Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
SSM Cardinal Glennon Children's Hospital
 
 
Doing business as
See Schedule O
 
Number and street (or P.O. box if mail is not delivered to street address)
10101 Woodfield Lane
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
St Louis, MO63132
D Employer identification number

43-0738490
E Telephone number

G Gross receipts $ 361,197,005
F Name and address of principal officer:
William Thompson
10101 Woodfield Lane
St Louis,MO63132
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.ssmhealth.com/system
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1949
M State of legal domicile: MO
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: A NOT-FOR-PROFIT 190-BED Inpatient & OUTPATIENT pediatric MEDICAL CENTER IN ST. LOUIS, MISSOURI. We specialize in neonatology, cardiology, pediatric and fetal surgery, and cancer services.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 6
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 2,153
6 Total number of volunteers (estimate if necessary) ............. 6 369
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 636,639
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -57,259
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,566,974 13,216,279
9 Program service revenue (Part VIII, line 2g) ......... 303,751,800 339,014,264
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,168,317 2,345,693
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 5,090,387 6,042,363
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 324,577,478 360,618,599
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 152,594 169,884
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 112,779,283 120,240,249
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 176,067,057 193,549,495
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 288,998,934 313,959,628
19 Revenue less expenses. Subtract line 18 from line 12....... 35,578,544 46,658,971
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 347,948,344 385,541,323
21 Total liabilities (Part X, line 26)............. 75,306,341 78,298,528
22 Net assets or fund balances. Subtract line 21 from line 20..... 272,642,003 307,242,795
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 285,929,267 including grants of $ 169,884 ) (Revenue $ 342,364,798 )
PLEASE SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet285,929,267
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III .............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,153
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
6
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletBonnie Thorn1195 Corporate Lake   St Louis,MO63132 (314) 989-3640
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Candace Jennings
 
Director & President
 10.0
.................
33.0 		X   X       0 679,759 243,808
(2) Sr Mary Jean Ryan FSM
 
Director & Chairperson
 1.0
.................
6.0 		X   X       0 0 0
(3) William Thompson
 
Director & Vice Chairperson
 1.0
.................
56.0 		X   X       0 2,253,539 4,386,662
(4) Sheila Bader
 
Pt Yr Director
 1.0
.................
1.0 		X           0 0 0
(5) Daniel Baumann MD
 
Pt Yr Director
 1.0
.................
41.0 		X           0 248,717 26,515
(6) Donald Binz MD
 
Pt Yr Director
 1.0
.................
41.0 		X           0 485,471 33,281
(7) Jan Cerny
 
Director
 1.0
.................
2.0 		X           0 0 0
(8) Christopher Howard
 
Director
 1.0
.................
53.0 		X           0 1,145,315 359,223
(9) Dee Joyner
 
Director
 1.0
.................
2.0 		X           0 0 0
(10) Mary McLennan MD
 
Pt Yr Director
 1.0
.................
1.0 		X           0 0 0
(11) John Oldani
 
Pt Yr Director
 1.0
.................
1.0 		X           0 2,786 0
(12) Shane Peng MD
 
Director
 1.0
.................
47.0 		X           0 952,393 287,170
(13) Barbara Turkington
 
Pt Yr Director
 1.0
.................
1.0 		X           0 0 0
(14) Karl Wilson PhD
 
Pt Yr Director
 1.0
.................
1.0 		X           0 0 0
(15) Philip Alderson MD
 
Pt Yr Director
 1.0
.................
2.0 		X           0 0 0
(16) James Bleicher MD
 
Director
 1.0
.................
42.0 		X           0 599,841 130,021
(17) Snehal Gandhi MD
 
Director
 1.0
.................
2.0 		X           0 0 0
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) William R Kauffman
 
Director
 1.0
.......................2.0 		X           0 0 0
(19) Fred P Pestello PhD
 
Director
 1.0
.......................2.0 		X           0 0 0
(20) Kathleen Becker
 
Pt Yr Hospital President
 20.0
.......................23.0 		    X       0 584,913 150,457
(21) Paula Friedman
 
Vice President
 1.0
.......................54.0 		    X       0 829,649 261,763
(22) Damon Harbison
 
Interim Hospital President
 40.0
.......................1.0 		    X       235,517 0 50,573
(23) Shari Jackson
 
Asst Secretary
 10.0
.......................30.5 		    X       0 72,414 17,358
(24) June Pickett
 
Secretary
 1.0
.......................65.1 		    X       0 261,177 47,284
(25) Karen Rewerts
 
System VP Finance
 10.0
.......................30.0 		    X       0 579,587 158,165
(26) Kris Zimmer
 
Treasurer
 1.0
.......................57.0 		    X       0 1,102,244 366,850
(27) Kevin Todd Johnson
 
Reg VP - Medical Affairs
 10.0
.......................31.0 		      X     0 671,197 207,563
(28) Terry Palmisano
 
VP Nursing - CGCMC
 40.0
.......................0 		      X     193,299 0 45,399
(29) Renee Roach
 
System VP - HR SSMHC Stl
 10.0
.......................30.0 		      X     0 324,183 69,602
(30) Pushpa Patel
 
Physician
 40.0
.......................0 		        X   288,904 0 37,845
(31) Pathma Ramesvara
 
Physician
 40.0
.......................0 		        X   294,921 0 27,897
(32) Timothy Reed
 
Physician
 40.0
.......................0 		        X   289,860 0 45,954
(33) Timothy Staed
 
Physician
 40.0
.......................0 		        X   302,876 0 50,231
(34) Yelena Podorozhansky
 
Physician
 40.0
.......................0 		        X   318,026 0 11,088
(35) Lynn Lenker
 
Former Key Employee
  
.......................40.0 		          X 0 379,824 105,813
(36) Deborah Walkenhorst
 
Former Key Employee
  
.......................0.0 		          X 0 425,062 17,949
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,923,403 11,598,071 7,138,471
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet127
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
ST LOUIS UNIVERSITY

1402 S GRAND BLVD
ST LOUIS,MO63104 		PHYSICIAN SERVICES 49,591,158
ALBERICI CONSTRUCTORS INC

8800 PAGE AVE
ST LOUIS,MO63114 		CONSTRUCTION SERVICES 4,228,223
ASSOC REGIONAL & UNIVERSITY PATHOLOGISTS

500 CHIPETA WAY
SALT LAKE CITY,UT84108 		LABORATORY SERVICES 972,341
Universal Hospital Services Inc

13601 Lakefront Drive
Earth City,MO63045 		Equipment maintenance 482,056
St Luke's Hospital of Kansas City

4401 Wornall
Kansas City,MO64111 		Medical Services 449,716
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet38
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 10,947,520
e Government grants (contributions)1e 1,587,894
f All other contributions, gifts, grants, and similar amounts not included above1f 680,865
g Noncash contributions included in lines 1a-1f:$ 235,697
h Total.Add lines 1a-1f.......MediumBullet 13,216,279
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621110 327,129,102 327,129,102    
b OTHER REVENUE 621110 10,537,705 10,537,705    
c LABORATORY REVENUE 621500 1,347,457 736,158 611,299  
d
e
f All other program service revenue. 0 0 0 0
g Total.Add lines 2a–2f.....MediumBullet 339,014,264
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 1,591,547     1,591,547
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   434,056
b Less: rental expenses   422,606
c Rental income or (loss) 0 11,450
d Net rental income or (loss)......MediumBullet 11,450     11,450
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   909,946
b Less: cost or other basis and sales expenses 155,800  
c Gain or (loss) -155,800 909,946
d Net gain or (loss).....MediumBullet 754,146     754,146
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a PHARMACY REVENUE 446110 3,961,833 3,961,833    
b CAFETERIA 722210 1,910,907   25,340 1,885,567
c PARKING FACILITY 900099 66,326     66,326
d All other revenue .... 91,847 0 0 91,847
e Total. Add lines 11a–11d ...... MediumBullet 6,030,913
12 Total revenue. See Instructions......MediumBullet 360,618,599 342,364,798 636,639 4,400,883
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 69,433 69,433
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 100,451 100,451
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 979,099 623,573 355,526  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 92,506,912 84,334,468 8,172,444  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,772,067 6,205,190 566,877  
9 Other employee benefits ....... 13,090,516 11,889,883 1,200,633  
10 Payroll taxes ........... 6,891,655 6,267,016 624,639  
11 Fees for services (non-employees):        
a Management ...... 12,849,543 1,585,586 11,263,957  
b Legal ......... 94,277   94,277  
c Accounting ........... 117,692   117,692  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 67,409,306 66,686,690 722,616 0
12 Advertising and promotion .... 256,392   256,392  
13 Office expenses ....... 9,488,202 8,693,338 794,864  
14 Information technology ...... 14,628,053 14,615,918 12,135  
15 Royalties ..        
16 Occupancy ........... 6,415,698 5,880,155 535,543  
17 Travel ............ 320,966 147,860 173,106  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 126,675 96,000 30,675  
20 Interest ........... 904,562 904,562    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 11,415,121 11,158,844 256,277  
23 Insurance ... 2,621,922   2,621,922  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 40,848,345 40,848,345    
b MEDICARE PROVIDER TAX 25,588,162 25,588,162    
c BOND RELATED FEES 225,136   225,136  
d LICENSES & TAXES 127,302 126,397 905  
e All other expenses 112,141 107,396 4,745 0
25 Total functional expenses. Add lines 1 through 24e 313,959,628 285,929,267 28,030,361 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments ......... 7,903,549 2 4,145,072
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 49,554,421 4 56,176,320
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6 0
7 Notes and loans receivable, net .... 7,540,397 7 10,663,138
8 Inventories for sale or use ........ 4,804,232 8 4,591,766
9 Prepaid expenses and deferred charges ...... 948,203 9 1,044,295
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 324,910,280
b Less: accumulated depreciation 10b 176,501,819 139,149,045 10c 148,408,461
11 Investments—publicly traded securities . 8,733,120 11 8,552,255
12 Investments—other securities. See Part IV, line 11 ..... 124,540,738 12 146,343,623
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 4,774,639 15 5,616,393
16 Total assets. Add lines 1 through 15 (must equal line 34)... 347,948,344 16 385,541,323
Liabilities 17 Accounts payable and accrued expenses ..... 29,076,285 17 29,140,707
18 Grants payable ...   18  
19 Deferred revenue .........   19 1,532,073
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 46,230,056 25 47,625,748
26 Total liabilities. Add lines 17 through 25.. 75,306,341 26 78,298,528
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 243,414,076 27 277,541,775
28 Temporarily restricted net assets ........... 12,158,129 28 12,808,812
29 Permanently restricted net assets 17,069,798 29 16,892,208
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 272,642,003 33 307,242,795
34 Total liabilities and net assets/fund balances ........ 347,948,344 34 385,541,323
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
360,618,599
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
313,959,628
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
46,658,971
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
272,642,003
5
Net unrealized gains (losses) on investments ...............
5
-3,083,493
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-8,974,686
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
307,242,795
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513...            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
SSM Cardinal Glennon Children's Hospital
  		Employer identification number
43-0738490
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
SSM Cardinal Glennon Children's Hospital
  		Employer identification number

43-0738490
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a)
No.from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
SSM Cardinal Glennon Children's Hospital
  		Employer identification number

43-0738490
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ......................................................................................................................SchCMd Bullet
$  
3
Volunteer hours .............................................................................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................    
c Total lobbying expenditures (add lines 1a and 1b) .......................................................................    
d Other exempt purpose expenditures .........................................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ..............................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2015


Schedule C (Form 990 or 990-EZ) 2015
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
57,643
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
57,643
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The organization paid dues to various state and national hospital associations and portions of these dues were allocated to lobbying activities.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The organization paid dues to various state and national hospital associations and portions of these dues were allocated to lobbying activities.
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 30,555,205 29,530,190 27,206,992 24,155,350 22,120,818
b Contributions ... 5,095 106,411 5,692 749,317 2,090,571
c Net investment earnings, gains, and losses -200,555 1,563,640 3,092,788 2,464,561 367,264
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		879,209 645,036 775,282 162,236 423,303
f Administrative expenses ....          
g End of year balance ...... 29,480,536 30,555,205 29,530,190 27,206,992 24,155,350
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet26 %
b
Permanent endowment SchDMd Bullet57 %
c
Temporarily restricted endowment SchDMd Bullet17 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
Yes
 
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ...   7,590,658 7,590,658
b Buildings   229,736,866 121,725,909 108,010,957
c Leasehold improvements   32,284 11,300 20,984
d Equipment ...   74,694,651 54,764,610 19,930,041
e Other ...   12,855,821   12,855,821
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 148,408,461
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c)Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) BENEFICIAL INTEREST IN FOUNDATION 		69,698,249 F

(B) SSM COMPREHENSIVE INVESTMENT PROGRAM 		76,645,374 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 146,343,623
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
RABBI TRUST LIABILITY 294,600
PENSION FUNDING LIABILITY 16,630,590
ASSET RETIREMENT OBLIGATION 2,394,025
ALLOCATED TAX EXEMPT BOND LIAB (ISSUED THROUGH SSM HEALTH CARE) 26,100,209
DUE TO AFFILIATES 371,258
OTHER LIABILITIES 1,817,945
THIRD PARTY PAYOR 17,121
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 47,625,748
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  

Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds TO SUPPORT THE PEDIATRIC MEDICAL SERVICES PROVIDED BY SSM CARDINAL GLENNON CHILDREN'S HOSPITAL.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SSM CARDINAL GLENNON CHILDREN'S HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SSM HEALTH (SSMH), A RELATED ORGANIZATION. SSMH 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 2015 OR 2014.
Schedule D (Form 990) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
No
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    2,361,402   2,361,402 0.75 %
b Medicaid (from Worksheet 3, column a) . . . . .     156,029,338 196,125,970 0 0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     3,608,576 3,143,544 465,032 0.15 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 161,999,316 199,269,514 2,826,434 0.90 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     3,958,186 3,902,916 55,270 0.02 %
f Health professions education (from Worksheet 5) . . .     61,770,464 16,127,335 45,643,129 14.54 %
g Subsidized health services (from Worksheet 6) . . . .     9,826,873 505,146 9,321,727 2.97 %
h Research (from Worksheet 7) .     655,852   655,852 0.21 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     320,775 5,000 315,775 0.10 %
j Total. Other Benefits . . 0 0 76,532,150 20,540,397 55,991,753 17.83 %
k Total. Add lines 7d and 7j . 0 0 238,531,466 219,809,911 58,818,187 18.73 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     312   312 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building     12,753 130 12,623 0 %
7 Community health improvement advocacy     388   388 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 13,453 130 13,323 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,778,952
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
 
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
 
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
 
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 SSM Health Cardinal Glennon Children's Hospital
1465 S GRAND BLVD
ST LOUIS,MO63104
WWW.CARDINALGLENNON.COM
429-17 		X X X X     X      
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SSM Health Cardinal Glennon Children's Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.ssmhealth.com/system/community-benefit
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SSM Health Cardinal Glennon Children's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.ssmhealth.com/system/exceptional-care/financial-assistance
b
http://www.ssmhealth.com/system/exceptional-care/financial-assistance
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

SSM Health Cardinal Glennon Children's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - SSM Health Cardinal Glennon Children's Hospital. SSM Health Cardinal Glennon Children's Hospital sought input from community stakeholders who represent the broad interest and diversity of St. Louis including representatives from both the St. Louis and the Missouri Health Departments. Participants were invited to a collaborative focus group, which was conducted in cooperation with BJC Healthcare St. Louis Children's Hospital. A list of leaders who participated in the focus group are listed on page 21 of the CHNA. Additional data was derived from a variety of sources including the Healthy Communities Institute (HCI).
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - SSM Health Cardinal Glennon Children's Hospital. PRIMARY DATA COLLECTION FOR THE CHNA INCLUDED USE OF COMMUNITY STAKEHOLDER FOCUS GROUP FEEDBACK. BECAUSE CARDINAL GLENNON AND BJC HEALTH SYSTEM'S ST. LOUIS CHILDREN'S HOSPITAL (SLCH) BOTH FOCUS ON ADDRESSING THE HEALTH NEEDS OF PEDIATRIC PATIENTS IN ST. LOUIS CITY, THE TWO HOSPITALS COMBINED EFFORTS TO SEEK INPUT FROM COMMUNITY STAKEHOLDERS. SSM Health Cardinal Glennon Children's Hospital WILL CONTINUE TO PARTNER WITH OTHER SSM HEALTH ST. LOUIS HOSPITALS TO ADDRESS IDENTIFIED NEEDS AS WELL.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - SSM Health Cardinal Glennon Children's Hospital. SSM Health's mission statement is "Through our exceptional health care services, we reveal the healing presence of God." During 2015, in collaboration with our community partners, SSM Health Cardinal Glennon Children's Hospital conducted a Community Health Needs Assessment (CHNA) and developed a strategic implementation plan for the 2016-2018 cycle. The strategic priorities we will address over the next three years include: access to care, maternal/infant health, and asthma. The SSM Health St. Louis Regional Board approved this CHNA on November 23, 2015. SSM Health Cardinal Glennon Children's Hospital last conducted a CHNA in 2012. The strategic priorities of the community benefit plan as identified in the 2013-2015 community health needs assessment (CHNA) are: pediatric injury and violence, asthma, and parental health literacy. Our needs assessment was completed June 2012 and adopted as part of our strategic plan on December 3, 2012. Goals and objectives were established to change behavior, provide metrics to measure change, and to impact the overall health of those we serve. All of the community benefit activities are designed to meet the needs identified in the CHNA. The 2012 SSM Health Cardinal Glennon Children's Hospital community needs assessment revealed pediatric injury and poisoning is the top reason for pediatric emergency visits, the third highest reason for pediatric inpatient hospitalizations and the leading cause of death of children in St. Louis City. Cardinal Glennon will partner with Better Family Life and Missouri Poison control to reduce pediatric injury and poisoning. * Cardinal Glennon's trauma team will partner with Better Family Life case management to refer all victims of violence patients from gunshot wounds or stabbings and assaults. * Support Missouri Poison Control's goals to: 1) reduce incidence, morbidity and mortality of poisoning in Missouri through outreach education and communication and 2) provide individualized recommendations for toxic exposures to both general public and health care professionals to reduce the impact on patient health and avert fatal outcomes through advising general public about toxic exposures and consulting with physicians to provide optimal treatment for individual poisoned patients. The following goals were achieved in 2015 to address pediatric injury and poisoning: Goal: Reduce the rate of ER visits resulting from pediatric injury and poisoning events by 2% (from 1467.6 to 1438.3 per population of 10,000), 2013 data show rate of emergency room visits of 1,387.9. Goal: Reduce the rate of inpatient hospitalizations resulting from pediatric injury and poisoning events by 2% (from 38.8 to 38.0 per population of 10,000), 2013 data show favorable results of only 37.8. The Poison Center responds to more than 193,000 calls for assistance each year, representing approximately one call for every 33 Missourians. Seventy-four percent of calls are managed over the phone by specially trained pharmacists and nurses working the poison hotline, avoiding unnecessary and costly emergency department, laboratory and physician fees. (For every $1 spent on poison center services, $12 in health care costs are avoided.) These figures alone attest to the need for the poison center as a public good. Although accidental exposures in children under the age of 5 are most frequently the reason for a call, other situations include substance abuse among youth and adults, medication errors in older adults, and exposures at the workplace. Thus, all ages and all states of life have need for the poison center. No other agencies or programs exist to fill this need in Missouri. Toll-free telephone availability of the poison center significantly improves access to expert advice for the population in federally designated medically underserved areas, health professional shortage areas and impoverished counties for whom access to other health care may be limited. Likewise, poison center telephone-based service to the population in the state's four metropolitan areas gives many medically underserved persons and disadvantaged minorities other options for care for poisoning emergencies besides overcrowded city hospitals. Such universal access to a central health resource acts to reduce health disparities for some of our most vulnerable populations. Public education presentations are also made available throughout the state to teach the basic strategies of poison prevention. This empowers and enables members of the community to act effectively for their own safety. The 2012 SSM Health Cardinal Glennon Children's Hospital community needs assessment revealed that parental level of education has an influence on their ability to access health services for their children, and non-English speaking parents are in need of short term translation services. The National Assessment for Health Literacy's predictive model shows that northeast St. Louis City has and will continue to have the lowest rates of average health literacy. Cardinal Glennon leadership will work with Health Literacy, Missouri by April 1, 2015 to determine: a) a more current baseline measure of average health literacy, and b) an initiative(s) to be implemented in 2015 to improve health literacy of parents of children served by Cardinal Glennon. The following goals were achieved in 2015 to address health literacy: Goal: Improve parental health literacy by 2% (from 13% to 12.7% lacking basic prose literacy skills) creating a reduction in preventable injuries. The 2012 SSM Health Cardinal Glennon Children's Hospital community needs assessment revealed that St. Louis City has a significantly higher rate of pediatric asthma emergency room visits and inpatient hospitalizations than the state of Missouri (19.6% compared to 10.1%) and greater within the African American population. SSM Health Cardinal Glennon Children's Hospital will partner with emergency services providers and pediatricians to reduce the number of asthma episodes that require emergency room or inpatient hospitalization intervention. * Reduce number of 30-day asthma readmissions at Cardinal Glennon by reducing non-compliance with discharge medications. * Improve pediatrician office utilization of best practice asthma clinical protocol by distributing protocol to pediatricians in St. Louis City. * Improve patient/family adherence to asthma treatment plan by developing and distributing an "adherence tips" educational document to be distributed to patients/ families upon discharge from Cardinal Glennon and pediatrician offices. The following goals were achieved in 2015 to address asthma related incidents: Goal: Reduce the number of emergency department visits with asthma as the primary diagnosis by 2% (from 336.7 to 330.0 per population of 10,000), number of emergency department visits declined sharply in 2015 to 313.2 per 10,000 population of 10,000. Goal: Reduce the rate of pediatric asthma inpatient hospitalizations by 2% (from 57.6 per population of 10,000 to 56.6), most recent results from 2013 demonstrate a rate per population of 10,000 of 38.3, well below baseline. The Cardinal Glennon Administrative team reviewed the final list of prioritized pediatric health needs for St Louis City, considering magnitude of impact on the community and alignment with the SSM Mission and Strategic Plan. The amount of resources required to address the issue and the hospital's ability to impact each issue were also considered. The Cardinal Glennon team's final prioritization matric including needs not address by Cardinal Glennon can be found in Appendix E of the 2012 CHNA.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?24
Name and address Type of Facility (describe)
1 SSM CARDINAL GLENNON PEDIATRICS - TROY
164 PROFESSIONAL PARKWAY
TROY,MO63379 		OUTPATIENT PEDIATRIC CLINIC
2 CARDINAL GLENNON SPECIALTY SERVICES - ST ANTHONY MED CENTER
12700 SOUTHFORK ROAD
SUITE 155
ST LOUIS,MO63128 		OUTPATIENT PEDIATRIC CLINIC
3 SSM CARDINAL GLENNON ER - DEPAUL HEALTH CENTER
12303 DEPAUL DRIVE
SUITE 300
BRIDGETON,MO63044 		OUTPATIENT PEDIATRIC CLINIC
4 SSM CARDINAL GLENNON PEDIATRICS - WARRENTON
511 ASHLAND
SUITE A
WARRENTON,MO63383 		OUTPATIENT PEDIATRIC CLINIC
5 SSM CARDINAL GLENNON PEDIATRICS - DEPAUL HEALTH CENTER
12255 DEPAUL DRIVE
SUITE 300
BRIDGETON,MO63044 		OUTPATIENT PEDIATRIC CLINIC
6 SSM CARDINAL GLENNON ER - ST JOSEPH HOSPITAL WEST
100 MEDICAL PLAZA
LAKE ST LOUIS,MO63367 		OUTPATIENT PEDIATRIC CLINIC
7 CARDINAL GLENNON ER - ST ANTHONY'S MEDICAL CENTER
MEDICAL PLAZA BUILDING
10010 KENNERLY ROAD
ST LOUIS,MO63128 		OUTPATIENT PEDIATRIC CLINIC
8 SSM CARDINAL GLENNON ER - ST CLARE HEALTH CENTER
1015 BOWLES AVENUE
FENTON,MO63026 		OUTPATIENT PEDIATRIC CLINIC
9 SSM CARDINAL GLENNON ER - ST JOSEPH HEALTH CENTER
300 FIRST CAPITAL DRIVE
ST CHARLES,MO63301 		OUTPATIENT PEDIATRIC CLINIC
10 SSM CARDINAL GLENNON PEDIATRICS ST JOSEPH WEST
400 MEDICAL PLAZA
SUITE 220
LAKE ST LOUIS,MO63367 		OUTPATIENT PEDIATRIC CLINIC
11 CARDINAL GLENNON SPECIALTY SERVICES - ANDERSON HOSPITAL
2133 VADALABENE DRIVE
MARYVILLE,IL62062 		OUTPATIENT PEDIATRIC CLINIC
12 SSM CARDINAL GLENNON SPECIALTY SERVICES - ST LUKE'S HOSPITAL
224 SOUTH WOODS MILL RD
CHESTERFIELD,MO63017 		OUTPATIENT PEDIATRIC CLINIC
13 CARDINAL GLENNON ER - ANDERSON HOSPITAL
6800 STATE ROUTE 162
MARYVILLE,IL62062 		OUTPATIENT PEDIATRIC CLINIC
14 SSM CARDINAL GLENNON SPECIALTY SERVICES - SE MO HOSPITAL
25 DOCTORS PARK
CAPE GIRARDEAU,MO63703 		OUTPATIENT PEDIATRIC CLINIC
15 SSM ST MARY'S PEDIATRICS
3348 AMERICAN DRIVE
JEFFERSON CITY,MO65109 		OUTPATIENT PEDIATRIC CLINIC
16 SSM CARDINAL GLENNON NEONATOLOGY SERVICES - ST MARY'S HEALTH CENTER
6420 CLAYTON ROAD
RICHMOND HEIGHTS,MO63117 		OUTPATIENT CLINIC
17 SSM CARDINAL GLENNON SPECIALTY SERVICES
6000 BOND AVENUE
CENTRALIA,IL62207 		OUTPATIENT PEDIATRIC CLINIC
18 SSM CARDINAL GLENNON SPECIALTY SERVICES - MT VERNON
1708 JEFFERSON AVENUE
SUITE 240
MT VERNON,IL62864 		OUTPATIENT PEDIATRIC CLINIC
19 SSM CARDINAL GLENNON SPECIALTY SERVICES - JEFFERSON COUNTY HEALTH DEPT
1 DOCTORS PARK ROAD
SUITE F
MT VERNON,IL62864 		OUTPATIENT CLINIC
20 SSM CARDINAL GLENNON SPECIALTY SERVICES - JACKSON COUNTY HEALTH DEPT
415 HEALTH DEPARTMENT ROAD
MURPHYSBORO,IL62996 		OUTPATIENT CLINIC
21 SSM CARDINAL GLENNON SPECIALTY SERVICES - FAYETTE COUNTY HEALTH DEPT
416 WEST EDWARDS STREET
VANDALIA,IL62471 		OUTPATIENT CLINIC
22 SSM CARDINAL GLENNON SPECIALTY SERVICES - JACKSON COUNTY HEALTH DEPT
101 EAST EDWARDSVILLE ROAD
WOOD RIVER,IL62095 		OUTPATIENT CLINIC
23 CARDINAL GLENNON SPECIALTY SERVICES - ANDERSON HOSPITAL
2133 VADALABENE DRIVE
MARYVILLE,IL62062 		OUTPATIENT CLINIC
24 SSM CARDINAL GLENNON SPECIALTY SERVICES
2900 FRANK SCOTT PARKWAY WEST
COPPER BEND SOUTH STE 950
BELLEVILLE,IL62223 		OUTPATIENT PEDIATRIC CLINIC
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I, Line 3b Eligibility for Discounted Care Services eligible under the financial assistance policy will be made available to the patient on a sliding fee scale, in accordance with financial need, as determined in reference to Federal Poverty Levels (FPL) in effect at the time of the determination. The basis for the amounts the hospital will charge patients qualifying for financial assistance is as follows: Patients whose family income is above 200% but not more than 400% of the FPL are eligible to receive discounted services at amounts no greater than the amounts generally billed to the hospital's commercially insured or Medicare patients.
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 Annual Report SSM Health Cardinal Glennon Children's Hospital is part of the integrated health system known as SSM Health. In an effort to strengthen its community benefit program, SSM Health plans for, measures, and communicates community benefits 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.
Schedule H, Part VI, Line 5 Promotion of Community Health (Continued) E. PACTS for Life/PALS PACTS for Life (Pediatric Advanced Cardiorespiratory and Trauma Support for life) was created by Cardinal Glennon emergency physician Anthony Scalzo, M.D., and provides training for caregivers in emergency life support. PALS (Pediatric Advanced Life Support) is the result of a collaboration between the American Heart Association (AHA) and the American Academy of Pediatrics. The courses are designed to provide caregivers with skills which will enable them to both recognize the potential for respiratory and/or cardiac arrest in infants and children, and intervene in an appropriate manner by providing a systemic approach to these patients. The courses are offered to physicians, nurses, paramedics, respiratory therapists, and other health care providers, and carry continuing education credits. F. School Partnership Program Children who are hospitalized or who live with chronic illness benefit from keeping much of their regular routines from their lives outside the hospital. Attending school, working on school academics and completing schoolwork are a healthy part of a child's life routine. Participating in school activities can give children hope of returning to normal events. To meet this very important need for normalcy and development, Cardinal Glennon has its very own school, the Shining Star School. Shining Star School helps promote general academic development, social and emotional development as well as the overall well-being of individual children and groups in the hospital setting. G. Community Education Cardinal Glennon provides education classes at various events throughout the area including: School Tools for Nurses through the School Nurse Partnership and coordinating activities/presentations to outside special groups regarding child life, including coordinating service project volunteers; Rally Squirrel Safety Treehouse in the Dan Dierdorf Emergency Center which provides tools to educate parents in the areas of environmental safety, home safety, disaster preparedness, and sports safety to decrease the risk of pediatric injury; H. Dorothy and Larry Dallas Heart Center The Dorothy and Larry Dallas Heart Center provides comprehensive heart care for children with heart defects and other problems. Through advanced diagnosed imaging, heart experts can determine if a baby has a heart problem while still in the womb and work with the family to determine the best course of action to treat the issue. The Dallas Heart Center has the most advanced diagnostic equipment to learn more about a child's heart through less invasive procedures. Digital echo technology and a cardiac ultrasound machine with advanced 3D imaging allow doctors to see 3D heart imaging in real time to make the most accurate diagnosis. I. St. Louis Fetal Care Institute The St. Louis Fetal Care Institute serves families across the country by offering the most comprehensive fetal care program in middle America. A multi-disciplinary team of pediatric and high-risk maternity experts are able to treat life-threatening conditions in babies before birth. Although many fetal conditions require only careful monitoring and preparation for the baby's birth, many conditions that threaten a baby's quality of life can be surgically corrected while the baby is still in the womb. In conditions such as Twin-Twin Transfusion Syndrome, congenital diaphragmatic hernia, amniotic band syndrome and large tumors, physicians have been able to provide life-changing intervention to allow a baby to be born healthy. Babies with Myelomeningocele, the most severe form of spina bifida, have been significantly helped through surgical intervention. The internationally known MOMS Trial determined that babies who have their spina bifida addressed through surgery in the womb have better function and do better as they age than babies who did not receive surgical intervention. The St. Louis Fetal Care Institute has become one of the only centers in the country to provide this type of life-changing surgery and has helped a number of children whose live would have otherwise been significantly different. J. Knights of Columbus Developmental Center The Knights of Columbus Developmental Center is an 11,000-square-foot space dedicated to helping children with autism and other neurodevelopmental disorders. The facility enables experts to see children with special needs in a health care setting developed just for them, outside the distractions of the hospital. The Knights of Columbus Developmental Center at SSM Cardinal Glennon helps children with autism and neurodevelopmental disorders to reach their highest potential through comprehensive evaluation, care, family guidance, education and innovative research. Children with autism spectrum disorders receive innovative care to treat their complex diagnoses. The multi-disciplinary provides applied behavioral analysis, speech and language therapy, occupational therapy and physical therapy as needed to children with autism. A PEERS Social Skill program teaches children with autism how to interact with others, which is often challenging for children on the autism spectrum disorder. The Knights of Columbus Developmental Center also has a dog therapy program. Trained therapy dog Higgins, a Goldendoodle, works with children to make them more comfortable with medical treatment and provide distraction during therapy sessions. K. Pediatric Research Institute The Pediatric Research Institute operates to improve and assure the health and safety of children in the greater St Louis area, promoting research that advances the knowledge and management of childhood health and diseases, a number of nationally known physician-scientists conduct research that can be applied to the clinical setting to improve disease prevention and treatment. Ongoing programs include the study of pediatric infections and vaccine development, cardiac transplant rejection, liver disease, metabolic diseases and neonatal lung inflammation. L. Community Outreach Cardinal Glennon supports numerous outreach programs throughout the community including: Holding a free public flu clinic; sponsoring a Milk Depot or "drop Off" for mothers in the community that want to donate breast milk to the Milk Bank; serving as Board members for organizations promoting community health related endeavors; providing funding for medication for children when families are unable to pay; donating medication to mission trips; providing meal tickets and cab fare to family members of patients; providing conference room space to organizations aligned with our mission/values. M. Nationally Recognized N. The Dan Dierdorf Emergency and Trauma Center The Dan Dierdorf Emergency and Trauma Center at SSM Health Cardinal Glennon Children's Hospital was the first Level I Pediatric Trauma Center in Missouri. We are designated a Level I Pediatric Trauma Center by both Missouri and Illinois. This means we can handle any type of emergency at any time of day. O. The GlennonKids Safety Program The GlennonKids Safety Program at SSM Cardinal Glennon Children's Medical Center and is dedicated to the prevention of childhood injuries. It also serves as the lead agency for Safe Kids St. Louis, a local chapter of the national Safe Kids program. Since its inception more than 20 years ago, the GlennonKids Safety Program has contributed to a 45 % national reduction in child fatalities resulting from unintentional injuries, saving more than 38,000 lives. We partner with Kohl's 4 Kids and West County EMS and Fire Protection District to provide free car seat inspections/ installations by certified child passenger safety (CPS) technicians and distribution of properly fitted bicycle helmets. Nearly 41,000 children visit our Emergency and Trauma Center each year for all types of injuries and illness, ranging from sprains and asthma attacks to serious trauma injuries that may occur during car accidents. Cardinal Glennon has been ranked among the country's top pediatric heart and neonatology programs in U.S. News and World Report's 2016 -17 Best Children's Hospitals rankings. Cardinal Glennon ranked 35th in gastroenterology and gastrointestinal surgery, 34th in cardiology and heart surgery and 49th in pediatric cancer. Cardinal Glennon is expanding the Dana Brown Neonatal Intensive Care Unit from 60 to 65 all-private rooms, Cardinal Glennon has a Level IV NICU, the highest designation available.
Schedule H, Part VI, Line 5 Promotion of Community Health (Continued) Glennon 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 * Cardinal Glennon is committed to providing a high quality patient care delivery system which includes the reinvestment of surplus funds
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Financial Assistance Methodology: The cost of financial assistance 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 charges, was used to compute financial assistance 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 costs 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 charges, was used to compute unreimbursed Medicaid costs. This is the ratio of total adjusted operating expenses to total gross patient revenue. The gross revenue amount is gross amount - prior to contractual adjustments and bad debts. Both gross revenue and costs 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. Subsidized health services costing methodology: The expenditures are determined based on actual invoices or dollar amounts spent and charged to these departments, reduced by any grant revenues restricted for these services, if any. Research costing methodology: Research expenses were taken from the income and expense statements 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, derived from the accounting system.
Schedule H, Part II Community Building Activities SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL 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 HEALTH IMPROVEMENT ADVOCACY: HOSPITAL STAFF MET WITH ST. LOUIS POLICE ASSOCIATION AND GOVERNMENT OFFICIALS. COMMUNITY BUILDING - COALITION BUILDING: HOSPITAL ADMINISTRATOR SITS ON BOARD OF HEALTH CARE FOR KIDS IN ST. LOUIS, AN ORGANIZATION THAT PROVIDES DENTAL AND PRIMARY CARE FOR CHILDREN IN THE METROPOLITAN AREA.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense reported in the accounting system, adjusted for bad debt recoveries, was used, multiplied by the cost to charge ratio using IRS Worksheet 2, Ratio of patient costs to charges.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology SSM Health Cardinal Glennon Children's Hospital 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, Line 4 Bad debt expense - financial statement footnote SSM Health Cardinal Glennon Children's Hospital is part of the SSM Health consolidated audit. The footnote that references bad debt expense in the December 31, 2015 consolidated audit is contained on page 16 and 17 of the attached financial statements.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The cost of providing care to Medicare eligible patients is greater than the reimbursement that Medicare allows on the Medicare cost report. SSM Health Cardinal Glennon Children's Hospital 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 2015 Medicare cost report.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance SSM Health Cardinal Glennon Children's Hospital 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 the expiration of the notification period. 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 SSM Health Cardinal Glennon Children's Hospital's collection and financial assistance policies.
Schedule H, Part V, Section B, Line 16a FAP website - SSM Health Cardinal Glennon Children's Hospital: Line 16a URL: http://www.ssmhealth.com/system/exceptional-care/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website - SSM Health Cardinal Glennon Children's Hospital: Line 16b URL: http://www.ssmhealth.com/system/exceptional-care/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - SSM Health Cardinal Glennon Children's Hospital: Line 16c URL: http://www.ssmhealth.com/system/exceptional-care/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 SSMH'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 conduced 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). CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: * Collect and enter data: Send out emails reminding staff to submit activities; enter data into Lyon; and run reports to share with leaders. * Finalize and report on prior year: Enter all prior year data into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. 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, all hospital CHNAs were 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 All SSMH 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 SSMH, including our special concern for people who are poor and vulnerable. SSMH 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. SSMH applies its charity care policies fairly and consistently. Each person is treated as an individual with specific needs for assistance without regard to payment. SSMH 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 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 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 4 Community information SSM Health Cardinal Glennon Children's Hospital defines its primary service area as the St Louis metropolitan statistical area, a 12 county region with an approximate population of 2.1 million in 2011. This includes 505,000 children (ages 0 - 17) who represent 24% of the region's population. The pediatric population is projected to grow in St Louis City, with the biggest growth projected to occur in the 3-9 age group. The number of children 0- 2 is projected to remain flat. More than 80% of the pediatric population in the St Louis Metropolitan Statistical Area (MSA) are between the ages of 3 - 17. The median household income in the St Louis MSA is $69,077 and approximately 31% of the population has a bachelor's degree or greater. Distribution of race/ethnicity in our community is white/Caucasian: 74%; black/African-American: 19%; Hispanic: 3%; other: 4%. 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. Additional information concerning the Cardinal Glennon service area can be found on pages 15 through 22 of the 2012 CHNA.
Schedule H, Part VI, Line 5 Promotion of community health SSM Health Cardinal Glennon Children's Hospital provides many community building activities to promote the health of the communities we serve in response to community identified needs. Listed are the primary initiatives that we support and their impact: A. Perinatal Outreach Services The outreach program provides services to perinatal care providers in Missouri and Illinois. The Program is designed to improve outcomes for mothers and babies through educational programs and quality improvement activities. Programs for both physicians and nurses include topic presentations, case reviews, fetal monitoring classes, neonatal resuscitation program training, and the stable program, a course in the stabilization of sick or preterm newborns. The department also participates in community organizations and boards as requested. A primary goal of the department is to assist health care professionals in developing quality care for mothers and babies for improved outcomes. B. Safe Kids Cardinal Glennon is the Missouri sponsor of Safe Kids Worldwide, an organization dedicated to injury prevention for children birth to 14 years of age. The parent organization, Safe Kids Worldwide, coordinates over 400 coalitions in the United States and many others in various countries. The primary focus of our local coalition is child passenger safety, because automobile crashes are the number one cause of child deaths in Missouri and the United States. The local program comprises 55 agencies in St Louis City, St Louis County, Washington, Jefferson and Franklin Counties to provide car seat checks to caregivers and also to provide low-cost car seats for low-income families. Beyond car seats, Safe Kids provides educational services as requested by communities for home safety, poison prevention, pedestrian safety, bicycle safety, and safe sleep. The program conducts needs assessments to determine areas for the greatest impact for services, and also works closely with a number of pediatric hospitals, pediatric hospital departments and multiple agencies to provide greater service to those in need. C. Footprints Footprints is a program of advocacy and support for children living with serious, complex illness. The mission of the program is to have our children, and their families live well along their journey. We define "living well" for each family by facilitating care coordination for the child; by working with the family members to develop a family centered plan of care for the child that focuses on the comfort of the child and respects the values and beliefs of the family; and by collaborating with the health care team to ensure the family goals are honored and supported by all those involved in caring for the child. Footprints children are followed by our staff while in the hospital, during outpatient clinic visits, and at home by means of numerous phone calls and at times, home visits. For some children, "living well" means being at home with family and friends, pets, etc., living as close to "normal" a life as possible. For others, it means having access to costly medical equipment or nursing services that are not covered by insurance, but are necessary to keep the child comfortable and "well" as possible. And lastly, for others, it means relief of some of the extraordinary expenses related to caring long term for a child with serious illness. Funds raised for the program allow us to address some of these needs. Footprints staff provide education to the local, regional, and national community around best practice pediatric palliative care. A three year, on going partnership with others in children's hospital programs in the state has allowed us the opportunity to establish access to pediatric palliative care, similar to the footprints model, in the Missouri cities of Springfield, Cape Girardeau, Columbia and other sites in St Louis. D. St. Louis Cord Blood Bank The St. Louis Cord Blood Bank, one of the largest public cord blood banks in the world, received licensure approval from the U.S. Food and Drug Administration to manufacture and distribute cord blood-derived stem cell products in 2013. It was the first bank in the region and the fourth bank in the world to earn this high distinction. The Blood Bank works with more than 450 doctors at 37 hospitals throughout Eastern Missouri, Southern Illinois, and the Kansas City, Missouri region. The St. Louis Cord Blood Bank collects, processes and stores umbilical cord blood, providing a life-saving use for a birth by-product that would otherwise be discarded as medical waste. Cord blood can be used to treat more than 80 diseases, including leukemia and sickle-cell anemia. Since 1995, over 180,000 families have donated their child's cord blood in the hope of saving the life of another unrelated person. The bank has distributed nearly 2,700 of these cord blood units for transplant worldwide saving more than 1,900 lives since it began. More than 31,000 units remain in storage at the St. Louis Cord Blood Bank, available to treat patients with an appropriate match or provide the material to better understand the biology of stem cells and expand applications for more treatments.
Schedule H, Part VI, Line 6 Affiliated health care system SSM Cardinal Glennon Hospital is a 501(c)(3) non profit corporation operating a children's hospital which serves a 12 county area surrounding the St Louis metropolitan area. It is the only children's hospital in the integrated health care system known as SSM Health.
Schedule H, Part VI, Line 7 State filing of community benefit report IL, MO, OK, WI
Schedule H (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number
43-0738490
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) RONALD MCDONALD HOUSE CHARITIES OF METRO ST LOUIS INC
3450 PARK AVENUE
ST LOUIS,MO63104 		43-1160478 501(C)(3) 5,000       General program support
(2) MATERNAL CHILD AND FAMILY HEALTH COALITION OF METROPOLITAN ST LOUIS
539 N GRAND
SUITE 403
ST LOUIS,MO63103 		41-2139772 501(C)(3) 13,000       General program support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
non-cash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of non-cash assistance
(1) Bus Passes/taxi/parking for patients' family members   18,005      
(2) Provide meals to patients' family members   9,022      
(3) Car Seats/Booster Seats/Bike Helmets   73,424      
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Schedule I, Part III, Column (b) MEAL TICKETS AND BUS PASSES/TAXI SERVICES/parking passes ARE GIVEN TO FAMILY MEMBERS WHOSE LOVED ONES ARE HOSPITALIZED AND WHO DO NOT HAVE THE FUNDS TO MEET THESE NEEDS. THE ORGANIZATION DOES NOT KEEP TRACK OF THE NUMBER OF INDIVIDUALS SERVED UNDER THESE GRANTS.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANTS ARE PROVIDED ONLY TO REGIONAL AND NATIONAL 501(C)(3) ORGANIZATIONS. THESE ORGANIZATIONS ARE EXPECTED TO MAINTAIN ADEQUATE CONTROLS REGARDING THE USE OF GRANT FUNDS FOR THEIR INTENDED PURPOSE.
Schedule I (Form 990) 2015



Additional Data


Software ID: 15000238
Software Version: 2015v2.1


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Candace Jennings
  Director & President 		(i)

(ii)		 0
-------------
617,954 		0
-------------
21,750 		0
-------------
40,055 		0
-------------
209,779 		0
-------------
34,029 		0
-------------
923,567 		0
-------------
21,750
2William Thompson
  Director & Vice Chairperson 		(i)

(ii)		 0
-------------
1,811,138 		0
-------------
308,788 		0
-------------
133,613 		0
-------------
4,365,995 		0
-------------
20,667 		0
-------------
6,640,201 		0
-------------
406,158
3Daniel Baumann MD
  Pt Yr Director 		(i)

(ii)		 0
-------------
240,717 		0
-------------
0 		0
-------------
8,000 		0
-------------
0 		0
-------------
26,515 		0
-------------
275,232 		0
-------------
0
4Donald Binz MD
  Pt Yr Director 		(i)

(ii)		 0
-------------
480,017 		0
-------------
0 		0
-------------
5,454 		0
-------------
0 		0
-------------
33,281 		0
-------------
518,752 		0
-------------
0
5Christopher Howard
  Director 		(i)

(ii)		 0
-------------
880,239 		0
-------------
114,623 		0
-------------
150,453 		0
-------------
325,161 		0
-------------
34,062 		0
-------------
1,504,538 		0
-------------
172,583
6Shane Peng MD
  Director 		(i)

(ii)		 0
-------------
769,472 		0
-------------
97,882 		0
-------------
85,039 		0
-------------
251,042 		0
-------------
36,128 		0
-------------
1,239,563 		0
-------------
137,782
7James Bleicher MD
  Director 		(i)

(ii)		 0
-------------
426,354 		0
-------------
0 		0
-------------
173,487 		0
-------------
109,250 		0
-------------
20,771 		0
-------------
729,862 		0
-------------
0
8Kathleen Becker
  Pt Yr Hospital President 		(i)

(ii)		 0
-------------
496,605 		0
-------------
25,899 		0
-------------
62,409 		0
-------------
117,997 		0
-------------
32,460 		0
-------------
735,370 		0
-------------
55,859
9Paula Friedman
  Vice President 		(i)

(ii)		 0
-------------
652,002 		0
-------------
78,209 		0
-------------
99,438 		0
-------------
241,557 		0
-------------
20,206 		0
-------------
1,091,412 		0
-------------
115,239
10Damon Harbison
  Interim Hospital President 		(i)

(ii)		 225,331
-------------
0 		0
-------------
0 		10,186
-------------
0 		26,698
-------------
0 		23,875
-------------
0 		286,090
-------------
0 		7,548
-------------
0
11June Pickett
  Secretary 		(i)

(ii)		 0
-------------
230,234 		0
-------------
0 		0
-------------
30,943 		0
-------------
23,052 		0
-------------
24,232 		0
-------------
308,461 		0
-------------
0
12Karen Rewerts
  System VP Finance 		(i)

(ii)		 0
-------------
529,282 		0
-------------
0 		0
-------------
50,305 		0
-------------
124,667 		0
-------------
33,498 		0
-------------
737,752 		0
-------------
19,960
13Kris Zimmer
  Treasurer 		(i)

(ii)		 0
-------------
869,852 		0
-------------
109,688 		0
-------------
122,704 		0
-------------
332,810 		0
-------------
34,040 		0
-------------
1,469,094 		0
-------------
161,838
14Lynn Lenker
  Former Key Employee 		(i)

(ii)		 0
-------------
312,790 		0
-------------
0 		0
-------------
67,034 		0
-------------
79,194 		0
-------------
26,619 		0
-------------
485,637 		0
-------------
13,120
15Deborah Walkenhorst
  Former Key Employee 		(i)

(ii)		 0
-------------
87,524 		0
-------------
0 		0
-------------
337,538 		0
-------------
1,021 		0
-------------
16,928 		0
-------------
443,011 		0
-------------
14,080
16Kevin Todd Johnson
  Reg VP - Medical Affairs 		(i)

(ii)		 0
-------------
585,807 		0
-------------
0 		0
-------------
85,390 		0
-------------
173,667 		0
-------------
33,896 		0
-------------
878,760 		0
-------------
23,320
17Terry Palmisano
  VP Nursing - CGCMC 		(i)

(ii)		 187,744
-------------
0 		0
-------------
0 		5,555
-------------
0 		32,089
-------------
0 		13,310
-------------
0 		238,698
-------------
0 		0
-------------
0
18Renee Roach
  System VP - HR SSMHC Stl 		(i)

(ii)		 0
-------------
304,162 		0
-------------
0 		0
-------------
20,021 		0
-------------
55,555 		0
-------------
14,047 		0
-------------
393,785 		0
-------------
0
19Pushpa Patel
  Physician 		(i)

(ii)		 285,931
-------------
0 		0
-------------
0 		2,973
-------------
0 		25,312
-------------
0 		12,533
-------------
0 		326,749
-------------
0 		0
-------------
0
20Pathma Ramesvara
  Physician 		(i)

(ii)		 273,511
-------------
0 		0
-------------
0 		21,410
-------------
0 		3,975
-------------
0 		23,922
-------------
0 		322,818
-------------
0 		0
-------------
0
21Timothy Reed
  Physician 		(i)

(ii)		 281,906
-------------
0 		0
-------------
0 		7,954
-------------
0 		21,141
-------------
0 		24,813
-------------
0 		335,814
-------------
0 		0
-------------
0
22Timothy Staed
  Physician 		(i)

(ii)		 299,702
-------------
0 		0
-------------
0 		3,174
-------------
0 		19,811
-------------
0 		30,420
-------------
0 		353,107
-------------
0 		0
-------------
0
23Yelena Podorozhansky
  Physician 		(i)

(ii)		 299,550
-------------
0 		0
-------------
0 		18,476
-------------
0 		6,692
-------------
0 		4,396
-------------
0 		329,114
-------------
0 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments The following individual listed on Schedule J Part II received a tax indemnification/Gross up payment in 2015. The payment was included in their taxable compensation. Timothy Reed Timothy Staed Yelena Podorozhansky
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The organization's top management official (hospital president) is compensated by a related organization that utilized the following to determine compensation: (1) independent compensation consultant; (2) compensation survey or study; (3) approval by the SSM Health President/CEO.
Schedule J, Part I, Line 4a Severance or change-of-control payment SSMH 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 SSMH. The following individual received payments under the plan. Deborah Walkenhorst $256,705
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Pension Restoration Plan: SSM Health (SSMH) provides this supplemental defined benefit nonqualified retirement plan to any employee who is a participant in the SSMH 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 SSMH'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 SSMH or (2) age 55 or older if the individual is no longer employed by SSMH. No reportable individuals listed on Part VII of Form 990 received distributions from this plan during 2015. Capital Accumulation Plan: SSMH 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 SSMH 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 2014 or after, the distribution will occur after the completion of four 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 2015. All distributions received from the plan in the current year were included in the individuals' taxable compensation. William Thompson $97,489 Christopher Howard $74,102 Shane Peng, MD $51,761 James Bleicher, MD $7,921 Kathleen Becker $29,996 Paula Friedman $38,208 Damon Harbison $8,998 June Pickett $18,727 Karen Rewerts $24,028 Kris Zimmer $53,267 Kevin Todd Johnson $27,745 Lynn Lenker $26,543 Deborah Walkenhorst $42,349
Schedule J (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 9,594 Market value
5 Clothing and household
goods ....... 		X 81,664 Market value
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ... X 18 10,677 Market value
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Toys ) X 164 106,718 Market value
26 Other Right pointing arrow large image ( Use of plane ) X 1 12,000 Market value
27 Other Right pointing arrow large image ( Medical equipment ) X 2 15,044 Cost
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2015)
Schedule M (Form 990) (2015)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I Explanation of reporting method for number of contributions The amount in column (b) represents the number of contributors for all types of items.
Schedule M (Form 990) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Return Reference Explanation
Form 990, Part III, Line 4a Description of Program Service Briefly describe the organization's mission: Since it was founded in 1872 by Catholic sisters, SSM Health (SSMH) has existed to meet the health needs of the communities it serves. SSMH is a Catholic, not-for- profit health system serving the comprehensive health needs of communities across the Midwest through one of the largest integrated delivery systems in the nation. With care delivery sites in Illinois, Missouri, Oklahoma, and Wisconsin, SSMH includes 19 acute care hospitals, one children's hospital, more than 60 outpatient care sites, a pharmacy benefit company, an insurance company, two long-term care facilities, comprehensive home care and hospice services, a technology company, and two Accountable Care Organizations. The health system employs more than 31,000 people and is affiliated with more than 8,500 physicians making it one of the largest employers in every community it serves. SSMH is sponsored by SSM Health Ministries, an independent 6- member body comprised of three Franciscan Sisters of Mary and three lay people who collectively hold certain reserved powers over SSMH. In the tradition of its founding sisters, SSMH strives to fulfill its mission by providing exceptional health care to everyone who comes to its hospitals, regardless of their ability to pay. About SSM Health Cardinal Glennon Children's Hospital: SSM Health Cardinal Glennon Children's Hospital is a 190-bed inpatient and outpatient pediatric medical center that treats children from Missouri, Illinois and around the world. Cardinal Glennon also operates 22 Close to Home locations in the bi-state area bringing the excellence of the medical center's care to your community. Cardinal Glennon specializes in neonatology, cardiology, pediatric and fetal surgery, and cancer services. SSM Health Cardinal Glennon Children's Hospital is home to the Bob Costas Cancer Center, where world-class expertise allows us to offer the latest in innovative and investigational treatments for children. The day hospital at the Bob Costas Cancer Center provides a comfortable setting for children to receive ongoing treatments, such as chemotherapy, transfusions, or other drug treatment, without being admitted to the hospital. Children can also undergo minor procedures under sedation in the comfort of the day hospital. Comforts such as the day hospital allow children to spend more time at home or school, continuing their daily routine and keeping life as normal as possible. US News and World Report has consistently ranked Cardinal Glennon as a top children's hospital nationally. In 2016, the hospital was ranked in three specialties: cardiology and heart surgery (#34), gastroenterology and GI surgery (#35), and pediatric cancer (#49). Describe the organization's approach to providing community benefit: SSM Health (SSM) 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 the 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). First, CHNA is the assessment and prioritization of community health needs and the adoption and implementation of strategies to address those needs. A CHNA is conduced 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: Kick-off meeting conducted and updated toolkit distributed; and periodic meetings scheduled to evaluate and monitor progress. Data collected and report made 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). Next, CBISA is the gathering, collecting, and reporting of all data relating to community benefit activities and programs across the System. A CBISA is conducted every year by each hospital according to the following steps: * Collect and enter data: Kick-off meeting conducted and updated toolkit distributed; new staff complete Lyon web-based course; and periodic meetings scheduled to evaluate and monitor progress. Emails sent reminding staff to submit activities; occurences entered into Lyon; and reports are produced and shared with leaders. * Finalize and report on prior year: All prior year data entered into Lyon by January 31; and communicate final prior year figures to IRS, System Board, and the community. System Office staff and leaders oversee and monitor SSM's Community Benefit Program, and ensure reporting is in compliance with IRS regulations. In collaboration with community stakeholders and partner organizations, all hospital CHNAs were 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. Describe the CHNA community benefit programs: For more information on CHNA community benefit programs provided by SSM Health Cardinal Glennon Children's Hospital, please see Schedule H, Part V. Organization description for tax exemption: In addition to its CHNA community benefit activities, SSM Health Cardinal Glennon Children's Hospital provides many community building activities to promote the health of the communities we serve in response to community identified needs. Listed are the primary initiatives that we support and their impact: A. Perinatal Outreach Services B. Safe Kids C. Footprints D. St. Louis Cord Blood Bank E. PACTS for Life/PALS F. School Partnership Program G. Community Education H. Dorothy and Larry Dallas Heart Center I. St. Louis Fetal Care Institute J. Knights of Columbus Developmental Center K. Pediatric Research Institute L. Community Outreach M. Nationally Recognized N. Dan Dierdoff Emergency and Trauma Center O. GlennonKids Safety Program Additional information on these programs can be found on Schedule H, Part VI. Glennon 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 * Cardinal Glennon is committed to providing a high quality patient care delivery system which includes the reinvestment of surplus funds Describe the corporation's financial assistance policies or programs (i.e. Charity Care, discounting) for low-income persons and how they are communicated to the public: For information on the financial assistance polices provided by SSM Health Cardinal Glennon Children's Hospital, please see Schedule H. Quantifiable Community Benefit: The following is a list of the types of programs and services that could be included as community benefit activities. Traditional Charity Care $ 2,361,402 Cost of Bad Debts $ 1,778,952 Community Benefit Programs $ 55,991,753 Total Quantifiable Community Benefit $ 60,132,107
Form 990, Part VI, Line 4 Significant changes to organizational documents As a result of the 2015 acquisition of SSM - SLUH Inc, the bylaws of SSM Cardinal Glennon Children's Hospital underwent several changes during the year. These changes include: (A) the minimum number of board members has increased from five to seven, (B) Reserved power of the member and decisions reserved to Saint Louis University, (C) Certain decisions of the corporation will now require a supermajority board vote (as described in the bylaws).
Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE MEMBER OF THE CORPORATION IS SSM HEALTH CARE ST LOUIS. SSM HEALTH CARE ST LOUIS IS A NONPROFIT 501(C)(3) ORGANIZATION THAT OPERATES SIX HOSPITALS. BOTH SSM CARDINAL GLENNON CHILDREN'S HOSPITAL AND SSM HEALTH CARE ST LOUIS ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS provided that the appointment of one or more additional members shall required the written consent of Saint Louis University (SLU) and TO APPOINT AND REMOVE THE individuals serving on the Board, other than the SLU Designated Directors who will be subject to designation for appointment and removal by SLU.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The member has the following powers: a. to establish and change the mission, philosophy and values of the Corporation, except to the extent limited by Approval of any material agreement between the Corporation and SSM Health Care Corporation (SSMHCC) or any other subsidiary of SSMHCC which is at variance from the agreed standards for intercompany contracting set forth in the Master Agreement; b. to appoint additional, successor or replacement members of the Corporation, provided, that the appointment of one or more additional members of the Corporation shall require the written consent of ST Louis University (SLU); c. to appoint and remove the individuals serving on the Board, other than the SLU Designated Directors who will be subject to designation for appointment and removal by SLU and as to whom SSMSL shall follow and implement the written instructions of SLU regarding the appointment and removal of the SLU Designated Directors; provided, however, that SSMHCC may remove SLU Designated Directors who violate the conflict of interest policy and other Board policies of the Corporation, as the same may be amended from time to time, upon prior written notice to SLU; d. to appoint and remove the President of the Corporation and the chief executive officer of any Health Care Operating Division, provided, that SSMHCC shall consult with SLU in connection with hiring certain senior employees e. to approve amendments to the Articles of Incorporation of the Corporation, but subject to SLU's prior written consent; f. to approve amendments to these Bylaws, but subject to SLU's prior written consent except that SLU's prior written consent is not required for non-material changes required by applicable law, regulation or any applicable accrediting entity g. to approve the dissolution of the Corporation, but subject to SLU's prior written consent; h. to approve the formation of a Controlled Subsidiary or a Remotely Controlled Subsidiary, provided, that any deviation from the requirements set forth elsewhere in the Bylaws shall require the prior written consent of SLU; I. to approve the acquisition or disposition by the Corporation of another legal entity or an interest in another legal entity, provided, that the Corporation shall obtain the written consent of SLU before divesting of, or admitting another Person as a member of, the Corporation or any other Section 3.1 Subsidiary (as defined in the SSMSL Bylaws) whose assets include the assets comprising CGCH; j. to authorize or approve the acquisition or disposition by the Corporation of real property or any interest in real property, provided, that the Corporation shall obtain the written consent of SLU before disposing of any real property or any interest in real property comprising a substantial portion of the operating assets of CGCH, except that the written consent of SLU shall not be required for the granting of utility easements or access easements which do not materially adversely affect the use of such real property; k. to (i) establish centralized employee benefit, insurance, investment, financing, corporate responsibility, performance assessment and improvement and other operational and support programs; (ii) require the participation of the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary in such programs; and (iii) authorize the opening and closing of bank accounts and investment accounts in the name of the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary in connection with such programs; provided that SSMHCC has determined in its reasonable discretion that such actions are not inconsistent with and do not violate the terms of the Members' Agreement, the Master Agreement, the Academic Affiliation Agreement, the SSMSL Bylaws and these Bylaws; l. to approve the strategic, financial and human resources plan of the Corporation, subject to SLU's rights set forth in the Bylaws; m. to appoint the auditor and corporate counsel for the Corporation; n. subject to SLU's rights in the bylaws, to authorize and approve borrowing money and entering into financial guaranties by the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary, 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 and any Controlled Subsidiary or Remotely Controlled Subsidiary; provided, that SSMHCC has determined in its reasonable discretion that such actions are not inconsistent with and do not violate the terms of the Members' Agreement, the Master Agreement, the Academic Affiliation Agreement, the SSMSL Bylaws and these Bylaws; o. to require the Corporation and any Controlled Subsidiary or Remotely Controlled Subsidiary to transfer assets, including but not limited to cash, to the SSMHCC or to any entity exempt from federal income tax as an organization described in Section 501(c)(3) of the Internal Revenue Code, or the corresponding provision of any future United States Internal Revenue Law, which is controlled by SSMHCC, to the extent necessary to accomplish the mission, goals and objectives of SSMHCC as determined by SSMHCC; provided, that SSMHCC has determined in its reasonable discretion that any such transfer would not reasonably be likely to result in a failure of the Corporation or such subsidiary to fulfill its commitments under the Members' Agreement, the Master Agreement or the Academic Affiliation Agreement; p. subject to SLU's rights in the bylaws, to approve the transfer of assets by the Corporation to any entity other than SSMHCC (other than transfers made in the ordinary course of operations of the Corporation, which will not require approval by the Member); and q. to determine the extent to which and the manner in which the powers described in this section which are reserved to SSMHCC 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; provided, that SSMHCC has determined in its reasonable discretion that any such determination or action is not inconsistent with and does not violate the terms of the Members' Agreement or the terms of the Master Agreement or the Academic Affiliation Agreement.
Form 990, Part VI, Line 11b Review of form 990 by governing body ACCOUNTING/FINANCE PERSONNEL AT EACH SSMH (SSM HEALTH SYSTEM) ENTITY, IN CONJUNCTION WITH SYSTEM FINANCE PERSONNEL, PREPARE INFORMATION AND SUPPORTING SCHEDULES THAT ARE USED TO PREPARE THE FORM 990. THIS INFORMATION IS THEN REVIEWED BY A SUPERVISOR/MANAGER AND SENT TO THE SYSTEM OFFICE, WHERE SSMH PERSONNEL PREPARE THE FORM 990. THE SYSTEM DIRECTOR - TAX AND COMPLIANCE REVIEWS THE COMPLETED RETURN AND PROVIDES THE RETURN TO ENTITY MANAGEMENT PERSONNEL FOR FINAL REVIEW PRIOR TO FILING. THE COMPLETE FORM 990 IS PROVIDED ELECTRONICALLY TO ALL BOARD MEMBERS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
Form 990, Part VI, Line 12c Conflict of interest policy BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY OF 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 MUCH 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, Line 19 Required documents available to the public THE YEAR-END AUDITED CONSOLIDATED FINANCE STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'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.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Miscellaneous sales revenue - Total Revenue: 91847, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 91847;
Form 990, Part IX, Line 11g Other Fees Medical Physician, Practitioner, Psychiatrist, Resident, and Therapist - Total Expense: 44991399, Program Service Expense: 44980156, Management and General Expenses: 11243, Fundraising Expenses: ; Recruitment, Consulting, Administrative, and PBS Fees - Total Expense: 16175370, Program Service Expense: 15463997, Management and General Expenses: 711373, Fundraising Expenses: ; Medical Lab, Radiology, Transportation - Total Expense: 6242537, Program Service Expense: 6242537, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Beneficial Interest in Foundation - -2735701; Transfers to Affiliates - -6238985;
FORM 990, PART I, DOING BUSINESS AS: SSM CARDINAL GLENNON CHILDREN'S HOSPITAL CURRENTLY CONDUCTS BUSINESS UNDER THE FOLLOWING REGISTERED NAMES: 1. CARDINAL GLENNON CHILDREN'S HOSPITAL 2. CARDINAL GLENNON CHILDREN'S HOSPITAL ACC PHARMACY 3. CARDINAL GLENNON CHILDREN'S HOSPITAL AMBULATORY CARE CENTER PHARMACY 4. CARDINAL GLENNON CHILDREN'S MEDICAL CENTER 5. GLENNON CARE PROFESSIONAL SERVICES 6. MISSOURI POISON CENTER 7. ST LOUIS CORD BANK 8. SSM CARDINAL GLENNON CHILDREN'S MEDICAL CENTER 9. SSM GLENNON CARE FOR KIDS 10. SSM CARDINAL GLENNON PEDIATRIC SLEEP & RESEARCH CENTER 11. SSM GLENNON CARE PEDIATRICS 12. SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v2.1
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
SSM Cardinal Glennon Children's Hospital
 
Employer identification number

43-0738490
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)SSM Health Care Corporation
10101 Woodfield Lane

St Louis,MO63132
46-6029223 		Health Care MO 501(c)(3   SSM Health Ministries
 
 
No
(2)SSMHC Liability Trust I
10101 Woodfield Lane

St Louis,MO63132
43-6331003 		Insurance MO 501(c)(3   SSM Health Care Corporation
 
 
No
(3)SSM Consolidated Health Services
10101 Woodfield Lane

St Louis,MO63132
43-1473657 		Health Care MO 501(c)(3   SSM Health Care Corporation
 
 
No
(4)SSM Policy Institute
10101 Woodfield Lane

St Louis,MO63132
43-1788151 		Health Care MO 501(c)(4   SSM Health Care Corporation
 
 
No
(5)SSM Health Care Portfolio Management Co
10101 Woodfield Lane

St Louis,MO63132
43-1825256 		Management MO 501(c)(3   SSM Health Care Corporation
 
 
No
(6)Cardinal Glennon Children's Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1754347 		Fundraising MO 501(c)(3 7 SSM Cardinal Glennon Children's Hospital
 
Yes
 
(7)SSM DePaul Health Center Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1776109 		Fundraising MO 501(c)(3 7 SSM Health Care St Louis
 
 
No
(8)SSM St Joseph Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1591556 		Fundraising MO 501(c)(3 7 SSM Health Care St Louis
 
 
No
(9)SSM St Clare Health Center Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1273310 		Fundraising MO 501(c)(3 7 SSM Health Care St Louis
 
 
No
(10)SSM St Mary's Health Center Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1552945 		Fundraising MO 501(c)(3 7 SSM Health Care St Louis
 
 
No
(11)SSM Health Care of Oklahoma Inc
10101 Woodfield Lane

St Louis,MO63132
73-0657693 		Health Care OK 501(c)(3 3 SSM Health Care Corporation
 
 
No
(12)St Anthony Hospital Foundation Inc
10101 Woodfield Lane

St Louis,MO63132
73-6104300 		Fundraising OK 501(c)(3 7 SSM Health Care of Oklahoma
 
 
No
(13)SSM Health Care of Wisconsin Inc
10101 Woodfield Lane

St Louis,MO63132
43-0688874 		Health Care WI 501(c)(3 3 SSM Health Care Corporation
 
 
No
(14)Dells Medical Building Inc
10101 Woodfield Lane

St Louis,MO63132
39-1613292 		MOB WI 501(c)(2   SSM Health Care of Wisconsin
 
 
No
(15)St Mary's Foundation Inc
10101 Woodfield Lane

St Louis,MO63132
43-1940686 		Fundraising WI 501(c)(3 7 SSM Health Care of Wisconsin
 
 
No
(16)St Clare Health Care Foundation Inc
10101 Woodfield Lane

St Louis,MO63132
43-1940683 		Fundraising WI 501(c)(3 7 SSM Health Care of Wisconsin
 
 
No
(17)Home Health United Inc
2802 Walton Commons Lane

Madison,WI53718
39-1539827 		Health Care WI 501(c)(3 9 SSM Health Care of Wisconsin
 
 
No
(18)Home Care United Inc
2802 Walton Commons Lane

Madison,WI53718
39-1776340 		Health Care WI 501(c)(3 9 SSM Health Care of Wisconsin
 
 
No
(19)HHU Xtra Care Inc
2802 Walton Commons Lane

Madison,WI53718
39-1705111 		Health Care WI 501(c)(3 9 SSM Health Care of Wisconsin
 
 
No
(20)Home Health United - VNS Foundation Inc
2802 Walton Commons Lane

Madison,WI53718
39-1839309 		Fundraising WI 501(c)(3 Type I NA
 
 
No
(21)SSM Regional Health Services
10101 Woodfield Lane

St Louis,MO63132
44-0579850 		Health Care MO 501(c)(3 3 SSM Health Care Corporation
 
 
No
(22)St Francis Hospital Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1099253 		Fundraising MO 501(c)(3 7 SSM Regional Health Services
 
 
No
(23)St Marys Health Center Jefferson City Missouri Foundation
10101 Woodfield Lane

St Louis,MO63132
43-1575307 		Fundraising MO 501(c)(3 Type I SSM Regional Health Services
 
 
No
(24)Good Samaritan Regional Health Center
10101 Woodfield Lane

St Louis,MO63132
43-0653587 		Health Care IL 501(c)(3 3 SSM Regional Health Services
 
 
No
(25)St Marys - Good Samaritan Inc
10101 Woodfield Lane

St Louis,MO63132
36-4170833 		Health Care IL 501(c)(3   SSM Regional Health Services
 
 
No
(26)Good Samaritan Regional Health Center Foundation
10101 Woodfield Lane

St Louis,MO63132
26-2884795 		Fundraising IL 501(c)(3 7 St Mary's - Good Samaritan Inc
 
 
No
(27)St Marys Hospital Foundation
10101 Woodfield Lane

St Louis,MO63132
36-4636691 		Fundraising IL 501(c)(3 7 St Mary's - Good Samaritan Inc
 
 
No
(28)St Mary's Hosptial Auxiliary
400 N Pleasant

Centralia,IL62801
23-7126345 		Fundraising IL 501(c)(3 9 St Mary's Hospital Foundation
 
 
No
(29)SSM Health Businesses
10101 Woodfield Lane

St Louis,MO63132
43-1333488 		Health Care MO 501(c)(3 9 SSM Health Care Corporation
 
 
No
(30)SSM Health Care St Louis
10101 Woodfield Lane

St Louis,MO63132
43-1343281 		Health Care MO 501(c)(3 3 SSM Health Care Corporation
 
 
No
(31)Centralia Medical Services Bldg Assoc
10101 Woodfield Lane

St Louis,MO63132
23-7408025 		MOB IL 501(c)(3   SSM Regional Health Services
 
 
No
(32)St Mary's Janesville Foundation Inc
2901 Landmark PL Ste 300

Madison,WI53713
27-3439133 		Fundraising WI 501(c)(3 7 SSM Health Care of Wisconsin
 
 
No
(33)Franciscan Sisters of Mary
3221 McKelvey Road Suite 107

St Louis,MO63044
43-1012492 		Religious Organization MO 501(c)(3 1 NA
 
 
No
(34)Lee Dewey Corporation
10101 Woodfield Lane

St Louis,MO63132
73-1279603 		MOB OK 501(c)(3   SSM Health Care of Oklahoma
 
 
No
(35)SSM Hospice and Home Care Foundation
10101 Woodfield Lane

St Louis,MO63132
30-0012246 		Fundraising MO 501(c)(3 7 SSM Health Businesses
 
 
No
(36)St Mary's Hospital Auxiliary
100 St Marys Medical Plaza

Jefferson City,MO65101
43-6049878 		Fundraising MO 501(c)(3 Type I NA
 
 
No
(37)Good Samaritan Hospital Auxiliary
1 Good Samaritan Way

Mt Vernon,IL62864
23-7049599 		Fundraising IL 501(c)(3 Type II NA
 
 
No
(38)St Anthony Shawnee Hospital Inc
1000 N Lee Ave

Oklahoma City,OK73102
45-5055149 		Health Care OK 501(c)(3 3 SSM Health Care of Oklahoma
 
 
No
(39)SSM Audrain Health Care Inc
10101 Woodfield Lane

St Louis,MO63132
43-1550298 		Health Care MO 501(c)(3 3 SSM Regional Health Services
 
 
No
(40)Audrain Medical Center Foundation Inc
620 E Monroe Street

Mexico,MO65265
43-1265060 		Fundraising MO 501(c)(3   SSM Audrain Health Care Inc
 
 
No
(41)St Mary's Hospital Centralia Illinois
10101 Woodfield Lane

St Louis,MO63132
37-0662580 		Health Care IL 501(c)(3 3 SSM Regional Health Services
 
 
No
(42)SSM-SLUH Inc
10101 Woodfield Lane

St Louis,MO63132
47-4196634 		Health Care MO 501(c)(3 3 SSM Health Care St Louis
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) SSM St Joseph Endoscopy Center LLC

10101 Woodfield Lane
St Louis,MO63132
27-0046559 		Surgery Services MO NA
  		N/A 0 0     0     0 %
(2) St Clare Imaging Services

707 14th Street Suite A
Baraboo,WI53913
20-0122365 		Diag Services WI NA
  		N/A 0 0     0     0 %
(3) Mt Vernon Radiation Therapy Center LLC

10101 Woodfield Lane
St Louis,MO63132
20-1382620 		Radiation Therapy IL NA
  		N/A 0 0     0     0 %
(4) Sleep & Neurology Center of S Illinois LLC

10101 Woodfield Lane
St Louis,MO63132
20-8468195 		Diag Services IL NA
  		N/A 0 0     0     0 %
(5) ChowSMGSI Office Building LLC

10101 Woodfield Lane
St Louis,MO63132
37-1383861 		MOB IL NA
  		N/A 0 0     0     0 %
(6) Oza Cancer Center LLC

10101 Woodfield Lane
St Louis,MO63132
20-1382727 		MOB IL NA
  		N/A 0 0     0     0 %
(7) Shawnee Real Estate Holdings LLC

1000 N Lee Ave
Oklahoma City,OK73102
45-5458304 		MOB OK NA
  		N/A 0 0     0     0 %
(8) SSM RX Express LLC

10101 Woodfield Lane
St Louis,MO63132
26-4031708 		Pharmacy MO NA
  		N/A 0 0     0     0 %
(9) Dean Clinic & St Marys Hospital Accountable Care Organization LLC

1808 West Beltline Highway
Madison,WI53713
45-2995500 		Accountable Care Organization WI NA
  		N/A 0 0     0     0 %
(10) Wisconsin Integrated Information Technology and Telemedicine Systems LLC

1808 West Beltline Highway
Madison,WI53713
39-2016715 		Information Technology Services WI NA
  		N/A 0 0     0     0 %
(11) Dean Health Holdings LLC

1277 Deming Way
Madison,WI53717
26-1594709 		Support Services WI NA
  		N/A 0 0     0     0 %
(12) Wingra Building Group

1808 West Beltline Highway
Madison,WI53713
39-0237060 		MOB WI NA
  		N/A 0 0     0     0 %
(13) Janesville Riverview Clinic Building Partnership

1808 West Beltline Highway
Madison,WI53713
39-6220698 		MOB WI NA
  		N/A 0 0     0     0 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) SSM Managed Care Organization LLC

10101 Woodfield Lane
St Louis,MO63132
43-1708511 		Health Promotion MO NA
  		C Corporation         No
(2) FPP Inc

10101 Woodfield Lane
St Louis,MO63132
43-1465174 		Health Care MO NA
  		C Corporation         No
(3) Diversified Health Services Corp

10101 Woodfield Lane
St Louis,MO63132
43-1369305 		Medical Equipment MO NA
  		C Corporation         No
(4) SSM Cardio and Thoracic Services Inc

10101 Woodfield Lane
St Louis,MO63132
26-0286559 		Health Care MO NA
  		C Corporation         No
(5) SSM Properties Inc

10101 Woodfield Lane
St Louis,MO63132
43-1462486 		Property Services MO NA
  		C Corporation         No
(6) SSM Depaul Medical Group Inc

10101 Woodfield Lane
St Louis,MO63132
43-1715106 		Health Care MO NA
  		C Corporation         No
(7) SSM St Charles Clinic Med Group Inc

10101 Woodfield Lane
St Louis,MO63132
43-0626408 		Physician Offices MO NA
  		C Corporation         No
(8) Health First Phys Management

10101 Woodfield Lane
St Louis,MO63132
73-1534336 		Medical Services OK NA
  		C Corporation         No
(9) SSMHCS Liability Trust II

10101 Woodfield Lane
St Louis,MO63132
81-6128118 		Insurance MO NA
  		C Corporation         No
(10) SSM Neurosciences Inc

10101 Woodfield Lane
St Louis,MO63132
26-3413981 		Health Care MO NA
  		C Corporation         No
(11) SSM Medical Group Inc

10101 Woodfield Lane
St Louis,MO63132
43-1664107 		Physician Offices MO NA
  		C Corporation         No
(12) SSMHC Insurance Company

10101 Woodfield Lane
St Louis,MO63132
03-0310431 		Insurance CA NA
  		C Corporation         No
(13) SSM Orthopedic Inc

10101 Woodfield Lane
St Louis,MO63132
27-1557033 		Health Care MO NA
  		C Corporation         No
(14) SSM Cancer Care Inc

10101 Woodfield Lane
St Louis,MO63132
27-1557324 		Health Care MO NA
  		C Corporation         No
(15) Physicians Services Corp of Southern Illinois

10101 Woodfield Lane
St Louis,MO63132
36-4161526 		Health Care IL NA
  		C Corporation         No
(16) Dean Health Systems Inc

1808 West Beltline Highway
Madison,WI53713
39-1128616 		Physician Offices WI NA
  		C Corporation         No
(17) Dean Health Insurance Inc

PO Box 56099
Madison,WI53705
39-1830837 		Insurance WI NA
  		C Corporation         No
(18) Dean Health Plan Inc

PO Box 56099
Madison,WI53705
39-1535024 		Insurance WI NA
  		C Corporation         No
(19) St Marys Dean Ventures Inc

1808 West Beltline Highway
Madison,WI53713
39-1628491 		Physician Offices WI NA
  		C Corporation         No
(20) Dean Retail Services Inc

1808 West Beltline Highway
Madison,WI53713
39-1717636 		Property Services WI NA
  		C Corporation         No
(21) Navitus Holdings LLC

1808 West Beltline Highway
Madison,WI53713
80-0968174 		Pharmacy Benefits WI NA
  		C Corporation         No
(22) Oza Oncology Inc

4117 Veterans Memorial Drive
Mt Vernon,IL62804
37-1343746 		Physician Offices IL NA
  		C Corporation         No
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Cardinal Glennon Children's Foundation

 C 10,673,876 Cost
(2) Cardinal Glennon Children's Foundation

 P 3,142,531 Cost




Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


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