDS, STAFF AND OTHER STAKEHOLDERS PROGRESS IN ADDRESSING TOP PRIORITIES IMPACTING COMMUNITY HEALTH 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.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.PART VI LINE 4: COMMUNITY INFORMATIONSSM HEALTH CARE ST LOUIS DEFINES ITS PRIMARY SERVICE AREA AS THE ST LOUIS METROPOLITAN STATISTICAL AREA, A 12 COUNTY REGION WITH AN APPROXIMATE POPULATION OF 2.8 MILLION IN 2010. HOUSEHOLD INCOME AND EDUCATION LEVELS ARE CONSISTENT WITH NATIONAL AVERAGES. DISTRIBUTION OF RACE/ETHNICITY IN OR COMMUNITY IS WHITE/CAUCASIAN: 76%; BLACK/AFRICAN-AMERICAN: 19%; HISPANIC: 2%; OTHER: 3%.DEMOGRAPHICS VARY CONSIDERABLY ACROSS THE ST LOUIS METROPOLITAN AREA. BECAUSE WE SUPPORT A WIDE RANGE OF LOCAL MARKETS AND CONSTITUENCIES, DEMOGRAPHICS ARE ALSO EVALUATED FOR OUR INDIVIDUAL SERVICE LINES AND CLINICAL DEPARTMENTS TO ENSURE WE FOCUS ON SPECIFIC COMMUNITY HEALTH NEEDS.SERVICES LINES PROVIDED BY SSM HEALTH CARE ST LOUIS INCLUDE: BEHAVIORAL HEALTH, BREAST CARE, CANCER CARE, HEART INSTITUTE, IMAGING, MATERNAL CARE, NEUROSCIENCES, ORTHOPEDICS, PAIN CARE, REHABILITATION, SLEEP SERVICES, AND WEIGHT-LOSS INSTITUTE. PART VI LINE 5: PROMOTION OF COMMUNITY HEALTH SSM HEALTH CARE'S MISSION STATEMENT IS "THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD". SSM HEALTH CARE ST LOUIS 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:PARISH NURSE PROGRAM:PARISH NURSES ARE SSM EMPLOYEES WHO DO 100% OF THEIR WORK IN THEIR CHURCHES. PARISH NURSES SERVE AS HEALTH EDUCATOR, HEALTH COUNSELOR, RESOURCE AND REFERRAL PERSON, AND COORDINATOR OF HEALTH RELATED SERVICES IN THEIR CHURCH. THEY OFFER ASSISTANCE TO INDIVIDUALS IN MODIFYING LIFE STYLES, ADJUSTING TO DISEASE, AND COPING WITH CHRONIC ILLNESS. THEY PROVIDE EMOTIONAL AND SPIRITUAL SUPPORT IN TIMES OF ANXIETY, CRISIS, AND TERMINAL ILLNESS.BREAST HEALTH:WHEN NEW BREAST CANCER CASES ARE DIAGNOSED AT > STAGE 1, DEATH RATES ARE HIGHER. AGE-ADJUSTED BREAST CANCER DEATHS IN THE DEPAUL COMMUNITY ARE HIGHER THAN THE NATIONAL CANCER DATABASE AVERAGE OF CASES DIAGNOSED AT STAGE 0-1. OUR INITIATIVE IS TO IMPROVE ACCESS TO SCREENING MAMMOGRAMS EVIDENCED BY INCREASING THE TOTAL NUMBER OF SCREENING MAMMOGRAMS PERFORMED. WE ARE EXPANDING COMMUNITY EDUCATION OPPORTUNITIES BY PROVIDING COMMUNITY OUTREACH EDUCATION EVENTS. METRICS RELATING TO THIS INITIATIVE IN 2010 FAR EXCEEDED 2009 RESULTS AS WELL AS 2010 GOALS.CT LUNG SCREENING:LUNG CANCER IS THE LEADING CAUSE OF CANCER DEATH IN THE UNITED STATES. DEATH RATES IN THE GREATER ST. CHARLES AREA FAR EXCEED THE HEALTHY COMMUNITIES GOAL FOR 2010. OUR INITIATIVE IS TO EXPAND PROGRAMS IN THE GREATER ST. CHARLES AREA TO INCREASE EARLY DETECTION OF LUNG CANCER WITH A FOCUS ON RESIDENTS WHO HAVE NEVER BEEN DIAGNOSED WITH CANCER, ARE OVER AGE 40, AND ARE A CURRENT OR FORMER SMOKER. EARLY DETECTION INCREASED SIGNIFICANTLY IN 2010 OVER 2009. SENIOR DENTAL CLINIC:POOR DENTAL HEALTH AFFECTS OVERALL HEALTH. OUR INITIATIVES PROVIDE LOW INCOME OLDER AND / OR DISABLED ADULTS WITHIN THE PRIMARY SERVICE AREA OF ST. CHARLES, LINCOLN AND WARREN COUNTIES WITH LOW-COST, PREVENTATIVE AND DIAGNOSTIC / INTERVENTIONAL DENTAL SERVICES AND PROVIDE FREE TRANSPORTATION. EDUCATIONAL & WELLNESS CLASSES: HEALTHY LIVING - A WEIGHT MANAGEMENT PROGRAM FOR ADULTS, LOOK GOOD/FEEL BETTER - A FREE NON-MEDICAL, BRAND-NEUTRAL NATIONAL PUBLIC SERVICE PROGRAM TO HELP WOMEN OFFSET APPEARANCE-RELATED CHANGES FROM CANCER TREATMENT, NUTRITION CONSULTATION, YOGA AND TAI CHI CLASSES.SUPPORT GROUPS, FOR EXAMPLE:LIFE AFTER BREAST CANCER, TOBACCO FREE FOR LIFE, WEEKLY CANCER SURVIVORS GROUP, MONTHLY CANCER CAREGIVERS GROUP, INTERNATIONAL MYELOMA FOUNDATION GROUP, LOSS & GRIEF.COLLABORATION WITH LOCAL NON-PROFIT ORGANIZATIONS ON A VARIETY OF ISSUES FROM DIRECT HEALTH RELATED CONCERNS TO QUALITY OF LIFE TOPICS. FOR EXAMPLE:ST. LOUIS CRISIS NURSERY, MARCH OF DIMES, HYDROCEPHALUS FOUNDATION, VISION FOR CHILDREN AT RISK, MISSISSIPPI VALLEY REGIONAL BLOOD BANK, UNITED WAY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER ASSOCIATION, CHILD-CENTER MARYGROVE, ST. CHARLES COUNTY YOUTH IN NEED, ALMOST HOME.PARTICIPATION IN COMMUNITY ORGANIZATIONS & TASK FORCES:EACH SSM HEALTH CARE ST. LOUIS ENTITY TAKES AN ACTIVE ROLE IN PARTICIPATING IN COMMUNITY ORGANIZATIONS AND TASK FORCES WHICH ARE FOCUSED ON STRENGTHENING THE COMMUNITY, I.E. REGIONAL ECONOMIC DEVELOPMENT ORGANIZATIONS, CHAMBER OF COMMERCE, SERVING AS POLICE DEPARTMENT SUB-STATIONS.HEALTH FAIRS & MEDICAL SCREENINGS:PARTICIPATE IN A VARIETY OF HEALTH FAIRS AND OFFER A VARIETY OF FREE MEDICAL SCREENINGS I.E. SUSAN G. KOMEN/SHOW ME HEALTHY WOMEN/WISE-WOMEN'S INFORMATION AND SCREENING ENDEAVOR - FREE SCREENING AND DIAGNOSTIC MAMMOGRAMS FOR UNDERINSURED AND UNINSURED WOMEN AGED 40 AND OLDER, COMMUNITY HEALTH FAIRSSPEAKERS BUREAU:PHYSICIANS, NURSES AND OTHER HEALTH CARE PROFESSIONALS AFFILIATED WITH SSM HEALTH CARE ARE AVAILABLE TO SPEAK TO BUSINESSES, SCHOOLS, AND CIVIC ORGANIZATIONS ON A VARIETY OF HEALTH CARE TOPICS.COMMUNITY ADVISORY BOARDS:THESE BOARDS ARE COMPRISED OF A DIVERSITY OF COMMUNITY LEADERS. WE SPONSOR REGULAR MEETINGS TO GET FEEDBACK FROM THE LEADERS AND TO SHARE INFORMATION TO TAKE TO THE COMMUNITY.CAR SEAT SAFETY PROGRAM:MOTOR VEHICLE CRASHES ARE THE LEADING CAUSE OF DEATH FOR CHILDREN 2-14 YEARS OLD. CORRECTLY USING A CAR SEAT CAN HELP PREVENT INJURIES AND DEATH TO YOUNG CHILDREN IN THE EVENT OF AN AUTOMOBILE ACCIDENT. OUR INITIATIVE INCLUDED OFFERING MONTHLY CAR SEAT SAFETY CHECKS AND HANDS ON EDUCATION FOR PARENTS AT NO CHARGE AS WELL AS SUPPLYING CAR SEATS TO FAMILIES WHO ARE UNABLE TO PROVIDE THEIR OWN. THE NUMBER OF SAFETY SEATS CHECKED / INSTALLED IN 2010 EXCEEDED OUR GOAL BY 16%. HEART SAFE COMMUNITY PROGRAM:IN COLLABORATION WITH AMERICAN RED CROSS AND OTHER ORGANIZATIONS. PROVIDE DISCOUNTED EQUIPMENT (E.G. AEDS), MEDICAL OVERSIGHT, AND ONGOING TRAINING SO THAT LOCAL BUSINESSES AND ORGANIZATIONS HAVE THE TOOLS TO RESPOND QUICKLY TO SUDDEN CARDIAC ARREST.DOMESTIC VIOLENCE:DOMESTIC VIOLENCE IS ALL TOO PREVALENT IN THE ST. MARY'S HEALTH CENTER (SMHC) COMMUNITY. VICTIMS OF VIOLENCE AND SEXUAL ASSAULT SEEKING EMERGENCY MEDICAL ASSISTANCE ARE SOMETIMES NOT IDENTIFIED AS SUCH AND DO NOT RECEIVE THE SUPPORT AND RESOURCES NEEDED TO ALTER THEIR CRISIS SITUATION. OUR INITIATIVE INCLUDES MAINTAINING A SEXUAL ASSAULT NURSE EXAMINER PROGRAM IN THE SMHC EMERGENCY DEPARTMENT. THIS IS THE ONLY OFFICIAL RAPE CRISIS EMERGENCY DEPARTMENT IN THE ST. LOUIS AREA.NURSING SCHOOLS AFFILIATIONS:CHAMBERLAIN COLLEGE, MARYVILLE UNIVERSITY, SOUTHERN ILLINOIS UNIVERSITY - EDWARDSVILLE, ST. LOUIS UNIVERSITY, UNIVERSITY OF MISSOURI - ST. LOUIS, CENTRAL METHODIST UNIVERSITY, EAST CENTRAL COMMUNITY COLLEGE, LEWIS AND CLARK COMMUNITY COLLEGE, LUTHERAN SCHOOL OF NURSING, ST. LOUIS COMMUNITY COLLEGE AT FLORISSANT VALLEY, FOREST PARK AND MERAMEC, ST. CHARLES COMMUNITY COLLEGE, SOUTHWESTERN ILLINOIS COMMUNITY COLLEGE AND PIKE LINCOLN TECH.PARTNERSHIP WITH LOCAL EMS PROVIDERS, PROVIDING MEDICAL DIRECTORSHIP AND PROTOCOLS FOR CARE DELIVERY AND MONTHLY EDUCATION ON VARIOUS TOPICS TO ENHANCE FIELD KNOWLEDGE.SSM HEALTH CARE ST LOUIS 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 7: AFFILIATED HEALTH CARE SYSTEMSSM HEALTH CARE ST LOUIS IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOW AS SSM HEALTH CARE. SSM HEALTH CARE ST LOUIS IS ONE OF THE LARGEST, FULL-SERVICE HEALTH CARE NETWORKS IN THE ST LOUIS, MISSOURI AREA. SSM HEALTH CARE ST LOUIS INCLUDES THE FOLLOWING OPERATING HOSPITALS: DEPAUL HEALTH CENTER ST JOSEPH HEALTH CENTER ST JOSEPH HEALTH CENTER - WENTZVILLE ST JOSEPH HOSPITAL WEST ST MARY'S HEALTH CENTER ST CLARE HEALTH CENTERPART VI LINE 8: STATE FILING OF COMMUNITY BENEFIT REPORTTHE SSM HEALTH CARE ANNUAL CONSOLIDATED COMMUNITY BENEFIT REPORT IS FILED IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN. PART VI, LINE 2: PART VI, LINE 3: PART VI, LINE 4: PART VI, LINE 6: PART VI, LINE 7: 1 MISSOURI HOSPITAL ASSOCIATION (POISON CONTROL) 1465 S GRAND BLVD ST LOUIS MO 63104 430738490 501(C)(3) 31384 SUPPORT POISON CONTROL CENTER PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT. X X 1 1 1 1 0 0 0 0 0 0 0 DANIEL BAUMANN MD 0 274919 0 0 0 7167 0 0 0 22768 0 304854 0 0 DONALD BINZ II MD 0 356273 0 0 0 7271 0 0 0 25571 0 389115 0 0 JAMES SANGER 0 681794 0 0 0 233117 0 22569 0 17683 0 955163 0 0 WILLIAM THOMPSON 0 830800 0 0 0 357652 0 585557 0 19865 0 1793874 0 0 KRIS ZIMMER 0 638080 0 0 0 85902 0 154088 0 26124 0 904194 0 0 JUNE L PICKETT 0 207597 0 0 0 13139 0 163178 0 16209 0 400123 0 0 KAREN REWERTS 339397 0 0 0 26517 0 117360 0 4312 0 487586 0 0 0 MARY SUE EMBERTSON 0 30736 0 0 0 239398 0 43477 0 14418 0 328029 0 0 STEVEN JOHNSON 0 564798 0 0 0 139870 0 213196 0 24666 0 942530 0 0 WILLIAM JENNINGS 0 311892 0 0 0 58495 0 58876 0 18535 0 447798 0 0 GASPARE CALVARUSO 0 384507 0 0 0 55140 0 123561 0 23612 0 586820 0 0 PATRICE KOMOROSKI 0 395375 0 0 0 106903 0 149696 0 7509 0 659483 0 0 SHERRY HAUSMANN 0 296792 0 0 0 50512 0 87517 0 22030 0 456851 0 0 SHERLYN HAILSTONE 0 506105 0 0 0 156364 0 121009 0 22882 0 806360 0 0 DREW RECTOR 0 309484 0 0 0 17916 0 37363 0 21916 0 386679 0 0 SHARON E DUDLEY 285026 0 0 0 15452 0 7451 0 17105 0 325034 0 0 0 LEE BERNSTEIN 268084 0 0 0 37114 0 47360 0 20403 0 372961 0 0 0 DEBORAH WALKENHORST 306415 0 0 0 28585 0 78558 0 16110 0 429668 0 0 0 LYNN LENKER 310844 0 0 0 42760 0 117815 0 20899 0 492318 0 0 0 KEVIN TODD JOHNSON 461034 0 0 0 59697 0 107985 0 26729 0 655445 0 0 0 MARGARET FOWLER 253106 0 0 0 22713 0 128090 0 22735 0 426644 0 0 0 LORRAINE MAE YEHLEN 234940 0 0 0 14733 0 116450 0 21941 0 388064 0 0 0 ROBERT PORTER 0 407816 0 0 0 86773 0 190902 0 22333 0 707824 0 0 SEAN HOGAN 0 292702 0 0 0 38387 0 75246 0 21371 0 427706 0 0 JAMES SCOTT 736539 0 0 0 1621 0 73944 0 56910 0 869014 0 0 0 WILLIAM HOLCOMB 422056 0 0 0 48231 0 94754 0 22226 0 587267 0 0 0 MARIO MORALES 408319 0 0 0 1207 0 11880 0 23225 0 444631 0 0 0 ANDREW KARANAS 396093 0 0 0 1297 0 39481 0 23559 0 460430 0 0 0 MARK RENKEN 312217 0 0 0 34074 0 25524 0 22837 0 394652 0 0 0 WILLIAM SCHOENHARD 0 0 0 0 0 282789 0 112880 0 17940 0 413609 0 0 SUPPLEMENTAL INFORMATION PART III PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2010. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. KAREN REWERTS DEBORAH WALKENHORST LYNN LENKER KEVIN TODD JOHNSON MARGARET FOWLER LORRAINE MAE YEHLEN WILLIAM HOLCOMB MARK RENKEN PART I, LINE 1A: THE FOLLOWING INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A REIMBURSEMENT OF HEALTH OR SOCIAL CLUB DUES IN 2010. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. MARK RENKEN PART I, LINE 3: COMPENSATION TO CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S CEO IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) WRITTEN EMPLOYMENT CONTRACT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4A: SEVERANCE PLAN: SSMHC HAS ADOPTED A SEVERANCE POLICY TO PROVIDE A FINANCIAL TRANSITION IN THE EVENT OF INVOLUNTARY TERMINATION WITHOUT CAUSE FOR EXECUTIVE LEVEL POSITIONS. THE AMOUNT OF THE COMPENSATION IS BASED ON THE POSITION HELD AND LENGTH OF SERVICE WITH SSMHC. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED SEVERANCE PAYMENTS DURING THE YEAR ENDED DECEMBER 31, 2010: WILLIAM SCHOENHARD $277,333 MAY SUE EMBERTSON $197,117 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 2010. 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 2010. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION. JAMES M SANGER $116,523 KRIS A ZIMMER $ 42,738 WILLIAM P THOMPSON $ 37,749 PATRICE KOMOROSKI $ 34,686 STEVEN JOHNSON $ 28,038 WILLIAM JENNINGS $ 28,475 GASPARE CALVARUSO $ 25,641 SHERLYNN HAILSTONE $ 23,111 SHERRY HAUSMANN $ 21,303 MARY SUE EMBERTSON $ 17,462 KEVIN TODD JOHNSON $ 13,716 LYNN LENKER $ 11,762 DEBORAH WALKENHORST $ 11,480 SHARON DUDLEY $ 10,784 LEE BERNSTEIN $ 10,724 JUNE PICKETT $ 7,123 KAREN REWERTS $ 5,391 MARGARET FOWLER $ 10,257 LORRAINE MAE YEHLEN $ 9,280 ROBERT PORTER $ 25,712 SEAN HOGON $ 17,441 MARK RENKEN $ 12,638 X EMERGENCY PREPAREDNESS 7 30663 FMV 0 1 0 FORM 990, PART I, DOING BUSINESS AS: SSM HEALTH CARE ST. LOUIS CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES: 1. MARYVILLE PEDIATRICS 2. SSM CARE MANAGEMENT COMPANY, 3. SSM HEALTH CARE SENIOR SERVICES 4. SSM DEPAUL HEALTH CENTER A. SSM BREAST CARE - DEPAUL HEALTH CENTER B. SSM CANCER CARE - DEPAUL HEALTH CENTER C. SSM HEART INSTITUTE D. SSM PHARMACY AT DEPAUL E. THE WOMEN'S PAVILION AT DEPAUL HEALTH CENTER 5. SSM ST. CLARE HEALTH CENTER A. SSM BREAST CARE - ST. CLARE HEALTH CENTER B. SSM CANCER CARE - ST. CLARE HEALTH CENTER C. SSM HEART INSTITUTE 6. SSM ST. JOSEPH HEALTH CENTER A. ST. JOSEPH HEALTH CENTER WOMEN'S AND CHILDREN'S SERVICES CLINIC B. SSM BREAST CARE - ST. CHARLES MEDICAL GROUP C. SSM BREAST CARE - ST. JOSEPH HEALTH CENTER D. SSM BREAST CARE - ST. JOSEPH HEALTH CENTER - WENTZVILLE E. SSM CANCER CARE - ST. JOSEPH HEALTH CENTER F. SSM HEART INSTITUTE G. SSM ST. JOSEPH HEALTH CENTER - WENTZVILLE H. SSM ST. JOSEPH URGENT CARE 7. SSM ST. JOSEPH HOSPITAL OF KIRKWOOD A. ST. JOSEPH HOSPITAL OF KIRKWOOD 8. SSM ST. JOSEPH HOSPITAL WEST A. ST. JOSEPH HOSPITAL WEST B. SSM BREAST CARE - ST. JOSEPH HOSPITAL WEST C. SSM CANCER CARE - ST. JOSEPH HOSPITAL WEST D. SSM HEART INSTITUTE 9. SSM ST. JOSEPH MEDICAL PARK A. SSM BREAST CARE - ST. JOSEPH MEDICAL PARK B. SSM CANCER CARE - ST. JOSEPH MEDICAL PARK C. THE IMAGING CENTER AT ST. JOSEPH MEDICAL PARK D. THE WOMEN'S CENTER AT ST. JOSEPH MEDICAL PARK 10. SSM ST. MARY'S HEALTH CENTER A. CLAYTON HEALTH SERVICES EAST B. CLAYTON HEALTH SERVICES WEST C. CLAYTON HEALTH SERVICES PHARMACY WEST D. SSM BREAST CARE - ST. MARY'S HEALTH CENTER E. SSM CANCER CARE - ST. MARY'S HEALTH CENTER F. SSM HEART INSTITUTE FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: SSM HEALTH CARE ST. LOUIS OPERATES SIX HOSPITALS AND HEALTH CENTERS AND PROVIDES OTHER RELATED HEALTH SERVICES IN THE GREATER ST. LOUIS, MISSOURI METROPOLITAN AREA. FORM 990, PART I, LIST OF INCLUDED DIVISIONS: SSM CARE MANAGEMENT 43-1343281 SSM NETWORK STL 43-1343281 ST. CLARE HEALTH CENTER 43-1343281 ST. MARY'S HEALTH CENTER - ST. LOUIS 43-0652681 ST. MARY'S HEALTH CENTER AUXILIARY 51-0235916 DEPAUL HEALTH CENTER 43-1704972 SSM REHABILITATION CENTER 43-0652662 SSM REHABILITATION INSTITUTE AUXILIARY 43-1112095 ST. JOSEPH HOSPITAL WEST 43-1417442 ST. JOSEPH HOSPITAL WEST MOB 43-1343281 ST. JOSEPH HEALTH CENTER 43-0652671 ST. JOSEPH HEALTH CENTER AUXILIARY 51-0234274 ST. JOSEPH SURGERY CENTER 43-1822767 ST. JOSEPH MEDICAL PARK 43-1343281 ST. JOSEPH HEALTH CENTER WOMENS & CHILDRENS SERVICES CLINIC 43-1835246 DEPAUL MEDICAL STAFF 43-1092983 PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: THE COMMUNITY BENEFIT CONTRIBUTION OF SSM HEALTH CARE ST. LOUIS INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. A. DESCRIBE THE CORPORATION'S MISSION AND PRIMARY EXEMPT PURPOSE. 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 OWNS, MANAGES AND IS AFFILIATED WITH 20 HOSPITALS, TWO NURSING HOMES AND HOME HEALTH AGENCIES IN FOUR STATES. THE HEALTH SYSTEM EMPLOYS APPROXIMATELY 22,000 PEOPLE AND IS AFFILIATED WITH MORE THAN 5,400 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. B. SUMMARIZE THE CORPORATION'S APPROACH TO PROVIDING COMMUNITY BENEFIT. SSM HEALTH CARE OF ST. LOUIS USES SEVERAL APPROACHES TO UNDERSTAND THE HEALTH CARE NEEDS OF OUR COMMUNITIES. FOR EXAMPLE, OUR LEADERS SERVE ON THE BOARDS OF TWO REGIONAL ORGANIZATIONS THAT OVERSEE THE HEALTH CARE SAFETY NET FOR OUR REGION, THE ST. LOUIS REGIONAL HEALTH COMMISSION (RHC) AND ST. LOUIS CONNECTCARE. THE RHC IS A COLLABORATIVE EFFORT OF ST. LOUIS CITY, ST. LOUIS COUNTY, THE STATE OF MISSOURI, HEALTH PROVIDERS, AND COMMUNITY MEMBERS TO IMPROVE THE HEALTH OF UNINSURED AND UNDERINSURED CITIZENS IN ST. LOUIS CITY AND COUNTY. ST. LOUIS CONNECTCARE IS THE LARGEST PROVIDER OF SPECIALTY CARE TO THE MEDICALLY UNDERSERVED IN ST. LOUIS CITY AND COUNTY. WE PARTICIPATE IN AND UTILIZE THE COMMUNITY HEALTH ASSESSMENTS AND RELATED STUDIES COORDINATED BY THE REGIONAL HEALTH COMMISSION. EACH SSM HOSPITAL TAKES AN ACTIVE ROLE IN PARTICIPATING IN COMMUNITY ORGANIZATIONS AND TASK FORCES WHICH ARE FOCUSED ON STRENGTHENING THE COMMUNITY (I.E. REGIONAL ECONOMIC DEVELOPMENT ORGANIZATIONS, CHAMBER OF COMMERCE). WE PARTICIPATE IN HEALTHY COMMUNITY INITIATIVES SPECIFIC TO THE INDIVIDUAL MARKET AREAS THAT WE SERVE. FOR EXAMPLE, SSM ST. JOSEPH HEALTH CENTER AND SSM ST. JOSEPH HOSPITAL WEST PARTICIPATED IN A HEALTH NEEDS ASSESSMENT DEVELOPED FOR ST. CHARLES COUNTY. EACH SSM HOSPITAL SUPPORTS A COMMUNITY ADVISORY BOARD THAT SERVES AS A LISTENING POST FOR DIALOGUE AND IDEAS THAT ARE SPECIFIC TO HEALTH NEEDS FOR EACH LOCAL MARKET. SSM SERVICE LINES AND CLINICAL DEPARTMENTS ALSO CONDUCT ASSESSMENTS TO FOCUS ON SPECIFIC COMMUNITY HEALTH NEEDS. EXAMPLES INCLUDE: SENIOR SERVICES, WOMEN'S HEALTH, BEHAVIORAL MEDICINE AND PROJECT BOOST, A CASE MANAGEMENT INITIATIVE AT SSM ST. MARY'S HEALTH CENTER TO IMPROVE SUPPORT FOR PATIENTS POST-DISCHARGE. SSM HEALTH CARE OF ST. LOUIS USES DEMOGRAPHIC, UTILIZATION AND TECHNOLOGY TRENDS GENERATED BY THE HEALTH CARE ADVISORY BOARD TO SIZE THE MARKET FOR BOTH INPATIENT AND OUTPATIENT HEALTH CARE NEEDS FOR THE IMMEDIATE AND LONG-TERM. WE USE THIS INFORMATION TO ADJUST CAPACITY TO MEET FUTURE DEMAND FOR HEALTH CARE SERVICES. C. DESCRIBE THE CORPORATION'S FINANCIAL ASSISTANCE POLICIES OR PROGRAMS (E.G. CHARITY CASE, 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 FLYERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. - NOTICES SENT WITH 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. 2. 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 OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS SSM HEALTH CARE ST. LOUIS PROVIDES MANY COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE. LISTED ARE A SAMPLING OF THESE INITIATIVES AND THEIR IMPACT: PARISH NURSE PROGRAM: PARISH NURSES ARE SSM EMPLOYEES WHO DO 100% OF THEIR WORK IN THEIR CHURCHES. PARISH NURSES SERVE AS HEALTH EDUCATOR, HEALTH COUNSELOR, RESOURCE AND REFERRAL PERSON, AND COORDINATOR OF HEALTH RELATED SERVICES IN THEIR CHURCH. THEY OFFER ASSISTANCE TO INDIVIDUALS IN MODIFYING LIFE STYLES, ADJUSTING TO DISEASE, AND COPING WITH CHRONIC ILLNESS. THEY PROVIDE EMOTIONAL AND SPIRITUAL SUPPORT IN TIMES OF ANXIETY, CRISIS, AND TERMINAL ILLNESS. BREAST HEALTH: WHEN NEW BREAST CANCER CASES ARE DIAGNOSED AT > STAGE 1, DEATH RATES ARE HIGHER. AGE-ADJUSTED BREAST CANCER DEATHS IN THE DEPAUL COMMUNITY ARE HIGHER THAN THE NATIONAL CANCER DATABASE AVERAGE OF CASES DIAGNOSED AT STAGE 0-1. OUR INITIATIVE IS TO IMPROVE ACCESS TO SCREENING MAMMOGRAMS EVIDENCED BY INCREASING THE TOTAL NUMBER OF SCREENING MAMMOGRAMS PERFORMED. WE ARE EXPANDING COMMUNITY EDUCATION OPPORTUNITIES BY PROVIDING COMMUNITY OUTREACH EDUCATION EVENTS. METRICS RELATING TO THIS INITIATIVE IN 2010 FAR EXCEEDED 2009 RESULTS AS WELL AS 2010 GOALS. BCT LUNG SCREENING: LUNG CANCER IS THE LEADING CAUSE OF CANCER DEATH IN THE UNITED STATES. DEATH RATES IN THE GREATER ST. CHARLES AREA FAR EXCEED THE HEALTHY COMMUNITIES GOAL FOR 2010. OUR INITIATIVE IS TO EXPAND PROGRAMS IN THE GREATER ST. CHARLES AREA TO INCREASE EARLY DETECTION OF LUNG CANCER WITH A FOCUS ON RESIDENTS WHO HAVE NEVER BEEN DIAGNOSED WITH CANCER, ARE OVER AGE 40, AND ARE A CURRENT OR FORMER SMOKER. EARLY DETECTION INCREASED SIGNIFICANTLY IN 2010 OVER 2009. SENIOR DENTAL CLINIC: POOR DENTAL HEALTH AFFECTS OVERALL HEALTH. OUR INITIATIVES PROVIDE LOW INCOME OLDER AND / OR DISABLED ADULTS WITHIN THE PRIMARY SERVICE AREA OF ST. CHARLES, LINCOLN AND WARREN COUNTIES WITH LOW-COST, PREVENTATIVE AND DIAGNOSTIC / INTERVENTIONAL DENTAL SERVICES AND PROVIDE FREE TRANSPORTATION. EDUCATIONAL & WELLNESS CLASSES: HEALTHY LIVING - A WEIGHT MANAGEMENT PROGRAM FOR ADULTS, LOOK GOOD... FEEL BETTER - A FREE NON-MEDICAL, BRAND-NEUTRAL NATIONAL PUBLIC SERVICE PROGRAM TO HELP WOMEN OFFSET APPEARANCE-RELATED CHANGES FROM CANCER TREATMENT, NUTRITION CONSULTATION, YOGA AND TAI CHI CLASSES. SUPPORT GROUPS, FOR EXAMPLE: LIFE AFTER BREAST CANCER, TOBACCO FREE FOR LIFE, WEEKLY CANCER SURVIVORS GROUP, MONTHLY CANCER CAREGIVERS GROUP, INTERNATIONAL MYELOMA FOUNDATION GROUP, LOSS & GRIEF. COLLABORATION WITH LOCAL NON-PROFIT ORGANIZATIONS ON A VARIETY OF ISSUES FROM DIRECT HEALTH RELATED CONCERNS TO QUALITY OF LIFE TOPICS. FOR EXAMPLE: ST. LOUIS CRISIS NURSERY, MARCH OF DIMES, HYDROCEPHALUS FOUNDATION, VISION FOR CHILDREN AT RISK, MISSISSIPPI VALLEY REGIONAL BLOOD BANK, UNITED WAY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER ASSOCIATION, CHILD-CENTER MARYGROVE, ST. CHARLES COUNTY YOUTH IN NEED, ALMOST HOME. PARTICIPATION IN COMMUNITY ORGANIZATIONS & TASK FORCES: EACH SSM HEALTH CARE ST. LOUIS ENTITY TAKES AN ACTIVE ROLE IN PARTICIPATING IN COMMUNITY ORGANIZATIONS AND TASK FORCES WHICH ARE FOCUSED ON STRENGTHENING THE COMMUNITY, I.E. REGIONAL ECONOMIC DEVELOPMENT ORGANIZATIONS, CHAMBER OF COMMERCE, SERVING AS POLICE DEPARTMENT SUB-STATIONS. HEALTH FAIRS & MEDICAL SCREENINGS: PARTICIPATE IN A VARIETY OF HEALTH FAIRS AND OFFER A VARIETY OF FREE MEDICAL SCREENINGS I.E. SUSAN G. KOMEN/SHOW ME HEALTHY WOMEN/WISE-WOMEN'S INFORMATION AND SCREENING ENDEAVOR - FREE SCREENING AND DIAGNOSTIC MAMMOGRAMS FOR UNDERINSURED AND UNINSURED WOMEN AGED 40 AND OLDER, COMMUNITY HEALTH FAIRS SPEAKERS BUREAU: PHYSICIANS, NURSES AND OTHER HEALTH CARE PROFESSIONALS AFFILIATED WITH SSM HEALTH CARE ARE AVAILABLE TO SPEAK TO BUSINESSES, SCHOOLS, AND CIVIC ORGANIZATIONS ON A VARIETY OF HEALTH CARE TOPICS. COMMUNITY ADVISORY BOARDS: THESE BOARDS ARE COMPRISED OF A DIVERSITY OF COMMUNITY LEADERS. WE SPONSOR REGULAR MEETINGS TO GET FEEDBACK FROM THE LEADERS AND TO SHARE INFORMATION TO TAKE TO THE COMMUNITY. CAR SEAT SAFETY PROGRAM: MOTOR VEHICLE CRASHES ARE THE LEADING CAUSE OF DEATH FOR CHILDREN 2-14 YEARS OLD. CORRECTLY USING A CAR SEAT CAN HELP PREVENT INJURIES AND DEATH TO YOUNG CHILDREN IN THE EVENT OF AN AUTOMOBILE ACCIDENT. OUR INITIATIVE INCLUDED OFFERING MONTHLY CAR SEAT SAFETY CHECKS AND HANDS ON EDUCATION FOR PARENTS AT NO CHARGE AS WELL AS SUPPLYING CAR SEATS TO FAMILIES WHO ARE UNABLE TO PROVIDE THEIR OWN. THE NUMBER OF SAFETY SEATS CHECKED / INSTALLED IN 2010 EXCEEDED OUR GOAL BY 16%. HEART SAFE COMMUNITY PROGRAM: IN COLLABORATION WITH AMERICAN RED CROSS AND OTHER ORGANIZATIONS. PROVIDE DISCOUNTED EQUIPMENT (E.G. AEDS), MEDICAL OVERSIGHT, AND ONGOING TRAINING SO THAT LOCAL BUSINESSES AND ORGANIZATIONS HAVE THE TOOLS TO RESPOND QUICKLY TO SUDDEN CARDIAC ARREST. DOMESTIC VIOLENCE: DOMESTIC VIOLENCE IS ALL TOO PREVALENT IN THE SMHC COMMUNITY. VICTIMS OF VIOLENCE AND SEXUAL ASSAULT SEEKING EMERGENCY MEDICAL ASSISTANCE ARE SOMETIMES NOT IDENTIFIED AS SUCH AND DO NOT RECEIVE THE SUPPORT AND RESOURCES NEEDED TO ALTER THEIR CRISIS SITUATION. OUR INITIATIVE INCLUDES MAINTAINING A SEXUAL ASSAULT NURSE EXAMINER PROGRAM IN THE ST. MARY'S HEALTH CENTER (SMHC) EMERGENCY DEPARTMENT. THIS IS THE ONLY OFFICIAL RAPE CRISIS EMERGENCY DEPARTMENT IN THE ST. LOUIS AREA. NURSING SCHOOLS AFFILIATIONS: CHAMBERLAIN COLLEGE, MARYVILLE UNIVERSITY, SOUTHERN ILLINOIS UNIVERSITY - EDWARDSVILLE, ST. LOUIS UNIVERSITY, UNIVERSITY OF MISSOURI - ST. LOUIS, CENTRAL METHODIST UNIVERSITY, EAST CENTRAL COMMUNITY COLLEGE, LEWIS AND CLARK COMMUNITY COLLEGE, LUTHERAN SCHOOL OF NURSING, ST. LOUIS COMMUNITY COLLEGE AT FLORISSANT VALLEY, FOREST PARK AND MERAMEC, ST. CHARLES COMMUNITY COLLEGE, SOUTHWESTERN ILLINOIS COMMUNITY COLLEGE AND PIKE LINCOLN TECH. PARTNERSHIP WITH LOCAL EMS PROVIDERS, PROVIDING MEDICAL DIRECTORSHIP AND PROTOCOLS FOR CARE DELIVERY AND MONTHLY EDUCATION ON VARIOUS TOPICS TO ENHANCE FIELD KNOWLEDGE. THE FOLLOWING IS A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS COMMUNITY BENEFIT ACTIVITIES. TRADITIONAL CHARITY CARE $ 33,518,489 UNPAID COST OF MEDICARE $ 18,903,128 UNPAID COST OF MEDICAID $ (13,136,636) COST OF BAD DEBT $ 15,173,748 COMMUNITY BENEFIT PROGRAMS $ 7,537,119 TOTAL QUANTIFIABLE COMMUNITY BENEFIT $ 61,995,848 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 HEALTH CARE ST LOUIS 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 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 ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS C. TO APPOINT AND REMOVE THE APPOINTED DIRECTORS AND THE EX OFFICIO DIRECTORS D. TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE CERTIFICATE OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, INCLUDING ACTIONS RELATING TO THE FORMATION, JOINING, OPERATION, WITHDRAWAL FROM AND TERMINATION OF A CREDIT GROUP OR AN OBLIGATED GROUP AND THE GRANTING OF SECURITY INTERESTS IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE MEMBER OF THE MEMBER AS DETERMINED BY THE MEMBER OF THE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTING/FINANCE PERSONNEL AT EACH SSMHC (SSM HEALTH CARE SYSTEM) ENTITY, IN CONJUNCTION WITH CORPORATE FINANCE PERSONNEL, PREPARE A CHECKLIST CONTAINING INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS CHECKLIST IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE CORPORATE OFFICE FOR FINAL REVIEW AND COORDINATION OF THE SYSTEM LEVEL FORM 990 INFORMATION. THE INFORMATION IS SUBMITTED TO AN OUTSIDE TAX CONSULTING FIRM WHO PREPARES AND SIGNS THE FORM 990 FROM THE SSMHC INFORMATION. PRIOR TO FINALIZING THE RETURN, A DRAFT IS SENT TO PERSONNEL AT SSMHC FOR REVIEW AND APPROVAL. UPON SSMHC APPROVAL, THE OUTSIDE PREPARER FORWARDS THE COMPLETED FORM 990 FOR THE APPROPRIATE SIGNATURES AND FILING ACTION. A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE BOARD AT THE NEXT SCHEDULED BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY TO THE BOARD OVERSEE COMPLIANCE WITH THIS REQUIREMENT. ALL BOARD MEMBERS WITH AN IDENTIFIED CONFLICT OF INTEREST ABSTAIN FROM BOARD DISCUSSIONS AND VOTES WHEN APPLICABLE. EMPLOYEES WITH PURCHASING AUTHORITY AND/OR ABILITY TO INFLUENCE PURCHASING DECISIONS ARE ASSIGNED THE CONFLICT OF INTEREST DISCLOSURE COURSE (COI) WHICH MUST BE COMPLETED ON LINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END. FORM 990, PART VI, SECTION B, LINE 15 ALL SSMHC EXECUTIVE SALARY/COMPENSATION INFORMATION IS BASED ON COMPARATIVE DATA WITH SIMILAR POSITIONS IN THE MARKET. THE COMPENSATION REVIEW PROCESS IS PERFORMED BY EXTERNAL INDEPENDENT COMPENSATION CONSULTANTS. THE SAME COMPARATIVE PROCESS IS PERFORMED INTERNALLY FOR EMPLOYEES. THE SALARY DATA AND POTENTIAL ADJUSTMENTS, FOR THE CEO OF THE SYSTEM, THE PRESIDENT/COO AND THE SENIOR VICE PRESIDENTS ARE PRESENTED TO THE SSMHC BOARD OF DIRECTORS BY THE SAME INDEPENDENT COMPENSATION CONSULTANTS TO APPROVE, DISAPPROVE, MODIFY. FORM 990, PART VI, SECTION C, LINE 19 THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENT FOR THE SSM HEALTH CARE SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH CARE'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. COPIES OF THE FORM 990 AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. AVG HOURS DEVOTED TO RELATED ORG(S) WHEN RELATED COMP IS REPORTED: FORM 990, PART VII: ALL INDIVIDUALS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION ARE EMPLOYED AND COMPENSATED BY THE ORGANIZATION OR BY A RELATED ORGANIZATION. IN ADDITION, ALL COMPENSATED REPORTABLE INDIVIDUALS LISTED ON FORM 990, PART VII WORK A MINIMUM OF 40 HOURS PER WEEK FOR SSMHC RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,968,857. BENEFICIAL INTEREST IN FOUNDATION 1,397,782. FUND BALANCE TRANSFER TO AFFILIATES 96,414,518. TOTAL TO FORM 990, PART XI, LINE 5: 95,843,443. 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