4A (Expenses $ 913343620 including grants of $ 993099) (Revenue $ 907782568)
PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS.

Schedule H, Part V, Section B, Line 3E
THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.

Schedule H, Part V, Section B, Line 5 Facility A, 1
"Facility A, 1 - SSM Health St. Anthony Hospital - Oklahoma City. We began the CHNA process with a review of the previous CHNA report and gathered feedback from internal and external stakeholders. Public Health and Population Based Data Sources The secondary data indicators included in this CHNA were based on the top health priority areas identified by the 2021 Oklahoma City-County Wellness Score completed by the Oklahoma City-County Health Department. Throughout the iterative process, indicators were also included if they related to one of the four main priority areas or themes identified through the qualitative data from the stakeholder meetings and community chats. Data representing the most recent year available are reported for all sources. We reviewed approximately 100 indicators including health outcomes and associated health factors for Oklahoma County residents. Indicators included demographic data, mortality data, economic and social factors, education, built environment, and health care access and quality. All indicators were assessed through the lens of health equity, keeping in mind the social determinants of health. We assembled a group of 65 community stakeholders representing 45 organizations including health care providers, social service providers, foundations, chambers of commerce, community development and finance organizations, education and employment training services, government services, transportation services, food and food security services, and elected officials. Populations experiencing health inequities were represented throughout the various stakeholder organizations involved. We presented a comprehensive overview of health indicator findings for Oklahoma County, and used a ""real time"" survey process to engage stakeholders and assess their views on the greatest factors for poor health outcomes in Oklahoma County. Stakeholder Meeting We assembled a group of 65 community stakeholders representing 45 organizations including health care providers, social service providers, foundations, chambers of commerce, community development and finance organizations, education and employment training services, government services, transportation services, food and food security services, and elected officials. Populations experiencing health inequities were represented throughout the various stakeholder organizations involved. We presented a comprehensive overview of health indicator findings for Oklahoma County, and used a ""real time"" survey process to engage stakeholders and assess their views on the greatest factors for poor health outcomes in Oklahoma County. Convenience Sample Survey We used the findings from the stakeholder meeting to create a community survey to collect information from Oklahoma County residents. To create the community survey, we contacted the Robert Wood Johnson Foundation for examples of surveys from other states that were successful in gathering information related to social determinants of health. We also considered questions from the Behavioral Risk Factor Surveillance Survey and other surveys. Through our partnership with the Oklahoma City- ounty Health Department, we utilized COVID-19 vaccination events to collect surveys. In addition, we enlisted the help of our stakeholders to send targeted emails to specific population groups. Surveys were made available in English and Spanish. After exclusion of incomplete surveys and those with a ZIP code outside of Oklahoma County, we had a final sample size of 956. Although this was not a probability sample, the demographics of the survey respondents are comparable to that of Oklahoma County with a few exceptions. To make the results more generalizable to Oklahoma County, we used post-stratification weighting. We used the American Community Survey to create benchmark totals for the following variables: Age, Sex, and Race. The survey questionnaire and full results are available in Appendix B. We facilitated sixteen ""Community Chats"" in the form of guided community chats to delve deeper into how people experience each of the four priority topic areas. We created facilitation guides for each priority topic to collect information on personal experiences, barriers to access, community perceptions, and opportunities to improve conditions in the community. Each Community Chat was moderated by a staff member from one of the partner health systems. As an expression of this CHNA's emphasis on health equity, we used intentional recruiting strategies to ensure Community Chat participants were representative of underserved members of the community. These strategies included partnering with charity clinics to recruit and host the conversations using a purposive, snowball sampling approach to recruit participants, and providing small giftcard incentives for participation. Our partners in recruitment included the Oklahoma City and Millwood Public School Districts, Good Shepherd Clinic, Crossings Community Clinic, Hilltop Clinic, Mary Mahoney Health Center, and the Health Alliance for the Uninsured. We were intentional about inviting Community Health Workers, frontline public health workers who are trusted members of the community, and those with lived and/or shared experiences of the underserved populations in Oklahoma County. Between May 23 and June 30, 2021, 111 participants engaged in 16 Community Chats: 4 on Health Care Access, 4 on Food Access, 3 on Education and 5 on Employment. All sessions were recorded, and audio files were anonymously transcribed to text documents. Text documents were uploaded to the qualitative data analysis software tool ""Dedoose"" for coding. Dedoose is a web-based program that allowed the researchers to organize and analyze research data into text formats for quantitative and qualitative data and facilitated mixed methods research output."

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - SSM Health St. Anthony Hospital - Oklahoma City. The hospital facility completed a joint 2021 CHNA with Integris Health, Mercy Hospital Oklahoma City, OU Health, and St. Anthony Hospital - Midwest.

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - SSM Health St. Anthony Hospital - Oklahoma City. The hospital facility completed a joint 2021 CHNA with the Oklahoma City-County Health Department.

Schedule H, Part V, Section B, Line 11 Facility A, 1
"Facility A, 1 - SSM Health St. Anthony Hospital - Oklahoma City. The hospital identified various health needs in the 2021 CHNA. In order to make meaningful impact, and to use its finances most effectively and efficiency, the hospital will place primary focus on the following key priorities: - Access to care - Access to healthy food - Education & employment Access to care Financial barriers and lack of insurance were the most significant barriers to accessing care identified during the CHNA. In Oklahoma County, the hypertension mortality rate was above the national age-adjusted death rate, as was the percentage of people who use tobacco products. Regular and reliable access to health services can increase quality of life and detect and treat preventable health conditions. Because of its urban setting, St. Anthony Hospital -Oklahoma City is uniquely positioned to support programs designed to address health needs of the city's homeless population. The hospital's action plan includes the following initiatives to improve access to care in the community served: - Partner with Cardinal Community House to provide respite care for patients experiencing homelessness. The respite shelter at Cardinal Community House provides patients a safe, medically appropriate environment to rest and heal after a hospitalization. Participants receive case management services, meals, and medication assistance. St. Anthony and Cardinal Community House will evaluate patient outcomes and readmission rates. - Partner with Mental Health Association Oklahoma to pilot a Street Medicine Team to provide care for persons experiencing homelessness in Oklahoma City. The team will provide primary care, mental health, and other support for people living on the streets. The OKC Street Medicine team will begin serving the city in 2022. - Launch Health Coaches for Hypertension classes in Oklahoma City. This is an eight-week course designed to improve hypertension self-management through group educational sessions and support offered by a trained health coach. Goal to conduct one cohort per quarter and reported program outcomes quarterly. - Utilize the Health Alliance for the Uninsured's Care Navigation program to provide successful referrals to community organizations for vulnerable patients. This program is a central hub for basic health, vision, dental, and social services to improve individual health outcomes. - Provide training for the hospital Case Management team on how to utilize the program and track monthly referrals. - Continue to provide support for Catholic Charities of the Archdiocese of Oklahoma City to offer counseling services in 6 vulnerable south Oklahoma City zip codes. - Provide community-based organizations with financial support for their work in addressing access to care in Oklahoma City Hospital goals for access to care are to: - Decrease the cardiovascular disease mortality rate in Oklahoma County from 281 per 100,000 (2016-2018 average, see page 8 of CHNA) - Decrease the hypertension mortality rate in Oklahoma County from 53 per 100,000 (2016-2018 average, see page 50 of CHNA) - Decrease the overall mortality rate for Oklahoma County of 932.6 deaths per 100,000 (2016-2018, see page 48 of CHNA) Access to healthy food 14% of Oklahoma County residents are food insecure. Food insecurity has an impact on a community's socioeconomic and health status. A healthy diet is difficult without access to nutritious food. The hospital's action plan includes the following initiatives to address a lack of access to healthy food: - Continue food insecurity screenings and the Food Pharmacy program at Family Medicine Center. - Commit FMC staff time to screen and distribute fresh produce and food boxes - Report the number of families served and evaluate the percentage of patients who access community food pantries and SNAP benefits using the resources included in the food boxes - Continue to sponsor the Backpacks for Kids program at Rockwood Elementary. Regional Food Bank of Oklahoma's Backpacks for Kids program provides children with food access issues food for the weekends when the schools cannot feed them. - Ongoing utilization of land, utilities, and financial support for the 8th Street Urban Farm. The 8th Street Urban Farm is located on the St. Anthony campus and operated by the Midtown Community Development Foundation. The farm was established in 2021. A portion of the harvested produce is distributed to Family Medicine Center patients as a supplement to the Food Pharmacy program. - Provide community-based organizations with financial support towards work in addressing food insecurity in Oklahoma City. Hospital goals for access to health food are to: - Decrease the heart disease mortality rate in Oklahoma County from 22.9 deaths per 100,000 (2016-2018, see page 50 of the CHNA) - Increase knowledge and encourage sustained behavior change as healthy foods are introduced from 8th Street Urban Farm - Increase the percentage of Oklahoma County residents who have access to healthy food for their family (see page 78 of CHNA) Education & Employment SSM Health is a proud member of the Healthcare Anchor Network. Members of the Healthcare Anchor Network commit to use their role as an ""Anchor Institution"" in their community to address the structural disparities that affect equitable health outcomes. In 2022 the entire SSM Health system, including St. Anthony Hospital -Oklahoma City, will begin to formulate a strategy to support the creation of equitable employment opportunities for marginalized community members. Local health ministries will determine whether to begin with a strategy focused on supply chain practices (making strategic purchasing decisions that support local and minority-owned/operated businesses) or job-training and hiring practices that increase access to meaningful employment in historically underserved segments of our local community. St. Anthony Hospital - Oklahoma City looks forward to participating in the Anchor Network strategy and believes that it presents an opportunity for a systemic response to the education and employment priorities identified in the Oklahoma County CHNA. The hospital has no plans to discontinue other community benefit efforts addressing the remaining CHNA-identified needs."

Schedule H, Part V, Section B, Line 2
SSM Health St. Anthony Hospital - Midwest was purchased by SSM Health Care of Oklahoma, Inc., in April 2021.

Schedule H, Part V, Section B, Line 3E
THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.

Schedule H, Part V, Section B, Line 5 Facility B, 1
"Facility B, 1 - SSM Health St. Anthony Hospital - Midwest. We began the CHNA process with a review of the previous CHNA report and gathered feedback from internal and external stakeholders. Public Health and Population Based Data Sources The secondary data indicators included in this CHNA were based on the top health priority areas identified by the 2021 Oklahoma City-County Wellness Score completed by the Oklahoma City-County Health Department. Throughout the iterative process, indicators were also included if they related to one of the four main priority areas or themes identified through the qualitative data from the stakeholder meetings and community chats. Data representing the most recent year available are reported for all sources. We reviewed approximately 100 indicators including health outcomes and associated health factors for Oklahoma County residents. Indicators included demographic data, mortality data, economic and social factors, education, built environment, and health care access and quality. All indicators were assessed through the lens of health equity, keeping in mind the social determinants of health. We assembled a group of 65 community stakeholders representing 45 organizations including health care providers, social service providers, foundations, chambers of commerce, community development and finance organizations, education and employment training services, government services, transportation services, food and food security services, and elected officials. Populations experiencing health inequities were represented throughout the various stakeholder organizations involved. We presented a comprehensive overview of health indicator findings for Oklahoma County, and used a ""real time"" survey process to engage stakeholders and assess their views on the greatest factors for poor health outcomes in Oklahoma County. Stakeholder Meeting We assembled a group of 65 community stakeholders representing 45 organizations including health care providers, social service providers, foundations, chambers of commerce, community development and finance organizations, education and employment training services, government services, transportation services, food and food security services, and elected officials. Populations experiencing health inequities were represented throughout the various stakeholder organizations involved. We presented a comprehensive overview of health indicator findings for Oklahoma County, and used a ""real time"" survey process to engage stakeholders and assess their views on the greatest factors for poor health outcomes in Oklahoma County. Convenience Sample Survey We used the findings from the stakeholder meeting to create a community survey to collect information from Oklahoma County residents. To create the community survey, we contacted the Robert Wood Johnson Foundation for examples of surveys from other states that were successful in gathering information related to social determinants of health. We also considered questions from the Behavioral Risk Factor Surveillance Survey and other surveys. Through our partnership with the Oklahoma City- ounty Health Department, we utilized COVID-19 vaccination events to collect surveys. In addition, we enlisted the help of our stakeholders to send targeted emails to specific population groups. Surveys were made available in English and Spanish. After exclusion of incomplete surveys and those with a ZIP code outside of Oklahoma County, we had a final sample size of 956. Although this was not a probability sample, the demographics of the survey respondents are comparable to that of Oklahoma County with a few exceptions. To make the results more generalizable to Oklahoma County, we used post-stratification weighting. We used the American Community Survey to create benchmark totals for the following variables: Age, Sex, and Race. The survey questionnaire and full results are available in Appendix B. We facilitated sixteen ""Community Chats"" in the form of guided community chats to delve deeper into how people experience each of the four priority topic areas. We created facilitation guides for each priority topic to collect information on personal experiences, barriers to access, community perceptions, and opportunities to improve conditions in the community. Each Community Chat was moderated by a staff member from one of the partner health systems. As an expression of this CHNA's emphasis on health equity, we used intentional recruiting strategies to ensure Community Chat participants were representative of underserved members of the community. These strategies included partnering with charity clinics to recruit and host the conversations using a purposive, snowball sampling approach to recruit participants, and providing small giftcard incentives for participation. Our partners in recruitment included the Oklahoma City and Millwood Public School Districts, Good Shepherd Clinic, Crossings Community Clinic, Hilltop Clinic, Mary Mahoney Health Center, and the Health Alliance for the Uninsured. We were intentional about inviting Community Health Workers, frontline public health workers who are trusted members of the community, and those with lived and/or shared experiences of the underserved populations in Oklahoma County. Between May 23 and June 30, 2021, 111 participants engaged in 16 Community Chats: 4 on Health Care Access, 4 on Food Access, 3 on Education and 5 on Employment. All sessions were recorded, and audio files were anonymously transcribed to text documents. Text documents were uploaded to the qualitative data analysis software tool ""Dedoose"" for coding. Dedoose is a web-based program that allowed the researchers to organize and analyze research data into text formats for quantitative and qualitative data and facilitated mixed methods research output."

Schedule H, Part V, Section B, Line 6a Facility B, 1
Facility B, 1 - SSM Health St. Anthony Hospital - Midwest. The hospital facility completed a joint 2021 CHNA with Integris Health, Mercy Hospital Oklahoma City, OU Health, and St. Anthony Hospital - Oklahoma City.

Schedule H, Part V, Section B, Line 6b Facility B, 1
Facility B, 1 - SSM Health St. Anthony Hospital - Midwest. The hospital facility completed a joint 2021 CHNA with the Oklahoma City-County Health Department.

Schedule H, Part I, Line 3c DISCOUNTED CARE EXCEPTIONS
"Patients whose family income exceeds 400% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of the hospital; however the discounted rates shall not be greater than the amounts generally billed to commercially insured [or Medicare] patients. In such cases, other factors may be considered in determining their eligibility for discounted or free services, including: * Bank accounts, investments and other assets * Employment status and earning capacity * Amount and frequency of bills for health care services * Other financial obligations and expenses * Generally, financial responsibility will be no more than 25% of gross family income. The hospital may utilize predictive analytical software or other criteria to assist in making a determination of financial assistance eligibility in situations where the patient qualifies for financial assistance but has not provided the necessary documentation to make a determination. This process is called ""presumptive eligibility."""

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
SSM Health Care Corporation, 46-6029223

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
The amounts reported on Form 990, Schedule H, Part I, Line 7a, 7b, and 7c were determined using the cost to charge ratio derived from worksheet 2 in the schedule h instructions. Form 990, schedule h, part I, Lines 7e, 7f, 7g, 7h, and 7i are reported at cost as reported in the organization's financial statements. The calculation of Schedule H, Part I, Line 7, Column F utilizes 990, Part IX, Line 25, Column A, which does not include Bad Debt Expense.

Schedule H, Part II Community Building Activities
SSM 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: LEADERSHIP DEVELOPMENT/TRAINING FOR COMMUNITY MEMBERS: FIRST AID TRAINING FOR GIRL SCOUT TROOP.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
FOR FINANCIAL STATEMENT PURPOSES, SSM Health HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER NORTON HOSPITAL'S FINANCIAL ASSISTANCE POLICY ON A GROSS BASIS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
SSM Health Care of Oklahoma, Inc. is part of the SSM Health consolidated audit. The footnote that references the treatment of uncollectible accounts and implicit price concessions in the December 31, 2022 consolidated audit is contained on page 13,14 and 15 of the attached financial statements.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
"SSM Health Care of Oklahoma, Inc. has established a written credit and collection policy and procedures. The billing and collection policies and practices reflect the mission and values of SSM Health, including our special concern for people who are poor and vulnerable. The Health Center embraces its responsibility to serve the communities in which it participates by establishing sound business practices. The Health Center's billing and collection practices will be fairly 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 financial assistance. All uninsured patients will be provided a standard discount for medically necessary inpatient and outpatient services, including services provided at off-campus outpatient sites. The hospital determined the amount of the discount based on the local managed care market, applicable statutory requirements and other relevant local circumstances. The rate must be no less than the lowest effective discount rate and no greater than the highest effective discount rate for the current managed care contracts of the hospital. Uninsured patients may also qualify for an additional discount based upon financial need under the system financial assistance policy. All accounts due from the patient will receive a statement after discharge or after final adjudication from patient's insurance. Generally the patient will receive 4 months (120 days) of in-house collection efforts (including early out vendors) and 12 months of bad debt collection efforts. The hospital will make Reasonable Efforts to determine FAP eligibility including: 1. The financial assistance summary will be included with each billing statement 2. Extraordinary Collection Activity (ECAs) may not occur until bad debt placement and only after 120 days. 3. ECAs must be suspended if a guarantor submits a FAP application during the application period. 4. Reasonable measures must be taken to reverse ECAs if the application is approved which may include refunding any payments made in excess of amounts owed as an FAP-eligible individual. 5. Bad Debt vendors will gain written approval from SSM prior to engaging in ECAs. SSM will review the accounts and verify satisfactory completion of reasonable efforts during the notification and application period. A waiver is not considered reasonable efforts. Obtaining a signed waiver that an individual does not wish to apply for FAP assistance or receive FAP application information will not meet the requirement to make ""reasonable efforts"" to determine whether the individual is FAP-eligible before engaging in ECAs. 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 St. Anthony Hospital's collection and financial assistance policies."

Schedule H, Part V, Section B, Line 16a FAP website
A - SSM Health St. Anthony Hospital - Oklahoma City: Line 16a URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance; B - SSM Health St. Anthony Hospital - Midwest: Line 16a URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - SSM Health St. Anthony Hospital - Oklahoma City: Line 16b URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance; B - SSM Health St. Anthony Hospital - Midwest: Line 16b URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - SSM Health St. Anthony Hospital - Oklahoma City: Line 16c URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance; B - SSM Health St. Anthony Hospital - Midwest: Line 16c URL: https://www.ssmhealth.com/for-patients/financial-assistance/hospital-financial-assistance;

Schedule H, Part VI, Line 2 Needs assessment
SSM Health (SSMH) participates in Community Benefit according to our vision. Through our participation in the healing ministry of Jesus Christ, communities, especially those that are economically, physically, and socially marginalized, will experience improved health in mind, body, spirit and environment. In the tradition of our founders, the Franciscan Sisters of Mary, caring for those in greatest need remains our organizational priority. Today our System Board monitors Community Benefit efforts, and views achievement of our vision as a primary responsibility. The purpose of SSM's Community Benefit program is to assess and address community health needs. Making our communities healthier in measurable ways is always our goal. To fulfill this commitment, SSM's Community Benefit is divided into two parts: 1) Community Health Needs Assessment (CHNA), and 2) Community Benefit Inventory for Social Accountability (CBISA). The CHNA is an assessment and prioritization of community health needs and the adoption and implementation of strategies to address those needs. A CHNA is conducted every three years by each hospital according to the following steps: * Assess and prioritize community health needs: Gather CHNA data from secondary sources; obtain input from stakeholders representing the broad interests of the community through interviews and focus groups; use data to select top health priorities; and complete written CHNA. * Develop, adopt, and implement strategies to address top-health priorities: Establish strategies to address priorities; complete Strategic Implementation Plan; obtain Regional/Divisional Board approval; and integrate strategies into operational plan. * Make CHNA widely available to the public: Publish CHNA and summary document on hospital's website. * Monitor, track, and report progress on top health priorities: Collect data and evaluate progress; report to Regional/Divisional Board every six months and System Board every year; share findings with community stakeholders; and send results to finance for submission to the Internal Revenue Service (IRS). System Office staff and leaders oversee and monitor SSMH's Community Benefit Program, and ensure reporting is in compliance with IRS regulations. In collaboration with community stakeholders and partner organizations, SSM Health Care Corporation also identifies needs based on assessments and research, and SSMH facilities also involve case managers and care team staff to pinpoint critical health issues in the community. All hospital CHNAs are completed, approved, and integrated into the organization's strategic plan. We continue to monitor and assess the progress of our local efforts in the spirit of caring for others and improving community health.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
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, website resources, 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 is also provided to public agencies.

Schedule H, Part VI, Line 7 State filing of community benefit report
OK

Schedule H, Part VI, Line 4 Community information
SSM Health St. Anthony Hospital - Oklahoma City and SSM Health St. Anthony Hospital - Midwest are located in Oklahoma County, Oklahoma, the most populous county in the state. The County had an estimated population of 797,434 residents in 2019, about 24% of Oklahoma's total. Oklahoma County is more diverse than other areas within the state, with 17.4% Hispanic/Latino, 14.8% black, and 56.0% white. The number of people living in poverty in Oklahoma County was estimated as one in six in 2018 (16.7%). This figure was higher than both the state poverty rate of 16.0% and the national poverty rate of 14.1% in 2018. Likewise, median household income for Oklahoma County was $52,855, slightly above $51,424 for the state, but significantly below the U.S. median household income of $60,293. Among Oklahoma County residents 18 and older, 30% held a bachelor's degree or higher in 2019. Unemployment numbers released in 2021 from the U.S. Bureau of Labor Statistics show that Oklahoma City ranks first for Metropolitan communities with a 2010 Census population of one million or more. Oklahoma City has an unemployment rate of 2.6%.19 This is the lowest rate since December 2019. Additional detailed information on the community for both hospitals is found throughout the 2021 CHNA.

Schedule H, Part VI, Line 5 Promotion of community health
SSM Health Care of Oklahoma, Inc. participates in a wide array of community programs throughout the area to further its exempt purpose of promoting the health of the community. The community initiatives build on the strengths of our communities and systems to improve the quality of life and to create a sense of hope. Community Benefit initiatives build community capacity and individual empowerment through community organizing, leadership development, partnerships, and coalition building. Our Community Health programs provide compassionate and competent care while they promote health improvement by reaching directly into the community to ensure that low-income and under-served persons can access health care services. In response to the global coronavirus pandemic, SSM Health Care of Oklahoma worked relentlessly to respond to community needs by developing and implementing strategies to address social needs of those served, providing screening & testing services, personal protective equipment and education throughout the community, as well as treatment for those who presented with COVID-19. SSM Health Care of Oklahoma promotes grassroots advocacy and engages persons of influence to affect social and public policy change in order to promote both community health and healthy communities. 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, * Engages in the training and education of health care professionals, * Participates in Medicaid, Medicare, Champus, Tricare, and/or other government-sponsored health care programs * All surplus funds generated by SSMH entities are reinvested in improving our patient care delivery system.

Schedule H, Part VI, Line 6 Affiliated health care system
SSM Health Care of Oklahoma, Inc. is a 501(c)(3) organization and is a member of the integrated health care system known as SSM Health. SSM Health (SSMH) is a centrally managed, fully integrated health care delivery system with its headquarters based in St. Louis, Missouri. SSM Health Care Corporation (SSMHCC) (doing business as SSMH) is the principal not-for-profit corporation and has been established as the parent corporation. SSMH owns and operates 22 adult hospitals, one pediatric hospital, thirteen post-acute care facilities, a national pharmacy benefit management company (PBM), an extensive network of physician practice operations, and other health care businesses. SSMH's hospital operations are located primarily in Missouri, Wisconsin, Oklahoma and Illinois, and its related businesses provide health related services in 50 states. SSMH's mission statement is as follows: Through our exceptional health care services, we reveal the healing presence of God. SSMHCC and most of its affiliated subsidiary corporations have been granted exemption from federal income tax as charitable organizations under Section 501(c)(3) of the Internal Revenue Code (IRC). Certain subsidiaries of SSMH are for-profit entities that are taxable under the IRC. SSMH is sponsored by SSM Health Ministries, an independent nine-member body composed of two Franciscan Sisters of Mary, one Sister of St. Agnes, one Jesuit priest, and five lay persons who collectively hold certain reserved powers over SSMH.