TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JAN CERNY...................................................................... DIRECTOR, VICE CHAIRPERSON	1.00 ................. 3.00	X	X		0	0	0
(2) SNEHAL GANDHI MD...................................................................... DIRECTOR	1.00 ................. 3.00	X			0	0	0
(3) DOUGLASS PETTY...................................................................... DIRECTOR	1.00 ................. 3.00	X			0	0	0
(4) DENNIS HARMS...................................................................... DIRECTOR	1.00 ................. 3.00	X			0	0	0
(5) JOSEPH YANCEY...................................................................... DIRECTOR	1.00 ................. 3.00	X			0	0	0
(6) CHRISTINE JACOBS MD...................................................................... DIRECTOR, ACTING DEAN, INTERIM VP MEDICAL AFFAIRS	1.00 ................. 3.00	X			0	0	0
(7) TIMOTHY JOHNSON MD...................................................................... DIRECTOR, SYSTEM VP MEDICAL GROUP & POP HEALTH OPS	1.00 ................. 50.00	X			0	749,701	300,989
(8) JEREMY FOTHERINGHAM...................................................................... CHAIRPERSON, PRESIDENT, REGIONAL PRESIDENT - ST. L	20.00 ................. 20.00	X	X		0	1,125,814	687,586
(9) STEPHEN SMITH...................................................................... DIRECTOR	1.00 ................. 3.00	X			0	0	0
(10) STEVE SMOOT...................................................................... VICE PRESIDENT, COO AT SSM HEALTH	1.00 ................. 50.00		X		0	2,054,358	1,204,489
(11) RANDY COMBS...................................................................... TREASURER, CFO AT SSM HEALTH	1.00 ................. 50.00		X		0	2,182,354	1,238,074
(12) DOUGLAS LONG...................................................................... SECRETARY, CLO AT SSM HEALTH	1.00 ................. 50.00		X		0	1,425,239	777,013
(13) EILEEN LAMM...................................................................... REGIONAL VP, FINANCE (MO/ILL)	20.00 ................. 20.00		X		0	516,349	204,353
(14) TINA GARRISON...................................................................... REGIONAL VP - CHIEF OPERATING OFFICER ST. LOUIS/SO	20.00 ................. 20.00			X	689,730	0	266,288
(15) JAKE BROOKS...................................................................... HOSPITAL PRESIDENT - SSM HEALTH ST. JOSEPH-ST. CHA	40.00 ................. 0.00			X	494,785	0	197,616
(16) DEBORAH GRAVES...................................................................... HOSPITAL PRESIDENT - SSM HEALTH ST. JOSEPH-LSL	40.00 ................. 0.00			X	523,925	0	69,488
(17) KYLE GRATE...................................................................... HOSPITAL PRESIDENT - SSM HEALTH ST. CLARE HOSPITAL	40.00 ................. 0.00			X	455,072	0	194,017

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) KEVIN ELLEDGE........................................................................ REGIONAL PRESIDENT - MEDICAL GROUP	20.00 .......................20.00	X			0	715,497	222,319
(19) JULIE WILHITE........................................................................ REGIONAL VP - HUMAN RESOURCES	20.00 .......................20.00	X			0	444,301	154,807
(20) BOB PENDLETON........................................................................ REGIONAL CHIEF CLINICAL OFFICER	20.00 .......................20.00	X			754,330	0	273,691
(21) RACHEL DONLAN........................................................................ REGIONAL VP - ACADEMIC & PHYSICIAN INTEGRATION	20.00 .......................20.00	X			0	429,496	171,125
(22) MIN PAN........................................................................ PHYSICIAN	40.00 .......................0.00		X		846,316	0	43,908
(23) MARIO MORALES........................................................................ PHYSICIAN	40.00 .......................0.00		X		1,468,272	0	47,060
(24) THOMAS LANDON........................................................................ PHYSICIAN	40.00 .......................0.00		X		803,502	0	53,819
(25) KATE APPLETON........................................................................ PHYSICIAN	40.00 .......................0.00		X		578,773	0	24,427
(26) ANDREA SCHWOERER........................................................................ PHYSICIAN	40.00 .......................0.00		X		663,466	0	49,707
(27) LAURA KAISER........................................................................ FORMER OFFICER, PRESIDENT/CEO AT SSM HEALTH	0.00 .......................50.00			X	0	4,644,135	3,002,313
(28) KAREN REWERTS........................................................................ FORMER OFFICER, SYSTEM VP FINANCE AT SSM HEALTH	0.00 .......................50.00			X	0	801,331	287,514
(29) MISTY JONES........................................................................ FORMER KEY EMPLOYE, VP HOSPITAL ADMINISTRATOR, COO	0.00 .......................50.00			X	491,500	0	179,264
(30) ALEXANDER GARZA MD........................................................................ FORMER OFFICER, CHIEF COMMUNITY HEALTH OFFICER	0.00 .......................50.00			X	0	1,032,700	624,655

(A) Name and business address	(B) Description of services	(C) Compensation
CARE STAT INC 13355 W WASHINGTON BLVD LOS ANGELES,CA90066	MEDICAL SERVICES	32,611,260
SOUND PHYSICIANS OF ILLINOIS LLC 1498 PACIFIC AVENUE TACOMA,WA95402	MEDICAL SERVICES	19,464,628
OMNICELL INC 4220 NORTH FREEWAY FORT WORTH,TX76137	MEDICAL SERVICES	18,452,419
VAYA WORKFORCE SOLUTIONS LLC 5930 CORNERSTONE CT W SAN DIEGO,CA92121	STAFFING SERVICES	16,730,098
METRO WEST ANESTHESIA GROUP INC 400 S WOODSMIL RD STE 140 CHESTERFIELD,MO63017	MEDICAL SERVICES	14,924,010
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 159

- TIN:

SCHEDULE A
(Form 990)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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.)..

First 5 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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization SSM HEALTH CARE ST LOUIS

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization SSM HEALTH CARE ST LOUIS		Employer identification number 43-1343281

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization SSM HEALTH CARE ST LOUIS			Employer identification number 43-1343281
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

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 HEALTH CARE ST LOUIS

Employer identification number

43-1343281

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

321,529

Total. Add lines 1c through 1i ....................................................................................................

321,529

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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
PART II-B, LINE 1:	THE ORGANIZATION PAID DUES TO VARIOUS NATIONAL AND LOCAL HOSPITAL ASSOCIATIONS AND A PORTION OF THESE DUES WAS ALLOCATED TO LOBBYING ACTIVITIES.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	5,012,499	4,577,652	4,176,315	5,003,511	3,332,047
b	Contributions ...	2,500	0	25,000	0	1,502,500
c	Net investment earnings, gains, and losses	74,344	434,847	376,337	672,804	502,477
d	Grants or scholarships ...		0	0	0	0
e	Other expenditures for facilities and programs ...		0	0	1,500,000	333,513
f	Administrative expenses ....		0	0	0	0
g	End of year balance ......	5,089,343	5,012,499	4,577,652	4,176,315	5,003,511

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

19.990 %

Permanent endowment right arrow

80.010 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 .....	64,821,837		64,821,837
b	Buildings ....	865,354,467	498,662,520	366,691,947
c	Leasehold improvements	56,407,564	40,197,741	16,209,823
d	Equipment ....	528,293,896	417,104,152	111,189,744
e	Other .....	43,980,934	777,779	43,203,155
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				602,116,506

Schedule D (Form 990) 2022

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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)INVESTMENT IN SUBSIDIARIES	29,852,196	F
(2)INTEREST IN FOUNDATION	28,373,762	F
(3)INTEREST IN INTERCOMPANY ENTITIES	2,278,849	F
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	60,504,807

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)COLLATERAL HELD UNDER AGREEMENT				30,174,239
(2)ESTIMATED THIRD PARTY SETTLEMENT				29,530,710
(3)INTERCOMPANY RECEIVABLE				209,021
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				59,913,970

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
PAYABLE TO THIRD-PARTY PAYORS	34,244,469
OPERATING RIGHT-OF-USE LIABILITIES	33,165,349
INTERCOMPANY PAYABLES	873,612,798
OTHER LONG-TERM LIABILITIES	602,694
DEFERRED COMPENSATION PLAN LIABILITIES	6,984,507
OTHER LIABILITIES	1,881



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	948,611,698
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) 2022

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

PART V, LINE 4:

ALL ENDOWMENT FUNDS WILL BE USED TO SUPPORT HEALTH CARE SERVICES.

PART X, LINE 2:

SSM HEALTH CARE ST LOUIS' 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 2023 OR 2022.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	35,315,404	0	35,315,404	1.730 %
b	Medicaid (from Worksheet 3, column a) . . . . .	330,850,954	334,430,074	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	25,584,657	16,188,324	9,396,333	0.460 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	391,751,015	350,618,398	44,711,737	2.190 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,377,439	25,000	5,352,439	0.260 %
f	Health professions education (from Worksheet 5) . . .	23,598,757	11,454,074	12,144,683	0.600 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0
h	Research (from Worksheet 7) .	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	111,078	0	111,078	0.010 %
j	Total. Other Benefits . .	29,087,274	11,479,074	17,608,200	0.870 %
k	Total. Add lines 7d and 7j .	420,838,289	362,097,472	62,319,937	3.060 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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			0	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			0	0
7	Community health improvement advocacy			121,555	0	121,555	0.010 %
8	Workforce development			1,963	0	1,963	0 %
9	Other			0	0
10	Total			123,518		123,518	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

38,854,142

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

268,381,439

Enter Medicare allowable costs of care relating to payments on line 5.....

340,794,728

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-72,413,289

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
11 SSM ST JOSEPH ENDOSCOPY CENTER LLC	OPERATE AN ENDOSCOPY CENTER	50.000 %	0 %	50.000 %
22 ST LOUIS CYBERKNIFE LLC	OPERATE A CANCER TREATMENT CENTER	44.000 %	0 %	56.000 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?6Name, 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)						Other (describe)	Facility reporting group
1	SSM HEALTH DEPAUL HOSPITAL-ST LOUIS 12303 DEPAUL DRIVE BRIDGETON,MO63044 HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/ST 414-27	X	X		X		A
2	SSM HEALTH ST MARY'S HOSPITAL-ST LOUIS 6420 CLAYTON ROAD ST LOUIS,MO63117 HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/ST 383-29	X	X	X	X		A
3	SSM HEALTH ST JOSEPH HOSPITAL-ST CHARLES 300 FIRST CAPITAL DRIVE ST CHARLES,MO63301 HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/ST 494-16	X	X		X		A
4	SSM HEALTH ST CLARE HOSPITAL-FENTON 1015 BOWLES AVENUE FENTON,MO63026 HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/ST 456-22	X	X		X
5	SSM HEALTH ST JOSEPH HOSPITAL-LAKE ST LOUIS 100 MEDICAL DRIVE LAKE ST LOUIS,MO63367 HTTPS://WWW.SSMHEALTH.COM/LOCATIONS/ST 381-29	X	X		X		A
6	SSM HEALTH REHABILITATION HOSPITAL 12380 DEPAUL DRIVE BRIDGETON,MO63044 HTTPS://WWW.SSM-REHAB.COM/ 522-4	X				REHAB HOSPITAL

Schedule H (Form 990) 2023

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)

	FACILITY REPORTING GROUP - A
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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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 .................

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..................................

Yes

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.SSMHEALTH.COM/RESOURCES/PAY-MY-BILL/FINANCIAL-ASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.SSMHEALTH.COM/RESOURCES/PAY-MY-BILL/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.SSMHEALTH.COM/RESOURCES/PAY-MY-BILL/FINANCIAL-ASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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 ST CLARE HOSPITAL-FENTON
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):

Yes

Community Health Needs Assessment

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?........................

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SSM HEALTH ST CLARE HOSPITAL-FENTON
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.SSMHEAL TH.COM/RESOURCES/PATIENTS-VISITORS/PA Y-MY-BILUFINANCIA

The FAP application form was widely available on a website (list url):

HTTPS://WWW.SSMHEAL TH.COM/RESOURCES/PATIENTS-VISITORS/PA Y-MY-BILUFINANCIA

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.SSMHEAL TH.COM/RESOURCES/PATIENTS-VISITORS/PA Y-MY-BILUFINANCIA

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	SSM HEALTH ST CLARE HOSPITAL-FENTON
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SSM HEALTH ST CLARE HOSPITAL-FENTON
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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 REHABILITATION 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):

Yes

Community Health Needs Assessment

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?........................

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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..................................

Yes

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://WWW.SSMHEALTH.COM/RESOURCES/ABOUT/COMMUNITY-HEALTH/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SSM HEALTH REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.SSM-REHAB.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANCIAL-ASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.SSM-REHAB.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.SSM-REHAB.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANCIAL-ASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	SSM HEALTH REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SSM HEALTH REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
SSM HEALTH ST. CLARE HOSPITAL-FENTON	PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
SSM HEALTH REHABILITATION HOSPITAL	PART V, SECTION B, LINE 3J: THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
SSM HEALTH ST. CLARE HOSPITAL-FENTON	PART V, SECTION B, LINE 5: A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEAL TH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: SOUTH ST. LOUIS COUNTY: COMMUNITY TREATMENT, INC. (COMTREA) EUREKA FIRE PROTECTION DISTRICT HANCOCK PLACE SCHOOL DISTRICT LEMAY CHILD AND FAMILY CENTER LINDBERGH SCHOOLS LINDBERGH SCHOOLS FOUNDATION PREVENT + ED (FORMERLY NCADA) SAINT LOUIS COUNTY DEPARTMENT OF HEAL TH ST. LOUIS SUBURBAN SCHOOL NURSES ASSOCIATION JEFFERSON COUNTY: AGING AHEAD ALZHEIMER'S ASSOCIATION, GREATER MISSOURI CHILDREN'S ADVOCACY CENTER OF EAST CENTRAL MISSOURI COMTREA COMTREA DENTAL FIRST UNITED METHODIST CHURCH OF FESTUS - CRYSTAL CITY EUREKA FIRE PROTECTION DISTRICT FESTUS R-6 SCHOOLS HILLSBORO R-111 SCHOOL DISTRICT JEFFERSON COLLEGE JEFFERSON COUNTY HEAL TH DEPARTMENT JEFFERSON COUNTY CIRCUIT COURT JEFFERSON COUNTY GROWTH ASSOCIATION JEFFERSON COUNTY JUVENILE OFFICE JOACHIM-PLATTIN AMBULANCE DISTRICT KEATON CENTER LANE CONSOLIDATED MERCY JEFFERSON NORTHWEST SCHOOL DISTRICT PATH GROUP PEACE PANTRY OF CEDAR HILL VALLE AMBULANCE DISTRICT
SSM HEALTH REHABILITATION HOSPITAL	PART V, SECTION B, LINE 5: A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEAL TH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEAL TH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: NORTH ST. LOUIS COUNTY:AGING AHEADALIVE AND WELL COMMUNITIESASTHMA AND ALLERGY FOUNDATION - ST. LOUIS CORNERSTONE REALTYJEWISH AND FAMILY SERVICES OF ST. LOUIS OUR FAMILY'S DOING YOGAREFUGE AND RESTORATION PREVENT+ EDST. LOUIS AREA DIAPER BANKST. LOUIS COUNTY DEPARTMENT OF HEALTH ST. LUKE'S HOSPITAL
SSM HEALTH REHABILITATION HOSPITAL	PART V, SECTION B, LINE 6A: THE HOSPITAL CONDUCTED AND COMPLETED ITS 2021 CHNA JOINTLY WITH SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS.
SSM HEALTH ST. CLARE HOSPITAL-FENTON	PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - MENTAL HEALTH - OVERWEIGHT/OBESITY - HEART HEALTH MENTAL HEALTH THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. MENTAL HEAL TH DIAGNOSIS HAVE BEEN ON THE INCREASE IN ST. LOUIS COUNTY EVERY YEAR, SINCE 2018, IN ALMOST EVERY CATEGORY INCLUDING ANXIETY AND FEAR DISORDERS, BIPOLAR MOOD DISORDERS, DEPRESSIVE MOOD DISORDERS AND SCHIZOPHRENIA AND PSYCHOTIC DISORDERS AS WELL AS TRAUMA AND STRESS RELATED DISORDERS. MENTAL HEALTH IS MORE THAN THE ABSENCE OF MENTAL ILLNESS IT IS ESSENTIAL FOR OVERALL HEALTH AND QUALITY OF LIFE. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY MENTAL HEALTH: - INCREASE ACCESS TO EXISTING MENTAL AND BEHAVIORAL HEAL TH PROGRAMS AND SERVICES- SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEAL TH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO MENTAL AND BEHAVIORAL HEALTH- STRENGTHEN INTERNAL BEHAVIORAL HEAL TH SERVICES AND CAPACITIES- PROMOTE SAFE MEDICATION DISPOSAL - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY, EDUCATION, AND STRATEGIC COMMUNICATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEALTH CARE- INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEAL TH TREATMENT AND CARE - HEAL THIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE OVERWEIGHT/OBESITY GOOD NUTRITION, PHYSICAL ACTIVITY, AND A HEAL THY BODY WEIGHT ARE ESSENTIAL PARTS OF A PERSON'S OVERALL HEALTH AND WELL-BEING. MOST AMERICANS, HOWEVER, DO NOT EAT A HEALTHFUL DIET AND ARE NOT PHYSICALLY ACTIVE AT LEVELS NEEDED TO MAINTAIN PROPER HEAL TH AND WEIGHT. IN JEFFERSON COUNTY, 32% OF ADULTS ARE CONSIDERED OBESE AND 29% IN ST. LOUIS COUNTY. CHRONIC DISEASES, OFTEN STRONGLY LINKED TO OBESITY, ARE THE LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES, CAUSING 7 OUT OF 10 DEATHS EACH YEAR. EXAMPLES OF CHRONIC DISEASES INCLUDE CARDIOVASCULAR DISEASE, ARTHRITIS, DIABETES AND CANCER. HEAL THY EATING & ACTIVE LIVING (HEAL) IS ESSENTIAL TO MANAGING OBESITY AND CHRONIC DISEASES. THE HOSPITAL HAS PLANNED THE FOLLOWING DIRECTIVES TO REDUCE OVERWEIGHT ISSUES AND OBESITY IN THE COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING OBESITY AND CHRONIC DISEASE - INCREASE ACCESS TO CHRONIC DISEASE MANAGEMENT SERVICES- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO HEALTHY EATING AND ACTIVE LIVING (HEAL)- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF OBESITY DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY, EDUCATION, AND STRATEGIC COMMUNICATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON FOOD INSECURITY AND HEAL TH FOOD ACCESS, AS WELL AS PHYSICAL ACTIVITY - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEALTHY EATING AND CHRONIC DISEASE MANAGEMENT- INCREASED COMMUNITY CONSUMPTION OF HEAL THY FOODS - INCREASED COMMUNITY PHYSICAL ACTIVITY - IMPROVED COMMUNITY ENVIRONMENTS, SCHOOLS, AND WORKSITES THAT SUPPORT HEAL- INCREASED ADVOCACY FOR CHANGE AND POLICIES SUPPORTING HEAL THY LIVING FOR ALLHEART HEALTH CONTROLLING RISK FACTORS FOR HEART DISEASE AND STROKE REMAINS A CHALLENGE. HIGH BLOOD PRESSURE, CIGARETTE SMOKING, AND HIGH BLOOD CHOLESTEROL ARE STILL MAJOR CONTRIBUTORS TO THE NATIONAL EPIDEMIC OF CARDIOVASCULAR DISEASE. THE RISK OF AMERICANS DEVELOPING AND DYING FROM CARDIOVASCULAR DISEASE WOULD BE SUBSTANTIALLY REDUCED IF MAJOR IMPROVEMENTS WERE MADE ACROSS THE U.S. POPULATION IN DIET AND PHYSICAL ACTIVITY, CONTROL OF HIGH BLOOD PRESSURE AND CHOLESTEROL, SMOKING CESSATION, AND APPROPRIATE ASPIRIN USE. AFRICAN AMERICAN RESIDENTS IN ST. LOUIS COUNTY ARE DISPROPORTIONATELY AFFECTED BY HEART DISEASE TO A STAGGERING DEGREE, CONSISTENTLY HAVING HIGHER MORTALITY AND HOSPITAL VISIT RATES COMPARED TO OTHER RACIAUETHNIC GROUPS IN THE COUNTY. THE HOSPITAL HAS THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE THE HEART HEALTH FOR ITS COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING NUTRITION AND HEART DISEASE - INCREASE ACCESS TO HEART DISEASE MANAGEMENT SERVICES - SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO NUTRITIOUS FOODS - STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF HEART DISEASE DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT- GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY, EDUCATION, AND STRATEGIC COMMUNICATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON HEART HEALTH AND NUTRITION- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEART HEALTH AND NUTRITION- INCREASED COMMUNITY CONSUMPTION OF NUTRITIOUS FOODS- INCREASED HEART HEAL THY ACTIVITIES - INCREASED POLICIES SUPPORTING HEALTHY LIVING FOR ALL THE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS TO ADDRESS ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.
SSM HEALTH REHABILITATION HOSPITAL	PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - BEHAVIORAL HEALTH- HEART HEALTH/NUTRITION- RESPIRATORY DISEASESBEHAVIORAL HEALTH BEHAVIORAL HEALTH (BH), INCLUSIVE OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, WAS DETERMINED TO BE A PRIORITY HEALTH NEED IN EACH HOSPITAL MINISTRY COMMUNITY'S CHNA PROCESS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. SUBSTANCE ABUSE DISORDERS HAVE A MAJOR IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, SIGNIFICANTLY CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL, AND PUBLIC HEALTH PROBLEMS. IN 2019, 18.5% OF RESIDENTS IN THE INNER NORTH REGION OF ST. LOUIS COUNTY REPORTED EXPERIENCING 14 OR MORE POOR MENTAL HEALTH DAYS IN THE PAST MONTH COMPARED TO THE NATIONAL AVERAGE OF 13.6%. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY BEHAVIORAL HEALTH: - INCREASE ACCESS TO EXISTING MENTAL AND BEHAVIORAL HEALTH PROGRAMS AND SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO BEHAVIORAL HEALTH - STRENGTHEN INTERNAL BEHAVIORAL HEAL TH SERVICES AND CAPACITIES - PROMOTE SAFE MEDICATION DISPOSAL - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEAL TH CARE- INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEALTH TREATMENT AND CARE - HEAL THIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE HEART HEALTH/NUTRITION CONTROLLING RISK FACTORS FOR HEART DISEASE AND STROKE REMAINS A CHALLENGE. HIGH BLOOD PRESSURE, CIGARETTE SMOKING, AND HIGH BLOOD CHOLESTEROL ARE STILL MAJOR CONTRIBUTORS TO THE NATIONAL EPIDEMIC OF CARDIOVASCULAR DISEASE. THE RISK OF AMERICANS DEVELOPING AND DYING FROM CARDIOVASCULAR DISEASE WOULD BE SUBSTANTIALLY REDUCED IF MAJOR IMPROVEMENTS WERE MADE ACROSS THE U.S. POPULATION IN DIET AND PHYSICAL ACTIVITY, CONTROL OF HIGH BLOOD PRESSURE AND CHOLESTEROL, SMOKING CESSATION, AND APPROPRIATE ASPIRIN USE. BLACK/AFRICAN AMERICAN RESIDENTS IN ST. LOUIS COUNTY ARE DISPROPORTIONATELY AFFECTED BY HEART DISEASE TO A STAGGERING DEGREE, CONSISTENTLY HAVING HIGHER MORTALITY AND HOSPITAL VISIT RATES COMPARED TO OTHER RACIAUETHNIC GROUPS IN THE COUNTY. THE HOSPITAL HAS THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE THE HEART HEALTH FOR ITS COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING NUTRITION AND HEART DISEASE - INCREASE ACCESS TO HEART DISEASE MANAGEMENT SERVICES - SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO NUTRITIOUS FOODS- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF HEART DISEASE DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING - ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATION THE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON HEART HEALTH AND NUTRITION - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEART HEALTH AND NUTRITION - INCREASED COMMUNITY CONSUMPTION OF NUTRITIOUS FOODS- INCREASED HEART HEALTHY ACTIVITIES - INCREASED ADVOCACY FOR CHANGE - INCREASED POLICIES SUPPORTING HEALTHY LIVING FOR ALL RESPIRATORY DISEASES RESPIRATORY DISEASES AFFECT MILLIONS OF PEOPLE IN THE UNITED STATES. THE BURDEN OF RESPIRATORY DISEASES AFFECTS INDIVIDUALS AND THEIR FAMILIES, SCHOOLS, WORKPLACES, NEIGHBORHOODS, CITIES, AND STATES. ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE SIGNIFICANT PUBLIC HEALTH BURDENS. THERE ARE ALSO SEVERAL EMERGING RESPLRATORY HEALTH ISSUES SUCH AS THE IMPACT OF ENVIRONMENTAL CHANGE AND INCREASING IMPORTANCE OF INDOOR AIR QUALITY. NORTH ST. LOUIS COUNTY HAS DISPROPORTIONATELY HIGHER RATES OF ASTHMA COMPARED TO OTHER AREAS IN ST. LOUIS COUNTY. HIGH ASTHMA HOTSPOTS ARE ASSOCIATED WITH CHARACTERISTICS OF ENVIRONMENT RISK. THE HOSPITAL HAS THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE RESPIRATORY DISEASE HEALTH AND CARE IN THE COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING RESPIRATORY HEALTH - INCREASE ACCESS TO RESPIRATORY HEALTH SERVICES AND PRESCRIPTIONS- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE AIR QUALITY- STRENGTHEN INTERNAL RESPIRATORY HEAL TH SERVICES, ENSURING EQUITY AND CULTURAL COMPETENCY- GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON RESPIRATORY DISEASES- INCREASED STAFF AWARENESS, KNOWLEDGE AND ABILITIES TO CARRY OUT CULTURALLY COMPETENT CARE - INCREASED COMMUNITY KNOWLEDGE OF THE IMPORTANCE OF RESPIRATORY DISEASE MANAGEMENT- INCREASED POLICIES THAT SUPPORT HEAL THY ENVIRONMENTS- INCREASED ADVOCACY FOR CHANGE- REDUCED DISPARITIES IN RESPIRATORY DISEASESTHE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS TO ADDRESS ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS, - FACILITY 2: SSM HEALTH ST. MARY'S HOSPITAL-ST. LOUIS, - FACILITY 3: SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARLES , - FACILITY 5: SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. LOUIS
GROUP A-FACILITY 1 -- SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 3J:	THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
GROUP A-FACILITY 1 -- SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 5:	A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEALTH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: ST. CHARLES COUNTY:AGING AHEAD CALVARY CHURCH COMMUNITY COUNCILEDC OF ST. CHARLES COUNTY FORT ZUMWALT SCHOOL DISTRICT LINDENWOOD ATHLETICSLUTHERAN HIGH SCHOOL - ST. CHARLES O'FALLON FIRE PROTECTION DISTRICT PREVENT+ EDSAINT LOUIS CRISIS NURSERYST. CHARLES COUNTY DEPARTMENT OF PUBLIC HEALTH STS. JOACHIM AND ANN CARE SERVICESUNITED SERVICES FOR CHILDREN US HOUSE OF REPRESENTATIVES YOUTH IN NEEDNORTH ST. LOUIS COUNTY:AGING AHEADALIVE AND WELL COMMUNITIESASTHMA AND ALLERGY FOUNDATION - ST. LOUIS CORNERSTONE REALTYJEWISH AND FAMILY SERVICES OF ST. LOUIS OUR FAMILY'S DOING YOGAREFUGE AND RESTORATION PREVENT+ EDST. LOUIS AREA DIAPER BANKST. LOUIS COUNTY DEPARTMENT OF HEALTH ST. LUKE'S HOSPITALST. LOUIS CITY:AFFINIA HEALTHCAREALIVE AND WELL COMMUNITIES BEHAVIORAL HEALTH NETWORK BJC HEALTHCARECASA DE SALUDCITY OF ST. LOUIS DEPARTMENT OF HEALTH COMMUNITY HEALTH IN PARTNERSHIP SERVICES (CHIPS) GATEWAY REGION YMCAHEALTH LITERACY MEDIA IFM COMMUNITY MEDICINEMISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES MISSOURI FOUNDATION FOR HEALTHOPERATION FOOD SEARCH PEOPLES HEALTH CENTER PLACES FOR PEOPLERISE COMMUNITY DEVELOPMENTST. LOUIS INTEGRATED HEALTH NETWORK ST. VINCENT DEPAULSTATE FARMURBAN LEAGUE OF METROPOLITAN YOUTH IN NEED
GROUP A-FACILITY 1 -- SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 6A:	THE HOSPITAL CONDUCTED AND COMPLETED ITS 2021 CHNA JOINTLY WITH SSM HEALTH REHABILITATION HOSPITAL.
GROUP A-FACILITY 1 -- SSM HEALTH DEPAUL HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 11:	THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - BEHAVIORAL HEALTH- HEART HEALTH/NUTRITION- RESPIRATORY DISEASESBEHAVIORAL HEALTH BEHAVIORAL HEALTH (BH), INCLUSIVE OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, WAS DETERMINED TO BE A PRIORITY HEALTH NEED IN EACH HOSPITAL MINISTRY COMMUNITY'S CHNA PROCESS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. SUBSTANCE ABUSE DISORDERS HAVE A MAJOR IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, SIGNIFICANTLY CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL, AND PUBLIC HEALTH PROBLEMS. IN 2019, 18.5% OF RESIDENTS IN THE INNER NORTH REGION OF ST. LOUIS COUNTY REPORTED EXPERIENCING 14 OR MORE POOR MENTAL HEALTH DAYS IN THE PAST MONTH COMPARED TO THE NATIONAL AVERAGE OF 13.6%. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY BEHAVIORAL HEALTH: - INCREASE ACCESS TO EXISTING MENTAL AND BEHAVIORAL HEALTH PROGRAMS AND SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO BEHAVIORAL HEALTH - STRENGTHEN INTERNAL BEHAVIORAL HEAL TH SERVICES AND CAPACITIES - PROMOTE SAFE MEDICATION DISPOSAL - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEAL TH CARE- INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEALTH TREATMENT AND CARE - HEAL THIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE HEART HEALTH/NUTRITION CONTROLLING RISK FACTORS FOR HEART DISEASE AND STROKE REMAINS A CHALLENGE. HIGH BLOOD PRESSURE, CIGARETTE SMOKING, AND HIGH BLOOD CHOLESTEROL ARE STILL MAJOR CONTRIBUTORS TO THE NATIONAL EPIDEMIC OF CARDIOVASCULAR DISEASE. THE RISK OF AMERICANS DEVELOPING AND DYING FROM CARDIOVASCULAR DISEASE WOULD BE SUBSTANTIALLY REDUCED IF MAJOR IMPROVEMENTS WERE MADE ACROSS THE U.S. POPULATION IN DIET AND PHYSICAL ACTIVITY, CONTROL OF HIGH BLOOD PRESSURE AND CHOLESTEROL, SMOKING CESSATION, AND APPROPRIATE ASPIRIN USE. BLACK/AFRICAN AMERICAN RESIDENTS IN ST. LOUIS COUNTY ARE DISPROPORTIONATELY AFFECTED BY HEART DISEASE TO A STAGGERING DEGREE, CONSISTENTLY HAVING HIGHER MORTALITY AND HOSPITAL VISIT RATES COMPARED TO OTHER RACIAUETHNIC GROUPS IN THE COUNTY. THE HOSPITAL HAS THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE THE HEART HEALTH FOR ITS COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING NUTRITION AND HEART DISEASE - INCREASE ACCESS TO HEART DISEASE MANAGEMENT SERVICES - SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO NUTRITIOUS FOODS- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF HEART DISEASE DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING - ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATION THE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON HEART HEALTH AND NUTRITION - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEART HEALTH AND NUTRITION - INCREASED COMMUNITY CONSUMPTION OF NUTRITIOUS FOODS- INCREASED HEART HEALTHY ACTIVITIES - INCREASED ADVOCACY FOR CHANGE - INCREASED POLICIES SUPPORTING HEALTHY LIVING FOR ALL RESPIRATORY DISEASES RESPIRATORY DISEASES AFFECT MILLIONS OF PEOPLE IN THE UNITED STATES. THE BURDEN OF RESPIRATORY DISEASES AFFECTS INDIVIDUALS AND THEIR FAMILIES, SCHOOLS, WORKPLACES, NEIGHBORHOODS, CITIES, AND STATES. ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE SIGNIFICANT PUBLIC HEALTH BURDENS. THERE ARE ALSO SEVERAL EMERGING RESPLRATORY HEALTH ISSUES SUCH AS THE IMPACT OF ENVIRONMENTAL CHANGE AND INCREASING IMPORTANCE OF INDOOR AIR QUALITY. NORTH ST. LOUIS COUNTY HAS DISPROPORTIONATELY HIGHER RATES OF ASTHMA COMPARED TO OTHER AREAS IN ST. LOUIS COUNTY. HIGH ASTHMA HOTSPOTS ARE ASSOCIATED WITH CHARACTERISTICS OF ENVIRONMENT RISK. THE HOSPITAL HAS THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE RESPIRATORY DISEASE HEALTH AND CARE IN THE COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING RESPIRATORY HEALTH - INCREASE ACCESS TO RESPIRATORY HEALTH SERVICES AND PRESCRIPTIONS- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE AIR QUALITY- STRENGTHEN INTERNAL RESPIRATORY HEAL TH SERVICES, ENSURING EQUITY AND CULTURAL COMPETENCY- GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON RESPIRATORY DISEASES- INCREASED STAFF AWARENESS, KNOWLEDGE AND ABILITIES TO CARRY OUT CULTURALLY COMPETENT CARE - INCREASED COMMUNITY KNOWLEDGE OF THE IMPORTANCE OF RESPIRATORY DISEASE MANAGEMENT- INCREASED POLICIES THAT SUPPORT HEAL THY ENVIRONMENTS- INCREASED ADVOCACY FOR CHANGE- REDUCED DISPARITIES IN RESPIRATORY DISEASESTHE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS TO ADDRESS ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.
GROUP A-FACILITY 2 -- SSM HEALTH ST. MARY'S HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 3J:	THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
GROUP A-FACILITY 2 -- SSM HEALTH ST. MARY'S HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 5:	A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEALTH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: ST. CHARLES COUNTY:AGING AHEAD CALVARY CHURCH COMMUNITY COUNCILEDC OF ST. CHARLES COUNTY FORT ZUMWALT SCHOOL DISTRICT LINDENWOOD ATHLETICSLUTHERAN HIGH SCHOOL - ST. CHARLES O'FALLON FIRE PROTECTION DISTRICT PREVENT+ EDSAINT LOUIS CRISIS NURSERYST. CHARLES COUNTY DEPARTMENT OF PUBLIC HEALTH STS. JOACHIM AND ANN CARE SERVICESUNITED SERVICES FOR CHILDREN US HOUSE OF REPRESENTATIVES YOUTH IN NEEDNORTH ST. LOUIS COUNTY:AGING AHEADALIVE AND WELL COMMUNITIESASTHMA AND ALLERGY FOUNDATION - ST. LOUIS CORNERSTONE REALTYJEWISH AND FAMILY SERVICES OF ST. LOUIS OUR FAMILY'S DOING YOGAREFUGE AND RESTORATION PREVENT+ EDST. LOUIS AREA DIAPER BANKST. LOUIS COUNTY DEPARTMENT OF HEALTH ST. LUKE'S HOSPITALST. LOUIS CITY:AFFINIA HEALTHCAREALIVE AND WELL COMMUNITIES BEHAVIORAL HEALTH NETWORK BJC HEALTHCARECASA DE SALUDCITY OF ST. LOUIS DEPARTMENT OF HEALTH COMMUNITY HEALTH IN PARTNERSHIP SERVICES (CHIPS) GATEWAY REGION YMCAHEALTH LITERACY MEDIA IFM COMMUNITY MEDICINEMISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES MISSOURI FOUNDATION FOR HEALTHOPERATION FOOD SEARCH PEOPLES HEALTH CENTER PLACES FOR PEOPLERISE COMMUNITY DEVELOPMENTST. LOUIS INTEGRATED HEALTH NETWORK ST. VINCENT DEPAULSTATE FARMURBAN LEAGUE OF METROPOLITAN YOUTH IN NEED
GROUP A-FACILITY 2 -- SSM HEALTH ST. MARY'S HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 6A:	THE HOSPITAL CONDUCTED AND COMPLETED ITS 2021 CHNA JOINTLY WITH SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL AND SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL.
GROUP A-FACILITY 2 -- SSM HEALTH ST. MARY'S HOSPITAL-ST. LOUIS PART V, SECTION B, LINE 11:	THE HOSPITAL IDENTIFIED VARIOUS HEALTH NEEDS IN THE 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITAL WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - BEHAVIORAL HEAL TH - OBESITY/CHRONIC DISEASES- VIOLENCE AND INJURY PREVENTION- HIGH-RISK PREGNANCY/WOMEN'S HEALTHBEHAVIORAL HEALTH BEHAVIORAL HEALTH (BH), INCLUSIVE OF MENTAL HEAL TH AND SUBSTANCE USE DISORDERS, WAS DETERMINED TO BE A PRIORITY HEALTH NEED IN EACH HOSPITAL MINISTRY COMMUNITY'S CHNA PROCESS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. SUBSTANCE ABUSE DISORDERS HAVE A MAJOR IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, SIGNIFICANTLY CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL, AND PUBLIC HEALTH PROBLEMS. IN ST. LOUIS CITY, RESIDENTS EXPERIENCE AN AVERAGE OF 5 POOR MENTAL HEALTH DAYS PER MONTH, ABOVE THE STATEWIDE AVERAGE OF 4.5. AND SIXTEEN PERCENT OF ST. LOUIS CITY RESIDENT EXPERIENCE MENTAL HEAL TH DISTRESS. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY BEHAVIORAL HEALTH: - INCREASE ACCESS TO EXISTING BEHAVIORAL HEAL TH PROGRAMS AND SERVICES- STRENGTHEN INTERNAL BEHAVIORAL HEAL TH SERVICES AND CAPACITIES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO BEHAVIORAL HEAL TH - PROMOTE EFFORTS THAT EMPOWER LOCAL COMMUNITIES TO DRIVE CHANGE - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY, PUBLIC HEALTH EDUCATION, AND STRATEGIC COMMUNICATION THE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEALTH CARE- INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEAL TH TREATMENT AND CARE - HEAL THIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE - INCREASED ADVOCACY FOR CHANGE OBESITY/CHRONIC CONDITIONSGOOD NUTRITION, PHYSICAL ACTIVITY, AND A HEAL THY BODY WEIGHT ARE ESSENTIAL PARTS OF A PERSON'S OVERALL HEAL TH AND WELL-BEING. MOST AMERICANS, HOWEVER, DO NOT EAT A HEALTHFUL DIET AND ARE NOT PHYSICALLY ACTIVE AT LEVELS NEEDED TO MAINTAIN PROPER HEALTH AND WEIGHT. IN ST. LOUIS CITY, 35% OF ADULTS ARE CONSIDERED OBESE AND ABOUT 30% REPORT NO LEISURE TIME PHYSICAL ACTIVITY. ADDITIONALLY, ST. LOUIS CITY RANKS BELOW THE STATE AVERAGE WHEN CONSIDERING FACTORS THAT CONTRIBUTE TO HEAL THY FOOD ENVIRONMENTS. CHRONIC DISEASES, OFTEN STRONGLY LINKED TO OBESITY, ARE THE LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES, CAUSING 7 OUT OF 10 DEATHS EACH YEAR. EXAMPLES OF CHRONIC DISEASES INCLUDE CARDIOVASCULAR DISEASE, ARTHRITIS, DIABETES AND CANCER. HEALTHY EATING & ACTIVE LIVING (HEAL) IS ESSENTIAL TO MANAGING OBESITY AND CHRONIC DISEASES. THE HOSPITAL HAS PLANNED THE FOLLOWING STRATEGIES TO REDUCE OBESITY AND CHRONIC DISEASE: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING OBESITY/CHRONIC DISEASE - INCREASE ACCESS TO CHRONIC DISEASE MANAGEMENT SERVICES- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO HEAL THY EATING AND ACTIVE LIVING (HEAL) - STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF OBESITY DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY, PUBLIC HEALTH EDUCATION, AND STRATEGIC COMMUNICATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS:- STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON FOOD INSECURITY AND HEAL THY FOOD ACCESS, AS WELL AS PHYSICAL ACTIVITY - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEALTHY EATING AND CHRONIC DISEASE MANAGEMENT- INCREASED COMMUNITY CONSUMPTION OF HEALTHY FOODS - INCREASED COMMUNITY PHYSICAL ACTIVITY - INCREASED COMMUNITY ENVIRONMENTS, SCHOOLS, AND WORKSITES THAT SUPPORT HEAL - INCREASED ADVOCACY FOR CHANGE - INCREASED POLICIES SUPPORTING HEALTHY LIVING FOR ALL VIOLENCE AND INJURY PREVENTIONVIOLENCE, AS WELL AS UNINTENTIONAL INJURIES ARE WIDESPREAD IN SOCIETY. BOTH UNINTENTIONAL INJURIES AND THOSE CAUSED BY ACT OF VIOLENCE ARE AMONG THE TOP 15 KILLERS FOR AMERICANS OF ALL AGES. BEYOND THEIR IMMEDIATE HEALTH CONSEQUENCES, INJURIES AND VIOLENCE HAVE A SIGNIFICANT IMPACT ON THE WELL-BEING OF AMERICANS. UNINTENTIONAL INJURIES ARE A LEADING KILLER OF CHILDREN AGES 1-17 IN MISSOURI. EASIER ACCESS TO SAFETY MEASURES SUCH GUN SAFETY LOCKS, CAR SEATS AND POISON PREVENTION STRATEGIES HELP TO REDUCE SUCH PREVENTABLE INJURIES. VIOLENCE IN ST. LOUIS CITY HAS BEEN A LONG-STANDING CHALLENGE FOR LOCAL RESIDENTS, HOWEVER, IN 2021, HOMICIDES IN ST. LOUIS CITY DROPPED 25% -A TESTAMENT TO HOW COLLECTIVE ACTION AND REGION-WIDE COLLABORATION CAN BEGIN TO MAKE A POSITIVE DIFFERENCE WHEN ADDRESSING COMPLEX COMMUNITY ISSUES. TO STAY ON THIS TRACK, WE MUST CONTINUE TO INVEST IN INNOVATIVE PROGRAMS, POLICIES AND LEADERSHIP FOR SUSTAINED ACTION. THE HOSPITAL HAS PLANNED THE FOLLOWING STRATEGIES TO REDUCE OBESITY AND CHRONIC DISEASE: - INCREASE ACCESS TO TRAUMA AND SOCIAL NEEDS SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF COMMUNITY PARTNERS ADDRESSING VIOLENCE/INJURY PREVENTION- SUPPORT/ADVOCATE FOR POLICIES THAT DECREASE VIOLENCE & INJURY PREVENTION- STRENGTHEN INTERNAL CAPACITIES TO ADDRESS VIOLENCE/INJURY PREVENTION THROUGH EDUCATION, SILLS BUILDING - DIRECT AND/OR COLLABORATIVE FUNDING- ENSURE DATA EQUITY & EVALUATION FOCUSED ON MEASURABLE IMPACTS.- SUPPORT PUBLIC HEALTH EDUCATION & STRATEGIC COMMUNICATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - INCREASED, MORE CONSISTENT SSM COMMUNITY PARTNERSHIPS FOCUSED ON VIOLENCE AND INJURY PREVENTION - INCREASED INTERNAL AND COMMUNITY AWARENESS & KNOWLEDGE OF THE AFFECTS OF VIOLENCE, TRAUMA AND UNINTENTIONAL INJURIES ON VULNERABLE PATIENTS/COMMUNITIES- HEAL THIER, SAFER HOMES AND COMMUNITY ENVIRONMENTS *INCREASED POLICIES SUPPORTING VIOLENCE & INJURY PREVENTION - INCREASED ADVOCACY FOR CHANGE HIGH-RISK PREGNANCY/WOMEN'S HEALTH WOMEN'S HEALTH BEFORE, DURING, AND AFTER PREGNANCY CAN HAVE A MAJOR IMPACT ON INFANTS' HEALTH AND WELLBEING. WOMEN WHO GET RECOMMENDED HEAL TH CARE SERVICES BEFORE THEY GET PREGNANT ARE MORE LIKELY TO BE HEALTHY DURING PREGNANCY AND TO HAVE HEAL THY BABIES. IN ST. LOUIS CITY, BLACK BABIES ARE THREE TIMES AS LIKELY TO DIE BEFORE THEIR FIRST BIRTHDAY AS WHITE BABIES. STRATEGIES TO HELP PREGNANT WOMEN GET MEDICAL CARE AND AVOID RISKY BEHAVIORS LIKE SMOKING OR DRINKING ALCOHOL CAN ALSO IMPROVE HEALTH OUTCOMES FOR INFANTS. ADDITIONALLY, PROVIDING CARE THAT IS CULTURALLY APPROPRIATE, INCLUDING EFFECTIVE COMMUNICATION, LISTENING, AND RESPECT CAN HELP TO REDUCES STRESS IN THE PREGNANCY CYCLE.THE HOSPITAL HAS PLANNED THE FOLLOWING DIRECTIVES TO IMPROVE WOMEN'S HEALTH AND INCREASE HEALTHY PREGNANCIES: - INCREASE ACCESS TO WOMEN'S HEALTH / HIGH-RISK PREGNANCY SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING WOMEN'S HEALTH / HIGH-RISK PREGNANCY / INFANT MORTALITY- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO WOMEN'S HEAL TH SERVICES - STRENGTHEN INTERNAL WOMEN'S HEAL TH SERVICES, ENSURING EQUITY AND CULTURAL COMPETENCY- GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY AND EVALUATION FOCUSED ON MEASURABLE IMPACTS- PUBLIC HEALTH EDUCATION- MONITORING AND EVALUATING PROGRESSTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON WOMEN'S HEALTH - INCREASED STAFF AWARENESS, KNOWLEDGE AND ABILITIES TO CARRY OUT CULTURALLY COMPETENT CARE - INCREASED COMMUNITY KNOWLEDGE OF IMPORTANCE OF SELF CARE DURING PREGNANCY AND ACCESS TO SERVICES - INCREASED POLICIES THAT SUPPORT WOMEN'S HEAL TH AND PREVENT HIGH-RISK PREGNANCY - INCREASED ADVOCACY FOR CHANGE - REDUCED DISPARITIES IN INFANT AND MATERNAL HEALTH THE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA. THE HOSPITALS HAVE NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.
GROUP A-FACILITY 3 -- SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARL PART V, SECTION B, LINE 3J:	THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
GROUP A-FACILITY 3 -- SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARL PART V, SECTION B, LINE 5:	A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEALTH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: ST. CHARLES COUNTY:AGING AHEAD CALVARY CHURCH COMMUNITY COUNCILEDC OF ST. CHARLES COUNTY FORT ZUMWALT SCHOOL DISTRICT LINDENWOOD ATHLETICSLUTHERAN HIGH SCHOOL - ST. CHARLES O'FALLON FIRE PROTECTION DISTRICT PREVENT+ EDSAINT LOUIS CRISIS NURSERYST. CHARLES COUNTY DEPARTMENT OF PUBLIC HEALTH STS. JOACHIM AND ANN CARE SERVICESUNITED SERVICES FOR CHILDREN US HOUSE OF REPRESENTATIVES YOUTH IN NEEDNORTH ST. LOUIS COUNTY:AGING AHEADALIVE AND WELL COMMUNITIESASTHMA AND ALLERGY FOUNDATION - ST. LOUIS CORNERSTONE REALTYJEWISH AND FAMILY SERVICES OF ST. LOUIS OUR FAMILY'S DOING YOGAREFUGE AND RESTORATION PREVENT+ EDST. LOUIS AREA DIAPER BANKST. LOUIS COUNTY DEPARTMENT OF HEALTH ST. LUKE'S HOSPITALST. LOUIS CITY:AFFINIA HEALTHCAREALIVE AND WELL COMMUNITIES BEHAVIORAL HEALTH NETWORK BJC HEALTHCARECASA DE SALUDCITY OF ST. LOUIS DEPARTMENT OF HEALTH COMMUNITY HEALTH IN PARTNERSHIP SERVICES (CHIPS) GATEWAY REGION YMCAHEALTH LITERACY MEDIA IFM COMMUNITY MEDICINEMISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES MISSOURI FOUNDATION FOR HEALTHOPERATION FOOD SEARCH PEOPLES HEALTH CENTER PLACES FOR PEOPLERISE COMMUNITY DEVELOPMENTST. LOUIS INTEGRATED HEALTH NETWORK ST. VINCENT DEPAULSTATE FARMURBAN LEAGUE OF METROPOLITAN YOUTH IN NEED
GROUP A-FACILITY 3 -- SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARL PART V, SECTION B, LINE 6A:	THE HOSPITAL CONDUCTED AND COMPLETED ITS 2021 CHNA JOINTLY WITH SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. LOUIS.
GROUP A-FACILITY 3 -- SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARL PART V, SECTION B, LINE 11:	THE HOSPITALS IDENTIFIED VARIOUS HEALTH NEEDS IN THEIR JOINTLY-COMPLETED 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITALS WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - OVERWEIGHT/OBESITY - BEHAVIORAL HEALTH- CHRONIC CONDITIONSOVERWEIGHT/OBESITY GOOD NUTRITION, PHYSICAL ACTIVITY, AND A HEALTHY BODY WEIGHT ARE ESSENTIAL PARTS OF A PERSON'S OVERALL HEALTH AND WELL-BEING. MOST AMERICANS, HOWEVER, DO NOT EAT A HEALTHFUL DIET AND ARE NOT PHYSICALLY ACTIVE AT LEVELS NEEDED TO MAINTAIN PROPER HEALTH AND WEIGHT. 32% PERCENT OF THE ADULT POPULATION (AGE 20 AND OLDER) IN ST. CHARLES COUNTY REPORTED A BODY MASS INDEX (BMI) GREATER THAN OR EQUAL TO 30 KG/M2 CLASSIFYING THEM AS OBESE. THE HOSPITAL HAS PLANNED THE FOLLOWING DIRECTIVES TO REDUCE OVERWEIGHT ISSUES AND OBESITY IN THE COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING OBESITY - INCREASE ACCESS TO WEIGHT MANAGEMENT SERVICES- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO HEAL THY EATING AND ACTIVE LIVING (HEAL)- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF OBESITY DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON NUTRITION INSECURITY AND HEALTH FOOD ACCESS, AS WELL AS PHYSICAL ACTIVITY - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEALTHY EATING AND PHYSICAL ACTIVITY - INCREASED COMMUNITY CONSUMPTION OF HEALTHY FOODS - INCREASED COMMUNITY PHYSICAL ACTIVITY - INCREASED ADVOCACY FOR CHANGE AND POLICIES SUPPORTING HEALTHY LIVING FOR ALL BEHAVIORAL HEAL TH BEHAVIORAL HEALTH (BH), INCLUSIVE OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, WAS DETERMINED TO BE A PRIORITY HEALTH NEED IN EACH HOSPITAL MINISTRY COMMUNITY'S CHNA PROCESS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. SUBSTANCE ABUSE DISORDERS HAVE A MAJOR IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, SIGNIFICANTLY CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL, AND PUBLIC HEALTH PROBLEMS. 32% PERCENT OF DRIVING DEATHS IN ST. CHARLES COUNTY INVOLVE ALCOHOL. 24% OF ADULTS IN ST. CHARLES COUNTY REPORT BINGE OR HEAVY DRINKING. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY BEHAVIORAL HEALTH: - INCREASE ACCESS TO EXISTING MENTAL AND BEHAVIORAL HEAL TH PROGRAMS AND SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO BEHAVIORAL HEALTH- STRENGTHEN INTERNAL BEHAVIORAL HEALTH SERVICES AND CAPACITIES - PROMOTE SAFE MEDICATION DISPOSAL - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEALTH CARE - INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEALTH TREATMENT AND CARE - HEALTHIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE CHRONIC CONDITIONS CHRONIC DISEASES ARE THE LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES, CAUSING 7 OUT OF 10 DEATHS EACH YEAR. EXAMPLES OF CHRONIC DISEASES INCLUDE CARDIOVASCULAR DISEASE, ARTHRITIS, DIABETES AND CANCER. SIX IN TEN AMERICANS LIVE WITH AT LEAST ONE CHRONIC DISEASE. CHRONIC DISEASES ARE THE LEADING CAUSES OF DEATH AND DISABILITY IN ST. CHARLES COUNTY, AND THEY ARE ALSO A LEADING DRIVER OF HEAL TH CARE COSTS. THE HOSPITALS HAVE THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE THE COMMUNITY CHRONIC DISEASE:- SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING CHRONIC DISEASE - SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO CHRONIC DISEASE MANAGEMENT- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF CHRONIC DISEASE DISPARITIES THROUGH - EDUCATION AND DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING - ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON CHRONIC DISEASE MANAGEMENT- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF CHRONIC DISEASE MANAGEMENT- INCREASED STAFF AWARENESS, KNOWLEDGE, AND ABILITIES TO CARRY OUT CULTURALLY-COMPETENT CARE- INCREASED ADVOCACY FOR CHANGE AND POLICIES SUPPORTING HEALTHY LIVING FOR ALL THE HOSPITALS HAVE NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.
GROUP A-FACILITY 5 -- SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. PART V, SECTION B, LINE 3J:	THE HOSPITAL FACILITIES ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAVE PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
GROUP A-FACILITY 5 -- SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. PART V, SECTION B, LINE 5:	A SINGLE ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE FOR COMMUNITY MEMBERS ACROSS MULTIPLE SERVICE AREAS OF ALL COLLABORATING HOSPITAL SYSTEMS, INCLUSIVE OF MISSOURI AND ILLINOIS. THE ONLINE COMMUNITY SURVEY WAS AVAILABLE TO COMPLETE FROM APRIL 2021 THROUGH JULY 2021. THIS SURVEY ASKED ABOUT PEOPLE'S PERSONAL HEALTH, THEIR THOUGHTS ABOUT THE COMMUNITY'S HEALTH, AND PROVIDED SECTIONS FOR PEOPLE TO PROVIDE ON WAYS TO IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEAL TH. THE SURVEY TOOK AN AVERAGE OF 10 MINUTES TO COMPLETE WITH A TOTAL OF 2,915 INDIVIDUALS COMPLETING THE SURVEY. A TOTAL OF 378 RESPONSES WERE RECEIVED FROM ST. LOUIS CITY ZIP CODES, ACCOUNTING FOR 13 PERCENT OF SURVEY RESPONSES. ALL RESPONDENTS WERE ASKED TO PROVIDE THEIR PRIMARY ZIP CODES, WHICH WERE TAGGED ACCORDING TO THE SSM AND PARTNER HOSPITAL CHNA COMMUNITY GEOGRAPHIES. COMMUNITY MEMBERS HAD THE OPTION TO SUBMIT OPEN ENDED RESPONSES, COMMENTS AND SUGGESTIONS THROUGHOUT THE SURVEY. ADDITIONALLY, COMMUNITY CONVERSATIONS WERE HELD VIRTUALLY, ENGAGING INDIVIDUALS FROM SSM HEALTH SERVICE AREAS WHERE RESPONSE RATES WERE SIGNIFICANTLY LOWER IN COMPARISON TO OTHER SERVICE AREAS. THESE CONVERSATIONS HELPED US LEARN MORE ABOUT RESIDENTS' CONCERNS, SOLICIT IDEAS, LEARN OF THEIR HEALTH CARE EXPERIENCES AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. THESE CONVERSATIONS ALSO PROVIDED CRITICAL INSIGHT ON COMMUNITY PERCEPTIONS AND GENERATED IDEAS ON HOW TO IMPROVE HEALTH CARE ACCESS AND RESOURCES. COMMUNITY LEADERS WERE ALSO ENGAGED TO COMPLETE THE STAKEHOLDER CHNA SURVEY. STAKEHOLDERS INCLUDED A DIVERSE GROUP OF COMMUNITY PROFESSIONALS FROM ORGANIZATIONS ACROSS SERVICE AREAS, PROVIDING A VAST ARRAY OF CRITICAL SERVICES INCLUDING HEALTH ACCESS, SOCIAL NEEDS, EDUCATION AND EMERGENCY SERVICES. UPON COMPLETION, SURVEYS WERE ANALYZED THROUGH THE SURVEY PLATFORM IN ORDER TO IDENTIFY COMMON THEMES. SECONDARY DATA WAS COLLECTED FROM MULTIPLE SOURCES INCLUDING THE COUNTY HEALTH RANKINGS, EXPLOREMOHEALTH, AND THINK HEALTH ST. LOUIS. ANALYSIS OF THESE DATA SOURCES REVEALED NOT ONLY THE MOST BURDENSOME HEALTH ISSUES, BUT ALSO HEALTH DISPARITIES AND KEY ISSUES IMPACTING SOCIAL DETERMINANTS OF HEAL TH. DATA ASSESSED INCLUDED DEMOGRAPHIC INFORMATION, CHRONIC DISEASE AND MORBIDITY/MORTALITY INFORMATION, HEALTH STATUS INDICATORS, HEALTH BEHAVIORS AND GENERAL ENVIRONMENT INFORMATION. THIS DATA IS COMPARED TO STATE AND NATIONAL BENCHMARKS. PRIMARY AND SECONDARY DATA WERE WEIGHTED IN ORDER TO DETERMINE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS, BASED ON IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL'S ABILITY TO MAKE MEANINGFUL IMPACT OVER THE NEXT SEVERAL YEARS. ORGANIZATIONS INCLUDED IN STAKEHOLDER DATA GATHERING AND DISCUSSION INCLUDE: ST. CHARLES COUNTY:AGING AHEAD CALVARY CHURCH COMMUNITY COUNCILEDC OF ST. CHARLES COUNTY FORT ZUMWALT SCHOOL DISTRICT LINDENWOOD ATHLETICSLUTHERAN HIGH SCHOOL - ST. CHARLES O'FALLON FIRE PROTECTION DISTRICT PREVENT+ EDSAINT LOUIS CRISIS NURSERYST. CHARLES COUNTY DEPARTMENT OF PUBLIC HEALTH STS. JOACHIM AND ANN CARE SERVICESUNITED SERVICES FOR CHILDREN US HOUSE OF REPRESENTATIVES YOUTH IN NEEDNORTH ST. LOUIS COUNTY:AGING AHEADALIVE AND WELL COMMUNITIESASTHMA AND ALLERGY FOUNDATION - ST. LOUIS CORNERSTONE REALTYJEWISH AND FAMILY SERVICES OF ST. LOUIS OUR FAMILY'S DOING YOGAREFUGE AND RESTORATION PREVENT+ EDST. LOUIS AREA DIAPER BANKST. LOUIS COUNTY DEPARTMENT OF HEALTH ST. LUKE'S HOSPITALST. LOUIS CITY:AFFINIA HEALTHCAREALIVE AND WELL COMMUNITIES BEHAVIORAL HEALTH NETWORK BJC HEALTHCARECASA DE SALUDCITY OF ST. LOUIS DEPARTMENT OF HEALTH COMMUNITY HEALTH IN PARTNERSHIP SERVICES (CHIPS) GATEWAY REGION YMCAHEALTH LITERACY MEDIA IFM COMMUNITY MEDICINEMISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES MISSOURI FOUNDATION FOR HEALTHOPERATION FOOD SEARCH PEOPLES HEALTH CENTER PLACES FOR PEOPLERISE COMMUNITY DEVELOPMENTST. LOUIS INTEGRATED HEALTH NETWORK ST. VINCENT DEPAULSTATE FARMURBAN LEAGUE OF METROPOLITAN YOUTH IN NEED
GROUP A-FACILITY 5 -- SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. PART V, SECTION B, LINE 6A:	THE HOSPITAL CONDUCTED AND COMPLETED ITS 2021 CHNA JOINTLY WITH SSM HEALTH ST. JOSEPH HOSPITAL-ST. CHARLES.
GROUP A-FACILITY 5 -- SSM HEALTH ST. JOSEPH HOSPITAL-LAKE ST. PART V, SECTION B, LINE 11:	THE HOSPITALS IDENTIFIED VARIOUS HEALTH NEEDS IN THEIR JOINTLY-COMPLETED 2021 CHNA. IN ORDER TO MAKE MEANINGFUL IMPACT, AND TO USE ITS FINANCES MOST EFFECTIVELY AND EFFICIENCY, THE HOSPITALS WILL PLACE PRIMARY FOCUS ON THE FOLLOWING KEY PRIORITIES: - OVERWEIGHT/OBESITY - BEHAVIORAL HEALTH- CHRONIC CONDITIONSOVERWEIGHT/OBESITY GOOD NUTRITION, PHYSICAL ACTIVITY, AND A HEALTHY BODY WEIGHT ARE ESSENTIAL PARTS OF A PERSON'S OVERALL HEALTH AND WELL-BEING. MOST AMERICANS, HOWEVER, DO NOT EAT A HEALTHFUL DIET AND ARE NOT PHYSICALLY ACTIVE AT LEVELS NEEDED TO MAINTAIN PROPER HEALTH AND WEIGHT. 32% PERCENT OF THE ADULT POPULATION (AGE 20 AND OLDER) IN ST. CHARLES COUNTY REPORTED A BODY MASS INDEX (BMI) GREATER THAN OR EQUAL TO 30 KG/M2 CLASSIFYING THEM AS OBESE. THE HOSPITAL HAS PLANNED THE FOLLOWING DIRECTIVES TO REDUCE OVERWEIGHT ISSUES AND OBESITY IN THE COMMUNITY: - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING OBESITY - INCREASE ACCESS TO WEIGHT MANAGEMENT SERVICES- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO HEAL THY EATING AND ACTIVE LIVING (HEAL)- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF OBESITY DISPARITIES THROUGH EDUCATION AND SKILLS DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON NUTRITION INSECURITY AND HEALTH FOOD ACCESS, AS WELL AS PHYSICAL ACTIVITY - INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF HEALTHY EATING AND PHYSICAL ACTIVITY - INCREASED COMMUNITY CONSUMPTION OF HEALTHY FOODS - INCREASED COMMUNITY PHYSICAL ACTIVITY - INCREASED ADVOCACY FOR CHANGE AND POLICIES SUPPORTING HEALTHY LIVING FOR ALL BEHAVIORAL HEAL TH BEHAVIORAL HEALTH (BH), INCLUSIVE OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, WAS DETERMINED TO BE A PRIORITY HEALTH NEED IN EACH HOSPITAL MINISTRY COMMUNITY'S CHNA PROCESS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY. SUBSTANCE ABUSE DISORDERS HAVE A MAJOR IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE EFFECTS OF SUBSTANCE ABUSE ARE CUMULATIVE, SIGNIFICANTLY CONTRIBUTING TO COSTLY SOCIAL, PHYSICAL, MENTAL, AND PUBLIC HEALTH PROBLEMS. 32% PERCENT OF DRIVING DEATHS IN ST. CHARLES COUNTY INVOLVE ALCOHOL. 24% OF ADULTS IN ST. CHARLES COUNTY REPORT BINGE OR HEAVY DRINKING. THE HOSPITAL HAS IMPLEMENTED THE FOLLOWING STRATEGIES TO IMPROVE COMMUNITY BEHAVIORAL HEALTH: - INCREASE ACCESS TO EXISTING MENTAL AND BEHAVIORAL HEAL TH PROGRAMS AND SERVICES - SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES AND CARE- SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS AND SERVICES TO BEHAVIORAL HEALTH- STRENGTHEN INTERNAL BEHAVIORAL HEALTH SERVICES AND CAPACITIES - PROMOTE SAFE MEDICATION DISPOSAL - FUND EVIDENCE-BASED & INNOVATIVE APPROACHES- ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - CONSISTENT AND STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON BEHAVIORAL HEALTH- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE AND IMPACT OF BEHAVIORAL HEALTH CARE - INCREASED POLICIES SUPPORTING EQUITABLE BEHAVIORAL HEALTH TREATMENT AND CARE - HEALTHIER COMMUNITIES WITH IMPROVED ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE CARE CHRONIC CONDITIONS CHRONIC DISEASES ARE THE LEADING CAUSE OF DEATH AND DISABILITY IN THE UNITED STATES, CAUSING 7 OUT OF 10 DEATHS EACH YEAR. EXAMPLES OF CHRONIC DISEASES INCLUDE CARDIOVASCULAR DISEASE, ARTHRITIS, DIABETES AND CANCER. SIX IN TEN AMERICANS LIVE WITH AT LEAST ONE CHRONIC DISEASE. CHRONIC DISEASES ARE THE LEADING CAUSES OF DEATH AND DISABILITY IN ST. CHARLES COUNTY, AND THEY ARE ALSO A LEADING DRIVER OF HEAL TH CARE COSTS. THE HOSPITALS HAVE THE FOLLOWING ACTION PLAN IN PLACE TO IMPROVE THE COMMUNITY CHRONIC DISEASE:- SUPPORT INITIATIVES THAT BUILD CAPACITY OF LOCAL PARTNERS ADDRESSING CHRONIC DISEASE - SUPPORT AND ADVOCATE FOR POLICIES THAT IMPROVE ACCESS TO CHRONIC DISEASE MANAGEMENT- STRENGTHEN INTERNAL AWARENESS AND KNOWLEDGE OF CHRONIC DISEASE DISPARITIES THROUGH - EDUCATION AND DEVELOPMENT - GUIDE DIRECT AND COLLABORATIVE FUNDING - ENSURE DATA EQUITY AND PUBLIC HEALTH EDUCATIONTHE SHORT-TERM AND LONG-TERM IMPACTS OF THESE ACTIVITIES ARE AS FOLLOWS: - STRATEGIC SSM AND COMMUNITY PARTNERSHIPS FOCUSED ON CHRONIC DISEASE MANAGEMENT- INCREASED INTERNAL AND COMMUNITY KNOWLEDGE AND AWARENESS OF THE IMPORTANCE OF CHRONIC DISEASE MANAGEMENT- INCREASED STAFF AWARENESS, KNOWLEDGE, AND ABILITIES TO CARRY OUT CULTURALLY-COMPETENT CARE- INCREASED ADVOCACY FOR CHANGE AND POLICIES SUPPORTING HEALTHY LIVING FOR ALL THE HOSPITALS HAVE NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS ADDRESSING ADDITIONAL HEALTH NEEDS AS OUTLINED IN ITS CHNA.

Schedule H (Form 990) 2023

Page 9

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?118
Name and address		Type of Facility (describe)
1	1 - CARDINAL GLENNON DELMAR THERAPY 5647 DELMAR BLVD FL 3 SAINT LOUIS,MO631122615	HOSPITAL OUTPATIENT
2	2 - CARDINAL GLENNON PEDIATRIC SPECIALTIES 3878 PERSHALL RD SAINT LOUIS,MO631351246	OUTPATIENT FACILITY
3	3 - KNIGHTS OF COLUMBUS DEVELOPMENT CTR 3800 PARK AVE SAINT LOUIS,MO631102514	OTHER HEALTH CARE FACILITY
4	4 - SSM CG PEDS INTEGRATIVE MEDICINE 12255 DE PAUL DR STE 370 BRIDGETON,MO63044	OUTPATIENT PEDIATRIC CLINIC
5	5 - SSM HEALTH BEHAVORIAL HEALTH 1027 BELLEVUE AVE STE LL33 SAINT LOUIS,MO631171851	BEHAVIORAL HEALTH
6	6 - SSM HEALTH BREAST CARE 1031 BELLEVUE AVE STE 100 SAINT LOUIS,MO631171855	OTHER HEALTH CARE FACILITY
7	7 - SSM HEALTH CANCER CARE 6400 CLAYTON RD STE 212 SAINT LOUIS,MO631171850	OTHER HEALTH CARE FACILITY
8	8 - SSM HEALTH CANCER CARE 6400 CLAYTON RD STE 302 SAINT LOUIS,MO631171850	OTHER HEALTH CARE FACILITY
9	9 - SSM HEALTH CANCER CARE 1011 BOWLES AVE SUITE G50 FENTON,MO630260562	OTHER HEALTH CARE FACILITY
10	10 - SSM SLUCARE COLORECTAL SURGERY 1011 BOWLES AVE SUITE 225 FENTON,MO630260562	OTHER HEALTH CARE FACILITY
11	11 - SSM HEALTH CANCER CARE 2325 DOUGHERTY FERRY ROAD STE 102 103 SAINT LOUIS,MO631223374	OTHER HEALTH CARE FACILITY
12	12 - SSM HEALTH CANCER CARE 1027 BELLEVUE AVE STE 103 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
13	13 - SSM HEALTH CARDINAL GLENNON PEDIATRICS 400 MEDICAL PLZ STE 220 LAKE SAINT LOUIS,MO633671417	OTHER HEALTH CARE FACILITY
14	14 - SSM HEALTH CARDINAL GLENNON PEDIATRICS 12255 DE PAUL DR STE 300 BRIDGETON,MO630442510	OTHER HEALTH CARE FACILITY
15	15 - SSM HEALTH CARDINAL GLENNON PEDIATRICS 13000 BUTLER CREST DR SAINT LOUIS,MO631284276	OTHER HEALTH CARE FACILITY
16	16 - SSM HEALTH CARDINAL GLENNON PEDIATRICS 224 S WOODS MILL RD STE 640 CHESTERFIELD,MO630173513	OTHER HEALTH CARE FACILITY
17	17 - SSM HEALTH HEART & VASCULAR CARE 1027 BELLEVUE AVE STE 200 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
18	18 - SSM HEALTH HEART & VASCULAR CARE 1035 BELLEVUE AVE STE 500 SAINT LOUIS,MO631171843	OTHER HEALTH CARE FACILITY
19	19 - SSM HEALTH HEART & VASCULAR CARE 1027 BELLEVUE AVE STE 202 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
20	20 - SSM HEALTH IMAGING SERVICES 6400 CLAYTON RD STE 104 SAINT LOUIS,MO631171850	OTHER HEALTH CARE FACILITY
21	21 - SSM HEALTH IMAGING SERVICES 1031 BELLEVUE AVE STE 150 SAINT LOUIS,MO631171869	OTHER HEALTH CARE FACILITY
22	22 - SSM HEALTH MEDICAL GROUP 19 THE BOULEVARD SAINT LOUIS RICHMOND HEIGHTS,MO631171118	OUTPATIENT FACILITY
23	23 - SSM HEALTH MEDICAL GROUP 1035 BELLEVUE AVE STE 500 SAINT LOUIS,MO631171843	OTHER HEALTH CARE FACILITY
24	24 - SSM HEALTH MEDICAL GROUP 1035 BELLEVUE AVE STE 400 SAINT LOUIS,MO631171844	OTHER HEALTH CARE FACILITY
25	25 - SSM HEALTH MEDICAL GROUP 1035 BELLEVUE AVE STE 320 SAINT LOUIS,MO631171845	OTHER HEALTH CARE FACILITY
26	26 - SSM HEALTH MEDICAL GROUP 1035 BELLEVUE AVE STE 305 SAINT LOUIS,MO631171845	OTHER HEALTH CARE FACILITY
27	27 - SSM HEALTH MEDICAL GROUP 1031 BELLEVUE AVE STE 100 SAINT LOUIS,MO631171855	OTHER HEALTH CARE FACILITY
28	28 - SSM HEALTH MEDICAL GROUP 8670 BIG BEND BLVD STE A SAINT LOUIS,MO631193839	OTHER HEALTH CARE FACILITY
29	29 - SSM HEALTH MEDICAL GROUP 9759 MANCHESTER RD SAINT LOUIS,MO631191346	OTHER HEALTH CARE FACILITY
30	30 - SSM HEALTH MEDICAL GROUP 3878 PERSHALL RD SAINT LOUIS,MO631351246	OUTPATIENT FACILITY
31	31 - SSM HEALTH NEUROSCIENCES 1035 BELLEVUE AVE STE 500 SAINT LOUIS,MO631171843	OTHER HEALTH CARE FACILITY
32	32 - SSM HEALTH PAIN CARE 1031 BELLEVUE AVE STE 310 SAINT LOUIS,MO631171857	OTHER HEALTH CARE FACILITY
33	33 - SSM HEALTH SLEEP SERVICES 1027 BELLEVUE AVE STE 101 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
34	34 - SSM HEALTH ST MARY'S RADIOLOGY 1031 BELLEVUE AVE STE 280 SAINT LOUIS,MO631171856	OTHER HEALTH CARE FACILITY
35	35 - SSM HEALTH URGENT CARE 2341 S BRENTWOOD BLVD SAINT LOUIS,MO631442033	OTHER HEALTH CARE FACILITY
36	36 - SSM HEALTH VASCULAR SERVICES 1027 BELLEVUE AVE STE G14 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
37	37 - SSM HEALTH WOMEN'S HEALTH 1027 BELLEVUE AVE STE 205 SAINT LOUIS,MO631171851	OTHER HEALTH CARE FACILITY
38	38 - ST LOUIS CYBERKNIFE 1011 BOWLES AVE STE G50 FENTON,MO630260562	OTHER HEALTH CARE FACILITY
39	39 - SSM HEALTH IMAGING SERVICES 711 VETERANS MEMORIAL PKWY STE 101 SAINT CHARLES,MO633032106	HOSPITAL OUTPATIENT
40	40 - SSM HEALTH MEDICAL GROUP 711 VETERANS MEMORIAL PKWY STE 300 SAINT CHARLES,MO633032106	HOSPITAL OUTPATIENT
41	41 - SSM HEALTH MEDICAL GROUP 711 VETERANS MEMORIAL PKWY STE 200 SAINT CHARLES,MO633032106	HOSPITAL OUTPATIENT
42	42 - SSM HEALTH SPECIALTY CARE SERVICES 711 VETERANS MEMORIAL PKWY STE 201 SAINT CHARLES,MO633032106	HOSPITAL OUTPATIENT
43	43 - SSM HEALTH MEDICAL GROUP 400 1ST CAPITOL DR SAINT CHARLES,MO633012880	HOSPITAL OUTPATIENT
44	44 - SSM HEALTH MEDICAL GROUP 5401 VETERANS MEMORIAL PKWY STE 101 SAINT PETERS,MO633761681	HOSPITAL OUTPATIENT
45	45 - SSM HEALTH MEDICAL GROUP 5401 VETERANS MEMORIAL PKWY SAINT PETERS,MO633761680	HOSPITAL OUTPATIENT
46	46 - SSM HEALTH MEDICAL GROUP 6994 MEXICO RD SAINT PETERS,MO633761512	HOSPITAL OUTPATIENT
47	47 - SSM HEALTH MEDICAL GROUP 1601 WENTZVILLE PKWY WENTZVILLE,MO633853814	HOSPITAL OUTPATIENT
48	48 - SSM HEALTH MEDICAL GROUP 1601 WENTZVILLE PKWY STE 117 WENTZVILLE,MO633853814	HOSPITAL OUTPATIENT
49	49 - SSM HEALTH MEDICAL GROUP 1551 WALL ST STE 330 SAINT CHARLES,MO633033544	HOSPITAL OUTPATIENT
50	50 - SSM HEALTH MEDICAL GROUP 1475 KISKER RD STE 100 SAINT CHARLES,MO633048787	OPT EXTENSION SITE
51	51 - SSM HEALTH MEDICAL GROUP 101 2ND ST SAINT CHARLES,MO633012807	HOSPITAL OUTPATIENT
52	52 - SSM HEALTH MEDICAL GROUP 1475 KISKER ROAD STE 125 SAINT CHARLES,MO633048781	HOSPITAL OUTPATIENT
53	53 - SSM HEALTH MEDICAL GROUP 500 MEDICAL DR WENTZVILLE,MO633853421	HOSPITAL OUTPATIENT
54	54 - SSM HEALTH MEDICAL GROUP 600 MEDICAL DR WENTZVILLE,MO633853421	HOSPITAL OUTPATIENT
55	55 - SSM HEALTH MEDICAL GROUP 801 MEDICAL DR STE 400 WENTZVILLE,MO633853824	HOSPITAL OUTPATIENT
56	56 - SSM HEALTH MEDICAL GROUP 1551 WALL ST SAINT CHARLES,MO633033539	HOSPITAL OUTPATIENT
57	57 - SSM HEALTH URGENT CARE 711 VETERANS MEMORIAL PKWY STE 100 SAINT CHARLES,MO633032106	HOSPITAL OUTPATIENT
58	58 - SSM HEALTH MEDICAL GROUP 1603 WENTZVILLE PARKWAY WENTZVILLE,MO633853826	HOSPITAL OUTPATIENT
59	59 - SSM HEALTH HEART & VASCULAR CARE 2 HARBOR BEND CT STE 100 LAKE SAINT LOUIS,MO633671478	OTHER HEALTH CARE FACILITY
60	60 - SSM HEALTH HEART & VASCULAR CARE 300 MEDICAL PLZ STE 160 LAKE SAINT LOUIS,MO633671481	OTHER HEALTH CARE FACILITY
61	61 - SSM HEALTH HEART & VASCULAR CARE 172 A PROFESSIONAL PKWY TROY,MO633792823	OTHER HEALTH CARE FACILITY
62	62 - SSM HEALTH IMAGING SERVICES 400 MEDICAL PLZ STE 50 LAKE SAINT LOUIS,MO633671491	OTHER HEALTH CARE FACILITY
63	63 - SSM HEALTH IMAGING SERVICES 164 PROFESSIONAL PKWY TROY,MO633792823	OTHER HEALTH CARE FACILITY
64	64 - SSM HEALTH MEDICAL GROUP 300 MEDICAL PLZ STE 150 LAKE SAINT LOUIS,MO633671483	OTHER HEALTH CARE FACILITY
65	65 - SSM HEALTH MEDICAL GROUP 722 N STATE HIGHWAY 47 STE B WARRENTON,MO633831108	OTHER HEALTH CARE FACILITY
66	66 - SSM HEALTH MEDICAL GROUP 1101 HIGHWAY K O FALLON,MO633668431	OTHER HEALTH CARE FACILITY
67	67 - SSM HEALTH MEDICAL GROUP 400 MEDICAL PLZ STE 200 LAKE SAINT LOUIS,MO633671417	OTHER HEALTH CARE FACILITY
68	68 - SSM HEALTH MEDICAL GROUP 300 MEDICAL PLZ STE 310 LAKE SAINT LOUIS,MO633671484	OTHER HEALTH CARE FACILITY
69	69 - SSM HEALTH MEDICAL GROUP 172 PROFESSIONAL PKWY LAKE SAINT LOUIS,MO633792823	OTHER HEALTH CARE FACILITY
70	70 - SSM HEALTH SLEEP SERVICES 400 MEDICAL PLZ STE 215 LAKE SAINT LOUIS,MO633671493	OTHER HEALTH CARE FACILITY
71	71 - SSM HEALTH MEDICAL GROUP 100 MEDICAL PLZ LAKE SAINT LOUIS,MO633671366	OTHER HEALTH CARE FACILITY
72	72 - SSM HEALTH WOMEN'S HEALTH 300 MEDICAL PLZ STE 221 LAKE SAINT LOUIS,MO633671483	OTHER HEALTH CARE FACILITY
73	73 - SSM HEALTH BEHAVIORAL HEALTH 1747 SMIZER STATION RD SUITE 2 FENTON,MO630262784	OUTPATIENT FACILITY
74	74 - SSM HEALTH BREAST CARE 1011 BOWLES AVE GROUND LEVEL FENTON,MO630262395	OUTPATIENT FACILITY
75	75 - SSM HEALTH HEART & VASCULAR CARE 1011 BOWLES AVE STE 300 FENTON,MO630262387	OUTPATIENT FACILITY
76	76 - SSM HEALTH HEART & VASCULAR CARE 1011 BOWLES AVE SUITE 205 FENTON,MO630262387	OUTPATIENT FACILITY
77	77 - SSM HEALTH MEDICAL GROUP 10296 BIG BEND RD STE 111 SAINT LOUIS,MO631226498	OUTPATIENT FACILITY
78	78 - SSM HEALTH MEDICAL GROUP 1296 JEFFCO BLVD ARNOLD,MO630102138	OUTPATIENT FACILITY
79	79 - SSM HEALTH MEDICAL GROUP 1011 BOWLES AVENUE SUITE 300 FENTON,MO630262387	OUTPATIENT FACILITY
80	80 - SSM HEALTH NEUROSCIENCES 1055 BOWLES AVE STE 200 FENTON,MO630262308	OUTPATIENT FACILITY
81	81 - SSM HEALTH PAIN CARE 1055 BOWLES AVE SUITE 200 FENTON,MO630262308	OUTPATIENT FACILITY
82	82 - SSM HEALTH SLEEP SERVICES 1015 BOWLES AVE STE 300 FENTON,MO630262394	OUTPATIENT FACILITY
83	83 - SSM HEALTH URGENT CARE 1296 JEFFCO BLVD ARNOLD,MO630102138	OUTPATIENT FACILITY
84	84 - SSM HEALTH VASCULAR SERVICES 1011 BOWLES AVE STE G20 FENTON,MO630262395	OUTPATIENT FACILITY
85	85 - SSM HEALTH WOMEN'S HEALTH 1011 BOWLES AVENUE SUITE 300 FENTON,MO630262387	OUTPATIENT FACILITY
86	86 - SSM BEHAVIORAL HEALTH URGENT CARE 12349 DE PAUL DR STE 110 BRIDGETON,MO630442512	URGENT CARE
87	87 - SSM HEALTH BREAST CARE 3440 DE PAUL LN STE 100 BRIDGETON,MO630443546	OTHER HEALTH CARE FACILITY
88	88 - SSM HEALTH CANCER CARE 12277 DE PAUL DR STE 310 BRIDGETON,MO630442529	OTHER HEALTH CARE FACILITY
89	89 - SSM HEALTH CANCER CARE 1475 KISKER RD STE 180 SAINT CHARLES,MO633048786	OTHER HEALTH CARE FACILITY
90	90 - SSM HEALTH CANCER CARE 400 MEDICAL PLZ STE 100 LAKE SAINT LOUIS,MO633671493	OTHER HEALTH CARE FACILITY
91	91 - SSM HEALTH CANCER CENTER 12303 DE PAUL DR STE 101 BRIDGETON,MO630442512	OTHER HEALTH CARE FACILITY
92	92 - SSM HEALTH DEPAUL HOSPITAL SURGERY 12266 DE PAUL DRIVE SUITE 10 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
93	93 - SSM HEALTH DPH RHEUM INFUSION SYS 1120 SHACKELFORD RD STE B FLORISSANT,MO630314369	OTHER HEALTH CARE FACILITY
94	94 - SSM HEALTH DPH RHEUM INFUSION SYS 12255 DE PAUL DR STE 501 BRIDGETON,MO630442510	OTHER HEALTH CARE FACILITY
95	95 - SSM HEALTH HEART & VASCULAR CARE 12255 DE PAUL DR STE 400 BRIDGETON,MO630442510	OTHER HEALTH CARE FACILITY
96	96 - SSM HEALTH HEART & VASCULAR CARE 12266 DE PAUL DR STE 205 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
97	97 - SSM HEALTH HEART & VASCULAR CARE 12266 DE PAUL DR STE 206 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
98	98 - SSM HEALTH IMAGING SERVICES 3440 DE PAUL LN STE 100 BRIDGETON,MO630443546	OTHER HEALTH CARE FACILITY
99	99 - SSM HEALTH MEDICAL GROUP 1120 SHACKELFORD RD FLORISSANT,MO630314369	OTHER HEALTH CARE FACILITY
100	100 - SSM HEALTH MEDICAL GROUP 12277 DE PAUL DR STE 403 BRIDGETON,MO630442536	OTHER HEALTH CARE FACILITY
101	101 - SSM HEALTH MEDICAL GROUP 2024 DORSETT VLG MARYLAND HEIGHTS,MO63043	OTHER HEALTH CARE FACILITY
102	102 - SSM HEALTH MEDICAL GROUP 14021 NEW HALLS FERRY RD FLORISSANT,MO630332708	OTHER HEALTH CARE FACILITY
103	103 - SSM HEALTH MEDICAL GROUP 12255 DE PAUL DR STE 500 BRIDGETON,MO630442515	OTHER HEALTH CARE FACILITY
104	104 - SSM HEALTH MEDICAL GROUP 12255 DE PAUL DR STE 600 BRIDGETON,MO630442515	OTHER HEALTH CARE FACILITY
105	105 - SSM HEALTH NEUROSCIENCES 12255 DE PAUL DR STE 200 BRIDGETON,MO630442510	OTHER HEALTH CARE FACILITY
106	106 - SSM HEALTH NEUROSCIENCES 12255 DE PAUL DR STE 830 BRIDGETON,MO630442510	OTHER HEALTH CARE FACILITY
107	107 - SSM HEALTH ORTHOPEDICS 12266 DE PAUL DR STE 110 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
108	108 - SSM HEALTH ORTHOPEDICS 1120 SHACKELFORD RD FLORISSANT,MO630314369	OTHER HEALTH CARE FACILITY
109	109 - SSM HEALTH ORTHOPEDICS 12266 DE PAUL DR STE 220 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
110	110 - SSM HEALTH PAIN CARE 12255 DE PAUL DR STE 120 BRIDGETON,MO630442513	OTHER HEALTH CARE FACILITY
111	111 - SSM HEALTH SLEEP SERVICES 3440 DE PAUL LN STE 207 BRIDGETON,MO630443546	OTHER HEALTH CARE FACILITY
112	112 - SSM HEALTH URGENT CARE 1120 SHACKELFORD RD FLORISSANT,MO630314369	DEDICATED EMERGENCY DEPARTMENT
113	113 - SSM HEALTH URGENT CARE 2022 DORSETT VLG MARYLAND HEIGHTS,MO63403	DEDICATED EMERGENCY DEPARTMENT
114	114 - SSM HEALTH VASCULAR SERVICES 12266 DE PAUL DR STE 315 BRIDGETON,MO630442514	OTHER HEALTH CARE FACILITY
115	115 - SSM HEALTH WOMEN'S HEALTH 12277 DE PAUL DR STE 301 BRIDGETON,MO630442529	OTHER HEALTH CARE FACILITY
116	116 - SSM SLUCARE PHYSICIANS GROUP 2315 DOUGHERTY FERRY ROAD STE 211 SAINT LOUIS,MO631223383	PHYSICIAN GROUP - INTERNAL MEDICINE
117	117 - SSM SLUCARE ORTHOPAEDIC SURGERY 1011 BOWLES AVENUE SUITE 400 405 FENTON,MO630262395	PHYSICIAN GROUP - ORTHOPAEDIC SURGERY
118	118 - SSM SLUCARE UROLOGY 6400 CLAYTON RD STE 201 SAINT LOUIS,MO631171850	PHYSICIAN GROUP - UROLOGY

Schedule H (Form 990) 2023

Page 10

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
PART I, LINE 3C:	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."
PART I, LINE 6A:	SSM HEALTH CARE CORPORATION, 46-6029223
PART I, LINE 7:	THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B, AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H, AND 71 ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE CALCULATION OF SCHEDULE H, PART I, LINE 7, COLUMN F UTILIZES 990, PART IX, LINE 25, COLUMN A, WHICH DOES NOT INCLUDE BAD DEBT EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:	SSM HEALTH CARE ST. LOUIS PARTICIPATES IN A WIDE ARRAY OF COMMUNITY AND CIVIC ORGANIZATIONS IN THE PROMOTION OF HEALTH CARE AND COMMUNITY BUILDING ACTIVITIES. SPECIFIC ACTIVITIES REPORTED IN PART II OF SCHEDULE H INCLUDE THE FOLLOWING:COMMUNITY HEALTH IMPROVEMENT ADVOCACY: EFFORTS TO GENERATE COMMUNITY-WIDE IMPROVEMENT AND RESPONSE FROM GOVERNMENT AND PRIVATE ORGANIZATIONS, INCLUDING ADVOCACY ON PUBLIC POLICY ISSUES THAT GO BEYOND HEALTH CARE, SUCH AS HOUSING, SAFETY, AND EDUCATION;WORKFORCE DEVELOPMENT: STUDENT OBSERVATION OF HEALTH CARE AND DIETARY PROFESSIONALS.
PART III, LINE 2:	AS A RESULT OF NEW ACCOUNTING GUIDANCE, BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.
PART III, LINE 3:	FOR FINANCIAL STATEMENT PURPOSES, SSM HEALTH HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THEREFORE, THERE IS NO AMOUNT REPORTED ON PART III, LINE 3 FOR THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER SSM HEALTH'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	SSM HEAL TH CARE ST. LOUIS IS PART OF THE SSM HEALTH CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES THE TREATMENT OF UNCOLLECTIBLE ACCOUNTS AND IMPLICIT PRICE CONCESSIONS IN THE DECEMBER 31, 2023 CONSOLIDATED AUDIT IS CONTAINED ON PAGE 13 AND 14 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COST WAS BASED ON THE MEDICARE PRINCIPLES USED IN COMPLETING THE MEDICARE COST REPORT. ALL COST REPORTED CAME FROM THE MEDICARE COST REPORT. SSM HEALTH ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SSM HEALTH BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES, AS MEDICARE ALLOWED COST IS LESS THAN ACTUAL COST.
PART III, LINE 9B:	SSM HEALTH CARE ST. LOUIS 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. SSM HEALTH CARE ST. LOUIS EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. SSM HEALTH CARE ST. LOUIS' BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RATE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY. ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING: 1.THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT. 2.EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS. 3.ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD. 4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL.5. BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSMH PRIOR TO ENGAGING IN ECAS. SSMH 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 CARE ST. LOUIS' COLLECTION AND FINANCIAL ASSISTANCE POLICIES.
PART VI, LINE 2:	SSM HEALTH (SSMH) PARTICIPATES IN COMMUNITY BENEFIT ACCORDING TO OUR VISION. THROUGH OUR PARTICIPATION IN THE HEALING MINISTRY OF JESUS CHRIST, COMMUNITIES, ESPECIALLY THOSE THAT ARE ECONOMICALLY, PHYSICALLY, AND SOCIALLY MARGINALIZED, WILL EXPERIENCE IMPROVED HEALTH IN MIND, BODY, SPIRIT AND ENVIRONMENT. IN THE TRADITION OF OUR FOUNDERS, THE FRANCISCAN SISTERS OF MARY, CARING FOR THOSE IN GREATEST NEED REMAINS OUR ORGANIZATIONAL PRIORITY. TODAY OUR SYSTEM BOARD MONITORS COMMUNITY BENEFIT EFFORTS, AND VIEWS ACHIEVEMENT OF OUR VISION AS A PRIMARY RESPONSIBILITY. THE PURPOSE OF SSM'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEAL TH NEEDS. MAKING OUR COMMUNITIES HEAL THIER 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 HEAL TH NEEDS AND THE ADOPTION AND IMPLEMENTATION OF STRATEGIES TO ADDRESS THOSE NEEDS. A CHNA IS CONDUCTED EVERY THREE YEARS BY EACH HOSPITAL ACCORDING TO THE FOLLOWING STEPS: ASSESS AND PRIORITIZE COMMUNITY HEALTH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATA TO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA. DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEAL TH 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 HEAL TH PRIORITIES: COLLECT DATA AND EVALUATE PROGRESS; REPORT TO REGIONAUDIVISIONAL BOARD EVERY SIX MONTHS AND SYSTEM BOARD EVERY YEAR; SHARE FINDINGS WITH COMMUNITY STAKEHOLDERS; AND SEND RESULTS TO FINANCE FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE (IRS). SYSTEM OFFICE STAFF AND LEADERS OVERSEE AND MONITOR SSMH'S COMMUNITY BENEFIT PROGRAM, AND ENSURE REPORTING IS IN COMPLIANCE WITH IRS REGULATIONS. IN COLLABORATION WITH COMMUNITY STAKEHOLDERS AND PARTNER ORGANIZATIONS, SSM HEALTH CARE CORPORATION ALSO IDENTIFIES NEEDS BASED ON ASSESSMENTS AND RESEARCH, AND SSMH FACILITIES ALSO INVOLVE CASE MANAGERS AND CARE TEAM STAFF TO PINPOINT CRITICAL HEAL TH ISSUES IN THE COMMUNITY. ALL HOSPITAL CHNAS ARE COMPLETED, APPROVED, AND INTEGRATED INTO THE ORGANIZATION'S STRATEGIC PLAN. WE CONTINUE TO MONITOR AND ASSESS THE PROGRESS OF OUR LOCAL EFFORTS IN THE SPIRIT OF CARING FOR OTHERS AND IMPROVING COMMUNITY HEALTH.
PART VI, LINE 3:	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 COUNSELINGTHE FOLLOWING TYPES OF NOTICES TO THE PUBLIC ARE PROVIDED: * SIGNS IN THE EMERGENCY DEPARTMENT, WEBSITE RESOURCES, AND PUBLIC WAITING AREAS.* BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. * NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES. * APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES.
PART VI, LINE 4:	SSM HEAL TH CARE ST LOUIS DEFINES ITS PRIMARY SERVICE AREA AS THE ST LOUIS METROPOLITAN STATISTICAL AREA (MSA), WHICH INCLUDES THE MISSOURI COUNTIES OF ST. LOUIS, ST. CHARLES, JEFFERSON, FRANKLIN, LINCOLN, AND WARREN AND ST. LOUIS CITY. BECAUSE WE SUPPORT A WIDE RANGE OF LOCAL MARKETS AND CONSTITUENCIES, DEMOGRAPHICS ARE ALSO EVALUATED FOR OUR INDIVIDUAL HOSPITAL SERVICE AREAS, SERVICE LINES AND CLINICAL DEPARTMENTS TO ENSURE WE FOCUS ON SPECIFIC COMMUNITY HEAL TH NEEDS. THE TOTAL POPULATION FOR THE MSA IS ESTIMATED AT 2.8 MILLION, MAKING THE AREA THE 21ST LARGEST METROPOLITAN AREA IN THE UNITED STATES; HOWEVER, IT SAW A DECLINE FROM 2020 TO 2021. ABOUT 41/3% OF THE POPULATION HAS A POST-SECONDARY DEGREE. THE POVERTY RATE FOR THE MSA WAS REPORTED AT 10.4% IN 2020. MORE DETAILED STATISTICS FOR EACH HOSPITAL'S COMMUNITY IS AS FOLLOWS: SSM HEAL TH ST. MARY'S HOSPITAL IS GEOGRAPHICALLY LOCATED IN MID-ST. LOUIS COUNTY, HOWEVER, THE PRIMARY AND SECONDARY SERVICE AREAS INCLUDE ZIP CODES IN BOTH ST. LOUIS COUNTY AND ST. LOUIS CITY. THERE ARE 28 ZIP CODES THAT ARE INCLUDED WITHIN OR OVERLAP THE SERVICE AREA. IN 2020, THE POPULATION OF ST. LOUIS COUNTY WAS APPROXIMATELY 980,000. SSM HEAL TH ST. JOSEPH - ST. CHARLES AND SSM HEAL TH ST. JOSEPH HOSPITAL - LAKE SAINT LOUIS HOSPITALS ARE LOCATED IN ST. CHARLES COUNTY, MISSOURI, AND SERVE THAT REGION AS WELL AS PARTS OF LINCOLN AND WARREN COUNTIES. THIS TRI-COUNTY AREA MAKES UP 80% OF THE HOSPITALS' PATIENTS SERVED AND INCLUDES 19 ZIP CODES. IN ADDITION TO THE LOCATIONS IN HISTORIC DOWNTOWN ST. CHARLES AND LAKE SAINT LOUIS, THE HOSPITAL HAS A LOCATION IN WENTZVILLE THAT PROVIDES EMERGENCY, OUTPATIENT, AND BEHAVIORAL MEDICINE SERVICES. THE SERVICE AREA HAD AN ESTIMATED POPULATION OF 500,000 PERSONS IN 2020 AND IS GROWING RAPIDLY. OVER 1/3 OF HOUSEHOLDS HAVE CHILDREN 18 OR UNDER. MEDIAN FAMILY INCOME IS JUST OVER $100,000, WELL ABOVE THE STATE AND NATIONAL AVERAGE. SSM HEAL TH ST. CLARE HOSPITAL - FENTON SERVES SOUTHWEST ST. LOUIS AND JEFFERSON COUNTIES. THERE ARE 10 ZIP CODES CONTAINED WITHIN OR OVERLAPPING THE SERVICE AREA. AS OF 2020 DATA, THE PRIMARY SERVICE AREA HAD AN ESTIMATED POPULATION OF 335,000 PERSONS. APPROXIMATELY 5.6% OF THE COMMUNITY POPULATION OVER 25 DID NOT HAVE A HIGH SCHOOL DIPLOMA, AND OVER 23% OF STUDENTS IN THE AREA ARE ELIGIBLE FOR FREE OR REDUCED-PRICE SCHOOL LUNCHES. OVER 18.5% OF THE POPULATION IS OVER THE AGE OF 64. SSM HEAL TH DEPAUL HOSPITAL - ST. LOUIS DEFINES ITS SERVICE AREA AS NORTH ST. LOUIS COUNTY, WHICH INCLUDES 18 ZIP CODES WITHIN OR THAT OVERLAP THE SERVICE AREA. AS OF 2020 DATA, NORTH ST. LOUIS COUNTY HAD AN ESTIMATED POPULATION OF 405,000 PERSONS. APPROXIMATELY 26.6% OF THE POPULATION HAS AT LEAST A BACHELOR'S DEGREE, AND THERE IS A 73.9% HIGH SCHOOL GRADUATION RATE. STATISTICS FOR METRO AREA AS A WHOLE: 1) HTTPS://WWW.STLTODAY.COM/NEWS/LOCAL/ILLINOIS/LATEST-POPULATION-ESTIMATES-SHOW-ST-LOUIS-METRO-AREA-LOSING-GROUND-THE-CITY-DROPPING-BELOW-300/ARTICLE%2045648CE9-5E61-5F71-94C6-959A6BD664AD.HTML2) HTTPS://WWW.ONESTL.ORG/INDICATORS/PROSPEROUS/METRIC/POVERTY3) HTTPS://STATISTICALATLAS.COM/STATE/MISSOURI/EDUCATIONAL-ATTAINMENT
PART VI, LINE 5:	SSM HEALTH CARE ST. LOUIS PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEAL TH OF THE COMMUNITY. THE COMMUNITY INITIATIVES BUILD ON THE STRENGTHS OF OUR COMMUNITIES AND SYSTEMS TO IMPROVE THE QUALITY OF LIFE AND TO CREATE A SENSE OF HOPE. COMMUNITY BENEFIT INITIATIVES BUILD COMMUNITY CAPACITY AND INDIVIDUAL EMPOWERMENT THROUGH COMMUNITY ORGANIZING, LEADERSHIP DEVELOPMENT, PARTNERSHIPS, AND COALITION BUILDING. OUR COMMUNITY HEALTH PROGRAMS PROVIDE COMPASSIONATE AND COMPETENT CARE WHILE THEY PROMOTE HEAL TH IMPROVEMENT BY REACHING DIRECTLY INTO THE COMMUNITY TO ENSURE THAT LOW-INCOME AND UNDER-SERVED PERSONS CAN ACCESS HEAL TH CARE SERVICES. IN RESPONSE TO THE GLOBAL CORONAVIRUS PANDEMIC, SSM HEALTH CARE ST. LOUIS WORKED RELENTLESSLY TO RESPOND TO COMMUNITY NEEDS BY DEVELOPING AND IMPLEMENTING STRATEGIES TO ADDRESS SOCIAL NEEDS OF THOSE SERVED, PROVIDING SCREENING & TESTING SERVICES, PERSONAL PROTECTIVE EQUIPMENT AND EDUCATION THROUGHOUT THE COMMUNITY, AS WELL AS TREATMENT FOR THOSE WHO PRESENTED WITH COVID-19. SSM HEALTH CARE ST. LOUIS PROMOTES GRASSROOTS ADVOCACY AND ENGAGES PERSONS OF INFLUENCE TO AFFECT SOCIAL AND PUBLIC POLICY CHANGE IN ORDER TO PROMOTE COMMUNITY HEAL TH. SSM HEAL TH CARE ST. LOUIS ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY, HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.
PART VI, LINE 6:	SSM HEALTH CARE ST LOUIS IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOW AS SSM HEALTH. SSM HEALTH CARE ST LOUIS IS ONE OF THE LARGEST, FULLSERVICE HEALTH CARE NETWORKS IN THE ST LOUIS, MISSOURI AREA. SSM HEALTH CARE ST LOUIS INCLUDES THE FOLLOWING OPERATING HOSPITALS: SSM HEALTH DEPAUL HOSPITAL - ST. LOUIS SSM HEALTH ST. JOSEPH HOSPITAL - ST. CHARLES SSM HEALTH ST. JOSEPH HOSPITAL - WENTZVILLE (REMOTE LOCATION OF ST. JOSEPH HOSPITAL) SSM HEALTH ST. JOSEPH HOSPITAL - LAKE SAINT LOUIS SSM HEALTH ST. MARY'S HOSPITAL - ST. LOUIS SSM HEALTH ST. CLARE HOSPITAL - FENTON.SSM HEALTH (SSMH) IS A CENTRALLY MANAGED, FULLY INTEGRATED HEALTH CARE DELIVERY SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSM HEALTH CARE CORPORATION (SSMHCC) (DOING BUSINESS AS SSMH) IS THE PRINCIPAL NOT-FOR-PROFIT CORPORATION AND HAS BEEN ESTABLISHED AS THE PARENT CORPORATION. SSMH OWNS AND OPERATES 22 ADULT HOSPITALS, ONE PEDIATRIC HOSPITAL, THIRTEEN POST-ACUTE CARE FACILITIES, A NATIONAL PHARMACY BENEFIT MANAGEMENT COMPANY (PBM), AN EXTENSIVE NETWORK OF PHYSICIAN PRACTICE OPERATIONS, AND OTHER HEALTH CARE BUSINESSES. SSMH'S HOSPITAL OPERATIONS ARE LOCATED PRIMARILY IN MISSOURI, WISCONSIN, OKLAHOMA AND ILLINOIS, AND ITS RELATED BUSINESSES PROVIDE HEALTH RELATED SERVICES IN 50 STATES. SSMH'S MISSION STATEMENT IS AS FOLLOWS:THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.SSMHCC AND MOST OF ITS AFFILIATED SUBSIDIARY CORPORATIONS HAVE BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). CERTAIN SUBSIDIARIES OF SSMH ARE FOR-PROFIT ENTITIES THAT ARE TAXABLE UNDER THE IRC.SSMH IS SPONSORED BY SSM HEALTH MINISTRIES, AN INDEPENDENT NINE-MEMBER BODY COMPOSED OF TWO FRANCISCAN SISTERS OF MARY, ONE SISTER OF ST. AGNES, ONE JESUIT PRIEST, AND FIVE LAY PERSONS WHO COLLECTIVELY HOLD CERTAIN RESERVED POWERS OVER SSMH.
PART VI, LINE 7, REPORTS FILED WITH STATES	MO

Schedule H (Form 990) 2023

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
SSM HEALTH CARE ST LOUIS

Employer identification number
43-1343281

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) ARCHDIOCESE OF ST LOUIS 20 ARCHBISHOP WAY DRIVE ST LOUIS,MO63119	43-0653244	501(C)(3)	69,000	GENERAL PURPOSE
(2) CARDINAL GLENNON CHILDREN'S FOUNDATION 3800 PARK AVE ST LOUIS,MO63110	43-1754347	501(C)(3)	10,000	GENERAL PURPOSE
(3) GREATER NORTH COUNTY CHAMBER OF COMMERCE 420 W WASHINGTON ST FLORISSANT,MO63031	43-0787393	501(C)(6)	6,770	GENERAL PURPOSE
(4) INSTITUTE FOR RESEARCH AND EDUCATION IN FAMILY 5501 DELMAR BLVD STE B560 ST LOUIS,MO63111	43-1863752	501(C)(3)	42,124	GENERAL PURPOSE
(5) OPERATION FOOD SEARCH 1644 LOTSIE BLVD ST LOUIS,MO63131	43-1241854	501(C)(3)	6,900	GENERAL PURPOSE
(6) SSM HEALTH FOUNDATION - ST LOUIS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131	87-4109859	501(C)(3)	2,478,874	GENERAL PURPOSE
(7) ST CHARLES REGIONAL CHAMBER OF COMMERCE 5988 MID RIVERS MALL DR ST CHARLES,MO63304	43-0620157	501(C)(6)	7,650	GENERAL PURPOSE
(8) ST LOUIS AREA DIAPER BANK 6141 ETZEL AVENUE ST LOUIS,MO63133	37-1787940	501(C)(3)	11,985	GENERAL PURPOSE
(9) ST LOUIS AREA FOOD BANK 70 CORPORATE WOODS DR BRIDGETON,MO63044	43-1253102	501(C)(3)	70,000	GENERAL PURPOSE
(10) ST LOUIS COUNTY 41 SOUTH CENTRAL CLAYTON,MO63105		GOVERNMENT	115,019	GENERAL PURPOSE
(11) THE DAISY FOUNDATION 6529 ALMIDA VISTA PL ANACORTES,WA98221	91-2009739	501(C)(3)	7,685	GENERAL PURPOSE
(12) THE SALVATION ARMY 3637 BROADWAY KANSAS CITY,MO64111	44-0545998	501(C)(3)	31,250	GENERAL PURPOSE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

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) 2023

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) PATIENT MEDICAL SUPPLIES ASSISTANCE	19747	73,405
(1)
(2)
(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

PART I, LINE 2:

THE PROCEDURES USED TO MONITOR THE USE OF GRANT FUNDING VARIES BASED ON THE GRANT RECIPIENT. GRANTS TO RELATED ENTITIES ARE MONITORED DIRECTLY BY THE ORGANIZATION WHEREBY THE RECIPIENT REPORTS ON THE SPECIFIC USE OF THE FUNDING. FOR GRANTS TO UNRELATED ENTITIES, THE ORGANIZATION UTILIZES THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) TO TRACK, STORE AND REPORT A WIDE RANGE OF INFORMATION RELATED TO GRANTS AND OVERALL COMMUNITY IMPACT. IN CERTAIN CIRCUMSTANCES, QUALIFYING EXPENSES MAY BE PAID ON BEHALF OF SYSTEM EMPLOYEES BASED UPON DEMONSTRATED FINANCIAL HARDSHIP CAUSED BY NATURAL DISASTERS, ILLNESS, OR OTHER UNFORESEEN TRAGEDY.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

Yes

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 on Line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1LAURA KAISER FORMER OFFICER, PRESIDENT/CEO AT SSM	(i) (ii)	0 ------------- 2,047,588	0 ------------- 1,868,164	0 ------------- 728,383	0 ------------- 2,978,810	0 ------------- 23,503	0 ------------- 7,646,448	0 ------------- 1,868,164
2RANDY COMBS TREASURER, CFO AT SSM HEALTH	(i) (ii)	0 ------------- 1,242,308	0 ------------- 669,269	0 ------------- 270,777	0 ------------- 1,203,989	0 ------------- 34,085	0 ------------- 3,420,428	0 ------------- 669,269
3STEVE SMOOT VICE PRESIDENT, COO AT SSM HEALTH	(i) (ii)	0 ------------- 1,173,646	0 ------------- 737,192	0 ------------- 143,520	0 ------------- 1,164,125	0 ------------- 40,364	0 ------------- 3,258,847	0 ------------- 878,090
4DOUGLAS LONG SECRETARY, CLO AT SSM HEALTH	(i) (ii)	0 ------------- 759,270	0 ------------- 495,539	0 ------------- 170,430	0 ------------- 753,634	0 ------------- 23,379	0 ------------- 2,202,252	0 ------------- 495,539
5JEREMY FOTHERINGHAM CHAIRPERSON, PRESIDENT, REGIONAL PRE	(i) (ii)	0 ------------- 789,865	0 ------------- 334,239	0 ------------- 1,710	0 ------------- 648,534	0 ------------- 39,052	0 ------------- 1,813,400	0 ------------- 334,239
6ALEXANDER GARZA MD FORMER OFFICER, CHIEF COMMUNITY HEAL	(i) (ii)	0 ------------- 591,556	0 ------------- 383,397	0 ------------- 57,747	0 ------------- 608,149	0 ------------- 16,506	0 ------------- 1,657,355	0 ------------- 436,242
7MARIO MORALES PHYSICIAN	(i) (ii)	1,231,528 ------------- 0	234,564 ------------- 0	2,180 ------------- 0	12,196 ------------- 0	34,864 ------------- 0	1,515,332 ------------- 0	0 ------------- 0
8KAREN REWERTS FORMER OFFICER, SYSTEM VP FINANCE AT	(i) (ii)	0 ------------- 589,021	0 ------------- 154,022	0 ------------- 58,288	0 ------------- 253,200	0 ------------- 34,314	0 ------------- 1,088,845	0 ------------- 207,408
9TIMOTHY JOHNSON MD DIRECTOR, SYSTEM VP MEDICAL GROUP &	(i) (ii)	0 ------------- 546,303	0 ------------- 162,711	0 ------------- 40,687	0 ------------- 266,170	0 ------------- 34,819	0 ------------- 1,050,690	0 ------------- 201,688
10BOB PENDLETON REGIONAL CHIEF CLINICAL OFFICER	(i) (ii)	637,684 ------------- 0	114,024 ------------- 0	2,622 ------------- 0	259,831 ------------- 0	13,860 ------------- 0	1,028,021 ------------- 0	114,024 ------------- 0
11TINA GARRISON REGIONAL VP - CHIEF OPERATING OFFICE	(i) (ii)	533,210 ------------- 0	122,385 ------------- 0	34,135 ------------- 0	240,884 ------------- 0	25,404 ------------- 0	956,018 ------------- 0	154,850 ------------- 0
12KEVIN ELLEDGE REGIONAL PRESIDENT - MEDICAL GROUP	(i) (ii)	0 ------------- 548,562	0 ------------- 63,521	0 ------------- 103,414	0 ------------- 208,947	0 ------------- 13,372	0 ------------- 937,816	0 ------------- 110,883
13MIN PAN PHYSICIAN	(i) (ii)	841,414 ------------- 0	0 ------------- 0	4,902 ------------- 0	27,672 ------------- 0	16,236 ------------- 0	890,224 ------------- 0	0 ------------- 0
14THOMAS LANDON PHYSICIAN	(i) (ii)	783,600 ------------- 0	15,000 ------------- 0	4,902 ------------- 0	19,050 ------------- 0	34,769 ------------- 0	857,321 ------------- 0	0 ------------- 0
15EILEEN LAMM REGIONAL VP, FINANCE (MO/ILL)	(i) (ii)	0 ------------- 410,075	0 ------------- 91,935	0 ------------- 14,339	0 ------------- 169,951	0 ------------- 34,402	0 ------------- 720,702	0 ------------- 103,885
16ANDREA SCHWOERER PHYSICIAN	(i) (ii)	607,440 ------------- 0	55,000 ------------- 0	1,026 ------------- 0	17,199 ------------- 0	32,508 ------------- 0	713,173 ------------- 0	0 ------------- 0
17JAKE BROOKS HOSPITAL PRESIDENT - SSM HEALTH ST.	(i) (ii)	405,498 ------------- 0	88,457 ------------- 0	830 ------------- 0	177,061 ------------- 0	20,555 ------------- 0	692,401 ------------- 0	88,457 ------------- 0
18MISTY JONES FORMER KEY EMPLOYE, VP HOSPITAL ADMI	(i) (ii)	424,661 ------------- 0	65,409 ------------- 0	1,430 ------------- 0	159,935 ------------- 0	19,329 ------------- 0	670,764 ------------- 0	65,409 ------------- 0
19KYLE GRATE HOSPITAL PRESIDENT - SSM HEALTH ST.	(i) (ii)	364,929 ------------- 0	78,569 ------------- 0	11,574 ------------- 0	161,485 ------------- 0	32,532 ------------- 0	649,089 ------------- 0	89,259 ------------- 0
20KATE APPLETON PHYSICIAN	(i) (ii)	567,074 ------------- 0	10,000 ------------- 0	1,699 ------------- 0	17,777 ------------- 0	6,650 ------------- 0	603,200 ------------- 0	0 ------------- 0
21RACHEL DONLAN REGIONAL VP - ACADEMIC & PHYSICIAN I	(i) (ii)	0 ------------- 331,259	0 ------------- 74,354	0 ------------- 23,883	0 ------------- 140,521	0 ------------- 30,604	0 ------------- 600,621	0 ------------- 97,481
22JULIE WILHITE REGIONAL VP - HUMAN RESOURCES	(i) (ii)	0 ------------- 344,502	0 ------------- 78,695	0 ------------- 21,104	0 ------------- 143,734	0 ------------- 11,073	0 ------------- 599,108	0 ------------- 96,485
23DEBORAH GRAVES HOSPITAL PRESIDENT - SSM HEALTH ST.	(i) (ii)	435,979 ------------- 0	38,389 ------------- 0	49,557 ------------- 0	47,286 ------------- 0	22,202 ------------- 0	593,413 ------------- 0	38,389 ------------- 0

Schedule J (Form 990) 2023

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
PART I, LINE 1A	SEVERAL INDIVIDUALS LISTED ON PART VII, SECTION A RECEIVED A TAX INDEMNIFICATION/GROSS UP PAYMENT IN 2023. THESE PAYMENTS WERE INCLUDED IN THEIR TAXABLE COMPENSATION.
PART I, LINE 3	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (REGIONAL PRESIDENT) HAS COMPENSATION THAT IS DETERMINED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE SSM HEAL TH PRESIDENT.
PART I, LINE 4B	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 THE SSMH 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 INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. 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 DEFERRALS FROM THIS PLAN IN 2023: STEVE SMOOT - 249,972 TIM JOHNSON, MD - 54,877 RANDY COMBS - 261,633 DOUGLAS LONG - 161,286 EILEEN LAMM - 39,082 JEREMY FOTHERINGHAM - 158,615 TINA GARRISON - 52,767 JAKE BROOKS - 39,253 DEBORAH GRAVES - 37,936 KYLE GRATE - $35,602 KEVIN ELLEDGE - 48,528 JULIE WILHITE - 32,119 BOB PENDLETON - 59,726 RACHEL DONLAN - 31,661 MIN PAN - 11,287 LAURA KAISER - 720,859 KAREN REWERTS - 56,755 MISTY JONES - 38,537 ALEXANDER GARZA, MD - 126,049 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. STEVE SMOOT - 140,898 TIM JOHNSON, MD - 38,977 EILEEN LAMM - 11,950 TINA GARRISON - 32,465 KYLE GRATE - 10,690 KEVIN ELLEDGE - 47,362 JULIE WILHITE - 17,791 RACHEL DONLAN - 23,127 LAURA KAISER - 1,488,789 KAREN REWERTS - 51,943 ALEXANDER GARZA, MD - 51,545

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

Return Reference	Explanation
FORM 990, PART I, ITEM C	DBA: CLAYTON HEALTH SERVICES PHARMACY WEST EAST CENTRAL MISSOURI AREA HEALTH EDUCATION CENTER. DBA: KNIGHTS OF COLUMBUS PEDIATRIC DEVELOPMENT CENTER SSM CARE MANAGEMENT COMPANY. DBA: SSM HEALTH/SAINT LOUIS UNIVERITY SCHOOL OF MEDICINE SSM HEALTH AT WORK. DBA: SSM HEALTH BEHAVIORAL HEALTH SSM HEALTH BEHAVIORAL HEALTH AT ST. VINCENT'S. DBA: SSM HEALTH BREAST CARE SSM HEALTH CANCER CARE. DBA: SSM HEALTH CARDINAL GLENNON PEDIATRICS SSM HEALTH DEPAUL HOSPITAL - ANNA HOUSE. DBA: SSM HEALTH DEPAUL HOSPITAL - ST. LOUIS SSM HEALTH DEPAUL HOSPITAL PHYSICIAN BILLING. DBA: SSM HEALTH DEPAUL HOSPITAL RHEUMATOLOGY INFUSION SERVICES SSM HEALTH DEPAUL HOSPITAL SURGERY CENTER. DBA: SSM HEALTH HEART & VASCULAR CARE SSM HEALTH IMAGING SERVICES. DBA: SSM HEALTH MEDICAL GROUP SSM HEALTH NEUROSCIENCES. DBA: SSM HEALTH ORTHOPEDICS SSM HEALTH OUTPATIENT CENTER. DBA: SSM HEALTH PAIN CARE SSM HEALTH PHARMACY. DBA: SSM HEALTH PRESCRIPTION CENTER SSM HEALTH SLEEP SERVICES. DBA: SSM HEALTH SPECIALTY PHARMACY SSM HEALTH ST. CLARE HOSPITAL - FENTON. DBA: SSM HEALTH ST. CLARE HOSPITAL PHYSICIAN BILLING SSM HEALTH ST. JOSEPH HOSPITAL - LAKE SAINT LOUIS. DBA: SSM HEALTH ST. JOSEPH HOSPITAL - LAKE SAINT LOUIS PHYSICIAN BILLING SSM HEALTH ST. JOSEPH HOSPITAL - ST. CHARLES. DBA: SSM HEALTH ST. JOSEPH HOSPITAL - ST. CHARLES PHYSICIAN BILLING SSM HEALTH ST. JOSEPH HOSPITAL - WENTZVILLE. DBA: SSM HEALTH ST. JOSEPH HOSPITAL - WENTZVILLE PHYSICIAN BILLING SSM HEALTH ST. JOSEPH HOSPITAL WENTZVILLE OUTPATIENT PHARMACY. DBA: SSM HEALTH ST. LOUIS SSM HEALTH ST. MARY'S HOSPITAL - ST. LOUIS. DBA: SSM HEALTH ST. MARY'S HOSPITAL PHYSICIAN BILLING SSM HEALTH ST. MARY'S RADIOLOGY. DBA: SSM HEALTH TREATMENT & RECOVERY SSM HEALTH URGENT CARE. DBA: SSM HEALTH VASCULAR SERVICES SSM HEALTH WEIGHT MANAGEMENT SERVICES. DBA: SSM HEALTH WOMEN'S HEALTH SSM INTEGRATED DISTRIBUTION & SERVICES CENTER.
FORM 990, PART V, LINE 1A:	ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION, EIN 46-6029223.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE CORPORATION ARE SSM HEALTH CARE CORPORATION AND SAINT LOUIS UNIVERSITY.
FORM 990, PART VI, SECTION A, LINE 7A	SSM HEALTH CARE CORPORATION (SSMHCC), AS ONE OF THE MEMBERS, HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS OF THE CORPORATION, PROVIDED THAT ANY APPOINTMENT OR REMOVAL REQUIRING THE WRITTEN CONSENT OF SLU HAS RECEIVED THAT APPROVAL. SSMHCC HAS THE POWER TO APPOINT AND REMOVE THE INDIVIDUALS SERVING ON THE BOARD, OTHER THAN THE SLU APPOINTED DIRECTORS. SLU RETAINS POWER TO APPOINT AND REMOVE INDIVIDUALS SERVING ON THE BOARD WHO HAVE BEEN APPOINTED BY SLU.
FORM 990, PART VI, SECTION A, LINE 7B	SSM HEAL TH CARE CORPORATION HAS THE FOLLOWING POWERS: (A) TO ESTABLISH AND CHANGE THE MISSION, PHILOSOPHY AND VALUES OF THE CORPORATION, (B) TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS OF THE CORPORATION, PROVIDED, THAT ANY MEMBER REQUIRING THE APPROVAL OF SLU RECEIVES THAT APPROVAL ACCORDING TO THE BYLAWS, (C) TO APPOINT AND REMOVE THE INDIVIDUALS SERVING ON THE BOARD, OTHER THAN THE SLU APPOINTED DIRECTORS WHO WILL BE SUBJECT TO APPOINTMENT AND REMOVAL BY SLU; PROVIDED, HOWEVER, THAT SSMHCC MAY REMOVE SLU APPOINTED DIRECTORS WHO VIOLATE CONFLICT OF INTEREST POLICY AND OTHER POLICIES OF THE CORPORATION, AS THE SAME MAY BE AMENDED FROM TIME TO TIME, UPON PRIOR WRITTEN NOTICE TO SLU PURSUANT TO THE MEMBERS' AGREEMENT, (D) TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION AND THE CHIEF EXECUTIVE OFFICER OF ANY COMPANY SUBSIDIARY AND ANY HEAL TH CARE OPERA TING DIVISION, PROVIDED, THAT SSMHCC SHALL (I) OBTAIN THE WRITTEN CONSENT OF SLU BEFORE APPOINTING ANY CHIEF EXECUTIVE OFFICER OF SLUH, (II) CONSULT WITH THE BOARD AND SLU BEFORE EXERCISING ITS RESERVED POWER TO REMOVE THE CHIEF EXECUTIVE OFFICER OF SLUH AND (ILL) CONSULT WITH SLU IN CONNECTION WITH HIRING CERTAIN SENIOR EMPLOYEES, (E) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION, AS PROVIDED THEREIN, BUT SUBJECT TO SLU'S PRIOR WRITTEN CONSENT, (F) TO APPROVE AMENDMENTS TO THESE BYLAWS, BUT SUBJECT TO SLU'S PRIOR WRITTEN CONSENT IS NOT REQUIRED FOR (I) NON-MATERIAL CHANGES REQUIRED BY APPLICABLE LAW, REGULATION OR ANY APPLICABLE ACCREDITING ENTITY, (G) TO APPROVE THE MERGER OR CONSOLIDATION OF THE CORPORATION; PROVIDED, THAT (I) SLU'S PRIOR WRITTEN CONSENT SHALL BE REQUIRED IN THE EVENT SUCH TRANSACTION CONSTITUTES A PROHIBITED CHANGE OF CONTROL, AND (II) WITH RESPECT TO A PERMITTED CHANGE OF CONTROL THAT IS A PERMITTED AFFILIATE CHANGE OF CONTROL, SSMHCC SHALL PROVIDE SLU WITH WRITTEN NOTICE NOT LESS THAN THIRTY DAYS PRIOR TO THE EFFECTIVE DATE OF SUCH CHANGE OF CONTROL, AND WITH RESPECT TO ANY OTHER PERMITTED CHANGE OF CONTROL, SSMHCC SHALL PROVIDE SLU WITH WRITTEN NOTICE WITHIN THIRTY (30) DAYS AFTER THE SIGNING OF A LETTER OF INTENT, IN BOTH CASES, WITH NO SEPARATE SLU APPROVAL RIGHT, (H) TO APPROVE THE DISSOLUTION OF THE CORPORATION, BUT SUBJECT TO SLU'S PRIOR WRITTEN CONSENT, (I) TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY, PROVIDED THAT CERTAIN DEVIATIONS FROM PROTOCOL REQUIRE THE APPROVAL OF SLU, (J) 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, (K) 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, (L) 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 AND THE BYLAWS, (M) TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION, SUBJECT TO SLU'S RIGHTS SET FORTH IN THE BYLAWS AND APPROVAL OF THE ACADEMIC PROGRAM STRATEGIC PLAN, (N) TO APPOINT THE AUDITOR AND CORPORA TE COUNSEL FOR THE CORPORATION, (O) SUBJECT TO SLU'S RIGHTS, 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 AND THE BYLAWS, (P) TO REQUIRE THE CORPORATION AND ANY CONTROLLED SUBSIDIARY OR REMOTELY CONTROLLED SUBSIDIARY TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO 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, (Q) SUBJECT TO SLU'S RIGHTS, 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 MEMBERS, AND (R) 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 NONCONTROLLED SUBSIDIARY; PROVIDED, THAT SSMHCC HAS DETERMINED IN ITS REASONABLE DISCRETION THAT ANY SUCH DETERMINATION OR ACTION IS NOT INCONSISTENT WITH AND DOES NOT VIOLA TE THE TERMS OF THE MEMBERS' AGREEMENT OR THE TERMS OF THE MASTER AGREEMENT OR THE ACADEMIC AFFILIATION AGREEMENT. SAINT LOUIS UNIVERSITY (SLU) HAS THE FOLLOWING POWERS: (A) THE APPOINTMENT AND REMOVAL OF THE SLU APPOINTED DIRECTORS TO THE BOARD CONSISTENT WITH SUCH STANDARDS FOR BOARD SERVICE AS APPEAR IN THE BYLAWS, 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 PURSUANT TO THE MEMBERS' AGREEMENT, (B) THE RIGHT TO MAKE RECOMMENDATIONS AND PROVIDE MEANINGFUL INPUT REGARDING THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLANS FOR THE CORPORATION, (C) APPROVAL OF ANY GUARANTY BY SLU OF CORPORATION DEBT, AND (D) IN ACCORDANCE WITH THE MASTER AGREEMENT, ESTABLISHING PAYOR CONTRACTING PARAMETERS FOR SLUCARE.
FORM 990, PART VI, SECTION A, LINE 8B	THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF THE PARENT ORGANIZATION, SSM HEALTH CARE CORPORATION (SSMH). THE RETURN IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM WHO SIGNS AS PAID PREPARER. THE RETURN IS THEN PROVIDED TO MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED BY THE TAX DEPARTMENT OF SSMH PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THE PRESIDENT AND SECRETARY 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 MUST BE COMPLETED ONLINE. PERIODICALLY THROUGH THE YEAR, THE ENTITY'S CORPORATE RESPONSIBILITY CONTACT PERSON (WITH THE HELP OF THE ENTITY'S LEARNING MANAGEMENT SYSTEM COORDINATOR) SENDS DEPARTMENT MANAGERS A LIST OF EMPLOYEES WHO HAVE NOT YET COMPLETED THEIR COI SO THEY CAN REMIND THE EMPLOYEES AND ENSURE THE EMPLOYEES HAVE TIME IN THEIR SCHEDULE TO COMPLETE THE REQUIRED COURSE. RESOLUTION OF ANY CONFLICTS THAT ARE DISCLOSED MUST BE DOCUMENTED AND KEPT ON FILE AT THE ENTITY. SUPERVISORS VERIFY REQUIRED COURSE COMPLETION PRIOR TO YEAR END.
FORM 990, PART VI, SECTION B, LINE 15	A RELATED ORGANIZATION UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19	THE YEAR-END AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND UNAUDITED QUARTERLY CONSOLIDATED FINANCIAL STATEMENT FOR THE SSM HEALTH 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 IX, LINE 11G	MEDICAL AND RELATED: PROGRAM SERVICE EXPENSES 204,368,550. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 204,368,550. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 42,988,538. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,988,538.
FORM 990, PART XI, LINE 9:	TRANSFER TO/FROM CONSOLIDATED ENTITIES -485,445,453. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -1,060,787. NET ASSETS RELEASED FROM RESTRICTION -3,023. AP OFFSET 847. BENEFICIAL INTEREST IN THE FOUNDATION 2,885,933.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SSM HEALTH CARE ST LOUIS

Employer identification number

43-1343281

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
(1) SSM ACO LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 90-0986282	HEALTH PROMOTION	MO	7,263,027	0	SSM HEALTH CARE ST LOUIS

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?
(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	Yes	No
(1)SSM HEALTH CARE CORPORATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 46-6029223	HEALTH CARE	MO	501(C)(3)	LINE 12A, I	SSM HEALTH MINISTRIES		No
(2)SSMHC LIABILITY TRUST I 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-6331003	INSURANCE	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION		No
(3)SSM CONSOLIDATED HEALTH SERVICES 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1473657	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE CORPORATION		No
(4)SSM POLICY INSTITUTE 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1788151	HEALTH CARE	MO	501(C)(4)		SSM HEALTH CARE CORPORATION		No
(5)SSM HEALTH CARE PORTFOLIO MANAGEMENT CO 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1825256	MANAGEMENT	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION		No
(6)SSM CARDINAL GLENNON CHILDREN'S HOSPITAL 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-0738490	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE ST LOUIS	Yes
(7)CARDINAL GLENNON CHILDREN'S FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1754347	FUNDRAISING	MO	501(C)(3)	LINE 7	SSM CARDINAL GLENNON CHILDREN'S HOSPITAL		No
(8)SSM HEALTH FOUNDATION - ST LOUIS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1552945	FUNDRAISING	MO	501(C)(3)	LINE 7	SSM HEALTH CARE ST LOUIS	Yes
(9)SSM HEALTH CARE OF OKLAHOMA INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 73-0657693	HEALTH CARE	OK	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION		No
(10)THE ST ANTHONY HOSPITAL FOUNDATION INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 73-6104300	FUNDRAISING	OK	501(C)(3)	LINE 7	SSM HEALTH CARE OF OKLAHOMA		No
(11)SSM HEALTH CARE OF WISCONSIN INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-0688874	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION		No
(12)DELLS MEDICAL BUILDING INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 39-1613292	MOB	WI	501(C)(2)		SSM HEALTH CARE OF WISCONSIN		No
(13)ST MARY'S FOUNDATION INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1940686	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN		No
(14)ST CLARE HEALTH CARE FOUNDATION INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1940683	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN		No
(15)HOME HEALTH UNITED INC 2802 WALTON COMMONS LANE MADISON,WI53718 39-1539827	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN		No
(16)HOME CARE UNITED INC 2802 WALTON COMMONS LANE MADISON,WI53718 39-1776340	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN		No
(17)HHU XTRA CARE INC 2802 WALTON COMMONS LANE MADISON,WI53718 39-1705111	HEALTH CARE	WI	501(C)(3)	LINE 10	SSM HEALTH CARE OF WISCONSIN		No
(18)SSM HEALTH AT HOME FOUNDATION OF WISCONSIN INC 2802 WALTON COMMONS LANE MADISON,WI53718 39-1839309	FUNDRAISING	WI	501(C)(3)	LINE 12A, I	HOME HEALTH UNITED INC		No
(19)SSM REGIONAL HEALTH SERVICES 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 44-0579850	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION		No
(20)ST MARY'S HEALTH CENTER JEFFERSON CITY MISSOURI FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1575307	FUNDRAISING	MO	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES		No
(21)GOOD SAMARITAN REGIONAL HEALTH CENTER 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-0653587	HEALTH CARE	IL	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES		No
(22)ST MARY'S HOSPITAL CENTRALIA ILLINOIS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 37-0662580	HEALTH CARE	IL	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES		No
(23)ST MARY'S - GOOD SAMARITAN INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 36-4170833	HEALTH CARE	IL	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES		No
(24)GOOD SAMARITAN REGIONAL HEALTH CENTER FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 26-2884795	FUNDRAISING	IL	501(C)(3)	LINE 7	ST MARY'S-GOOD SAMARITAN INC		No
(25)ST MARY'S HOSPITAL FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 36-4636691	FUNDRAISING	IL	501(C)(3)	LINE 7	ST MARY'S-GOOD SAMARITAN INC		No
(26)ST MARY'S HOSPITAL AUXILIARY 400 N PLEASANT CENTRALIA,IL62801 23-7126345	FUNDRAISING	IL	501(C)(3)	LINE 10	ST MARY'S HOSPITAL FOUNDATION		No
(27)SSM HEALTH BUSINESSES 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1333488	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE CORPORATION		No
(28)SSM HEALTH CARE ST LOUIS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1343281	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE CORPORATION		No
(29)CENTRALIA MEDICAL SERVICES BLDG ASSOC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 23-7408025	MOB	IL	501(C)(3)	LINE 12A, I	SSM REGIONAL HEALTH SERVICES		No
(30)ST MARY'S JANESVILLE FOUNDATION INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 27-3439133	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN		No
(31)SSM HEALTH MINISTRIES 3221 MCKELVEY ROAD SUITE 107 BRIDGETON,MO63044 43-1012492	RELIGIOUS ORGANIZATION	MO	501(C)(3)	LINE 1	N/A		No
(32)LEE DEWEY CORPORATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 73-1279603	MOB	OK	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF OKLAHOMA		No
(33)ST MARY'S HOSPITAL AUXILIARY 100 ST MARYS MEDICAL PLAZA JEFFERSON CITY,MO65101 43-6049878	FUNDRAISING	MO	501(C)(3)	LINE 12B, II	N/A		No
(34)GOOD SAMARITAN HOSPITAL AUXILIARY 1 GOOD SAMARITAN WAY MOUNT VERNON,IL62864 23-7049599	FUNDRAISING	IL	501(C)(3)	LINE 12C, III-FI	N/A		No
(35)ST ANTHONY SHAWNEE HOSPITAL INC 1000 N LEE AVE OKLAHOMA CITY,OK73102 45-5055149	HEALTH CARE	OK	501(C)(3)	LINE 3	SSM HEALTH CARE OF OKLAHOMA		No
(36)SSM AUDRAIN HEALTH CARE INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1550298	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM REGIONAL HEALTH SERVICES		No
(37)SSM-SLUH INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 47-4196634	HEALTH CARE	MO	501(C)(3)	LINE 3	SSM HEALTH CARE ST LOUIS	Yes
(38)AGNESIAN HEALTHCARE INC 430 E DIVISION ST FOND DU LAC,WI54935 39-0807236	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE OF WISCONSIN		No
(39)RIPON MEDICAL CENTER INC 845 PARKSIDE STREET RIPON,WI54971 39-1101287	HEALTH CARE	WI	501(C)(3)	LINE 3	AGNESIAN HEALTHCARE INC		No
(40)WAUPUN MEMORIAL HOSPITAL INC 620 WEST BROWN STREET WAUPUN,WI53963 39-0806265	HEALTH CARE	WI	501(C)(3)	LINE 3	AGNESIAN HEALTHCARE INC		No
(41)ST FRANCIS HOME OF FOND DU LAC WISCONSIN INC 33 EVERETT STREET FOND DU LAC,WI54935 39-1029998	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC		No
(42)SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO N8114 COUNTY WW MOUNT CALVARY,WI53057 39-1022770	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC		No
(43)VILLA ROSA INC N8120 COUNTY WW MOUNT CALVARY,WI53057 42-1670962	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC		No
(44)THE CHRISTIAN HOME AND REHABILITATION CENTER INCORPORATED 331 BLY STREET WAUPUN,WI53963 39-0884514	HEALTH CARE	WI	501(C)(3)	LINE 10	AGNESIAN HEALTHCARE INC		No
(45)THE MONROE CLINIC INC 515 22ND AVENUE MONROE,WI53566 39-0808509	HEALTH CARE	WI	501(C)(3)	LINE 3	SSM HEALTH CARE OF WISCONSIN		No
(46)MONROE CLINIC AND HOSPITAL FOUNDATION INC 515 22ND AVENUE MONROE,WI53566 20-5769038	FUNDRAISING	WI	501(C)(3)	LINE 7	SSM HEALTH CARE OF WISCONSIN		No
(47)AGNESIAN HEALTHCARE FOUNDATION INC 430 E DIVISION ST FOND DU LAC,WI54935 39-1684956	FUNDRAISING	WI	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF WISCONSIN		No
(48)SHARED MAGNETIC RESONANCE IMAGING FACILITY INC 1104 JOHN NOLEN DRIVE MADISON,WI53713 39-1534744	HEALTH CARE	WI	501(C)(3)	LINE 12A, I	SSM HEALTH CARE OF WISCONSIN		No
(49)SSM HEALTH CARDINAL GLENNON TRANSPORT 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 86-3519607	HEALTH CARE	MO	501(C)(3)	LINE 12A, I	SSM CARDINAL GLENNON CHILDREN'S HOSPITAL		No
(50)SSM HEALTH FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 87-4109859	FUNDRAISING	MO	501(C)(3)	LINE 12A, I	SSM HEALTH CARE CORPORATION		No
(51)SSM HEALTH CARE GROUP 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 88-0988603	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH CARE ST LOUIS	Yes
(52)THE SARAH COMMUNITY 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1784657	HEALTH CARE	MO	501(C)(3)	LINE 10	SSM HEALTH BUSINESSES		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) SSM ST JOSEPH ENDOSCOPY CENTER LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 27-0046559	SURGERY SERVICES	MO	SSM HEALTH CARE ST LOUIS	RELATED	3,294,282	2,808,455		No			No	50.000 %
(2) ST CLARE IMAGING SERVICES LLC 707 14TH STREET SUITE A BARABOO,WI53913 20-0122365	DIAG. SERVICES	WI	N/A					No			No
(3) MT VERNON RADIATION THERAPY CENTER LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 20-1382620	RADIATION THERAPY	IL	N/A					No		Yes
(4) SLEEP & NEUROLOGY CENTER OF SOUTHERN ILLINOIS LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 20-8468195	DIAG. SERVICES	IL	N/A					No			No
(5) CHOWSMGSI OFFICE BUILDING LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 37-1383861	MOB	IL	N/A					No			No
(6) OZA CANCER CENTER LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 20-1382727	MOB	IL	N/A					No			No
(7) SHAWNEE REAL ESTATE HOLDINGS LLC 1000 N LEE AVE OKLAHOMA CITY,OK73102 45-5458304	MOB	OK	N/A					No			No
(8) DEAN CLINIC & ST MARY'S HOSPITAL ACCOUNTABLE CARE ORGANIZATION LLC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 45-2995500	ACCOUNTABLE CARE ORGANIZATION	WI	N/A					No			No
(9) WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-2016715	INFORMATION TECHNOLOGY SERVICES	WI	N/A					No			No
(10) WINGRA BUILDING GROUP 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-0237060	MOB	WI	N/A					No			No
(11) JANESVILLE RIVERVIEW CLINIC BUILDING PARTNERSHIP 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-6220698	MOB	WI	N/A					No			No
(12) 1110 N CLASSEN BLVD LLC 1110 N CLASSEN BOULEVARD OKLAHOMA CITY,OK73106 73-1158158	MOB	OK	N/A					No		Yes
(13) SSM ST CLARE SURGICAL CENTER LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 26-1439695	SURGERY SERVICES	MO	N/A					No			No
(14) WINDMILL LLP 50 VILLAGE VIEW LANE CHESTERFIELD,MO63017 43-1804651	INVESTMENTS	MO	N/A					No			No
(15) NAVITUS HEALTH SOLUTIONS LLC 361 INTEGRITY DRIVE MADISON,WI53717 04-3608530	PHARMACY BENEFIT MANAGEMENT	WI	N/A					No			No
(16) SSM SELECT REHAB ST LOUIS LLC 4714 GETTYSBURG ROAD MECHANICSBURG,PA17055 26-3694972	HEALTH CARE	DE	SSM HEALTH CARE ST LOUIS	EXCLUDED				No			No	49.000 %
(17) EPIPHANY RX LLC 361 INTEGRITY DRIVE MADISON,WI53717 36-4855405	PHARMACY BENEFIT MANAGEMENT	DE	N/A					No			No
(18) RXPRECHECK LL 278 FRANKLIN RD BRENTWOOD,TN37027 81-2842151	PHARMACY BENEFIT MANAGEMENT	TN	N/A					No			No
(19) ARCHIMEDES LLC 278 FRANKLIN RD BRENTWOOD,TN37027 81-1158028	PHARMACY BENEFIT MANAGEMENT	TN	N/A					No			No
(20) BLOOM TREE LONG-ONLY FUND QP LP FKA BLOOM TREE PONDEROSA FUNDS QP LP 101 PARK AVENUE 33RD FL NEW YORK,NY10178 82-3704522	INVESTMENTS	DE	N/A					No			No
(21) NECICF II AIV2-B LP 300 DELAWARE AVE STE 210 WILMINGTON,DE19801 84-5058167	INVESTMENTS	DE	N/A					No			No
(22) BISON CAPITAL PARTNERS VI-A LP 233 WILSHIRE BLVD STE 425 SANTA MONICA,CA90401 87-4006968	INVESTMENTS	DE	N/A					No			No

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?
(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	Yes	No
(1) SSM MANAGED CARE ORGANIZATION LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1708511	HEALTH PROMOTION	MO	SSM HEALTH CARE ST LOUIS	C	1,966,614	188,793	100.000 %		No
(2) FPP INC & SUBS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1465174	HEALTH CARE	MO	N/A	C					No
(3) DIVERSIFIED HEALTH SERVICES CORP 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1369305	MEDICAL EQUIPMENT	MO	N/A	C					No
(4) SSM PROPERTIES INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1462486	PROPERTY SERVICES	MO	N/A	C					No
(5) HEALTHFIRST PHYSICIAN MANAGEMENT SERVICES 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 73-1534336	MEDICAL SERVICES	OK	N/A	C					No
(6) SSMHC LIABILITY TRUST II 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 81-6128118	INSURANCE	MO	N/A	C					No
(7) SSM MEDICAL GROUP INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-1664107	PHYSICIAN OFFICES	MO	N/A	C					No
(8) SSMHC INSURANCE COMPANY PO BOX 1051 GT GRAND CAYMAN CJ 03-0310431	INSURANCE	CJ	N/A	C					No
(9) PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 36-4161526	HEALTH CARE	IL	N/A	C					No
(10) DEAN HEALTH SYSTEMS INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-1128616	PHYSICIAN OFFICES	WI	N/A	C					No
(11) DEAN RETAIL SERVICES INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-1717636	PROPERTY SERVICES	WI	N/A	C					No
(12) SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM ASSOCIATION INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 83-2038674	CONDO ASSOCIATION	WI	N/A	C					No
(13) SSM HEALTH PHARMACY LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 26-4031708	PHARMACY	MO	N/A	C					No
(14) NAVITUS HOLDINGS LLC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 80-0968174	PHARMACY	WI	N/A	C					No
(15) MS COMMUNITY JV LLC 401 CARLSON PARKWAY CP330 MINNETONKA,MN55305 87-3240022	INSURANCE	DE	N/A	C					No
(16) QUALITY DRUG CORPORATION 239 BROADWAY LAGUNA BEACH,CA92651 33-0644268	PHARMACY BENEFITS	CA	N/A	C					No
(17) ST MARY'S HOSPITAL CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC 707 SOUTH MILLS STREET MADISON,WI53715 000000000	CONDO ASSOCIATION	WI	N/A	C					No
(18) PARTNERS GROUP PMC PRIVATE CREDIT LP C/O MAPLES CORPORATE SERVICES LTD GRAND CAYMAN CJ 98-1439264	INVESTMENT	CJ	N/A	C					No
(19) OMNINHEALTH HOLDINGS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 88-4144276	HEALTH CARE CONSULTING	DE	N/A	C					No

Schedule R (Form 990) 2023

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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) SSM HEALTH FOUNDATION - ST LOUIS	B	2,004,484	BOOK
(2) SSM HEALTH FOUNDATION - ST LOUIS	B	2,478,874	BOOK

Schedule R (Form 990) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OPERATES SEVEN HOSPITALS AND HEALTH CARE CENTERS UNDER SIX SEPARATE HOSPITAL LICENSES IN THE GREATER ST. LOUIS METROPOLITAN AREA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	12,069
6	Total number of volunteers (estimate if necessary) .............	6	602
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	6,541,472
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	263

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,249,272	2,292,524
9	Program service revenue (Part VIII, line 2g) .........	1,664,339,783	2,097,964,741
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,808,870	11,983,487
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	23,858,864	42,003,251
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,693,256,789	2,154,244,003
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,116,784	3,537,048
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	643,599,665	864,950,812
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,041,034,465	1,169,184,097
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,685,750,914	2,037,671,957
19	Revenue less expenses. Subtract line 18 from line 12.......	7,505,875	116,572,046
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,383,505,018	1,055,613,909
21	Total liabilities (Part X, line 26).............	1,107,436,500	1,130,681,567
22	Net assets or fund balances. Subtract line 21 from line 20.....	276,068,518	-75,067,658

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,852,517,464 including grants of $ 3,537,048 ) (Revenue $ 2,113,018,794 )
	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-FORPROFIT 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 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 650 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 12 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, A HEALTH INSURANCE COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 13,900 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. 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 CARE ST LOUIS: SSM HEALTH CARE ST LOUIS PROVIDES HEALTH CARE SERVICES AT SIX WHOLLY-OWNED ACUTE CARE HOSPITALS: SSM HEALTH DEPAUL HOSPITAL-ST LOUIS, SSM HEALTH ST MARY'S HOSPITAL-ST LOUIS, SSM HEALTH ST JOSEPH HOSPITAL-ST CHARLES, SSM HEALTH ST CLARE HOSPITAL-FENTON, SSM HEALTH ST JOSEPH HOSPITAL-LAKE ST LOUIS, AND SSM HEALTH ST JOSEPH HOSPITAL-WENTZVILLE. SSM HEALTH CARE ST LOUIS IS ALSO THE SOLE CORPORATE MEMBER OF SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL AND SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL. SINCE SSM HEALTH'S FOUNDING SISTERS BEGAN THEIR MINISTRY IN ST. LOUIS WITH JUST $5 AMONG THEM MORE THAN 145 YEARS AGO, IT HAS GROWN INTO ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. IN THE ST. LOUIS REGION, SSM HEALTH OPERATES EIGHT HOSPITALS, AS WELL AS NUMEROUS URGENT CARE LOCATIONS, SSM HEALTH EXPRESS CLINICS AT WALGREENS, SSM HEALTH MEDICAL GROUP OFFICES, PEDIATRIC SPECIFIC LOCATIONS, OUTPATIENT REHAB CENTERS, OCCUPATIONAL HEALTH LOCATIONS AND HOSPICE AND HOME HEALTH SERVICES. SSM HEALTH CARE ST. LOUIS ALSO IS PARTIAL OWNER OF SSM HEAL TH REHABILITATION HOSPITAL, A SPECIALTY REHABILITATION HOSPITAL THAT OFFERS CARE AND ADVANCED TREATMENT FOR INDIVIDUALS WITH STROKE, BRAIN INJURY, SPINAL CORD INJURY, NEUROLOGICAL DISORDERS, AMPUTATION, JOINT REPLACEMENT AND OTHER ORTHOPEDIC TRAUMA, AS WELL AS GENERAL MEDICAL REHABILITATION NEEDS. SSM HEALTH DEPAUL HOSPITAL-ST LOUIS OPENED IN 1828, WAS THE FIRST HOSPITAL WEST OF THE MISSISSIPPI RIVER AND REMAINS THE OLDEST CONTINUOUSLY EXISTING BUSINESS IN ST LOUIS. TODAY SSM HEALTH DEPAUL HOSPITAL-ST LOUIS OFFERS THE ONLY LEVEL II TRAUMA CENTER IN NORTH ST. LOUIS COUNTY AND SERVES PATIENTS FROM ACROSS THE ST. LOUIS METROPOLITAN AREA, WITH CONCENTRATION IN THE SURROUNDING COMMUNITIES OF BRIDGETON, FLORISSANT, HAZELWOOD, ST ANN, ST JOHN, MARYLAND HEIGHTS AND OVERLAND IN MISSOURI. SSM HEAL TH DEPAUL HOSPITAL-ST LOUIS OFFERS A WIDE RANGE OF COMPREHENSIVE MEDICAL CARE INCLUDING INPATIENT AND OUTPATIENT SURGERIES USING STATE-OF-THE-ART TECHNOLOGY AND FACILITIES. WE OFFER THE MOST ADVANCED TECHNOLOGY AND PROCEDURES AVAILABLE INCLUDING MINIMALLY INVASIVE HEART, SPINE, KNEE, HIP AND WEIGHT LOSS SURGERY. THE JOINT COMMISSION HAS ALSO DESIGNATED THE HOSPITAL AS A JOINT COMMISSION CERTIFIED PRIMARY STROKE CENTER, DISTINGUISHING IT FROM OTHER STROKE CENTERS, FOR MEETING THE HIGHEST STANDARDS OF CARE ESTABLISHED BY THE JOINT COMMISSION TO RECEIVE AND TREAT THE MOST COMPLEX STROKE CASES, AS A CERTIFIED HIP REPLACEMENT CENTER, A CERTIFIED KNEE REPLACEMENT CENTER, AND IS DESIGNATED AS A LEVEL I TIME CRITICAL DIAGNOSIS STEMI CENTER. IT IS ALSO A BARIATRIC SURGERY CENTER OF EXCELLENCE AS ENDORSED BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY. SSM HEALTH ST. MARY'S HOSPITAL IS A TWO-TIME WINNER OF THE PREMIER AWARD FOR QUALITY AND A LEVEL II TIME CRITICAL DIAGNOSIS STEMI CENTER. THE HOSPITAL HAS DISTINCTIVE CAPABILITIES IN HEART ATTACK CARE, HIGH-RISK PREGNANCIES, AND FETAL SURGERY. ADDITIONALLY, THE HOSPITAL HAS A CHEST PAIN CENTER, ADVANCED STROKE CARE CLINIC AND THE LATEST IMAGING AND OUTPATIENT SERVICES. A TEACHING HOSPITAL, SSM HEAL TH ST. MARY'S OFFERS AN INDEPENDENT, ACCREDITED INTERNAL MEDICINE RESIDENCY PROGRAM AND IS THE PRIMARY LOCATION FOR ST. LOUIS UNIVERSITY SCHOOL OF MEDICINE'S DEPARTMENT OF OBSTETRICS AND GYNECOLOGY AND ITS FAMILY PRACTICE RESIDENCY PROGRAMS. SSM HEALTH ST. JOSEPH HOSPITAL-ST CHARLES IS LOCATED IN A HISTORIC DOWNTOWN DISTRICT AND HAS BEEN SERVING THE NEEDS OF THE COMMUNITY SINCE 1885. SSM ST. JOSEPH HOSPITALST CHARLES HAS GROWN STRUCTURALLY AND TECHNOLOGICALLY THROUGHOUT THE PAST 125 YEARS TO MEET THE NEEDS OF AN EVER-GROWING AND CHANGING POPULATION. TODAY, THE ACUTE CARE HOSPITAL OFFERS HIGHLY-SPECIALIZED CARE FOR CRITICALLY ILL PATIENTS. THE HOSPITAL EXCELS IN MANY AREAS, INCLUDING OPEN-HEART SURGERY, CARDIAC CATHETERIZATIONS, TRAUMA AND EMERGENCY SERVICES, SLEEP MEDICINE, OBSTETRICS, SURGICAL SERVICES, ONCOLOGY, VASCULAR SURGERY, ORTHOPEDICS AND GASTROENTEROLOGY. THE FACILITY IS DESIGNATED AS A LEVEL II TRAUMA CENTER, A JOINT COMMISSION-CERTIFIED PRIMARY STROKE CENTER AND THE ONLY LEVEL I TIME CRITICAL DIAGNOSIS STEMI CENTER IN ST. CHARLES COUNTY. SSM HEAL TH ST. JOSEPH HOSPITAL-LAKE SAINT LOUIS IS THE LEADING PROVIDER OF HEALTH CARE SERVICES FOR WESTERN ST. CHARLES, WARREN AND LINCOLN COUNTIES. THE HOSPITAL IS A STATE-DESIGNATED LEVEL ILL TRAUMA CENTER, A LEVEL II TIME CRITICAL DIAGNOSIS STEMI CENTER AND SPECIALIZES IN OBSTETRIC AND PEDIATRIC CARE. IT ALSO OFFERS INPATIENT AND OUTPATIENT HEALTH CARE SERVICES. IN 2014 IT WAS NAMED ONE OF THE NATION'S TOP 100 HOSPITALS BY TRUVEN HEAL TH ANALYTICS AND MADE BECKER'S HOSPITAL REVIEW'S LIST OF 100 GREAT COMMUNITY HOSPITALS. SSM HEALTH ST. JOSEPH HOSPITAL-WENTZVILLE HAS BEEN PROVIDING HIGH QUALITY HEALTH CARE TO RESIDENTS IN WESTERN ST. CHARLES, WARREN, LINCOLN, AND MONTGOMERY COUNTIES SINCE 1987. OPERATING UNDER THE SSM HEAL TH ST. JOSEPH HOSPITAL-ST. CHARLES HOSPITAL LICENSE, THE FACILITY CURRENTLY OFFERS PATIENTS IN WENTZVILLE AND SURROUNDING COMMUNITIES A 24-HOUR EMERGENCY DEPARTMENT AND AMBULATORY SERVICES, AS WELL AS CONVENIENT ACCESS TO OUTPATIENT PROGRAMS, INCLUDING DIAGNOSTIC, CARDIOLOGY, PULMONARY AND REHAB SERVICES. BEHAVIORAL HEAL TH INPATIENT AND OUTPATIENT CARE ALSO IS AN INTEGRAL PART OF THE SERVICES OFFERED AT THE HOSPITAL. THE HOSPITAL OFFERS INPATIENT PSYCHIATRIC CARE ON CAMPUS WITH CLOSE SUPERVISION, WITH THE GOAL OF STABILIZING PATIENTS AND HELPING THEM UNDERSTAND THEIR CONDITION AND DEVELOP COPING STRATEGIES TO MANAGE THEIR EMOTIONS AND BEHAVIORS. SSM HEALTH ST. CLARE HOSPITAL-FENTON IS A LEVEL I TIME CRITICAL DIAGNOSIS STEM! CENTER AND A LEVEL I STROKE CENTER, SERVES THE MEDICAL NEEDS OF THE EXPANDING COMMUNITY IN SOUTHWEST ST. LOUIS COUNTY. SPECIALIZING IN HEART AND VASCULAR, NEUROSCIENCES, CANCER CARE, MATERNITY AND OTHER MEDICAL SERVICES. THE HOSPITAL ALSO RECEIVED THE HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD IN 2019. SSM HEALTH CARE ST LOUIS 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 HEAL TH CARE PROFESSIONALS,- PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEAL TH CARE PROGRAMS - ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.QUANTIFIABLE UNCOMPENSATED CARE: THE FOLLOWING IS A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE INCLUDED AS UNCOMPENSATED CARE: TRADITIONAL CHARITY CARE - $35,315,404UNPAID COST OF OTHER MEANS-TESTED PROGRAMS - $9,396,333TOTAL QUANTIFIABLE UNCOMPENSATED CARE - $44,711,736

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 expenses1,852,517,464

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	7,769,671	16,121,275	10,274,522

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,004,484
e	Government grants (contributions)		1e	106,281

f	All other contributions, gifts, grants, and similar amounts not included above		1f	181,759

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		2,292,524

		Business Code
2a	NET PATIENT SERVICE RE	622110	1,838,113,324	1,838,113,324
b	340B PHARMACY REVENUE	456110	95,028,685	95,028,685
c	PHARMACY REVENUE	456110	85,555,141	84,542,278	1,012,863
d	MANAGEMENT FEES	561000	32,010,003	32,010,003
e	CORPORATE FEES	561000	7,574,018	7,574,018
f	All other program service revenue.		39,683,570	39,683,570
g	Total. Add lines 2a–2f .....		2,097,964,741

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,726,987			7,726,987
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	13,214,141
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	13,214,141
d	Net rental income or (loss).......			13,214,141			13,214,141
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	5,080,491
b	Less: cost or other basis and sales expenses	7b	0	823,991
c	Gain or (loss)	7c	5,080,491	-823,991
d	Net gain or (loss).........			4,256,500			4,256,500
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	1,020,596
b	Less: cost of goods sold ..		10b	672,444
c	Net income or (loss) from sales of inventory..			348,152			348,152

Business Code
11a	JV & LTACH/REHAB		621110	18,697,812	16,066,916	2,630,896
b	CAFETERIA		722210	6,845,433			6,845,433
c	LABORATORY		621500	2,878,702		2,878,702
d	All other revenue ....			19,011		19,011
e	Total. Add lines 11a–11d ......			28,440,958
12	Total revenue. See instructions.....			2,154,244,003	2,113,018,794	6,541,472	32,391,213

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	3,463,643	3,463,643
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	73,405	73,405
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	3,918,942	3,773,557	145,385
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	670,764	645,880	24,884
7	Other salaries and wages........	715,419,747	688,879,021	26,540,726
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	29,919,826	28,809,857	1,109,969
9	Other employee benefits .......	65,097,522	62,682,526	2,414,996
10	Payroll taxes ...........	49,924,011	48,071,924	1,852,087
11	Fees for services (non-employees):
a	Management ......	40,619,026	40,577,671	41,355
b	Legal .........	1,606,059		1,606,059
c	Accounting ...........
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)	247,357,088	247,357,088
12	Advertising and promotion ....	165,192	165,192
13	Office expenses .......	30,918,012	26,946,478	3,971,534
14	Information technology ......	52,277,806	52,277,806
15	Royalties ..
16	Occupancy ...........	50,937,671	48,440,205	2,497,466
17	Travel ............	1,371,855	601,211	770,644
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	338,431	277,354	61,077
20	Interest ...........
21	Payments to affiliates .......	132,480,181	5,100,678	127,379,503
22	Depreciation, depletion, and amortization ..	55,194,037	52,472,341	2,721,696
23	Insurance ...	10,954,662	187,546	10,767,116
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 & EQUI	464,872,593	464,872,593	0	0
b	TAXES	72,861,374	72,828,216	33,158	0
c	LICENSES, DUES & SUBSCR	4,137,965	2,642,166	1,495,799	0
d	BANK FEES	2,620,994	900,935	1,720,059	0
e	All other expenses	471,151	470,171	980
25	Total functional expenses. Add lines 1 through 24e	2,037,671,957	1,852,517,464	185,154,493	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,371,074	1	1,051,045
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			279,039,666	4	258,680,788
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			41,318,038	8	43,992,850
9	Prepaid expenses and deferred charges ......			7,665,188	9	7,289,363
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,558,858,698
b	Less: accumulated depreciation	10b	956,742,192	598,590,204	10c	602,116,506
11	Investments—publicly traded securities .			0	11	5,340,588
12	Investments—other securities. See Part IV, line 11 .....			355,125,492	12	0
13	Investments—program-related. See Part IV, line 11 ..			53,192,327	13	60,504,807
14	Intangible assets ...............			16,367,748	14	16,723,992
15	Other assets. See Part IV, line 11 ...........			30,835,281	15	59,913,970
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,383,505,018	16	1,055,613,909

17	Accounts payable and accrued expenses .....	201,230,623	17	172,350,413
18	Grants payable ...		18
19	Deferred revenue .........	10,685,580	19	9,203,262
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	423,977
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	92,217
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	895,520,297	25	948,611,698
26	Total liabilities. Add lines 17 through 25..	1,107,436,500	26	1,130,681,567

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	256,784,693	27	-93,287,673
28	Net assets with donor restrictions ...........	19,283,825	28	18,220,015
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	276,068,518	32	-75,067,658
33	Total liabilities and net assets/fund balances ........	1,383,505,018	33	1,055,613,909