JANE PHILLIPS NOWATA HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- JANE PHILLIPS NOWATA HOSPITAL INC (EIN 73-1440267)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-10
- IRS object ID
- 201811309349300846
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-10T09:02:03-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731440267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JANE | BusinessNameControlTxt |
| Phone | 3147338000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1Txt |
| City | Nowata | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74048 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tonya Mershon | PersonNm |
| Person Title | Tax Officer | PersonTitleTxt |
| Signature | 2017-10-26 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nowata Health Center | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mike Moore | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1Txt |
| City | Nowata | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74048 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,942,973 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.stjohnhealthsystem.com/jane-phillips/services/nowata-health-center | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 39 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,497,832 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,932,558 | CYProgramServiceRevenueAmt |
| PY Investment Income | $73 | PYInvestmentIncomeAmt |
| CY Investment Income | $199 | CYInvestmentIncomeAmt |
| PY Other Revenue | $934 | PYOtherRevenueAmt |
| CY Other Revenue | $10,216 | CYOtherRevenueAmt |
| PY Total Revenue | $4,498,839 | PYTotalRevenueAmt |
| CY Total Revenue | $4,942,973 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,626,137 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,969,624 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,090,302 | PYOtherExpensesAmt |
| CY Other Expenses | $2,052,100 | CYOtherExpensesAmt |
| PY Total Expenses | $4,726,939 | PYTotalExpensesAmt |
| CY Total Expenses | $5,021,724 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$228,100 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$78,751 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,443,047 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,660,998 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $788,156 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $531,628 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,654,891 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,129,370 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,387,032 | ExpenseAmt |
| Revenue | $4,932,558 | RevenueAmt |
| Desc | Jane Phillips Nowata Hospital, Inc. is a Medicare designated critical access hospital that provides medical services to the residents of Nowata and northeastern Oklahoma. The hospital operates a 24-hour emergency department and a variety of other health care services and is an affiliate of Jane Phillips Memorial Medical Center, Inc. As such, it is part of St. John health System, Inc. | Desc |
| Total Program Service Expenses | $3,387,032 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 39 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alan Townsend | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9187442740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1923 South Utica Avenue | AddressLine1Txt |
| City | Tulsa | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 741046502 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| STAN DEFEHR MD | |||||||||
| CHAIRMAN | 0.1 | 40.1 | Yes (X) | Yes (X) | $0 | $635,105 | $39,720 | ||
| MERL LINDSTROM | |||||||||
| VICE-CHAIRMAN | 0.1 | 0.1 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIKE MOORE | |||||||||
| DIRECTOR/PRESIDENT/COO | 0.1 | 42.5 | Yes (X) | Yes (X) | $0 | $371,408 | $27,897 | ||
| DAVID J PYNN | |||||||||
| SVP AH-MNSTRY MKT EXEC TULSA | 0.1 | 45.6 | Yes (X) | Yes (X) | $0 | $2,363,767 | $44,442 | ||
| SHERRY DOTY | |||||||||
| DIRECTOR | 0.1 | 0.1 | Yes (X) | $0 | $0 | $0 | |||
| LINDEL FIELDS | |||||||||
| DIRECTOR | 0.1 | 0.1 | Yes (X) | $0 | $0 | $0 | |||
| MARK HEADLEY | |||||||||
| DIRECTOR | 0.1 | 0.1 | Yes (X) | $0 | $0 | $0 | |||
| DAVID KING | |||||||||
| DIRECTOR | 0.1 | 0.1 | Yes (X) | $0 | $0 | $0 | |||
| SONYA SAYLES | |||||||||
| DIRECTOR | 0.1 | 0.1 | Yes (X) | $0 | $0 | $0 | |||
| LEX ANDERSON | |||||||||
| TREASURER/EXEC VP & SJHS CFO | 0.1 | 58.8 | Yes (X) | $0 | $872,214 | $35,074 | |||
| RONALD J BRASEL | |||||||||
| VP FINANCE - CFO SJMC/JP | 0.1 | 43.9 | Yes (X) | $0 | $206,634 | $30,430 | |||
| KEVIN STECK | |||||||||
| SECRETARY - VP INTEGRITY & COMPLIANCE | 0.1 | 40.4 | Yes (X) | $0 | $349,418 | $17,263 | |||
| ALFRED W GARTZKE MD | |||||||||
| PHYSICIAN | 40.0 | 0 | $233,956 | $0 | $21,997 | Yes (X) | |||
| DEBRA J ROBNETT-BELL | |||||||||
| Physician Assistant | 40.0 | 0 | $159,991 | $0 | $15,735 | Yes (X) | |||
| JEFFREY L GIBSON | |||||||||
| PHYSICIAN | 40.0 | 0 | $106,188 | $0 | $25,543 | Yes (X) | |||
| VICKY S USHER | |||||||||
| RN I | 40.0 | 0 | $123,817 | $0 | $10,351 | Yes (X) | |||
| SAMUEL C ANDERSON | |||||||||
| FORMER OFFICER (END 6/2014) | 0.0 | 0.0 | $0 | $482,528 | $16,950 | Yes (X) | |||
| DAVID STIRE | |||||||||
| FORMER OFFICER (END 12/2014) | 0.0 | 0.0 | $0 | $339,866 | $15,510 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $623,952 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,620,940 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $300,912 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621990 | $4,912,558 | $4,912,558 |
| GOVERNMENT CLINICAL INCENTIVES | 900099 | $20,000 | $20,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,932,558 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $199 | TotalRevenueColumnAmt |
| Exclusion | $199 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $10,216 | TotalRevenueColumnAmt |
| Exclusion | $10,216 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,216 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,942,973 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,932,558 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,415 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,525,296 | TotalAmt |
| Program Services | $2,123,435 | ProgramServicesAmt |
| Management And General | $401,861 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,670 | TotalAmt |
| Program Services | $72,037 | ProgramServicesAmt |
| Management And General | $13,633 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,594 | TotalAmt |
| Program Services | $159,423 | ProgramServicesAmt |
| Management And General | $30,171 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,064 | TotalAmt |
| Program Services | $142,160 | ProgramServicesAmt |
| Management And General | $26,904 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,897 | TotalAmt |
| Management And General | $34,897 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$320 | TotalAmt |
| Management And General | -$320 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660 | TotalAmt |
| Management And General | $660 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,984 | TotalAmt |
| Program Services | $195,173 | ProgramServicesAmt |
| Management And General | $53,811 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,036 | TotalAmt |
| Program Services | $4,215 | ProgramServicesAmt |
| Management And General | $8,821 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,940 | TotalAmt |
| Program Services | $2,402 | ProgramServicesAmt |
| Management And General | $31,538 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,123 | TotalAmt |
| Program Services | $1,255 | ProgramServicesAmt |
| Management And General | $1,868 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,969 | TotalAmt |
| Program Services | $22,973 | ProgramServicesAmt |
| Management And General | $59,996 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,799 | TotalAmt |
| Program Services | $10,092 | ProgramServicesAmt |
| Management And General | $1,707 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,535 | TotalAmt |
| Program Services | $3,513 | ProgramServicesAmt |
| Management And General | $22 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,118 | TotalAmt |
| Program Services | $9,273 | ProgramServicesAmt |
| Management And General | $349,845 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,577 | TotalAmt |
| Management And General | $2,577 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $701,081 | $127,339 | $573,742 |
| PROFESSIONAL FEES FROM AFFILIATES | $264,811 | $264,811 | |
| MEDICAL SUPPLIES | $163,564 | $163,564 | |
| PHYSICIAN FEES FROM AFFILIATES | $59,634 | $59,634 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,692 | TotalAmt |
| Program Services | $25,733 | ProgramServicesAmt |
| Management And General | $42,959 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,021,724 | TotalAmt |
| Program Services | $3,387,032 | ProgramServicesAmt |
| Management And General | $1,634,692 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $238,497 | BOYAmt |
| EOY | $1,246 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $995,880 | BOYAmt |
| EOY | $727,401 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,062 | BOYAmt |
| EOY | $49,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,363,363 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,043,726 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,468,580 | BOYAmt |
| EOY | $1,319,637 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $603,122 | BOYAmt |
| EOY | $472,596 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,083,906 | BOYAmt |
| EOY | $90,972 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,443,047 | BOYAmt |
| EOY | $2,660,998 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,925 | BOYAmt |
| EOY | $283,922 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,231 | BOYAmt |
| EOY | $247,706 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $788,156 | BOYAmt |
| EOY | $531,628 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,654,891 | BOYAmt |
| EOY | $2,129,370 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,654,891 | BOYAmt |
| EOY | $2,129,370 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,443,047 | BOYAmt |
| EOY | $2,660,998 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$78,751 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,446,770 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $660 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $660 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. JANE PHILLIPS NOWATA HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. JANE PHILLIPS NOWATA HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $170,000 | OtherCostOrOtherBasisAmt |
| Book Value | $170,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,900,152 | OtherCostOrOtherBasisAmt |
| Depreciation | $842,122 | DepreciationAmt |
| Book Value | $1,058,030 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $253,211 | OtherCostOrOtherBasisAmt |
| Depreciation | $182,715 | DepreciationAmt |
| Book Value | $70,496 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,000 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,889 | DepreciationAmt |
| Book Value | $21,111 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,319,637 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated settlements - Third party payor | |
| DUE TO AFFILIATES | $243,025 |
| Recovery Tail Liability | $4,681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $247,706 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System"), which include the activity of Jane Phillips Nowata Hospital, Inc.: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $545,600 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $545,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1086 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,004,661 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | -$503,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,508,086 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.3003 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,550,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | -$503,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,053,686 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.4090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,550,261 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | -$503,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,053,686 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.4090 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $262,590 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,108,280 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,340,459 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,767,821 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Health Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1Txt |
| City | Nowata | CityNm |
| State Abbreviation | OK | StateAbbreviationCd |
| ZIP | 74084 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://www.stjohnhealthsystem.com/ | WebsiteAddressTxt |
| State License | 2187 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.stjohnhealthsystem.com/about/community-health-needs-assessment | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.stjohnhealthsystem.com/about/community-health-needs-assessment | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.stjohnhealthsystem.com/about/payment-for-services | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.stjohnhealthsystem.com/about/payment-for-services | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.stjohnhealthsystem.com/about/payment-for-services | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. Community input is a primary focus of the most recent CHNA that was adopted and approved before June 30, 2016 for the fiscal year 2017-2019. Accordingly, input from community members, community leaders and representatives, as well as the St. John System's Community Health Needs Assessment (CHNA) advisory group and leadership was obtained to expand upon information gleaned from the secondary data review. A concerted effort was made to obtain community input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge and expertise of public health issues and populations deemed vulnerable. This assessment also took in to account the importance of engaging communities on an ongoing basis and the promotion of a continual dialogue. This includes disseminating the results of the assessment within the community and engaging the community in mutually reinforcing and community-driven activities to improve the community health and well-being. This assessment employed several methods of community input to yield the desired results. For the purposes of this assessment, community input was obtained through the following methods: 1) A community input meeting with 15 community members, leaders, and representatives; 2) Input from the public health workforce and local partnerships; and 3) Input from the health system's Community Health Needs Assessment (CHNA) Advisory Group and leadership. The hospital engaged the Washington County Health Department (oversees Nowata County) as well a multitude of other community partner organizations throughout this community health needs assessment. The health system hospital worked closely with these partners to conduct this assessment. Throughout the assessment process, the hospital worked to initiate and strengthen our relationships with these community partners and will continue to do so to promote effective and community-driven community health improvement initiatives within Washington County. On May 2, 2016, a total of 16 community leaders and representatives participated in a community input meeting conducted at Jane Phillips Nowata Hospital, Inc. The purpose of this meeting was to solicit community input from persons representing the broad interests of the community, especially those most in need. The meeting was intended to obtain community input specific to the hospital and surrounding community of Nowata County. The meeting took place over a two-hour period and consisted of four main exercises: 1) Hospital assessment exercises, 2) Nominal group exercise to validate and prioritize health needs based on top health needs identified, 3) Community perception group exercise, and 4) Community capacity assessment exercise. The following community agencies and organizations participated in the hospital's meeting: Arvest Bank Nowata, Cherokee Nation - Will Rogers Health Center, City of Nowata, Dr. Jeffrey Gibson, DO- Family Practice Physician's Office, Elder Care, Morton Comprehensive Health Services, Nowata Community Advancement Network, Nowata United Methodist Church, Oklahoma Department of Human Services, Regent Bank, and Washington County Health Department (oversees Nowata County). A Community Health Needs Assessment (CHNA) advisory group was formed in the beginning of this assessment process to provide direction, input, and guidance. This group met several times during the process between February and May 2016. Group membership consisted of thirteen key representatives from hospital facilities, St. John Clinic, and departments throughout the health system. These members assisted with the design and coordination of the hospital community health input meetings and helped to compile information and data related to our evaluation of impact from our 2013 community health needs assessment process. Additional members of hospital and health system leadership were also engaged to provide input and guidance throughout the process. A short community health needs prioritization survey was emailed to CHNA advisory group members and hospital/health system leadership via SurveyMonkey in April 2016. A total of fifteen members and leadership responded to the survey. Community input was solicited from a diverse set of community stakeholders such as community members, community organizations, and the public health workforce. A variety of sources ensured that as many different perspectives as possible were represented while satisfying the broad interests of the community. Sources of community input for this assessment were as follows: - Community leaders and representatives - Local public health workforce and coalitions/partnerships - Members and representatives of medically underserved, low-income, minority, at-risk, and otherwise vulnerable populations, and - St. John System CHNA advisory group and leadership. Community stakeholders who provided community input represented a variety of community sectors including: community members, healthcare providers and services, education and academia, non-profit agencies, community-based organizations, private businesses, community developers, faith communities and faith-based organizations, government representatives, safety net service providers, economic and workforce development, mental health/behavioral health services, law enforcement and first responders, public health workforce, and other interest groups working with at-risk and vulnerable populations. This assessment especially focused on community input from those with special knowledge or expertise in public health as well as members and representatives of medically underserved, low income, minority, or otherwise vulnerable populations. Each offered critical strengths and insights on the health needs and assets of the community. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. The other hospital facilities, with which the reporting hospital facility conducted its CHNA, include: - St. John Medical Center, Inc. - St. John Broken Arrow, Inc. - Owasso Medical Facility, Inc. - St. John Sapulpa, Inc. - Jane Phillips Memorial Medical Center, Inc. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. The other organizations, with which the reporting hospital facility conducted its CHNA, include: - The Washington County Health Department (oversees Nowata County) |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. How the CHNA needs were met in FY 2017 for the CHNA that was adopted and approved before June 30, 2016 for fiscal year 2017-2019: Using the CHNA completed in 2016, the St. John System developed, adopted, and worked on executing a fiscal year 2017-2019 implementation strategy to address the priority community health needs identified in the community-wide Community Health Needs Assessment. Input from community members, community leaders and representatives, as well as the St. John System's Community Health Needs Assessment (CHNA) advisory group and leadership was obtained for identification and prioritization of needs. A concerted effort was made to obtain community input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge and expertise of public health issues and populations deemed vulnerable. The hospital collaborated with the Tulsa health department, pathways to health, and a diverse range of community stakeholders in Tulsa County on this process. The following community health needs were selected as the top four priorities in the 2016 CHNA for St. John System and the hospital to address in fiscal year 2017-2019: 1) Access to care, 2) Behavioral health, 3) Wellness and chronic disease prevention, and 4) Health literacy. In fiscal year 2017, the following initiatives were undertaken to address the priority needs: 1) Access to Care: Access to services in Oklahoma is a significant challenge due to the limited availability of primary care physicians and stress on hospital emergency room access and inpatient beds due to a growing number of transfers from underserved rural areas in Oklahoma. The St. John System and hospital worked to improve access as needed for healthcare services in solidarity with those living in poverty and/or deemed otherwise vulnerable through the following activities: - The Tulsa Day Center for the Homeless ("Day Center") houses a medical clinic partially funded by St. John Health System that works to reduce barriers to health care for individuals experiencing homelessness. The clinic operations at the day center include a Nurse Practitioner (NP) with support staff consisting of both employed and volunteer nurses and medical assistants. This makes the cost per encounter very low, but also limits some of the services that can be provided in this setting. Accordingly, a goal was established to increase access for primary care services due to the level of acuity needed for this population. Methods employed to achieve this goal included increasing the clinic hours available and adding a primary care physician during part of the clinic hours. Based on the number of hours scheduled and worked by primary care provider at the Tulsa Day Center for the Homeless Clinic, access to primary care coverage was increased by more than 24 hours per week. This was a 4 hour (20%) increase from year to date FY 16 baseline of 20 hours per week to year to date FY 17. - Promotion of access to an ongoing source of primary care and preventive services for persons who are uninsured, underinsured, and/or living in poverty through services offered at the St. John Medical Access Clinic (MAC). Through partnerships established during FY 17, the clinic now serves as a primary medical home for victims of human trafficking and domestic violence who are accessing local shelters as well as clients of Women In Recovery (WIR), an intensive outpatient alternative for eligible women facing long prison sentences for non-violent, drug-related offenses. - Follow-up care and safe transition home for patients discharging from the St. John System who do not have a primary care provider or who cannot get an appointment with their provider through services provided by St. John System' s two transitional care clinics at this hospital and Jane Phillips Memorial Medical Center, Inc. A total of 133 patients were seen in the St. John Medical Center, Inc. Transitional Care Clinic in FY 17. 2,568 (91.65%) follow-up calls known as connects calls were completed with patients discharged from the hospital in FY 17 by clinic staff. - Promotion of access to affordable health insurance coverage through state legislative advocacy. Unfortunately, despite advocacy efforts, no extra funds for healthcare and no increase in coverage were achieved in FY17 as a cigarette tax fee was passed through state legislation, but overturned in Supreme Court. - Efforts to increase the proportion of persons who can obtain or not delay in obtaining necessary prescription medicines through the Dispensary Of Hope (DOH) program. The DOH connects surplus medications from manufacturers, distributors, and providers to clinics and pharmacies serving the poor and uninsured. Pharmacy and clinic partners provide DOH medications to patients free of charge, track and segregate DOH inventory, and qualify patients (less than or equal to 200% of the federal poverty level). The program serves safety net clinics in the greater Tulsa area including the Good Samaritan Mobile Health Clinics and the St. John Medical Access Clinic (MAC). In FY17 the DOH program was expanded to include qualifying patients in three departments within the St. John System: the Transitional Care Clinic, The Heart Failure Clinic, and the Diabetes Education Center. Additionally, the DOH program was expanded within the community to an additional Good Samaritan Mobile Clinic site in Creek County and the Tulsa Day Center for Homeless medical clinic. The DOH has demonstrated to be a positive factor in improving outcomes of uninsured patients with chronic conditions and has been shown to decrease preventable hospital encounters. - Reduction in barriers to accessing to healthcare services by providing transportation assistance to community-dwelling persons served by St. John System and the hospital who are living in poverty and/or are otherwise deemed vulnerable. Through an agreement with Morton Comprehensive Community Health Center (FQHC) for their bus services, St. John System provides transportation to those in need in the community who meet specific criteria. In FY17 1,635 rides were provided and over $155,000 was provided in funding for this initiative. An agreement with LYFT was also secured to begin providing additional transportation assistance to patients in need. The St. John System and the hospital worked to increase recruitment and hiring of providers to improve access to primary care and specialty services in the communities served. This strategy included the exploration of methods to extend hours among St. John clinic primary care providers and adopt plans to utilize various hours in primary care clinics. Many communities served by St. John System and the hospital include partial or total identified healthcare shortage areas. Improving access to care through provider recruitment addresses these shortage areas, reduces health disparities, and promotes health equity among persons deemed vulnerable. The St. John System and the hospital additionally worked to improve access as needed for healthcare services in solidarity with those living in poverty and/or deemed otherwise vulnerable through the Medial Access Program (MAP). The MAP program proactively seeks and serves uninsured patients. It consists of the operation of a St. John-owned primary care clinic that operates as a medical home for uninsured patients with chronic health problems, donations to other organizations that operate free clinics, and a voucher program in which the free clinic partners can refer patients for specialty and diagnostic care. For extended outreach in the community, St. John partners with several local health and community service agencies to identify patients who qualify for the program. |
| Schedule H, Part V, Section B, Line 11 Facility , 2 | Facility , 2 - Jane Phillips Nowata Hospital, Inc.. 2) Behavioral health: St. John System and the hospital are addressing behavioral health through efforts to improve access to behavioral health services to promote a reduction of suicide rates in Tulsa County and surrounding areas throughout the following activities: - Promotion of access to behavioral health services for at-risk populations through early identification and intervention via an integrated model of behavioral health in primary care. This was accomplished through the implementation of clinic-wide PHQ9 depression screenings, full suicide risk assessments for high/positive scores on PHQ9 depression screenings, and expansion of the number of behavioral health therapists embedded in clinics. - Promotion of access to behavioral health services through state legislative advocacy. Through legislative advocacy the Mark Costello Act was passed in 2017. This legislation is aimed at helping families get assisted outpatient treatment for adult relatives experiencing mental illness before a situation reaches a crisis. Unfortunately, despite advocacy efforts, no additional funding for the Oklahoma Department of Mental Health And Substance Abuse Services was obtained as a cigarette tax fee was passed through state legislation, but overturned in Supreme Court. - Increased access to behavioral health services for community-dwelling persons in need of outpatient psychiatry services in Washington County through the addition of an APRN to the outpatient psychiatric clinic at Jane Phillips Memorial Medical Center, Inc. - Promotion of additional capacity for humanized behavioral health crisis and acute care through increased access to behavioral health professionals and services as well as increased assessment and recognition of suicide risks at the community level. This included collaboration with the City of Tulsa, Tulsa Fire Department, The Mental Health Association of Oklahoma, and other community partners on a multidisciplinary emergency response system that focuses on de-escalating mental health crises of individuals who frequently use hospital emergency departments and redirects them to immediate behavioral health services. Additionally, this included suicide risk assessment training for associates and community members and the implementation of a systematic approach in health system to support efforts to humanize crisis and acute care at a community level. |
| Schedule H, Part V, Section B, Line 11 Facility , 3 | Facility , 3 - Jane Phillips Nowata Hospital, Inc.. 3) Wellness and chronic disease prevention: St. John System and the hospital addressed wellness and chronic disease prevention through the following activities: - A heart failure initiative aimed to improve health outcomes and reduce preventable Congestive Heart Failure (CHF) readmissions among diverse populations diagnosed with CHF. Congestive Heart Failure (CHF) patients from diverse populations including racial and ethnic minorities and those living in socioeconomically disadvantaged conditions often face a myriad of barriers to care. Accordingly, this initiative aims to reduce health disparities and to promote health equity among this patient population through structured transition and an expanded follow-up approach provided across a continuum of care regardless of ability to pay. The initiative works to increase engagement and reduce barriers to care through the provision of educational classes (average 25 patients per class per week with an additional 5-10 patient's education done at bedside per week), support groups 1x/week (average 15-18 patients per session), referrals to the Heart Failure Clinic (increase of >100% in new patient volume since December 2016) and Cardiac/Heart Failure rehab (total of 129 patients enrolled in FY17), root cause analysis case staffings, the provision of loaned blood pressure cuffs (107 BP cuffs) and weight scales (318 scales), medication assistance for those without a payer source through the dispensary of hope program, and transportation assistance through the Morton Transportation Assistance Program (138 rides provided). - Promotion of equitable and patient-centered pre-diabetic and diabetic care in solidarity with those living in poverty and/or who may be otherwise deemed vulnerable. St. John System and the hospital implemented an initiative to support patients diagnosed with diabetes or pre-diabetes discharging from the hospital who lack primary care follow-up through patient-centered transition of care, education, and disease management support services through collaboration among the Diabetes Education Center, Transitional Care Clinic, and the Medical Access Program. Diabetes is more prevalent among persons living in poverty and minority populations, and/or populations who are otherwise deemed vulnerable; through equitable prevention and care management programs such as this initiative, health disparities are addressed. In FY 17, a total of 142 patients diagnosed with diabetes and pre-diabetes who lacked primary care follow-up were served by this initiative. - Efforts to improve in health outcomes for individuals who are in a pre-condition state or who have been diagnosed with a chronic disease. The St. John System and hospital have worked to promote healthy diet, physical activity, and prevention oriented wellness through health system support of community-based initiatives in partnership with local health departments, coalitions, community-based organizations, and schools; participation in local activities, education classes, events, and health fairs; and chronic disease management support. The St. John Health System and its hospitals sponsored and participated in over 100 community events and health fairs throughout the FY 2017. St. John associates promoted health and wellness through health screenings and public education at these events. The health system and hospital also hosted a multitude of public health education seminars, classes, and symposiums on a variety of wellness topics including, but not limited to: diabetes, heart health, stroke, safety and prevention, trauma, maternal and child health, joint care, cancer care, healthy diet and nutrition, and the promotion of physical activity. The hospital annually hosts on-site blood drives in support of the American Red Cross. The St. John System and the hospital sponsored and participated in several local health promotion walks and runs during FY 17 including, but not limited to the: American Cancer Society's Relay for Life Events, American Heart and American Stroke Associations' Heart Walk, Susan G. Komen's Race for The Cure, Parkinson's Foundation of Oklahoma's Tulsa Parkinson's Walk & 5k, The Oklahoma Chapter of The Alzheimer's Association's Walk to End Alzheimer's, The Colon Cancer Coalition's Get Your Rear in Gear Tulsa Event, The Arthritis Foundation's Jingle Bell Run, and The Eastern Oklahoma Veteran Affairs Healthcare System (Move) 2017 Nobesity Revolution - Obesity Awareness Campaign Walk. The St. John System and the hospital also actively participate in the community-wide coalition, Pathways to Health (P2H), which supports the Tulsa Health Department and a multitude of community partners. P2H was formed by the Tulsa Health Department in 2008 in response to a challenge to decrease the overlap of health services and identify gaps where leaders are missing vulnerable populations. Today, P2H is an incorporated non-profit entity with the goal to connect community health resources to those who need it most. P2H leverages community-wide partnerships with more than 90 local agencies, organizations, corporations and health systems to improve the health and wellness of residents of Tulsa County. The St. John System was the presenting sponsor for the 30th Annual Tour De Tulsa Charity Bike Ride on May 6th, 2017. The event is coordinated by the Tulsa Bike Club and Tulsa Health Department with proceeds benefiting Pathways To Health (P2H), the non-profit arm of the Tulsa Health Department. Each year the sponsorship funds are used to give back to the community and help fund community partner's projects that have the gravest need, reach the most people, use best practices, and can be sustained overtime. Last year the ride netted about $26,000 and proceeds were distributed to community agencies to improve population health in Tulsa County. St. John Health System was proud to be the presenting sponsor of the Tour De Tulsa Charity Bike Ride. This event paired our ongoing commitment to encourage physical activity for individuals of all ages, while supporting vital community programs that focus on initiatives to improve overall health outcomes to area residents. - The hospital participates as an ACO participant in the Medicare Shared Savings Program Accountable Care Organization which establishes several quality and process outcome measures that pertain to chronic disease management such as diabetes, hypertension, coronary artery disease, and COPD. - Employed physicians of the health system also participate in the Comprehensive Primary Care Plus model which focuses on a medical home model in care for high risk patients with chronic conditions. 4) Health Literacy: The St. John System and hospital are addressing health literacy to the help persons of diverse backgrounds navigate health services and gain empowerment in taking charge of their own health through the following activities: - Assessment of health literacy needs among patients of diverse backgrounds to work towards assisting patients in understanding how to navigate health services and gain empowerment in taking charge of their own health improvement with the St. John Medical Center Transitional Care Clinic as the pilot site for this effort. During FY 17, 3 staff members were trained to screen patients with the Pfizer Health Literacy tool. A total of 119 patients were screened in FY 17. |
| Schedule H, Part V, Section B, Line 11 Facility , 4 | Facility , 4 - Jane Phillips Nowata Hospital, Inc.. Community Engagement and Community Benefit Sponsorships: In addition to the above, the St. John System has established a process for supporting community requests for sponsorships that align with the 4 priority community health needs as aforementioned. Each year a budget is established for this purpose and is exceeded through identification of additional community requests. A community engagement committee consisting of key St. John System leadership has been established to improve the coordination, process, and tracking for this category of community benefit spend. In FY 17, a total of $178,875 was provided to support activities led community-based organizations to address the 4 priority community health needs. St. John System sponsored activities led by the following organizations in FY 17: Arthritis Foundation- Oklahoma Office; Susan G. Komen Breast Cancer Foundation- Tulsa Affiliate, Reach Out And Read (program helps children succeed in school by partnering with doctors to prescribe books and encourage families to read together); Community Health Connection, Inc.; Arubah Community Clinic Association; Creek County Community Partnership (Creek County Community Baby Shower); The Parent Child Center Of Tulsa; American Heart Association (Heart Walk, Power To End Stroke, And Vestido Rojo); Tulsa Food Security Council (Annual Oklahoma Food Insecurity Summit); Just Hope Inc.; Mental Health Association Of Oklahoma; Colon Cancer Coalition; Pathways To Health Community Partnership, Inc. (30th Annual Tour De Tulsa Charity Bike Ride); Community Food Bank of Eastern Oklahoma; Hive Resource Consortium/Tulsa Cares; Tulsa Baseball Inc. (Tulsa Driller's Strike Out Stroke Night); Parkinson Foundation of Oklahoma; Leukemia And Lymphoma Society; Alzheimer's Association; Goodwill Industries of Tulsa, Inc.; Muscular Dystrophy Association; Oklahoma Project Woman, Inc.; Child Abuse Network; Owasso Community Resources; Hospitality House of Tulsa; Brady Craft, Inc./108 Contemporary; River Parks Foundation; Veterans Of Foreign Wars, Post 577 (Eastern Oklahoma VA Healthcare System 2017 Nobesity Revolution Obesity Awareness Campaign); American Cancer Society; and the Margaret Hudson Program. Needs not addressed: The community health needs assessment completed by June 30, 2016, inevitably identified more significant health needs than the hospital, St. John System, and community partners can or should address as priority health needs. It would not be prudent to spread hospital and community resources across too many initiatives. Accordingly, the hospital, St. John System, and community partners instead decided to focus attention on priority areas to help ensure sufficient resources are available. Some reasons for not addressing certain needs include: 1) Need being addressed by others; 2) Insufficient resources (financial and personnel) to address the need; 3) Issue is not a priority for community members and therefore approach is unlikely to succeed; 4) Lack of evidence-based approach for addressing the problem; 5) Need is not as pressing as other problems; 6) Need is not as likely to be resolved as other problems; and 7) Hospital and/or health system does not have expertise to effectively address the need. The following significant health need was identified, but will not be addressed directly by the hospital and St. John System as a priority health need: - Tobacco use and cessation: the community identified this need as one that was already being sufficiently addressed at the time and did not feel issue was as pressing other needs identified (this was a change in perspective from our previous community health needs assessment process in 2013 when the need was identified as a priority need). It is important that note that, although not a priority health need for the purposes of this process, the hospital and St. John System will continue existing activities regarding tobacco use and cessation. While not necessarily noted as one of our four priority health needs, the remainder of significant community health needs identified were closely inter-related with the priority needs. So, while, they may not be explicitly listed as a priority health need, the hospital and St. John System do feel confident that the needs are being addressed by addressing the four selected priority health needs. |
| Schedule H, Part V, Section B, Line 16 Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. Signs are posted in waiting rooms and at the admissions offices to notify patients that the hospital has a financial assistance policy. In addition, every billing statement, the hospital's website, and admission packets include information regarding the financial assistance policy. The policy is provided at the request of the patient. |
| Schedule H, Part V, Section B, Line 20 Facility , 1 | Facility , 1 - Jane Phillips Nowata Hospital, Inc.. Jane Phillips Nowata Hospital, Inc. provides a 50% discount on gross charges and a 10% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due. |
| Field | Value | IRS element (for citing) |
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| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
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| Schedule H, Part VI, Line 5 Promotion of Community Health: Part B | Part B (Continued from Part A): The "Medical Access Program" ("MAP"): Consistent with our mission and values, the St. John System has created programs to seek out better ways to serve the uninsured and vulnerable. The St. John System and hospital have continued work on an outreach project to improve access to medical care to the poor that is referred to as the "Medical Access Program" ("MAP"). Supported in part by funding from The Chapman Trusts (a collection of private trusts of which the Medical Center is one of the beneficiaries), the program is a comprehensive effort to provide increased access to medical services across a broad continuum of care to the poor and disadvantaged in the Tulsa metropolitan area. The program is a collaborative effort led by the Medical Center that includes financial support for new and existing community outreach activities. Key elements of the program include: - Expanded access to free primary care clinic visits provided primarily through direct funding to the University of Oklahoma's free clinics and Good Samaritan mobile clinics. - Including the above two free access points to primary care, the map program supports a total of 8 free and 2 sliding scale clinics through the "voucher" program, which provides patients of the primary care providers free access to: - Diagnostic and specialty testing; - Diagnostic imaging services, including basic x-ray, CT, ultrasound and MRI; - 23 specialty medical services available thru St. John employed providers, University Of Oklahoma providers, and other specialty medical service providers in the community; - The delivery of specialized care in both an outpatient and inpatient setting; i.e., all expenses relating to that episode of care is free to the patient: the specialist fee, facility charges, lab, radiology, anesthesiology; until the patient is discharged from the specialist back to the patient's primary care provider at their medical home; - Operation of a "medical home" clinic for uninsured patients. -Expansion of access to free prescriptions and other medications in collaboration with the Dispensary Of Hope (DOH) pharmacy operated by St. John Medical Center. It is hoped that MAP can continue to grow and serve as a model for collaboration and outreach than cannot only be used to provide more effective health care in Tulsa to its most needy citizens, but also serve as a model for other communities. St. John hospitals also participated in a program sponsored by the Tulsa Medical Society to provide free surgical services to certain patients. Support for Medical Education: The hospitals continue to invest in medical education to support the expansion of physicians, nurses and allied health professionals that will serve the current and future generations of patients in the service area. The hospitals participate in St. John System's coordinated effort to assess community need collaboratively with other interested parties in the community and to allocate capital and human resources to address the needs of the entire service area. Other Promotion of Community Health: Each St. John System hospital provides subsidized vital emergency services in its community. The St. John System is attempting to promote community health in several additional ways. Most of the affiliated primary care physicians have or are establishing advanced primary care models of care that are attempting to improve health status of their patients by better emphasizing preventive care and health screening and by better management of chronic disease. This includes participation in the Medicare Comprehensive Primary Care Plus Model and Oklahoma's first Medicare Shared Savings Program Accountable Care Organization (ACO). The affiliated primary care physicians utilize a sophisticated electronic medical record that helps provide real time information to make it easier to manage patients' care. The hospitals and the other hospitals in the system have invested heavily in clinical information systems and electronic medical records as to better manage patient care during each episode of acute care. The St. John System supports and participates in a regional Health Information Exchange which further promotes the exchange of health data in an effort to improve quality and reduce cost of care for the community. St. John is investing in new systems of care to provide better coordination of care between all the different providers responsible for portions of each patient's care with an emphasis on prevention, screening and coordination of chronic care. The hospitals and the St. John Health System have invested in tertiary services that are needed by the community. Examples of which include development of Oklahoma's only ACS Level II Trauma Center (the highest accredited center in Tulsa), northeastern Oklahoma's only Joint Commission accredited stroke center, neonatal intensive care, sophisticated medical technology including all-digital diagnostic radiology, Cyberknife, and other forms of radiation therapy, a kidney transplant center, Davinci robotic surgery, an endovascular operating suite, orthopedic and neurosurgical centers of excellence, sophisticated cardiovascular care that emphasizes rapid and effective intervention for heart attack victims and preventive care for those with chronic heart conditions. The St. John System is also accredited as a participant in the MD Anderson Cancer Network bringing expertise in sub-specialty cancer care to residents of our community. The hospitals have an open medical staff and have community, religious and physician representatives serving on its Board. The Medicare Shared Savings Program Accountable Care Organization includes community representatives on the board and a health department representative on an active committee. The St. John System has created and is continuing to create systems and policies to promote better coordination of care and allocation of resources throughout the system. The hospitals participate in many community-wide health screening and health education events as well as hosting many such events that are open to the public. During this fiscal year, the organization participated in over 100 documented events system-wide. The associates, physicians, and facilities of the St. John System provide services to thousands of patients every day. Among the services provided annually are: Total Discharges (Excluding Normal Newborns) - 40,763 Total Observation Days - 15,318 Combined Discharges and Observation Days - 56,081 Total Patient Days (Excl. Normal Newborn and Observations) - 189,942 Births - 3,489 Emergency Room Visits - 154,224 Selected Outpatient Visits (Excl. Er & One Day Surgeries) - 601,397 Inpatient Surgical Cases - 11,651 Outpatient Surgical Cases - 18,052 Physician Office Patient Visits - 615,158 Urgent Care Clinic Patient Visits - 64,855 Combined Physician Office and Urgent Care Visits - 680,013 Total Laboratory Procedures (Incl. Hospital & Reference Labs) - 8,618,936 Summary: The thousands of associates, physicians and volunteers that make up St. John Health System, Inc. touch the lives of thousands of patients every day and millions of patients every year. As we seek to transform health care in Oklahoma and the U.S., St. John is challenged by many factors including: lack of public resources in Oklahoma that are devoted to both care for the poor; reductions in reimbursement due to a struggling oil industry; health care infrastructure, and medical education; competition from investor-owned health care facilities that do not share St. John's mission of service and emphasis on service to the poor and powerless but which seek to gain market share in commercially insured patients; poor economic and health care demographic factors contributing to generally poor health status and high rates of poverty and uninsured in Oklahoma; and the challenge of transition to payment for value. Finally, as one of only two major tax-exempt health systems in our service area, the St. John System reinvests profits generated into new or expanded services for the community. |
| Schedule H, Part V, Section B, Line 17 Billing and Collection Policy | During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. |
| Schedule H, Part I, Line 6a Community benefit report prepared by related organization | The hospitals are wholly-owned (wholly-sponsored) subsidiary of St. John Health System, Inc. - ein 73-1215174 - ("SJHS"). SJHS prepared a consolidated community benefit report for the consolidated organization as well as for each hospital. The reports are made available on demand and are referenced by the organization in a number of public meetings and community outreach activities. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2017 was $416,478 at charges, ($262,590 at cost). |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply and the financial assistance program is followed. |
| Schedule H, Part V, Section B, Line 16a FAP website | - Jane Phillips Nowata Health Center: Line 16a URL: http://www.stjohnhealthsystem.com/about/payment-for-services; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - Jane Phillips Nowata Health Center: Line 16b URL: http://www.stjohnhealthsystem.com/about/payment-for-services; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - Jane Phillips Nowata Health Center: Line 16c URL: http://www.stjohnhealthsystem.com/about/payment-for-services; |
| Schedule H, Part VI, Line 2 Needs assessment | As aforementioned in part v, section b, the hospital conducted a Community Health Needs Assessment (CHNA) jointly with its parent entity - St. John Health System, Inc. St. John System and the hospital collaborated with the Tulsa Health Department, Pathways To Health, and a diverse range of community stakeholders in Tulsa County on this process. The 2016 CHNA has been posted to the hospital and St. John System websites.: http://www.stjohnhealthsystem.com/about/community-health-needs-assessment Following the 2016 CHNA, the St. John System and hospital have continued dialogue with the community and participate in additional ongoing community-based needs assessments. The St. John System and the hospital have joined with more than 65+ community partners, led by the Tulsa Health Department and Pathways To Health, to work together to create the 2017-2019 Community Health Improvement Plan For Tulsa County (CHIP). The overall goal of the plan is to improve the health and well-being of Tulsa county residents to become the healthiest county in the state. The CHIP is divided into two priority areas to address access to health resources and health education and education systems. This plan aligns with goals in the fiscal year 2017-2019 implementation strategy developed for St. John Health System and its hospitals. St. John System and the hospital participate in the Tulsa Area Free Clinic Coalition which assesses, promotes, and supports the provision of compassionate health are the medically underserved in the Tulsa area, with many of the participants providing access to care. In addition, St. John System and the hospital participate in the indigent care expansion group which consists of several key safety net service stakeholders and funders who regularly meet to discuss current resources and unmet needs for the medically underserved to access care in the Tulsa area. The Cancer Committee works year-round to uphold quality standards established and evaluated by the Commission on Cancer, a program of the American College Of Surgeons. Through these efforts, the Cancer Committee promotes and improves cancer prevention, treatment, research and education through various programs and activities at both St. John Medical Center, Inc. And Oklahoma Cancer Specialists and Research Institute (OCSRI), St. John System's Partner in Cancer Care. Programs and activities are concerned with the full continuum of cancer, from prevention to survivorship and end-of-life care. A community needs assessment is conducted every three years by the cancer committee to drive a patient navigation process, as well as decisions for annual prevention, screening and community outreach programs. The assessment helps ensure that programs and activities of the committee are working to address health care disparities and barriers to cancer care, especially at the St. John System and OCSRI. In addition to the above, the Medical Access Program ("MAP") was created through joint endeavors of certain Chapman Trusts and the St. John System. This program supports and enhances access to health care services to the most vulnerable members of the Tulsa community. St. John System hospitals, including St. John Sapulpa, Inc., St. John Broken Arrow, Inc., Owasso Medical Facility, Inc., and St. John Medical Center, Inc. participate in this initiative. This indigent care program is overseen by representatives of St. John and, trustees of the Chapman Trusts. Input is also solicited from the University Of Oklahoma School Of Community Medicine In Tulsa. The MAP program includes participation of other health care providers including Good Samaritan Clinics, Day Center for the Homeless, Community Health Connection FQHC, Morton Health FQHC, Tulsa Dream Center, Arubah Clinic, Rockford Medical Access Clinic ("MAC"), and a network of volunteer physician providers and other organizations. The MAP program regularly receives input from all these organizations on needed services in the community which helps to prioritize the limited resources available to address community needs. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The hospitals have a team of financial counselors who, prior to discharge, attempt to visit in person with all uninsured inpatients and all inpatients likely to qualify as medically indigent to explain our financial assistance policies and help guide them through the process of applying for financial assistance. We also attempt to meet with all the families of all Medicaid beneficiaries or individuals who we believe could potentially qualify for Medicaid to help them apply for coverage. The hospitals mention the existence of the financial assistance policy and provides a phone number to call: on its website, in admitting materials, on all invoices for services sent to patients, and in other ways. |
| Schedule H, Part VI, Line 4 Community information | As described above, the hospital is part of St. John Health System, Inc. ("St. John System"). Although the St. John System provides a full spectrum of health-related services throughout eastern Oklahoma and southeastern Kansas, its tertiary operations and a large part of its other services are concentrated in the Tulsa metropolitan statistical area (the "Tulsa MSA"). According to the 2010 Census, the state of Oklahoma had a resident population of 3,751,351 persons compared to 3,450,654 persons in 2000. This is an 8.7% increase. It had an estimated resident population of 3,923,561 persons in 2016; 4.6% increase from 2010. The U.S. Census Bureau estimated that in 2009 13.5% of the Oklahoma resident population was eligible for Medicare, compared to 14.7% in 2000 (17% in 2015). Tulsa County, Oklahoma and the counties that make up the Tulsa MSA, according to the 2010 census, had populations of 603,403 and 1,008,460, respectively. This compares to populations of 563,299 and 803,235 persons, respectively in 2000 and represents population growth of 7.1% and 25.5%, respectively. The data shows that the counties in the Tulsa MSA that surround Tulsa County grew much faster from 2000 to 2010. At the same time, the population within Tulsa County shifted away from the city of Tulsa and to suburbs such as Owasso and Broken Arrow. The cities of Broken Arrow and Owasso are served by St. John Broken Arrow Inc. and Owasso Medical Facility Inc. respectively and were two of the fastest growing communities in Oklahoma between 2000 and 2010. The population of the city of Owasso grew 56% to 28,915 from 2000 to 2010 and the population of the city of Broken Arrow grew 32% to 98,850 from 2000 to 2010. Wagoner county (southeast of Tulsa) and Rogers county (northeast of Tulsa) showed the two highest population growth rates from 2000 to 2010. Every county in the 8 county Tulsa MSA except Pawnee County grew in population from 2000 to 2010. Washington County, directly north of Tulsa county and which includes the city of Bartlesville and is served by Jane Phillips Memorial Medical Center, Inc., also grew in population from 2000 to 2010. Creek County, served by St. John Sapulpa Inc., had a population of 69,967 in 2010 and Nowata County, served by Jane Phillips Nowata Hospital, Inc. had a population of 10,536 in 2010. When the populations of Creek County, Nowata County, and Washington County are added to the population of Tulsa County, the 2010 combined population was 1,139,939. The area served appears to be following the state and national trend of a declining share of young people (loss of 8% of the population share in Tulsa County) and a growing proportion of the older population (gain of 4% in Tulsa County). This evolving population age composition presents new challenges and opportunities for the community as a whole. The estimated median household income for Tulsa County in 2013 was $48,181. The estimated per capita income for Washington County in 2013 was $27,513. The estimated per capita income for Nowata County in 2013 was $20,523. The estimated per capita income for Creek County in 2013 was $22,736. There was clear racial inequality among median household incomes. Additionally, median household incomes increased with age until the 65 and older age group. This is most likely attributable to lower incomes after retirement. Estimates for 2013 stated that the poverty rate (below 100%) for Tulsa County was 15.9 percent. The estimated 2014 poverty rate (below 100%) was 14.3 percent for Washington County, 15. 4 percent for Creek County, and 18.7 percent for Nowata County. According to the Oklahoma State Department of Health's 2014 State of the State's Health report, one in six people in Creek County, Nowata County, and Washington County lived in poverty and one in seven people in Tulsa County lived in poverty. Racial and age disparity among those living in poverty is evident in the area served. Since 2013, Oklahoma is participating in the Federally-facilitated Health Insurance Marketplace. In 2013, before the first open enrollment period for the Health Insurance Marketplace, Oklahoma's uninsured rate of 20.5 percent and was 4.1 percent greater than the national uninsured rate. In 2015, Oklahoma's uninsured rate improved as it decreased to 15.4%. The 2015 Oklahoma uninsured rate is a 5.1 percent decrease since 2013 prior to the first open enrollment period. Oklahoma's rate of uninsured was 4.7 percent greater than the national rate. The 2015 rates of uninsured were as follows: 16 percent in Creek County, 16 percent in Nowata County, 20 percent in Washington County, and 13 percent for Tulsa County. Despite some recent attention to Medicaid expansion in state Legislature in 2016 after years of no traction, as of 2017 Oklahoma has not expanded Medicaid coverage to low-income adults. Tulsa County had 157,240 unduplicated Medicaid enrollees during 2013 which represents 25.8 percent of the total population. Creek County had 11,742 unduplicated Medicaid enrollees during 2010-2014 which represents 20.58 percent of the total population. Nowata County had 10,351 unduplicated Medicaid enrollees during 2011-2015 which represents 22.95 percent of the total population. Washington County had 7,619 unduplicated Medicaid enrollees during 2010-2014 which represents 17.6 percent of the total population. There is significant disparity in the general health of populations within the service area depending upon where an individual lives and to what socioeconomic and ethnic group they belong. For example, citizens who reside in "north" Tulsa and in some areas of "east" and "west" Tulsa generally have poorer health and shorter life spans than individuals who live in "south" Tulsa. Geographic health disparities such as this exist across the area served. Members of minority groups (many of whom reside in the geographic areas described above) share these same health characteristics. It has been demonstrated that these individuals have less access to regular health care services, including specialty care and many seek even their primary care in hospital emergency rooms, including all of the St. John Health System, Inc. Hospitals. Some significant minority groups in the hospital and St. John Health System, Inc.'s principal service area includes Native Americans, Hispanics and African Americans. Each of these groups shares common socioeconomic challenges making them more likely to experience health disparities. Each of these groups has unique ethnic health risk factors that contribute to health status that is generally poorer than their white counterparts. However, even among the white population in the hospitals service area, there is significant adverse health care status. Oklahoma (including the hospital service area) ranks near the bottom in many if not most measures of health status in the U.S. the St. John Health System and hospitals serve a diverse representation of health disparities in one of the lowest ranked states in the United States for health status (46th in 2016). Within the state of Oklahoma, counties served by the health system rank from 16th out of 77 to 63rd out of 77. This ranking is based on each state's performance on the core measures which include behaviors, community and environmental factors, health policy, clinical care, and outcomes. Among health determinants, Oklahoma ranks number 47, and among health outcomes, number 44. Among seniors, Oklahoma ranks number 49, and among women and children, number 46. Oklahoma's most extreme challenges include risky health behaviors such as high levels of smoking, high levels of uninsured, high levels of poverty, limited access to primary care and behavioral health services, inadequate prenatal care, and high rates of premature death. There are high rates of infant mortality, deaths by suicide and drug overdose, diabetes, obesity, upper respiratory illness, chronic heart conditions, and many other factors. Access to services in Oklahoma is a significant challenge due to the limited availability of primary care physicians and stress on hospital emergency room access and inpatient beds due to a growing number of transfers from underserved rural areas in Oklahoma. Ina addition, there are federally-designated medically underserved areas present in the community. These factors among individuals and families in the communities and geographies served by the hospital which create many challenges in meeting the demand for basic services and in improving the health status of the population. |
| Schedule H, Part VI, Line 5 Promotion of community health | Part A: The St. John System is a growing integrated delivery system that serves eastern Oklahoma, southeastern Kansas, and the surrounding area. It has grown significantly in recent years, with increasing revenues from outpatient and physician professional services as well as other post-acute services. Acute care services are provided on six hospital campuses that are owned by the St. John System. The owned hospitals are St. John Medical Center, Inc. (the tertiary center in Tulsa, Oklahoma), Jane Phillips Memorial Medical Center Inc. in Bartlesville, Owasso Medical Facility, Inc. in Owasso, Oklahoma, St. John Broken Arrow, Inc. in Broken Arrow, Oklahoma, and St. John Nowata Hospital, Inc., a critical access hospital in Nowata, Oklahoma, and St. John Sapulpa, Inc., a critical access hospital in Sapulpa, Oklahoma. Acute care services are also provided at an additional rural critical access hospital which is owned or managed by Jane Phillips. Diagnostic services and certain acute care services are also provided in a variety of free-standing (including hospital-based) settings. Serving Oklahoma for more than 90 years, the St. John System now includes over 500 employed physicians and "mid-level providers", and several urgent care clinics. Community Benefit Report: St. John Health System, Inc.'s (the "St. John System" or "St. John") mission is to improve the health status of the individuals who live in the communities we serve with a special emphasis on those living in poverty and those who are vulnerable among us; faithful to the teaching of Jesus Christ and the values of our sponsors and the Catholic Church. Our promise to our patients and to our communities is to provide medical excellence and compassionate care. We strive to provide Healthcare that Works, Healthcare that is Safe, and Healthcare that Leaves No One Behind. To meet this mission the St. John System has operated since the 1920's; growing from a fledgling community hospital in what was then the southern edge of Tulsa, Oklahoma to an integrated health care delivery system serving northeastern Oklahoma and surrounding states. The St. John System includes: thousands of associates (8,000 in FY 2017), employed physicians, and advanced practice providers, hundreds more independent physicians, and dozens of volunteers. They serve patients in the six owned hospitals operating nearly 800 beds; dozens of physician offices, clinics, and urgent care centers, a reference laboratory, and partnerships and ventures that include a health insurance company, several ambulatory surgery centers, and other healthcare activities. Together our associates, physicians, and volunteers touch the lives of thousands of patients every day, including those living in poverty and/or deemed otherwise vulnerable. The St. John System is committed to continue the legacy of health care excellence and service started by our original founders and sponsors the Sisters of the Sorrowful Mother by continuing to provide vital services to the communities with continued emphasis on service to the those living in poverty and/or who may otherwise be deemed vulnerable or powerless. We endeavor to establish trusted relationships with our patients over their entire lives: seeking to improve their health and working to health their minds and bodies when afflicted by injury or illness. Our Enabling Strengths: We use our enabling strengths to achieve our mission and vision. Those strengths include: a model community of inspired people working to provide our services and achieve our mission; empowering knowledge - clinical and business information systems that provide our associates Actionable, timely data and information upon which they can make informed decisions; the creation of trusted partnerships with external partners to expand our capabilities, complement our service offerings and fulfill our mission; and achieving vital presence in the communities we serve. This vital presence contemplates creation and continuation of important safety net services, world-class centers of clinical excellence and creation of medical homes that promote each individual's participation in their own health and well-being and which create and sustain the infrastructure for promoting health communities. Our Point of View: Health care delivery and financing in the U.S. must change. The cost of the current system relative to the value that communities and individuals are receiving is not sustainable. In order to meet the health care needs and contribute to economic vitality of communities, with special attention to the poor and vulnerable, health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Delivering safe, high-quality care that is low cost with an exceptional patient experience will increasingly require providers to have a strong regional presence, integrated physician relationships and capabilities across the care continuum. Sustaining the St. John mission into the future will require a more continuous, dynamic relationship with those we serve and the ability to share risk with healthcare purchasers, as opportunities for inpatient growth or commercial rate increases will be limited. The movement to managing health of defined populations demands massive transformational change. This requires rapid assessment, assembly and deployment of the necessary capabilities. We believe the St. John System is well positioned to lead this transformation. Community benefit: The community benefit provided by the St. John System includes: uncompensated care for the poor, support for the education of medical professionals, provision of subsidized health services, support for other community organizations, initiatives to improve community health, and medical research to be some of the key areas of focus for providing community benefit. The St. John System does not include amounts recorded as bad debt; payment of property, sales, use, income, payroll, and other taxes; considerable economic value provided to the local communities in which we operate as components of community benefit. The St. John System does include Medicare shortfalls. Care for the Poor: "Care For The Poor" (which includes the estimated cost of services provided to patients who qualify for financial assistance (charity) and the uncompensated cost of care provided to Medicaid beneficiaries) is the largest financial category of community benefit. Support for graduate and allied health medical education is the second largest. St. John provides discounts of at least 50% to all uninsured patients and additional discounts of at least 10% to uninsured patients who make the agreed upon timely payments for services they receive. All uninsured individuals living in households with incomes at or below 400% of the federal poverty limit qualify for free care for medically necessary services. Insured patients and others who are faced with financially catastrophic medical bills are also eligible for and encouraged to seek financial assistance. (Continued Part B) |
| Schedule H, Part VI, Line 6 Affiliated health care system | St. John Health System, Inc., headquartered in Tulsa, Oklahoma, and with facilities located throughout eastern Oklahoma and southeastern Kansas, is an Oklahoma nonprofit health system. It owns and operates an integrated tertiary health care delivery system that provides services eastern Oklahoma and southeastern Kansas. St. John Health System, Inc. And its subsidiaries, affiliates, and employed and affiliated physicians, provide health care services for patients of all ages across a broad continuum of care, from physician primary care and specialty services to ambulatory, and inpatient acute and post-acute services. The health ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of the health ministry are related to providing health care services. Ascension Health Alliance, D/B/A Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or health ministries, located in 23 states and the District of Columbia. Ascension is sponsored by Ascension sponsor, a Public Juridic person. The participating ORGANIZATIONS/ENTITIES of ascension sponsor are the Daughters Of Charity Of St. Vincent De Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of The Sisters Of St. Joseph Of Carondelet; the congregation of Alexian Brothers Of The Immaculate Conception Province, Inc. - American Province; and The Sisters Of The Sorrowful Mother Of The Third Order Of St. Francis Of Assisi - US/Caribbean Province. Mission: The St. John System directs its governance and management activities toward strong, vibrant, Catholic health ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the St. John System's mission of service to those persons living in poverty and other vulnerable persons, each health ministry accepts patients regardless of their ability to pay. The St. John System uses five categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: - Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. - Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty (other programs for persons who are poor) includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. - Community benefit (other programs for the general community) consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. - Medicare shortfall consists of the calculated unreimbursed costs of services provided to Medicare patients. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | OK |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STAN DEFEHR MD | ||||||||||||||
| CHAIRMAN | $0 | $480,423 | $0 | $143,862 | $0 | $10,820 | $0 | $14,575 | $0 | $25,145 | $0 | $674,825 | $0 | $0 |
| MIKE MOORE | ||||||||||||||
| DIRECTOR/PRESIDENT/COO | $0 | $247,626 | $0 | $63,304 | $0 | $60,478 | $0 | $17,225 | $0 | $10,672 | $0 | $399,305 | $0 | $0 |
| DAVID J PYNN | ||||||||||||||
| SVP AH-MNSTRY MKT EXEC TULSA | $0 | $804,882 | $0 | $1,362,969 | $0 | $195,916 | $0 | $16,269 | $0 | $28,173 | $0 | $2,408,209 | $0 | $0 |
| SAMUEL C ANDERSON | ||||||||||||||
| FORMER OFFICER (END 6/2014) | $0 | $0 | $0 | $0 | $0 | $482,528 | $0 | $0 | $0 | $16,950 | $0 | $499,478 | $0 | $0 |
| DAVID STIRE | ||||||||||||||
| FORMER OFFICER (END 12/2014) | $0 | $0 | $0 | $48,466 | $0 | $291,400 | $0 | $0 | $0 | $15,510 | $0 | $355,376 | $0 | $0 |
| LEX ANDERSON | ||||||||||||||
| TREASURER/EXEC VP & SJHS CFO | $0 | $448,110 | $0 | $255,006 | $0 | $169,098 | $0 | $15,205 | $0 | $19,869 | $0 | $907,288 | $0 | $0 |
| RONALD J BRASEL | ||||||||||||||
| VP FINANCE - CFO SJMC/JP | $0 | $143,038 | $0 | $36,815 | $0 | $26,781 | $0 | $9,453 | $0 | $20,977 | $0 | $237,064 | $0 | $0 |
| KEVIN STECK | ||||||||||||||
| SECRETARY - VP INTEGRITY & COMPLIANCE | $0 | $232,265 | $0 | $58,385 | $0 | $58,768 | $0 | $13,787 | $0 | $3,476 | $0 | $366,681 | $0 | $0 |
| ALFRED W GARTZKE MD | ||||||||||||||
| PHYSICIAN | $233,650 | $0 | $0 | $0 | $306 | $0 | $6,072 | $0 | $15,925 | $0 | $255,953 | $0 | $0 | $0 |
| DEBRA J ROBNETT-BELL | ||||||||||||||
| Physician Assistant | $153,776 | $0 | $0 | $0 | $6,215 | $0 | $8,562 | $0 | $7,173 | $0 | $175,726 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | ASCENSION HEALTH, AN AFFILIATE ORGANIZATION OF JANE PHILLIPS NOWATA HOSPITAL, INC., USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individual(s) received severance payments from the organization or a related organization: Samuel C Anderson - $480,118 David Stire - $291,400 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the Organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No individuals received current year distributions. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY ST. JOHN HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF Jane Phillips Nowata Hospital, Inc., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE ST. JOHN HEALTH SYSTEM, INC. EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 15a COMPENSATION OF THE CEO | In determining compensation of the organization's PRESIDENT & CEO, the process, performed by Ascension Health, a related organization of St. John Nowata Hospital, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The compensation committee reviewed and approved the compensation. In the review of the compensation, the PRESIDENT & CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation was recorded in the compensation committee minutes. The individual was not present when his compensation was decided. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. JOHN HEALTH SYSTEM, INC. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | JANE PHILLIPS NOWATA HOSPITAL, INC. HAS A SINGLE CORPORATE MEMBER, ST. JOHN HEALTH SYSTEM, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF JANE PHILLIPS NOWATA HOSPITAL, INC. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to Jane Phillips Nowata Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, ST. JOHN HEALTH SYSTEM, INC. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Line 19 Required documents available to the public | The Organization will provide any documents open to public inspection upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | TRANSFERS WITH ALPHA FUND - -1671428; NET TRANSFERS WITH AFFILIATES - 224658; |
| Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS | THE ACTIVITY OF JANE PHILLIPS NOWATA HOSPITAL, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF JANE PHILLIPS NOWATA HOSPITAL, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF JANE PHILLIPS NOWATA HOSPITAL, INC.. |
| Form 990, Part XII, Line 2c AUDIT COMMITTEE | JANE PHILLIPS NOWATA HOSPITAL, INC.is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 631455998 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | NA | false |
| ASCENSION HEALTH | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 631455998 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | ASCENSION HEALTH ALLIANCE | false |
| ST JOHN HEALTH SYSTEM INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731215174 | SYSTEM PARENT | OK | 501(c)(3) | Type I | ASCENSION HEALTH | false |
| ST JOHN SAPULPA INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 730662663 | HEALTH CARE | OK | 501(c)(3) | 3 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| JANE PHILLIPS MEMORIAL MEDICAL CENTER | ||||||||||
| 3500 E FRANK PHILLIPS BLVD | BARTLESVILLE | OK | 74006 | 730606129 | HEALTH CARE | OK | 501(c)(3) | 3 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN HEALTH SYSTEM FOUNDATION INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731133139 | HEALTH CARE | OK | 501(c)(3) | 7 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN MEDICAL CENTER INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 730579286 | HEALTH CARE | OK | 501(c)(3) | 3 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN VILLAS INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731077367 | NURSING HOME | OK | 501(c)(3) | 10 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| OWASSO MEDICAL FACILITY INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 203700131 | HEALTH CARE | OK | 501(c)(3) | 3 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN BROKEN ARROW INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 383833117 | HEALTH CARE | OK | 501(c)(3) | 3 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN AUXILIARY INC | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 730999759 | HEALTH CARE | OK | 501(c)(3) | 10 | ST JOHN HEALTH SYSTEM INC | Yes (true) |
| ST JOHN BUILDING CORPORATION | ||||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 611659782 | REAL ESTATE | OK | 501(c)(2) | ST JOHN HEALTH SYSTEM INC | Yes (true) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| Oklahoma Cancer Specialists Real Estate Company LLC | ||||||||
| 12697 E 51st St South | TULSA | OK | 74146 | 473843491 | REAL ESTATE HOLDING | OK | NA | N/A |
| SJFI LLC | ||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 462713285 | ACCOUNTABLE CARE ORGANIZATION | OK | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| UTICA SERVICES INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731057650 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| REGIONAL MEDICAL LABORATORIES INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731131608 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| PHYSICIAN SUPPORT SERVICES INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731437252 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| OMNI MEDICAL GROUP INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731335536 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| ST JOHN URGENT CARE CLINICS INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 204990275 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| ST JOHN ANESTHESIA SERVICES INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 203690446 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| ST JOHN PHYSICIANS INC | |||||||||
| 1923 SOUTH UTICA AVENUE | TULSA | OK | 74104 | 731321032 | MEDICAL SERVICES | OK | NA | C Corporation | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| REGIONAL MEDICAL LABORATORIES INC | ||
| L | $264,811 | FAIR MARKET VALUE |
| ST JOHN PHYSICIANS INC | ||
| L | $59,634 | FAIR MARKET VALUE |
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