4A (Expenses $ 296532867 including grants of $ 0) (Revenue $ 345576913)
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 $ 17850950.

"SCHEDULE H, PART I, QUESTION 3BELIGIBILITY FOR DISCOUNTED CARESSM HEALTH CARE OF OKLAHOMA 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%SCHEDULE H, PART I, QUESTION 3COTHER CRITERIA FOR FREE OR DISCOUNTED CAREAN 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 OF OKLAHOMA 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"". SCHEDULE H, PART I, QUESTION 6ACOMMUNITY BENEFIT REPORTINGSSM HEALTH CARE OF OKLAHOMA 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.SCHEDULE H, PART I, QUESTION 7DESCRIPTION OF COSTING METHODOLOGYCHARITY 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. SCHEDULE H, PART IICOMMUNITY BUILDING ACTIVITIESSSM HEALTH CARE OF OKLAHOMA 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 & PHYSICAL IMPROVEMENTS: PARTICIPATE IN REBUILDING TOGETHER WITH USE OF STAFF TO IMPROVE/REPAIR HOMES OF LOW INCOME ELDERLY PERSONS IN THE COMMUNITY.COMMUNITY BUILDING & WORKFORCE DEVELOPMENT: EDUCATE AND INFORM PHARMACY STUDENTS OF OPPORTUNITIES AND BENEFITS OF WORKING IN THE HOSPITAL SETTING."

"SCHEDULE H, PART III, SECTION A, LINE 4BAD DEBT EXPENSESSM HEALTH CARE OF OKLAHOMA 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 $35,509,978 AT CHARGES AND $12,290,213 AT COST.SSM HEALTH CARE OF OKLAHOMA DID NOT MAKE AN ESTIMATE OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.SCHEDULE H, PART III, SECTION B, LINE 8MEDICARE SHORTFALL INCLUDED IN COMMUNITY BENEFIT 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 OF OKLAHOMA 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. SCHEDULE H, PART III, SECTION C, LINE 9BCOLLECTION PRACTICESSSM HEALTH CARE OF OKLAHOMA 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 OF OKLAHOMA'S COLLECTION AND CHARITY POLICIES.SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT PROCESSTHE ANNUAL STRATEGIC, FINANCIAL, AND HUMAN RESOURCES PLANNING PROCESS HAS INCLUDED AN ASSESSMENT OF THE COMMUNITY'S NEEDS TO INCLUDE THE IDENTIFICATION OF SPECIFIC AND MEASUREABLE HEALTHY COMMUNITIES' INITIATIVES. HEALTHY COMMUNITIES' INITIATIVES DEMONSTRATE THE LEADERSHIP ROLE THAT SSM HEALTH CARE OF OKLAHOMA 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 HEALTHADDITIONALLY, ST. ANTHONY AND BONE AND JOINT HOSPITAL AT ST. ANTHONY PARTICIPATE IN CENTRAL OKLAHOMA TURNING POINT, A NATIONAL PROGRAM TO PROMOTE LOCAL HEALTH INITIATIVES BY BUILDING HEALTHY COMMUNITIES THROUGH PUBLIC/PRIVATE PARTNERSHIPS. BONE AND JOINT HOSPITAL AT ST. ANTHONY COLLABORATES WITH STATE AGENCIES, HEALTHCARE PROVIDERS, AND EDUCATION AND BUSINESS LEADERS. BECAUSE OF ITS SPECIALTY HOSPITAL STATUS, BONE AND JOINT HOSPITAL AT ST. ANTHONY FOCUSES ON AREAS WHERE IT CAN MAKE AN IMPACT AND AS A RESULT, HAS CHOSEN OSTEOPOROSIS PREVENTION AS ITS COMMUNITY INITIATIVE."

"SCHEDULE H, PART VI, LINE 3PATIENT 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.SCHEDULE H, PART VI LINE 4COMMUNITY INFORMATIONSSM HEALTH CARE OF OKLAHOMA'S MARKET IS DEFINED BY ITS PRIMARY AND SECONDARY SERVICE AREA. THE PRIMARY SERVICE AREA INCLUDES OKLAHOMA, CANADIAN, CLEVELAND AND POTTAWATOMIE COUNTIES, AND THE SECONDARY MARKET IS COMPRISED OF 11 RURAL COUNTIES SURROUNDING OKLAHOMA CITY, OKLAHOMA. THE TOTAL POPULATION OF THE PRIMARY AND SECONDARY MARKET IS APPROXIMATELY 1.5 MILLION. THE PRIMARY SERVICE AREA EXPERIENCED AN AVERAGE POPULATION PERCENT INCREASE FROM 2000 TO 2010 OF 17%. THE AVERAGE HOUSEHOLD INCOME IS $49,123 WITH 13% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL. ST. ANTHONY PROVIDES GENERAL, TERTIARY ACUTE CARE SERVICES INCLUDING CARDIOLOGY, ONCOLOGY, BEHAVIORAL MEDICINE, SURGERY, KIDNEY TRANSPLANTATION, AND A VARIETY OF OTHER DISCIPLINES. ST. ANTHONY HAS BROUGHT MANY ""FIRSTS"" TO HEALTH CARE IN OKLAHOMA (FIRST ICU, FIRST KIDNEY TRANSPLANT, FIRST NEUROSURGICAL INSTITUTE), INCLUDING BRINGING THE STATE'S ONLY CYBERKNIFE TECHNOLOGY TO OKLAHOMANS. BONE AND JOINT HOSPITAL AT ST. ANTHONY IS UNIQUE IN THAT THE HOSPITAL, PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS ARE COMMITTED SOLELY TO ORTHOPEDIC CARE. OUR STAFF OFFERS A RANGE OF ORTHOPEDIC SERVICES INCLUDING HIP AND KNEE REPLACEMENT, SPINE SURGERY, PAIN MANAGEMENT, SPORTS MEDICINE, ARTHROSCOPIC PROCEDURES, FOOT AND ANKLE SURGERY, HAND SURGERY, AND ROBOTIC SURGERY.THROUGH SAINTS MEDICAL GROUP, SSM HEALTH CARE OF OKLAHOMA PROVIDES PRIMARY CARE PHYSICIANS IN FAMILY MEDICINE, INTERNAL MEDICINE AND PEDIATRICS. SPECIALTY SERVICE LINES INCLUDE CARDIOLOGY, DERMATOLOGY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, PULMONARY, THORACIC SURGERY, VASCULAR SURGERY, DIAGNOSTIC/MEDICAL TESTING SERVICES, AND A OCCUPATIONAL HEALTH NETWORK.SCHEDULE H, PART VI LINE 5PROMOTION OF COMMUNITY HEALTHSSM HEALTH CARE'S MISSION STATEMENT IS ""THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD."" SSM HEALTH CARE OF OKLAHOMA 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:BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS COMMUNITY EDUCATION AND SCREENING OPPORTUNITIES TO AREA ORGANIZATIONS AND THE GENERAL PUBLIC. SPECIAL ATTENTION IS GIVEN TO ENSURE THAT DIVERSE GROUPS OF THE LOCAL POPULATION ARE IDENTIFIED AND PROVIDED WITH EDUCATIONAL/SCREENING OPPORTUNITIES.BONE AND JOINT HOSPITAL AT ST. ANTHONY OFFERS ONGOING COMMUNITY EDUCATION REGARDING OSTEOARTHRITIS, OSTEOPOROSIS, SPINE PAIN AND OTHER ORTHOPEDIC-RELATED TOPICS. THE CLASSES ARE FREE OF CHARGE AND FEATURE A BONE AND JOINT HOSPITAL AT ST. ANTHONY PHYSICIAN WHO DONATES HIS TIME FOR THE SEMINARS.BONE AND JOINT HOSPITAL AT ST. ANTHONY PARTICIPATES IN HEALTH FAIRS WHERE FREE BONE DENSITY SCREENINGS ARE OFFERED. THROUGH THE FREE CLINIC, CROSS AND CROWN, BONE AND JOINT HOSPITAL AT ST. ANTHONY PROVIDED FREE X-RAY SERVICES TO 14 UNINSURED INDIVIDUALS REFERRED TO US BY THE CLINIC IN 2010. FURTHER, BONE AND JOINT HOSPITAL AT ST. ANTHONY SUPPORTS THE EFFORTS OF THE ARTHRITIS FOUNDATION BY SUPPORTING FUNDRAISING AND AWARENESS EFFORTS INCLUDING BEING THE TITLE SPONSOR OF THE LOCAL CHAPTER'S ANNUAL ARTHRITIS WALK. ST. ANTHONY HOSPITAL SPONSORED VARIOUS EDUCATIONAL EVENTS INCLUDING ITS ANNUAL STROKE OF COURAGE PROGRAM TO RAISE STROKE AWARENESS AND ITS CELEBRITY CHEF EVENT TO PROMOTE HEART HEALTHY EATING. THE HOSPITAL AND ITS EMPLOYEES PARTICIPATE IN REBUILDING TOGETHER TO REHABILITATE A HOME FOR AN INDIVIDUAL WITHIN THE COMMUNITY WHO DOES NOT HAVE THE MEANS TO MAKE NECESSARY REPAIRS TO ENSURE A SAFE, WARM HOME. ST. ANTHONY ALSO PROVIDED SUPPLIES TO BENEFIT LITTLE FLOWER CLINIC THAT PROVIDES CARE TO THE UNDERSERVED IN ITS COMMUNITY IN 2010.ADDITIONALLY, NUMEROUS SUPPORT GROUPS, CHILDBIRTH CLASSES, MEDIA HEALTH INFORMATION STORIES, SEMINARS ON A RANGE OF HEALTHY TOPICS, HEALTH FAIRS AND HEALTH PROFESSIONALS PROVIDE SUBSTANTIAL BENEFIT TO THE COMMUNITY. IN 2010, THE HOSPITAL INTRODUCED THE MIDTOWN MARKET AT SAINTS, A COMMUNITY LOCAL FOOD FARMERS' MARKET HOSTED WEEKLY ON THE HOSPITAL CAMPUS FROM MAY THROUGH OCTOBER. IT ALSO SPONSORED OTHER EVENTS TO SUPPORT COMMUNITY HEALTH AND FITNESS INCLUDING THE DOWNTOWN DASH (3RD YEAR TO SPONSOR) AND REDBUD CLASSIC (THE 29TH YEAR TO SPONSOR) AS WELL AS THE AMERICAN HEART ASSOCIATION HEART WALK. THE HOSPITAL WEBSITE, SAINTSOK.COM, PROVIDES HEALTH INFORMATION USEFUL TO THE COMMUNITY THROUGH A COMPILATION OF HEALTH EDUCATION TOPICS, HEALTH RISK APPRAISALS, AND OTHER TOOLS DESIGNED TO ASSIST INDIVIDUALS WITH HEALTH CONCERNS AND ENCOURAGE A HEALTHIER LIFESTYLE. THESE SERVICES ARE IN ADDITION TO THE TRADITIONAL CHARITY CARE PROVIDED CONSISTENT WITH THE HOSPITAL'S MISSION. SSM HEALTH CARE OF OKLAHOMA 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 SCHEDULE H, PART VI LINE 6AFFILIATED HEALTH CARE SYSTEMSSM HEALTH CARE OF OKLAHOMA IS A HEALTH CARE NETWORK THAT ENCOMPASSES SSM HEALTH CARE FACILITIES IN OKLAHOMA. THIS CONSISTS OF TWO HOSPITALS IN OKLAHOMA CITY, BONE AND JOINT HOSPITAL AT ST ANTHONY AND ST ANTHONY HOSPITAL AND A PHYSICIAN ORGANIZATION, SAINTS MEDICAL GROUP. SSMOK IS SPONSORED BY THE FRANCISCAN SISTERS OF MARY AND IS OWNED AND OPERATED BY SSM HEALTH CARE (SSMHC) BASED IN ST. LOUIS, MISSOURI."

SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORTTHE SSM HEALTH CARE ANNUAL CONSOLIDATED COMMUNITY BENEFIT REPORT IS FILED IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN.