2018-08-15T07:38:27-05:00 2017-09-30 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2016-10-01 260532528 THE PHYSICIAN'S HOSPITAL IN ANADARKO % SEAN J KIRRANE PHYS 4052472553 1002 CENTRAL BOULEVARD ANADARKO OK 73005 CHARLES M ELDRIDGE PRESIDENT 2018-08-14 true Scott J Mariani P00642486 9738989494 2016 2022-09-23 18:48:47Z CHARLES M ELDRIDGE 8502 EAST CHAPMAN AVE STE 431 ORANGE CA 92869 25292683 false X WWW.ANADARKOHOSPITAL.COM X 2007 OK To provide high quality health services and facilities for the community, to promote wellness, to relieve suffering, and to restore health. 5 5 0 3 0 15900 13601 24308553 25159044 369 675 131439 119363 24456261 25292683 0 0 0 0 0 0 0 0 0 35128497 37102568 35128497 37102568 -10672236 -11809885 9605498 9445601 64433524 76133512 -54828026 -66687911 X THE MISSION OF THE PHYSICIANS' HOSPITAL IN ANADARKO PROVIDES HIGH QUALITY HEALTH SERVICES AND FACILITIES FOR THE COMMUNITY, TO PROMOTE WELLNESS, TO RELIEVE SUFFERING AND TO RESTORE HEALTH IN A FISCALLY RESPONSIBLE MANNER WHICH CONTRIBUTES OT THE PHYSICAL, PSYCHOLOGICAL, SOCIAL AND SPIRITUAL WELL-BEING OF THE PATIENTS AND COMMUNITIES WHICH IT SERVES. IN ADDITION, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. false false 33392312 0 25159044 EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 33392312 true true false false false false false false false false true false false true true true 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 false true false false false true 16 0 true 0 false false false false false true true false false false false false X 5 5 false true false false true true true true false false false true true true true true true false false OK X SEAN J KIRRANE 9737065197 4323 NORTH WEST 63RD STREET OKLAHOMA CITY OK 73116 X JT GOOMBI CHAIR - DIRECTOR 1.0 0.0 X X 0 0 0 DAVID SCOTT VICE CHAIR - DIRECTOR 1.0 0.0 X X 0 0 0 WILSON DAINGKAU DIRECTOR 1.0 0.0 X 0 0 0 DONALD HASLAM MD DIRECTOR 1.0 0.0 X 0 0 0 CHARLES M ELDRIDGE PRESIDENT 40.0 0.0 X 0 157500 17980 0 157500 17980 0 false true false FIRST PHYSICIANS SERVICES LLC 4324 NW 63RD STREET SUITE 232 OKLAHOMA CITY OK 73116 it 5907576 FIRST PHYSICIAN's business solution 4324 NW 63RD STREET SUITE 232 OKLAHOMA CITY OK 73116 management 5368397 FIRST PHYSICIANS RESOURCES LLC 4324 NW 63RD STREET SUITE 232 OKLAHOMA CITY OK 73116 STAFFING 3551213 SOUTHERN PLAINS MEDICAL CENTER 2222 W IOWA AVE CHICKASHA OK 73018 MEDICAL 2978846 NOVITAS SOLUTIONS INC 2020 TECHNOLOGY PARKWAY SUITE 140 MECHANICSBURG PA 17050 BILLING/COLLECTION 1005184 12 X 13601 13601 NET PATIENT SERVICE REVENUE 541900 25030577 25030577 OTHER HEALTHCARE RELATED REVENUE 541900 128467 128467 25159044 675 675 0 0 53962 53962 0 53962 53962 0 0 0 0 0 0 0 0 0 0 CAFETERIA REVENUE 722514 65401 65401 65401 25292683 25159044 120038 0 0 0 0 0 0 0 0 0 0 0 239469 215522 23947 74000 66600 7400 0 0 0 0 6405 5765 640 359207 323286 35921 0 0 563445 507100 56345 47224 42502 4722 0 455 409 46 1248631 1123768 124863 0 313416 282074 31342 103834 93451 10383 PURCHASED SERVICES 23534953 21181458 2353495 0 CONTRACTED SERVICES 8816382 7934744 881638 0 MEDICAL SUPPLIES 1248883 1123995 124888 0 REPAIRS AND MAINTENANCE 238210 214389 23821 0 308054 277249 30805 37102568 33392312 3710256 0 X 0 0 245172 287470 0 0 3200288 3671858 0 0 0 0 0 0 158540 182490 28855 26782 7955754 3385027 4871218 4570727 0 0 0 0 0 0 0 0 1101425 706274 9605498 9445601 53193724 64963010 0 0 0 0 0 0 0 0 0 0 0 0 11005234 10936152 234566 234350 64433524 76133512 X -54828026 -66687911 0 0 0 0 -54828026 -66687911 9605498 9445601 X -11809885 -50000 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5704000 1735782 3968218 79786 15836 63950 1815720 1633409 182311 356248 356248 4570727 OTHER RECEIVABLE 116667 RECEIVABLE 0 SECURITY DEPOSITS 50948 DUE FROM THIRD PARTY REC. 538659 706274 0 DUE TO AFFILIATE 234350 234350 X SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN ONE CURA WELLNESS, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ISSUES AUDITED CONSOLIDATED FINANCIAL STATEMENTS WHICH INCLUDE ALL AFFILIATES; INCLUDING THIS ORGANIZATION. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS WERE PREPARED FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2017 AND SEPTEMBER 30, 2016; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FIN 48 (ASC 740) FOOTNOTE BELOW IS FROM THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION FOLLOWS ACCOUNTING GUIDANCE FOR UNCERTAINTIES IN INCOME TAX POSITIONS WHICH REQUIRES THAT A TAX PROVISION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. PURSUANT TO THE GUIDANCE IN THIS ACCOUNTING PRONOUNCEMENT, THE ORGANIZATION HAS DETERMINED THAT NO UNRECOGNIZED TAX BENEFITS EXIST AS OF SEPTEMBER 30, 2017 AND 2016 AND DOES NOT EXPECT THIS DETERMINATION TO CHANGE SIGNIFICANTLY OVER THE NEXT 12 MONTHS. THE ORGANIZATION PREVIOUSLY RECORDED ESTIMATED PENALTIES FOR THE LATE FILINGS OF ITS TAX RETURNS. SUCH ESTIMATED PENALTIES WERE RECOGNIZED AS OPERATING EXPENSES AND THE CORRESPONDING LIABILITY WAS INCLUDED IN ACCRUED EXPENSES IN THE FINANCIAL STATEMENTS. THE ORGANIZATION REQUESTED AN ABATEMENT OF THE PENALTIES FOLLOWING THE FILING AND ACCEPTANCE OF ITS TAX RETURNS WHICH WAS SUBSEQUENTLY GRANTED BY THE INTERNAL REVENUE SERVICE. AS A RESULT, THE ESTIMATED PENALTIES AND ACCRUED EXPENSE WERE REVERSED DURING THE YEAR ENDED SEPTEMBER 30, 2017. true true X true X true X true true true false false 2764159 2791801 2764159 2791801 0.00000 6254 0 6254 6254 0 6254 2770413 2791801 6254 0.00000 false 2905193 1034249 true false 1 1 THE PHYSICIAN'S HOSPITAL IN ANADARKO 1002 CENTRAL BOULEVARD ANADARKO OK 73005 WWW.ANADARKOHOSPITAL.COM 2216 X X X X 1 THE PHYSICIAN'S HOSPITAL IN ANADARKO false false true X X X X X X X X X 13 true false true true X WWW.OKRURALHEALTHWORKS.ORG X true 13 true WWW.OKRURALHEALTHWORKS.ORG false true X 150. 250. X X X true true X X X true X WWW.ANADARKOHOSPITAL.COM X WWW.ANADARKOHOSPITAL.COM X WWW.ANADARKOHOSPITAL.COM X X X X X X false X false X true X true true SCHEDULE H, PART V, SECTION B, QUESTIONS 5 & 6 THE CHNA DATA WAS SUPPLEMENTED BY MEETINGS AND DISCUSSIONS WITH THE LOCAL HEALTH DEPARTMENT WHERE DATA WAS SHARED FROM THEIR OWN NEEDS ASSESSMENTS. IN ADDITION, INPUT WAS DERIVED FROM THE COUNTY-WIDE TASK FORCE WHICH PROVIDED INSIGHT AND EXPERTISE, LEADING TO THE IDENTIFICATION OF COUNTY-WIDE HEALTH PRIORITIES. DETAILS INCLUDING THE COUNTY-WIDE TASK FORCE MEMBERS, COMMUNITY MEETING ATTENDEES AND PROCESS ARE CONTAINED IN THE CHNA. SCHEDULE H, PART V, SECTION B, QUESTION 7B DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 7B, IS THE HOME PAGE FOR OKLAHOMA RURAL HEALTH WORKS. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE OKLAHOMA RURAL HEALTH WORKS WEBSITE: http://www.okruralhealthworks.org/PDFWEB/AE-13169.pdf SCHEDULE H, PART V, SECTION B, QUESTION 11 THE FACILITY, WITH LIMITED RESOURCES, PRIORITIZED HEALTH NEEDS IDENTIFIED AND DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THESE PRIORITY HEALTH NEED AREAS. THE CHNA INFORMS THE FACILITY'S STRATEGIC PLANNING WHICH INCORPORATES ELEMENTS FROM THE CHNA IMPLEMENTATION PLAN IN ITS STRATEGIES TO MEET ITS GOAL OF IMPROVED COMMUNITY HEALTH. THE CHNA IMPLEMENTATION PLAN ALSO INCLUDES RESOURCES, ACTIONS AND GOALS (MEASURABLE). AS DISCUSSED ABOVE, THE FACILITY CONDUCTED A COMPREHENSIVE ASSESSMENT AND A MYRIAD OF HEALTH NEEDS WERE IDENTIFIED. GIVEN LIMITED RESOURCES, NEEDS WERE PRIORITIZED WITH CONSIDERATION OF SERVICE ARRAY OFFERED BY THE FACILITY AND ABILITY TO COLLABORATE. SCHEDULE H, PART V, SECTION B, QUESTION 16 DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTIONS 16A, 16BAND 16C, IS THE HOME PAGE FOR THE ORGANIZATION. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT THE FOLLOWING URL WHICH IS INCLUDED IN THE ORGANIZATION'S WEBSITE: http://anadarkohospital.com/wp-content/uploads/2018/07/TPHAFAP.pdf SCHEDULE H, PART V, SECTION B, QUESTION 18E Due to billing system limitations the hospital bills all uninsured patients at gross charges. Prior to the transaction closing on August 11, 2011; the hospital had historically been owned by for profit operators. As such, the billing software still reflects a carryover from the previous ownership. The organization and its management company are curently taking actions so as to reasonably remedy this situation and to fully comply with the regulations of IRC Code Section 501(r). The current policy allows for the following actions: i. The patient, or financially responsible individual, will receive an itemized billing WITHIN 30 DAYS OF DISCHARGE DATE. The statement will include SERVICE DATE, EPISODE NUMBER, TOTAL CHARGES AND a copy of the payment arrangement or a request for payment arrangement if not completed at time of service. ii. If the account is not paid or acceptable arrangements made by the first of the following month, aging of account will begin and be monitored by Patient Account Representative. iii. If no activity on account after the first 60 days, the account will be set to receive the first of two collections letters at 90 days. At such time as it is determined that the account is inactive, the hospital will then write off any unpaid account balance. As the hospital is operating within the confines of the system limitations no patients are reported to collection agencies, lawsuits filed, no liens are placed on any residences and no body attachments filed. The hospital, in providing financial assistance to those patients deemed FAP eligible, must operate within the cofines of the current billing system. As such, in working with the current billing system limitations, the hospital is forced to characterize charity care as bad debt write offs. hospital will then write off any unpaid account balance. As the hospital is operating within the confines of the system limitations no patients are reported to collection agencies, lawsuits filed, no liens are placed on any residences and no body attachments filed. The hospital, in providing financial assistance to those patients deemed FAP eligible, must operate within the cofines of the current billing system. As such, in working with the current billing system limitations, the hospital is forced to characterize charity care as bad debt write offs. SCHEDULE H, PART V, SECTION B, QUESTIONS 23 & 24 Due to billing system limitations the hospital bills all uninsured patients at gross charges. Prior to the transaction closing on August 11, 2011; the hospital had historically been owned by for profit operators. As such, the billing system still reflects a carryover from the previous ownership. Upon determination of a patient being FAP eligible a sliding scale based upon the 2017 Federal Poverty Guidelines is applied to gross charges. Due to billing system limitations as set forth above, which are a carryover from the prior for profit system, the patient billing process requires the mailing of two collection letters to the patients within the first sixty days. After said letters are mailed the billing system then permits the write off of the balance owed for any FAP eligible patients. The intention of the hospital is to work closely with those FAP eligible patients and respect their rights and as such no reports are filed with credit agencies, lawsuits, liens on residences or body attachments are undertaken. The organization and its management company are currently taking actions so as to reasonably remedy this situation and to fully comply with the regulations of IRC Code Section 501(r). SCH H, PART V, SECTION B, Q'S 2,3J,6A,7D,13B,13H,15E,16J,19E,20E,21C&21D NOT APPLICABLE. Part i, line 3c The Physicians' Hospital in Anadarko ("TPHA") provides charity care to both financially indigent and medically indigent individuals. The income based AND PRESUMPTIVE BASED criteria used to determine eligibility is per Senate Bill 500 passed by the 79th Legislature of the State of Oklahoma, Regular Session and based upon the Department of Health and Human Services (HHS) poverty guidelines, also referred to as the Federal Poverty Guidelines (FPG). FPG are included in the criteria for determining eligibility for charity and discount care. Schedule h, part i; question 6a Not applicable. Schedule h, part i, question 7 THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED. Schedule h, part ii Not applicable. Schedule h, part iii, section a; questions 2, 3 & 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM THE FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. ONE CURA WELLNESS, INC. AND ITS AFFILIATES, INCLUDING ITS HOSPITALS AND SUBSIDIARIES, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PLEASE REFER TO FOOTNOTE 8 ON PAGE 14 OF THE ONE CURA WELLNESS, INC. AUDITED CONSOLIDATED FINANCIAL STATEMENTS ATTACHED TO THIS FORM 990. The Organization may provide care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Organization does not expect payment, recorded charges for charity care are deducted from patient fee revenues in order to reflect net patient service revenue. For the years ended September 30, 2017 and 2016, there were no charges related to charity care. Schedule h, part iii, section b; question 8 Medicare costs were derived from the FISCAL YEAR 2017 Medicare cost report. Bad debt is community benefit and associated costs are includable on the form 990, schedule h, part i. The organization feels bad debt is community benefit and associated costs are includable on the form 990, schedule h, part i. As outlined more fully below, the CORPORATION believes that these services and related costs promote the health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purposes and mission in providing medically necessary healthcare services to all individual's in a non-discriminatory manner without regard to race, color, creed, sex, national origin, religion or ability to pay and consistent with the community benefit standard promulgated by the irs. The community benefit standard is the current standard for a hospital for recognition as a tax-exempt and charitable organization under internal revenue code ("irc") 501(c)(3). The CORPORATION is recognized as a tax-exempt entity and charitable organization under 501(c)(3) of the irc. Although there is no definition in the tax code for the term "charitable" a regulation promulgated by the department of the treasury provides some guidance and states that "[t]he term charitable is used in section 501(c)(3) in its generally accepted legal sense,provides examples of charitable purposes, including the relief of the poor or unprivileged; the promotion of social welfare; and the advancement of education, religion, and science. Note it does not explicitly address the activities of hospitals. In the absence of explicit statutory or regulatory requirements applying the term "charitable" to hospitals, it has been left to the irs to determine the criteria hospitals must meet to qualify as irc 501(c)(3) charitable organizations. The original standard was known as the charity care standard. This standard was replaced by the irs with the community benefit standard which is the current standard. Charity care standard In 1956, the irs issued revenue ruling 56-185, which addressed the requirements hospitals needed to meet in order to qualify for irc 501(c)(3) status. One of these requirements is known as the "charity care standard." under the standard, a hospital had to provide, to the extent of its financial ability, free or reduced-cost care to patients unable to pay for it. A hospital that expected full payment did not, according to the ruling, provide charity care based on the fact that some patients ultimately failed to pay. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that publicly supported community hospitals would normally qualify as charitable organizations because they serve the entire community, and a low level of charity care would not affect a hospital's exempt status if it was due to the surrounding community's lack of charitable demands. Community benefit standard In 1969, the irs issued revenue ruling 69-545, which "remove[d]" from revenue ruling 56-185 "the requirements relating to caring for patients without charge or at rates below cost." under the standard developed in revenue ruling 69-545, which is known as the "community benefit standard," hospitals are judged on whether they promote the health of a broad class of individuals in the community. The ruling involved a hospital that only admitted individuals who could pay for the services (by themselves, private insurance, or public programs such as Medicare), but operated a full-time emergency room that was open to everyone. The irs ruled that the hospital qualified as a charitable organization because it promoted the health of people in its community. The irs reasoned that because the promotion of health was a charitable purpose according to the general law of charity, it fell within the "generally accepted legal sense" of the term "charitable," as required by treas. Reg. 1.501(c)(3)-1(d)(2). The irs ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The irs concluded that the hospital was "promoting the health of a class of persons that is broad enough to benefit the community" because its emergency room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the irs highlighted included the following: its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education, and research; it was controlled by a board of trustees that consisted of independent civic leaders; and hospital medical staff privileges were available to all qualified physicians. Bad debt is community benefit and associated costs are includable on the form 990, schedule h, part i. The american hospital association ("aha") feels bad debt is community benefit and thus includable on the form 990, schedule h, part i. This CORPORATION agrees with the aha position. Both the aha and this organization also feel that patient bad debt is a community benefit and thus includable on the form 990, schedule h, part i. There are compelling reasons that patient bad debt should be counted as quantifiable community benefit as follows: - a significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for hospitals' charity care or financial assistance programs. A 2006 congressional budget office ("cbo") report, nonprofit hospitals and the provision of community benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200% of the federal poverty line." - the report also noted that a substantial portion of bad debt is pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency department, regardless of ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. As a result, roughly 40% of bad debt is pending charity care. - the cbo concluded that its findings "support the validity of the use of uncompensated care [bad debt and charity care] as a measure of community benefits" assuming the findings are generalizable nationwide; the experience of hospitals around the nation reinforces that they are generalizable. As outlined by the aha, despite the hospitals' best efforts and due diligence, patient bad debt is a part of the hospital's mission and charitable purposes. Bad debt represents part of the burden hospitals shoulder in serving all patients regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, the hospital invests significant resources in systems and staff training to assist patients that are in need of financial assistance. The organization and its management company are currently taking actions so as to reassembly remedy this situation and to fully comply with the regulations of IRC Code Section 501(r). studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200% of the federal poverty line." - the report also noted that a substantial portion of bad debt is pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency department, regardless of ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. As a result, roughly 40% of bad debt is pending charity care. - the cbo concluded that its findings "support the validity of the use of uncompensated care [bad debt and charity care] as a measure of community benefits" assuming the findings are generalizable nationwide; the expe Schedule h, part iii, section b; question 9b The hospital also has a Charity and Uncompensated Care Policy to assure patients are provided with charity care assistance determined by state and federal regulations. It is the policy that TPHA may inform each patient of the charity care program and how to apply. Patients who desire to apply for charity care should complete a Financial Assistance application form and return the completed application form to the hospital. Along with promotion of the charity care program, Patient Registration will refer patients who may quality for financial assistance from a government agency to the appropriate program, such as Medicaid. Patients not eligible for charity care will be financially counseled for all other options. An uninsured patient who does not qualify as financially or medically indigent could receive a discount according to policy. At the time of the patient visit and part of the registration process at the facility, the following options are made available to patients: - counseling for possible eligibility for medical assistance including Medicaid and ssi; and - counseling for possible eligibility for the Charity Care Program. In addition to the above options, the facility has established a payment program to assist with individuals who do not qualify for Charity Care or a government program. Schedule h, part vi; question 2 In conjunction with the Oklahoma Office of Rural Health, TPHA conducts a Community Health Needs Assessment (CNHA) every three years per Internal Revenue Code Section 501(c)(3) and the Patient Protection and Affordable Care Act (ACA), passed on March 23, 2010. The CNHA is a review of key factor information and health indicators which includes: a review of healthcare utilization of its service area population by services (urology, cardiology, obstetrics, etc.) for determining increased or decreased health needs; healthcare service estimates and forecasts (both inpatient and outpatient); assessments of local demographic and socioeconomic information; health factors and outcomes; hospital usage and satisfaction; existing hospital services; and, a review of health status/needs assessments and studies conducted by external parties (Caddo County Health Department, etc.). To ensure the CNHA is accurate with the community's needs, the hospital holds four public Town Hall meeitngs to discuss local data and information/health needs, economic impact, health needs survey, and community action plan. The CNHA also pulls data from government entities including; U.S. Bureau of Census, IMPLAN, Oklahoma State Department of Health, and other support agencies. The goal behind CNHA is to gather community input that leads to recommendations on how the hospital can better meet and serve residents' needs. This includes an extensive review of the population's healthcare needs and gaps (physicians, specialists, services, etc) every three years. The results of the CNHA are published via electronic and non-electronic means. Schedule h, part vi; question 3 TPHA educates patients in a number of ways regarding financial assistance including: i. Charity Care signs posted throughout the facility, mainly in patient registration areas; ii. Registration clerk educates patients on the financial assistance options during registration; iii. Inpatient admission packets include information regarding our financial assistance programs; and iv. TPHA's website displays the Charity Care policy and procedure for public viewing. Schedule h, part vi; question 4 The physicians' Hospital in Anadarko City is located in Anadarko, Caddo County, Oklahoma. According to the 2010 Census, Caddo County has a population of just under 29,600. Anadarko accounts for 6,761 of the overall total. Caddo County also consists of 15 Towns and 13 communities. The Primary Medical Services Area population consists of 52.9% White, 35.3% Native American, 2.4% Black, 8.3% Hispanic Origin, 7.2% Two or more Races, and 2.3% Other. When compared to the rest of the State (8.2%, Anadarko has a significantly higher Native American population present.It was noted on the last Needs Assessment, changes in racial and ethnic groups can impact the delivery of healthcare services, largely due to language barriers and dramatically different prevalence rates for specific diseases, such as diabetes. A noticeable trend in Oklahoma is the growth in the Hispanic origin population. In 2010, those of Hispanic origin accounted for 8.9% of the total state population. This trend is evident in Caddo County with 10.1% of the local population of Hispanic Origin. Anadarko historically is lower on most economic categories compared to the State average. Anadarko has a median household income of $28,750, compared to the State median household income of $46,236. According to the U.S. Census, residents living below the poverty level in Anadarko of 35.6%, compared to Oklahoma's average of 16.6%. Caddo County population reflect a 26% uninsured rate with a margin of 22-34%. TPHA is committed to service for its communities both within Anadarko and surrounding areas communities. The mission of The Physicians' Hospital in Anadarko is to provide high quality health services and facilities for the community, to promote wellness, to relieve suffering, and to restore health in a fiscally responsible manner which contributes to the physical, psychological, social and spiritual well-being of the patients and communities which it serves. Schedule h, part vi; question 5 Community building activities undertaken by TPHA to improve the medical and socioeconomic well-being of the communities in our care. This is accomplished through a number of outreach activities targeted to promote heaLth and healthcare in the community. TPHA provides educational materials, conducts community health fairs, CHNA, participates in local partner health fairs, organizes and conducts community specific health taskforces (i.e. teen suicide prevention). The hospital also holds health certifications and education events on BLCS, ACLS, PALs and other related health care events to the community. TPHA holds an annual board meeting open to the public. The majority of the board of trustee's members are individuals with local businesses, community Leaders or whom reside in the community. Hospital staff members serve on the boards of many local not-for-profit organizations (IHS, Chamber of Commerce, etc.) and provide other forms of support. All qualified physicians are extended privileges by their respective departments. Under the directive of the corporate finance office, surplus funds are utilized for capital projects to improve services or purchase equipment which in turn, benefit the community. Please also refer to form 990, schedule o, which contains the organization's community benefit statement and summary of all entities which comprise the healthcare system. Schedule h, part vi; question 6 Outlined below is a summary of the entities which comprise ONE CURA WELLNESS. Not for profit health care system entities ONE CURA WELLNESS, INC. ONE CURA WELLNESS, INC. ("ONE CURA") is the tax-exempt parent of ONE CURA WELLNESS, INC. ("system"). This integrated healthcare delivery system consists of a group of affiliated healthcare organizations. The sole member of each entity is ONE CURA. The System is an integrated network of healthcare providers throughout the state of OKLAHOMA. ONE CURA is an organization recognized by the internal revenue service as tax-exempt pursuant to internal revenue code 501(c)(3) and as a supporting organization pursuant to internal revenue code 509(a)(3). As the parent organization of a tax-exempt integrated healthcare delivery system in OKLAHOMA, ONE CURA strives to continually develop and operate a multi CRITICAL ACCESS hospitAl healthcare system which provides substantial community benefit through the provision of a comprehensive spectrum of healthcare services to the residents of OKLAHOMA and surrounding communities. ONE CURA ensures that its system provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origins, religion or ability to pay. No individuals are denied necessary medical care, treatment or services. The system's active CRITICAL ACCESS hospitals include: THE PHYSICIAN'S HOSPITAL IN ANADARKO AND STROUD REGIONAL MEDICAL CENTER. EAch of these hospitals operates consistently with the following criteria outlined in irs revenue ruling 69-545: 1. Each provide medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self- pay, Medicare and Medicaid patients; 2. Each operate an active emergency room for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. Each maintain an open medical staff, with privileges available to all qualified physicians; and 4. Control of each rests with its board of trustees and the board of trustees of the corporation. Both boards are comprised of independent civic leaders and other prominent members of the community. 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care; programs and activities. THE PHYSICIAN'S HOSPITAL IN ANADARKO THE PHYSICIAN'S HOSPITAL IN ANADARKO ("TPHA") is a 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN ANADARKO, CADDO county, OKLAHOMA. TPHA is recognized by the internal revenue service as an internal revenue code section 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, TPHA provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Moreover, TPHA operates consistently with the criteria outlined in irs revenue ruling 69-545 STROUD REGIONAL MEDICAL CENTER STROUD REGIONAL MEDICAL CENTER ("SRMC") is a 25-BED CRITICAL ACCESS HOSPITAL located in STROUD, LINCOLN county, OKLAHOMA. SRMC is recognized by the internal revenue service as an internal revenue code section 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, SRMC provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Moreover, SRMC operates consistently with the criteria outlined in irs revenue ruling 69-545. ONE CURA FAMILY CLINIC ANADARKO, INC. ONE CURA FAMILY CLINIC ANADARKO, INC. PROVIDES ACCESS TO AFFORDABLE QUALITY PRIMARY AND PREVENTIVE HEALTHCARE TO THE COMMUNITIES IN GREATER CADDO COUNTY IN A PATIENT CENTERED, SAFE, COMPASSIONATE ENVIRONMENT. ONE CURA FAMILY CLINIC ANADARKO, INC.S APPLICATION TO BE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION IS CURRENTLY PENDING. ONE CURA FAMILY CLINIC STROUD, INC. ONE CURA FAMILY CLINIC STROUD, INC. PROVIDES ACCESS TO AFFORDABLE QUALITY PRIMARY AND PREVENTIVE HEALTHCARE TO THE COMMUNITIES IN GREATER LINCOLN COUNTY IN A PATIENT CENTERED, SAFE, COMPASSIONATE ENVIRONMENT. ONE CURA FAMILY CLINIC STROUD, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. Schedule h, part vi; question 7 Not applicable. X false true false false false false false false false CHARLES M ELDRIDGE PRESIDENT 0 157500 0 0 0 0 0 11299 0 6681 0 175480 0 0 SCHEDULE J, PART I; QUESTION 4B The deferred compensation amount in Column C for the following individual includes unvested benefits in a split dollar life insurance plan which are subject to a substantial risk of complete forfeiture. Accordingly, he may never actually receive the unvested benefit amount. The amount outline herein was not included in his 2016 Form W-2, Box 5 as Taxable Medical Wages: Charles M. Eldridge, $6,349. CORE FORM, PART I AND PART X CORE FORM, PART I; REVENUE AND EXPENSES AND CORE FORM, PART X; BALANCE SHEET, WERE RESTATED TO REFLECT THE AUDITED FINANCIAL STATEMENTS. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS THE PHYSICIANS' HOSPITAL IN ANADARKO ORIGINALLY OPENED IN JUNE OF 1978 WITH FINANCING MADE AVAILABLE MOSTLY FROM THE FARMER'S HOME ADMINISTRATION. PATIENT ROOMS WERE FURNISHED BY PRIVATE CITIZENS WHO WANTED QUALITY HEALTHCARE IN THEIR COMMUNITY. THE HOSPITAL WAS OWNED BY THE CITY OF ANADARKO AND CONTINUED TO GROW AND SERVE THE HEALTHCARE NEEDS OF THE COMMUNITY. IN 2002 IT WAS PURCHASED BY A PRIVATE COMPANY. AFTER SEVERAL YEARS OF FINANCIAL DIFFICULTY, AND THE HOSPITAL OWNERSHIP CHANGING SEVERAL TIMES, THE HOSPITAL WAS BOUGHT BY ITS CURRENT OWNER ONE CURA WELLNESS, INC. IN 2011. CORE FORM, PART VI, SECTION A; QUESTION 3 THE HOSPITAL ENGAGES FIRST PHYSICIAN'S BUSINESS SOLUTIONS, LLC TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO FIRST PHYSICIAN'S BUSINESS SOLUTIONS, LLC IN THE MANAGEMENT AND SUPPORT SERVICES OF THE HOSPITAL. THE HOSPITAL ENGAGES FIRST PHYSICIANS SERVICES, LLC TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO FIRST PHYSICIANS SERVICES, LLC IN THE MANAGEMENT OF FURNISHING INFORMATION TECHNOLOGY, DIAGNOSTIC TESTING SERVICES, ELECTRONIC HEALTH RECORDS SOFTWARE AND SYSTEMS, MANAGEMENT OF PROFESSIONAL SERVICES AND OTHER ANCILLARY SERVICES OF THE HOSPITAL. THE HOSPITAL ENGAGES FIRST PHYSICIANS RESOURCES, LLC TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO FIRST PHYSICIANS RESOURCES, LLC IN THE LEASING OF VARIOUS CLINICAL, ADMINISTRATIVE AND OTHER PERSONNEL, INCLUDING PHYSICIANS AND SENIOR EXECUTIVES, WHO ARE QUALIFIED TO PROVIDE SERVICES TO THE HOSPITAL FOR THE EFFICIENT AND EFFECTIVE OPERATION OF THE HOSPITAL. THE HOSPITAL ENGAGES FIRST PHYSICIANS REALTY GROUP, LLC TO LEASE LAND AND BUILDINGS, INCLUDING THE RIGHT TO USE ALL OF THE PARKING AREAS, DRIVEWAYS, ROADS, ALLEYS, MEANS OF INGRESS AND EGRESS AND OTHER PORTIONS OF THE PREMISES IN THE OPERATION OF THE HOSPITAL. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 ONE CURA WELLNESS, INC. ("ONE CURA") IS THE SOLE MEMBER OF THIS ORGANIZATION. ONE CURA HAS THE ULTIMATE AUTHORITY TO APPOINT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11 THE ORGANIZATION IS AN AFFILIATE IN ONE CURA WELLNESS, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). ONE CURA WELLNESS, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. FIRST PHYSICIAN SERVICES, LLC, THE MANAGEMENT COMPANY UTILIZED BY THE ORGANIZATION, PERFORMED A REVIEW OF THE FEDERAL FORM 990. THE ONE CURA WELLNESS, INC. BOARD OF DIRECTORS HAS DELEGATED TO THE MANAGEMENT COMPANY THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. IN ADDITION, THE SYSTEM'S OUTSIDE TAX COUNSEL PERFORMED A DETAILED REVIEW OF THE DRAFT FEDERAL FORM 990. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND LEADERSHIP TEAM ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE ORGANIZATION'S MANAGEMENT COMPANY. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, AND DIRECTORS ANNUALLY. IF AN INDIVIDUAL DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE INDIVIDUAL'S POTENTIAL CONFLICT IS REFERRED TO THE ORGANIZATION'S CEO AND OUTSIDE GENERAL COUNSEL, WHICH EVALUATE THE CONFLICT AND ITS POTENTIAL IMPACT ON THE INDIVIDUAL'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH THE ORGANIZATION'S OUTSIDE COUNSEL, THE OUTSIDE GENERAL COUNSEL WILL TAKE ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION'S CEO IS COMPENSATED BY A RELATED ORGANIZATION, NOT THIS ORGANIZATION. THE INDIVIDUAL'S COMPENSATION IS DETERMINED BY THE RESPECTIVE ORGANIZATION'S BOARD OF DIRECTORS, TAKING INTO ACCOUNT COMPENSATION OF COMPARABLE POSITIONS. THE ORGANIZATION HAS NO OTHER OFFICERS OR KEY EMPLOYEES OTHER THAN THE CEO. CORE FORM, PART VI, SECTION B; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF OKLAHOMA SECRETARY OF STATE. CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECTS A BOARD MEMBER/OFFICER RECEIVING COMPENSATION FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS THE HEALTHCARE SYSTEM'S CEO AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. CORE FORM, PART VIII, PG 1, PT 1, QUESTION 5 & PG 5, QUESTION 2A THIS ORGANIZATION HAS NO EMPLOYEES AND ACCORDINGLY ISSUED NO FORMS W-2. PLEASE REFER TO PART VI, QUESTION 3 WORDING WHEREBY THIS ORGANIZATION ENGAGES FIRST PHYSICIAN'S BUSINESS SOLUTIONS, LLC TO BE AN AGENT OF THE HOSPITAL AND DELEGATES CONTROL TO FIRST PHYSICIAN'S BUSINESS SOLUTIONS, LLC IN THE MANAGEMENT AND SUPPORT SERVICES OF THE HOSPITAL. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE OF ONE CURA WELLNESS, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR THE DIRECTOR WHO RECEIVED COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY REFLECTS TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDES: - NET EQUITY TRANSFER TO ONE CURA WELLNESS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($50,000). CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN ONE CURA WELLNESS, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS ONE CURA WELLNESS, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF ONE CURA WELLNESS, INC. AND ALL AFFILIATES WITHIN THE SYSTEM FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2017 AND SEPTEMBER 30, 2016; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. ONE CURA WELLNESS' MANAGEMENT COMPANY, FIRST PHYSICIAN'S SERVICES, LLC, ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. ONE CURA WELLNESS INC 8502 EAST CHAPMAN AVE STE 431 ORANGE CA 92869 451870767 HEALTH SVCS. CA 501(C)(3) 509(A)(3) NA false STROUD REGIONAL MEDICAL CENTER 2308 HIGHWAY 66 WEST STROUD OK 74079 260532635 HEALTH SVCS. OK 501(C)(3) HOSPITAL ONE CURA false ONE CURA FAMILY CLINIC-STROUD INC 2308 HIGHWAY 66 WEST Stroud OK 74079 811824062 HEALTH SVCS. OK 501(C)(3) 509(a)(2) ONE CURA false ONE CURA FAMILY CLINIC-ANADARKO INC 1002 E CENTRAL BOULEVARD ANADARKO OK 73005 811804262 HEALTH SVCS. OK APP PENDING 509(A)(2) ONE CURA false false true false false false false false false false false false false false false false false false false false ONE CURA WELLNESS INC B 50000 COST