4A (Expenses $ 996737131 including grants of $ 350386) (Revenue $ 1096690700)
SEE SCHEDULE O

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: