2021-06-15T11:37:19-05:00 2020-06-30 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2019-07-01 731192764 INTEGRIS HEALTH INC % KATHRYN INGERLY INTE 4059512732 5300 N INDEPENDENCE AVENUE OKLAHOMA CITY OK 73112 DOUGLAS M SMITH VP FINANCIAL REPORTING 4059512744 2021-06-11 true BRITTANY K ELLISER P01284594 2253444000 2021-06-02 2019 2022-09-23 18:48:47Z SEE SCHEDULE O TIMOTHY PEHRSON 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 316262570 false X WWW.INTEGRISOK.COM X 1983 OK TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 14 0 12412 43 2465584 332711 188604 312387170 311561993 4302976 3906287 2288969 605686 319311826 316262570 411700 625000 0 0 134514677 126111421 0 0 0 180153322 193463948 315079699 320200369 4232127 -3937799 2169345017 2102839265 716154485 788647222 1453190532 1314192043 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 176670633 250000 306290464 INTEGRIS HEALTH IS THE CONTROLLING MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES IN THE STATE OF OKLAHOMA. SEE SCHEDULE O, GENERAL STATEMENTS 2 THROUGH 4. 176670633 true true false true false false false false false false true false true false true false false true false false true false false false false false false true false true false false false false false false true true true false false false true true true true false false true X 1063 0 true 12412 true true true true CJ false false false false false false false false false false X 14 0 true false false false false false false true true false false true true true true true true true true true true OK X KATHRYN INGERLY 4059493085 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 X TIMOTHY PEHRSON PRESIDENT/CEO 40.0 0.0 X X 1159067 0 308500 CHRIS HAMMES COO OF IH 32.0 8.0 X 1073983 0 221641 TOMMY IBRAHIM CHIEF HUMAN RESOURCES OFFICER 40.0 0.0 X 746697 0 165062 JEFFREY CRUZAN CHIEF MEDICAL OFFICER 40.0 0.0 X 461947 353342 53236 DOUGLAS M SMITH CFO OF IH 32.0 8.0 X 712012 0 114852 MARK PASQUALE SENIOR VICE PRESIDENT 40.0 0.0 X 722438 0 33996 MICHAEL HATCH CHIEF HUMAN RESOURCES OFFICER 40.0 0.0 X 496756 0 100497 ANGELA COSBY PRESIDENT IMG 0.0 0.0 X 546737 0 33657 TERESA WILLIAMS VICE PRESIDENT 40.0 0.0 X 383842 0 36477 JAQUETTA CLEMONS SENIOR VICE PRESIDENT 40.0 0.0 X 403135 0 13703 LEROY SOUTHMAYD III DIRECTOR MEDICAL INFORMATICS 40.0 0.0 X 365486 0 35419 SUSAN GARCIA VICE PRESIDENT 40.0 0.0 X 258521 0 121943 BRENT DAVIS VICE PRESIDENT 40.0 0.0 X 337387 0 31216 BENJAMIN MANSALIS MED. DIRECTOR CMIO/SENIOR VP 40.0 0.0 X 335393 0 32255 MICHAEL WEED SENIOR VICE PRESIDENT 40.0 0.0 X 330611 0 26033 ANDREW BARSALOUX MEDICAL DIRECTOR CMIO 40.0 0.0 X 328411 0 25377 ERIC DEDEKE MEDICAL DIRECTOR CMIO 40.0 0.0 X 325692 0 25866 KERRI BAYER CHIEF HR OFFICER/VP 40.0 0.0 X 259369 0 62523 MICHAEL MCCONNELL VICE PRESIDENT 40.0 0.0 X 290348 0 20810 GEORG LUNDAY DIRECTOR PHARMACY/VP 40.0 0.0 X 259132 0 37938 HARTFORD WATKINS VICE PRESIDENT 40.0 0.0 X 247716 0 23404 ALLISON PETERSEN ASST. SECRETARY 40.0 0.0 X 208729 0 45101 DAVID R HADLEY FORMER OFFICER 0.0 0.0 X 244392 0 0 MICHAEL BOWLING FORMER KEY EMPLOYEE 0.0 0.0 X 127300 0 21706 PHILLIP MOSCA MD DIRECTOR 1.0 30.0 X 32129 66120 0 CHRISTOPHER TURNER DIRECTOR & CHAIR/AUDIT COMM 1.0 1.0 X X 32728 0 0 PETER B DELANEY DIRECTOR & BOARD CHAIRMAN 1.0 1.0 X X 31906 0 0 MARSHALL SNIPES DIRECTOR & CHAIR/FINANCE COMM 1.0 1.0 X X 30922 0 0 EDMUND O MARTIN DIRECTOR 1.0 0.0 X 30337 0 0 GEORGIANNE SNOWDEN MD DIRECTOR & CHAIR/QUAILTY COMM 1.0 0.0 X X 29980 0 0 DAVID THOMPSON DIRECTOR 1.0 1.0 X 29950 0 0 JOEY SAGER DIRECTOR 1.0 1.0 X 29121 0 0 LUKE R CORBETT DIRECTOR & CHAIR/GOV COMM 1.0 1.0 X X 28600 0 0 MARK WERNER MD DIRECTOR 1.0 0.0 X 28100 0 0 LINDA VYTLACIL PHD DIRECTOR 1.0 0.0 X 27680 0 0 NEAL HOGAN PHD DIRECTOR 1.0 0.0 X 26798 0 0 ELLIOTT R SCHWARTZ DO DIRECTOR 1.0 0.0 X 24900 0 0 PRAVENE NATH MD FORMER DIRECTOR 0.0 0.0 X 13550 0 0 10657230 419462 1591212 181 true true false VIZIENT INC 75 REMITTANCE DR STE 1855 CHICAGO IL 60675 PROFESSIONAL SERVICE 6162809 GE PRECISION HEALTHCARE LLC PO BOX 96483 CHICAGO IL 60693 SOFTWARE SYSTEMS 5174904 ACKERMAN MCQUEEN INC 1601 NORTHWEST EXPRESSWAY OKLAHOMA CITY OK 73118 ADVERTISING 4800619 UNITY BPO INC 4100 OSUNA RD ALBUQUERQUE NM 87109 SOFTWARE SYSTEMS 4684976 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 53288 SOFTWARE SYSTEMS 3888408 149 188604 78804 188604 AFFILIATED SERVICE REVENUE 900003 264558430 262092846 2465584 MANAGEMENT FEES 900003 30804294 30804294 RENTAL INCOME 532000 12624047 12624047 CHILDREN'S PLACE 900003 2064189 2064189 TELEMEDICINE 900003 330440 330440 1180593 438837 741756 311561993 3906287 3906287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DISCOUNTS ON PURCHASES 900003 598831 598831 OTHER REVENUE 900003 6855 6855 605686 316262570 306290464 2465584 7317918 625000 625000 0 0 0 9592990 5289575 4303415 0 537824 296556 241268 0 90829200 50083221 40745979 0 5076421 2799139 2277282 0 12940142 7135194 5804948 0 7134844 3934153 3200691 0 121998 67270 54728 0 524237 289064 235173 0 969516 534591 434925 0 300252 165559 134693 0 0 217151 119737 97414 0 19365527 10678152 8687375 0 1683706 928395 755311 0 5389619 2971836 2417783 0 0 0 11526185 6355538 5170647 0 717808 395799 322009 0 0 640885 353384 287501 0 1586951 875045 711906 0 0 34194414 18854800 15339614 0 7389614 4074633 3314981 0 PURCHASED SERVICES 100850263 55608835 45241428 0 RIF & RECRUITMENT 4901665 2702778 2198887 0 BANK FEES 1096573 604650 491923 0 UNRELATED BUS. INCOME TAXES 1060 1060 0 0 1986524 926669 1059855 320200369 176670633 143529736 0 0 0 63087537 27089097 0 0 45473542 50642068 0 0 0 0 51737 67 0 0 16475306 17705748 503967338 317123761 207720898 186843577 0 0 95925805 77388369 1715416610 1716572677 0 0 25193582 26597662 2169345017 2102839265 363525808 72570587 0 0 0 0 0 0 0 0 0 0 0 0 0 2829869 352628677 713246766 716154485 788647222 X 1453190532 1314192043 0 0 1453190532 1314192043 2169345017 2102839265 X -3937799 899353 -135960043 X false true X true false X X X 7 INTEGRIS BAPTIST MEDICAL CENTER INC 731034824 3 true 0 0 INTEGRIS RURAL HEALTH INC 731444504 3 true 0 0 INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORPORATION 731089149 3 true 0 0 INTEGRIS AMBULATORY CARE CORPORATION 731192765 3 true 0 0 INTEGRIS HOSPICE INC 731369586 10 true 0 0 WESTERN VILLAGE ACADEMY INC 731588764 2 true 250000 0 INTEGRIS HEALTH EDMOND INC 451027361 3 true 0 0 7 250000 0 false false false false false true false false false false false false false false false false false SUPPLEMENTAL INFORMATION 1 SCHEDULE A, PART IV, SECTION A. LINE 1 INTEGRIS HEALTH, INC.'S (INTEGRIS) AMENDED AND RESTATED CERTIFICATE OF INCORPORATION SPECIFIES INTEGRIS' SUPPORTED ORGANIZATIONS BY CLASS OR PURPOSE. SECTION 3, PARAGRAPH FOUR OF THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION SPECIFIES THAT INTEGRIS IS EXCLUSIVELY ORGANIZED AS A SUPPORTING ORGANIZATION, AS DEFINED UNDER SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE, TO BE OPERATED EXCLUSIVELY FOR THE SUPPORT AND BENEFIT OF ORGANIZATIONS OF WHICH IT IS DIRECTLY OR INDIRECTLY THE SOLE MEMBER AND WHICH ARE ORGANIZATIONS DESCRIBED IN SECTON 501(C)(3) AND ARE NOT PRIVATE FOUNDATIONS BECAUSE THEY ARE DESCRIBED IN SECTIONS 509(A)(1) OR 509(A)(2) OF THE INTERNAL REVENUE CODE. SUPPLEMENTAL INFORMATION 2 SCHEDULE A, PART IV, SECTION A. LINE 6 GRANTS ARE MADE AT THE DIRECTION OF THE SUPPORTED ORGANIZATIONS IN THE COMMUNITIES SERVED BY THEM. SUPPLEMENTAL INFORMATION 3 SCHEDULE A, PART IV, SECTION B. LINE 1 PURSUANT TO THE ORGANIZATION'S BYLAWS, AT ALL TIMES A MAJORITY OF INTEGRIS' OFFICERS MUST BE, AND ARE, INDIVIDUALS THAT ARE CONCURRENTLY OFFICERS OF ONE OR MORE OF ITS SUPPORTED ORGANIZATIONS AND ARE APPOINTED BY THE RESPECTIVE BOARDS OF THOSE SUPPORTED ORGANIZATIONS. ACCORDINGLY, INTEGRIS MEETS THE "OPERATED, SUPERVISED, OR CONTROLLED BY" RELATIONSHIP TEST FOR QUALIFICATION AS A TYPE I SECTION 509(A)(3) SUPPORTING ORGANIZATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 300252 300252 300252 300252 176370381 1691570500 176670633 1691870752 1000000 1000000 250000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 235278 160471 263222 300252 959223 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE C, PART II-A, LINE 1 AFFILIATED GROUP LIST: INTEGRIS HEALTH, INC. 5300 N. INDEPENDENCE AVENUE, SUITE 130 OKLAHOMA CITY, OK 73112 EIN: 73-1192764 TOTAL PROGRAM EXPENSES $176,670,633 THE OTHER AFFILIATED MEMBERS HAVE NOT INCURRED ANY EXPENSES FOR LOBBYING ACTIVITIES. SEE SCHEDULE R-1, PART II FOR A COMPLETE LIST OF AFFILIATED MEMBERS. 17937465 17937465 61281097 49812551 11468546 5504809 5473002 31807 415186412 259197137 155989275 4057555 2641071 1416484 186843577 INTEGRIS BAPTIST MED.CTR.,INC. 626184319 F INTEGRIS HEALTH FDN., INC. 67780836 F INTEGRIS AMBULATORY CARE CORP 270398231 F INTEGRIS REALTY, LLC 61905742 F 5300 GRAND LIMITED PARTNERSHIP 16894 F MEDICAL PARKING, LLC 4253635 F INTEGRIS PROHEALTH, INC. 24285955 F INTEGRIS ARCADIA TRAILS 18922002 F QUALITY ALLIANCE ASSURANCE 478860 F INTEGRIS HEALTH EDMOND, INC. 112632922 F INTEGRIS SO. OKC HOSP.CORP. 260056564 F INTEGRIS HEALTH PARTNERS, LLC -1667211 F INTEGRIS CARDIOVASCULAR -30985839 F BAPTIST HEALTHCARE OF OKLAHOMA 258666201 F INTEGRIS GROVE HOSPITAL 30000000 F LIFECARE HEALTH LLC 1621990 F 2 CORP PLAZA 318593 F INTEGRIS HOSPICE, INC. 10009686 F HEFNER POINT MEDICAL 1693297 F 1716572677 0 PENSION LIABILITY 416986906 POST-RETIREMENT HEALTH BENEFIT 2002199 OTHER LONG TERM LIABILITIES 39120893 LONG TERM LEASE PAYABLE 2058054 INTERCOMPANY PAYABLES 251683696 LT SOCIAL SECURITY WITHHELD 1395018 713246766 Central America and the Caribbean 0 0 Program Services CAPTIVE INSURANCE 19806000 0 0 0 0 19806000 19806000 true false true true false false SUPPLEMENTAL INFORMATION 1 SCHEDULE F, PART I, LINE 3 INTEGRIS HEALTH, INC. IS THE SOLE OWNER OF A CAPTIVE INSURANCE COMPANY LOCATED IN THE CENTRAL AMERICA/CARIBBEAN REGION. THE EXPENDITURES SHOWN IN PART I LINE 3 REPRESENT THE EXPENSES INCURRED BY THE CAPTIVE INSURANCE COMPANY AS DETERMINED USING THE ACCRUAL METHOD FOR THE YEAR ENDING JUNE 30, 2020. true WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE STE 130 OKC OK 73112 731588764 501(C)(3) 250000 TO FUND OPERATIONS OKLAHOMA CITY BOATHOUSE FOUNDATION 725 S LINCOLN BLVD OKC OK 731294430 201837237 501(C)(3) 40000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 752315129 135613797 501(C)(3) 25000 GENERAL SUPPORT JIM THORPE ASSOCIATION INC 20 S MICKEY MANTLE DR OKC OK 731042433 731306116 501(C)(3) 35000 GENERAL SUPPORT UNITED WAY OF CENTRAL OKLAHOMA 1444 NW 28TH ST OKC OK 731063430 730589829 501(C)(3) 95000 GENERAL SUPPORT GREATER OKLAHOMA CITY CHAMBER OF COMMERCE 123 PARK AVENUE OKC OK 731029005 730381180 501(C)(6) 80000 GENERAL SUPPORT AMERICAN INDIAN CULTURAL CENTER FOUNDATION 659 FIRST AMERICANS BLVD OKC OK 731296142 731554119 501(C)(3) 100000 GENERAL SUPPORT 6 1 SUPPLEMENTAL INFORMATION 1 SCHEDULE I, PART I, LINE 2 INTEGRIS HEALTH, INC. (SYSTEM) PROVIDES FUNDS TO VARIOUS COMMONLY CONTROLLED HOSPITALS AND AFFILIATES TO SUPPORT THEIR OPERATIONS. THE SYSTEM DETERMINES THE AMOUNT OF THE FUNDS PROVIDED ON AN ANNUAL BASIS. AS PART OF ITS COMMITMENT TO THE COMMUNITIES IT SERVES, INTEGRIS HEALTH, INC. MAKES GRANTS TO OTHER CHARITABLE AND CIVIC ORGANIZATIONS THAT BENEFIT THOSE COMMUNITIES. GRANTS ARE REVIEWED AND APPROVED THROUGH THE ANNUAL BUDGETARY PROCESS BY THE CEO AND THE BOARD OF DIRECTORS OF INTEGRIS HEALTH. SEE SCHEDULE O, GENERAL STATEMENTS 2 THROUGH 4 FOR A FULL COPY OF THE INTEGRIS HEALTH SYSTEM COMMUNITY BENEFIT REPORT, WHICH PROVIDES GREATER DETAIL WITH RESPECT TO INTEGRIS HEALTH'S RETURNSHIP AND COMMUNITY BUILDING EFFORTS. X X X X false true false false false false false true false TIMOTHY PEHRSON PRESIDENT/CEO 913234 0 230379 0 15454 0 288443 0 20057 0 1467567 0 0 0 DOUGLAS M SMITH CFO OF IH 487336 0 212977 0 11699 0 95788 0 19064 0 826864 0 0 0 ALLISON PETERSEN ASST. SECRETARY 204514 0 750 0 3465 0 31210 0 13891 0 253830 0 0 0 CHRIS HAMMES COO OF IH 644265 0 401961 0 27757 0 202467 0 19174 0 1295624 0 0 0 KERRI BAYER CHIEF HR OFFICER/VP 222504 0 26662 0 10203 0 42690 0 19833 0 321892 0 0 0 JAQUETTA CLEMONS SENIOR VICE PRESIDENT 224815 0 166578 0 11742 0 13502 0 201 0 416838 0 0 0 ANGELA COSBY PRESIDENT IMG 69190 0 476584 0 963 0 24544 0 9113 0 580394 0 0 0 JEFFREY CRUZAN CHIEF MEDICAL OFFICER 204888 353342 246965 0 10094 0 33157 0 20079 0 515183 353342 0 0 SUSAN GARCIA VICE PRESIDENT 209207 0 40365 0 8949 0 121788 0 155 0 380464 0 0 0 MICHAEL HATCH CHIEF HUMAN RESOURCES OFFICER 333671 0 151631 0 11454 0 80541 0 19956 0 597253 0 0 0 TOMMY IBRAHIM CHIEF HUMAN RESOURCES OFFICER 581875 0 153082 0 11740 0 145646 0 19416 0 911759 0 0 0 GEORG LUNDAY DIRECTOR PHARMACY/VP 222698 0 27977 0 8457 0 18753 0 19185 0 297070 0 0 0 BENJAMIN MANSALIS MED. DIRECTOR CMIO/SENIOR VP 297797 0 31332 0 6264 0 14364 0 17891 0 367648 0 0 0 MICHAEL MCCONNELL VICE PRESIDENT 242567 0 39448 0 8333 0 12808 0 8002 0 311158 0 0 0 MARK PASQUALE SENIOR VICE PRESIDENT 113933 0 604040 0 4465 0 28000 0 5996 0 756434 0 0 0 HARTFORD WATKINS VICE PRESIDENT 202308 0 33594 0 11814 0 9898 0 13506 0 271120 0 0 0 MICHAEL WEED SENIOR VICE PRESIDENT 253324 0 67492 0 9795 0 6920 0 19113 0 356644 0 0 0 ANDREW BARSALOUX MEDICAL DIRECTOR CMIO 260748 0 66808 0 855 0 11000 0 14377 0 353788 0 0 0 BRENT DAVIS VICE PRESIDENT 248272 0 76583 0 12532 0 11302 0 19914 0 368603 0 0 0 ERIC DEDEKE MEDICAL DIRECTOR CMIO 311082 0 13405 0 1205 0 17803 0 8063 0 351558 0 0 0 LEROY SOUTHMAYD III DIRECTOR MEDICAL INFORMATICS 227262 0 136881 0 1343 0 20864 0 14555 0 400905 0 0 0 TERESA WILLIAMS VICE PRESIDENT 202267 0 170681 0 10894 0 20026 0 16451 0 420319 0 0 0 DAVID R HADLEY FORMER OFFICER 0 0 0 0 244392 0 0 0 0 0 244392 0 0 0 MICHAEL BOWLING FORMER KEY EMPLOYEE 123542 0 0 0 3758 0 13277 0 8429 0 149006 0 0 0 PRAVENE NATH MD FORMER DIRECTOR 13550 0 0 0 0 0 0 0 0 0 13550 0 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART I, LINE 4B THE FILING ORGANIZATION IS THE CONTROLLING MEMBER ORGANIZATION OF AN INTEGRATED HEALTHCARE SYSTEM (SYSTEM). THE SYSTEM 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 NON QUALIFIED 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. KERRI BAYER TOMMY IBRAHIM ANGELA COSBY MARK PASQUALE JEFFREY CRUZAN TIMOTHY PEHRSON CHRIS HAMMES ALLISON PETERSEN MICHAEL HATCH DOUGLAS M. SMITH SUPPLEMENTAL INFORMATION 2 SCHEDULE J, PART I, LINE 7 THE FILING ORGANIZATION IS THE CONTROLLING MEMBER ORGANIZATION OF AN INTEGRATED HEALTHCARE SYSTEM (SYSTEM). THE SYSTEM 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. SEE PART V false SUPPLEMENTAL INFORMATION 1 (A) NAME OF INTERESTED PERSON: ACKERMAN MCQUEEN, INC. (B) RELATIONSHIP: BOARD MEMBER HAS AN OWNERSHIP INTEREST IN ACKERMAN MCQUEEN, INC. (C) AMOUNT: $5,268,769 (D) DESCRIPTION OF TRANSACTION: ADVERTISING SERVICES (E) SHARING OF ORGANIZATION'S REVENUES: NO (A) NAME OF INTERESTED PERSON: M. MARTIN (B) RELATIONSHIP: DAUGHTER-IN-LAW OF BOARD MEMBER (C) AMOUNT: $132,696 (D) DESCRIPTION OF TRANSACTION: EMPLOYMENT SERVICES (E) SHARING OF ORGANIZATION'S REVENUES: NO X MEDICAL EQUIPMENT 2 49180 FMV X OTHER EQUIPMENT 2 29624 FMV false true false GENERAL STATEMENT 1 FORM 990, BOX C: DOING BUSINESS AS OKLAHOMA BUSINESS HEALTH INSTITUTE PARTNERS IN OKLAHOMA PARTNERS IN PRACTICE CARELINE INTEGRIS INTEGRIS HEALTH INTEGRIS HEALTHCARE INTEGRIS HEALTHCARE SYSTEM MISSION OF PREVENTION WORKING TOGETHER FOR A QUALITY LIFE LIFESPAN TELEREHAB MOVE FOR LIFE MAN CARD THE MOST DEDICATED PEOPLE HRANYTIME INTEGRIS CANCER INSTITUTE OF OKLAHOMA THE INTEGRIS PROTON CAMPUS INTEGRIS ONE CALL INTEGRIS ONE CALL TRANSFER CENTER INTEGRIS SLEEP DISORDERS CENTER OF OKLAHOMA THE CHILDREN'S PLACE AT INTEGRIS SOUTHWEST MEDICAL CENTER FUN AND FIT FUN AND FIT KIRKLAND THE MOST CHALLENGING HEALING INTEGRIS FAMILY OF FOUNDATIONS INTEGRIS CANCER INSTITUTE OF OKLAHOMA RESEARCH - METRO INTEGRIS TELESTROKE NETWORK OF OKLAHOMA TELESTROKE NETWORK OF OKLAHOMA INSTITUTE FOR ADVANCED THERAPEUTICS AND RESEARCH INTEGRIS HEART MIDWEST REGIONAL INTEGRIS COMMUNITY CLINIC INTEGRIS ONE CARE INTEGRIS OFFICE OF RESEARCH ADMINISTRATION GENERAL STATEMENT 2 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 3 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 4 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 5 PART V: QUESTION 2A THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF EMPLOYEES REPORTED ON INTEGRIS HEALTH, INC.'S 2018 FORM W-3. INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, ACTS AS THE PAYROLL AGENT FOR ALL OF THE SYSTEM ENTITIES AND ALL SYSTEM EMPLOYEES ARE INCLUDED ON ITS FORM W-3 AND ITS FORM 941, EMPLOYER'S QUARTERLY FEDERAL TAX RETURN. THE SALARIES ARE REIMBURSED TO INTEGRIS HEALTH, INC. BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990 PARTS VII, IX, AND SCHEDULE J AS APPROPRIATE. THE AMOUNTS REPORTED ON PART V, LINE 2A OF THE FORMS 990 OF THE INDIVIDUAL ENTITIES WITHIN THE SYSTEM REPRESENT THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE RESPECTIVE FILING ORGANIZATIONS DURING THE 2018 TAX YEAR, AND THOSE EMPLOYEES ARE ALSO INCLUDED IN THE TOTAL REPORTED ON THE INTEGRIS HEALTH, INC. FORM 990, PART V, LINE 2A. GENERAL STATEMENT 6 PART VI: QUESTION 2 THE FILING ORGANIZATION IS THE CONTROLLING MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM (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, EMPLOYEES, OR INDEPENDENT CONTRACTORS OF RELATED ENTITIES WITHIN THE SYSTEM: LUKE R. CORBETT JOEY SAGER DANIEL DAVIS ELLIOTT SCHWARTZ, D.O. PETER DELANEY DOUGLAS M. SMITH CHRIS HAMMES MARSHALL SNIPES NEAL HOGAN, PH.D. GEORGIANNE SNOWDEN, M.D. PHILIP MOSCA, MD. DAVID THOMPSON TIMOTHY PEHRSON CHRISTOPHER TURNER ALLISON PETERSEN LINDA VYTLACIL, PH.D. MARK WERNER, M.D. GENERAL STATEMENT 7 PART VI: SECTION B. POLICIES PART VI: QUESTION 11B - THE FILING ORGANIZATION IS THE CONTROLLING MEMBER ORGANIZATION OF AN INTEGRATED HEALTHCARE SYSTEM (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 8 PART VI: SECTION B. POLICIES PART VI: QUESTION 12C - THE FILING ORGANIZATION IS THE CONTROLLING MEMBER ORGANIZATION OF AN INTEGRATED HEALTHCARE SYSTEM (SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE SYSTEM 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 SYSTEMS'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 GOVERANCE COMMITTEE, A COMMITTEE OF THE SYSTEM'S BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF THE SYSTEM AND A DISQUALIFIED PERSON. GENERAL STATEMENT 9 PART VI: SECTION B. POLICIES PART VI: QUESTION 15A AND 15B - THE FILING ORGANIZATION IS THE CONTROLLING MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM (SYSTEM). COMPENSATION FOR THE CEO, MANAGING DIRECTORS AND 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 FILING ORGANIZATION'S 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 10 PART VI: SECTION C. DISCLOSURE PART VI: QUESTION 19 - THE FILING ORGANIZATION IS THE CONTROLLING MEMBER ORGANIZATION OF AN INTEGRATED HEALTHCARE SYSTEM (SYSTEM). THE SYSTEM DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR THE SYSTEM. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION. GENERAL STATEMENT 11 PART XI: RECONCILIATION OF NET ASSETS, LINE 9 ACTUARIAL ADJUSTMENT TO RETIREMENT PLAN BALANCE ($ 137,150,611) INCOME FROM SUBSIDIARIES - EQUITY METHOD $ 940,568 EQUITY TRANSFERS FROM SUBSIDIARIES $ 250,000 -------------- TOTAL ($ 135,960,043) MEDICAL PARKING INC 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 731210537 PARKING FAC. OK 1221841 4266610 IH INTEGRIS REALTY LLC 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 731192750 PROPERTY MGMT OK 13467258 62790797 IH INTEGRIS HEALTH AFFILIATES LLC 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 HEALTH CARE OK 0 0 IH INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192765 HEALTH CARE OK 501(C)(3) LINE 3 IH true INTEGRIS HOSPICE INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731369586 HEALTH CARE OK 501(C)(3) LINE 10 IH true 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 true INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731444504 HEALTH CARE OK 501(C)(3) LINE 3 IH true 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 true INTEGRIS HEALTH FOUNDATION INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731047338 FUNDRAISING OK 501(C)(3) LINE 7 IH true 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 true INTEGRIS MENTAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH true BMPA LTD 73-1228665 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MED. 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(IRH) INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) INTEGRIS HEALTH FOUNDATION, INC. (IH FDN.) INTEGRIS HEALTH, INC. (IH) INTEGRIS AMBULATORY CARE CORPORATION (IACC) INTEGRIS PROHEALTH, INC. (PROHEALTH)