2011-11-15T11:26:57-06:00 2010-12-31 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 77002 990 2010-01-01 440579850 SSM REGIONAL HEALTH SERVICES SSMR 3149947800 477 NORTH LINDBERGH BLVD ST LOUIS MO 63141 JUNE L PICKETT 3149947800 2011-11-15 1 NANCY Z EVETTS 7139822000 2010 2016-02-24 21:20:13Z SEE SCHEDULE O WILLIAM P THOMPSON 477 NORTH LINDBERGH BLVD ST LOUIS MO 63141 216145449 0 0928 X WWW.SSMHC.COM X 2000 MO OPERATES TWO HOSPITALS AND HEALTH CENTERS IN JEFFERSON CITY, MISSOURI AND MARYVILLE, MISSOURI. 12 1 1812 432 7805403 -217285 517571 735088 206840339 205599260 775624 1413625 7867713 8281171 216001247 216029144 422219 313256 0 0 98106162 101455776 0 0 142987 106178168 120830982 204706549 222600014 11294698 -6570870 140254460 137523233 51918642 53525919 88335818 83997314 X THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD. 0 0 195390641 313256 206105638 SEE SCHEDULE O 195390641 1 1 0 1 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 209 0 1 1812 1 1 1 0 0 0 0 0 0 0 0 0 X 12 1 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 X SR MARY JEAN RYAN 1.00 X 0 0 0 STEVEN BARNEY 1.00 X 0 575163 78630 PAULA FRIEDMAN 1.00 X 0 531902 191134 CHRISTOPHER HOWARD 1.00 X 0 643777 218635 THOMAS K LANGSTON 1.00 X 0 552855 304182 PHILLIP GUSTAFSON 1.00 X 0 534331 102866 DIXIE L PLATT 1.00 X 0 484132 190796 JAMES M SANGER 1.00 X 0 914911 40252 WILLIAM P THOMPSON 1.00 X X 0 1188452 605422 KRIS A ZIMMER 1.00 X X 0 723982 180212 MARY STARMANN HARRISON 1.00 X 0 780068 259699 JUNE L PICKETT 1.00 X 0 220736 179387 JOCELYN SKIDMORE 40.00 X 133480 0 78255 THOMAS LUEBBERING 40.00 X 39961 0 32433 BRIAN DEAN 40.00 X 141002 0 21010 GRAY COX 40.00 X 334552 0 211954 R BRENT VANCONIA 40.00 X 436511 0 163827 CATHY NEW 40.00 X 156331 0 124671 PATRICK HARR MD 40.00 X 399809 0 144680 SCOTT HOLMAN DO 40.00 X 423429 0 103905 CATHERINE ABRAMS 40.00 X 225796 0 63011 JOHN LUCIO DO 40.00 X 248057 0 56637 SUSAN MANKOSKI 40.00 X 162935 0 57781 GARF THOMAS 40.00 X 150921 0 35795 THOMAS DISTEFANO MD 40.00 X 986430 0 191904 JANE DAWSON MD 40.00 X 455786 0 95789 DAMIEN MIZERA MD 40.00 X 524992 0 94363 ARMIT P SINGH 40.00 X 437371 0 65200 JOHN CROUCH MD 40.00 X 444276 0 108194 5701639 7150309 4000624 77 0 1 0 CAPITAL EMERGENCY PHYSICIANS 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY MO 65101 MEDICAL PHYSICIAN SERVICES 2162040 EMERGENCY PRACTICE ASSOCIATES INC 3840 W 9TH ST WATERLOO IA 50702 EMERGENCY ROOM PHYSICIAN SERVICES 1278916 MID-MISSOURI ANESTHESIA 1445 CHRISTY DRIVE JEFFERSON CITY MO 65101 MEDICAL PHYSICIAN SERVICES 1218000 MORRISON MANAGEMENT SPECIALISTS 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 MEDICAL MANAGEMENT FEES 1093172 JEFFERSON CITY MEDICAL GROUP 1241 W STADIUM JEFFERSON CITY MO 65109 MEDICAL PHYSICIAN SERVICES 686491 41 142017 588742 4329 4506 735088 PATIENT SERVICE REV 621110 204315399 204315399 OTHER REVENUE 621110 1283861 1283861 205599260 800362 800362 41417 78913 -37496 -37496 -37496 618052 21900 26689 618052 -4789 613263 613263 12898 1433 11465 11465 21377 9270 12107 12107 PHARMACY REVENUE 446110 7368913 7368913 CHILD CARE CENTER 624410 388826 388826 LABORATORY REV 621500 335355 318669 16686 202001 171023 30978 8295095 216029144 206088952 7805403 1399701 301586 301586 11670 11670 3112008 3112008 73773348 63258757 10427038 87553 6501636 5407038 1086235 8363 12988136 10797062 2175655 15419 5080648 4190125 884343 6180 4528218 798806 3729412 368824 368824 73069 73069 13072574 12108533 964041 926668 348306 578362 44858851 44268882 576298 13671 8445640 8445640 4626801 4399599 227202 433950 247653 185399 898 204191 159373 44818 974648 974648 9544168 9336663 206513 992 3650133 1272249 2377884 BAD DEBT 17609214 17609214 0 0 MEDICARE PROVIDER TAX 10933042 10933042 0 0 BOND RELATED FEES 212273 197626 14647 0 LICENSES 200161 200161 0 0 MISCELLANEOUS EXPENSES 168557 124008 34638 9911 222600014 195390641 27066386 142987 937158 25687434 23247494 26081882 25732718 20000 20000 4169013 4402699 2787201 1834444 145100084 95191727 53067327 49908357 22544752 25558196 5896851 5882167 140254460 137523233 13733875 15024134 38184767 38501785 51918642 53525919 X 87040507 82478990 1184311 1407324 111000 111000 88335818 83997314 140254460 137523233 X -6570870 2232366 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 23821 0 0 0 23821 0 116307 2098 7405 111000 118719 1500 4614 8526 116307 173727 -55008 118719 1.00000 0 0 4619933 4619933 79666825 51797545 27869280 555923 425333 130590 54729294 42259060 12470234 5528109 709789 4818320 49908357 BENEFICIAL INTEREST IN FOUNDATIONS 7826713 F EQUITY IN JOINT VENTURES 463009 F SSM CENTRAL INVESTMENT POOL 17268474 F 25558196 PENSION FUNDING LIABILITY 7265140 RABBI TRUST LIABILITY 1130322 THIRD PARTY PAYOR 282470 ASSET RETIREMENT LIABILITY 851105 DEFERRED COMPENSATION LIABILITY 1097711 ALLOCATED TAX EXEMPT BOND DEBT (ISSUED BY SSM HEALTH CARE) 27875037 38501785 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS AND MISSION OF ST. MARY'S HEALTH CENTER. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 2010 OR 2009. 1 1 X 1 X 1 X 0.0 1 1 1 0 1 1 4078357 4078357 0.01990 30424689 27070293 3354396 0.01640 34503046 27070293 7432753 0.03630 319000 10691 308309 0.00150 38919 38919 0.00020 426657 22204 404453 0.00200 784576 32895 751681 0.00370 35287622 27103188 8184434 0.04000 6534 6534 0.00000 197632 197632 0.00100 2468 160 2308 0.00000 206634 160 206474 0.00100 1 8419728 59671565 67188386 -7516821 X 1 0 1 SMHC MUSC COMGMT LLC MANAGEMENT 0.50000 0.50000 2 SMHC SGRL COMGMT LLC MANAGEMENT 0.50000 0.50000 3 SMHC CARDIO CMGT 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 2 ST FRANCIS HOSPITAL & HEALTH SERVICES

2016 S MAIN MARYVILLE MO 64468

X X X NA 1 25 ST MARY'S MEDICAL CLINIC - BELLE

100 HIGHWAY 28 BELLE MO 65013

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S HEALTH PSYCHOLOGY

3702 W TRUMAN BLVD SUITE 115 JEFFERSON CITY MO 65109

OFFSITE CLINIC - O/P PSYCHIATRIC SERVICES ST MARY'S MEDICAL CLINIC - HOLTS SUMMIT

140 NORTHSTAR HOLTS SUMMIT MO 65043

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S MEDICAL CLINIC - JEFFERSON CI

2511 W EDGEWOOD SUITE D JEFFERSON CITY MO 65109

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

2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 65049

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S OCCUPATIONAL MEDICINE

2511 W EDGEWOOD SUITE F JEFFERSON CITY MO 65109

OFFSITE CLINIC - OCCUPATIONAL MEDICINE ST MARY'S PEDIATRICS

3348 AMERICAN AVENUE JEFFERSON CITY MO 65109

OFFSITE CLINIC - PEDIATRICS ST MARY'S MEDICAL CLINIC - TIPTON

875 HWY 5 SOUTH PO BOX 667 TIPTON MO 65081

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S URGENT CARE - JEFFERSON CITY

2511 W EDGEWOOD SUITE D JEFFERSON CITY MO 65109

OFFSITE CLINIC - URGENT CARE ST MARY'S URGENT CARE - LAKE OZARK

2265 BAGNELL DAM BLVD SUITE 103 LAKE OZARK MO 65049

OFFSITE CLINIC - URGENT CARE ST MARY'S MEDICAL CLINIC - VERSAILLES

801 KIDWELL DRIVE VERSAILLES MO 65084

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S MEDICAL CLINIC - WESTPHALIA

1875 HWY 63 WESTPHALIA MO 65085

OFFSITE CLINIC - FAMILY PRACTICE ST MARY'S CARDIOVASCULAR SURGERY

200 ST MARYS MEDICAL PLAZA SUITE 203 JEFFERSON CITY MO 65101

OFFSITE CLINIC - CARDIOVASCULAR SERVICES ST MARY'S CANCER SPECIALISTS

200 ST MARYS MEDICAL PLAZA SUITE 202 JEFFERSON CITY MO 65101

OFFSITE CLINIC - O/P ONCOLOGY SERVICES ST MARY'S OUTPATIENT REHAB & SPINE CENT

2511 W EDGEWOOD SUITE G JEFFERSON CITY MO 65109

OFFSITE CLINIC - O/P PT, OT, SPEECH & SPINE SERVICES ST MARY'S HOLTS SUMMIT PHARMACY

140 NORTHSTAR HOLTS SUMMIT MO 65043

RETAIL PHARMACY ST MARY'S TIPTON PHARMACY

875 HWY 5 SOUTH PO BOX 667 TIPTON MO 65081

RETAIL PHARMACY ST MARY'S WESTPHALIA PHARMACY

1875 HWY 63 WESTPHALIA MO 65085

RETAIL PHARMACY ST MARY'S PLAZA PHARMACY

200 ST MARYS MEDICAL PLAZA SUITE 204 JEFFERSON CITY MO 65101

RETAIL PHARMACY ST MARY'S SLEEP DISORDERS CENTER

3348 AMERICAN AVENUE JEFFERSON CITY MO 65109

SLEEP DISORDERS CENTER ST FRANCIS FAMILY HEALTH CARE- EAST

114 E SOUTH HILLS DR MARYVILLE MO 64468

PEDIATRIC CLINIC HARDIN MEDICAL CLINIC

408 SOUTH DODGE STREET BEDFORD IA 50833

OUTPATIENT CLINIC ST FRANCIS GRANT CITY MEDICAL CLINIC

24 WEST 4TH STREET GRANT CITY MO 64456

PRIMARY CARE, INTERNAL MDICINE AND ORTHOPEDIC CLINIC ST FRANCIS FAMILY LIFE SERVICES

114 EAST SOUTH HILLS DRIVE MARYVILLE MO 64468

MENTAL HEALTH OUTPATIENT WEST NODAWAY HEALTH CLINIC

221 EAST MAIN STREET BURLINGTON JUNCTION MO 64428

PRIMARY CARE CLINIC PART I, LINE 3C: SSM 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 PERCENTAGE LESS 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%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. TO FURTHER STREAMLINE AND AUTOMATE THE FINANCIAL ASSISTANCE PROCESS, SSM REGIONAL HEALTH SERVICES 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, LINE 6A: SSM 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 2010 ANNUAL COMMUNITY BENEFIT REPORT FOR THE SYSTEM CAN BE FOUND AT WWW.SSMHC.COM. PART I, LINE 7: CHARITY 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 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, L7 COL(F): SSM REGIONAL HEALTH SERVICES HAD BAD DEBT EXPENSE IN THE AMOUNT OF $17,609,214 REPORTED ON PART IX LINE 24 OF THE FORM 990; HOWEVER IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS PART I, LINE 7, COLUMN F. PART II: SSM 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 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.COMMUNITY BUILDING - PHYSICAL IMPROVEMENTS: PROVIDED ACTIVE SUPPORT FOR THE BUILDING OF HOMES FOR LOW-INCOME RESIDENTS OF NODAWAY COUNTY THROUGH THE NODAWAY COUNTY HABITAT FOR HUMANITYCOMMUNITY BUILDING - COALITION BUILDING: PROVIDES LEADERSHIP AND COMMUNICATION RESOURCES TO EFFECT CHANGE FOR HEALTHIER LIFESTYLES THROUGH COLLABORATIVE PARTNERSHIPS WITH COMMUNITY GROUPS TO IMPROVE THE COMMUNITY'S HEALTH. PART III, LINE 4: SSM REGIONAL HEALTH SERVICES IS PART OF THE SSM HEALTH CARE 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 $18,308,151 AT CHARGES AND $8,419,728 AT COST.SSM 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, 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 2010 MEDICARE COST REPORT. PART III, LINE 9B: SSM 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. PART VI, LINE 2: 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 REGIONAL HEALTH SERVICES 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 (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 INITIATIVES, EACH SSM HEALTH CARE HOSPITAL WILL CONDUCT A SEPARATE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TO SUPPORT THE COMPLETION OF A CHNA IN ACCORDANCE WITH ESTABLISHED GUIDELINES, A SIX-STEP PROCESS WAS DEVELOPED. THE PROCESS DEFINES AN APPROACH THAT CAN BE USED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY SSM HEALTH CARE AND DEVELOP STRATEGIES FOR MEETING THOSE NEEDS. THE PROCESS INCLUDES:- DEVELOP A PLAN TO ADDRESS HEALTH REFORM MANDATES TO INCLUDE DEFINING HOW THE ASSESSMENT AND BY WHOM THE ASSESSMENT WILL BE COMPLETED; IDENTIFYING THE STAKEHOLDERS INVOLVED; AND THE TIME FRAME FOR COMPLETION- PERFORM DATA COLLECTION INCLUDING IDENTIFYING THE GEOGRAPHIC AREA SERVED, ACCESSING SECONDARY DATA SOURCES AND COORDINATING INTERVIEWS, SURVEY AND/OR FOCUS GROUPS FOR PRIMARY DATA COLLECTION- PERFORM DATA ANALYSIS BY EVALUATING QUANTITATIVE AND QUALITATIVE DATA TO IDENTIFY AND PRIORITIZE HEALTH NEEDS AND OPPORTUNITIES- CREATE A PLAN WITH GOALS, STRATEGIES, ACTIONS, DUE DATES, AND RESOURCE REQUIREMENTS WHICH INCLUDES INPUT FROM CONSTITUENTS- OBTAIN APPROVAL FROM SYSTEM MANAGEMENT TO BE ADOPTED 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 VI, LINE 3: 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 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: ST MARY'S HEALTH CENTER DEFINES ITS PRIMARY AND SECONDARY SERVICE AREAS AS THE NINE COUNTY AREA INCLUDING CALLAWAY, CAMDEN, COLE, GASCONADE, MARIES, MONITEAU, MILLER, MORGAN AND OSAGE LOCATED IN CENTRAL MISSOURI. THE AREA IS PROJECTED TO HAVE A GROWTH RATE OF 3.5% FROM 2009 TO 2014 WITH CAMDEN COUNTY HAVING THE LARGEST GROWTH RATE OF 6.1% FROM 2009 - 2014. THE MEDIAN AGE IN THE SERVICE IS 38.9 AND THE AVERAGE HOUSEHOLD INCOME IS $55,642. ST FRANCIS HOSPITAL & HEALTH SERVICES IS LOCATED IN MARYVILLE, MISSOURI, IN RURAL NORTHWEST MISSOURI. NODAWAY COUNTY IS THE PRIMARY SERVICE AREA. THE SECONDARY SERVICE ARE INCLUDES THE SURROUNDING COUNTIES OF ANDREW, ATCHISON, HOLT, GENTRY, AND WORTH, MISSOURI AND TAYLOR, IOWA. NODAWAY COUNTY HAS A POPULATION OF 23,370, A 6.7% INCREASE FROM 2000 - 2010. THE MEDIAN HOUSEHOLD INCOME IS $36,677 AND 21% OF THE POPULATION IS BELOW THE 2009 POVERTY LEVEL. THE COUNTY IS PREDOMINATELY WHITE (94.5%). 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 6: SSM 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, MO IN KEEPING WITH AREA SCHOOL DISTRICT WELLNESS PROGRAMS, THE HOSPITAL'S COMMUNITY EDUCATION SPECIALIST AND ONE OF THE LAB PERSONNEL PROVIDED LAB AND BONE DENSITY SCREENINGS FOR TEN AREA SCHOOLS. THESE WERE PROVIDED ON SITE TO REDUCE THE COSTS OF DISTRICT EMPLOYEES TRAVELING TO A MEDICAL FACILITY FOR THE TESTING. IN ADDITION, LAB CHARGES WERE DISCOUNTED. IN 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. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO ST. 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. ST. MARY'S HEALTH CENTER 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 HEALTH CENTER PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $62,166 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 EMERGENCY ROOMS THAT ARE OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY,- HAS OPEN MEDICAL STAFFS 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: SSM REGIONAL HEALTH SERVICES IS A HEALTH CARE NETWORK 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, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN 1 LINCOLN UNIVERSITY 820 CHESTNUT ST JEFFERSON CITY MO 65102 446001089 501(C)(3) 62166 REGISTERED NURSE TRAINING PROGRAM HAITIAN HEALTH FOUNDATION 97 SHERMAN ST NORWICH CT 06360 061135999 501(C)(3) 6000 DISASTER RELIEF CONTRIBUTION JEFFERSON CITY AREA YMCA PO BOX 104176 JEFFERSON CITY MO 65110 430953286 501(C)(3) 10000 CAPITAL CAMPAIGN ROMAN CATHOLIC DIOCESE OF JEFFERSON CITY PO BOX 104900 JEFFERSON CITY MO 65110 440612540 501(C)(3) 16000 PASTORAL CARE SERVICES GRANT NODAWAY COUNTY HABITAT FOR HUMANITY PO BOX 274 MARYVILLE MO 64468 562397352 501(C)(3) 6500 SUPPORT FOR LOCAL HABITAT FOR HUMANITY HOUSE PROJECT ST FRANCIS HOSPITAL FOUNDATION 2016 S MAIN MRYVILLE MO 64468 431099253 501(C)(3) 15000 SUPPORT FOR PURCHASE OF MEDICAL EQUIPMENT HEARTLAND FOUNDATION 518 S 6TH ST JOSEPH MO 64501 431262768 501(C)(3) 6250 SUPPORT HEALTHY COMMUNITIES INITIATIVE ST LOUIS REGIONAL DSH AUTHORITY PO BOX 60 JEFFERSON CITY MO 65102 061642698 501(C)(3) 89105 LOW INCOME MEDICAL CLINIC FUNDING THROUGH MHA MHA CENTER FOR EDUCATION 4712 COUNTRY CLUB DRIVE JEFFERSON CITY MO 65109 430898947 501(C)(3) 18254 SCHOLARSHIP FUNDING THROUGH MHA JEFFERSON CITY PUBLIC SCHOOLS DBA NICHOLS CAREER CENTER 605 UNION STREET JEFFERSON CITY MO 65101 446003078 GOV'T ENTITY 11425 RADIOLOGY TECHNICIAN PROGRAM 9 1 EMPLOYEE ASSISTANCE PROGRAM 140 7810 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. APPROVED GRANT APPLICATIONS FOR GRANTS TO INDIVIDUALS ARE FORWARDED TO THE ORGANIZATION AND PAYMENT IS MADE TO THE APPROPRIATE VENDOR. X 1 1 0 1 0 0 0 0 0 0 0 STEVEN BARNEY 0 486155 0 0 0 89008 0 58965 0 19665 0 653793 0 0 PAULA FRIEDMAN 0 456901 0 0 0 75001 0 176489 0 14645 0 723036 0 0 CHRISTOPHER HOWARD 0 531763 0 0 0 112014 0 190893 0 27742 0 862412 0 0 THOMAS K LANGSTON 0 439665 0 0 0 113190 0 275586 0 28596 0 857037 0 0 PHILLIP GUSTAFSON 0 505622 0 0 0 28709 0 75722 0 27144 0 637197 0 0 DIXIE L PLATT 0 420917 0 0 0 63215 0 164658 0 26138 0 674928 0 0 JAMES M SANGER 0 681794 0 0 0 233117 0 22569 0 17683 0 955163 0 0 WILLIAM P THOMPSON 0 830800 0 0 0 357652 0 585557 0 19865 0 1793874 0 0 KRIS A ZIMMER 0 638080 0 0 0 85902 0 154088 0 26124 0 904194 0 0 MARY STARMANN HARRISON 0 638784 0 0 0 141284 0 226110 0 33589 0 1039767 0 0 JUNE L PICKETT 0 207597 0 0 0 13139 0 163178 0 16209 0 400123 0 0 JOCELYN SKIDMORE 120048 0 0 0 13432 0 67563 0 10692 0 211735 0 0 0 BRIAN DEAN 137860 0 0 0 3142 0 0 0 21010 0 162012 0 0 0 GRAY COX 259416 0 0 0 75136 0 180143 0 31811 0 546506 0 0 0 R BRENT VANCONIA 375406 0 0 0 61105 0 132729 0 31098 0 600338 0 0 0 CATHY NEW 145378 0 0 0 10953 0 114050 0 10621 0 281002 0 0 0 PATRICK HARR MD 349937 0 0 0 49872 0 118691 0 25989 0 544489 0 0 0 SCOTT HOLMAN DO 400254 0 0 0 23175 0 77092 0 26813 0 527334 0 0 0 CATHERINE ABRAMS 215728 0 0 0 10068 0 45067 0 17944 0 288807 0 0 0 JOHN LUCIO DO 244951 0 0 0 3106 0 45854 0 10783 0 304694 0 0 0 SUSAN MANKOSKI 154508 0 0 0 8427 0 46128 0 11653 0 220716 0 0 0 GARF THOMAS 150271 0 0 0 650 0 26997 0 8798 0 186716 0 0 0 THOMAS DISTEFANO MD 951445 0 0 0 34985 0 174501 0 17403 0 1178334 0 0 0 JANE DAWSON MD 435846 0 0 0 19940 0 79532 0 16257 0 551575 0 0 0 DAMIEN MIZERA MD 522426 0 0 0 2566 0 62926 0 31437 0 619355 0 0 0 ARMIT P SINGH 395169 0 0 0 42202 0 59888 0 5312 0 502571 0 0 0 JOHN CROUCH MD 409359 0 0 0 34917 0 73688 0 34506 0 552470 0 0 0 PART I, LINE 1A THE FOLLOWING INDIVIDUALS THAT ARE LISTED ON PART VII OF THE FORM 990 RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2010. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION. PATRICK HARR, MD SCOTT HOLMAN, DO THOMAS DISTEFANO, MD JANE DAWSON, MD ARMIT SINGH JOHN COUCH, MD SUPPLEMENTAL INFORMATION PART III 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 RECEIVED PAYMENTS UNDER THIS PLAN. PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS 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 MARY STARMANN HARRISON $44,302 CHRISTOPHER HOWARD $43,454 KRIS A ZIMMER $42,738 WILLIAM P THOMPSON $37,749 THOMAS LANGSTON $35,357 DIXIE PLATT $33,079 STEVEN BARNEY $55,321 R BRENT VANCONIA $25,570 GRAY COX $18,875 JOCELYN SKIDMORE $12,700 PAULA FRIEDMAN $9,648 CATHY NEW $9,495 JUNE PICKETT $7,123 SUSAN MANKOSKI $5,993 DAMIEN MIZERA MD STUDENT LOAN X 20000 20000 0 0 1 20000 TERI HARR FAMILY MEMBER OF KEY EMPLOYEE 67798 EMPLOYMENT 0 NICOLE MAUGHAN FAMILY MEMBER OF KEY EMPLOYEE 61058 EMPLOYMENT 0 RYAN HOLMAN FAMILY MEMBER OF KEY EMPLOYEE 10283 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. CENTER FOR PLASTIC & RESTORATIVE SURGERY B. COMPREHENSIVE WOUND HEALTH CENTER AT ST. MARY'S C. ST. MARY'S CANCER SPECIALISTS D. ST. MARY'S HEALTH PSYCHOLOGY E. ST. MARY'S HOLTS SUMMIT PHARMACY F. ST. MARY'S MEDICAL CLINIC - BELLE G. ST. MARY'S MEDICAL CLINIC - ELDON H. ST. MARY'S MEDICAL CLINIC - HOLTS SUMMIT I. ST. MARY'S MEDICAL CLINIC - LINN J. ST. MARY'S MEDICAL CLINIC - TIPTON K. ST. MARY'S MEDICAL CLINIC - VERSAILLES I. ST. MARY'S MEDICAL CLINIC - WESTPHALIA M. ST. MARY'S MEDICAL PLAZA PHARMACY N. ST. MARY'S OCCUPATIONAL MEDICINE O. ST. MARY'S PEDIATRICS P. ST. MARY'S REHABILITATION Q. ST. MARY'S SLEEP CENTER R. ST. MARY'S SPORTS MEDICINE & REHABILITATION CENTER S. ST. MARY'S TIPTON PHARMACY T. ST. MARY'S URGENT CARE AT THE LAKE U. ST. MARY'S WESTPHALIA PHARMACY V. THE VASCULAR INSTITUTE AT ST. MARY'S PROGRAM SERVICE STATEMENT FORM 990, PART III LINE 4A, DESCRIPTION OF PROGRAM SERVICE: THE COMMUNITY BENEFIT CONTRIBUTION OF SSM REGIONAL HEALTH SERVICES INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1: QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE CORPORATION'S COMMUNITY BENEFIT MISSION, HOW THE MISSION IS TRANSLATED INTO A PROACTIVE APPROACH DESIGNED TO MEET COMMUNITY HEALTH NEEDS, HOW THE CORPORATION MEETS TAX-EXEMPT REQUIREMENTS, AND A DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT HIGHLIGHT THE CORPORATION'S IMPACT ON COMMUNITY HEALTH. SECTION 2: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE CORPORATION'S COMMUNITY BENEFIT CONTRIBUTION IN FINANCIAL TERMS PRESENTING THE AMOUNT OF CHARITY CARE, THE UNPAID SHORTFALL FROM GOVERNMENT HEALTH CARE FOR THE INDIGENT, AND THE NET EXPENSE OF COMMUNITY BENEFIT SERVICES. SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT 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 OPERATES 16 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 5,000 PHYSICIANS. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMHC STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. B. SUMMARIZE THE CORPORATION'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 ORGANIZATIONS, 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 STUDIES WITH UTILIZATION QUESTIONS, AS WELL AS VITAL MARKET DATA, TO ASSESS COMMUNITY NEED ON A ANNUAL BASIS. FOR INSTANCE, WE UTILIZE HIDI MARKETING DATA TO ASSESS PROMINENT DISEASE CATEGORIES BY AGE AND GENDER IN OUR NINE COUNTY SERVICE AREA TO DETERMINE THE MOST EFFECTIVE OUTREACH FOR THE UNDERSERVED. FOCUS GROUPS ARE ALSO USED FOR OUR MAJOR SERVICE LINES. ST. MARY'S PARTICIPATES IN COMMUNITY NEEDS ASSESSMENTS, SUCH AS THE INITIATIVES WITH THE COMMUNITY HEALTH CENTER (FREE MEDICAL CLINIC), COLE COUNTY DEPARTMENT OF HEALTH, AND JEFFERSON CITY PUBLIC SCHOOLS (CHILDHOOD OBESITY). C. DESCRIBE THE CORPORATION'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. 2. 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. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS ST. FRANCIS HOSPITAL AND HEALTH SERVICES - MARYVILLE, MO IN KEEPING WITH AREA SCHOOL DISTRICT WELLNESS PROGRAMS, THE HOSPITAL'S COMMUNITY EDUCATION SPECIALIST AND ONE OF THE LAB PERSONNEL PROVIDED LAB AND BONE DENSITY SCREENINGS FOR TEN AREA SCHOOLS. THESE WERE PROVIDED ON SITE TO KEEP DOWN THE COSTS OF DISTRICT EMPLOYEES TRAVELING TO A MEDICAL FACILITY FOR THE TESTING. ADDITIONALLY, LAB CHARGES WERE DISCOUNTED. IN 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. ST. MARY'S HEALTH CENTER - JEFFERSON CITY, MO ST. 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. ST. MARY'S HEALTH CENTER 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 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 HEALTH CENTER PARTNERS WITH LINCOLN UNIVERSITY BY DONATING $62,166 TO THE NURSING PROGRAM AS WELL AS PROVIDING A CLINICAL SETTING FOR THE RN STUDENTS TO LEARN. 4. LINK TO ADDITIONAL COMMUNITY BENEFIT INFORMATION ADDITIONAL INFORMATION REGARDING SSMHC'S 2009 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.SSMHC.COM. SECTION 2 - 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 $4,078,357 UNPAID COST OF MEDICARE $7,516,831 UNPAID COST OF MEDICAID $3,354,396 COST OF BAD DEBT $8,419,728 COMMUNITY BENEFIT PROGRAMS $ 751,681 TOTAL $24,120,983 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 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 GAINS ON INVESTMENTS: 1,193,344. BENEFICIAL INTEREST IN FOUNDATION 1,079,714. TRANSFERS TO AFFLIATES -40,692. TOTAL TO FORM 990, PART XI, LINE 5: 2,232,366. 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 SSMHCS 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 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 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 477 N LINDBERGH BLVD ST LOUIS MO 63141 430738490 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE ST LOUIS 0 GLENNON HOSPITAL GUILD 477 N LINDBERGH BLVD ST LOUIS MO 63141 431030299 FUNDRAISING MO 501(C)(3) LINE 9 SSM CARDINAL GLENNON HOSPITAL 0 CARDINAL GLENNON CHILDREN'S FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431754347 FUNDRAISING MO 501(C)(3) LINE 7 SSM CARDINAL GLENNON 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 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 OK 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 WI 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 0 ST MARY'S HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 431575307 FUNDRAISING MO 501(C)(3) LINE 11B, II SSM REGIONAL HEALTH SERVICES 0 ST MARY'S HOSPITAL 477 N LINDBERGH BLVD ST LOUIS MO 63141 370662580 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER 477 N LINDBERGH BLVD ST LOUIS MO 63141 430653587 HEALTH CARE IL 501(C)(3) LINE 3 SSM REGIONAL HEALTH SERVICES 0 ST MARY'S - GOOD SAMARITAN INC 477 N LINDBERGH BLVD ST LOUIS MO 63141 364170833 HEALTH CARE IL 501(C)(3) LINE 11A, I SSM REGIONAL HEALTH SERVICES 0 GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 262884795 FUNDRAISING IL 501(C)(3) LINE 7 ST MARY'S - GOOD SAMARITAN 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 0 SSM HEALTH BUSINESSES 477 N LINDBERGH BLVD ST LOUIS MO 63141 431333488 HEALTH CARE MO 501(C)(3) LINE 3 SSM HEALTH CARE CORPORATION 0 SSM HOSPICE & HOME CARE FOUNDATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 300012246 FUNDRAISING MO 501(C)(3) LINE 7 SSM HEALTH BUSINESSES 0 CENTRALIA MEDICAL SERVICES BLDG ASSOC 477 N LINDBERGH ST LOUIS MO 63141 237408025 HEALTH CARE IL 501(C)(3) LINE 11B, II SSM REGIONAL HEALTH SERVICES 0 ST MARY'S JANESVILLE FOUNDATION INC 2901 LANDMARK PL STE 300 MADISON WI 53713 273439133 FUNDRAISING WI 501(C)(3) LINE 7 SSM HEALTH CARE OF WISCONSIN 0 FRANCISCAN SISTERS OF MARY 1100 BELLEVUE AVE ST LOUIS MO 63117 431012492 RELIGIOUS ORGANIZATION MO 501(C)(3) LINE 1 N/A 0 LEE DEWEY CORPORATION 477 N LINDBERGH BLVD ST LOUIS MO 63141 731279603 MOB OK 501(C)(3) LINE 11A, I SSM HEALTH CARE OF OKLAHOMA 0 HEALTH CARE FOR KIDS 4055 LINDELL BLVD ST LOUIS MO 63108 431620093 HEALTH CARE MO 501(C)(3) LINE 3 SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 0 SSM SJ ENDOSCOPY 477 N LINDBERGH BLVD ST LOUIS MO 63141 270046559 SURGERY SERVICES MO N/A SSMCDI IMAGING 5775 WAYZATA BOULEVARD SUITE 400 ST LOUIS PARK MN 55416 263791858 IMAGING SERVICES MO N/A SSM SELECT REHAB 4716 OLD GETTYSBURG ROAD MECHANICSBURG PA 17055 263694972 HEALTH CARE MO N/A SA MT AMB SRUG 110 N LEE OKLAHOMA CITY OK 73103 731528341 SURGERY SERVICES OK N/A ST ANTHONY HOSPITAL CARDIOVASCULAR SERVICES 477 N LINDBERGH BLVD ST LOUIS MO 63141 760825755 HEALTH CARE OK N/A B&J MB OFF BUILD 1000 N LEE OKLAHOMA CITY OK 73103 731533449 MOB OK N/A B&J MANAGEMENT 1000 N LEE STREET OKLAHOMA CITY OK 73102 364645813 MANAGEMENT OK N/A WIITTS LLC 2901 LANDMARK PLACE SUITE 300 MADISON WI 53713 392016715 MED. INF. SYSTEMS WI N/A SHARED IMAGING SERVICES 915 17TH STREET PRAIRIE DU SAC WI 53578 391971378 DIAG. SERVICES WI N/A ST CLARE IMAGING SERVICES 707 14TH STREET SUITE A BARABOO WI 53913 200122365 DIAG. SERVICES WI N/A MEADOW RIDGE 1402 PANKRATZ STREET SUITE 110 MADISON WI 53704 391991403 ASST. LIVING WI N/A DEAN HEALTH HOLD 1277 DEMING WAY MADISON WI 53717 261594709 IT SERVICES WI N/A MV RAD THERAPY 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 223296 201359 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 181515 176128 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 301498 85522 0 1 0.50000 CHOWSMGSI 605 N 12TH STREET MOUNT VERNON IL 62864 371383861 MOB MO N/A COMP CANCER CARE 477 N LINDBERGH BLVD ST LOUIS MO 63141 201382727 MOB IL N/A CLASSEN ASSOCIATES 110 N CLASSEN OKLAHOMA CITY OK 73106 731158158 MOB OK N/A M&C REALTY 1603 WENTZVILLE PARKWAY STE 121 WENTZVILLE MO 63385 621851447 MOB MO N/A SURG CNTR MW CITY 8121 NATIONAL AVE SUITE 108 MIDWEST CITY OK 73110 232697171 SURGERY SERVICES OK N/A SSM WELLBRIDGE 6140 GREENWOOD PLAZA BLVD GREENWOOD VILLAGE CO 80111 431794814 FITNESS CENTER MO N/A MIA OF ST CHARLES 132 NORTH KANSAS ST ROOM 212 EDWARDSVILLE IL 62025 422125740 DIAG. 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