2020-07-14T11:14:01-05:00 2019-06-30 KPMG LLP 210 Park Ave Suite 2650 Oklahoma City OK 73102 990 2018-07-01 731047338 INTEGRIS HEALTH FOUNDATION INC % KATHRYN INGERLY INTE 4059512747 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DOUGLAS M SMITH VP FINANCIAL REPORTING 4059512744 2020-07-13 true BRITTANY K ELLISER P01284594 4052396411 199.206.0.5 73017020201965000002 2020-07-14 P 0EAA22B2C3DA13DBE0E7C6D8610A4AA845F8EF4C 0EAA22B2C3DA13DBE0E7C6D8610A4AA845F8EF4C 2018 2021-01-29 14:40:06Z TIMOTHY PEHRSON 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 10355787 false X WWW.INTEGRISOK.COM X 1978 OK THE FOUNDATION PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO IMPROVE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 9 9 12 9 -387433 -388471 6005038 8370781 0 0 3285718 1835549 -105575 -105123 9185181 10101207 10692108 9442873 0 0 1214650 1230242 0 0 2415709 747639 1242960 12654397 11916075 -3469216 -1814868 77358679 75771148 7909591 7994988 69449088 67776160 X INTEGRIS HEALTH FOUNDATION, INC. PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO PROMOTE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. false false 9442873 9442873 SEE SCHEDULE O - GENERAL STATEMENT 1 9442873 true true false false false false false false true true true true false false false false false true false false false false false false true false false true false true false false false false false false false false false true false false false true true false false false true X 0 0 true 12 true true true false false false false true true false false false false false false X 9 9 true false false false true true true true true false false true true true true true true false false false OK X KATHRYN INGERLY 4059493085 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 X HARRISON LEVY DIRECTOR 1.0 0.0 X 0 0 0 RON MCCORD DIRECTOR 1.0 0.0 X 0 0 0 MARCEL WALTHER DIRECTOR 1.0 0.0 X 0 0 0 SHERYL COLTON DIRECTOR 1.0 0.0 X 0 0 0 PAUL SILVERSTEIN DIRECTOR 1.0 0.0 X 0 0 0 SUSAN BREWER DIRECTOR 1.0 0.0 X 0 0 0 SUSAN MORITZ SECRETARY 1.0 0.0 X X 0 0 0 JIM WALLIS CHAIRMAN 1.0 0.0 X X 0 0 0 JOEL CHAMPLIN VICE CHAIRMAN 1.0 0.0 X X 0 0 0 TIMOTHY PEHRSON DIRECTOR 1.0 39.0 X 0 614405 7012 DOUGLAS M SMITH ASST. SECRETARY 1.0 39.0 X 0 0 0 DANIEL DAVIS ASST. TREASURER THRU NOV 2018 1.0 39.0 X 0 1335553 93393 BETH A PAUCHNIK ASST. SECRETARY THRU NOV 2018 1.0 39.0 X 0 2300122 110788 ANNE CLOUSE PRESIDENT FOUNDATION 39.0 1.0 X 238017 0 12529 BECKY ENDICOTT MAJOR GIFTS CONSULTANT 40.0 0.0 X 112269 0 25539 JONATHAN MCCOY DIRECTOR ANNUAL GIVING 40.0 0.0 X 110574 0 24124 SCOTT PETERSON DIRECTOR MAJOR GIFTS 40.0 0.0 X 132278 0 16892 DAVID R HADLEY FORMER OFFICER 0.0 0.0 X 0 244392 0 593138 4494472 290277 4 true true false SEE SCHEDULE O GENERAL STATEMENT 8 148000 2 1394110 31600 6945071 5500 8370781 0 1835549 -387433 2222982 0 0 0 0 0 0 143829 1394110 254580 -110751 -110751 0 0 0 0 0 0 MISC. INCOME 900099 5628 5628 5628 10101207 -387433 2117859 9442873 9442873 0 0 0 259475 259475 0 754175 754175 41174 41174 110134 110134 65284 65284 57493 57493 0 614 614 0 0 0 308635 308635 46 46 632000 632000 0 0 127615 127615 22623 22623 0 8057 8057 0 0 3999 3999 14585 14585 PURCHASED SERVICES 86272 86272 DONOR CULTIVATION 49789 49789 DUES & MEMBERSHIPS 5179 5179 ALL OTHER EXPENSES -73947 -73947 11916075 9442873 57493 2415709 0 0 2138574 1781596 12561829 9821417 0 41831 0 0 0 0 0 0 0 0 0 0 482531 461492 25037 21039 0 0 62397769 63860730 0 0 0 0 235470 244535 77358679 75771148 7785044 7874127 0 0 0 0 0 0 124547 120861 0 0 0 0 0 0 0 0 7909591 7994988 X 13357380 11439232 48800306 48405879 7291402 7931049 69449088 67776160 77358679 75771148 X -1814868 -109758 251698 X false true X true false X 2284561 14030014 12015978 6005038 8370781 42706372 0 0 2284561 14030014 12015978 6005038 8370781 42706372 3882905 38823467 1097649 1144913 1171695 1977671 2346930 7738858 0 0 0 0 0 0 21 20 18 12 5628 5699 50450929 0.76953 0.81570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true X 7291402 478963 160684 7931049 6650307 626912 277906 263723 7291402 6167522 60584 705539 283338 6650307 6242907 50696 -76659 49422 6167522 6307018 48780 25090 137981 6242907 0.88870 0.11130 false false 11130 11130 39798 34871 4927 431603 426621 4982 21039 BOARD DESIGNATED INVESTMENTS 63688520 F RESTRICTED FUND INVESTMENTS 172210 F 63860730 SUPPLEMENTAL INFORMATION 1 SCHEDULE D, PART IV, LINE 2B GIFT ANNUITIES AND CHARITABLE REMAINDER TRUSTS CONSIST OF CONTRIBUTED AMOUNTS SUBJECT TO OBLIGATIONS TO MAKE PERIODIC PAYMENTS TO BENEFICIARIES OVER A SPECIFIED PERIOD. THE LIABILITIES SHOWN ARE RECORDED AT THE ACTUARIAL PRESENT VALUES OF THE AGGREGATE LIABILITY BASED ON THE SPECIFIED PERIOD. A DISCOUNT RATE WAS USED TO DETERMINE THE PRESENT VALUE OF THE LIABILITIES. SUPPLEMENTAL INFORMATION 2 SCHEDULE D, PART V, LINE 4 THE MAJORITY OF THE ENDOWMENT FUNDS ARE RESTRICTED FOR USE IN FUNDING THE INTEGRIS HEALTH SYSTEM'S CENTERS FOR EXCELLENCE. SPECIALIZED CENTERS OF EXCELLENCE HAVE BEEN DEVELOPED THROUGH VARIOUS INTEGRIS ENTITIES TO PROVIDE THE HIGHEST STANDARD OF CARE FOR OUR COMMUNITIES. CENTERS OF EXCELLENCE INCLUDE THE PAUL SILVERSTEIN BURN CENTER, INTEGRIS HEART HOSPITAL, NAZIH ZUHDI TRANSPLANT INSTITUTE, TROY & DOLLIE SMITH CANCER CENTER, WOMEN'S CENTER, HENRY G. BENNETT JR. FERTILITY INSTITUTE, SLEEP DISORDERS CENTER OF OKLAHOMA, THE HOUGH EAR INSTITUTE, THE CENTRAL OKLAHOMA CANCER CENTER, SOUTHWEST BREAST HEALTH AND IMAGING CENTER, INTEGRIS JIM THORPE REHABILITATION NETWORK, INTEGRIS NEUROMUSCULAR CENTER, SLEEP DISORDERS CENTER OF OKLAHOMA AND THE JAMES R. DANIEL STROKE CENTER OF OKLAHOMA. IH FDN GALA 1209670 1128670 81000 4576 72865 5200 84571 GOLF TOURN. 132150 108786 23364 1200 14176 31554 2294 2 196119 156654 39465 200 3000 8704 3700 22540 1537939 1394110 143829 1400 14176 39130 81569 8900 109405 254580 -110751 true INTEGRIS BAPTIST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE OKC OK 73112 731034824 501(C)(3) 567375 877540 FMV EQUIPMENT & MISC. TO FUND OPERATIONS INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE OKC OK 73112 731192765 501(C)(3) 172302 TO FUND OPERATIONS INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORP 5300 N INDEPENDENCE AVE OKC OK 73112 731089149 501(C)(3) 90470 96062 FMV EQUIP. & RENOVATIONS TO FUND OPERATIONS INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE OKC OK 73112 731192764 501(C)(3) 226744 105967 FMV VEHICLE & RENOVATION TO FUND OPERATIONS INTEGRIS HEALTH EDMOND INC 5300 N INDEPENDENCE AVE OKC OK 73112 451027361 501(C)(3) 7036938 52781 FMV EQUIPMENT & VEHICLE TO FUND OPERATIONS INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE OKC OK 73112 731444504 501(C)(3) 218572 250229 FMV EQUIPMENT & MISC. TO FUND OPERATIONS 6 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE I, PART I, LINE 2 INTEGRIS HEALTH FOUNDATION, INC. (IH FDN OR FOUNDATION) WAS ESTABLISHED TO SUPPORT, THROUGH FUNDRAISING AND GRANT MAKING ACTIVITIES, THE NOT-FOR-PROFIT CHARITABLE AFFILIATES OF INTEGRIS HEALTH, INC. (AFFILIATE OR AFFILIATES OF INTEGRIS HEALTH SYSTEM), INCLUDING BUT NOT LIMITED TO INTEGRIS BAPTIST MEDICAL CENTER, INC. THE PROCESS FOR PROVIDING GRANTS TO AFFILIATES OF INTEGRIS HEALTH SYSTEM BEGINS WITH A REQUEST FOR FUNDING FROM THE AFFILIATE TO THE IH FDN. A DEPARTMENT DIRECTOR OF THE AFFILIATE MAKES AN INITIAL REQUEST TO THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT OF THE AFFILIATE. THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT VALIDATES THE DEPARTMENT'S NEED FOR THE FUNDS AND APPROVES THE REQUEST. THIS APPROVAL INDICATES THAT THE REQUESTED FUNDS ARE IN KEEPING WITH THE AFFILIATE'S OVERALL CHARITABLE GOALS. ONCE VALIDATED, THE REQUEST IS SENT TO IH FDN'S OFFICE TO VERIFY THE FUNDS ARE AVAILABLE. IH FDN'S PRESIDENT THEN REVIEWS THE REQUEST TO CONFIRM THE REQUESTED USE OF FUNDS ARE IN KEEPING WITH THE FOUNDATION'S CHARITABLE PURPOSES AND WITH THE INTENT OF DONORS TO THE FOUNDATION. ASSUMING THIS IS THE CASE, THE FOUNDATION PRESIDENT APPROVES THE REQUEST. FUNDS REQUESTED BY THE AFFILIATES GENERALLY FALL INTO TWO CATEGORIES: CAPITAL AND NON-CAPITAL. THE REQUEST FOR FUNDS FORM MEMORIALIZES THE MOVEMENT OF FUNDS FROM THE FOUNDATION TO THE AFFILIATE FOR REIMBURSEMENT OF ITEMS PURCHASED. false true false false false false false true false ANNE CLOUSE PRESIDENT FOUNDATION 191938 0 37893 0 8186 0 5375 0 7154 0 250546 0 0 0 DANIEL DAVIS ASST. TREASURER THRU NOV 2018 0 417269 0 901027 0 17257 0 76864 0 16529 0 1428946 0 0 BETH A PAUCHNIK ASST. SECRETARY THRU NOV 2018 0 497906 0 1788836 0 13380 0 98605 0 12183 0 2410910 0 0 DAVID R HADLEY FORMER OFFICER 0 0 0 0 0 244392 0 0 0 0 0 244392 0 0 TIMOTHY PEHRSON DIRECTOR 0 354491 0 253599 0 6315 0 0 0 7012 0 621417 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART I, LINE 3 INTEGRIS HEALTH FOUNDATION, INC. (IHF) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IHF RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIALS. 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 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS 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 AND RECEIVED A PAYMENT DURING THE YEAR. DANIEL DAVIS AND BETH A. PAUCHNIK RECEIVED A PAYMENT FROM THE PLAN IN THE CURRENT YEAR EQUAL TO $174,445 AND $766,922 RESPECTIVELY. 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. X 1 5500 FMV false true false GENERAL STATEMENT 1 PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS HEALTH FOUNDATION, INC. WAS ESTABLISHED TO FACILITATE FINANCIAL SUPPORT FOR THE ORGANIZATION BY CONNECTING DONORS TO THEIR INTEGRIS PASSIONS AS IT RELATES TO THE MYRIAD OF PROGRAMS AND SERVICES OF INTEGRIS HEALTH, INC. AND ITS CHARITABLE AFFILIATES. THE INTEGRIS HEALTH FOUNDATION ACCOMPLISHED THE FOLLOWING FOR FY19: THE INTEGRIS GALA DREW A CROWD OF 810 GUESTS AND SECURED A RECORD-BREAKING TOTAL OF $1,210,500 FOR THE BENEFIT OF INTEGRIS NAZIH ZUHDI TRANSPLANT INSTITUTE. PROCEEDS FROM THE EVENT FUNDED EQUIPMENT AND RESEARCH ADVANCES AND STARTED THE SAMARA FAMILY TRANSPLANT PATIENT ASSISTANCE FUND. THE INTEGRIS GOLF CLASSIC BENEFITTED BENNETT FERTILITY INSTITUTE. THE EVENT CELEBRATED MORE THAN $125,500 RAISED TO FUND CUTTING-EDGE TECHNOLOGY TO IMPROVE OUTCOMES FOR FAMILIES SEEKING FERTILITY TREATMENT. EVENT PROCEEDS PROCURED EQUIPMENT INCLUDING A COMPUTER-CONTROLLED LASER TO CONDUCT EMBRYONIC BIOPSIES AND GENETIC TESTING; AND FUNDED A NEW ULTRASOUND MACHINE TO PROVIDE HIGHER ACCURACY AND BETTER CARE FOR OUR PATIENTS. THE EIGHTH SEVENTH ANNUAL INTEGRIS YOU&I EMPLOYEE GIVING CAMPAIGN EXPERIENCED RECORD-BREAKING SUCCESS AS WE WELCOMED THE GIFTS OF MORE THAN 3,373 INTEGRIS EMPLOYEES AND PHYSICIANS. THIS GENEROSITY WAS MET BY MATCHING GIFTS OF INTEGRIS VOLUNTEER AUXILIARIES ACROSS THE STATE AMOUNTING TO $245,000 FOR A TOTAL EXCEEDING $892,750 RAISED FOR VARIOUS CARE CENTERS THROUGHOUT THE SYSTEM. CONSTRUCTION ON THE ARCADIA TRAILS CENTER FOR ADDICTION RECOVERY WAS COMPLETED IN SPRING 2019 AND THE FACILITY OFFICIALLY OPENED IN MAY 2019. THE FOUNDATION CONTINUES TO FOCUS ON RAISING SCHOLARSHIP FUNDS FOR FUTURE PATIENTS. THE INTEGRIS FOUNDATION INVESTED MORE THAN $9 MILLION BACK TO OUR HOSPITALS, IMPACTING PATIENT CARE AND ADVANCING OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. GENERAL STATEMENT 2 PART V: QUESTION 1A AND 2A 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 2018 TAX YEAR. GENERAL STATEMENT 3 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 OFFICER AND DIRECTOR 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: BETH A. PAUCHNIK DANIEL DAVIS DOUGLAS M. SMITH TIMOTHY PEHRSON GENERAL STATEMENT 4 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTIONS 6, 7A & 7B - INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HEALTH FOUNDATION, INC. AS SUCH IT HAS THE POWER (1) TO SELECT AND REMOVE ALL OFFICERS, AGENTS AND EMPLOYEES OF THE CORPORATION, PRESCRIBE SUCH POWERS AND DUTIES FOR THEM AS MAY BE CONSISTENT WITH LAW, WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, (2) TO CONDUCT, MANAGE AND CONTROL THE AFFAIRS AND BUSINESS OF THE CORPORATION, AND TO MAKE SUCH RULES AND REGULATIONS THEREFORE CONSISTENT WITH LAW, OR WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, AS THEY MAY DEEM BEST, SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, (3) TO FIX AND LOCATE FROM TIME TO TIME ONE OR MORE SUBSIDIARY OFFICES OF THE CORPORATION WITHIN OR WITHOUT THE STATE OF OKLAHOMA; AND TO ADOPT, MAKE AND USE A CORPORATE SEAL, AND TO ALTER THE FORM OF SUCH SEAL FROM TIME TO TIME, AS IN THEIR JUDGEMENT THEY MAY DEEM BEST, PROVIDED SUCH SEAL AT ALL TIMES COMPLY WITH THE PROVISIONS OF LAW, THE CERTIFICATE OF INCORPORATION AND THESE BYLAWS. GENERAL STATEMENT 5 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 6 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 POLICES 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 7 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 8 PART VII: SECTION B. INDEPENDENT CONTRACTORS DINI PARTNERS INC. FUNDRAISING $148,000 2727 ALLEN PARKWAY, SUITE 1650 CONSULTANTS HOUSTON, TX 77019 GENERAL STATEMENT 9 PART XI: RECONCILIATION OF NET ASSETS, LINE 9 PROVISION FOR BAD DEBT $251,698 INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192765 HEALTH CARE OK 501(C)(3) LINE 3 IH 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 INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192764 HEALTH CARE OK 501(C)(3) LINE 12-I NA false WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC false 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. 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