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)
(1) MICHAEL BAUMGARTNER...................................................................... DIRECTOR, REGIONAL PRESIDENT-SOUTHERN ILLINOIS	1.00 ................. 40.00	X	X	0	563,577	295,955
(2) MATTHEW FLANIGAN...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(3) JEREMY FOTHERINGHAM...................................................................... DIRECTOR, CHAIRPERSON, REGIONAL PRESIDENT	0.00 ................. 40.00	X		0	1,125,814	687,586
(4) PAULA FRIEDMAN...................................................................... DIRECTOR, VICE CHAIRPERSON	1.00 ................. 0.00	X	X	0	0	0
(5) DAMON HARBISON...................................................................... DIRECTOR, HOSPITAL PRESIDENT-SSM HEALTH ST. MARY'S	40.00 ................. 0.00	X	X	478,548	0	228,496
(6) DR JEAN BENOIT-HOULE...................................................................... DIRECTOR, SSM HEALTH GOOD SAMARITAN HOSPITAL PHYSI	1.00 ................. 0.00	X		0	0	0
(7) TENA HOYT...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(8) DR ERICA IBENDAHL...................................................................... DIRECTOR, SSM HEALTH MEDICAL GROUP PHYSICIAN	1.00 ................. 0.00	X		0	0	0
(9) JEREMY MIDURA...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(10) DR SUDEEP NAIR...................................................................... DIRECTOR, SSM HEALTH MEDICAL GROUP PHYSICIAN	1.00 ................. 0.00	X		0	0	0
(11) SUZIE SCHMIDT...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(12) RAJENDRA SHROFF MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(13) PATRICIA WILLIAMS...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(14) RANDY COMBS...................................................................... TREASURER, CHIEF FINANCIAL OFFICER AT SSM HEALTH	0.00 ................. 40.00		X	0	2,182,354	1,238,074
(15) DOUGLAS LONG...................................................................... SECRETARY, GENERAL COUNSEL AT SSM HEALTH	0.00 ................. 40.00		X	0	1,425,239	777,013
(16) RACHEL HALL...................................................................... ASSISTANT SECRETARY	40.00 ................. 0.00		X	0	88,558	30,654
(17) JOHN SNODSMITH...................................................................... REGIONAL VP, FINANCE	0.00 ................. 40.00		X	0	292,287	99,350

(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) JULIE LONG........................................................................ VP - STRATEGIC PLANNING	0.00 .......................40.00	X			0	417,253	178,318
(19) JOHN KOHLER SR........................................................................ CHIEF MEDICAL OFFICER	0.00 .......................40.00	X			0	334,507	64,243
(20) HOLLIE COLLE........................................................................ VP HOSPITAL OPERATIONS	40.00 .......................0.00	X			184,039	0	62,133
(21) MATTHEW SCOTT........................................................................ DIRECTOR - PHARMACY	40.00 .......................0.00	X			172,469	0	72,131
(22) MARLA SMITH........................................................................ DIRECTOR - NURSING	40.00 .......................0.00	X			168,807	0	55,883
(23) MAAMOUN JUNIDI........................................................................ PHYSICIAN	40.00 .......................0.00		X		337,461	0	4,942
(24) TRACY FISCUS........................................................................ ADMINISTRATIVE DIRECTOR - NURSING	40.00 .......................0.00		X		213,193	0	50,621
(25) CHRISTY DETERING........................................................................ NURSE PRACTITIONER	40.00 .......................0.00		X		169,869	0	9,963
(26) AMBER WENNERSTROM........................................................................ NURSE PRACTITIONER	40.00 .......................0.00		X		186,153	0	37,432
(27) TODD DAVIS........................................................................ PHARMACIST	40.00 .......................0.00		X		168,178	0	42,730
(28) LAURA KAISER........................................................................ PRESIDENT/CEO OF SSM HEALTH	0.00 .......................40.00			X	0	4,644,135	3,002,313
(29) MATT KINSELLA........................................................................ PT YR REGIONAL VP FINANCE	0.00 .......................40.00			X	0	532,042	201,905
(30) KAREN REWERTS........................................................................ SYSTEM VP, FINANCE (MO/ILL)	0.00 .......................40.00			X	0	801,331	287,514
(31) GEORGE DANEKER........................................................................ INTERIM CHIEF MEDICAL OFFICER - SOUTHERN ILLINOIS	40.00 .......................0.00			X	0	443,773	58,437
(32) MELISSA KARAFFA........................................................................ NURSE PRACTITIONER	40.00 .......................0.00			X	161,335	0	45,077

(A) Name and business address	(B) Description of services	(C) Compensation
ANESTHESIA ASSOCIATES OF SOUTHERN ILLINO 2700 TURNBERRY DRIVE MARION,IL62959	MEDICAL SERVICES	3,252,083
VAYA WORKFORCE SOLUTIONS 5930 CORNERSTONE CT W STE 300 SAN DIEGO,CA92121	STAFFING SERVICES	2,430,154
TRIMEDX HOLDINGS LLC 5451 LAKEVIEW PARKWAY S DR INDIANAPOLIS,IN46268	CLINICAL ENGINEERING SERVICES	1,166,796
SODEXO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO,IL60674	DIETARY SERVICES	1,026,989
MIDWEST EMERGENCY DEPARTMENT SERVICES IN 320 E US HWY 50 OFALLON,IL62269	MEDICAL SERVICES	831,574
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 24

- 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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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 ST MARY'S HOSPITAL CENTRALIA ILLINOIS

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 ST MARY'S HOSPITAL CENTRALIA ILLINOIS		Employer identification number 37-0662580

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 ST MARY'S HOSPITAL CENTRALIA ILLINOIS			Employer identification number 37-0662580
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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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

3,998

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

3,998

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 STATE AND NATIONAL 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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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)

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

3a(ii)

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

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 .....	1,302,150		1,302,150
b	Buildings ....	47,293,918	23,979,040	23,314,878
c	Leasehold improvements	787,310	677,522	109,788
d	Equipment ....	41,410,032	29,982,620	11,427,412
e	Other .....	299,418	15,090	284,328
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				36,438,556

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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)DUE FROM AFFILIATES				69,040,380
(2)OPERATING RIGHT OF USE ASSETS				1,668,953
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				70,709,333

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
DEFERRED COMPENSATION	369,673
ASSET RETIREMENT OBLIGATION	90,101
OTHER LONG TERM LIABILITIES	1,164,114
THIRD PARTY PAYORS	3,975,866
OPERATING LEASE OBLIGATIONS	558,596
INTERCOMPANY PAYABLES	2,256,143



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	8,414,493
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 X, LINE 2:

ST MARY'S HOSPITAL, CENTRALIA, ILLINOIS' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF A RELATED ORGANIZATION, SSM HEALTH (SSMH). 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 2022 OR 2023.

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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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) . . .	978,585	0	978,585	0.960 %
b	Medicaid (from Worksheet 3, column a) . . . . .	31,756,564	31,627,218	129,346	0.130 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	2,343,483	1,605,725	737,758	0.720 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	35,078,632	33,232,943	1,845,689	1.810 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	104,253	0	104,253	0.100 %
f	Health professions education (from Worksheet 5) . . .	291,982	0	291,982	0.290 %
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) . . . .	58,825	0	58,825	0.060 %
j	Total. Other Benefits . .	455,060		455,060	0.450 %
k	Total. Add lines 7d and 7j .	35,533,692	33,232,943	2,300,749	2.260 %

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
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

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. ......

3,029,143

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).....

20,103,307

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

27,781,957

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

-7,678,650

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 %
1
2
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?1Name, 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)
1	SSM HEALTH ST MARY'S HOSPITAL - CENTRALIA 400 N PLEASANT AVENUE CENTRALIA,IL62801 HTTPS://WWW.SSMHEAL TH.COM/LOCATIONS/S 0002642	X	X	X

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 MARY'S HOSPITAL - CENTRAL
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/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/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)

	SSM HEALTH ST MARY'S HOSPITAL - CENTRAL
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):

HTTPS://WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIA

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

HTTPS://WWW.SSMHEALTH.COM/RESOURCES/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL

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

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

	SSM HEALTH ST MARY'S HOSPITAL - CENTRAL
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)

	SSM HEALTH ST MARY'S HOSPITAL - CENTRAL
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 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. MARY'S HOSPITAL - CENTRALIA	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. MARY'S HOSPITAL - CENTRALIA	PART V, SECTION B, LINE 5: IN CONDUCTING THIS ASSESSMENT, THE SSM HEALTH COMMUNITY HEAL TH TEAM SOUGHT INPUT FROM THE COMMUNITY THROUGH A COMMUNITY WIDE HEALTH SURVEY, HOSTED FOCUS GROUPS, AND CONDUCTED KEY INFORMANT INTERVIEWS. NO GROUPS IN THE COMMUNITY WERE EXCLUDED FROM PARTICIPATING IN THE ASSESSMENT. SECONDARY DATA WAS COLLECTED FROM VARIOUS ORGANIZATIONS, SUCH AS THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEAL TH RANKINGS, SPARKMAP, BROADSTREET.IQ, AND THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH. EACH OF THESE SOURCES OF PRIMARY DATA (COMMUNITY INPUT) WAS ANALYZED ALONG ASIDE SECONDARY DATA. NO WRITTEN COMMENTS WERE RECEIVED ON THE SSM HEALTH SOUTHERN ILLINOIS 2019- 2021 COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY HEALTH SURVEY FROM MARCH 15, 2021, TO MAY 24, 2021, INDIVIDUALS WITHIN THE COMMUNITY WERE INVITED TO COMPLETE A THIRTY NINE QUESTION COMMUNITY HEALTH SURVEY. THE ONLINE SURVEY WAS PROMOTED THROUGH SOCIAL MEDIA, PRESS RELEASES, COUNTY AND CITY CHAMBERS OF COMMERCE, E MAIL INVITATIONS TO SSM HEAL TH PHYSICIANS, STAFF, AND VOLUNTEER BOARDS AS WELL AS EMAIL INVITATIONS TO PUBLIC OFFICIALS, COMMUNITY ORGANIZATIONS, AND CHURCHES. PAPER SURVEYS WERE AVAILABLE AT THE HOSPITAL ENTRANCES AND LOCAL PUBLIC LIBRARIES. 577 RESIDENTS OF THE 23 ZIP CODES OF THE DEFINED COMMUNITIES COMPLETED SURVEYS; 3 OF THE 577 SURVEYS WERE COMPLETED USING A PAPER SURVEY. FOCUS GROUPS FOCUS GROUPS WERE MODERATED, CONDUCTED, AND ANALYZED BY THE COMPANY, STEFANIE SANTOS MCLEESE: PR AND BRAND STRATEGY. AS PART OF THE BROADER COMMUNITY HEAL TH NEEDS ASSESSMENT (CHNA) DATA GATHERING PROCESS, THREE AUDIENCES WERE IDENTIFIED AS PRIORITIES FOR FURTHER INVESTIGATION, EITHER DUE TO STATISTICAL UNDER REPRESENTATION IN THE 2021 CHNA SURVEY OR GENERAL URGENCY AS INDICATED IN SURVEY RESULTS. ONE GROUP WAS ASSIGNED TO REPRESENT EACH OF THESE AUDIENCES. WHEN POSSIBLE, CHNA INITIATIVES FOCUS ON THE COLLECTION OF HEAL TH NEEDS FROM A REPRESENTATIVE MIX OF FIRST PERSON PERSPECTIVES. HOWEVER, CERTAIN GROUPS MAY BE MORE RELUCTANT OR SIMPLY LESS LIKELY TO SHARE THEIR DIRECT FEEDBACK FOR A VARIETY OF REASONS. IN CASES LIKE THESE, IT CAN BE APPROPRIATE TO ENGAGE INDIVIDUALS WITH DIRECT CONTACT WITH THESE POPULATIONS TO PROVIDE THE NECESSARY STORY, POINT OF VIEW, AND CONTEXT, HELPING TO ENSURE THE CHNA INCORPORATES THE NEEDS OF THESE GROUPS. THE SSM HEALTH COMMUNITY HEALTH TEAM CONDUCTED A RIGOROUS, BEST PRACTICE NETWORK RECRUIT FOR EACH OF THE THREE GROUPS, BEGINNING WITH KNOWN STAKEHOLDERS WITH APPROPRIATE CONTEXT BEFORE BRANCHING OUT TO RECRUIT STAKEHOLDERS SUGGESTED AS IDEAL FOR REPRESENTING THE POPULATIONS IN QUESTION BY THOSE KNOWN STAKEHOLDERS. GROUP EMPHASIS AND PARTICIPANT SUMMARY - INDIVIDUALS EXPERIENCING HOUSING INSTABILITY OR HOMELESSNESS: SEVEN PARTICIPANTS REPRESENTING LOCAL COMMUNITY SERVICES ORGANIZATIONS; TWO OF THESE PARTICIPANTS HAD PERSONALLY EXPERIENCED HOUSING INSTABILITY - BLACK COMMUNITY MEMBERS : THREE CHURCH LEADERS SERVING PREDOMINANTLY BLACK CONGREGATIONS - INDIVIDUALS EXPERIENCING MENTAL HEALTH DIFFICULTIES: NINE PARTICIPANTS REPRESENTING LOCAL COMMUNITY SERVICE ORGANIZATIONS WHICH ON FOCUS MENTAL HEALTH SERVICES KEY INFORMANT INTERVIEWS THE COMMUNITY HEALTH TEAM INTERVIEWED 28 KEY COMMUNITY MEMBERS HEALTH CARE ADMINISTRATIONS, SOCIAL SERVICE ORGANIZATION LEADERS, LAW ENFORCEMENT, EDUCATIONAL LEADERS, CIVIC ORGANIZATIONAL LEADERS, AND KEY COMMUNITY LEADERS TO GATHER INPUT ON THE HEAL TH NEEDS, STRENGTHS, CONCERNS, AND AREAS OF IMPROVEMENT NEEDED IN OUR COMMUNITY. SEVERAL OF THE INTERVIEWS INVOLVED MORE THAN ONE PERSON FROM THE ORGANIZATION. INTERVIEWS WERE CONDUCTED IN PERSON OR VIA VIRTUAL VIDEO MEETING SOFTWARE DEPENDING ON THE INDIVIDUAL'S PREFERENCES. ALL INTERVIEWS WERE RECORDED AND TRANSCRIBED VIA AUTO TRANSCRIPTION SOFTWARE.
SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA	PART V, SECTION B, LINE 6A: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA CONDUCTED ITS 2021 CHNA IN COOPERATION WITH SSM HEALTH GOOD SAMARITAN HOSPITAL - MT. VERNON.
SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA	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: - SUBSTANCE ABUSE- MENTAL HEALTH- NUTRITION, WEIGHT, AND EXERCISESUBSTANCE ABUSE ACCORDING TO THE CDC'S NATIONAL CENTER FOR HEALTH STATISTICS PROVISIONAL, DRUG OVERDOSE DEATHS HAVE INCREASED FROM 78,056 IN 2019/2020 TO 100,306 IN 2020/2021. IN ILLINOIS, THE OVERALL AGE ADJUSTED DRUG OVERDOSE MORTALITY RATE IN 2019 WAS 21.9 PER 100,000 POPULATION. ILLINOIS HAS ALSO BEEN RANKED 24TH IN THE COUNTRY FOR OVERALL DRUG OVERDOSE FATALITY RATE. ACCORDING TO THE CDC'S CENTER FOR VITALS STATISTICS, MORTALITY RATES DUE TO POISONING WERE 26 PER 100,000 POPULATION FOR MARION COUNTY AND 22 PER 100,000 FOR JEFFERSON COUNTY. TOBACCO USE IS THE LEADING CAUSE OF PREVENTABLE DISEASE, DISABILITY, AND DEATH IN THE UNITED STATES. CIGARETTE SMOKING CAUSES MORE THAN 480,000 DEATHS ANNUALLY, INCLUDING 41,000 DEATHS FROM SECONDHAND SMOKE. FOR EVERY AMERICAN WHO DIES BECAUSE OF SMOKING, AT LEAST 30 ARE LIVING WITH A SERIOUS SMOKING RELATED ILLNESS. ACCORDING TO CDC'S BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, OVER 15% OF RESIDENTS IN ILLINOIS WERE CURRENT SMOKERS IN 2019. ADDITIONALLY, IN 2019, 22.7% OF ILLINOIS HIGH SCHOOL YOUTH REPORTED CURRENTLY USING ANY TOBACCO PRODUCT, INCLUDING E CIGARETTES. AMONG ILLINOIS HIGH SCHOOL YOUTH, 4.7% REPORTED CURRENTLY SMOKING CIGARETTES. THE PERCENT OF ADULTS WHO REGULARLY SMOKE IN BOTH MARION AND JEFFERSON COUNTY IS APPROXIMATELY 20%, HIGHER THAN THE STATE AVERAGE. THE HOSPITAL HAS THE FOLLOWING STRATEGIES ADDRESSING SUBSTANCE ABUSE IN ITS COMMUNITY: - PROVIDE OPPORTUNITIES FOR PROPER DRUG DISPOSAL FOR OTC AND CONTROLLED SUBSTANCES - INSTALL COMPREHENSIVE MEDICATION COLLECTION KIOSKS, PENDING DEA APPROVAL, AT EACH HOSPITAL - CREATE AND DISTRIBUTE EDUCATION REGARDING AT HOME DRUG DISPOSAL BEST PRACTICES - DISTRIBUTE "AT-HOME" DISPOSAL KITS TO HIGH RISK POPULATIONS - PROVIDE EDUCATION ON OPIOID MISUSE AND PROVIDE NALOXONE TO COMMUNITY MEMBERS - APPLY FOR A STATE OF ILLINOIS NALOXONE STANDING ORDER FOR SSM HEALTH PHARMACY AND ENSURE LISTING ON STATE AND NATIONAL WEBSITES- IDENTIFY ELIGIBLE ORGANIZATIONS WILLING TO PARTICIPATE IN THE ILLINOIS DRUG OVERDOSE PREVENTION PROGRAM (DOPP)- PROMOTE NARCAN PICK-UP AVAILABILITY AT SPECIFIED COMMUNITY-BASED LOCATIONS- PROVIDE EDUCATION OPPORTUNITIES ON NARCAN ADMINISTRATION AND DISPERSE NARCAN FOR HOUSEHOLDS TO HAVE ON-HAND IN AN EMERGENCY - PROVIDE PREVENTION AND CESSATION EDUCATION ON TOBACCO AND VAPING USE- INITIATE THE IMPLEMENTATION OF CATCH MY BREATH PROGRAM IN LOCAL SCHOOLS- PROVIDE RESOURCES AND EDUCATIONAL OPPORTUNITIES FOR TOBACCO AND VAPING CESSATION IN THE COMMUNITY - PROVIDE INCENTIVE OPPORTUNITIES FOR LOCAL SCHOOLS TO PARTICIPATE IN SMOKING PREVENTION EDUCATION GOALS FOR THE SUBSTANCE ABUSE HEALTH PRIORITY ARE:- DECREASE INCIDENCE OF IMPROPER DRUG USE - DECREASE INCIDENCE OF PRESCRIPTION DRUG DEPENDENCE- REDUCE EMERGENCY HOSPITAL VISITS DUE TO DRUG-RELATED INCIDENTS - DECREASE RATE OF OPIOID OVERDOSE - REDUCE PREVALENCE OF TOBACCO RELATED HEALTH DISPARITIES MENTAL HEALTH MARION AND JEFFERSON COUNTIES ARE RANKED AMONG THE LOWEST QUARTILE OF ADULTS REPORTING POOR MENTAL HEALTH DAYS, WITH AN AVERAGE OF OVER 5 POOR MENTAL HEALTH DAYS PER MONTH. ACCORDING TO UNITED HEALTH FOUNDATION'S US HEALTH RANKINGS, OVER 14% OF ILLINOIS RESIDENTS HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER. THE RATE OF SUICIDE IN ILLINOIS IS 11.3 PER 100,000 POPULATION. ADDITIONALLY, THE RATE OF SUICIDE IN MARION COUNTY IS 26 PER 100,000 POPULATION, AND JEFFERSON COUNTY IS 15 PER 100,000 POPULATION. BOTH RATES OF SUICIDE ARE HIGHER THAN THE AVERAGE RATE OF SUICIDE IN THE STATE. THE HOSPITAL'S ACTION PLAN INCLUDES THE FOLLOWING INITIATIVES TO ADDRESS MENTAL HEALTH IN THE REGION SERVED: - PROVIDE EDUCATIONAL OPPORTUNITIES FOR COMMUNITY MEMBERS- OFFER QUESTION, PERSUADE, REFER (QPR) GATEKEEPER TRAINING - IMPLEMENT ADULT AND YOUTH MENTAL HEALTH FIRST AID TRAININGS - PROVIDE RESOURCES TO INCREASE KNOWLEDGE OF ACCESSIBLE MENTAL HEALTH SERVICES - INCREASE DISTRIBUTION OF COMMUNITY MENTAL HEALTH RESOURCE GUIDE - BEGIN DISTRIBUTING THE NATIONAL SUICIDE PREVENTION LIFELINE TO COMMUNITY MEMBERS AND PARTNERING ORGANIZATIONS- ENHANCE COLLABORATIVE EFFORTS WITH COMMUNITY PARTNERS - DEVELOP RELATIONSHIPS WITH NEW AND EXISTING COMMUNITY PARTNERS - SPONSOR COMMUNITY EVENTS AND INITIATIVES HOSTED BY PARTNERS - PROVIDE EDUCATIONAL OPPORTUNITIES ON TRAUMA INFORMED CARE - PROVIDE CME OPPORTUNITIES TO SSM HEALTH AND COMMUNITY CLINICIANS ON TRAUMA INFORMED CARE -PROVIDE GENERAL EDUCATION WORKSHOPS ON TRAUMA INFORMED COMMUNITY BUILDING AND RESILIENCE EXPECTED OUTCOMES OF THESE STRATEGIES INCLUDE THE FOLLOWING: - REDUCE NUMBER OF REPORTED MENTALLY UNHEALTHY DAYS- INCREASE PERCENTAGE OF INDIVIDUALS RECEIVING TREATMENT FOR CHRONIC MENTAL ILLNESS- REDUCE PREVALENCE OF UNTREATED DEPRESSION/ANXIETY- DECREASE SUICIDE RATE- DECREASE EMERGENCY DEPARTMENT VISITS FOR NONFATAL INTENTIONAL INJURYNUTRITION, WEIGHT AND EXERCISE OBESITY IS A SERIOUS CHRONIC DISEASE THAT CONTINUES TO INCREASE IN THE UNITED STATES AND CAN LEAD TO OTHER SERIOUS ILLNESSES LIKE TYPE II DIABETES, HEART DISEASE, AND CANCER. IN JEFFERSON AND MARION COUNTIES, OVER 30% OF ADULTS LIVING IN THE COMMUNITY ARE OBESE (BML=30+), WHICH IS SLIGHTLY LOWER THAN THE STATE AVERAGE PERCENTAGE OF ADULTS WITH OBESITY, AT 32%. COMMUNITY REPRESENTATIVES WHO PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT HAVE IDENTIFIED OBESITY AS A SIGNIFICANT NEED TO BE ADDRESSED IN THE AREA. ACCESS TO NUTRITIOUS FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY PLAYS A VITAL ROLE IN REDUCING THE PREVALENCE OF OBESITY AND CHRONIC DISEASE. WITHIN THE JEFFERSON AND MARION COUNTY AREAS, 14% OF THE POPULATION EXPERIENCE FOOD INSECURITY, OR A LACK OF RESOURCES TO FEED ALL MEMBERS OF THEIR HOUSEHOLD. ADDITIONALLY, THE RATE OF AVAILABLE FITNESS AND RECREATION FACILITIES PER 100,000 POPULATION IS APPROXIMATELY 15 IN BOTH JEFFERSON AND MARION COUNTY. THE RATE IN ILLINOIS FOR RECREATION AND FITNESS FACILITIES IS ONLY 12.5 PER 100,000 POPULATION. MANY TIMES, THESE FACILITIES HAVE A COST FOR MEMBERSHIP, WHICH CAN ALSO POSE A BARRIER TO MANY COMMUNITY MEMBERS. COSTS FOR FITNESS CENTER MEMBERSHIPS TYPICALLY RANGE FROM $10 TO $100 EACH MONTH. THE HOSPITAL HAS OUTLINED THE STRATEGIES BELOW TO IMPROVE COMMUNITY HEALTH RELATED TO NUTRITION, WEIGHT AND EXERCISE: - PROMOTE ACCESS TO NUTRITIOUS FOOD FOR THOSE EXPERIENCING FOOD INSECURITY - PROVIDE SUPPORT FOR MOBILE MARKETS AND TO LOCAL COMMUNITY FOOD PANTRIES- IDENTIFY LOCATIONS FOR LITTLE FOOD PANTRY BOX INSTALLATION - SUPPORT EXISTING AND ESTABLISH ADDITIONAL COMMUNITY GARDENS AND THE TRAINING OF MASTER GARDENERS - PROVIDE OPPORTUNITIES FOR EDUCATION AND ENGAGEMENT REGARDING NUTRITION, WEIGHT AND EXERCISE- FUND SCHOLARSHIPS FOR IDENTIFIED VULNERABLE POPULATIONS TO PARTICIPATE IN FELICIAN WELLNESS CENTERS' NEXT (NUTRITION, EXERCISE, AND PHYSICAL ACTIVITY) PROGRAM- PROVIDE EVIDENCE-BASED CHRONIC DISEASE/DIABETES SELF-MANAGEMENT COURCES- PROVIDE SUPPORT IN OFFERING ACCESSIBLE COMMUNITY FITNESS COURSES- BUILD PARTNERSHIPS WITH OUTSIDE ORGANIZATIONS TO BUILD COMMUNITY PROGRAMS- PARTNER WITH LOCAL SCHOOLS TO PROMOTE THE USDA'S TEAM NUTRITION PROGRAM- DEVELOP RELATIONSHIPS WITH NEW AND EXISTING COMMUNITY PARTNERS- SPONSOR COMMUNITY EVENTS AND INITIATIVES HOSTED BY PARTNERSLONG-TERM, THE HOSPITAL HOPES FOR THESE OUTCOMES:- REDUCE PERCENTAGE OF ADULTS WITH OBESITY- REDUCE PERCENTAGE OF INDIVIDUALS WITH TYPE II DIABETES- REDUCE PERCENTAGE OF INDIVIDUALS WITH CHRONIC DISEASE- DECREASE POPULATION WHO EXPERIENCE FOOD INSECURITY - REDUCE OBESITY-RELATED DISABILITY- IMPROVE QUALITY OF LIFE THE HOSPITAL HAS NO PLANS TO DISCONTINUE OTHER COMMUNITY BENEFIT EFFORTS TO ADDRESS OTHER NEEDS NOTED IN ITS 2021 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?8
Name and address		Type of Facility (describe)
1	1 - SSM HEALTH MEDICAL GROUP 1054 MARTIN LUTHER KING CENTRALIA,IL62801	OUTPATIENT CLINIC
2	2 - SSM HEALTH MEDICAL GROUP 432 N PLEASANT AVE CENTRALIA,IL62801	OUTPATIENT CLINIC
3	3 - SSM HEALTH MEDICAL GROUP 1050 MARTIN LUTHER KING SUITE 104 CENTRALIA,IL62801	OUTPATIENT CLINIC
4	4 - SSM HEALTH MEDICAL GROUP 402 N PLEASANT AVE CENTRALIA,IL62801	OUTPATIENT CLINIC
5	5 - SSM HEALTH MEDICAL GROUP 1250 W WHITTAKER ST STE B SALEM,IL628811902	OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT
6	6 - SSM MEDICAL GROUP 1445 W BROADWAY CENTRALIA,IL628815613	OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT PHYSICIAN OFFICES
7	7 - SSM HEALTH BEHAVIORAL HEALTH 444 N PLEASANT AVE CENTRALIA,IL628013006	OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT BEHAVIORAL HEALTH
8	8 - SSM HEALTH CANCER CARE 1052 MARTIN LUTHER KING DR STE 100 CENTRALIA,IL628013002	OTHER HEALTHCARE FACILITY: HOSPITAL OUTPATIENT CANCER CENTER
9
10

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 HEAL TH 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 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 ST. MARY'S HOSPITAL - CENTRALIA 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 ST. MARY'S HOSPITAL - CENTRALIA HAS ESTABLISHED A WRITTEN CREDIT AND COLLECTION POLICY AND PROCEDURES. THE BILLING AND COLLECTION POLICIES AND PRACTICES REFLECT THE MISSION AND VALUES OF SSM HEALTH, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE, THE HEALTH CENTER EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH IT PARTICIPATES BY ESTABLISHING SOUND BUSINESS PRACTICES. THE HEALTH CENTER'S BILLING AND COLLECTION PRACTICES WILL BE FAIRLY AND CONSISTENTLY APPLIED. ALL STAFF AND VENDORS ARE EXPECTED TO TREAT ALL PATIENTS CONSISTENTLY AND FAIRLY REGARDLESS OF THEIR ABILITY TO PAY. THEY RESPOND TO PATIENTS IN A PROMPT AND COURTEOUS MANNER REGARDING ANY QUESTIONS ABOUT THEIR BILLS AND PROVIDE NOTIFICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL UNINSURED PATIENTS WILL BE PROVIDED A STANDARD DISCOUNT FOR MEDICALLY NECESSARY INPATIENT AND OUTPATIENT SERVICES, INCLUDING SERVICES PROVIDED AT OFF-CAMPUS OUTPATIENT SITES. THE HOSPITAL DETERMINED THE AMOUNT OF THE DISCOUNT BASED ON THE LOCAL MANAGED CARE MARKET, APPLICABLE STATUTORY REQUIREMENTS AND OTHER RELEVANT LOCAL CIRCUMSTANCES. THE RATE MUST BE NO LESS THAN THE LOWEST EFFECTIVE DISCOUNT RATE AND NO GREATER THAN THE HIGHEST EFFECTIVE DISCOUNT RATE FOR THE CURRENT MANAGED CARE CONTRACTS OF THE HOSPITAL. UNINSURED PATIENTS MAY ALSO QUALIFY FOR AN ADDITIONAL DISCOUNT BASED UPON FINANCIAL NEED UNDER THE SYSTEM FINANCIAL ASSISTANCE POLICY. ALL ACCOUNTS DUE FROM THE PATIENT WILL RECEIVE A STATEMENT AFTER DISCHARGE OR AFTER FINAL ADJUDICATION FROM PATIENT'S INSURANCE. GENERALLY THE PATIENT WILL RECEIVE 4 MONTHS (120 DAYS) OF IN-HOUSE COLLECTION EFFORTS (INCLUDING EARLY OUT VENDORS) AND 12 MONTHS OF BAD DEBT COLLECTION EFFORTS. THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE FAP ELIGIBILITY INCLUDING: 1.THE FINANCIAL ASSISTANCE SUMMARY WILL BE INCLUDED WITH EACH BILLING STATEMENT 2.EXTRAORDINARY COLLECTION ACTIVITY (ECAS) MAY NOT OCCUR UNTIL BAD DEBT PLACEMENT AND ONLY AFTER 120 DAYS. 3.ECAS MUST BE SUSPENDED IF A GUARANTOR SUBMITS A FAP APPLICATION DURING THE APPLICATION PERIOD. 4. REASONABLE MEASURES MUST BE TAKEN TO REVERSE ECAS IF THE APPLICATION IS APPROVED WHICH MAY INCLUDE REFUNDING ANY PAYMENTS MADE IN EXCESS OF AMOUNTS OWED AS AN FAP-ELIGIBLE INDIVIDUAL. 5.BAD DEBT VENDORS WILL GAIN WRITTEN APPROVAL FROM SSM PRIOR TO ENGAGING IN ECAS. SSM WILL REVIEW THE ACCOUNTS AND VERIFY SATISFACTORY COMPLETION OF REASONABLE EFFORTS DURING THE NOTIFICATION AND APPLICATION PERIOD. A WAIVER IS NOT CONSIDERED REASONABLE EFFORTS. OBTAINING A SIGNED WAIVER THAT AN INDIVIDUAL DOES NOT WISH TO APPLY FOR FAP ASSISTANCE OR RECEIVE FAP APPLICATION INFORMATION WILL NOT MEET THE REQUIREMENT TO MAKE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN ECAS. ALL OUTSIDE COLLECTION AGENCIES MUST COMPLY WITH STATE AND FEDERAL LAWS, COMPLY WITH THE ASSOCIATION OF CREDIT AND COLLECTION PROFESSIONAL'S CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY AND COMPLY WITH SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA'S 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 SSMH'S COMMUNITY BENEFIT PROGRAM IS TO ASSESS AND ADDRESS COMMUNITY HEAL TH NEEDS. MAKING OUR COMMUNITIES HEALTHIER IN MEASURABLE WAYS IS ALWAYS OUR GOAL. TO FULFILL THIS COMMITMENT, SSMH'S COMMUNITY BENEFIT IS DIVIDED INTO TWO PARTS: 1) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND 2) COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA). THE CHNA IS AN ASSESSMENT AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS AND THE ADOPTION AND IMPLEMENTATION OF STRATEGIES TO ADDRESS THOSE NEEDS. A CHNA IS CONDUCTED EVERY THREE YEARS BY EACH HOSPITAL ACCORDING TO THE FOLLOWING STEPS: ASSESS AND PRIORITIZE COMMUNITY HEALTH NEEDS: GATHER CHNA DATA FROM SECONDARY SOURCES; OBTAIN INPUT FROM STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH INTERVIEWS AND FOCUS GROUPS; USE DATA TO SELECT TOP HEALTH PRIORITIES; AND COMPLETE WRITTEN CHNA. DEVELOP, ADOPT, AND IMPLEMENT STRATEGIES TO ADDRESS TOP-HEAL TH PRIORITIES: ESTABLISH STRATEGIES TO ADDRESS PRIORITIES; COMPLETE STRATEGIC IMPLEMENTATION PLAN; OBTAIN REGIONAUDIVISIONAL 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, OUTPATIENT AND INPATIENT REGISTRATION AND PUBLIC WAITING AREAS. BROCHURES OR FLIERS PROVIDED AT TIME OF REGISTRATION AND AVAILABLE IN THE FINANCIAL COUNSELING AREAS. NOTICES SENT WITH OR ON PATIENT BILLS OR COMMUNICATIONS SENT TO PATIENTS AND GUARANTORS RELATED TO MEDICAL SERVICES. APPLICATIONS PROVIDED TO UNINSURED PATIENTS AT THE TIME OF REGISTRATION. THE APPLICATION FOR CHARITY CARE, TOGETHER WITH ANY INSTRUCTIONS, MUST CLEARLY STATE THE POLICIES REGARDING CHARITY CARE, INCLUDING EXCLUDED SERVICES, ELIGIBILITY CRITERIA AND DOCUMENTATION REQUIREMENTS. INFORMATION ABOUT THE ENTITY'S CHARITY POLICIES IS ALSO PROVIDED TO PUBLIC AGENCIES.
PART VI, LINE 4:	SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, IN PARTNERSHIP WITH SSM HEAL TH GOOD SAMARITAN HOSPITAL - MOUNT VERNON, DEFINES ITS PRIMARY SERVICE AREA AS MARION AND JEFFERSON COUNTIES IN ILLINOIS. THERE ARE 23 ZIP CODES THAT ARE LOCATED WITHIN OR PARTIALLY WITHIN THE COMMUNITY. THIS AREA HAD AN ESTIMATED POPULATION OF 81,171 PEOPLE IN 2020 AND ACCOUNTS FOR 54% OF THE TOTAL PATIENTS SERVED BY THE HOSPITALS. THE SECONDARY SERVICE AREA IS ANOTHER 84,000 PEOPLE AND 17% OF INPATIENT-CARE PATIENTS SERVED. THE MEDIAN AGE IN THE COMMUNITY IS 41.0 YEARS OLD, WHICH IS OLDER THAN THE U.S. MEDIAN AGE OF 38.1 YEARS. THE POPULATION HAS ALSO DECREASED ABOUT 3.7% IN THE LAST 10 YEARS. IN THE AREA SERVED, THE POVERTY LEVEL IS 18.0%, SIGNIFICANTLY MORE THAN THE 13% RATES FOR BOTH ILLINOIS AND THE U.S. AS A WHOLE. MEDIAN FAMILY INCOME IS $60,361, COMPARED TO $83,279 FOR ILLINOIS AND $77,263 FOR THE NATION. LIFE EXPECTANCY ALSO FALLS BEHIND STATE AND U.S. RATES FOR THIS AREA. ADDITIONAL INFORMATION CONCERNING THE SERVICE AREA CAN BE FOUND STARTING ON PAGE 6 OF THE 2021 CHNA.
PART VI, LINE 5:	SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA PARTICIPATES IN A WIDE ARRAY OF COMMUNITY PROGRAMS THROUGHOUT THE AREA TO FURTHER ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY. THE COMMUNITY INITIATIVES BUILD ON THE STRENGTHS OF OUR COMMUNITIES AND SYSTEMS TO IMPROVE THE QUALITY OF LIFE AND TO CREATE A SENSE OF HOPE. COMMUNITY BENEFIT INITIATIVES BUILD COMMUNITY CAPACITY AND INDIVIDUAL EMPOWERMENT THROUGH COMMUNITY ORGANIZING, LEADERSHIP DEVELOPMENT, PARTNERSHIPS, AND COALITION BUILDING. OUR COMMUNITY HEALTH PROGRAMS PROVIDE COMPASSIONATE AND COMPETENT CARE WHILE THEY PROMOTE 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, ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS 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 ST. MARY'S HOSPITAL - CENTRALIA ADVOCATES FOR VULNERABLE POPULATIONS BY DEVELOPING RELATIONSHIPS WITH POLICY MAKERS AND THROUGH TARGETED EDUCATION EFFORTS. ALL PROJECTS INCLUDE MEASURABLE OBJECTIVES WITH A SPECIFIC TIME FRAME AND HAVE ACTIVITIES THAT WILL FAVORABLY AFFECT HEALTH STATUS INDICATORS. PROJECTS TO ACCOMPLISH HEALTH STATUS OBJECTIVES MAY INCLUDE: DISEASE PREVENTION PROGRAMS; HEALTH EDUCATION PROGRAMS; HEALTH CARE PROGRAMS FOR INDIVIDUALS WITH SPECIAL HEALTH CONCERNS; AND OTHER PROJECTS THAT IMPROVE COMMUNITY HEAL TH STATUS. PROJECTS TO ADDRESS THE HEAL TH PROBLEMS OF MINORITIES, THE POOR, AND OTHER MEDICALLY UNDERSERVED POPULATIONS MAY INCLUDE: IMPROVING ACCESSIBILITY AND CONTINUITY OF CARE; WORKING TO REDUCE DISPARITIES IN HEALTH STATUS; AND SPONSORING EFFORTS TO INCREASE THE NUMBER OF MINORITIES, THE POOR, AND UNDERSERVED WHO ENTER HEALTH PROFESSIONS AND WORK IN MEDICALLY UNDERSERVED COMMUNITIES. PROJECTS DESIGNED TO CONTAIN THE GROWTH OF COMMUNITY HEAL TH CARE COSTS MAY INCLUDE: IMPROVING EFFICIENCY OF SERVICES; IMPROVING CASE MANAGEMENT AND CONTINUITY OF CARE; SPONSORING HEALTH PROMOTION, DISEASE PREVENTION, AND SELFCARE ACTIVITIES; CONTAINING HEALTH CARE COSTS; AND REDUCING REDUNDANCIES. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS 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 HEAL TH CARE PROGRAMS ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.
PART VI, LINE 6:	ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS IS A 501(C)(3) ORGANIZATION AND IS A MEMBER OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH. ALONG WITH GOOD SAMARITAN REGIONAL HEALTH CENTER, IT IS PART OF A JOINT OPERATING AGREEMENT BETWEEN SSM HEALTH BASED IN ST LOUIS, MISSOURI, AND FELICIAN SISTERS, INC. OF CHICAGO. TOGETHER THE HOSPITALS ARE PURSUING A VISION TO CREATE A COMPREHENSIVE, REGIONAL HEALTH CARE ENTERPRISE COVERING A NINE COUNTY AREA IN SOUTH CENTRAL ILLINOIS. SSM HEALTH (SSMH) IS A CENTRALLY MANAGED, FULLY INTEGRATED HEAL TH CARE DELIVERY SYSTEM WITH ITS HEADQUARTERS BASED IN ST. LOUIS, MISSOURI. SSM HEAL TH 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	IL

Schedule H (Form 990) 2023

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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
ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number
37-0662580

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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) ST MARY'S HOSPITAL FOUNDATION 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131	36-4636691	501(C)(3)	127,595	0			GENERAL SUPPORT

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)
(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

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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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

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 PRESIDENT/CEO OF SSM HEALTH	(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, CHIEF FINANCIAL OFFICER A	(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
3DOUGLAS LONG SECRETARY, GENERAL COUNSEL AT SSM HE	(i) (ii)	0 ------------- 759,270	0 ------------- 495,539	0 ------------- 170,430	0 ------------- 753,634	0 ------------- 23,379	0 ------------- 2,202,252	0 ------------- 495,539
4JEREMY FOTHERINGHAM DIRECTOR, CHAIRPERSON, REGIONAL PRES	(i) (ii)	0 ------------- 789,865	0 ------------- 334,239	0 ------------- 1,710	0 ------------- 648,534	0 ------------- 39,052	0 ------------- 1,813,400	0 ------------- 334,239
5KAREN REWERTS SYSTEM VP, FINANCE (MO/ILL)	(i) (ii)	0 ------------- 589,021	0 ------------- 154,022	0 ------------- 58,288	0 ------------- 253,200	0 ------------- 34,314	0 ------------- 1,088,845	0 ------------- 207,408
6MICHAEL BAUMGARTNER DIRECTOR, REGIONAL PRESIDENT-SOUTHER	(i) (ii)	0 ------------- 236,516	0 ------------- 233,270	0 ------------- 93,791	0 ------------- 285,804	0 ------------- 10,151	0 ------------- 859,532	0 ------------- 233,270
7MATT KINSELLA PT YR REGIONAL VP FINANCE	(i) (ii)	0 ------------- 405,421	0 ------------- 105,716	0 ------------- 20,905	0 ------------- 160,100	0 ------------- 41,805	0 ------------- 733,947	0 ------------- 125,530
8DAMON HARBISON DIRECTOR, HOSPITAL PRESIDENT-SSM HEA	(i) (ii)	366,317 ------------- 0	85,494 ------------- 0	26,737 ------------- 0	178,768 ------------- 0	49,728 ------------- 0	707,044 ------------- 0	111,394 ------------- 0
9JULIE LONG VP - STRATEGIC PLANNING	(i) (ii)	0 ------------- 319,559	0 ------------- 76,123	0 ------------- 21,571	0 ------------- 147,362	0 ------------- 30,956	0 ------------- 595,571	0 ------------- 96,034
10GEORGE DANEKER INTERIM CHIEF MEDICAL OFFICER - SOUT	(i) (ii)	0 ------------- 373,699	0 ------------- 46,272	0 ------------- 23,802	0 ------------- 35,172	0 ------------- 23,265	0 ------------- 502,210	0 ------------- 46,272
11JOHN KOHLER SR CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 273,681	0 ------------- 60,259	0 ------------- 567	0 ------------- 36,472	0 ------------- 27,771	0 ------------- 398,750	0 ------------- 60,259
12JOHN SNODSMITH REGIONAL VP, FINANCE	(i) (ii)	0 ------------- 257,255	0 ------------- 34,175	0 ------------- 857	0 ------------- 69,162	0 ------------- 30,188	0 ------------- 391,637	0 ------------- 34,175
13MAAMOUN JUNIDI PHYSICIAN	(i) (ii)	330,013 ------------- 0	526 ------------- 0	6,922 ------------- 0	0 ------------- 0	4,942 ------------- 0	342,403 ------------- 0	0 ------------- 0
14TRACY FISCUS ADMINISTRATIVE DIRECTOR - NURSING	(i) (ii)	194,909 ------------- 0	15,030 ------------- 0	3,254 ------------- 0	31,870 ------------- 0	18,751 ------------- 0	263,814 ------------- 0	15,030 ------------- 0
15HOLLIE COLLE VP HOSPITAL OPERATIONS	(i) (ii)	170,413 ------------- 0	13,270 ------------- 0	356 ------------- 0	36,882 ------------- 0	25,251 ------------- 0	246,172 ------------- 0	13,270 ------------- 0
16MATTHEW SCOTT DIRECTOR - PHARMACY	(i) (ii)	158,006 ------------- 0	0 ------------- 0	14,463 ------------- 0	21,481 ------------- 0	50,650 ------------- 0	244,600 ------------- 0	0 ------------- 0
17MARLA SMITH DIRECTOR - NURSING	(i) (ii)	155,236 ------------- 0	12,146 ------------- 0	1,425 ------------- 0	25,850 ------------- 0	30,033 ------------- 0	224,690 ------------- 0	12,146 ------------- 0
18AMBER WENNERSTROM NURSE PRACTITIONER	(i) (ii)	117,129 ------------- 0	68,694 ------------- 0	330 ------------- 0	11,204 ------------- 0	26,228 ------------- 0	223,585 ------------- 0	0 ------------- 0
19TODD DAVIS PHARMACIST	(i) (ii)	166,319 ------------- 0	1,000 ------------- 0	859 ------------- 0	9,989 ------------- 0	32,741 ------------- 0	210,908 ------------- 0	0 ------------- 0
20MELISSA KARAFFA NURSE PRACTITIONER	(i) (ii)	124,654 ------------- 0	36,294 ------------- 0	387 ------------- 0	10,179 ------------- 0	34,898 ------------- 0	206,412 ------------- 0	0 ------------- 0
21CHRISTY DETERING NURSE PRACTITIONER	(i) (ii)	149,658 ------------- 0	20,181 ------------- 0	30 ------------- 0	1,183 ------------- 0	8,780 ------------- 0	179,832 ------------- 0	0 ------------- 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 (HOSPITAL 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: JEREMY FOTHERINGHAM $158,615 DAMON HARBISON $37,247 RANDALL COMBS $261,633 DOUGLAS LONG $161,286 JOHN SNODSMITH $11,873 JULIE LONG $31,049 JOHN KOHLER, SR $21,610 HOLLIE COLLIE $6,962 LAURA KAISER $720,859 MATT KINSELLA $39,596 KAREN REWERTS $56,755 GEORGE DANEKER $17,035 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. DAMON HARBISON $25,899 JULIE LONG $19,911 MATT KINSELLA $19,814 KAREN REWERTS $53,386

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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE CORPORATION SHALL HAVE TWO (2) MEMBERS: THE CORPORATE MEMBER, WHICH SHALL BE SSM REGIONAL HEALTH SERVICES, A MISSOURI NONPROFIT CORPORATION, AND THE MANAGING MEMBER, WHICH SHALL BE ST. MARY'S - GOOD SAMARITAN, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS, SSM REGIONAL HEALTH SERVICES, AND ST. MARY'S - GOOD SAMARITAN, INC., ARE PART OF THE INTEGRATED HEALTH CARE SYSTEM KNOWN AS SSM HEALTH.
FORM 990, PART VI, SECTION A, LINE 7A	THE CORPORATE MEMBER HAS THE POWER TO APPOINT ADDITIONAL, SUCCESSOR OR REPLACEMENT MEMBERS AND ELECT AND REMOVE DIRECTORS EXCEPT EX OFFICIO DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE CORPORATE MEMBER 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 C. TO ELECT AND REMOVE THE DIRECTORS D. TO APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER OF ANY OPERATING DIVISION OF THE CORPORATION E. TO APPROVE THE AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION AS PROVIDED THEREIN F. TO APPROVE AMENDMENTS TO THE BYLAWS OF THE CORPORATION G. TO APPROVE THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION H. TO APPROVE THE FORMATION OF A CONTROLLED SUBSIDIARY OR A REMOTELY CONTROLLED SUBSIDIARY I. TO APPROVE THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION J. TO APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF ANOTHER LEGAL ENTITY OR AN INTEREST IN ANOTHER LEGAL ENTITY K. TO AUTHORIZE OR APPROVE THE ACQUISITION OR DISPOSITION BY THE CORPORATION OF REAL PROPERTY OR ANY INTEREST IN REAL PROPERTY L. TO ESTABLISH CENTRALIZED EMPLOYEE BENEFIT, INSURANCE, INVESTMENT, FINANCING, CORPORATE RESPONSIBILITY, PERFORMANCE ASSESSMENT AND IMPROVEMENT AND OTHER OPERATIONAL AND SUPPORT PROGRAMS, TO REQUIRE THE PARTICIPATION OF THE CORPORATION IN SUCH PROGRAMS, AND TO AUTHORIZE THE OPENING AND CLOSING OF BANK ACCOUNTS AND INVESTMENT ACCOUNTS IN THE NAME OF THE CORPORATION IN CONNECTION WITH SUCH PROGRAMS M. TO APPROVE THE STRATEGIC, FINANCIAL AND HUMAN RESOURCES PLAN OF THE CORPORATION N. TO APPOINT THE AUDITOR AND CORPORATE COUNSEL FOR THE CORPORATION O. TO AUTHORIZE AND APPROVE BORROWING MONEY AND ENTERING INTO FINANCIAL GUARANTIES BY THE CORPORATION, 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 INTEREST IN THE PROPERTY OF THE CORPORATION P. TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OF THE CORPORATE MEMBER OR TO ANY ENTITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER OF THE CORPORATE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS, AND OBJECTIVE OF THE MEMBER OF THE CORPORATE MEMBER AS DETERMINED BY THE MEMBER OF THE CORPORATE MEMBER Q. TO APPROVE THE TRANSFER OF ASSETS BY THE CORPORATION TO ANY ENTITY OTHER THAN THE MEMBER OF THE CORPORATE MEMBER, OTHER THAN TRANSFERS MADE IN THE ORDINARY COURSE OF OPERATIONS OF THE CORPORATION WHICH WILL NOT REQUIRE CORPORATE MEMBER APPROVAL; AND R. TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE CORPORATE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF ANY CONTROLLED SUBSIDIARY, REMOTELY CONTROLLED SUBSIDIARY OR NON-CONTROLLED SUBSIDIARY AND EXERCISED WITH RESPECT TO ANY CONTROLLED SUBSIDIARY, ANY REMOTELY CONTROLLED SUBSIDIARY OR ANY NON-CONTROLLED SUBSIDIARY. THE MANAGING MEMBER HAS THE FOLLOWING POWERS: CERTAIN POWERS ARE RESERVED TO THE MANAGING MEMBER, INCLUDING THE AUTHORITY TO TAKE SUCH ACTIONS ON BEHALF OF THE CORPORATION AS ARE VESTED IN THE MANAGING MEMBER UNDER THE JOINT OPERATING AGREEMENT (JOA), SUBJECT TO THE LIMITATIONS OF APPLICABLE LAW. THE MANNER TO WHICH THE MANAGING MEMBER EXERCISES SUCH RESERVED POWERS SHALL BE DETERMINED PURSUANT TO THE PROVISIONS OF THE JOA AND THE BYLAWS OF THE MANAGING MEMBERS. IN ADDITION, THE MANAGING MEMBER SHALL PARTICIPATE IN THE ELECTION OF THE DIRECTORS TO THE EXTENT OUTLINED IN THE ORGANIZATION'S BYLAWS.
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 (SSM). THE FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. ANY QUESTIONS ARE ADDRESSED TO THE TAX DIRECTOR OF SSM 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 STATEMENTS FOR THE SSM HEALTH SYSTEM ARE MADE AVAILABLE TO THE PUBLIC ON SSM HEALTH'S WEBSITE. THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE ILLINOIS 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	OTHER FEES: PROGRAM SERVICE EXPENSES 13,548,644. MANAGEMENT AND GENERAL EXPENSES 647,799. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,196,443.
FORM 990, PART XI, LINE 9:	CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 7,756,753.

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

ST MARY'S HOSPITAL CENTRALIA ILLINOIS

Employer identification number

37-0662580

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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		No
(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		No
(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		No
(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		No
(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
(53)VISITING NURSE ASSOCIATION OF GREATER ST LOUIS 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 43-0567000	HEALTH CARE	MO	501(C)(3)	LINE 7	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	(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	N/A				No			No
(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) SHAWNEE REAL ESTATE HOLDINGS LLC 1000 N LEE AVE OKLAHOMA CITY,OK73102 45-5458304	MOB	OK	N/A				No			No
(6) 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
(7) WISCONSIN INTEGRATED INFORMATION TECHNOLOGY AND TELEMEDICINE SYSTEMS LLC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-2016715	INFORMATION TECHNOLOGY SERVICES	WI	N/A				No			No
(8) 1110 N CLASSEN BLVD LLC 1110 N CLASSEN BOULEVARD OKLAHOMA CITY,OK73106 73-1158158	MOB	OK	N/A				No		Yes
(9) WINDMILL LLP 50 VILLAGE VIEW LANE CHESTERFIELD,MO63017 43-1804651	INVESTMENTS	MO	N/A				No			No
(10) SSM SELECT REHAB ST LOUIS LLC 4714 GETTYSBURG ROAD MECHANICSBURG,PA17055 26-3694972	HEALTH CARE	DE	N/A				No			No
(11) 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
(12) NECICF II AIV2-B LP 300 DELAWARE AVE STE 210 WILMINGTON,DE19801 84-5058167	INVESTMENTS	DE	N/A				No			No
(13) 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	N/A	C					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) PHYSICIANS SERVICES CORP OF SOUTHERN ILLINOIS INC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 36-4161526	HEALTH CARE	IL	N/A	C					No
(9) DEAN HEALTH SYSTEMS INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-1128616	PHYSICIAN OFFICES	WI	N/A	C					No
(10) DEAN RETAIL SERVICES INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 39-1717636	PROPERTY SERVICES	WI	N/A	C					No
(11) SSM HEALTH JANESVILLE CAMPUS CONDOMINIUM ASSOCIATION INC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 83-2038674	CONDO ASSOCIATION	WI	N/A	C					No
(12) SSM HEALTH PHARMACY LLC 12800 CORPORATE HILL DRIVE ST LOUIS,MO63131 26-4031708	PHARMACY	MO	N/A	C					No
(13) NAVITUS HOLDINGS LLC 1808 WEST BELTLINE HIGHWAY MADISON,WI53713 80-0968174	PHARMACY	WI	N/A	C					No
(14) MS COMMUNITY JV LLC 401 CARLSON PARKWAY CP330 MINNETONKA,MN55305 87-3240022	INSURANCE	DE	N/A	C					No
(15) QUALITY DRUG CORPORATION 239 BROADWAY LAGUNA BEACH,CA92651 33-0644268	PHARMACY BENEFITS	CA	N/A	C					No
(16) ST MARY'S HOSPITAL CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC 707 SOUTH MILLS STREET MADISON,WI53715 000000000	CONDO ASSOCIATION	WI	N/A	C					No
(17) 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) ............................

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) .......................

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

Yes

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

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) ...................

Yes

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

Yes

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

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

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

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

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)	(d) Method of determining amount involved
(1) GOOD SAMARITAN REGIONAL HEALTH CENTER	A	BOOK
(2) SSM HEAL TH CARE OF WISCONSIN	L	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: TO CONTINUE THE HEALING MINISTRY OF JESUS CHRIST BY IMPROVING & PROVIDING REGIONAL, COST EFFECTIVE QUALITY HEALTH SERVICES FOR EVERYONE, WITH A SPECIAL CONCERN FOR THE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	703
6	Total number of volunteers (estimate if necessary) .............	6	49
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,407,452	6,468,846
9	Program service revenue (Part VIII, line 2g) .........	120,802,670	123,978,437
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	51,283	436,024
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	471,501	485,479
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	127,732,906	131,368,786
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	21,161	134,691
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)	44,319,842	46,320,637
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)....	61,948,252	55,474,830
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	106,289,255	101,930,158
19	Revenue less expenses. Subtract line 18 from line 12.......	21,443,651	29,438,628
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	132,060,450	135,782,680
21	Total liabilities (Part X, line 26).............	74,255,762	40,782,611
22	Net assets or fund balances. Subtract line 21 from line 20.....	57,804,688	95,000,069

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 84,742,949 including grants of $ 134,691 ) (Revenue $ 123,978,437 )
	SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 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, 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 ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS: SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, OPERATING IN PARTNERSHIP WITH THE FELICIAN SISTERS, IS A 125-BED HOSPITAL WITH A STRONG HISTORY OF OVER 100 YEARS OF COMMUNITY ENGAGEMENT. ST. MARY'S HOSPITAL DELIVERS HOSPITAL SERVICES IN INPATIENT, AMBULATORY SURGERY, OUTPATIENT, AND EMERGENCY ROOM SETTINGS. KEY SERVICE LINES INCLUDE BEHAVIORAL HEALTH, CANCER, MATERNITY, OCCUPATIONAL MEDICINE, WEIGHT MANAGEMENT SERVICES, WOUND CARE, AND MANY MORE. THE HOSPITAL'S SURGERY CENTERS ARE EQUIPPED WITH THE LATEST INNOVATIONS IN TECHNOLOGY ENSURING OUR PATIENTS HAVE ACCESS TO THE MOST ADVANCED TREATMENT WHILE STAYING CLOSE TO HOME. TO PROVIDE COMPLETE NEUROLOGICAL CARE, OUR SPECIALISTS ARE SUPPORTED BY BOARD CERTIFIED NEURORADIOLOGISTS, A FULL-SERVICE REHABILITATION UNIT, A HOME HEALTH DEPARTMENT, 24-HOUR MRI SERVICE, NEURODIAGNOSTIC EQUIPMENT, AND CARDIAC CATHETERIZATION LABORATORIES. SSM HEAL TH ST. MARY'S HOSPITAL - CENTRALIA ALSO OPERATES THE LITTLE EGYPT BREAST AND CERVICAL CANCER PROGRAM AND HAS BEEN A LEAD AGENCY FOR THIS ILLINOIS PUBLIC HEALTH PROGRAM SINCE 1998. THE PROGRAM OFTEN SERVES AS A LAST RESORT FOR BREAST AND CERVICAL CANCER SCREENINGS AND EDUCATION FOR WOMEN WHO ARE UNINSURED. FOR SEVEN CONSECUTIVE YEARS, HEAL THGRADES HAS PRESENTED ST. MARY'S HOSPITAL THE OUTSTANDING PATIENT EXPERIENCE AND CRITICAL CARE EXCELLENCE AWARDS. IN 2014, QUEST BY PREMIER INC. RECOGNIZED ST. MARY'S HOSPITAL-CENTRALIA WITH THE CITATION OF MERIT AWARD FOR HIGH-VALUE HEALTHCARE. IN 2016, SSM HEALTH ANNOUNCED A $20 MILLION RENOVATION PLAN FOR ST. MARY'S HOSPITAL CENTRALIA, WHICH WILL INCLUDE INTERIOR AND EXTERIOR UPGRADES, INCLUDING EXPANSION OF THE SURGERY DEPARTMENT AND IMPROVEMENTS TO THE EMERGENCY DEPARTMENT. ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: - OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY - HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA - HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY- ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS- PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS - ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM.QUANTIFIABLE UNCOMPENSATED CARE: THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE QUANTIFIED AS UNCOMPENSATED CARE: TRADITIONAL CHARITY CARE$ 605,655 UNPAID COST OF MEDICARE SERVICES$ 6,767,110 UNPAID COST OF OTHER GOVERNMENT PROGRAMS$ 1,157,502 TOTAL QUANTIFIABLE UNCOMPENSATED CARE$ 8,530,267 SCHEDULE H, PART VI, QUESTION 4: COMMUNITY INFORMATION: DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. UPDATED 7/18/2022 SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA, IN PARTNERSHIP WITH SSM HEALTH GOOD SAMARITAN HOSPITAL - MOUNT VERNON, DEFINES ITS PRIMARY SERVICE AREA AS MARION AND JEFFERSON COUNTIES IN ILLINOIS. THERE ARE 23 ZIP CODES THAT ARE LOCATED WITHIN OR PARTIALLY WITHIN THE COMMUNITY. THIS AREA HAD AN ESTIMATED POPULATION OF 81,171 PEOPLE IN 2020 AND ACCOUNTS FOR 54% OF THE TOTAL PATIENTS SERVED BY THE HOSPITALS. THE SECONDARY SERVICE AREA IS ANOTHER 84,000 PEOPLE AND 17% OF INPATIENT-CARE PATIENTS SERVED. THE MEDIAN AGE IN THE COMMUNITY IS 41.0 YEARS OLD, WHICH IS OLDER THAN THE U.S. MEDIAN AGE OF 38.1 YEARS. THE POPULATION HAS ALSO DECREASED ABOUT 3.7% IN THE LAST 10 YEARS. IN THE AREA SERVED, THE POVERTY LEVEL IS 18.0%, SIGNIFICANTLY MORE THAN THE 13% RATES FOR BOTH ILLINOIS AND THE U.S. AS A WHOLE. MEDIAN FAMILY INCOME IS $60,361, COMPARED TO $83,279 FOR ILLINOIS AND $77,263 FOR THE NATION. LIFE EXPECTANCY ALSO FALLS BEHIND STATE AND U.S. RATES FOR THIS AREA. ADDITIONAL INFORMATION CONCERNING THE SERVICE AREA CAN BE FOUND STARTING ON PAGE 6 OF THE 2021 CHNA.

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 expenses84,742,949

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	2,240,052	12,850,870	7,530,770

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,528,149
e	Government grants (contributions)		1e	2,940,697

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

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

h Total. Add lines 1a-1f.......		6,468,846

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	123,745,072	123,745,072
b	340B PHARMACY REVENUE	446110	61,256	61,256
c	CORPORATE FEES	561000	38,972	38,972
d	MANAGEMENT FEES	561000	36,000	36,000
e
f	All other program service revenue.		97,137	97,137
g	Total. Add lines 2a–2f .....		123,978,437

3 Investment income (including dividends, interest, and othersimilar amounts) ......			271,403			271,403
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	226,984
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	226,984
d	Net rental income or (loss).......			226,984			226,984
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		164,621
b	Less: cost or other basis and sales expenses	7b		0
c	Gain or (loss)	7c		164,621
d	Net gain or (loss).........			164,621			164,621
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
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA REVENUE		722210	258,394			258,394
b	BEAUTY SHOP REVENUE		812900	101			101
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			258,495
12	Total revenue. See instructions.....			131,368,786	123,978,437	0	921,503

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	134,691	134,691
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
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 ...........	2,672,931	2,509,024	163,907
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	31,497,412	29,565,957	1,931,455
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,771,285	1,662,668	108,617
9	Other employee benefits .......	7,903,070	7,418,445	484,625
10	Payroll taxes ...........	2,475,939	2,324,112	151,827
11	Fees for services (non-employees):
a	Management ......	1,332,168	817,138	515,030
b	Legal .........	126,616		126,616
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)	14,196,443	13,548,644	647,799
12	Advertising and promotion ....	26,729	7,876	18,853
13	Office expenses .......	1,581,697	1,494,614	87,083
14	Information technology ......	3,167,566	3,167,566
15	Royalties ..
16	Occupancy ...........	2,427,810	2,427,810
17	Travel ............	235,475	212,933	22,542
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	24,310	20,614	3,696
20	Interest ...........
21	Payments to affiliates .......	11,620,074	150,595	11,469,479
22	Depreciation, depletion, and amortization ..	4,131,192	3,866,688	264,504
23	Insurance ...	889,875	6,763	883,112
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	10,596,690	10,553,763	42,927
b	TAXES	4,766,172	4,766,172
c	LICENSES, DUES, SUBSCRI	228,712	71,845	156,867
d	BANK FEES	108,270		108,270
e	All other expenses	15,031	15,031
25	Total functional expenses. Add lines 1 through 24e	101,930,158	84,742,949	17,187,209	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 ........			122,942	1	129,870
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			17,025,888	4	24,491,034
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 ............			2,337,462	8	1,953,230
9	Prepaid expenses and deferred charges ......			664,628	9	395,075
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	91,092,828
b	Less: accumulated depreciation	10b	54,654,272	37,797,529	10c	36,438,556
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			894,437	13	1,153,383
14	Intangible assets ...............			630,679	14	512,199
15	Other assets. See Part IV, line 11 ...........			72,586,885	15	70,709,333
16	Total assets. Add lines 1 through 15 (must equal line 33)...			132,060,450	16	135,782,680

17	Accounts payable and accrued expenses .....	8,796,683	17	10,215,840
18	Grants payable ...		18
19	Deferred revenue .........		19
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 ..	53,034,000	23	21,872,788
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	279,490
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	12,425,079	25	8,414,493
26	Total liabilities. Add lines 17 through 25..	74,255,762	26	40,782,611

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	57,047,129	27	94,161,504
28	Net assets with donor restrictions ...........	757,559	28	838,565
	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 ...........	57,804,688	32	95,000,069
33	Total liabilities and net assets/fund balances ........	132,060,450	33	135,782,680