ssm health st. louis university hospital page 1 of 2 · ssm health provided the audited financial...

Episcopal Presbyterian Health Trust Responsive Grants

New Grant Request: August 21, 2019

SSM Health St. Louis University Hospital EPHT Board Report- August 21, 2019

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Organization SSM Health Foundation – St. Louis University Hospital Grant Request $50,000 Purpose of Grant Capital Campaign Use of Funds Furnishings and Technology for Discharge Lounge Persons Served 15,000 Grant Period 9/1/2019 – 8/31/2020

Report Summary SSM Health’s healing heritage began with five founding Sisters of Saint Mary in 1872 and now includes more than 60 outpatient care sites and 20 hospitals in four states. The mission, through our exceptional health care services, we reveal the healing presence of God, however, is essentially the same as that of the Sisters in 1872. SSM Health’s St. Louis University (SLU) Hospital is an academic center and teaching hospital for St. Louis University and a Level 1 Trauma Center located in the heart of St. Louis City. The hospital has 356 beds and in 2018 provided 16,900 inpatient admissions, 101,000 outpatient visits, and 45,000 emergency room visits. As a safety net provider for vulnerable and low-income populations, SLU Hospital exemplifies SSM Health’s statement that no patient is turned away for an inability to pay. The existing SLU Hospital was built in 1933 and is no longer capable of accommodating the technological and medical advancements needed for quality care, thus SSM Health is building a new hospital including an expanded Emergency Department (ED) and Trauma Center. Currently, SLU Hospital is on pace to serve over 45,000 patients this year in its ED with an estimated 3,000 per year leaving without being seen due to treatment delays and space shortages. For some of the ED’s patients, the emergency room may be the only care they receive and coming to the ED may take the place of a medical home. SSM Health is requesting funding to support furnishings and technology for the new ED Discharge Lounge available for all patients as they leave the SLU Hospital Emergency Department. The ED Discharge Lounge will provide patients with a space that is protected from the elements and extreme weather, televisions, phones, and turkey sandwiches. The Lounge will be staffed with a nurse who will assist with ensuring that discharge moves smoothly, as well as stay abreast of patients’ conditions while they wait in the Lounge. SLU Hospital’s experience indicates that the greatest benefit will come to those people in St. Louis who are discharged from the ED and have limited resources. One-third of the hospital’s ED patients are from St. Louis and over 40% of all visitors are low-income, underinsured, or uninsured. Outcomes Identified outcomes include:

• To improve patient outcomes, patient flow, and access to care for 50,000 patients annually • To positively illustrate the healing presence of God through a nurse-staffed Discharge Lounge where

patients may wait for transportation after discharge • To impact directly 15,000 vulnerable and low-income patients

Episcopal Presbyterian Health Trust Responsive Grants

New Grant Request: August 21, 2019

SSM Health St. Louis University Hospital EPHT Board Report- August 21, 2019

of 2

Financial Summary SSM Health provided the audited financial statements for the corporation as a whole and the capital budget for the St. Louis Hospital ED and Trauma Center. SSM Health is an $8 Billion corporation, though it is also fairly leveraged. In both 2017 and 2018, SSM Health had revenues that surpassed expenses. To date, SSM Health Foundation has secured $5.1 million towards the over all philanthropic goal of $11 million. An additional $1.1 million in gifts is pending.

Funding Rationale While the need for an up-to-date hospital, emergency department, and discharge lounge in the City of St. Louis is very real, furnishings and technology for the discharge lounge do not contribute to the actual provision of medical care and fall outside of EPHT’s stated funding priorities.

Staff Recommendations At $416,000 in grants -0- At $255,000 in grants -0- At $195,000 in grants -0-

Previous Funding N/A Total Program Budget: $ 511,000,000; $6,200,000 for the expanded emergency department Trust Requested Grant: $ 50,000 Trust allocation: < 1% Cost per person (EPHT): $ 3.33

Missouri CGA V.2.0: Page 2 of 14

Common Grant Application Cover Sheet Grantmaker to whom this application is submitted:

Application date: June 27, 2019

Organization’s legal name: (as shown on IRS Letter of Determination)

SSM Health Foundation – St. Louis

Doing business as: (if different from legal name)

EIN #: 43-1552945

Address: 12312 Olive Blvd. Ste. 100

City: St. Louis, State: MO ZIP code: 63141

Org. Telephone #: 314-523-8082 Org. Fax #: 314-523-8767

Org. Website: www.givetossmhealth.org Org. Email Address: [email protected]

Executive Director: (or top executive)

Mr. Paul Ross Foundation President (Please include prefix and title)

Phone #: 314-523-8003

Email address: [email protected]

Main contact(s) for this proposal:

Mrs. Sara Monks Geringer, JD Grant Officer (Please include prefix and title)

Phone #: 3014-523-8082

Email address: [email protected]

Board President: Mr. Steve Smith, CEO, Lawrence Group Phone #: 314-733-2286

Email address: steve.smith@ thelawrencegroup.com

Organization’s tax exempt status/IRS designation (e.g., 501(c)(3), 501(c)(9), etc.)

501(c)(3) (Attach a copy of the IRS Letter of Determination- NOTE- this is not the state sales and use tax exemption certificate. If there has been a name change provide copies of the amended state certificate of incorporation and amended IRS Letter of Determination.)

If not a 501(c)(3) nonprofit, then who is the fiscal agent?

NA (Attach a copy of the written agreement from fiscal agent plus fiscal agent’s contact information and EIN.)

Organization’s mission statement: Through our exceptional health care services, we reveal the healing presence of God.


Type of request (check one): Note: not all funders support each type of request. Check with individual grantmaker. [ ] Capacity Building Support [ ] Project/Program Support

[ ] New Project [ ] Existing Project [ ] Expansion of Existing Project

[X ] Capital Campaign [ ] Other (explain) [ ] General Operating Support Project/campaign name: (if general operating please indicate)

The Grand New SSM Health Saint Louis University Hospital

Proposal summary: In 100 words or less summarize the purpose of this request. SSM Health SLU Hospital has served the St. Louis community for 80 years as a multidisciplinary academic center and the teaching hospital. However, its outdated infrastructure and capabilities prevent us from reaching all who seek our care – especially in the area of emergency medicine. We invite the EPHT to partner in the Grand New SSM Health SLU Hospital’s expanded ED and Trauma Center – a community strategy to extend the healing presence of God and increase access to care for those in and around this urban, safety net hospital.

Funding period requested: (be specific)

9/1/19 through 8/31/20 Amount requested: $50,000

Total project budget for this period: (not required if generaloperating request)

$511,000,000 Organizational annual budget:

$2,332,315

Organization fiscal year: January 1 through December 31

Geographic area(s) served by county. Please provide % served from the City of St. Louis.

SSM Health SLU Hospital’s service area includes 2.4 million people across the St. Louis region and southern Illinois, including 75+ rural community hospitals in neighboring counties, which lack the equipment and expertise to treat the most severe emergencies/traumas. Of those served by SSM Health SLU Hospital, 33% are residents of the City of St. Louis. (For this project. If general operations support, for this organization).

Does your organization receive funding from a giving federation? Please list all that apply. (e.g., United Way, Arts and Education Council, Jewish Federation, etc.)

The SSM Health Foundation – St. Louis does not receive giving federation support.

Agreement I certify, to the best of my knowledge, that all information included in this proposal is correct. The tax exempt status of this organization is still in effect. If a grant is awarded to this organization, then the proceeds of that grant will not be distributed or used to benefit any organization or individual supporting or engaged in unlawful activities.

In compliance with the USA Patriot Act and other counterterrorism laws, I certify that all funds received from this funder will be used in compliance with all applicable anti-terrorist financing and asset control laws, statutes, and executive orders.

Paul Ross, President

06/28/19 Signature & Title of Authorized Representative (e.g. Executive Director) Date


NARRATIVE

SECTION A: ORGANIZATION INFORMATION 1. Brief summary of organization’s history.SSM Health’s healing heritage began November 16, 1872, when five founding sisters arrived in St. Louis from Germany. Led by Mother Mary Odilia Berger, the sisters had just $5 among them, but they carried something much greater – a ministry of healing, courage and unwavering faith that would become SSM Health. More than 35,000 talented employees and medical professionals are part of this incredible legacy and the continued pursuit of SSM Health’s Mission: Through our exceptional health care services, we reveal the healing presence of God. We serve communities in Missouri, Illinois, Oklahoma, and Wisconsin through more than 60 outpatient care sites and 20 hospitals. The St. Louis region is comprised of six adult hospitals – including SSM Health Saint Louis University Hospital, an academic medical center – and one pediatric hospital, which provide patients convenient access to a continuum of care for general health as well as specialty care. While we strive to provide the latest in high-technology medicine, we also share a deep, Catholic heritage that empowers us to be caregivers at every level. We treat each patient as a whole person – body, mind and spirit – and we provide exceptional care with compassion and respect. Furthermore, no patient is turned away for an inability to pay, consistent with the legacy of our founding sisters. Last year, we cared for over 1.1 million patients in the St. Louis region and provided over $200 million in charity care and community benefit. 2. Brief description of the organization’s current programs, activities, number served annually, and recent accomplishments.


SSM Health Saint Louis University (SLU) Hospital has served the St. Louis community for 80 years as a multidisciplinary academic center and the teaching hospital for SLU School of Medicine. Among its noted awards, the hospital is a nationally recognized American College of Surgeons Level 1 Trauma Center and is one of only two Level 1 Trauma Centers in a 300 mile radius of urban and rural communities. Additionally, SSM Health SLU Hospital is:

• The only in Missouri and Illinois, and one of only 13 in the U.S., to receive the American Heart Association’s “Get withthe Guidelines” Gold Plus performance award for treating patients with heart failure and stroke.

• A Joint Commission Top Performer on Key Quality Measures recipient.• Home to the only outpatient bone marrow transplant center in the region, allowing some patients the ability to return

home during treatment rather than face a lengthy, inpatient hospital stay.• A trusted leader in the training of trauma care for U.S. Air Force medical teams through the C-STARS (Center for

Sustainment of Trauma and Readiness Skills) program.• A partner in the provision of health and wellness services to our veteran population through service relationships with

local Veterans Administration hospitals.• Ranked number 79 on Newsweek's World's Best Hospitals 2019, with notable performance in 1) Anesthesiology,

Perioperative and Pain Medicine; 2) Cardiology, 3) Gastroenterology, and 4) Traumatology, Orthopedics and SpineSurgery.

Our 356-bed quaternary and tertiary teaching hospital offers medically advanced health and wellness services in more than 30 care concentrations. In 2018, many patients chose SSM Health SLU Hospital for their healthcare in times of need. We welcomed: 16,900 Admissions, 100,974 Outpatient Visits, and 44,922 Emergency Room Visits, served by 2,105 Employees, 570 Medical Staff, 700 Medical Students, 550 Residents, and 150 Volunteers. SSM Health SLU Hospital prides itself on the delivery of exceptional care to those who choose our academic medical center, as well as those with limited care options. We are a safety net provider for vulnerable and low income populations.

The existing SSM Health SLU Hospital was built in 1933 and due to facility limitations, is no longer capable of accommodating technological and medical advancements needed for patient care. Its replacement is crucial; we must expand and update our physical space to care for a growing patient population; drive innovation for value based care; increase medical education opportunities; and accommodate high utilization levels in emergency and trauma services, intensive care, and other services.

Complementary to the health advancements this facility will bring, the replacement and expansion of this hospital anchors a larger Midtown redevelopment initiative that will not only integrate the hospital with neighboring SLU School of Medicine and SSM Health Cardinal Glennon Children’s Hospital, but also will revitalize the City of St. Louis with an anticipated $7 billion in added investment, create thousands of jobs, bring increased residents and resources to the area, and drive additional innovation and commercial development. The SSM Health Foundation – St. Louis is raising up to $11 million in contributed support toward this important capital project that will open September 1, 2020.

While the Foundation is raising funds for the entire project, the focus of this proposal is the Expanded Emergency Department (ED) and Trauma Center; and, the Foundation is raising up to $6.2 million for this segment of the overall project.

SECTION B: DIVERSITY, EQUITY, & INCLUSION Your answers will provide a valuable perspective on our potential grantees’ capacity to address the issues of diversity, equity, and inclusion (DEI). See User Guide for more information and examples. 3. List any internal or external efforts your organization is currently undertaking to incorporate diversity, equity, and/or

inclusion (DEI) into its policies and practices. Are there DEI initiatives your organization hopes to undertake?


Understanding and decreasing health disparities is a significant component of SSM Health’s Mission and values as we serve a diverse population, including those who choose SSM Health for their care and those who have nowhere else to turn. Our patient population includes significant numbers of minorities as well as those who are low-income and uninsured. Yet, SSM Health strives to serve all patients with dignity and respect. We have several initiatives across our ministries that seek to address diversity in healthcare and ensure the delivery of culturally competent services. For instance, diversity and inclusion are focal points with benchmarks in the 2023 Strategic Plan. Additionally, we offer an internal diversity and inclusion website, with various resources to facilitate understanding and tolerance. The website also offers educational sessions and outlines cultural competency standards. These valuable resources guide our staff to better understand where our patients may be coming from – as well as our colleagues – and the factors that may inform their health decisions and practices.

Further advancing a diverse and respectful work environment for our staff, visitors, and patients, SSM Health has prioritized personal development opportunities for staff and prospective employees. We teach skills that many take for granted and which are necessary to secure and maintain a job – including the creation of a resume, simple math skills, etc. Through these development efforts, we strive to recruit, train, and maintain individuals from all communities and backgrounds, and which can help us to better understand those we serve. Furthermore, these programs help SSM Health to examine its own practices and refine opportunities for maximum inclusion, while also maintaining our company standards for quality and Mission. 4. How are the demographics of the community/clients your organization serves reflected in the composition of your staff,

board, and/or volunteers? Are there ways that your organization strives to incorporate the perspective of thecommunity/clients your organization serves?(Examples of demographics that may apply to your work include age, ability, national origin, religion, sexual orientation,socio-economic level, veteran status, or personal experience with issue (e.g., previous client of your organization)).

Our Patients. SSM Health is dedicated to providing compassionate care to all patients who enter our doors regardless of race, religion, age, sexual orientation, veteran status, disability, national origin, or gender. This welcoming environment includes patients who are unable to pay for care, who may be homeless, and who may be struggling with mental health conditions. We strive for every person who walks through our doors to feel respected and comfortable while in our care.

Our Workforce, Board, and Volunteers. SSM Health embraces diversity in its workforce, board, and volunteers. These teams are comprised of diverse group of individuals who bring their unique experiences and histories to our organization, making it more informed and tolerant in the way we treat one another and in patient care. Consistent with out our founding sisters’ legacy of caring for all, SSM Health also seeks to recruit employees, board, and volunteers who reflect diverse backgrounds. In our facilities, you will find physicians, nursing staff, health professionals, administrative and support staff from many races, many cultures, and many backgrounds, all of whom have a single focus – providing you with exceptional care.

Our Suppliers. SSM Health is committed to equal opportunity for its employees and business vendors. Our Minority Business Enterprise (MBE) program encourages and supports purchasing goods and services from businesses owned by minorities, women, disabled individuals, disabled veterans, and small business enterprises. Additionally, each SSM Health entity commits to a 10% discretionary spending goal as part of our MBE program. Supplier diversity is consistent with our values of compassion, respect, excellence, stewardship, and community.

Our Communities. At SSM Health, we support and form alliances with organizations whose missions call for rigorous pursuit of fairness and equality for all people. Some of the organizations we support include: A WORLD OF DIFFERENCE Institute, Anti-Defamation League (ADL), Guardian Angel Settlement Association, INROADS, National Association for the Advancement of Colored People (NAACP), National Association of Women Business Owners (NAWBO), National Black MBA Association, National Conference for Community and Justice, St. Louis Diversity Initiative, St. Louis Internship Program, St. Louis Minority Business Council, The St. Louis American, and United Way.

SECTION C: DESCRIPTION OF COMMUNITY/CLIENT NEEDS & STRENGTHS 5. What are the community/client needs or problems that will be addressed by this project? Why is this issue important?


SSM Health SLU Hospital operates the busiest Emergency Department (ED) in the City of St. Louis. In 2019, we are on pace to serve 45,000+ patients; yet, we know there are more who continue to go without needed emergency care. Many of our communities have healthcare provider/facility shortages, decreased utilization of preventative and primary care, and increasing trauma needs at 10-20% annually. SSM Health SLU Hospital serves not only those in the metropolitan area, but also in 75 neighboring communities (many rural), which lack the resources to treat critical patients. As the need for our emergency/trauma services increases, so do space and patient flow challenges. The Grand New SSM Health SLU Hospital – our replacement hospital and ambulatory care center campaign – is just one of SSM Health’s responses to these needs.

The medical care provided in our hospital’s ED may be the only care some patients receive and frequently takes the place of prevention and routine wellness visits that many of us take for granted. However, due to its age and outdated capabilities, the current hospital facility prevents our providers from seeing all who seek our care. An estimated 250+ individuals leave the ED each month (3,000+ per year) before being seen, due to treatment delays and space shortages in the ED and hospital. These challenges create additional health risks for an already-unhealthy population and negatively impact the health and wellness of our neighbors. Our healing heritage moves us to devise solutions to the challenges we face and to seek creative ways to reach those who need us most. We know that community stakeholders, such as the Episcopal Presbyterian Health Trust (EPHT), have a demonstrated commitment to partnership in this area and lifting up vulnerable populations such as those we serve at SSM Health SLU Hospital. With your support in this initiative, we can improve access to emergency and trauma care for all – and especially for those with limited resources.

While SSM Health SLU Hospital’s ED and Trauma Center is a project with many capital expenses, we propose directing EPHT’s support to the patient Discharge Lounge, which will be available for all patients, but is anticipated to benefit most those in the City of St. Louis who are discharged from the ED and who have limited resources. The Discharge Lounge will provide patients with a space that is protected from the elements and extreme weather, televisions, phones, and turkey sandwiches. Furthermore, the lounge will be staffed by a nurse to stay abreast of the patients leaving our facility and their conditions, while also keeping the admission and discharge flow moving smoothly from the ED and hospital treatment beds, continually creating space for new patients to receive care. The Discharge Lounge is a prime example of SSM Health’s commitment to our founding sisters’ legacy to care for all who enter our doors; and given what we know about the EPHT’s commitment to the most vulnerable City residents, we feel that it may be a match with your interests as well. While the EPHT’s gift could be directed to any component in this lounge, it would make a significant impact by supporting the Discharge Lounge furniture, televisions, and telephones offered for discharge patient use; and, to the extent that this lounge will foster improved patient flow in/out of the ED and Trauma Center, your gift will impact all who seek care in our facility! To show our gratitude for EPHT’s support, SSM Health would appreciate the opportunity to display a recognition plaque in the Discharge Lounge, or some other agreeable naming, if permitted to do so.


6. Identify 3-5 strengths of the community/clients that your organization serves AND explain how those strengths mightcontribute to the success of this project.

Strengths that set our community apart and stand to positively impact the ED and Trauma Center portion of the Grand New SSM Health SLU Hospital are: 1) a robust network of community support services that are willing to work with ED/Trauma providers to create a comprehensive network of resources for vulnerable populations. Hospitals face significant resource and regulatory barriers in addressing all social and needs of patients. Thus, we rely on partners to collaborate and create a comprehensive community response to patient needs. Partnerships with community services will remain critical to our ability to treat the patient’s entire body, mind, and spirit, in addition to other social factors that influence health, wellness, and ED/trauma service utilization. 2) The community in which we serve is comprised of many generous individuals and businesses that donate their time and resources to SSM Health so that we may extend the healing presence of God to all. Support comes in a variety of ways, including service on governing/advisory boards, leading task forces to raise capital and generate awareness, and even grateful patients serving as peer supports for their neighbors struggling with like conditions. The generosity of our community is an asset and we anticipate will be a component critical to the success of a new hospital, providing physical resources as well as increased opportunities to pursue our Mission and serve our community. 3) The patients at SSM Heath SLU Hospital’s ED and Trauma Center often have no way to pay for care, yet they come to us with trust that regardless of their background or income, we will provide them the same compassionate care as we do to other patients. Our community partners also exhibit significant trust in the SSM Health team and have confidence that their investments will be used to lift up those who need care most and to advance health and wellness in our home community. Without this level of trust in our hospitals and staff from patients and supporters alike, SSM Health would be unable to make great strides in public health and access to care for those who rely on our services. While the three strengths listed herein will not guarantee success of the Grand New SSM Health SLU Hospital, they are assets to the project and will foster the partnership – inside and outside – of the hospital, which is necessary for long term success. SECTION D: PROJECT INFORMATION 7. Describe who will be served by this grant? Please include what percentage of those served live in poverty and how youdefine poverty.SSM Health SLU Hospital’s ED and Trauma Center delivers exceptional care to those who choose our academic medical center, as well as vulnerable populations with limited care options. In 2018, we treated almost 45,000 emergencies. Of those served, 54% are female and 46% are male; furthermore, 49% are Caucasian, 41% are African American, 3% are Hispanic, 1% is Asian, and 6% are comprised of other ethnicities. Of the total emergency patients, 33% are City residents and over 40% are low income/underinsured/uninsured; however, no one is turned away for an inability to pay. 8. How many will be served with funding from this grant?While the Discharge Lounge will be available to all patients, those who will benefit most are vulnerable patients with limited resources – be it food, shelter, transportation, etc. Historically, City residents make up a significant portion of this population as they are able to walk or take the bus to our hospital. If EPHT were to direct a gift of $50,000 to the furnishings and technology in the Discharge Lounge, we estimate it would impact 15,000+ discharged emergency patients annually, while improving patient flow and patient care for all. 9. What are your project goals? (Operating or capital requests: what are your agency’s major goals?)Our healing heritage moves us to devise solutions to public health challenges and reach those who need us most. A replacement hospital – the Grand New SSM Health SLU Hospital – with a significantly expanded ED and Trauma Center, improved patient flow, ED observation beds, and a Discharge Lounge are just a few of SSM Health’s responses to these needs. The d expanded care spaces will improve patient care and increase access for those who chose our hospital and those with nowhere else to turn. It will allow us to serve those who currently leave before being seen, while increasing resources for all who seek out SSM Health SLU Hospital’s emergency medicine innovation, expertise, and Mission-driven, compassionate care. 10. What activities do you intend to engage in or provide to achieve the aforementioned goals? Please provide an in-depth

description of the activities/services, including: 1) how much, 2) how often, 3) how long activities/services will be provided. Forexpanded project requests, distinguish between current and expanded activities/services.

The primary activities that will provide for the project goals include: 1) the construction of the SSM Health SLU Hospital ED and Trauma Center from August 31, 2017 to September 1, 2020; 2) the facility’s opening/operation on September 1, 2020; 3) ongoing staff simulations and training between January 1, 2019 and September 1, 2020 to prepare for patient care in the new space on opening day; 4) patient and family advisory committee input on the new facility and its operation; and 5) public relations and communications activities between August 31, 2017 to September 1, 2020 (any beyond) such as billboards, television spots, radio, social media, etc. to increase awareness of the project and its role in the SSM Health Mission. 11. What are the anticipated short-term and long-term measurable outcomes that would be achieved by this grant?


Identified outcomes include: 1) To improve patient outcomes, patient flow, and access to care for 50,000+ patients annually, including those who leave our ED each year without being seen due to wait times. Patients will experience additional treatment space for emergency and trauma care, including a Clinical Decision Unit with 10 observation beds for patients who are not ready for admission. 2) To positively illustrate the healing presence of God and compassionate care, we will provide patients with a nurse staffed Discharge Lounge, where they may wait for transportation after discharge, with access to free food and drink. This space will provide temporary food and shelter, while also opening up emergency and treatment beds. While the lounge will be available to all, we anticipate impacting directly, 15,000+ vulnerable and low income patients with this resource. 12. What is the timeline for implementing this grant?Construction for the SSM Health SLU Hospital’s ED and Trauma Center began August 31, 2017. It will see its first patient on September 1, 2020. During construction, SSM Health distributes a comprehensive monthly report to internal stakeholders that outlines 1) completed activities/processes, 2) upcoming activities/processes, 3) safety plans (work hours, injuries, safety orientation, etc.) 4) inclusion data (subcontractor, minority, and women workforce hours), 5) cost status (project commitment figures, comparison to control estimates), 6) drone photographs and access to live footage of the site, and 7) master timeline review. The most recent timeline is as follows: Schematic Design & Design Dev. Phase – Complete Hospital Site Work, Commenced – 2/2017 Construction Document Phase, Commenced – 7/2017 Commencement of Mass Excavation Construction Phase – 8/2017 Drilled Piers – Complete Foundation Wall Construction – Complete Hospital Steel Erection – Complete Hospital Concrete Decks/Flatwork, Commenced – 4/2018 ACC Steel Erection – Complete Hospital Tower & ACC Steel Topping Out – Complete Garage Construction, Commenced – 4/2018 Surgery, D&T Platform Dried In – 3/2019 Garage Available for Parking – 10/2019 ACC Dried In – 6/2019 Hospital Tower Dried In – 4/2019 ACC Construction, Substantial Completion – 2/2020 Hospital Construction, Substantial Completion – 5/2020 First Patient Day – 9/1/2020 West Pavilion Renovations – Post 9/1/2020 13. What are the organization’s most significant interactions with other organizations and initiatives? For project requests,

address this question with respect to that project only. (e.g., who are the other partners, what is your past experiencecollaborating with each organization, what is their role in this project, and what is their expertise, etc.?)

During the construction phase of this project, the SSM Health team works closely with contractors hired to develop and build the expanded facility, as well as those providing goods and services in the process. These relationships include Alberici Construction – the lead contracting company on this effort – and subcontractors including Guarantee Electrical, Interface Construction, and Lawrence Group. These companies are leaders in hospital development and St. Louis specific projects. Additionally, SSM Health SLU Hospital works alongside major supplies such as Siemens for specialized medical equipment that will enable cutting edge research, teaching, and patient care.

Post construction, once the new ED and Trauma Center is treating patients, we work with health partners such as those who provide contract services for our patients, as well as those supporting program development/expansion, medical education, and those in the community who share in the service to common patients. Partners in these efforts include companies such as SLU School of Medicine, Komen Missouri, Schumacher Clinical Partners, the Archdiocese of St. Louis, Gilead Sciences, and area first responders. Each of our partners brings expertise that enhances the hospital and the emergency services it provides. 14. What other agencies or projects are doing similar work in the region and how are you different?At this time, we are unaware of any other new hospitals, academic medical centers, EDs, or trauma centers that are under construction in the region, demonstrating just how significant this effort is for the community and those we serve. But, if we were to compare our emergency health and wellness services with those of other hospitals and academic medical centers in the City of St. Louis – i.e. Barnes Jewish – the distinguishing feature of SSM Health is our compassionate care and that no patient is turned away for an inability to pay. These characteristics are only enhanced by SSM Health’s roots in faith and our skilled experts in over 30 care concentrations.


15. Who are the key staff members, board members, and/or volunteers who will ensure the success of theproject/organization and what are their qualifications?

A project of this magnitude relies on the skills and collaboration of many key individuals – including but not limited to leadership, strategy, design, marketing, contractors, doctors, nurses, and development. Of these team members, the project is led by Ms. Kelly Baumer, Vice President of Specialty Projects at SLU Hospital. Kelly has been part of SSM Health SLU Hospital since 1997, starting her career as a physical therapist before becoming Chief Strategy Officer in 2008. Prior to that, Kelly served as a senior administrator, administrator of ancillary services, director of the TenetCare outpatient facility and an inpatient supervisor. In her current role as Vice President, she oversees the sales and outreach teams, client services, and the construction/development of the replacement hospital at SSM Health’s academic medical center, SLU Hospital. Among her achievements, she led development of the MidAmerica Stroke Network, a hub and spoke system designed to provide advanced stroke care in the southern Missouri and southern Illinois regions. Kelly is a graduate of Maryville University with a bachelor’s degree in physical therapy. Additional project staff include the SSM Health Foundation President, Paul Ross, and the Capital Campaign Chairs – Dr. Jerry Dwyer, a cardiologist, and Derrick Martin, regional president of iHeart Radio. Paul has over 20 years’ experience in fundraising and the campaign chairs are members of the Foundation’s Board of Directors, bringing energy for the project and a passion for improved health and wellness in our region. 16. What staff, board, or volunteer training and professional development needs are required to implement this project, if

any? Please be specific (e.g. trainings on cultural competency, effective use of social media, or fundraising techniques).In addition to our customary training and professional development, that which is required for the SSM Health SLU Hospital’s ED and Trauma Center include project management for large scale capital developments with many moving parts and safety protocols for our teams to be visiting an active construction site on a daily basis. Furthermore, we are focusing on skills training with leadership and board members in the areas of business development and fundraising techniques to maximize project sustainability opportunities post construction.

17. How does this request fit within your organization’s long-term goals? (We define long-term as the time-period beyondthis grant). How does this project support your organization’s implementation of its strategic plan?

Long term goals: The Grand New SSM Health SLU Hospital’s ED and Trauma Center is an illustration of SSM Health’s investment in the health and wellness of our region, as well as developing a network of community partners collaborating to advance public health and the social determinants of health. It is our hope that this request not only aligns with SSM Health’s long term goals, but also with the EPHT’s long term goals and creates a meaningful opportunity for you to become part of the solution to St. Louis’s health challenges. Support from the EPHT will improve access to health care for patients who are uninsured or underinsured, train the next generation of health professionals to care for those in need, and fund programs to address the most pressing health needs.

Strategic plan: The development of the ED and Trauma Center in the City of St. Louis is a key component of SSM Health’s 2023 Strategic Plan to stay relevant and fulfill our Mission by finding new and better ways to deliver care and to keep people healthy. The 2023 Plan outlines our system’s commitment to serving as a leader in the delivery of compassionate, safe, affordable and accessible care designed around the needs of the individual. Furthermore, it creates a framework for us to nurture the well-being of our communities and partner with others to seek out innovative solutions to improve health at every stage of life. SSM Health’s 2023 Plan has four main focus areas: 1) Growth and partnerships to expand access and services in our communities so that we are able to achieve better patient outcomes and lower the total cost of care. 2) Exceptional performance through practices such as streamlining leadership accountability and developing consistent policies/practices/care definitions that align with national best practices. 3) Connectivity and culture that links our employees to SSM Health’s Mission, Vision and Values, while also engaging and empowering our team members through improved professional development opportunities and meaningful succession planning, celebrating innovation, and sharing our learnings. 4) Transforming health care delivery to better meet people where they are by investing in innovative new technology, systems and services – including expansion of virtual care and behavioral health, while addressing the social determinants of health and advocating for health coverage for all. While it may seem optimistic that an expanded ED and Trauma Center can help accomplish these things, we know it can, and it must. This project provides the physical space for increased access to care for vulnerable populations and those seeking innovative treatments and research opportunities. It will open the door for new collaboration with community resources, government at all levels, educational institutions, and even our colleagues at other health care institutions. We understand that changing the landscape of public health is a job we cannot do alone, but it is one that we can lead with purpose and a plan. We are ready and hope the EPHT will join us in this important movement. 18. What is your long-term funding plan once funding from this funder ends? (For project requests, address this questionwith respect to that project only).


Long term sustainability for SSM Health SLU Hospital requires us to provide residents and patients with a unique experience, as well as access to elevated levels of care and innovation that far exceed those available in more traditional settings. Furthermore, we must offer providers, educators, and medical students with transformative opportunities that lead the industry in innovation, value, and patient outcomes. SSM Health’s Mission, vision, and values will guide us as we strive to meet these challenge and ensure our efforts remain focused on advancing public health and wellness in a manner consistent with our rich Catholic heritage and the compassion of our founding sisters.

To demonstrate its commitment to the community and to healthcare, SSM Health is contributing $500 million to the new SSM Health SLU Hospital redevelopment project – $9.3 million of which is specific to the ED and Trauma Center. At the conclusion of the campaign and redevelopment, we will continue to invest in the infrastructure and technology needs to maximize patient care, educational opportunities, and community impact.

Financial sustainability is projected through a standard hospital insurer payer mix including Medicaid, Medicare, indemnity insurance, and managed care insurance payments received. Additionally, sustainability will be enhanced through SSM Health Foundation – St. Louis efforts to secure continued philanthropic support from community partners, grantors, and benefactors – including the establishment of an endowment fund to maximize community investment and leverage philanthropic dollars for years to come. 19. Describe the extent to which your project/organization is based on evidence-based, best, or promising practices. SSM Health is a healthcare delivery system spanning multiple states. Our ability to provide healthcare and interventions based on evidence-based, best, or promising practices is critical to our ability to maintain provider accreditations, credentials for specialty care, and billing/collection for service rendered. Furthermore, SSM Health SLU Hospital, as an academic medical center, is licensed to conduct medical research. This research is regulated highly by internal and external bodies to ensure patient safety and confidentiality, but also allows exploration for innovative and efficient treatments and therapies.

SECTION E: EVALUATION 20. What tools and processes does your organization use to measure whether or not your program is achieving its goals and

outcomes? Describe the measurement tools (e.g., intake sheets, participation checklists, pre/post surveys, clientquestionnaires follow-up surveys, co-design evaluation tools/co-collect data with your clients/community members, etc.).

As referenced above in Section D12, the construction phase of the project includes distribution of a comprehensive monthly report to internal stakeholders that outlines 1) completed activities/processes, 2) upcoming activities/processes, 3) safety plans (work hours, injuries, safety orientation, etc.) 4) inclusion data (subcontractor, minority, and women workforce hours), 5) cost status (project commitment figures, comparison to control estimates), 6) drone photographs and access to live footage of the site, and 7) master timeline review.

Post construction, SSM Health will employ more traditional measures to assess the impact of its hospital and services provided. In addition to patient demographics, diagnoses, and outcomes, we will focus on assessment of patient flow, wait times, readmissions, patients who leave before being seen, and SSM Health’s system wide continuous quality improvement (CQI) processes surrounding patient care quality/satisfaction, staff satisfaction, and lean but effective policies and procedures. The measures will be in addition to external assessments conducted by our accrediting bodies and the credentials received for specialty services. 21. How will the evaluation results be used to inform/strengthen future programming and organizational operations?SSM Health is committed to CQI; an essential component of this process is processing evaluation results and using them to better programming/operations. To maximize the impact of evaluation results at SSM Health SLU Hospital and in the ED and Trauma Center, our regional CQI team will assist in applying the following model: 1) Apply tools, change actions; 2) Borrow/develop techniques, change habits; 3) Develop new beliefs, change values; and 4) Forever improve, culture change, understand and embed principles. This feedback loop will be continuous and multi-sector for maximum impact.


SECTION F: BUDGET NARRATIVE JUSTIFICATION 22. After completing the CGA budget template (NOTE: check both tabs of the spreadsheet), please provide a description of

each expense and revenue line item listed on the program/project budget. Indicate whether this is a new expense foryour project or if funding is being requested to cover a current/existing expense. For example, if you list personnelexpenses, please state whether these funds will be used for new or existing staff positions. Explain how the numbers arebeing calculated.

The capital budget for the SSM Health SLU Hospital ED and Trauma Center is attached, showing high level income and expenses, which are one-time costs resulting from construction. Our emergency services are the main entry point into our hospital with 45,000+ patients annually and with over 60% of those being admitted. The volume and limited space create patient care and flow challenges. The Discharge Lounge will improve these components significantly as patients are discharged, offered a space to wait and/or make arrangements upon release, and creating room for new patients.

A gift from EPHT can be incorporated into any section of this project; However, in Section C5, SSM Health proposes a $50,000 gift be used for the provision of furnishings and technology for the Discharge Lounge. We invite the EPHT to visit with SSM Health if alternate uses of funds are requested. We would be happy to offer additional gift/naming opportunities.

QUESTIONS FOR CAPITAL CAMPAIGN REQUESTS

SECTION G: CAPITAL CAMPAIGN REQUESTS (this additional information is required) 23. Discuss the feasibility and cost of the capital campaign and its implications in relation to the organization’s ongoing

operations expenses.The Rome Group conducted a feasibility study for the Grand New SSM Health SLU Hospital and its ED and Trauma Center. It showed that in order to be successful, we must invest in community awareness of SSM Health, SSM Health SLU Hospital, and the relationship between SSM Health and SLU. Many of those polled found this information confusing, especially after SSM Health’s recent acquisition of this hospital from Tenet Healthcare. As a result, leadership determined that significant community awareness is needed to share this valuable resource with our communities. Furthermore, the feasibility study found the initial, overarching, philanthropic goal of $25 million to be unrealistic and a more feasible amount of $11 million was identified. Since this campaign is for a replacement hospital, it is anticipated that the expenses will be short term and will result in increased operations expenses as the community becomes aware of the agency, the hospital, its innovation, and patient-centered design. 24. Specify support received to date and the number of prospects approached and/or identified.As of today’s date, we have secured $5.1 million toward our overall goal from 26 benefactors, ranging from $2,000 to $2.5 million. Furthermore, $1.1 million in gifts are pending from 11 benefactors, ranging from $7,000 to $500,000. 25. Identify potential naming opportunities.SSM Health proposes a naming opportunity for EPHT that includes a plaque naming the Discharge Lounge in your honor. Recall that this innovative lounge, is a critical component of improved patient flow in the new facility as we provide patients a place to arrange transportation, be protected from weather/elements, have access to a nurse, and/or eat food (provided at no charge) after discharge. The Discharge Lounge will be available to all patients but especially valuable to those with limited resources and a limited support system. Should you wish to explore additional or alternative naming opportunities, we would be happy to discuss in more detail and create an opportunity that meets your needs. 26. Indicate the board’s financial participation in the campaign (percent participating and amount contributed).All Board of Trustee members are encouraged to contribute at least $10,000 annually to a regional priority, which includes the Grand New SSM Health SLU Hospital Campaign, but also includes a mammography machine at SSM Health St. Clare Hospital, a SSM Health St. Louis regional women’s health effort, and a SSM Health St. Louis regional behavioral health priority. For this campaign specifically, 19% of the Board has participated, pledging $1,177,000. 27. Describe plans for funding the ongoing maintenance of the new capital project.Post construction, SSM Health will continue to invest in the infrastructure and technology needs of the new facility to maximize patient care, educational opportunities, and community impact. Resources for the ongoing maintenance will come from revenues generated from patient care as well as from operation reserves. An SSM Health endowment also is planned to support additional capital needs. 28. Detail financing (e.g., loans, tax credits, etc.) that might be undertaken in addition to raising funds from the public.


As noted in Section D18, SSM Health is contributing $500 million to the new SSM Health SLU Hospital redevelopment project – $9.3 million of which is specific to the ED and Trauma Center. Furthermore, the SSM Health Foundation – St. Louis is working alongside community leaders such as the EPHT and the St. Louis Community Foundation – who share a commitment to public health and wellness and access to care for vulnerable populations – to raise $11 million for this overall initiative and $6.2 million for the ED and Trauma Center. Employees also have an opportunity to support this effort and such investment is encouraged for leadership. 29. Indicate whether the campaign is open or in its quiet phase and when the campaign began. Also indicate if timing is a

factor or if a “window of opportunity” exists that could impact the success of the campaign.Construction for the SSM Health SLU Hospital’s ED and Trauma Center began August 31, 2017. It will accept its first patient September 1, 2020. The campaign’s general fundraising periods are as follows: Phase 1, Year 1: Leadership giving, Phase 2, Year 2: High and mid-level solicitations, and Phase 3, Year 3: Final opportunities including employee and public/annual giving. Currently, we are in Year 2. While a gift in Year 2 would create significant momentum for other foundations supporting capital, we understand that EPHT’s own giving calendar is the best determinate of when a gift would be most appropriate.

REQUIRED ATTACHMENTS

1. Copy of the current IRS Letter of Determination indicating tax-exempt status. Attached.

2. List of current board of directors. Include the following information for each board member:• Professional affiliations (name of organization of employment and title)• ZIP code of residence (e.g. 63105, 63135) Attached.

3. If applicable: Letter of support from each collaborating organization that explains their role and is signed by the topexecutive(s) of that organization. Not applicable

4. If applicable: Memorandum of Understanding or contract between the organization and the fiscal agent/fiscalsponsor. Not applicable

5. Financials Attached.NOTE: financial statements are to be prepared according to generally accepted accounting procedures (GAAP)

• Project budget (must use Excel CGA Project Budget template included as part of this application)• Internally prepared income statement for current fiscal year. (You may use Excel CGA Organizational Budget

template included in this application or your own personal template).AND

i. Complete copy of organization’s audited/reviewed/compiled financial statements for the last fiscal year(which should include two (2) years of financial information).OR

ii. Organization’s most recently filed Form 990, plus internally prepared financial statements for the pasttwo (2) years. Must include:

* Statement of activities (income statement)* Statement of financial position (balance sheet)* Statement of cash flow

6. Additional Attachments: Individual grantmakers may choose to request additional attachments. Please check with theindividual grantmaker. Attached.

Please read the following statements and check both the boxes certifying that this application is complete according to the requirements set forth by the grantmaker.


XXX I have reviewed the website or spoken with the grantmaker to whom I am submitting this application and have reviewed their mission, funding interests, process, and requirements to determine if my request is a funding fit.

XXX I have included in this application any additional materials and attachments required by this funder.

Episcopal Presbyterian Health Trust

Salary and Benefits -$ -$ Contract Services (consulting, professional, fundraising) -$ -$ Occupancy (rent, utilities, maintenance) -$ -$ Training & Professional Development -$ -$ Insurance -$ -$ Travel -$ -$ Equipment -$ -$ Supplies -$ -$ Printing, Copying & Postage -$ -$ Evaluation -$ -$ Marketing -$ -$ Conferences, meetings, etc. -$ -$ Administration -$ -$ Other - Emergency Management Services Arrival Space 378,727.20$ -$ Other - Public Entrance Space 1,071,550.98$ Other - Registration Space 123,498.00$ Other - Intake Area 1,045,616.40$ Other - Trauma Rooms 485,758.80$ Other - Treatment/ Resuscitation 271,695.60$ Other - Main Emergency Department 2,484,368.10$ Other - Behavioral Care Space 633,956.40$ Other - Diagnostics/Treatment 518,691.60$ Other - Support Function Space 172,897.20$ Other - Staff Support Space 1,189,697.40$ Other - Ground Helipads (2) 200,000.00$ Other - Emergency Parking Lot (15,000 sf X $6.66) 100,000.00$ Other - Land Allocation 259,479.29$ Other - Design Fees 1,106,938.00$ Other - Furniture, Fixtures, Equipment 4,073,206.27$ 50,000.00$ Other - IT (Voice Data Low Voltage Systems) 460,681.55$ Other - Consulting Costs 367,242.96$ Other - Contingency 692,812.96$

TOTAL EXPENSES 15,636,819$ 50,000$

Contributions, Gifts, Grants, & Earned RevenueLocal Government -$ -$ State Government -$ -$

Federal Government -$ -$ Individuals 112,000$ -$

*Foundation - Enterprise Holdings Foundation 500,000$ -$ *Foundation - Mabee Foundation 300,000$ -$ *Foundation - Raskob Foundation -$ 75,000$

*Foundation - Episcopal Presbyterian Health Trust -$ 50,000$ *Foundation - Jordan Charitable Foundation -$ 27,000$

*Corporation - Alberici 2,625,000.00$ -$ *Corporation - Murphy Company 300,000.00$ -$

*Corporation - Gilead Sciences (Emergency Lab focused) 281,714.00$ -$ *Corporation - Ameren 250,000.00$ -$

*Corporation - Lawrence Group 250,000.00$ -$ *Corporation - Mid-America Transplant 100,000.00$ -$

*Corporation - Schumacher Clinical Partners 100,000.00$ -$ *Corporation - Guarantee Electrical 100,000.00$ -$

*Corporation - EPIC 50,000.00$ -$ *Corporation - Northstar Management 63,000.00$ -$

*Corporation - Color Art 25,000.00$ -$ *Corporation - Greensfelder, Hemker & Gale 25,000.00$ -$

*Corporation - HGA 25,000.00$ -$ *Corporation - Northern Trust 20,000.00$ -$

*Corporation - Silvercrest Asset Management 10,000.00$ -$ *Corporation - Sterling Capital Management 3,500.00$ -$

*Corporation - KPFF 2,500.00$ -$ *Corporation- Edward Jones -$ 750,000$ *Corporation- Mallinckrodt -$ 250,000$

*Corporation-______________ -$ -$ *Federation-_______________ -$ -$

*Other - SSM Health Corporation 9,342,105.00$ -$ -$ -$ -$ -$ -$

Membership Income -$ -$ Program Service Fees -$ -$

Products -$ -$ Fundraising Events (net) -$ -$

Investment Income -$ -$ In-Kind Support -$ -$

TOTAL REVENUES 14,484,819$ 1,152,000$ *Please specify for contributions over $1,000.

Amount Requested from FunderTotal Project Expenses

Missouri CGA - Project Budget (Required)

Committed PendingRevenues

Expenses

SSM Health Foundation St. Louis / SSM Health SLU Hospital ED/L1 Trauma

1

Member Title Company & Address Residence Zip

David Baker Vice President Warrenton Oil Company2299 S. Spoede LaneWarrenton, MO 63383

63383

Michael Bowers Chief Operating Officer

SSM Health 1173 Corporate LakeSt. Louis, MO 63132

63124

Travis Capers President SSM Health St. Mary's Hospital 6420 Clayton Road

St. Louis, MO 63117

63108

Darren Clay President Clay Piping Systems, Inc.1360 N. Price RoadSt Louis, MO 63132

63132

Dr. Jerome Dwyer Cardiologist 3009 N. Ballas Road, Suite 202BSt. Louis, MO 63131

63131

Tina Garrison President SSM Health St. Clare Hospital 1015 Bowles AvenueFenton, MO 63026

63026

Constance Gully President & CEO

Parents as Teachers2228 Ball Drive

St. Louis, MO 63146

63146

Kevin Gunn Principal Paladin Energy Strategies LLC17 Larkdale Drive

St. Louis, MO 63124

63124

James Hall Regional Vice Chairman

Enterprise Bank & Trust1052 S. Kirkwood Road

Kirkwood, MO 63122

63129

Ellis Hawkins President SSM Health DePaul Hospital 12303 DePaul DriveSt. Louis, MO 63044

63005

Gregory HesserChair-Elect

President Alberici Constructors 8800 Page Avenue

St. Louis, MO 63114

63017

Gregory Keller CEO Renaissance Financial 5700 Oakland Ave., Suite 400

St. Louis, MO 63110

63122

Robert KoesterTreasurer

CFO Murphy Company1233 N. Price RoadSt. Louis, MO 63132

62226

SSM HEALTH FOUNDATION - ST. LOUIS BOARD OF TRUSTEES ROSTER

2



AmparoKollman-Moore Secretary

Principal AKM, LLC - International Business Consulting311 Berry Bush CourtWildwood, MO 63011

63011

Steven Lierman Partner StoneBridge Senior Living 2500 S. Old Highway 94, Suite 104

St. Charles, MO 63303

63304

Derrick Martin Region President iHeart Media St. Louis1001 Highlands Plaza Drive West, Suite 200

St. Louis, MO 63110

63110

John Meara President Argent Capital Management100 S. Brentwood Blvd., Suite 110

Clayton, MO 63105

63304

Michael Prost Managing Partner Mueller Prost7733 Forsyth Blvd., Suite 1200

Clayton, MO 63105

63005

Dr. Henry Randall Executive Director, Abdominal

Transplant Center

SSM Health Saint Louis University Hospital 3635 Vista Avenue, 11th Floor

St. Louis, MO 63110

63017

Paul Ross President SSM Health Foundation - St. Louis12312 Olive Blvd., Suite 100

St. Louis, MO 63141

63301

Dr. William Schroer Orthopedic Surgeon

SSM Health DePaul Hospital 12349 DePaul Drive, Suite 100

Bridgeton, MO 63044

63303

Steven Scott President SSM Health Saint Louis University Hospital3635 Vista Avenue

St. Louis, MO 63110

63108

Stephen SmithBoard Chair

CEO Lawrence Group319 N. 4th Street, Suite 1000

St. Louis, MO 63102

63124

Anthony Soukenik Attorney & Shareholder

Sandberg, Phoenix & von Gontard600 Washington Ave., Suite 1500

St. Louis, MO 63101

63031

Kirk Syberg Owner Syberg Family of Restaurants2430 Old Dorsett RoadSt. Louis, MO 63043

63043

3



Lisle Wescott President SSM Health St. Joseph Hospitals100 Medical Plaza, Suite 1202

Lake St Louis, MO 63367

63368


SSM HEALTH FOUNDATION - ST. LOUIS REQUIRED ATTACHMENTS

Please find the following, after this page:

Financials

1) Internally prepared income statement for current fiscal year. (You may use Excel CGA Organizational Budget template included in this application or your own personal template); and complete copy of organization’s audited/reviewed/compiled financial statements for the last fiscal year (which should include two (2) years of financial information).

\\ds.ad.ssmhc.com\ssmdfs\MCO\UserHome\smnksg\My Documents\Grants\Grants Pending\Episcopal Presbyterian\2019 Income Statement SSM Health SLUH.xlsx 6/28/2019 4:38 PM

SSM HEALTH ST LOUIS TOTAL HOSPITALIncome StatementAccountability View

EPSI2019

Patient Revenue Inpatient Services 4,180,688 Outpatient Services 3,941,791 Gross Patient Revenue 8,122,479

Deductions from Patient Revenue Contractual Discounts 5,488,074 Bad Debt 168,828 Provision for Charity 198,240 Total Deductions from Revenue 5,855,142

Net Patient Revenue 2,267,337

Other Operating Revenue 173,202 Beneficial Interest in Foundation 3,769

Total Other Operating Revenue 176,971

Total Operating Revenue 2,444,308

Operating Expenses Salaries and Wages 691,197 Employee Benefits 198,263 Contract Labor 12,000 Professional fees 234,832 Supplies 473,604 Purchased Services 414,500 Depreciation and Amortization 88,013 Interest 12,563 Bad Debt 456 Insurance 16,088 Other 190,799

Total Operating Expenses 2,332,315

Excess of Revenue over Expenses 111,993 from Operations

Foundation 3,769Exclude Foundation 108,223

Note:Accountability view starting 2016.