2021-06-15T15:01:01-05:00 2020-06-30 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2019-07-01 731192765 INTEGRIS AMBULATORY CARE CORP % KATHRYN INGERLY INTE 4059496026 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DOUGLAS M SMITH EXECUTIVE VP, CFO 4059512736 2021-06-11 true BRITTANY K ELLISER P01284594 2253444000 2021-06-07 2019 2022-09-23 18:48:47Z SEE SCHEDULE O CHRIS HAMMES 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 240857800 false X www.integrisok.com X 1983 OK TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 1 0 1406 544 844 2272575 5246112 219171628 234219045 -830 -43241 186453 1392643 221629826 240814559 1490578 0 0 0 183137362 199411677 0 0 0 58730096 60176755 243358036 259588432 -21728210 -18773873 269196872 193896981 290364965 233588947 -21168093 -39691966 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 242998408 234004722 SEE SCHEDULE O STATEMENTS 2 THROUGH 5 242998408 true true false false false false false false false false true false true false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false true true true true false false true X 0 0 true 1406 true true true false false false false false false false false false false false X 1 0 true false false false true true true true true false false true true true true true true false true true true OK X KATHRYN INGERLY 4059493085 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 X SCOTT SHADFAR PHYSICIAN 40.0 0.0 X 1540308 0 23370 TIMOTHY PEHRSON FORMER DIRECTOR 0.0 40.0 X 0 1159067 308500 HANI BARADI PHYSICIAN 40.0 0.0 X 1401505 0 35594 JEREMY PHELPS PHYSICIAN 40.0 0.0 X 1384508 0 34850 CHRIS HAMMES COO OF IH 1.0 39.0 X X 0 1073983 221641 CHRISTOPHER LENTZ PHYSICIAN/MEDICAL DIRECTOR 40.0 0.0 X 1202108 0 26011 NATHANIEL STETSON PHYSICIAN 40.0 0.0 X 1167848 0 35612 DOUGLAS M SMITH CFO OF IH 1.0 39.0 X 0 712012 114852 SUNNIE GLOVER SENIOR VICE PRESIDENT 40.0 0.0 X 271512 0 19732 DAVID R HADLEY FORMER OFFICER & DIRECTOR 0.0 0.0 X 0 244392 0 6967789 3189454 820162 404 true true false ANESTHESIA MEDIAL PROFESSIONALS PLL PO BOX 1540 EDMOND OK 73083 ANESTHESIA SERVICE 1644244 COMPHEALTH PO BOX 972651 DALLAS TX 75397 CONTRACT STAFFING 642609 DIAGNOSTIC LAB OF OKLAHOMA 225 NE 97TH STREET OKLAHOMA CITY OK 73114 REFERENCE LAB 533397 CARAVAN HEALTH INC PO BOX 219286 KANSAS CITY MO 64121 ACO SERVICE 453630 SULLIVANCOTTER HOLDING INC 62272 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 SOFTWARE SYSTEMS 356173 15 2434172 2811940 5246112 NET PATIENT REVENUE 621990 152891280 152891280 QUALITY INCENTIVES 900003 2783844 2783844 INCOME FROM JOINT VENTURES 621990 10157814 10157814 SYSTEM SERVICE REVENUE 900003 64833297 64833297 ELECTRONIC HEALTH RECORDS 900003 2988900 2988900 563910 349587 844 213479 234219045 0 0 0 0 0 0 0 43241 -43241 -43241 -43241 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900003 1392643 1392643 1392643 240814559 234004722 844 1562881 0 0 0 0 278851 278851 0 173551759 173551759 0 5697149 5697149 0 11528910 11528910 0 8355008 8355008 0 16590024 0 16590024 0 0 0 0 0 3228083 3228083 111546 111546 0 11727974 11727974 0 0 0 11564366 11564366 0 469151 469151 0 0 461885 461885 0 0 0 2595925 2595925 0 3188350 3188350 0 PURCHASED SERVICES 9141366 9141366 0 0 DUES & MEMBERSHIPS 372757 372757 0 0 CONTRACT LABOR 229568 229568 0 0 LICENSES/PERMITS ETC. 178901 178901 0 0 316859 316859 259588432 242998408 16590024 0 18659 17147 65795590 3771 0 0 53360917 42085804 0 0 0 0 156880 156880 44103 79578 38597 137499 37900210 24317439 14308539 13582771 0 0 4937487 5187487 127671474 129781418 2864626 2864626 0 0 269196872 193896981 289270061 228886087 0 0 1094904 3088027 0 0 0 0 0 0 0 0 0 0 0 1614833 290364965 233588947 X -21168093 -39691966 0 0 -21168093 -39691966 269196872 193896981 X -18773873 250000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 70327 70327 10488136 3803806 6684330 2803596 1756339 1047257 23928574 18600305 5328269 609577 156989 452588 13582771 INVESTMENT IN LAKESIDE 19764481 F INVESTMENT IN SW ORTHO 113260748 F INVESTMENT IN JV COMMUNITY -3242270 F INVESTMENT IN MEDICAL PLAZA -1541 F 129781418 0 LT SOCIAL SECURITY TAX WITHHELD 1614833 1614833 X SCHEDULE D, PART X, LINE 2 INTEGRIS HEALTH, INC. AND ITS TAX-EXEMPT CONTROLLED AFFILIATES HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT UNDER THE PROVISION OF INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ENTITIES DESCRIBED UNDER IRC SECTION 501(C)(3). ACCORDINGLY, NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. true true X true X true X true true false true true 962423 962423 0.00370 7383657 4206161 3177496 0.01220 8346080 4206161 4139919 0.01590 1434630 1434630 0.00550 8700 8700 0.00010 1443330 1443330 0.00560 9789410 4206161 5583249 0.02150 250000 250000 0.00090 250000 250000 0.00090 true 15785558 0 8812604 2805926 6006678 X true true LAKESIDE WOMEN'S WOMEN'S HEALTH 0.75 0.25 MEDPLAZA IMAGING RADIOLOGY IMAGING CENTER 0.5 0.5 SW AMBSURGERY CTR AMBULATORY SURGERY CENTER 0.251 0.499 COMM HOSP NORTH LLC HEALTH CARE 0.255 0.49 TPG HOSPITAL HEALTH CARE 0.255 0.49 HPI NORTH HEALTH CARE 0.255 0.49 HPI PHYSCIANS LLC HEALTH CARE 0.255 0.49 HPI HOLDCO HEALTH CARE 0.255 0.49 HPI LLC HEALTH CARE 0.255 0.49 OCOM HEALTH CARE 0.251 0.499 4 1 LAKESIDE WOMEN'S HOSPITAL LLC 11200 N PORTLAND OKLAHOMA CITY OK 73120 WWW.INTEGRISOK.COM 2339 X X X A 2 OK CTR ORTHPDIC & MLTI-SPCLTY SURG 8100 S WALKER OKLAHOMA CITY OK 73139 WWW.OCOMHOSPITAL.COM 2347 X X B 3 COMMUNITY HOSPITAL LLC 3100 SW 89TH OKLAHOMA CITY OK 73189 COMMUNITYHOSPITALOKC.COM 2341 X C 4 TPG HOSPITAL LLC 9204 N MAY AVE OKLAHOMA CITY OK 73120 NWSURGICALOKC.COM 2329 X C A 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X X true 15 true SEE PART V, SECTION C false true X 150. 300. X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false B 2 false true false false true X 150. 300. X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X false X false false C 34 false true false false true X 150. 151. X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X true X false false SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART V: INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IACC FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED BELOW. REPORTING GROUP B PART V, SECTION B, LINE 2 ACQUISITION DETAILS IF HOSPITAL FACILITY ACQUIRED OR PLACED INTO SERVICE AS A TAX-EXEMPT HOSPITAL IN THE CURRENT YEAR OR IMMEDIATELY PRECEDING YEAR. OKLAHOMA CENTER FOR ORTHOPAEDIC AND MULTI-SPECIALTY SURGERY, LLC (OCOM) WAS RESTRUCTURED EFFECTIVE NOVEMBER 1, 2018 WHEN A NEW JOINT VENTURE WAS FORMED BETWEEN INTEGRIS AMBULATORY CARE CORPORATION (INTEGRIS), AN OKLAHOMA NOT FOR PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3), AND USP OKLAHOMA, INC. (USP OK), AN OKLAHOMA FOR PROFIT CORPORATION THAT IS AN AFFILIATE OF UNITED SURGICAL PARTNERS. WHEN THE NEW JOINT VENTURE WAS FORMED WITH INTEGRIS, OCOM BECAME SUBJECT TO THE 501(R) PROVISIONS. AS SUCH, OCOM'S FIRST COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CURRENTLY IN THE PROCESS OF BEING COMPLETED WITH PLANS FOR ITS APPROVAL AND ADOPTION ON OR BEFORE ITS DUE DATE OF JUNE 30, 2021. ADDITIONALLY, THE RELATED IMPLEMENTATION STRATEGY WILL BE APPROVED AND ADOPTED ON OR BEFORE ITS DUE DATE OF NOVEMBER 15, 2021. REPORTING GROUP C PART V, SECTION B, LINE 2 HEALTH VENTURES IS A PARTNERSHIP FORMED IN FY2019 BETWEEN IACC, AN OKLAHOMA NOT FOR PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3) AND USP OKLAHOMA, INC. (USP), AN UNRELATED OKLAHOMA FOR PROFIT CORPORATION FOR THE PURPOSE OF ACQUIRING OWNERSHIP IN OR DEVELOPLING FREESTANDING AMBULATORY SURGERY HOSPITALS. ON NOVEMBER 1, 2018, HEALTH VENTURES ACQUIRED 51% OF HPI HOLDINGS, LLC (HPI). HPI OWNS A 100% INTEREST IN COMMUNITY HOSPITAL, LLC AND TPG HOSPITAL, LLC. THIS JOINT VENTURE OPERATED THE COMMUNITY HOSPITAL AND TPG HOSPITAL FACILITIES DURING THE TAX YEAR. THE JOINT VENTURE IS A PARTNERSHIP FOR WHICH A FORM 1065 IS FILED. HOWEVER, WHEN HPI WAS ACQUIRED BY HEALTH VENTURES, COMMUNITY HOSPITAL AND TPG HOSPITAL BECAME SUBJECT TO THE 501(R) PROVISIONS. SUPPLEMENTAL INFORMATION 2 REPORTING GROUP A PART V, SECTION B, LINE 5: IN CONDUCTING THE CHNA, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY SURVEYS, LISTENING SESSIONS, FOCUS GROUPS, AND LOCAL DATA COLLECTION. ETHNICITIES INPUT WAS OBTAINED FROM SURVEYS BY TARGETING POPULATION GATHERING PLACES SUCH AS COMMUNITY CLINIC, CHURCHES, HEALTH DEPARTMENT, HUMAN SERVICES, AFTER SCHOOL PROGRAMS, AND PUBLIC TRANSPORTATION SERVICES. SUPPLEMENTAL INFORMATION 3 REPORTING GROUP A PART V, SECTION B, LINE 6A: THE FACILITIES LISTED IN THE METRO AREA USED THE SAME SURVEY, BUT SOME CONTENTS OF THE PLANS WERE CHANGED DUE TO SOME DEMOGRAPHIC ASPECTS OF THE COMMUNITIES (IE LARGE HISPANIC POPULATION, HIGHER SOCIO ECONOMIC FACTORS, ETC). THOSE FACILITIES INCLUDED: INTEGRIS HEALTH EDMOND, INTEGRIS BAPTIST MEDICAL CENTER, LAKESIDE WOMEN'S HOSPITAL, INTEGRIS SOUTHWEST MEDICAL CENTER, AND INTEGRIS CANADIAN VALLEY HOSPITAL. DUE TO THEIR CLOSE PROXIMITY AND GEOGRAPHIC LOCATION, INTEGRIS GROVE HOSPITAL AND INTEGRIS BAPTIST REGIONAL HEALTH CENTER USED THE SAME. INTEGRIS BASS BAPTIST HEALTH CENTER AND INTEGRIS NORTHWEST SPECIALTY HOSPITAL USED THE SAME SURVEY SINCE THEY SHARE THE SAME ZIP CODE. EACH FACILITY PLACED THE ASSESSMENT SURVEY ON THEIR WEB SITE'S HOME PAGE. SUPPLEMENTAL INFORMATION 4 REPORTING GROUP A PART V, SECTION B, LINE 6B: OKLAHOMA CITY-COUNTY HEALTH DEPARTMENT SUPPLEMENTAL INFORMATION 5 REPORTING GROUP A PART V, SECTION B, LINE 7D: THE CHNA IS WIDELY AVAILABLE TO THE COMMUNITY. THE PLANS WERE ALSO ADDED TO EACH FACILITY'S WEBSITE AND CLEARLY TITLED. THE PLANS WERE ALSO DISTRIBUTED TO ADMINISTRATION, LOCAL BOARDS, AT COMMUNITY FORUMS, COALITIONS, OTHER LOCAL AGENCIES AND ORGANIZATIONS. COPIES OF THE PLAN WERE PLACED IN EACH FACILITY'S ADMINISTRATION OFFICES FOR DISTRIBUTION AS WELL. SUPPLEMENTAL INFORMATION 6 REPORTING GROUP A PART V, SECTION B, LINE 11: THE CHNA PROCESS ASSISTED IN DETERMINING AVAILABLE RESOURCES, GAPS IN SERVICES, AND BOTH PERCEIVED AND ACTUAL NEEDS WITHIN THE INTEGRIS SERVICE AREAS. MANY OF THE NEEDS IDENTIFIED WERE COMMON WITHIN THE VARIOUS SERVICE AREAS, INCLUDING ACCESS TO CARE, TOBACCO USE, OBESITY, MENTAL HEALTH AND SUBSTANCE ABUSE. OTHERS, HOWEVER, SUCH AS CHILD ABUSE AND TEEN PREGNANCY, WERE NOT AS PREDOMINANT. THE NEEDS IDENTIFIED BY THE CHNA WERE INITIALLY PRIORITIZED THROUGH COLLABORATION WITH THE LOCAL COMMUNITY COALITIONS. THESE LOCAL PRIORITIZED NEEDS WERE THEN REEXAMINED BY INTEGRIS TO DETERMINE WHICH NEEDS COULD MOST EFFECTIVELY BE IMPACTED BY INTEGRIS THROUGH ADMINISTRATION OF THE DEVELOPED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND WHICH, IF ANY OF THE REMAINING, WERE CURRENTLY BEING ADDRESSED THROUGH OTHER COMMUNITY RESOURCES AND/OR SERVICES. INTEGRIS OPTED TO CONCENTRATE ON FOUR FOCUS AREAS FOR THE CHIPS IN EACH OF THE SERVICE AREAS-OBESITY, MENTAL HEALTH, ACCESS TO CARE/FOOD INSECURITY, AND TOBACCO-BELIEVING THAT A UNITED EFFORT WOULD ALLOW FOR A SHARING OF RESOURCES, PERSONNEL, PROGRAMS, ETC. AND ENSURE CONSISTENCY IN IMPLEMENTATION AND EVALUATION METHODS, THEREBY INCREASING THE POTENTIAL TO MORE EFFECTIVELY COMBAT THE ISSUES SYSTEM-WIDE. OTHER COMMONLY IDENTIFIED NEEDS SUCH AS DIABETES, HEART DISEASE, AND SUBSTANCE ABUSE THAT ARE ASSOCIATED RISK FACTORS FOR THE PRIMARY FOCUS AREAS ARE ADDRESSED IN ONE OR MORE OF THOSE RESPECTIVE SECTIONS OF THE CHIP. IT WAS DETERMINED THAT THE REMAINING NEEDS THAT WERE HIGHLY PRIORITIZED WITHIN CERTAIN SERVICE AREAS WERE PREVIOUSLY IDENTIFIED AND ALREADY BEING ADDRESSED THROUGH LOCAL AGENCY AND/OR COALITION AND PARTNERSHIP EFFORTS WITHIN THE COMMUNITIES. AS SUCH, INTEGRIS COMMITTED TO PROVIDE SUPPORT AND RESOURCES TO THE COMMUNITY PARTNERS TAKING THE LEAD ON THOSE PARTICULAR ISSUES. SUPPLEMENTAL INFORMATION 7 REPORTING GROUP A PART V, SECTION B, LINE 7A AND LINE 10A: HTTPS://INTEGRISOK.COM/ABOUT-INTEGRIS/SERVING-OUR-COMMUNITY/REPORTS SUPPLEMENTAL INFORMATION 8 REPORTING GROUP A PART V, SECTION B, LINES 16A, 16B, AND 16C: INTEGRISOK.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE REPORTING GROUP B PART V, SECTION B, LINES 16A, 16B, AND 16C: THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY FOR OCOM, AND TRANSLATIONS OF THESE DOCUMENTS INTO LANGUAGES OF LIMITED ENGLISH PROFICIENT POPULATIONS, CAN BE FOUND ON THE FOLLOWING WEBSITE: HTTPS://OCOMHOSPITAL.COM/FINANCIAL-ASSISTANCE-POLICY-2/ REPORTING GROUP C PART V, SECTION B, LINES 16A, 16B, AND 16C: HTTPS://COMMUNITYHOSPITALOKC.COM/PATIENTS/ACCOUNT-ASSISTANCE REPORTING GROUP B PART V, SECTION B, LINE 20D EXPLANATION IF ORGANIZATION DID NOT MAKE PRESUMPTIVE ELIGIBILITY DETERMINATIONS: OCOM DID NOT MAKE ANY PRESUMPTIVE ELIGIBILITY DETERMINATIONS DURING THE TAX YEAR. ALL PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION AND A PLAIN LANGUAGE SUMMARY AT ADMISSION OR UPON REQUEST. ALL PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE DURING THE APPLICATION PERIOD, WHICH ENDS ON THE 240TH DAY AFTER OCOM MAILS OR ELECTRONICALLY PROVIDES THE INDIVIDUAL WITH THE FIRST BILLING STATEMENT. ONCE AN APPLICATION IS RECEIVED IT IS GIVEN TO THE COLLECTIONS MANAGER TO REVIEW FOR PRE-APPROVAL PER FPL GUIDELINES. IF PRE-APPROVED, AN ADJUSTMENT REQUEST IS THEN GIVEN TO THE BUSINESS OFFICE MANAGER TO REVIEW FOR FIRST LEVEL APPROVAL. IF APPROVED FIRST LEVEL, THE FINANCIAL ASSISTANCE APPLICATION AND ADJUSTMENT REQUEST ARE SENT TO THE CFO OR CEO FOR FINAL APPROVAL. THE PATIENT IS THEN NOTIFIED VIA CALL AND/OR LETTER THAT HIS OR HER APPLICATION HAS BEEN APPROVED. PART V, SECTION B, LINE 21 DETAILS REGARDING WRITTEN POLICY RELATING TO HOSPITAL FACILITY'S EMERGENCY MEDICAL CARE REQUIRING THE HOSPITAL FACILITY TO PROVIDE EMERGENCY MEDICAL CARE TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY: OCOM HAS NOT ENGAGED IN ACTONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS DEMANDING THAT EMERGENCY DEPARTMENT PATIENTS PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR ENGAGING IN DEBT COLLECTION ACTIVITIES THAT INTERFERE WITH THE NON-DISCRIMINATORY PROVISION OF EMERGENCY MEDICAL CARE, CONSISTENT WITH 501(R) REQUIREMENTS. ON APRIL 29, 2021, OCOM'S BOARD OF DIRECTORS AMENDED ITS EMTALA POLICY TO RELFECT THIS PRACTICE AND INCLUDE THE FOLLOWING LANGUAGE: OCOM PROVIDES, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. HOSPITAL PERSONNEL ARE PROHIBITED FROM ENGAGING IN ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS DEMANDING THAT EMERGENCY DEPARTMENT PATIENTS PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR ENGAGING IN DEBT COLLECTION ACTIVITIES THAT INTERFERE WITH THE NON-DISCRIMINATORY PROVISION OF EMERGENCY MEDICAL CARE. REPORTING GROUP C PART V, SECTION B, LINES 16 AND 23: SEE PART VI FOR 501(R) REPORTING OF ERRORS AND CORRECTIONS 2 SOUTHWEST AMBULATORY SURGERY CENTER LLC 8125 SOUTH WALKER OKLAHOMA CITY OK 73139 AMBULATORY SURGERY CENTER MEDICAL PLAZA IMAGING CENTER 3330 NW 56TH OKLAHOMA CITY OK 73112 RADIOLOGY IMAGING CENTER SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART VI: INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IACC FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED BELOW. IACC DOES NOT HAVE A DIRECTLY OWNED HOSPITAL FACILITY, BUT OWNS A MINORITY INTEREST IN FOUR HOSPITAL FACILITIES, OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY (OCOM), THROUGH ITS INVESTMENT IN SOUTHWEST AMBULATORY SURGERY CENTER, LLC, COMMUNITY HOSPITAL AND TPG HOSPITAL (D/B/A NW SURGICAL HOSPITAL (HPI FACILITIES), THROUGH ITS INVESTMENT IN HPI AND LAKESIDE WOMEN'S HOSPITAL, LLC (LWH). THE ACTIVITY REPORTED ON SCHEDULE H, PARTS I-III INCLUDES THE ACTIVITY OF OCOM, HPI FACILITIES & LWH AS WELL AS THE THE DIRECT ACTIVITY OF IACC AND IACC'S PROPORTIONATE SHARE OF THE ACTIVITY OF THE NON-HOSPITAL JOINT VENTURES LISTED ON SCHEDULE H, PART V, SECTION D. SUPPLEMENTAL INFORMATION 2 REPORTING GROUP A PART I, LINE 6A: INTEGRIS HEALTH, INC., (EIN: 73-1192764), THE PARENT ORGANIZATION OF INTEGRIS AMBULATORY CARE CORPORATION, PRODUCES A CONSOLIDATED COMMUNITY BENEFIT REPORT THAT IS MADE AVAILABLE TO THE PUBLIC. BENEFIT REPORT THAT IS MADE AVAILABLE TO THE PUBLIC. BENEFIT REPORT THAT IS MADE AVAILABLE TO THE PUBLIC. SUPPLEMENTAL INFORMATION 3 REPORTING GROUP A PART I, LINE 7: COSTING METHODOLOGY: THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON PART 1, LINE 7. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. REPORTING GROUP B PART I, LINE 7: OCOM'S TOTAL EXPENSE INCLUDED IN PART IX, LINE 25, COLUMN (A) OF FORM 990 WAS $259,879,676. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $2,105,663. THIS LEFT A TOTAL EXPENSE OF $257,774,013 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SUPPLEMENTAL INFORMATION 4 REPORTING GROUP A PART II: COMMUNITY BUILDING ACTIVITIES COMMUNITY-BUILDING ACTIVITIES IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSE OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS. 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 HEALTH CARE ORGANIZATION. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS AND EXPENSES FOR THE DEVELOPMENT OF A VARIETY OF COMMUNITY-BUILDING PROGRAMS AND PARTNERSHIPS. SUPPLEMENTAL INFORMATION 5 REPORTING GROUP A PART III, LINES 2, 3 AND 4: The amount of bad debt expense on line 2 was estimated as a result of the following processes: Net patient service revenue is reported at the amount that reflects the consideration to which INTEGRIS Health expects to be entitled in exchange for providing patient care. Healthcare services promised in the contract with a patient represent a bundle of goods and (or) services that is distinct and accounted for as a single performance obligation. The transaction price for the bundled goods and (or) services provided is estimated by reducing the total standard charges by variable price concessions, including contractual adjustments based on the terms provided by (in the case of Medicare and Medicaid) or negotiated with (in the case of managed care and commercial insurance companies) third-party payors, INTEGRIS Health discount policies, and other implicit price concessions based on historical collections experience for uninsured and under-insured patients who do not qualify for financial assistance. A portfolio approach by major payor categories and types of service was used to estimate the historical collections experience. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenue in the period of the change. Portfolio collection estimates are updated at least quarterly based on actual collections experience. INTEGRIS Health believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach was used. Subsequent changes that are determined to be the result of an adverse change in the patient s ability to pay are assessed first for eligibility for charity care or recorded as bad debt expense. Patient accounts are monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. Accounts are written off when all reasonable internal and external collection efforts have been performed. In accordance with its purpose and values, INTEGRIS Health is committed to providing high-quality, cost-effective health services to the community, including such underserved groups as the indigent and the elderly. Self-pay revenues are derived primarily from patients who do not have any form of health coverage. The revenues associated with self-pay patients are generally reported at INTEGRIS Health's gross charges. INTEGRIS Health evaluates these patients, after the patient's medical condition is determined to be stable, for their ability to pay based upon federal and state poverty guidelines, or qualifications for Medicaid or other governmental assistance programs, as well as INTEGRIS Health's policy for charity care. During fiscal year 2020, new software was engaged to accomplish a more thorough evaluation of presumptive eligibility for charity. This new capability of assessing presumptive charity was applied to all outstanding balances. Accounts that were previously reserved as contractual allowances were determined to be eligible for charity care treatment and that amount is reflected in the fiscal year 2020 costs. As such, integris does not believe any portion of the amount on line 2 is reasonably attributable to patients who qualify for financial assistance. THE BAD DEBT FOOTNOTE IS ON PAGES 10-11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. REPORTING GROUP B: PART III, lINE 2: THE METHODOLOGY USED TO CALCULATE THE ORGANIZATION'S BAD DEBT EXPENSE IS AS FOLLOWS: -75% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE AGED 120 DAYS OR GREATER (EXCLUDING LEGAL LIABILITY), PLUS 25% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE IN THE 90 DAY BUCKET. WE RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. -AN ADDITIONAL RESERVE IS APPLIED ON TOP OF THE RESERVE ABOVE FOR SELF-PAY PATIENTS BASED ON HISTORICAL PAYMENT TRENDS. REPORTING GROUP B PART III, LINE 3: METHODOLOGY USED BY THE ORGANIZATION TO ESTIMATE THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FAP OCOM CLASSIFIES FINANCIAL ASSISTANCE AS A CONTRACTUAL WRITE OFF AND NOT AS BAD DEBT, AND DOES NOT ATTRIBUTE ANY PORTION OF ITS BAD DEBT REPORTED ON PART III, LINE 2 TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS CHARITY POLICY. REPORTING GROUP B PART III, LINE 4: FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE OCOM DOES NOT HAVE A STAND-ALONE AUDIT AND IS INCLUDED IN THE CONSOLIDATED FINANCIALS OF INTEGRIS AMBULATORY CARE CORP, WHICH DOES NOT SPECIFICALLY ADDRESS BAD DEBT. OCOM ACCOUNTS FOR BAD DEBT EXPENSE AS FOLLOWS: -75% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE AGED 120 DAYS OR GREATER (EXCLUDING LEGAL LIABILITY), PLUS 25% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE IN THE 90 DAY BUCKET. WE RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. DAYS OR GREATER (EXCLUDING LEGAL LIABILITY), PLUS 25% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE IN THE 90 DAY BUCKET. WE RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE IN THE 90 DAY BUCKET. WE RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS. SUPPLEMENTAL INFORMATION 6 REPORTING GROUP A PART III, LINE 8: THE AMOUNTS REPORTED ON PART III, LINES 5 AND 6 REPRESENT INTEGRIS AMBULATORY CARE CORPORATION'S (IACC) PROPORTIONATE SHARE OF THE ALLOWABLE COSTS AND MEDICARE REIMBURSMENTS THAT ARE REPORTED ON OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY'S (OCOM) MEDICARE COST REPORT & LAKESIDE WOMEN'S HOSPITAL LLC (LWH) MEDICARE COST REPORT. COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO AND THE MEDICARE FILED COST REPORT. REPORTING GROUP B PART III, LINE 8: THE COST TO CHARGE METHODOLOGY WAS USED IN ORDER TO CALCULATE THE MEDICARE ALLOWABLE COSTS RELATED TO PAYMENTS RECEIVED FROM MEDICARE. ANY RESULTING SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. SUPPLEMENTAL INFORMATION 7 REPORTING GROUP A PART III, LINE 9B: PATIENTS MAY, AT ANY TIME DURING THE COLLECTION CYCLE, SUBMIT FINANCIAL INFORMATION FOR FINANCIAL ASSISTANCE OR CHARITY CONSIDERATION PURSUANT TO INTEGRIS POLICY SYS-RCM-100 CHARITY SERVICES. ALL AVAILABLE AVENUES OF ASSISTANCE AND AVAILABLE PAYMENTS FROM THIRD PARTY PAYORS MUST BE EXHAUSTED BEFORE SUCH ASSISTANCE FOR CHARITY OR OTHER FINANCIAL ASSISTANCE IS CONSIDERED. IACC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. SUPPLEMENTAL INFORMATION 8 REPORTING GROUP A PART VI, LINE 2: NEEDS ASSESSMENT INTEGRIS HEALTH UTILIZES A VARIETY OF TOOLS TO DETERMINE THE HEALTH CARE NEEDS OF OUR COMMUNITIES. THESE INCLUDE PARTNERSHIPS WITH LOCAL COMMUNITY AGENCIES AND ORGANIZATIONS TO DETERMINE SPECIFIC TARGET MARKET NEEDS, PROGRAM SURVEYS AND COMMUNITY FOCUS GROUPS, PROGRAM EVALUATIONS FROM PARTICIPANTS IN OUR COMMUNITY HEALTH SCREENINGS, HEALTH EDUCATION AND SUPPORT GROUPS, THE COUNTY HEALTH RANKINGS REPORT AND THE OKLAHOMA STATE HEALTH DEPARTMENT'S "STATE OF THE STATE HEALTH REPORT." AFTER REVIEWING THESE MATERIALS FOR ISSUES CONCERNING ACCESS TO CARE, HEALTH EDUCATION NEEDS AND GAPS IN SERVICES IN OUR COMMUNITIES, INTEGRIS HEALTH DETERMINES HOW TO ADDRESS THESE ISSUES BY DEVELOPING PROGRAMS/SERVICES TO IMPLEMENT, INCLUDING, BUT NOT LIMITED TO, HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION AND WELLNESS PROGRAMS, SUPPORT GROUPS, AND ACCESS TO HEALTH CARE FACILITIES. INTEGRIS HEALTH UTILIZES OUR HEALTH SYSTEM RESOURCES, FACILITIES AND PERSONNEL FOR MANY OF THESE PROGRAMS, BUT ALSO PARTNERS WITH OUR COMMUNITIES AND DEVELOPS COLLABORATIONS WITH LOCAL NON-PROFIT AGENCIES, CIVIC ORGANIZATIONS, SCHOOLS, AND CHURCHES TO IMPROVE THE ISSUES IDENTIFIED. REPORTING GROUP B PART VI, LINE 2: NEEDS ASSESSMENT OCOM WAS RESTRUCTURED EFFECTIVE NOVEMBER 1, 2018 WHEN A NEW JOINT VENTURE WAS FORMED BETWEEN INTEGRIS AMBULATORY CARE CORPORATION (INTEGRIS), AN OKLAHOMA NOT FOR PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3), AND USP OKLAHOMA, INC. (USP OK), AN OKLAHOMA FOR PROFIT CORPORATION THAT IS AN AFFILIATE OF UNITED SURGICAL PARTNERS. WHEN THE NEW JOINT VENTURE WAS FORMED WITH INTEGRIS, OCOM BECAME SUBJECT TO THE 501(R) PROVISIONS. AS SUCH, A COMMUNITY HEALTH NEEDS ASSESSMENT FOR OCOM IS IN THE PROCESS OF BEING COMPLETED WITH PLANS FOR ITS APPROVAL AND ADOPTION ON OR BEFORE ITS DUE DATE OF JUNE 30, 2021. ADDITIONALLY, THE RELATED IMPLEMENTATION STRATEGY WILL BE APPROVED AND ADOPTED BEFORE ITS DUE DATE OF NOVEMBER 15, 2021. REPORTING GROUP C PART VI, LINE 2: NEEDS ASSESSMENT HEALTH VENTURES IS A PARTNERSHIP FORMED IN FY2019 BETWEEN IACC, AN OKLAHOMA NOT FOR PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3) AND USP OKLAHOMA, INC. (USP), AN UNRELATED OKLAHOMA FOR PROFIT CORPORATION FOR THE PURPOSE OF ACQUIRING OWNERSHIP IN OR DEVELOPLING FREESTANDING AMBULATORY SURGERY HOSPITALS. ON NOVEMBER 1, 2018, HEALTH VENTURES ACQUIRED 51% OF HPI HOLDINGS, LLC (HPI). HPI OWNS A 100% INTEREST IN COMMUNITY HOSPITAL, LLC AND TPG HOSPITAL, LLC. THIS JOINT VENTURE OPERATED THE COMMUNITY HOSPITAL AND TPG HOSPITAL FACILITIES DURING THE TAX YEAR. THE JOINT VENTURE IS A PARTNERSHIP FOR WHICH A FORM 1065 IS FILED. HOWEVER, WHEN HPI WAS ACQUIRED BY HEALTH VENTURES, COMMUNITY HOSPITAL AND TPG HOSPITAL BECAME SUBJECT TO THE 501(R) PROVISIONS. SUPPLEMENTAL INFORMATION 9 REPORTING GROUP A PART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCE INTEGRIS HEALTH USES A MULTI-FACETED APPROACH TO EDUCATE OUR PATIENTS ON THE AVAILABILITY OF CHARITY AS WELL AS STATE AND FEDERAL FINANCIAL ASSISTANCE. THIS INCLUDES: *POSTERS CLEARLY DISPLAYED IN EVERY PATIENT REGISTRATION AREA SPEAKING TO OUR FINANCIAL ASSISTANCE PROGRAMS. *A FINANCIAL RIGHTS AND RESPONSIBILITY BROCHURE GIVEN TO EVERY PATIENT AT THE TIME OF THEIR REGISTRATION WHICH PROVIDES FINANCIAL ASSISTANCE PROGRAM DETAILS. *A CLEARLY MARKED PRESENCE ON THE INTEGRIS HEALTH ON-LINE BUSINESS OFFICE WEBSITE WITH A SECTION DEVOTED TO FINANCIAL ASSISTANCE PROGRAM DETAILS AS WELL AS AN ON-LINE CHARITY APPLICATION. *A DESCRIPTION OF THE FINANCIAL ASSISTANCE PROGRAM AS WELL AS THE APPLICATION PROCESS IS INCLUDED ON EVERY PATIENT BILL. FINANCIAL COUNSELORS MEET WITH PATIENTS TO IDENTIFY ELIGIBILITY FOR FEDERAL AND STATE ASSISTANCE PROGRAMS. REPORTING GROUP B PART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCE OCOM PATIENTS WERE INFORMED AND EDUCATED OVER THE PHONE OR IN PERSON PRIOR TO MEDICAL SERVICES BEING PROVIDED ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE. IF A PATIENT DECIDED TO APPLY FOR FINANCIAL ASSISTANCE AFTER THE MEDICAL SERVICES WERE PROVIDED, PATIENTS WERE FURTHER EDUCATED OVER THE PHONE OR IN PERSON ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY APPLICATION INSRUCTIONS WERE ALSO MADE AVAILABLE ONLINE WITH THE ABILITY TO BE PRINTED DIRECTLY FROM THE OCOM WEBSITE, WITHOUT CHARGE. PATIENTS COULD ALSO REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY APPLICATION INSTRUCTIONS FROM OCOM'S WEBSITE OR BY MAIL BY CALLING THE OCOM BUSINESS OFFICE. REPORTING GROUP C PART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCE HPI FACILITY PATIENTS WERE INFORMED AND EDUCATED ONLINE, BY TELEPHONE, BY MAIL, ON POSTED SIGNS AND PAPER COPIES OR BROCHURES LOCATED IN ALL REGISTRATION AREAS THROUGHOUT THE FACILITIES, IN PERSON, AND IN BILLING STATEMENTS ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE.EGISTRATION STAFF REFERS PATIENTS TO WEBSITE AND TO THE BILLING DEPARTMENT AS NEEDED OR REQUESTED. THEY PRINT OFF CHARITY APPLICATIONS AND ASSISTS PATIENTS IN COMPLETING. IF TRANSLATION IS NEEDED TO HELP COMPLETE FORMS A CALL IS MADE INTO THE LANGUAGE LINE FOR ASSISTANCE. IF FINANCIAL NEED IS DETERMINED WHEN PATIENT IS IN PERSON AT FACILITY, EXAMPLE LACK OF INSURANCE OR UNABLE TO PAY, PATIENT IS ASSISTED WITH APPLICATION AND/OR REFERRED TO BILLING TO ASSIST. SCHEDULING, FINANCIAL COUNSELOR, REGISTRATION, AND AUTHORIZATION DEPARTMENT, REFER PATIENTS IN NEED OF ASSISTANCE TO WEBSITE AND TO BILLING AS NEEDED. SUPPLEMENTAL INFORMATION 10 REPORTING GROUP A PART VI, LINE 4: COMMUNITY INFORMATION INTEGRIS HEALTH SYSTEM IS THE STATE'S LARGEST OKLAHOMA-OWNED HEALTH CARE SYSTEM AND ONE OF THE STATE'S LARGEST PRIVATE EMPLOYERS, WITH HOSPITALS, REHABILITATION CENTERS, PHYSICIAN'S CLINICS, MENTAL HEALTH FACILITIES, CANCER CENTERS, INDEPENDENT LIVING CENTERS, AND HOME HEALTH AGENCIES THROUGHOUT MOST OF THE STATE. ALL COUNTIES IN WHICH INTEGRIS HEALTH OPERATES INCLUDE ONE OR MORE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS. INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS LOCATED IN OKLAHOMA CITY, WHICH IS IN OKLAHOMA COUNTY IN CENTRAL OKLAHOMA. REPORTING GROUP B PART VI, LINE 4: COMMUNITY INFORMATION OCOM IS LOCATED IN SOUTH OKLAHOMA CITY WITH AN HOPD LOCATION (OCOM NORTH) IN NORTHWEST OKLAHOMA CITY AND THREE FREESTANDING IMAGING FACILITIES TO SERVICE OKLAHOMA CITY, IN OKLAHOMA COUNTY, OKLAHOMA. OKLAHOMA CITY IS THE COUNTY SEAT AND THE LARGEST CITY IN THE STATE. THERE ARE 20 CITIES AND SMALL TOWNS LOCATED IN THE COUNTY. THE ECONOMY SPECIALIZES IN OIL, GAS, QUARRYING, EXTRACTION, MANAGEMENT OF COMPANIES AND ENTERPRISES, AND PUBLIC ADMINISTRATION. ACCORDING TO THE 2016 POPULATION ESTIMATES, THE POPULATION OF OKLAHOMA COUNTY WAS 770,101. AS OF 2016, THE MEDIAN AGE FOR OKLAHOMA COUNTY IS 34.3 YEARS WHILE THE MEDIAN AGE FOR THE STATE OF OKLAHOMA IS 36.2 YEARS. OVER 16.0% OF THE PEOPLE IN OKLAHOMA COUNTY LIVED BELOW THE POVERTY LEVEL AND WERE NOT ALWAYS ABLE TO MEET THEIR BASIC NEEDS LIKE AFFORDABLE HOUSING, HEALTH CARE, HEALTHY FOOD, TRANSPORTATION, AND SOCIAL SERVICES (2016). IN 2016, THE OKLAHOMA MEDICAL HOUSEHOLD INCOME WAS $48,987 COMPARED TO $48,038 FOR THE STATE OF OKLAHOMA. THE MAJORITY OF RESIDENTS IN OKLAHOMA COUNTY IDENTIFY AS WHITE-NON-HISPANIC. THE NEXT LARGEST RACES/ETHNICITIES IN OKLAHOMA COUNTY ARE THE AFRICAN AMERICAN AND AMERICAN INDIAN/ALASKAN NATIVE POPULATIONS AT 16% AND 7% RESPECTIVELY (U.S. CENSUS BUREAU 2012-016, AMERICAN COMMUNITY SURVEY, 5-YEAR ESTIMATES). AVERAGE LIFE EXPECTANCY VARIES WIDELY THROUGHOUT OKLAHOMA COUNTY. IN THE 73131 ZIP CODE, CITIZENS HAVE AN OVERALL LIFE EXPECTANCY OF ALMOST 83 YEARS. FURTHER SOUTH IN THE 73145 ZIP CODE, RESIDENTS HAVE AN OVERALL LIFE EXPECTANCY OF 64 YEARS. DURING 2012-2016, THE PERCENT OF STUDENTS RECEIVING THEIR HIGH SCHOOL DIPLOMA IN OKLAHOMA COUNTY WAS 86.4% WHICH WAS SLIGHTLY LOWER THAT THE STATE AT 87.3%. HOWEVER, OKLAHOMA COUNTY HAD A HIGHER PERCENTAGE OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE (30.8%) THAN THE STATE (24.5%) DURING THIS SAME PERIOD. DURING 2012-2016, 15.8% OF PERSONS UNDER THE AGE OF 65 IN OKLAHOMA COUNTY WERE WITHOUT HEALTH INSURANCE, WHICH WAS SLIGHTLY LOWER THAN THE STATE AT 16.1%. IN 2016, 9.5% OF PERSONS UNDER THE AGE OF 18 IN OKLAHOMA COUNTY WERE WITHOUT HEALTH INSURANCE, COMPARED TO 8% OF PERSONS IN THE STATE OF OKLAHOMA WHO WERE WITHOUT HEALTH INSURANCE. ACCORDING TO THE OKLAHOMA HEALTH CARE AUTHORITY, 795,577 OF PERSONS IN THE STATE OF OKLAHOMA WERE ENROLLED IN MEDICAID OF WHICH 166,505 OF THOSE ENROLLED WERE IN OKLAHOMA COUNTY, (2018). MEDICARE ENROLLMENT IN THE STATE OF OKLAHOMA IN 2018 WAS APPROXIMATELY 578,271, ACCORDING TO THE CENTER FOR MEDICARE AND MEDICAID SERVICES, OF WHICH 124,591 ENROLLED WERE IN OKLAHOMA COUNTY. OCOM SOUTH IS LOCATED IN SOUTH OKLAHOMA CITY, NEAR INTEGRIS SOUTHWEST AND PROVIDES CARE TO THE CITIZENS OF SOUTH OKLAHOMA CITY AND SURROUNDING AREAS. OCOM SOUTH RECEIVED A CERTIFICATE OF DISTINCTION FROM THE JOINT COMMISSION IN APRIL 2019 FOR OUR TOTAL JOINT REPLACEMENT FOR BOTH HIPS AND KNEES. SUPPLEMENTAL INFORMATION 11 REPORTING GROUP A PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH EVIDENCE OF THE ORGANIZATIONS' RESPONSIVENESS TO THE COMMUNITY, INCLUDING OPPORTUNITIES FOR COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS. IACC'S BOARD OF DIRECTORS IS APPOINTED BY INTEGRIS HEALTH, INC. INTEGRIS HEALTH, INC. IS GOVERNED BY A BOARD OF DIRECTORS SPECIFICALLY MADE UP OF MEN AND WOMEN WHO LIVE AND WORK IN THE COMMUNITY INCLUDING: LOCAL BUSINESS OWNERS, CIVIC LEADERS, COMMUNITY VOLUNTEERS, REPRESENTATIVES WORKING IN HIGHER EDUCATION, UTILITY COMPANIES, AND A VARIETY OF NON-PROFIT ORGANIZATIONS. PATIENT AND COMMUNITY ADVISORY GROUPS HAVE ALSO BEEN ESTABLISHED AT SEVERAL INTEGRIS FACILITIES ACROSS THE STATE. THESE GROUPS GIVE HOSPITAL LEADERS INPUT, SUGGESTIONS, AND FEEDBACK ON WAYS TO IMPROVE PROGRAMS, SERVICES, COMMUNITY NEEDS, AND PROCESS IMPROVEMENT IN CLINICAL AREAS. PROGRAMS ESTABLISHED TO MEET COMMUNITY NEEDS INCLUDE A FALLS PREVENTION PROGRAM FOR SENIOR CITIZENS, COMMUNITY HEALTH SCREENINGS AND PHYSICIAN LECTURES REQUESTED BY LOCAL SCHOOLS, CHURCHES, CIVIC GROUPS, AND COMMUNITY LEADERS TO ADDRESS SPECIFIC HEALTH ISSUES WHICH INCLUDE: DIABETES, CANCER DIAGNOSIS AND TREATMENT OPTIONS, OBESITY AND PHYSICAL FITNESS PROGRAMS, MEN'S UROLOGICAL HEALTH PROGRAMS AND PROSTATE SCREENINGS, CANCER SCREENINGS, SPANISH DIABETES SUPPORT GROUP, AFRICAN AMERICAN MEN AND WOMEN'S HEART HEALTH, AND STROKE LECTURES. ADVOCACY INITIATIVES FOR PROMOTING COMMUNITY-WIDE, STATE OR NATIONAL EFFORTS TO IMPROVE HEALTH OF THE POPULATION AND INCREASE ACCESS. INTEGRIS HEALTH PARTNERS WITH THE OKLAHOMA LIONS CLUB MOBILE HEALTH UNIT, THE OKLAHOMA STATE HEALTH DEPARTMENT, AND THE OKLAHOMA TURNING POINT PROGRAM TO INCREASE HEALTH SCREENING OPPORTUNITIES AND HEALTH ACCESS FOR PEOPLE LIVING IN RURAL, UNDERSERVED AREAS OF OKLAHOMA. THE PARTNERSHIP INCLUDES DONATION OF RESOURCES AND MONEY TO SPONSOR THE OPERATION OF THE LIONS MOBILE HEALTH UNIT WHICH TRAVELS AROUND THE STATE OFFERING FREE HEALTH SCREENINGS AND MEDICAL INFORMATION. THE OKLAHOMA STATE HEALTH DEPARTMENT AND THE OKLAHOMA TURNING POINT PROGRAM ASSIST WITH HEALTH SCREENINGS AND HELP WITH REFERRALS TO MEDICAL HOMES AND CLINICS FOR PEOPLE WITHOUT A PHYSICIAN AND FOR THOSE UNINSURED OR UNDERINSURED. INTEGRIS HEALTH PARTNERS WITH THE OKLAHOMA TURNING POINT PROGRAM, LOCAL CIVIC GROUPS, SUCH AS OUR CHAMBERS OF COMMERCE, ROTARY, AND KIWANIS CLUBS, TECHNOLOGY SCHOOLS, COMMUNITY COLLEGES, CHURCHES, AND LOCAL SCHOOLS IN A VARIETY OF EVENTS AND PROGRAMS TO EDUCATE THE COMMUNITY ON HEALTH/WELLNESS ISSUES, CREATE OPPORTUNITIES FOR HEALTH ACCESS, PROVIDE COMMUNITY SCREENINGS IN UNDERSERVED AREAS OF OKLAHOMA, AND TO GIVE STUDENTS AND COMMUNITY MEMBERS THE OPPORTUNITY TO VOLUNTEER FOR THESE EVENTS. THIS INCLUDES MEDICAL STUDENTS WHO WORK WITH INTEGRIS ACROSS THE STATE AT OUR EVENTS TO LEARN MORE ABOUT PROVIDING HEALTH SERVICES TO THE COMMUNITY AND TO HELP TRAIN THEM FOR FUTURE WORK IN THE HEALTHCARE ARENA. THE HOSPITAL'S ROLE IN WORKING WITH OTHERS TO IDENTIFY COMMUNITY NEEDS AND ADDRESS COMMUNITY PROBLEMS. INTEGRIS HEALTH WORKS WITH THE OKLAHOMA HOSPITAL ASSOCIATION, THE OKLAHOMA STATE MEDICAL ASSOCIATION, THE ALLIANCE FOR THE UNINSURED, THE OKLAHOMA STATE HEALTH DEPARTMENT, THE OKLAHOMA MENTAL HEALTH ASSOCIATION, AND LOCAL NON-PROFIT ORGANIZATIONS SUCH AS THE OKLAHOMA CHAPTERS OF AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER SOCIETY, AND OTHER LOCAL HEALTH AND WELLNESS ORGANIZATIONS AND AGENCIES TO DETERMINE HEALTH CARE NEEDS IN THE STATE, ISSUES CONCERNING SPECIFIC CITIES, ACCESS TO HEALTH ISSUES, NEIGHBORHOOD AND ENVIRONMENT ISSUES, AND OTHER SOCIAL DETERMINANTS OF HEALTH THAT AFFECT THE LIVES OF OUR RESIDENTS. A VARIETY OF COALITIONS, TASK FORCES, AND COMMITTEES HAVE BEEN STARTED TO ADDRESS SPECIFIC HEALTH AND WELLNESS ISSUES AND TO DETERMINE INTERVENTIONAL STRATEGIES FOR IMPLEMENTATION. THE IMPACT PROGRAMS ARE HAVING ON COMMUNITY HEALTH, ESPECIALLY PREVENTION ACTIVITIES, EFFORTS TO IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES, AND REDUCING HEALTH CARE COSTS. INTEGRIS COMMUNITY HEALTH PROGRAMS ACROSS THE STATE ARE IMPLEMENTED TO EDUCATE OUR RESIDENTS ABOUT HEALTH AND WELLNESS ISSUES AFFECTING THEM AND THEIR COMMUNITIES. WORKING WITH PARTNER AGENCIES AND ORGANIZATIONS IN THE COMMUNITIES WE SERVE GIVES US THE OPPORTUNITY TO CREATE PROGRAMS THAT SPECIFICALLY ADDRESS NEGATIVE HEALTH INDICATORS AFFECTING THE COMMUNITY. PREVENTION AND HEALTH EDUCATION HAVE BEEN THE PRIORITY FOR INTEGRIS FOR MANY YEARS IN AN EFFORT TO BETTER EDUCATE THE PUBLIC ON TAKING CARE OF THEIR HEALTH AND CREATING AWARENESS ABOUT HOW THEIR BEHAVIORS MAY NEGATIVELY AFFECT THEIR HEALTH AND THE HEALTH OF THEIR FAMILIES. WORKING WITH PARTNER AGENCIES, ORGANIZATIONS, PHYSICIANS, AND LOCAL CLINICS, INTEGRIS HAS BEEN ABLE TO HELP SLOWLY IMPROVE HEALTH IN SOME INDICATORS, SUCH AS CHILDHOOD IMMUNIZATIONS, ADULT IMMUNIZATIONS, AND SMALL STEP TOWARD IMPROVING CHILDHOOD OBESITY WITH SEVERAL PROGRAMS IMPLEMENTED IN THE METROPOLITAN AREAS, INCREASING ACCESS BY DEVELOPING REFERRAL NETWORKS BETWEEN FREE CLINICS ACROSS OKLAHOMA CITY AND IN SOME RURAL AREAS. ALL OF THESE PROGRAMS AND PARTNERSHIPS, COUPLED WITH EDUCATING THE COMMUNITY ABOUT AVAILABLE SERVICES, CAN HELP US CONTINUE TO REDUCE SOME OF THE HEALTHCARE COSTS WE SEE IN OUR HOSPITALS, CLINICS, AND EMERGENCY DEPARTMENTS. REPORTING GROUP B PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH OCOM IS A MEMBER OF THE OHA, WHICH ADVOCATES FOR AFFORDABLE, HIGH-QUALITY CARE FOR THE STATE OF OK AND SUPPORTING RURAL HEALTH. OCOM CONTRACTS WITH RESEARCH INTERNATIONAL TO PERFORM IMAGING STUDIES FOR PATIENTS INVOLVED IN RESEARCH. OCOM PARTICIPATED IN THE HEALTHY OVER HUNGRY CEREAL DRIVE WHICH SUPPORTS THE REGIONAL FOOD BANK OF OKLAHOMA TO HELP SUPPORT OKLAHOMA'S MOST VULNERABLE AND HUNGRY, AND PARTICIPATES IN THE OKLAHOMA BLOOD INSTITUTE BLOOD DRIVE TWICE A YEAR. SUPPLEMENTAL INFORMATION 12 REPORTING GROUP A PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLES IACC IS A MEMBER OF INTEGRIS HEALTH SYSTEM, OF WHICH INTEGRIS HEALTH, INC. IS THE CONTROLLING MEMBER. INTEGRIS HEALTH SYSTEM IS AN OKLAHOMA HEALTH CARE SYSTEM WHICH SUPPORTS THE COMMUNITY NEEDS ACROSS THE STATE. THE MISSION OF INTEGRIS HEALTH IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. THE FACILITIES OF OTHER TAXPAYERS ARE LISTED ON THE SCHEDULE H OF THEIR RESPECTIVE FORMS 990. SEE SCHEDULE O, GENERAL STATEMENTS 3 THROUGH 5 FOR ADDITIONAL INFORMATION REGARDING THE INTEGRIS HEALTH SYSTEM. REPORTING GROUP B PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLES AS DESCRIBED ABOVE, OCOM WAS RESTRUCTURED EFFECTIVE NOVEMBER 1, 2018 WHEN A NEW JOINT VENTURE WAS FORMED BETWEEN INTEGRIS AND USP OK. WHEN THE NEW JOINT VENTURE WAS FORMED WITH INTEGRIS, OCOM BECAME SUBJECT TO THE 501(R) PROVISIONS. SUPPLEMENTAL INFORMATION 13 REPORTING GROUP A PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT ALL STATES WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: OK REPORTING GROUP B PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT OCOM WAS NOT REQUIRED TO FILE, AND DID NOT FILE, A COMMUNITY BENEFIT REPORT WITH THE STATE OF OKLAHOMA FOR THE FISCAL YEAR ENDED JUNE 30, 2020. REPORTING GROUP C PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT A COMMUNITY BENEFIT REPORT WAS NOT FILED WITH THE STATE OF OKLAHOMA FOR THE FISCAL YEAR ENDED JUNE 30, 2020. SUPPLEMENTAL INFORMATION 14 REPORTING GROUP C PART VI - REPORTING OF SECTION 501(R)-RELATED ERRORS AND CORRECTIONS: IN NOVEMBER 2018 THE HPI FACILITIES WERE ACQUIRED BY THE ORGANIZATION. DURING THE PREPARATION OF THE 2018 990 (SPRING OF 2020) IT WAS DISCOVERED THAT AGB HAD NOT BEEN INTENTIONALLY CALCULATED FROM THE DATE OF ACQUISITION. ON ITS 2018 SCH H, THE RESPONSE TO PART V, LINE 23 WAS ANSWERED 'YES', INDICATING IT HAD CHARGED FAP ELIGIBLE INDIVIDUALS IN EXCESS OF AGB FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE BECAUSE, AT THE TIME OF REPORTING, IT WAS UNKNOWN WHETHER AND TO WHAT EXTENT AN ERROR HAD OCCURRED. UPON DISCOVERY, STEPS WERE TAKEN TO DETERMINE WHETHER FAP INDIVIDUALS WERE CHARGED IN EXCESS OF AGB. THE AGB % WAS DETERMINED, USING THE LOOKBACK METHOD ON 7/17/2020. ALL CHARGES FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE WERE EVALUATED FOR THE TIME PERIOD WHEN AGB WAS NOT CALCULATED. BASED ON THIS EVALUATION OF PATIENT ACCOUNTS, NO FAP ELIGIBLE INDIVIDUAL WAS PERSONALLY RESPONSIBLE FOR AN AMOUNT IN EXCESS OF AGB. AS SUCH, THE FACILITIES RESPONSE TO SCH H, PART V, LINE 23 FOR THE 2018 TAX YEAR SHOULD HAVE BEEN 'NO', INDICATING A FAILURE DID NOT OCCUR. IN SPRING 2020, HPI BECAME AWARE THE FOLLOWING DOCUMENTS FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY AND CHARITY APPLICATION, WERENT TRANSLATED INTO THE PRIMARY LANGUAGE OF VIETNAMESE FOR OUR ELP POPULATION. WE HAD FORMS IN SPANISH BUT NOT VIETNAMESE. AS SOON AS IT WAS DISCOVERED, WE VERIFIED WITH OUR INTEGRIS PARTNER WHICH PRIMARY LANGUAGES WERE NEEDED. WE HAD REQUIRED DOCUMENTS TRANSLATED AND POSTED TO OUR WEBSITE 8/4/2020. WHILE PRIOR TO AUGUST 2020 WE DID NOT HAVE FORMS TRANSLATED TO VIETNAMESE, WE DID HAVE THE FORMS AVAILABLE IN SPANISH, AND WE DID HAVE TRANSLATION SERVICES IN PLACE AT EACH FACILITY TO ASSIST OUR OTHER ELP POPULATIONS. UTILIZATION OF OUR TRANSLATION SERVICE MITIGATED MOST IF NOT ALL ANY IMPACT ON OUR PATIENTS DUE TO NOT HAVING THE TRANSLATED FORMS AVAILABLE. IT WOULD BE DIFFICULT TO MEASURE ANY IMPACT OF THE FAILURE ON THE ELP VIETNAMESE POPULATION SERVED BY THE FACILITIES. false true false false false false false true false DOUGLAS M SMITH CFO OF IH 0 487336 0 212977 0 11699 0 95788 0 19064 0 826864 0 0 SUNNIE GLOVER SENIOR VICE PRESIDENT 218299 0 43371 0 9842 0 11764 0 7968 0 291244 0 0 0 HANI BARADI PHYSICIAN 1146330 0 253936 0 1239 0 15250 0 20344 0 1437099 0 0 0 CHRISTOPHER LENTZ PHYSICIAN/MEDICAL DIRECTOR 700952 0 497604 0 3552 0 17598 0 8413 0 1228119 0 0 0 JEREMY PHELPS PHYSICIAN 765553 0 618136 0 819 0 15250 0 19600 0 1419358 0 0 0 SCOTT SHADFAR PHYSICIAN 923458 0 615903 0 947 0 15250 0 8120 0 1563678 0 0 0 NATHANIEL STETSON PHYSICIAN 778149 0 388866 0 833 0 15250 0 20362 0 1203460 0 0 0 DAVID R HADLEY FORMER OFFICER & DIRECTOR 0 0 0 0 0 244392 0 0 0 0 0 244392 0 0 CHRIS HAMMES COO OF IH 0 644265 0 401961 0 27757 0 202467 0 19174 0 1295624 0 0 TIMOTHY PEHRSON FORMER DIRECTOR 0 913234 0 230379 0 15454 0 288443 0 20057 0 1467567 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART I, LINE 3 INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IACC RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS OFFICERS. INTEGRIS UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THIS COMPENSATION. SUPPLEMENTAL INFORMATION 2 SCHEDULE J, PART I, LINE 4B INTEGRIS HEALTH PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NONQUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. CHRIS HAMMES TIMOTHY PEHRSON DOUGLAS M. SMITH SUPPLEMENTAL INFORMATION 3 SCHEDULE J, PART I, LINE 7 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. IN THE SECOND PLAN, CERTAIN EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION PURSUANT TO THEIR WRITTEN EMPLOYMENT AGREEMENTS. ALL INCENTIVE COMPENSATION IS SUBJECT TO A CAP AND DOES NOT EXCEED 50% OF THE PHYSICIAN'S TOTAL COMPENSATION. THERE ARE A VARIETY OF METHODS USED TO CALCULATE INCENTIVE COMPENSATION BASED ON THE PHYSICIAN'S PERSONAL PRODUCTION, RANGING FROM (I) A SPECIFIED PERCENTAGE OF NET INCOME LESS EXPENSES; (II) A SPECIFIED PERCENTAGE OF TOTAL COLLECTIONS LESS EXPENSES; (III) A SPECIFIED PERCENTAGE OF BASE SALARY BASED COMPLIANCE WITH CERTAIN QUALITY, PATIENT SATISFACTION, PRODUCTION AND FINANCIAL INDICATORS; (IV) A SPECIFIED PERCENTAGE OF BASE SALARY BASED ON COMPLIANCE WITH QUALITY, GUIDING VALUES, PATIENT SATISFACTION AND PRODUCTRION CRITERIA; (V) A SPECIFIED PERCENTAGE OF FEE-BASED COLLECTIONS AND CAPITATION COLLECTIONS, IF APPLICABLE, IN EXCESS OF QUARTERLY SALARY; (VI) QUARTERLY BONUSES MEASURED BY RVUS THAT EXCEED A SPECIFIED TARGET PER QUARTER; AND (VII) PRO RATA SHARE OF ANNUAL INCENTIVE POOLS BASED UPON PRODUCTION, COMPLIANCE WITH CLINICAL GUIDELINES, QUALITY AND PATIENT SATISFACTION CRITERIA. GENERAL STATEMENT 1 FORM 990, BOX C: DOING BUSINESS AS CHEST PAIN EMERGENCY CENTER PROHEALTH LABORATORY MEDICAL PLAZA IMAGING CENTER MERIDIAN OCCUPATIONAL HEALTH CENTER MERIDIAN PRIORITY OCCUPATIONAL HEALTH CENTER FAMILY PHYSICIANS OF OKLAHOMA CITY INTEGRIS HOMECARE PLUS SAMARITAN HOME INFUSION SAMARITAN HEALTH SERVICES INTEGRIS FAMILY CARE CENTER SOUTH PENN FAMILY MEDICINE CENTER SOUTH PENN FAMILY MEDICINE CLINIC INTEGRIS AMBULATORY CARE REHABILITATION SERVICES INTEGRIS FAMILY CARE CENTRAL BAPTIST COMMUNITY CLINIC INNER EAR RESEARCH TEAM INTEGRIS EXPRESS CARE INTEGRIS MEDICAL GROUP INTEGRIS JIM THORPE REHABILITATION INTEGRIS ADVANCED CARDIAC CARE INTEGRIS JIM THORPE OUTPATIENT REHABILITATION HEFNER POINTE INTEGRIS JIM THORPE REHABILITATION ENID INTEGRIS JIM THORPE REHABILITATION HOBBY LOBBY INTEGRIS MEDICAL GROUP OCCUPATIONAL MEDICINE GENERAL STATEMENT 2 PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS INCLUDED IN THE INTEGRIS HEALTH SYSTEM. IACC PROVIDED CHARITY CARE AT COST OF $2,539,293 USING A COST TO CHARGE RATIO METHOD OF CALCULATION. IACC ALSO PROVIDED CARE FOR PATIENTS WHO DID NOT PAY AND MUST BE WRITTEN OFF AS BAD DEBT COST OF $2,238,861 BASED ON A COST TO CHARGE RATIO METHOD OF CALCULATION. FOR ADDITIONAL DETAILS REGARDING COMMUNITY BENEFIT SEE THE ATTACHED COMPLETE COMMUNITY BENEFIT REPORT ON SCHEDULE O STATEMENTS 3 THROUGH 5. GENERAL STATEMENT 3 PART III, LINE 4A: COMMUNITY BENEFIT REPORT INTEGRIS COMMUNITY BENEFIT REPORT 2020 A MESSAGE FROM OUR PRESIDENT AND CEO INTEGRIS Health is an Oklahoman-based, not-for-profit health system that has served Oklahoma communities for more than 100 years. Our mission is partnering with people to live healthier lives. That means we strive to meet your health needs in whatever setting works best for you. INTEGRIS Health actively partners with other community organizations to improve access to health care and outcomes, including free clinics, health screenings, wellness promotions, health education, health support groups, mentoring programs for at-risk youth, clean up after natural disasters and assistance for the elderly. The global COVID-19 pandemic has made our efforts to improve health for our communities even more important as we strive to be the most trusted partner for health. This report highlights a few ways INTEGRIS Health positively impacted our communities last year. We are humbled at the opportunity to care for the lives of our fellow Oklahomans and thank you for trusting us with your care. Warmly, Tim Pehrson President and CEO Mission: Partnering with people to live healthier lives Vision: The Most Trusted Partner for Health Values: iCare-Integrity. Compassion. Accountability. Respect. Excellence. An Overview of the INTEGRIS Health COVID-19 Response The year 2020 will most likely be remembered as the year of COVID-19. As Oklahomans and INTEGRIS Health caregivers, our reputation for taking care of our patients and one another is well-deserved. 2020 was no different. While this pandemic presented challenges the likes of which we had never experienced, our caregivers and volunteers worked tirelessly, around the clock to provide patients the best care possible during a most unsettling, uncertain, unpredictable time. First COVID patient admitted to INTEGRIS Health March 16, 2020 Patients discharged/recovered 4,107 as of Jan. 31, 2021 Food drive items donated 2,355 pounds No. of Oklahoma COVID-19 patients cared for 4,938 as of Jan. 31, 2021 No. of masks made by volunteers 18,839 No. of homemade PPE items produced (face shields and surgical bonnets) 21,274 No. of INTEGRIS Health caregiver vaccines administered 21,105 as of Feb. 12, 2021 No. of community vaccines administered 5,000 as of Feb. 12, 2021 No. of INTEGRIS Health caregiver volunteers for disaster resource pools 434 COVID-19 Patient and Caregiver Diary How the Year 2020 Changed Us INTEGRIS Health caregivers and patients shared their stories during the most trying year in recent memory. Take a look at their stories, and how they triumphed over trauma. Enid Priest Shares His Personal Experience with COVID-19 On June 27, his 45th anniversary of ordination to priesthood, Father Mark Mason began experiencing chills despite the fact it was nearly 100 degrees outside. He tried putting on heavier clothing and lying down, but the chills persisted even under thick blankets. Local Man Survives COVID-19: Credits Convalescent Plasma and Remdesivir Don Wentroth celebrated Fathers Day and his 66th birthday this June, but like everything else in the year 2020, they werent the celebrations he had hoped for due to COVID-19. An ER Nurse Asks for Patience in the Rush to Return to Normal INTEGRIS Southwest Medical Center ER Nurse Rachel McCloy says the COVID-19 experience feels like a "hurry up and wait" scenario. An INTEGRIS Health Respiratory Therapist Describes the Pandemic Jennifer Blevin is a Respiratory Therapist working in the COVID Unit at INTEGRIS Southwest Medical Center. She says the current situation caused by the coronavirus pandemic can be described in one word tense. Pregnant and Testing Positive for COVID-19 "It started with a mild cough," describes Carly McKenzie. it just progressively got worse. It hurt to breathe. But honestly, I was more worried about my unborn baby than myself." 2020 Community Benefits by the Numbers INTEGRIS Health provided $65,363,664 in community benefits including the cost of bad debt. This includes our returnship, community building efforts, uncompensated services and Medicaid services. Returnship Returnship epitomizes our mission of giving back to our communities. It takes the form of hundreds of programs and acts of charity provided daily across the state of Oklahoma. * Free health screenings * Support groups * Medical services * Educational programs * Health fairs * Other charitable acts as reflected in the previous pages Our returnship efforts equaled $3,751,268. Community Building Community building is another vital way we give back. These efforts address the root causes of health problems. Some community building activities include the following. * Housing physical improvements * Economic development * Community support * Environmental enhancements * Advocacy for community health advancements Our community building efforts equaled $422,503. Uncompensated Services and Medicaid Services Uncompensated services comprise the costs of providing free and reduced-cost care. As a system of not-for-profit hospitals, INTEGRIS Health provides services to everyone, regardless of the ability to pay. Thus, we provide a much-needed safety net for members of our community who would otherwise have no access to medical care. Charity care costs are based on the overall hospital cost-to-charge ratios. INTEGRIS Health also provides care to patients who qualify for Medicaid programs. INTEGRIS Health provided charity care and Medicaid services at an estimated cost of $32,905,024. Bad Debt In addition, INTEGRIS Health incurred bad debt with an estimated cost of $28,284,869 based on the overall hospital cost-to-charge ratio. INTEGRIS Health Outreach Events and Programs ACS - Making Strides Kick-off Breakfast ACS Board Call - OK/TX Panhandle ACS Board Candidate Selection ACS Board Meeting ACS Making Strides Booth ACS Meeting ACS MWOY Planning Meeting ACS OKC Leadership Council Retreat ACS RMWP Luncheon ACS State Board Recruitment Lunch ACS Volunteer Driver Appreciation ALA Meeting Alzheimers Association American Academy of Family Physicians - Dr. Toms Owens American Cancer Society American Cancer Society Board Meeting American Cancer Society Making Strides Campaign American Cancer Society Real Men Wear Pink American Heart Association American Lung Association American Lung Association Sponsorship American Lung Association Support Group Christmas Annas House Foundation Anti-Vaping Seminar at Chisholm High School Art Exhibit Celebration of Life Ask a Dietitian Baby Cafe/Milk Bar- INTEGRIS Health Edmond Bedlam Battle Blood Drive Better Breathers Better Breathers Support Group Blood Pressure Screenings - Buffalo Run Boy Scouts 2020 Brain Health Series Brain Injury Support Group Breast Cancer Lunch and Learn Bright Futures Career Fair Burn Center Community Lectures FY 2019-20 Burn Center Lectures Nursing Students FY 2019-20 Calm Waters Center for Children and Families Cameron University Adult ICU Fall Clinical Rotation Cameron University Fall ED Respiratory Clinical Cameron University ICU Summer Rotations Cameron University NICU Respiratory Therapy Fall Rotations Cameron University PICU Respiratory Therapy Cameron University Respiratory Therapy ED Clinical Cameron University Respiratory Therapy Spring Rotations Cameron University Summer Respiratory Therapy Cancer Support Group in Spanish/Grupo de Apoyo de Cancer CancerCheck African American Health Fair CancerCheck Hispanic Health Fair Cardiology Education to Great Plains Residents CART House Gala CASA Donation CDSA Wine Tour Celebration of Life, National Cancer Survivors Day Chair Exercise Changing Your Weighs Chaplain Community Support Chisholm High School Athletic Sponsorship Christian Medical Clinic CLEET Lunch and Learn Commerce Head Start Physicals Community Blood Drive Community Flu Shots and BP Readings Community Health Improvement Organization Board Community Hours for Tim Pehrson, CEO, FY 2019-20 Community Nutrition Program Yukon Library Community Paramedic Program Community Wellness Budget FY 2019-20 Cooking Class for City of Miami employees Cooks Training for Area School Cooks Culinary Classroom Nutrition Instruction CV Tech Foundation GENERAL STATEMENT 4 PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED DCCP (Delaware County Coalition Partnership) Meeting DCCSAN Weekly Child Abuse Meetings De Mujer a Mujer: Mesa Redonda Sobre Violencia Domstica Woman to Woman: Domestic Violence Roundtable Deaconess Pregnancy & Adoption DEEP (Diabetes Empowerment Education Program) Delaware County Community Health Education Classes Delaware County Community Outreach Flu Shots Down Syndrome Support Group DPP (Diabetes Prevention Program) Elders Health Fair Day Emergency Management Emergency Medical Service Community Support Emerging Trends for the Church Enid Charity Ball Donation 2019 Enid Community Screenings Enid High School Baseball Support Enid Public Schools Foundation Education Equipping the Faith Community to Minister to Those with Dementia Fairview Youth and Adult Triathlon Fall Prevention Farm-to-School at SHA Western Village FFAC Committee Meeting Financial Health for Clergy - Special Clergy Lunch Fit, Not Frail - 4-part series - Nutrition/Fitness Fit, Not Frail - 4-part series - Senior Weight Management Fit, Not Frail - First of 4-part series - Mabel Fry Flu Shot Clinic Follow Your Instinct - Save Lives Blood Drive Food Demonstration at the Moore Food and Resource Center Francis Tuttle CART II Fall 2019 Respiratory Adult ICU Francis Tuttle CART II NICU Respiratory Clinicals Francis Tuttle CART II Respiratory Spring Clinicals Adult ICU Francis Tuttle CART II Respiratory Spring Clinicals NICU Francis Tuttle CART II Spring PFT Clinical Rotations Francis Tuttle CART Respiratory PFT Clinicals Fall Francis Tuttle Respiratory Therapeutics 1 Spring (12-hour shifts) Francis Tuttle Respiratory Therapeutics 1 Fall (12-hour shifts) Francis Tuttle Respiratory Therapy Summer Clinicals (June 2020) Ft. Reno DAR 2020 Get Pink Luncheon Getting a Good Nights Sleep Gideons Meeting Prayer Breakfast Go Red For Your Heart/Vestido Rojo Grand Lake Area Stroke Support Group Grandparents: A Grand Perspective Great Land Run Education Fund Grief Support Groups Meeting Grove Tween Fair Health Alliance for the Uninsured Health Planning Coalition Healthy Living, Livestrong at the YMCA Healthy Schools Oklahoma Hearing Helpers 2020 Heart Healthy Eating for "New View" VITAL Heather Harkness Memorial Events Heroes Help - Paramedic Hispanic radio, television and newspaper Holy Angels Health Fair/Feria de Salud en Santos Hope Support Group Hopkins DDP Class Horticulture Therapy at Arcadia Trails INTEGRIS Hospice Circle of Love Benefit Clay Shoot Hospice Grief Recovery Program Hough Ear Institute Infant Crisis Center In-Kind Donation of Space/Staff for MDA Clinic INTEGRIS Health Baptist Milk Bar Lactation Support Group (July - March) INTEGRIS Health Cardiology Conference INTEGRIS Health Community Clinic INTEGRIS Health FitClub FY 2019-20 INTEGRIS Health Pharmaceutical Assistance Program FY 20 INTEGRIS Health Volunteer Auxiliary Monthly Meeting Integrity in Medicine ITN Central Oklahoma Jay Head Start Physicals Jay Public Schools Inservice JFK Camp "You Can Be A Hero" Presentation Jordan Cash OHA Meetings JWL of Enid La Leche League 2020 Lay Health Promoters/Promotoras de Salud Leukemia & Lymphoma Society Light the Night LifeShare Foundation Light the Night Executive Leadership Limb Loss Support Group LiveStrong Cancer Survivor Support Group LLS 2020 MWOY Meeting LLS Man of Year LLS Man of Year - Winter Cocktail LVAD Support Group Making Strides Against Breast Cancer OKC - Applause Making Strides Fundraiser Booth Making Strides Kickoff Booth - INTEGRIS Baptist Making Strides Kickoff Campaign - INTEGRIS Southwest Making Strides T-shirt Distribution Booth Man and Woman of the Year 2020 Kick Off Meeting Man and Woman of the Year 2020 Candidate Workshop Man of the Year Fundraiser Brainstorming Session Man of Year Fundraising Meeting Man Up Marriage and Family Therapy Internships Mary Pinzon Stroke Awareness/Education Meals on Wheels FY 2019-20 Medical Marijuana Lunch and Learn Medical Student Family Medicine Rotation Meditation Sessions at INTEGRIS Cancer Institute Meeting Room for Community Organizations Mens Health Barbershop Outreach Mens Health Screening, Nutrition Education Mens Health University: NE OKC Health Taskforce Mental Health Meeting Meridian Tech Students Miami Head Start Physicals Miami High School Students CPR training Miami Physical Therapy Students Miami Public School Inservice Presentation Mind, Body, Spirit Volunteer Mini Health Fairs Ministering to Children in Time of Crisis Mobile Health Screening Unit Monthly Lectures/Conferencias Mensuales Monthly Nutrition Program - Brookline Moral Injury: Healing the Wounds of Ministry NAMI Support Group NEO Nursing Advisory Council NEO Nursing Students NESA Meetings Newsletters/VIVA INTEGRIS Non-Reimbursed IRB Fees FY 2019-20 Northeastern Tribal Health System (NTHS) Diabetes NTC Afton Nursing Students NTC Kansas Nursing Students Nursing, AUA, surgical tech and paramedic students Nutrition Class for Cardiac Rehab Patients Nutrition Class Series/Clase de Nutricin Nutrition Education at Arcadia Trails INTEGRIS Nutrition Education at Staff Development Training Nutrition Education for Parents - Monroe Elementary Nutrition Education for Students - John Rex Middle School Nutrition Education Project 31 - Breast Cancer Online Support Group Nutrition Presentation - City of Edmond Nutrition Presentation - First Church Bethany Nutrition Presentation - Pete White Health and Wellness Center Nutrition Presentation for HLC - MAPS3 (Rockwell) Nutrition Presentation for HLC - Rockwell Nutrition Presentation for Metro YMCA Staff Nutrition Presentation for Parkinsons Support Nutrition Presentation for Seniors - INTEGRIS Southwest Nutrition Presentation for Statewide Librarian Conference Nutrition Program - Brookline Nutrition Program "Heart Smart Eating" Nutrition Program for Edmond Senior Center Nutrition Program for Pete White (Northcare) Nutrition Program for Seniors - Brookline OBI Blood Drives 2020 OCDDA Presentation OCU 2020 OK/TX/PAN Area Board Virtual Meeting: ACS Oklahoma Blood Institute Oklahoma County Medical Society - Dr. Toms Owens Oklahoma Family Center for Autism Oklahoma Project Woman Oklahoma School of Science & Mathematics Board Oklahoma School of Science and Mathematics Oklahoma Senior Games Oklahoma State Medical Association- Dr. Toms Owen Oklahoma State Respiratory Care Board of Directors Oklahoma State Stroke Systems Advisory Committee OKTXPAN ACS Area Board Meeting Oran Lee Speaking at Mental Health and Addiction Recovery Workgroup Orthopedic Provider Standby for Football/Basketball OSSM Foundation Board of Trustees Meeting OSSM Foundation Full Board Meeting OSSM Parents Association Reception OT and OTA 100 Student Internships Jan. 1 to June 3 OT and OTA 100 Student Internships July 1 to Dec. 3 OT and OTA 200 Student Internships Jan. 1 to June 3 OT and OTA 200 Student Internships July 1 to Dec. 3 Ottawa Community Health Series Ottawa County Community Health Series Ottawa County Farmers Market Board Meeting OU MHA Advisory Board Breakfast Meeting OUHSC Medical Student Course 19-20 Physical Therapy Community Hours Physical Therapy Students Positive Directions Mentoring Program FY 2019-20 Pre- and Post-conference rooms for Clinical Nursing Pregnancy Talks at Jay Public Schools Prenatal Classes Professional Staff Education, Sports Nutrition Project 31 Project 31 Breast Cancer Support Group Project 31 Cancer Support Group Christmas Party Project Search 2020 Conference Rooms PT 100 Student Internships Jan. 1 to June 30, 2020 PT 100 Student Internships July 1 to Dec. 31, 2019 PT 200 Student Internships - Jan. 1 to June 30, 2020 PT 200 Student Internships - July 1 to Dec. 31, 2019 Public Health Institute of Oklahoma Quapaw Head Start Physicals Radiation Therapy Student Hours Radiology Students Real Men Wear Pink ACS Making Strides Fundraiser Real Men Wear Pink Fundraiser Real Men Wear Pink Taco Lunch - Dr. Hassan REC Days Redlands 2020 Relay for Life Walk and Dinner Auction Resource Room Rose State Adult Floor Respiratory Clinicals Rose State Fall Pulmonary Diagnostics Clinicals Rose State Pulmonary Diagnostics Clinicals RT 200 Student Internships - July 1 to Dec. 31, 2019 GENERAL STATEMENT 5 PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED Savannah Station Board of Directors 2020 School Garden Education - Adams Elementary Senior Life Nutrition Program - INTEGRIS Southwest Senior Life Wellness Budget FY 2019-20 SHA Community Clinic SLP 100 Student Internships July 1 to Dec. 31, 2019 SLP 200 Student Internships - Jan. 1 to June 30, 2020 SLP 200 Student Internships - July 1 to Dec. 31, 2019 Souper Bowl Saturday Speaker at First Presbyterian Speech Pathology Students Spinal Cord Injury Support Group Sponsor OSSMs 2020 Quantum Experience Spotlight on Stretching Stanley Hupfeld Academy 4th Grade Baking Classes Stanley Hupfeld Academy Annual Health and Science Fair Stanley Hupfeld Academy Support FY 2019-20 Stephen Grigar 2020 Stitching For Sanity Successful Breastfeeding July 1, 2019 to Feb. 15, 2020 Summer (June) Respiratory Clinicals - Rose State Survivors of Suicide Support Group SWOSU 2020 Tenaciously Teal Sponsorship Teresa Gray: CART House TFCU Health Fair The Care Giver Soul The Foundation for OKCPS UCO Community and Public Health Internships INTEGRIS Cancer Institute UMICORE Health Fair (Safety Day) Under the Surface Understanding the Changes in Medicine United Way Chili Cook-Off United Way Donation United Way of Canadian County Variety Care Vascular Screenings free of charge to qualifying population Walk For Life Wellness Where You Are - Edmond Wellness Where You Are - Yukon Wellness Wise Guys Clinic Workers Comp Lunch and Learn YMCA YMCA Annual Campaign YMCA Board of Directors YMCA Meeting Yoga Healing through Movement / Safer At Home Yoga Yoga in Your Chair Yoga Nidra Experience Youth and Family Services Youth Experiencing Success Luncheon 2020 Yukon Community Screenings Yukon Public School Health Fair Yukon Rotary 2020 YWCA YWCA Purses with Purpose Annual Sponsorship GENERAL STATEMENT 6 PART V: QUESTION 1A AND 2A PART V: QUESTION 1A - INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, PAYS ALL VENDORS FOR SERVICES PROVIDED TO ALL ENTITIES WITHIN THE SYSTEM. ACCORDINGLY, COMPENSATION PAID TO INDEPENDENT CONTRACTORS IS REPORTED ON THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS OF INTEGRIS HEALTH, INC., EIN 73-1192764. EXPENSES ARE ALLOCATED TO AND REIMBURSED BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990, PART VII, SECTION B AND PART IX, AS APPROPRIATE. PART V: QUESTION 2A - THE SALARIES REFLECTED ON FORM 990, PART IX, LINE 7, WERE ALL REPORTED ON THE FORM 941 EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, OF INTEGRIS HEALTH, INC.,EIN 73-1192764. THESE SALARIES WERE REIMBURSED TO INTEGRIS HEALTH, INC. AND WERE INCLUDED IN THE NUMBER OF EMPLOYEES ON INTEGRIS HEALTH, INC.'S FORM W-3. THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2019 TAX YEAR. GENERAL STATEMENT 7 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTION 2 - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE FOLLOWING OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BY VIRTUE OF THEIR POSITIONS AS OFFICERS, DIRECTORS, OR EMPLOYEES OF RELATED ENTITIES WITHIN THE SYSTEM: CHRIS HAMMES DOUGLAS M. SMITH GENERAL STATEMENT 8 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTIONS 6, 7A AND 7B - INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS AMBULATORY CARE CORPORATION. AS SUCH IT HAS THE POWER (1) TO ELECT THE DIRECTORS OF THE CORPORATION AND TO REMOVE THE ENTIRE BOARD OF DIRECTORS OR ANY INDIVIDUAL DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE, (2) TO APPROVE OR DISAPPROVE ANY ACTION TAKEN BY THE BOARD OF DIRECTORS AMENDING, ALTERING, CHANGING OR REPEALING THE BYLAWS, AND (3) TO VOTE ON ALL MATTERS WHERE THE AUTHORIZATION OR APPROVAL OF THE SOLE MEMBER IS REQUIRED BY THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR STATE LAW. GENERAL STATEMENT 9 PART VI: SECTION B. POLICIES PART VI: QUESTION 11B - THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE SYSTEM HAS A SINGLE AUDIT COMPLIANCE COMMITTEE WHICH OVERSEES THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AS WELL AS THE FILING OF FEDERAL AND STATE TAX FORMS. THE SYSTEM ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF FORM 990 TO PREPARE THE FORM. A DRAFT FORM 990 IS PROVIDED TO THE SYSTEM VICE PRESIDENT, FINANCE FOR REVIEW. A FINAL FORM 990 IS GIVEN TO THE SYSTEM CHIEF FINANCIAL OFFICER FOR REVIEW, APPROVAL, AND SIGNATURE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, AS WELL AS TO THE SYSTEM'S AUDIT/COMPLIANCE COMMITTEE, FOR REVIEW PRIOR TO FILING THE RETURN. GENERAL STATEMENT 10 PART VI: SECTION B. POLICIES PART VI: QUESTION 12C - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE INTEGRIS CODE OF CONDUCT. ALL SYSTEM EMPLOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION AND ARE INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS, TO REFER ANY CONFLICT OF INTEREST QUESTIONS TO THE SYSTEM'S COMPLIANCE OFFICER OR THROUGH THE ANONYMOUS INTEGRITY LINE. ALL NEW MANAGERS RECEIVE ADDITIONAL TRAINING ON CONFLICT OF INTEREST POLICIES DURING LEADERSHIP TRAINING. LEGAL SERVICES REVIEWS ALL CONTRACTS FOR CONFLICTS OF INTEREST. INTERNAL AUDIT CONDUCTS AUDITS FOR POSSIBLE CONFLICTS OF INTEREST BASED ON THEIR ANNUAL RISK ASSESSMENT. CORPORATE COMPLIANCE INCLUDES ASSESSMENTS FOR CONFLICTS OF INTEREST IN ITS ANNUAL WORK PLAN AND CONDUCTS SPECIALIZED TRAINING FOR HIGH RISK AREAS. THE GOVERNANCE COMMITTEE, A COMMITTEE OF THE INTEGRIS HEALTH BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF INTEGRIS AND A DISQUALIFIED PERSON. GENERAL STATEMENT 11 PART VI: SECTION B. POLICIES PART VI: QUESTION 15B - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). COMPENSATION FOR VICE PRESIDENTS IS ANALYZED BY AN INDEPENDENT HEALTH CARE CONSULTING FIRM. THE ANALYSIS INCLUDES A FAIR MARKET VALUE ASSESSMENT AND ESTABLISHMENT OF A RANGE FOR EACH POSITION BASED ON RESEARCH OF COMPARABLE HEALTH CARE SYSTEMS OF SIMILAR SIZE. THE REPORT AND RECOMMENDED COMPENSATION LEVELS FOR EACH EXECUTIVE MANAGEMENT POSITION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE INTEGRIS HEALTH BOARD OF DIRECTORS AND ULTIMATELY THE FULL BOARD OF DIRECTORS. THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REFLECTS A REVIEW OF THE COMPARABILITY DATA, THE EXECUTIVE PERFORMANCE REVIEWS AND THE DECISION-MAKING PROCESS. GENERAL STATEMENT 12 PART VI: SECTION C. DISCLOSURE PART VI: QUESTION 19 - THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR INTEGRIS HEALTH, INC., A RELATED CORPORATION. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION. GENERAL STATEMENT 14 PART XI: RECONCILIATION OF NET ASSETS, LINE 9 INVESTMENT IN WESTERN VILLAGE ACADEMY $250,000 CARAVAN HEALTH ACO 34 LLC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 300865115 ACO DE 0 0 IACC INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192764 HEALTH CARE OK 501(C)(3) LINE 12-I NA false INTEGRIS HOSPICE INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731369586 HEALTH CARE OK 501(C)(3) LINE 10 IH false INTEGRIS BAPTIST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731034824 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731444504 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS SOUTHWEST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731089149 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS HEALTH FOUNDATION INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731047338 FUNDRAISING OK 501(C)(3) LINE 7 IH false WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC true INTEGRIS HEALTH EDMOND INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 451027361 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS MENTAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH false BMPA LTD 73-1228665 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MED. OFFICE BLDG. OK NA N/A QC-III 20-8723857 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK NA N/A DIAGNOSTIC LAB 73-1560760 LYNDHURST NJ 07071 LYNDHURST NJ 07940 CLINICAL LAB NJ NA N/A MPI CENTER 73-1283942 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK IACC RELATED -150380 71469 false true 0.50000 HILLCRESTINTEGRIS HEALTH LLC OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 DORMANT OK NA N/A LAKESIDE 73-1493662 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK IACC RELATED 4372139 19104179 false 844 true 0.78077 5300 GRAND 73-1306794 FRANKLIN TN 37067 FRANKLIN TN 37067 REAL ESTATE TN NA N/A INTEGRIS USPHLTH 35-2632292 ADDISON TX 75001 ADDISON TX 75001 MEDICAL SERVI TX IACC RELATED 12787271 112721790 false true 0.50100 INTEGRIS EMER HOSP 90-1215089 THE WOODLANDS TX 77381 THE WOODLANDS TX 77381 HEALTH CARE TX IACC RELATED -7251693 706546 false -8137707 true 0.51000 INTEGRIS PROHEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731046179 RETAIL PHARMACY OK NA C Corp false THE STANLEY F HUPFELD REMAIN TRUST 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 266238051 FINANCIAL OK NA Trust false QUALITY ALLIANCE ASSURANCE CP PO BOX 10027 KYI-1001 GRAND CAYMAN CJ 981060671 INSURANCE CJ NA C Corp false BAPTIST HEALTH SYSTEM INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731477468 DORMANT OK NA C Corp false ONE CARE INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 DORMANT OK NA C Corp false VADOVATIONS INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 270821922 HEALTH CARE OK NA C Corp false INTEGRIS HEALTH PARTNERS LLC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 453482852 HEALTH CARE OK NA C Corp false INTEGRIS CARDIOVASCULAR PHYSICIANS LLC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 452867352 HEALTH CARE OK NA C Corp false false false true false false false false false false true true true true false false true true false true LAKESIDE WOMEN'S HOSPITAL LLC c 5060915 FMV LAKESIDE WOMEN'S HOSPITAL LLC p 5853729 FMV LAKESIDE WOMEN'S HOSPITAL LLC q 663895 FMV