2023-05-11T20:05:09-05:00 2022-06-30 ERNST & YOUNG US LLP 2323 VICTORY AVENUE SUITE 2000 DALLAS TX 75219 990 2021-07-01 814322087 Saint Francis Hospital Muskogee Inc % DEBORAH DAGE SAIN 9184948418 6600 S Yale Avenue Suite 400 Tulsa OK 741363319 Deborah Dage Treasurer/CFO 9184948418 2023-05-11 true Deborah Dage 999009999 Stephanie Lew P01080011 2149698000 2 2021 2023-04-26 12:10:37Z Deborah Dage 6161 S Yale Ave Tulsa OK 741363319 193918024 false X HTTPS://WWW.SAINTFRANCIS.COM/MUSKOGEE X 2016 OK To extend the presence and healing ministry of Christ in all we do. 8 7 1200 0 0 0 7070098 750000 167075479 191548723 -127908 123585 782781 937182 174800450 193359490 104670 30826 0 0 69423522 83920584 0 0 0 83087638 91586790 152615830 175538200 22184620 17821290 129303401 140731129 18992740 22736599 110310661 117994530 X TO EXTEND THE PRESENCE AND HEALING MINISTRY OF CHRIST IN ALL WE DO. false false 161562701 30826 191548723 See Schedule O 161562701 true false false false false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true X 126 0 true 1200 true false false false false false false false false false false false false X 8 7 true true false false true true true true true false false true true true true true true true true false OK X DEBORAH DAGE 9184948418 6161 S YALE AVENUE TULSA OK 741363319 X Jake Henry Jr Former Pres./CEO/Director 1.0 39.0 X 0 3759482 46316 Barry L Steichen Vice President/COO/Director 1.0 39.0 X 0 1464798 188354 Eric E Schick Treasurer/CFO (Termed 9/2021) 1.0 39.0 X 0 1247675 54265 Cliff A Robertson MD President/Director(Beg 7/2021) 1.0 39.0 X X 0 1124072 0 Seyed Hassany MD Physician 1.0 39.0 X 5550 716114 58193 Ziad Hawa MD Physician 39.0 1.0 X 694267 25653 57437 Michael J Lissau Secretary 1.0 39.0 X 0 650648 111398 David Polizzi MD Physician 1.0 39.0 X 372013 345009 43173 Olankunie Ajanaku MD Physician 39.0 1.0 X 699191 7200 35540 Selamawit Negusse MD Physician 1.0 39.0 X 50004 581805 56693 Deborah D Dage Treasurer (Beg 1/2022) 1.0 39.0 X 0 661163 0 Michele Keeling President 40.0 0.0 X 409638 0 87900 Thomas G Neff Former Secretary 0.0 40.0 X 0 441007 44419 William R Lissau Director (Non-Voting) 1.0 0.0 X 0 0 0 JUDY KISHNER Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Charles W McEntee MD Director (Beg 1/2022) 1.0 0.0 X 0 0 0 JOHN-KELLY C WARREN Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Mike Cooke JD Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Tom Cooper Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Mike Case Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Father Gary Kastl Director (Beg 1/2022) 1.0 0.0 X 0 0 0 Ashley Gable MD Director (Termed 5/2022) 1.0 0.0 X 0 0 0 Jonathan Baldwin MD Physician 39.0 1.0 X 0 0 0 2230663 11024626 783688 82 true true false Crossland Construction Co Inc Po Box 45 833 S East Ave COLUMBUS KS 66725 Construction Svcs 6876416 Medefis Inc PO BOX 5068 NEW YORK NY 100875068 Contract Staff Svcs 5694372 Emergency Medicine Physicians 4535 Dressler Rd NW CANTON OH 447186803 Healthcare Svcs 2510750 Intuitive Surgical Inc 1020 Kifer Rd SUNNYVALE CA 94086 Healthcare Svcs 1986567 Northstar Anesthesia 6225 N State Hwy 161 Ste 200 IRVING TX 75038 Healthcare Svcs 1877367 34 750000 750000 PATIENT SVCS, NET OF CONTRACTUAL ADJ. 621110 191548723 191548723 191548723 12580 12580 0 0 405179 335858 69321 0 69321 69321 333681 222676 111005 111005 111005 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722210 762310 762310 PHARMACY 446110 92144 92144 ALL OTHER REVENUE 900099 13407 13407 867861 193359490 191548723 0 1060767 30826 30826 0 0 0 512331 512331 0 71089325 69398461 1690864 0 3176414 2985976 190438 4816790 4455629 361161 4325724 3993276 332448 0 184373 35 184338 38750 38750 0 0 0 10607423 10612294 -4871 62738 58025 4713 2654381 2545799 108582 1607427 1607129 298 0 2163959 293526 1870433 179586 176490 3096 0 72337 56375 15962 0 0 8130403 8235182 -104779 1600508 72289 1528219 MEDICAL SUPPLIES 39898137 39844019 54118 BAD DEBT EXPENSE 9742539 9742539 0 MAINTENANCE 5816203 5703370 112833 MEDICAID SHOPP FEE 3140692 0 3140692 5687334 1751461 3935873 175538200 161562701 13975499 0 80937 82133 0 0 0 0 14612960 18628186 0 0 0 0 0 0 4345119 5146784 860978 1917606 150775816 36415598 108836185 114360218 0 0 0 0 0 0 0 0 567222 596202 129303401 140731129 16102268 20411861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2890472 2324738 18992740 22736599 X 110310661 117994530 0 0 110310661 117994530 129303401 140731129 X 17821290 -10137421 X true X true X true false X 9280000 9280000 84605047 13699777 70905270 4380806 1243399 3137407 43938726 21453399 22485327 8571237 19023 8552214 114360218 0 PROFESSIONAL LIABILITY RESERVE 2324738 2324738 X Schedule D, Part X, Line 2 Accounting Standards Codification Topic (ASC) 740, Income Taxes, provides guidance regarding recognition, de-recognition, measurement, and disclosure of all tax positions. In accordance with the requirements of ASC 740, Saint Francis Hospital Muskogee, Inc. identifies and documents uncertain tax positions for all open tax years. If uncertain tax positions are identified, they are analyzed to determine the proper unit of account. Next they are tested to determine whether a tax asset or a tax liability should be recognized. Saint Francis Hospital Muskogee, Inc. has determined that the position on uncertain tax positions is more likely than not to be fully sustained upon examination. Therefore, no liability or asset for uncertain tax positions needs to be recorded. The Tax Cuts and Jobs Act (the Act) was enacted on December 22, 2017. The provisions of the Act do not have a material effect on Saint Francis Hospital Muskogee, Inc.'s consolidated financial statements. Certain regulatory guidance provides for a measurement period of up to one year during which accounting for the tax effects of the Act may be completed. Saint Francis Hospital Muskogee, Inc. will continue to evaluate the impact of the Act and may record adjustments as additional information and guidance are released by the Internal Revenue Service. true true X true X 225. false true true true false true true 1682779 0 1682779 0.01010 41567594 40336359 1231235 0.00740 43250373 40336359 2914014 0.01750 27320123 21491704 5828419 0.03510 27320123 21491704 5828419 0.03510 70570496 61828063 8742433 0.05260 283302 0 283302 0.00170 47500 0 47500 0.00030 330802 0 330802 0.00200 true 9742539 6819777 80061203 60962683 19098520 X true true 1 1 Saint Francis Hospital Muskogee Inc 300 Rockefeller Drive Muskogee OK 74401 HTTPS://WWW.SAINTFRANCIS.COM/MUSKOGEE 2177 X X X Saint Francis Hospital Muskogee Inc 1 false false true X X X X X X X X X 22 true true false true X See Schedule H, Part V, Section C X true 19 true See Schedule H, Part V, Section C false true X 225. 0. X X X X X true true true X See Schedule H, Part V, Section C X See Schedule H, Part V, Section C X See Sch H, Part V, Section C X X X X X X X true X false X X X X X true X false false Part V, Section B, Line 5 The most recent Community Health Needs Assessment (CHNA) completed by Saint Francis Health System, Inc. to assess the health needs of the communities served by the hospital components of its health system: Saint Francis Hospital, Inc., Laureate Psychiatric Clinic and Hospital, Inc., Saint Francis Hospital Muskogee, Inc., Saint Francis Hospital South, LLC, and Saint Francis Hospital Vinita, Inc., included the collection and analysis of both quantitative (over 140 public health indicators and quantitative survey methods) and qualitative (organization and community representative interviews and qualitative survey methods) data to identify and create a comprehensive list of health needs for each community. Community input was obtained from a broad range of community members through key informant interviews, focus groups and a multi-modal consumer survey of over 600 community residents. Individuals with knowledge, information and expertise relevant to the health needs in the community were consulted including representatives from county and state public health departments as well as leaders, representatives and members of vulnerable populations and other individuals with strong expertise in local health needs. The names of the organizations providing input is provided in Appendix A: CHNA Data Sources and Dates and Appendix B: List of Organizations Represented in Key Informant Interviews and Community Feedback of the CHNA located https://www.saintfrancis.com/about-us/commitment-to-community. Part V, Section B, Line 6a The hospital facilities included in the CHNA included Saint Francis Hospital, Inc., Saint Francis Hospital South, LLC, Laureate Psychiatric Clinic and Hospital, Inc., Saint Francis Hospital Vinita, Inc. and Saint Francis Hospital Muskogee, Inc. Part V, Section B, Line 7a https://www.saintfrancis.com/about-us/commitment-to-community Part V, Section B, Line 10a https://www.saintfrancis.com/about-us/commitment-to-community Part V, Section B, Line 11 The Community Health Needs Assessment (CHNA) identified 14 conditions as community health needs (in order of highest priority) of the primary service area as heart disease/stroke; mental health; access to health care services; diabetes; nutrition/physical activity/weight; cancer; substance abuse; respiratory disease; infant health/family planning; tobacco use; injury/violence; potentially disabling conditions; oral health; and sexual health. After prioritizing the health needs identified, a final list of priority needs was selected by considering additional criteria, such as Saint Francis Health System, Inc.'s scope of services as a health provider and its ability to effectively address the priority health need. Saint Francis Health System Inc.'s entities, including Saint Francis Hospital Muskogee, Inc., are addressing the following significant health needs identified as referenced in its Community Health Needs Assessment and Implementation Strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. - Mental health - Access to health care services - Diabetes Part V, Section B, Line 13b Patients who have been evaluated and identified to be financial assistance plan-eligible and meet the criteria established by Saint Francis Hospital Muskogee, Inc. according to relevant circumstances regarding income, assets, or other resources available to the patient or patient's family, are considered charity and therefore, by hospital policy, are not billed for any services. Part V, Section B, Line 16a, b, and c https://www.saintfrancis.com/patients-and-guests/for-patients/billing-and- insurance/financial-assistance Part V, Section B, Line 16j The billing statement includes information regarding financial assistance availability. Additionally, MyChart, a secure online tool that allows patients to connect with their personal health information 24/7, provides a link which takes the patient to the financial assistance letter and application form. Part V, Section B, Line 20e The following actions are completed prior to initiating collection actions: - Proactive phone calls - Statements are sent - Messages are sent to MyChart users Part V, Section B, Line 22d Amounts generally billed(AGB) are determined under the prospective method using Medicaid reimbursement rates. Additionally, a self-pay discount of 60 percent is provided on all charges for uninsured patients. Part I, Line 3c Income-based criteria is used as the basis in determining eligibility for free health services. Part I, Line 6a Saint Francis Health System, Inc. 73-1501972, the parent organization of Saint Francis Hospital Muskogee, Inc. produces a consolidated community benefit report included in an annual issue of the Saint Francis Health System magazine "Presence" that is made available to the public through the organization's website at https://www.saintfrancis.com/about-us/media/presence-magazine Part I, Line 7 Costing Methodology: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7c. For amounts reported on lines 7e - 7i, actual expenses for each community benefit activity are tracked and reported using the organization's accounting general ledger and are not based on a cost to charge ratio. The number reflected on line 7, column (f) excludes bad debt expense. The supplemental hospital offset payment program (SHOPP) was created and implemented in calendar year 2011 for the purpose of assuring access to quality care for Oklahoma Medicaid members. The program is designed to assess Oklahoma hospitals, unless exempt, a supplemental hospital offset payment program fee. The collected fees are placed in pools and then allocated to hospitals based on Medicaid revenues as directed by legislation. The Oklahoma Health Care Authority (OHCA) does not guarantee that allocation will equal or exceed the amount of the supplemental hospital offset payment program fees that were paid by Saint Francis Hospital Muskogee, Inc. Part II: Community Building Activities Community building activities improve the community's health and safety by addressing the root cause of health problems. These activities strengthen the community's capacity to promote the health and well-being of its residents by offering the expertise and resources of the healthcare organization. Costs for these activities include cash donations and expenses for the development of a variety of community-building programs and partnerships. See Schedule O for additional information regarding Saint Francis Health System, Inc.'s and Saint Francis Hospital Muskogee, Inc.'s community building activities aimed at promoting the health of the community. Part III, Section A, Line 2 Saint Francis Hospital Muskogee, Inc. has an established process to determine the adequacy of the allowance for uncollectable receivables that relies on a number of analytical tools and benchmarks to arrive at a reasonable allowance. No single statistic or measurement determines the adequacy of the allowance for uncollectable receivables. Some of the analytical tools that Saint Francis Hospital Muskogee, Inc. utilizes include, but are not limited to, historical cash collection experience, revenue trends by payer classification, and revenue days in accounts receivable. Accounts receivable are written off after collection efforts have been followed in accordance with Saint Francis Hospital Muskogee, Inc.'s policies. Part III, Section A, Line 3 The bad debt expense attributable to patients eligible under the organizations financial assistance policy is calculated from a sample review of all bad debt accounts and subsequent information. Part III, Section A, Line 4 Saint Francis Health System, Inc. 73-1501972, the parent organization of Saint Francis Hospital Muskogee, Inc., produces consolidated financials which include the financial position and results of financial operations of Saint Francis Hospital Muskogee, Inc. The consolidated financial statements are audited on an annual basis. Saint Francis Health System, Inc's audited consolidated financial statements provide a separate footnote addressing the organization's net patient accounts receivables on pages 7, 8, and 9. Saint Francis Health System, Inc. reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP). Part III, Section B, Line 8 Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio and the Medicare filed cost report. Part III, Line 9b Saint Francis Hospital Muskogee, Inc.'s debt collection policy is to pursue collections of patient balances from patients who have the ability to pay for the services. Saint Francis Hospital Muskogee, Inc. applies its collections efforts consistently and fairly to all patients regardless of insurance. Saint Francis Hospital Muskogee, Inc. works with those individuals who do not have the financial resources to pay outstanding balances to qualify for Saint Francis Hospital Muskogee, Inc.'s financial assistance policy. Charges to patients qualifying for charity care under the Saint Francis Hospital Muskogee, Inc. financial assistance policy are written off 100 percent. Part VI, Line 2 Costing Methodology: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7c. For amounts reported on lines 7e - 7i, actual expenses for each community benefit activity are tracked and reported using the organization's accounting general ledger and are not based on a cost to charge ratio. The number reflected on line 7, column (f) excludes bad debt expense. The supplemental hospital offset payment program (SHOPP) was created and implemented in calendar year 2011 for the purpose of assuring access to quality care for Oklahoma Medicaid members. The program is designed to assess Oklahoma hospitals, unless exempt, a supplemental hospital offset payment program fee. The collected fees are placed in pools and then allocated to hospitals based on Medicaid revenues as directed by legislation. The Oklahoma Health Care Authority (OHCA) does not guarantee that allocation will equal or exceed the amount of the supplemental hospital offset payment program fees that were paid by Saint Francis Hospital Muskogee, Inc. Part II: Community-Building Activities Community-building activities improve the community's health and safety by addressing the root cause of health problems. These activities strengthen the community's capacity to promote the health and well-being of its residents by offering the expertise and resources of the healthcare organization. Costs for these activities include cash donations and expenses for the development of a variety of community-building programs and partnerships. See Schedule O for additional information regarding Saint Francis Health System, Inc.'s and Saint Francis Hospital Muskogee, Inc.'s community-building activities aimed at promoting the health of the community. Part VI, Line 3 Patient Education of Eligibility for Assistance Saint Francis Health System, Inc. and its entities are committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Saint Francis Health System, Inc. makes every effort to educate patients on charity, its financial assistance policy and about their eligibility for assistance under Federal, State, or local government programs during registration, pre-registration, post-registration and following discharge in languages appropriate for the population being served. This includes several ways including, but not limited to, the following: - A brochure titled "Patient Financial Policy" on financial rights and responsibility is provided to every patient at the time of their registration and is available on the Saint Francis Health System, Inc. website. The brochure provides financial assistance program details. - The financial assistance policy, plain language summary, and application are posted on the Saint Francis Health System, Inc. website in English and the Limited English Proficiency languages of the Primary Service Area (PSA). - Saint Francis Health System, Inc. prints a phone number on the back of billing invoices where patients can obtain information about financial assistance. - Self-pay patients are visited by a financial counselor upon admission to verify their self-pay status. The financial counselor works with the self-pay patients to determine if the patient may qualify for assistance under a government sponsored plan. If the patient does not qualify for a government sponsored plan then the financial counselor works with the patient to determine if they qualify for charity based on the Saint Francis Health System, Inc.'s financial assistance policy. - Saint Francis Health System, Inc. offers the financial assistance policy, as well as payment options during the follow-up collection calls. policy, as well as payment options during the follow up collection calls. Part VI, Line 4 Community Information The Primary Service Area (PSA) of Saint Francis Hospital Muskogee, Inc. consists of Muskogee, Cherokee, Haskell, McIntosh, Okmulgee, Sequoyah and Wagner Counties, where a significant majority of inpatient admissions originate. Additional information regarding the community can also be found below, and in the community health needs assessment and implementation strategy located on the organization's website at https://www.saintfrancis.com/about-us/commitment-to-community. The most recent 2022 census report identified approximately 305,000 people in the PSA. The PSA is comprised of the following representation: - 61% Caucasian - 21% Native-American - 6% Two or more races - 4% Hispanic or Latino - 7% African-American - 1% Asian In 2022, the median household income for the PSA was $44,200 (about 43 percent below the US median) and the 2022 mean household income was $64,100 (about 48 percent below the US average). The per capita income for the PSA is 48 percent below the national median and 22 percent lower than the average for Oklahoma. In 2022, approximately 32 percent of the PSA's population lives in poverty, with the number falling to 10 percent for those under 18. Over 17 percent of households in the psa received food stamps/Supplemental Nutrition Assistance Program (SNAP) benefits within 2022. The uninsured rate in the PSA is approximately 18 percent. Distressingly, when narrowing focus to the PSA civilian population age 19 to 64 that participates in the labor force, the uninsured rate rises to over 24 percent. During Oklahoma's 2022 fiscal year, there were 1,075,881 unduplicated Medicaid enrollees; meaning nearly 27 percent of the state's population was enrolled in the Medicaid program at some point in time. The PSA was home to 93,412 unduplicated enrollees or approximately 31 percent of the PSA's population. Part VI, Line 5 Promotion of Community Health Saint Francis Hospital Muskogee, Inc. is part of an integrated healthcare delivery system with the mission of extending the presence and healing ministry of Christ in all we do. Saint Francis Health System, Inc., as a Catholic organization, seeks to reflect the presence of Christ in every personal and corporate encounter. Saint Francis Hospital Muskogee, Inc. is dedicated to giving back to the community in which its employees live and work. Saint Francis Health System, Inc. and Saint Francis Hospital Muskogee, Inc.'s governing body is comprised of community representatives on the Board of Directors that provide leadership and governance for the organization. The Board of Directors has the overall responsibility for the charitable contributions and the mission of Saint Francis Hospital Muskogee, Inc. and the other entities that are part of Saint Francis Health System, Inc. The members of the Board of Directors are selected based on their areas of expertise and experience including such areas as education, research, business and government. The members of the governing body contribute their wisdom, insights, and expertise to ensure the organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for Saint Francis Health System, Inc. Saint Francis Hospital Muskogee, Inc. provides financial assistance in the form of charity care to patients who are indigent and satisfy certain requirements. Additionally, Saint Francis Hospital Muskogee, Inc. is committed to treating patients who are eligible for means-tested government programs such as Medicaid and other government-sponsored programs including Medicare, with care being provided regardless of the reimbursement shortfall, and thereby relieves the state and federal government of the burden of paying the full cost of care for those patients. Often, patients are unaware of the federal, state and local programs available to them for financial assistance, or they are unable to access them due to the cumbersome enrollment process required to receive these benefits. Saint Francis Health System, Inc. offers assistance in enrollment to these government programs or extends financial assistance in the form of charity care through the organization's Financial Assistance Policy. Saint Francis Hospital Muskogee, Inc. reinvests its net operating income back into the facility to improve patient care, to benefit society and to allow Saint Francis Hospital Muskogee, Inc. to carry out its vision to be the regional leader in the delivery of quality Catholic healthcare services. Part VI, Line 6 Affiliated Health Care System Saint Francis Hospital Muskogee, Inc., is part of Saint Francis Health System, Inc. Over 30,700 patients were seen in the hospital's emergency room. Additionally, Saint Francis Hospital Muskogee, Inc. admitted approximately 8,600 patients; provided ancillary and diagnostic services on an outpatient basis to an additional 62,400 patients; and handled approximately 570 births. See Schedule O for additional information regarding Saint Francis Hospital Muskogee, Inc.'s role within Saint Francis Health System, Inc. Part VI, Line 7 - State filing of community benefit report Saint Francis Health System, Inc., which includes Saint Francis Hospital Muskogee, Inc., publishes a community benefit report in Oklahoma. A written report that is included in an annual issue of the Saint Francis Health System, Inc. magazine "Presence" which is distributed across eastern Oklahoma and to all Saint Francis Health System, Inc. locations for display and pickup to help educate the community on the benefits that Saint Francis Hospital Muskogee, Inc. and Saint Francis Health System, Inc. provide to the communities we serve in return for our not-for-profit status. The report is also made available to the public on the health system's website. true Muskogee Jr Livestock Show PO Box 2784 Muskogee OK 74402 731325124 501(c)(3) 15800 General Support 1 Schedule I, Part I, Line 2 Saint Francis Hospital Muskogee, Inc. provides charitable contributions to other 501(c)(3) exempt organizations that further the exempt purposes of Saint Francis Hospital Muskogee, Inc. The Saint Francis Health System, Inc. executive director of corporate communications and marketing arranges the sponsorships each year as determined by the communities in which Saint Francis Hospital Muskogee, Inc. has a presence. Saint Francis Hospital Muskogee, Inc. does not monitor the use of charitable contributions since contributions are only made to section 501(c)(3) public charities that further the exempt purpose of Saint Francis Hospital Muskogee, Inc. X X X X false true false false false false false false false Jake Henry Jr Former Pres./CEO/Director 0 1197607 0 2557492 0 4383 0 37390 0 8926 0 3805798 0 0 Barry L Steichen Vice President/COO/Director 0 1146365 0 311418 0 7015 0 161747 0 26607 0 1653152 0 0 Thomas G Neff Former Secretary 0 308694 0 122523 0 9790 0 26393 0 18026 0 485426 0 0 Eric E Schick Treasurer/CFO (Termed 9/2021) 0 976426 0 265473 0 5776 0 34782 0 19483 0 1301940 0 0 Michael J Lissau Secretary 0 507476 0 138793 0 4379 0 88307 0 23091 0 762046 0 0 Michele Keeling President 324430 0 79568 0 5640 0 69212 0 18688 0 497538 0 0 0 Olankunie Ajanaku MD Physician 676287 0 7800 7200 15104 0 35540 0 0 0 734731 7200 0 0 Deborah D Dage Treasurer (Beg 1/2022) 0 558188 0 96942 0 6033 0 0 0 0 0 661163 0 0 Cliff A Robertson MD President/Director(Beg 7/2021) 0 601678 0 500000 0 22394 0 0 0 0 0 1124072 0 0 Ziad Hawa MD Physician 654100 25653 20667 0 19500 0 35540 0 21897 0 751704 25653 0 0 David Polizzi MD Physician 372013 313759 0 15000 0 16250 35540 0 7633 0 415186 345009 0 0 Seyed Hassany MD Physician 5550 696614 0 0 0 19500 0 35540 0 22653 5550 774307 0 0 Selamawit Negusse MD Physician 50004 562305 0 0 0 19500 0 35540 0 21153 50004 638498 0 0 Part I, Line 3 Saint Francis Hospital Muskogee, Inc. is an entity of the Saint Francis Health System, Inc. Saint Francis Health System, Inc.'s compensation committee reviews and approves the compensation of the officers. Part I, Line 4b A select group of highly compensated employees of Saint Francis Health System, Inc., and its related entities, Saint Francis Hospital, Inc., Laureate Psychiatric Clinic and Hospital, Inc., Warren Clinic, Inc., Saint Francis Hospital South, LLC, The Children's Hospital Foundation at Saint Francis, Saint Francis Hospital Vinita, Inc., and Saint Francis Hospital Muskogee, Inc., are eligible to participate in a nonqualified deferred compensation plan under Section 457(b) and 457(f) of the Internal Revenue Code of 1986, as amended under the economic growth and tax relief reconciliation act of 2001. Note: None of the individuals listed on Schedule J are compensated as board members of the reporting entity. The reported compensation is for services as employees of the reporting entity or related organization. Form 990, Part III, Line 4a Saint Francis Hospital Muskogee, Inc. is a member of Saint Francis Health System, Inc. Saint Francis Health System, Inc. is a catholic, not-for-profit health system whose mission is to extend the presence and healing ministry of Christ in all we do. Saint Francis Hospital Muskogee, Inc.'s accomplishments include operating an acute care hospital where admitting physicians, who are primarily practitioners in the local area, provide inpatient/outpatient and emergency care services to residents of Muskogee and the surrounding areas. In fiscal year 2022, Saint Francis Hospital Muskogee, Inc. provided approximately $1,683,000 of charity care (measured at established rates) and $1,231,000 in unreimbursed Medicaid services (measured at established rates). Healthgrades, a website devoted to providing independent ratings and assessments of healthcare providers, recognized Saint Francis Hospital Muskogee with five-star ratings on its website for the conditions and procedures: COPD and Respiratory Failure. Form 990, Part V, Line 2b Saint Francis Payroll Services, LLC, EIN 45-0470422, has been authorized to act as a common pay agent under Section 3504 of the Internal Revenue Code for Saint Francis Health System, Inc. effective July 1, 2002, in accordance with revenue procedure 70-6, 1970-1 C.B. 420. Saint Francis Payroll Services, LLC assumed reporting obligations for federal income tax, social security, Medicare withholding tax purposes as well as advance payment of earned income credit for Saint Francis Health System, Inc. and year-end reporting effective July 1, 2002. Form 990, Part VI, Section A, Line 2 Description of Relationships Many of the persons listed on Part VII have a "business relationship" with each other by virtue of serving on related Saint Francis Health System, Inc. entity boards and other corporation boards. The organization has determined these associations do not present a conflict of interest. Cliff A. Robertson M.D, an officer and director, served on a board outside of Saint Francis Health System, Inc. with another director, William R. Lissau. William K. Warren, Jr., a trustee, is the father of John Kelly C. Warren, a director and chairman of the board, and has a family relationship. William R. Lissau, a director, has business relationships with William K. Warren Jr., a trustee, and John Kelly C. Warren, a director and chairman of the board. William R. Lissau, a director, is the father of Michael Lissau, an officer, and has a family relationship. Bishop David Konderla, a trustee, serves on other boards outside of Saint Francis Health System, Inc. with William R. Lissau, a director. Form 990, Part VI, Section A, Line 3 The director functions are delegated to the Saint Francis Health System, Inc. board of directors. Form 990, Part VI, Section A, Line 6 Saint Francis Health System, Inc. is the sole member of Saint Francis Hospital Muskogee, Inc. Form 990, Part VI, Section A, Line 7a Saint Francis Health System, Inc., the sole member of Saint Francis Hospital Muskogee, Inc. appoints the governing body. Form 990, Part VI, Section A, Line 7b As the sole member of Saint Francis Hospital Muskogee, Inc., Saint Francis Health System, Inc., has authority to follow its bylaws which dictates the following: Either the board of directors and a majority of the trustees or unanimous trustee approval is required for the sale of corporate assets valued at $10,000,000 or more. Additionally, the trustees have sole authority to: - amend the certificate of incorporation - approve mergers or consolidations - approve the sale, lease or transfer of all, or substantially all, of the assets of the corporation - amend the bylaws - appointment of board members - approve dissolution or revocation of dissolution of the corporation Form 990, Part VI, Section B, Line 11b The finance committee, a sub-committee of the board of directors of Saint Francis Health System, Inc. has access to the password-protected form 990 online prior to filing with the IRS. Form 990, Part VI, Section B, Line 12c The organization uses the conflict of interest, whistleblower and record-retention policies of Saint Francis Health System, Inc. A request for information on potential conflicts is solicited annually from directors, trustees and all employees at manager level and above to monitor proposed or ongoing transactions for conflicts of interest and dealing with potential or actual conflicts. One director, two officer/directors and one officer reported potential conflicts that were addressed by the governing body. Conflicts are regularly disclosed and addressed. Form 990, Part VI, Section B, Lines 15a and 15b Compensation of officers and senior level management is reviewed annually, and approved by the compensation committee with guidance from independent consultants and the use of comparative data. Form 990, Part VI, Section C, Line 19 These requests are determined on a case-by-case basis. Form 990, Part VII, Section A The hours per week reported on Form 990, Part VII for officers and directors are the hours spent on the filing entity only. The remaining portion of the 40 hours per week of the officers and directors with related compensation is allocated among the entities reported on Schedule R. Form 990, Part XI, Line 9 The change in fund balance of -$10,137,421 was a net equity transfer. Saint Francis Hospital Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 730700090 Health Svcs OK 501(c)(3) 3 SFHS true Laureate Psychiatric Clinic & Hosp Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 731308273 Health Svcs OK 501(c)(3) 3 SFHS true Warren Clinic Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 731310891 Health Svcs OK 501(c)(3) 3 SFHS true Saint Francis Health System Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 731501972 Health Svcs OK 501(c)(3) 12b Type II NA false The Children's Hosp Fdn at Saint Francis 6600 S Yale Ave Ste 400 Tulsa OK 74136 202843418 Health Svcs OK 501(c)(3) 12a Type I SFHS true Saint Francis Hospital Vinita Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 813747248 Health Svcs OK 501(c)(3) 3 SFHS true Saint Francis Hospital South LLC 6600 S Yale Ave Ste 400 Tulsa OK 74136 010603214 Health Svcs OK 501(c)(3) 3 SFHS true Saint Francis Payroll Services LLC 6600 S Yale Ave Ste 400 Tulsa OK 74136 450470422 Common Pay Agent OK SFHS C corp 0 0 true Xavier Insurance Company Inc 76 St Paul St Ste 500 Burlington VT 05401 030333599 Captive Insurance VT SFHS C corp 0 0 true Saint Francis Hlth Sys Gen-Prof Lia PO Box 3038 Milwaukee WI 53215 756583874 Self Insurance OK SFHS Trust 0 0 true false true false false false false false false true true false false true false false true true true true Saint Francis Hospital Inc M 5712556 Trans Review Saint Francis Hospital Inc P 167231721 Trans Review Saint Francis Hospital Inc Q 186180104 Trans Review Saint Francis Hospital Inc S 111474 Trans Review Saint Francis Hospital South LLC P 427894 Trans Review Saint Francis Hospital South LLC Q 149992 Trans Review Saint Francis Hospital Vinita Inc P 111833 Trans Review Saint Francis Hospital Vinita Inc I 55464 Trans Review Laureate Psychiatric Clinic and Hospital Inc Q 970677 Trans Review Laureate Psychiatric Clinic and Hospital Inc P 1219643 Trans Review Warren Clinic Inc J 367054 Trans Review Warren Clinic Inc P 16771539 Trans Review Warren Clinic Inc Q 14839155 Trans Review Warren Clinic Inc M 360991 Trans Review