2022-05-12T17:52:53-05:00 2021-06-30 ERNST & YOUNG US LLP 2323 VICTORY AVENUE SUITE 2000 DALLAS TX 75219 990 2020-07-01 731310891 Warren Clinic Inc % DEBORAH DAGE WARR 9185028126 6600 S Yale Ave Suite 400 Tulsa OK 741363319 Deborah Dage TREASURER/CFO 9184948418 2022-05-12 true Deborah Dage 999009999 Stephanie Lew P01080011 2149698000 2 2020 2022-09-23 18:48:47Z Deborah Dage 6161 S Yale Ave Tulsa OK 741363319 208635349 false X HTTPS://WWW.SAINTFRANCIS.COM/WARREN X 1987 OK To extend the presence and healing ministry of Christ in all we do. 7 4 1634 0 0 0 75 20 185072884 199724016 -39588 76541 7580913 8829935 192614284 208630512 4281 750 0 0 188866603 198763981 0 0 0 58900378 57334811 247771262 256099542 -55156978 -47469030 105634991 122713415 99490329 112404382 6144662 10309033 TO EXTEND THE PRESENCE AND HEALING MINISTRY OF CHRIST IN ALL WE DO. false false 231768396 750 208515223 Warren Clinic, Inc. and its employee providers provide quality medical healthcare regardless of race, creed, sex, national origin, handicap, age or ability to pay. It has a strong commitment to help meet the needs of the communities it serves. Recognizing this commitment, Warren Clinic, Inc. provides services to both Medicaid and indigent patients. The unreimbursed value of providing care to these patients was $18,877,000 in fiscal year 2021. Warren Clinic, Inc. provides physician services to communities which are designated physician shortage areas. Training for medical students is also provided by Warren Clinic, Inc. physicians. 231768396 true false false true false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false true false false false false false false true true true false false true X 149 0 true 1634 true false false false false false false false false false false false false X 7 4 true true false false true true true true true false false true true true true true true true true true true OK X DEBORAH DAGE 9184948418 6161 S YALE AVE Tulsa OK 741363319 X Jake Henry Jr President/CEO/Director/Trustee 1.0 39.0 X X 0 2518780 52908 Robert Garrett MD Physician 35.0 5.0 X 2250471 102000 48820 Johnathon Ledet MD Physician 40.0 0.0 X 1672365 0 56496 Scott Dull MD Physician 35.0 5.0 X 1591433 69000 22985 Hassan Kaleem MD Physician 40.0 0.0 X 1413122 0 56675 Nikhil Mukhi MD Physician 40.0 0.0 X 1408608 0 0 Barry L Steichen Vice President/COO 1.0 39.0 X X 0 1146432 173865 Eric E Schick Treasurer/CFO 1.0 39.0 X 0 923696 154584 Michael J Lissau Secretary 1.0 39.0 X 0 505912 100725 Thomas G Neff Former Secretary 0.0 40.0 X 0 515905 65332 Charley Trimble Former Administrator 0.0 40.0 X 0 529002 50021 Collin Henry Administrator 40.0 0.0 X 340801 0 72050 William R Lissau Director 1.0 0.0 X 0 0 0 William K Warren Jr Trustee 1.0 0.0 X 0 0 0 Judy Kishner Trustee 1.0 0.0 X 0 0 0 Jeffrey Smith Trustee 1.0 0.0 X 0 0 0 John-Kelly C Warren Trustee 1.0 0.0 X 0 0 0 8676800 6310727 854461 364 true true false Crossland Construction Company 833 SE AVENUE COLUMBUS KS 66725 CONSTRUCTION SVCS 3965525 WARREN PROFESSIONAL BUILDING CORP 6565 S YALE AVE TULSA OK 74136 BUILDING RENT 1060841 UROLOGIC SPECIALISTS OF OKLAHAMA 10901 E 48TH ST SO TULSA OK 74146 PHYSICIAN SERVICES 1010628 WEATHERBY LOCUMS INC 6451 NORTH FEDERAL HIGHWAY SUITE 7 FORT LAUDERDALE FL 33308 Phys Replacement Svc 572319 JACKSON COKER 2655 NORTHWINDS PKWY ALPHARETTA GA 30009 Phys Replacement Svc 342363 21 20 20 PHYSICIAN SERVICES 621300 198544126 198544126 RENTAL INCOME FROM AFFILIATES 532000 1179890 1179890 199724016 81378 81378 0 0 38728 38728 0 38728 38728 4837 -4837 -4837 -4837 0 0 0 0 0 0 0 0 0 AFFILIATE REVENUE - BUSINESS OFFICE 900099 3973176 3973176 PRIMARY RELIEF FUND/PRIMARY CARE FIRST INCOME 900099 4816939 4816939 AFFILIATE REVENUE - OTHER 900099 1092 1092 8791207 208630512 208515223 115269 750 750 0 0 0 426330 0 426330 308328 308328 172555425 161091290 11464135 10851149 10976790 -125641 6716276 5733895 982381 7906473 7399638 506835 0 0 47928 47928 15229 15229 0 0 9482586 4170669 5311917 258076 127611 130465 4208345 3260385 947960 571555 380829 190726 0 11997278 10409651 1587627 101037 88645 12392 0 273887 265644 8243 0 0 4419579 3946698 472881 3963084 2706798 1256286 MEDICAL SUPPLIES 10084748 9368231 716517 BAD DEBT EXPENSE 5042724 5042724 ADMINISTRATIVE EXPENSE 5244451 5244451 EMPLOYEE EXPENSE 814532 734227 80305 809772 804241 5531 256099542 231768396 24331146 0 104122 103994 20660433 28645739 0 0 15492141 16755828 0 0 0 0 955717 1112570 0 0 711916 332097 70756843 32307305 32619538 38449538 0 0 0 0 0 0 0 0 35091124 37313649 105634991 122713415 55263237 68810818 0 0 0 0 0 0 0 0 0 0 0 0 370278 496806 43856814 43096758 99490329 112404382 X 6144662 10309033 0 0 6144662 10309033 105634991 122713415 X -47469030 51633401 X true X true X true false X false false false false false false false false true 15229 15229 false Schedule C, Part II-B, Line 1i Warren Clinic, Inc., through the membership dues paid on behalf of physicians to the American Medical Association and Oklahoma State Medical Association, participates in lobbying and grass roots lobbying activity. It is less than a substantial part of the total expenditures in a taxable year. The lobbying and grass roots lobbying activity is related to legislation affecting Warren Clinic, Inc. and operation of the Warren Clinic, Inc. for its charitable purposes, in particular the promotion of health. "Grass roots lobbying activity" means any attempt by the AHA to influence any legislation by affecting the opinions of the general public or any segment thereof. "Lobbying" means any attempt to influence legislation through communications with any member or employee of a legislative body who may participate in the crafting of legislation. 3073475 3073475 28443024 13942936 14500088 8788814 3831993 4956821 22926588 14532376 8394212 7524942 7524942 38449538 OPERATING LEASES 36467471 OTHER LONG TERM RECEIVABLES 676725 DUE FROM CUSTOMERS 106083 OTHER ACCRUED ACCOUNTS REC. 63370 37313649 0 OPERATING LEASE LIABILITY 31354495 PROF LIABILITY INSURANCE RESERVE 11742263 43096758 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, Warren Clinic, 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. Warren Clinic, Inc. has assessed its uncertain tax positions and determined they are more likely than not to be fully sustained upon examination. Therefore, no liability or asset for uncertain tax positions needs to be recorded. X X X X false true false false false false false false false Jake Henry Jr President/CEO/Director/Trustee 0 1479112 0 1030901 0 8767 0 36896 0 16012 0 2571688 0 0 Barry L Steichen Vice President/COO 0 879902 0 259515 0 7015 0 148117 0 25748 0 1320297 0 0 Eric E Schick Treasurer/CFO 0 695039 0 221227 0 7430 0 130058 0 24526 0 1078280 0 0 Thomas G Neff Former Secretary 0 380169 0 118954 0 16782 0 36896 0 28436 0 581237 0 0 Charley Trimble Former Administrator 0 393716 0 113038 0 22248 0 25496 0 24525 0 579023 0 0 Michael J Lissau Secretary 0 375498 0 126175 0 4239 0 78506 0 22219 0 606637 0 0 Collin Henry Administrator 263116 0 76014 0 1671 0 58682 0 13368 0 412851 0 0 0 Robert Garrett MD Physician 1947471 102000 300000 0 3000 0 33596 0 15224 0 2299291 102000 0 0 Johnathon Ledet MD Physician 1627266 0 0 0 45099 0 35246 0 21250 0 1728861 0 0 0 Hassan Kaleem MD Physician 1413122 0 0 0 0 0 35246 0 21429 0 1469797 0 0 0 Scott Dull MD Physician 1588183 69000 0 0 3250 0 0 0 22985 0 1614418 69000 0 0 Nikhil Mukhi MD Physician 1400418 0 0 0 8190 0 0 0 0 0 1408608 0 0 0 Schedule J, Part I, Line 3 Warren Clinic, 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. Schedule J, 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. Martina Hum MD Married to Senior VP 308328 Physcian Compensation false Schedule L, Part IV, Line 1 Dr. Martina Hum, an employed physician of Warren Clinic, Inc., is married to Thomas G. Neff, Senior Vice President of strategic planning for Saint Francis Health System, Inc. Dr. Hum's compensation and benefits are reported on Form 990, Part IX, Line 6. 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 and Medicare withholding tax purposes for Saint Francis Health System, Inc. and year-end reporting effective July 1, 2002. Form 990, Part V, Line 15 Common Law Employees: Individuals listed as officers of the organization that are paid full time by a related organization are common law employees of Saint Francis Health System, Inc., a separate legal entity. It is the intention of Saint Francis Health System, Inc. and the filing organization to make information accessible and transparent, reporting those Saint Francis Health System, Inc. employees who have officer and key employee responsibilities to the filing organization. Form 990, Part VI, 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 Systems, Inc. entity boards. The organization has determined these associations do not present a conflict of interest. Jake Henry Jr., an officer and director, serves on other boards outside of Saint Francis Health System, Inc. with Barry Steichen an officer and director, and Eric Schick, an officer. Jake Henry Jr., an officer and director, serves on boards outside of Saint Francis Health System, Inc. with William R. Lissau, a director and John-Kelly Warren, a trustee. Jake Henry J., an officer and director, the uncle of Collin Henry, the administrator have a family relationship. William R. Lissau, a director, and Michael Lissau, an officer have a family relationship. Form 990, Part VI, Line 3 The organization by its bylaws and resolution delegates governance of its operations to the directors of Saint Francis Health System, Inc. Form 990, Part VI, Line 6 The organization has five trustees who elect the board of directors. Form 990, Part VI, Line 7a The organization has five trustees who elect the board of directors. Form 990, Part VI, Line 7b The organization delegated authority to Saint Francis Health System, Inc. As such, 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, 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, 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 for proposed or ongoing transactions for conflicts of interest and dealing with potential or actual conflicts. The Directors, Trustees and Officers with potential conflicts recuse themselves from events that would result in a conflict. One director, one director/officer/trustee, one officer, one director, three trustees and one key employee reported potential conflicts that were addressed by the governing body. Conflicts are regularly disclosed and addressed. Form 990, Part VI, Lines 15a & b 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, Line 1 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 other changes in net assets or fund balances of $51,633,401 are made up of equity transfers from/to related parties. 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 Saint Francis Hospital Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 730700090 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 Laureate Psychiatric Clinic & Hospital 6600 S Yale Ave Ste 400 Tulsa OK 74136 731308273 Health Svcs OK 501(c)(3) 3 SFHS true The Children's Hosp Fnd 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 Muskogee Inc 6600 S Yale Ave Ste 400 Tulsa OK 74136 814322087 Health Svcs OK 501(c)(3) 3 SFHS true Saint Francis Payroll Services LLC 6600 S Yale Ave Ste 400 Tulsa OK 741363319 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 SFH C Corp 0 0 true Saint Francis Health Sys Gen-Prof Liab PO Box 3038 Milwaukee WI 53215 756583874 Self Insurance OK SFHS Trust 0 0 true false false true false false false false false true true true true true false false true true true true SAINT FRANCIS HOSPITAL INC J 1170598 Trans Review SAINT FRANCIS HOSPITAL INC K 1221860 Trans Review SAINT FRANCIS HOSPITAL INC L 11374785 Trans Review SAINT FRANCIS HOSPITAL INC M 8746282 Trans Review Saint Francis Hospital Inc P 427638541 Trans Review Saint Francis Hospital Inc Q 368918607 Trans Review Saint Francis Hospital Inc R 57988 Trans Review Saint Francis Hospital Inc S 1154930 Trans Review LAUREATE PSYCHIATRIC CLINIC & HOSPITAL INC L 358632 Trans Review Saint Francis Hospital Muskogee Inc Q 12502059 Trans Review Saint Francis Hospital Muskogee Inc K 321604 Trans Review Saint Francis Hospital Muskogee Inc P 10550246 Trans Review Saint Francis Hospital Muskogee Inc L 251321 Trans Review SAINT FRANCIS HOSPITAL SOUTH LLC K 313300 Trans Review SAINT FRANCIS HOSPITAL SOUTH LLC L 257197 Trans Review Saint Francis Hospital South LLC P 9617636 Trans Review Saint Francis Hospital South LLC Q 11195282 Trans Review Saint Francis Hospital Vinita Inc K 149076 Trans Review Saint Francis Hospital Vinita Inc Q 188835 Trans Review Saint Francis Hospital Vinita Inc P 129233 Trans Review