2018-05-08T09:20:24-05:00 2017-06-30 KPMG LLP 210 Park Ave Suite 2650 Oklahoma City OK 73102 990 2016-07-01 451027361 INTEGRIS HEALTH EDMOND INC % JAQUETTA CLEMONS INTE 4059496026 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DANIEL DAVIS CFO 4059512736 2018-04-16 true MORGAN L SOUZA P00652612 4052396411 2018-04-15 2016 2022-09-23 18:48:47Z SEE SCHEDULE O C BRUCE LAWRENCE 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 71163101 false X WWW.INTEGRISOK.COM X 2011 OK TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. X 11 8 225 98 0 65521068 10491969 57047758 60671132 9155 0 0 0 122577981 71163101 0 0 0 0 17780833 18965393 0 0 0 37058334 39166368 54839167 58131761 67738814 13031340 99492856 100209570 13854264 1539638 85638592 98669932 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 49658720 60671132 SEE SCHEDULE O STATEMENTS 2 THROUGH 4 49658720 true true false false false false false false false false true false false false false false false true false false false false false false false false true true false false true false false false false false false false true false false false true false true false false false true X 0 0 225 true false false false false false false false false false false X 11 8 true false false false true true true true true false false true true true true true true true true false OK X JAQUETTA CLEMONS 4059512732 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 X LARITA ARAGON DIRECTOR 1.0 0.0 X 0 0 0 PETER DOBELBOWER DIRECTOR 1.0 0.0 X 0 0 0 MITZI HANCUFF DIRECTOR 1.0 0.0 X 0 0 0 JULIE HANSEN MD DIRECTOR 1.0 39.0 X 0 375601 22727 RAY HIBBARD CHAIRMAN 1.0 0.0 X 0 0 0 WILLIAM E SMITH MD DIRECTOR 1.0 0.0 X 0 0 0 RANDY STAFFORD VICE CHAIRMAN 1.0 0.0 X 0 0 0 PHILLIP K SWYDEN DIRECTOR 1.0 0.0 X 0 0 0 CLINTON WALLIS MD EX-OFFICIO CHIEF OF STAFF 1.0 0.0 X 18000 3022 0 JANET YOWELL SECRETARY 1.0 0.0 X 0 0 0 C BRUCE LAWRENCE EX-OFFICIO-PRESIDENT/CEO IH 1.0 39.0 X X 0 1041789 384000 AVILLA T WILLIAMS EX-OFFICIO-PRESIDENT IHE 40.0 0.0 X 280854 0 53337 CHRIS M HAMMES EX-OFFICIO-VP/COO IH 1.0 39.0 X 0 639089 186555 DAVID R HADLEY CHIEF FINANCIAL OFF. THRU 8/16 0.0 0.0 X 0 651258 20313 TOM HONAN INTERIM CFO THRU 10/16 1.0 39.0 X 0 296574 0 DANIEL DAVIS CHIEF FINANCIAL OFFICER 1.0 39.0 X 0 74212 290 ANGIE KAMERMAYER VP CHIEF NURSING OFFICER 40.0 0.0 X 183657 0 41658 JONATHAN RULE VICE PRESIDENT 40.0 0.0 X 141393 0 13866 DJANGO BELOTE DIRECTOR PHARMACY 40.0 0.0 X 142711 0 14764 JULIE HECK TEAM MANAGER RN 40.0 0.0 X 114347 0 17873 NICOLETTE MOMAN CLINICAL DIRECTOR I 40.0 0.0 X 115437 0 12227 COLBY PYLE RN STAFF 2 40.0 0.0 X 120212 0 10863 EVELYN RADICHEL CLINICAL DIRECTOR I 40.0 0.0 X 107262 0 30608 SUDHIR KHANNA MD FORMER DIRECTOR 0.0 40.0 X 0 191687 10078 1223873 3273232 819159 13 true true false SEE SCHEDULE O GENERAL STATEMENT 1 5840866 14 10491969 11773 10491969 NET PATIENT REVENUE 621990 58848980 58848980 RENTAL INCOME 532000 1009805 1009805 ELECTRONIC HEALTH RECORDS 900099 385302 385302 CAFETERIA 722320 292187 292187 GIFT SHOP 900099 121572 121572 13286 4260 9026 60671132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71163101 60248347 422785 0 0 0 0 708478 708478 0 14087019 14087019 843396 843396 2267756 2267756 1058744 1058744 8473041 8473041 0 0 0 0 0 2793156 2793156 4035 4035 9550063 9550063 0 0 799337 799337 16648 16648 0 3021 3021 3030600 3030600 0 5243799 5243799 -20537 -20537 PURCHASED SERVICES 3487462 3487462 0 0 RIF & RECRUITMENT 2335448 2335448 0 0 CONTRACT LABOR 2069378 2069378 0 0 SHOPP FEE 1118998 1118998 0 0 261919 261919 58131761 49658720 8473041 0 0 1842023 0 0 0 0 6854981 7784364 0 0 0 0 0 0 877807 970400 49142 0 121669521 32095403 91581795 89574118 0 0 0 0 0 0 0 0 129131 38665 99492856 100209570 13854264 1539638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13854264 1539638 X 85638592 98669932 0 0 0 0 85638592 98669932 99492856 100209570 13031340 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8187716 8187716 80763507 10719801 70043706 29180346 20964541 8215805 3537952 411061 3126891 89574118 true true X true X true X true true false true true 928522 928522 0.01600 7235663 2879251 4356412 0.07490 8164185 2879251 5284934 0.09090 11125 11125 0.00020 4798 4798 0.00010 17409 17409 0.00030 33332 33332 0.00060 8197517 2879251 5318266 0.09150 493 493 289 289 782 782 false 1712435 85622 12697611 15992972 -3295361 X true true 1 1 INTEGRIS HEALTH EDMOND INC 4801 INTEGRIS PARKWAY EDMOND OK 73034 WWW.INTEGRISOK.COM 2381 X X X INTEGRIS HEALTH EDMOND INC 1 false false true X X X X X X X X X 15 true true true true X SEE PART V, SECTION C X X true 15 true SEE PART V, SECTION C false true X 150. 300. X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART V: INTEGRIS HEALTH EDMOND, INC. (IHE) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IHE FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED BELOW. SUPPLEMENTAL INFORMATION 2 PART V, SECTION B, LINE 5: PUBLIC HEALTH EXPERTISE WAS UTILIZED WITH EACH FACILITY USING THE OKLAHOMA STATE DEPARTMENT OF HEALTH'S TURNING POINT CONSULTANT. EACH CONSULTANT GAVE THEIR INPUT BASED ON COUNTY DATA AND GAVE THEIR APPROVAL OF THE CHOSEN INDICATORS. THEY ALSO SIGNED IN APPROVAL OF THE OVERALL STRATEGIC PLAN. EACH CONSULTANT HELPED THE INDIVIDUAL COALITIONS PRIORITIZE THEIR COUNTY'S NEEDS BASED ON SEVERAL FACTORS. PUBLIC HEALTH EXPERTS INCLUDED: CENTRAL OKLAHOMA TURNING POINT WELLNESS CHAIR: KEITH KLESZYNSKI IN CONDUCTING THE CHNA, THE HOSPITALS TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY SURVEYS, LISTENING SESSIONS, FOCUS GROUPS, AND LOCAL DATA COLLECTION. ETHNICITIES INPUT WAS OBTAINED FROM SURVEYS BY TARGETING POPULATION GATHERING PLACES SUCH AS COMMUNITY CLINIC, CHURCHES, HEALTH DEPARTMENT, HUMAN SERVICES, AFTER SCHOOL PROGRAMS, AND PUBLIC TRANSPORTATION SERVICES. SUPPLEMENTAL INFORMATION 3 PART V, SECTION B, LINE 6A: THE FACILITIES LISTED IN THE METRO AREA USED THE SAME SURVEY, BUT SOME CONTENTS OF THE PLANS WERE CHANGED DUE TO SOME DEMOGRAPHIC ASPECTS OF THE COMMUNITIES (IE LARGE HISPANIC POPULATION, HIGHER SOCIO ECONOMIC FACTORS, ETC). THOSE FACILITIES INCLUDED: INTEGRIS HEALTH EDMOND, INTEGRIS BAPTIST MEDICAL CENTER, LAKESIDE WOMEN'S HOSPITAL, OKLAHOMA CENTER OF ORTHOPEDIC MULTI-SPECIALTY SURGERY, INTEGRIS SOUTHWEST MEDICAL CENTER, AND INTEGRIS CANADIAN VALLEY HOSPITAL. DUE TO THEIR CLOSE PROXIMITY AND GEOGRAPHIC LOCATION, INTEGRIS GROVE HOSPITAL AND INTEGRIS BAPTIST REGIONAL HEALTH CENTER USED THE SAME. INTEGRIS BASS BAPTIST HEALTH CENTER AND INTEGRIS NORTHWEST SPECIALTY HOSPITAL USED THE SAME SURVEY SINCE THEY SHARE THE SAME ZIP CODE. EACH FACILITY PLACED THE ASSESSMENT SURVEY ON THEIR WEB SITE'S HOME PAGE. SUPPLEMENTAL INFORMATION 4 PART V, SECTION B, LINE 6B: OKLAHOMA CITY-COUNTY HEALTH DEPARTMENT SUPPLEMENTAL INFORMATION 5 PART V, SECTION B, LINE 7D: THE CHNA IS WIDELY AVAILABLE TO THE COMMUNITY. THE PLANS WERE ALSO ADDED TO EACH FACILITY'S WEBSITE AND CLEARLY TITLED. THE PLANS WERE ALSO DISTRIBUTED TO ADMINISTRATION, LOCAL BOARDS, AT COMMUNITY FORUMS, COALITIONS, OTHER LOCAL AGENCIES AND ORGANIZATIONS. COPIES OF THE PLAN WERE PLACED IN EACH FACILITY'S ADMINISTRATION OFFICES FOR DISTRIBUTION AS WELL. SUPPLEMENTAL INFORMATION 6 PART V, SECTION B, LINE 11: THE CHNA PROCESS ASSISTED IN DETERMINING AVAILABLE RESOURCES, GAPS IN SERVICES, AND BOTH PERCEIVED AND ACTUAL NEEDS WITHIN THE INTEGRIS SERVICE AREAS. MANY OF THE NEEDS IDENTIFIED WERE COMMON WITHIN THE VARIOUS SERVICE AREAS, INCLUDING HEART DISEASE, DIABETES, TOBACCO USE, OBESITY, MENTAL HEALTH AND SUBSTANCE ABUSE. OTHERS, HOWEVER, SUCH AS CHILD ABUSE AND TEEN PREGNANCY, WERE NOT AS PREDOMINANT. THE NEEDS IDENTIFIED BY THE CHNA WERE INITIALLY PRIORITIZED THROUGH COLLABORATION WITH THE LOCAL COMMUNITY COALITIONS. THESE LOCAL PRIORITIZED NEEDS WERE THEN REEXAMINED BY INTEGRIS TO DETERMINE WHICH NEEDS COULD MOST EFFECTIVELY BE IMPACTED BY INTEGRIS THROUGH ADMINISTRATION OF THE DEVELOPED CHIP AND WHICH, IF ANY OF THE REMAINING, WERE CURRENTLY BEING ADDRESSED THROUGH OTHER COMMUNITY RESOURCES AND/OR SERVICES. INTEGRIS OPTED TO CONCENTRATE ON THE SAME THREE FOCUS AREAS FOR THE CHIPS IN EACH OF THE SERVICE AREAS-HEART DISEASE, MENTAL HEALTH, AND OBESITY-BELIEVING THAT A UNITED EFFORT WOULD ALLOW FOR A SHARING OF RESOURCES, PERSONNEL, PROGRAMS, ETC. AND ENSURE CONSISTENCY IN IMPLEMENTATION AND EVALUATION METHODS, THEREBY INCREASING THE POTENTIAL TO MORE EFFECTIVELY COMBAT THE ISSUES SYSTEM-WIDE. OTHER COMMONLY IDENTIFIED NEEDS SUCH AS DIABETES, TOBACCO USE, AND SUBSTANCE ABUSE THAT ARE ASSOCIATED RISK FACTORS FOR THE PRIMARY FOCUS AREAS ARE ADDRESSED IN ONE OR MORE OF THOSE RESPECTIVE SECTIONS OF THE CHIP. IT WAS DETERMINED THAT THE REMAINING NEEDS THAT WERE HIGHLY PRIORITIZED WITHIN CERTAIN SERVICE AREAS WERE PREVIOUSLY IDENTIFIED AND ALREADY BEING ADDRESSED THROUGH LOCAL AGENCY AND/OR COALITION AND PARTNERSHIP EFFORTS WITHIN THE COMMUNITIES. AS SUCH, INTEGRIS COMMITTED TO PROVIDE SUPPORT AND RESOURCES TO THE COMMUNITY PARTNERS TAKING THE LEAD ON THOSE PARTICULAR ISSUES. SUPPLEMENTAL INFORMATION 7 PART V, SECTION B, LINE 7A AND LINE 10A: HTTPS://INTEGRISOK.COM/ABOUT-INTEGRIS/SERVING-OUR-COMMUNITY/REPORTS SUPPLEMENTAL INFORMATION 8 PART V, SECTION B, LINE 16A, 16B, AND 16C: INTEGRISOK.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE SUPPLEMENTAL INFORMATION 9 INTEGRIS HEALTH SYSTEMS INTERNAL AUDIT FUNCTION PERFORMED A COMPLIANCE ASSESSMENT OF THE SYSTEMS ADHERENCE TO THE FINAL SECTION 501(R) REGULATIONS, APPLICABLE TO ALL INTEGRIS HEALTH SYSTEM HOSPITAL FACILITIES BEGINNING WITH THE FISCAL YEAR ENDED JUNE 30, 2017. FIELDWORK WAS INITIATED, PERFORMED, AND COMPLETED DURING APRIL MAY 2017. THE OBJECTIVE OF THIS ASSESSMENT WAS TO EVALUATE THE COMPLIANCE OF EACH INTEGRIS HOSPITAL FACILITY WITH THE FINAL REGULATIONS ISSUED ON DECEMBER 30, 2014, IDENTIFY ANY COMPLIANCE GAPS, AND IMMEDIATELY FACILITATE THE CORRECTION OF ANY IDENTIFIED DEFICIENCIES. DURING THAT ASSESSMENT, THE FOLLOWING DEFICIENCIES WERE IDENTIFIED AND CORRECTED: LIMITATIONS ON CHARGES 1. DURING FISCAL YEAR ENDED JUNE 30, 2017, THE METHODS USED FOR DETERMINING AND APPLYING AMOUNTS GENERALLY BILLED (AGB) DID NOT MEET THE SPECIFIC REQUIREMENTS OF TREAS. REG. SECTION 1.501(R)-5. THOUGH INTEGRIS CHOSE TO APPLY THE LOOK-BACK METHOD OF DETERMINING AGB, THE AGB PERCENTAGE WAS APPLIED ON A FISCAL YEAR BASIS RATHER THAN WITHIN 120 DAYS OF THE END OF THE 12-MONTH PERIOD USED IN CALCULATING THE AGB PERCENTAGES. AS A RESULT, INTEGRIS INADVERTENTLY APPLIED AN ERRONEOUS AGB PERCENTAGE, INITIALLY APPLYING A 28% AGB RATHER THAN A 27% AGB TO ALL FACILITIES WITHIN THE SYSTEM, AS THIS WAS THE LOWEST AGB FOR ANY FACILITY. REFUNDS OF THE ABG DIFFERENCES WERE MADE TO AFFECTED FAP-ELIGIBLE PATIENTS. IT WAS SUBSEQUENTLY DISCOVERED THAT CERTAIN PATIENT REFUNDS WERE DUE TO PATIENTS WHO HAD MADE A PAYMENT AND THEN WERE DETERMINED TO BE FAP-ELIGIBLE FOR 100% FREE CARE. INTEGRIS BEGAN PROCESSING THOSE REFUNDS AS SOON AS THEY WERE DISCOVERED. 2. UPON CALCULATION OF THE CORRECTED AGB, IMPLEMENTATION OF THE CORRECTED AGB WAS IMMEDIATELY ENACTED AND INTEGRIS REVIEWED PATIENT ACCOUNTS TO DETERMINE WHETHER ANY PATIENT WAS OVERBILLED AS A RESULT OF THE ERROR. FOR THE CALENDAR YEAR 2017 FINANCIAL ASSISTANCE POLICY (FAP), THE AGB FOR THE LOOK-BACK PERIOD WAS DETERMINED TO BE 27%. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE IN 2017 WERE NOT CHARGED MORE THAN 27% OF BILLED CHARGES FOR ANY MEDICALLY NECESSARY SERVICES. THIS CALCULATION WILL BE DONE YEARLY AND IMPLEMENTED BY THE 120TH DAY AFTER THE END OF THE 12-MONTH PERIOD USED BY INTEGRIS IN CALCULATING THE AGB PERCENTAGES TO DETERMINE THE AGB. REFUNDS OF THE ABG DIFFERENCES WERE MADE TO AFFECTED PATIENTS. ALTHOUGH TOTAL PATIENT REFUNDS TO FAP-ELIGIBLE PATIENTS FOR THE FISCAL YEAR CAN BE DETERMINED, THE EXACT NUMBER OF INDIVIDUALS AND DOLLAR AMOUNTS ATTRIBUTABLE SOLELY TO THE ABG MISCALCULATION CANNOT BE EASILY IDENTIFIED. 3. TO MINIMIZE THE LIKELIHOOD OF RECURRING ERRORS AND TO FACILITATE THE PROMPT IDENTIFICATION AND CORRECTION OF ANY SUCH FUTURE FAILURES THAT DO OCCUR, THE AGB CALCULATION WILL BE DONE YEARLY AND IMPLEMENTED BY THE 120TH DAY AFTER THE END OF THE 12-MONTH PERIOD USED BY INTEGRIS IN CALCULATING THE AGB PERCENTAGES TO DETERMINE THE AGB. THE LOWEST AGB OF ALL INTEGRIS HOSPITAL FACILITIES WILL BE APPLIED TO ALL HOSPITAL FACILITIES WITHIN THE SYSTEM. FINANCIAL ASSISTANCE POLICY 1. AT THE TIME OF THE COMPLIANCE ASSESSMENT, THE FAP WAS NOT FULLY COMPLIANT WITH SECTION 501(R) REGULATIONS. NECESSARY REVISIONS INCLUDED DESCRIBING THE METHOD FOR DETERMINING AGB, OUTLINING THE PERCENTAGES FOR AGB, DESCRIBING ALL DISCOUNTS AVAILABLE AND ELIGIBILITY CRITERIA FOR EACH DISCOUNT, INCLUDING A COMPLETE LIST OF PROVIDERS DELIVERING EMERGENCY OR MEDICALLY NECESSARY CARE, DESCRIBING THE REFUND PROCESS IF AN ELIGIBLE PATIENT WAS CHARGED IN EXCESS OF AGB, AND PROVIDING CONTACT INFORMATION TO OBTAIN INFORMATION ABOUT THE POLICY AND/OR ASSISTANCE WITH THE APPLICATION PROCESS. 2. TO CORRECT THESE DEFICIENCIES, THE FAP WAS REVISED AND REVIEWED WITH INTEGRIS LEGAL COUNSEL TO MEET ALL 501(R) CRITERIA, AND APPROVED BY INTEGRIS BOARD OF DIRECTORS. ALL REQUIRED DOCUMENTATION, INCLUDING THE FAP, PLAIN LANGUAGE SUMMARY, AND BILLING AND COLLECTIONS POLICY, WAS MADE AVAILABLE IN ALL REQUIRED LANGUAGES ON THE INTEGRIS HEALTH SYSTEM PUBLIC WEBSITE AND AVAILABLE TO PATIENT ACCESS AREAS. ALL CORRECTIVE ACTIONS WERE TAKEN BEFORE JUNE 30, 2017. 3. TO MINIMIZE THE LIKELIHOOD OF RECURRING ERRORS AND TO FACILITATE THE PROMPT IDENTIFICATION AND CORRECTION OF ANY SUCH FUTURE FAILURES THAT DO OCCUR, THE FAP WILL BE REVIEWED ANNUALLY BY THE SYSTEM BUSINESS OFFICE IN CONCURRENCE WITH 501(R) GUIDELINE POLICIES, APPLICATIONS, AND PLAIN LANGUAGE SUMMARIES. FURTHER, SPECIFIC 501(R) TRAINING AND EDUCATION WAS PROVIDED TO APPLICABLE PERSONNEL TO ENSURE A COMPLETE, THOROUGH, AND CONSISTENT UNDERSTANDING BY ALL STAFF WITH RELATED RESPONSIBILITIES, PRIOR TO JUNE 30, 2017. WIDE PUBLICATION AND AVAILABILITY OF FINANCIAL ASSISTANCE POLICY (FAP) AND RELATED INFORMATION 1. AT THE TIME OF THE COMPLIANCE ASSESSMENT, NOT ALL SIGNAGE DISPLAYS AND TRANSLATED FAP INFORMATION REQUIRED UNDER TREAS. REG. SECTION 1.501(R)-4 WERE PRESENT IN THE INTEGRIS HOSPITAL FACILITIES EMERGENCY AND/OR ADMISSION AREAS, AS WELL AS ON THE ORGANIZATIONS PUBLIC WEBSITE. 2. TO CORRECT THESE DEFICIENCIES, POSTERS AT ALL IDENTIFIED ACCESS POINTS WERE COMPLETED BY APRIL 30, 2017 AND INTEGRIS IMPLEMENTED A POLICY THAT SYSTEM LEADERSHIP WILL AUDIT FOR POSTER COMPLIANCE AT LEAST QUARTERLY. THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY WERE ALL MADE AVAILABLE IN LANGUAGES WITH SIGNIFICANT POPULATIONS (ENGLISH, SPANISH, AND VIETNAMESE), PRIOR TO JUNE 30, 2017. 3. TO MINIMIZE THE LIKELIHOOD OF RECURRING ERRORS AND TO FACILITATE THE PROMPT IDENTIFICATION AND CORRECTION OF ANY SUCH FUTURE FAILURES THAT DO OCCUR, DEPARTMENT EDUCATION FOR ALL ACCESS AND PATIENT FINANCIAL SERVICES STAFF WAS PERFORMED BEFORE JUNE 30, 2017 AND WILL BE CONDUCTED ANNUALLY THEREAFTER. SYSTEM WIDE COMMUNICATION ABOUT THE LAW AND INTEGRIS RESPONSIBILITIES TO MAKE FAP INFORMATION WIDELY AVAILABLE WAS SENT TO ALL EMPLOYEES AND INTEGRIS QUERIED ALL APPLICABLE OUTSOURCED VENDORS TO INSURE COMPLIANCE WITH INTEGRIS POLICIES, WHERE APPLICABLE, AND REQUIRE THEM TO TRAIN THEIR STAFF, PROVIDE DOCUMENTATION AND AUDIT REGULARLY. THESE MEASURES WERE IMPLEMENTED PRIOR TO JUNE 30, 2017. BILLING AND COLLECTIONS POLICY 1. AT THE TIME OF THE COMPLIANCE ASSESSMENT, THE BILLING AND COLLECTIONS POLICY WAS NOT FULLY COMPLIANT WITH SECTION 501(R) REGULATIONS. NECESSARY REVISIONS INCLUDED THE DESCRIPTION OF PROCESS, TIMEFRAMES, AND REASONABLE EFFORTS THE HOSPITAL WILL MAKE TO DETERMINE WHETHER AN INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING INTO EXTRAORDINARY COLLECTION ACTIVITIES AS WELL AS THE OFFICE, DEPARTMENT, COMMITTEE OR OTHER BODY WITH THE FINAL AUTHORITY OR RESPONSIBILITY FOR DETERMINING THE HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS FAP-ELIGIBLE AND MAY THEREFORE ENGAGE IN ECAS AGAINST THE INDIVIDUAL. FURTHER, ALTHOUGH THE FAP SPECIFIES INTEGRIS HAS A SEPARATE POLICY, NEITHER THE FAP NOR THE BCP STATE HOW THE PUBLIC CAN OBTAIN COPIES OF THE SEPARATE BCP (AND ANY NECESSARY TRANSLATIONS). 2. TO CORRECT THESE DEFICIENCIES, THE BILLING AND COLLECTION POLICY WAS REVISED AND REVIEWED WITH INTEGRIS LEGAL COUNSEL TO MEET ALL 501(R) CRITERIA, AND APPROVED BY INTEGRIS BOARD OF DIRECTORS. INDIVIDUALS CAN OBTAIN THE POLICY IN A NUMBER OF WAYS AS DESCRIBED IN SECTION 4.0 OF THE BILLING AND COLLECTIONS POLICY. 3. TO MINIMIZE THE LIKELIHOOD OF RECURRING ERRORS AND TO FACILITATE THE PROMPT IDENTIFICATION AND CORRECTION OF ANY SUCH FUTURE FAILURES THAT DO OCCUR, THE BILLING AND COLLECTION POLICY WILL BE REVIEWED ANNUALLY BY THE SYSTEM BUSINESS OFFICE IN CONCURRENCE WITH 501(R) GUIDELINE POLICIES, APPLICATIONS, AND PLAIN LANGUAGE SUMMARIES. THE PROCESS TO REVIEW AND ENSURE THAT DUE DILIGENCE IS COMPLETED WILL BE DONE BY THE SYSTEM DIRECTOR OVER CUSTOMER SERVICE ON AN AS NEEDED BASIS (I.E., AS PATIENTS BECOME ELIGIBLE FOR ECAS). THEY WILL REVIEW RANDOM ACCOUNTS TO ENSURE THAT THE INDIVIDUAL IS RECEIVING THE CORRECT NUMBER OF STATEMENTS AND CALLS AS OUTLINED AND IN COMPLIANCE WITH INTEGRIS BILLING AND COLLECTION POLICY. SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART VI: INTEGRIS HEALTH EDMOND, INC. (IHE) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IHE FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED BELOW. SUPPLEMENTAL INFORMATION 2 PART I, LINE 3C: N/A SUPPLEMENTAL INFORMATION 3 PART I, LINE 6A: INTEGRIS HEALTH, INC.,(EIN: 73-1192764), THE PARENT ORGANIZATION OF IHE, PRODUCES A CONSOLIDATED COMMUNITY REPORT THAT IS MADE AVAILABLE TO THE PUBLIC. SUPPLEMENTAL INFORMATION 4 PART I, LINE 7, COLUMN F: BAD DEBT OF $0 (GROSS CHARGES) WAS SUBTRACTED FROM PART IX LINE 25(A) $58,131,761 TO ARRIVE AT TOTAL EXPENSE. SUPPLEMENTAL INFORMATION 5 PART I, LINE 7: COSTING METHODOLOGY: THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON PART 1, LINE 7. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. SUPPLEMENTAL INFORMATION 6 PART II: COMMUNITY BUILDING ACTIVITIES COMMUNITY-BUILDING ACTIVITIES IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSE OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS AND EXPENSES FOR THE DEVELOPMENT OF A VARIETY OF COMMUNITY-BUILDING PROGRAMS AND PARTNERSHIPS. SUPPLEMENTAL INFORMATION 7 PART III, LINES 2, 3 AND 4: NET PATIENT SERVICE REVENUE IS RECORDED AT ESTABLISHED RATES, NET OF CONTRACTUAL ADJUSTMENTS, CHARITY CARE ADJUSTMENTS, ADMINISTRATIVE ADJUSTMENTS, AND NET PATIENT BAD DEBT. RETROACTIVELY CALCULATED CONTRACTUAL ADJUSTMENTS ARISING UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED. ADJUSTMENTS TO ESTIMATES IN FUTURE PERIODS ARE RECORDED AS FINAL SETTLEMENTS ARE DETERMINED OR AS ADDITIONAL INFORMATION BECOMES AVAILABLE. ACCOUNTS RECEIVABLE ARE RECORDED NET OF AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND CONTRACTUAL ADJUSTMENTS OF APPROXIMATELY $684,757,000 AND $645,936,000 AT JUNE 30, 2017 AND 2016, RESPECTIVELY WHICH IS FROM THE CONSOLIDATED AUDIT. ALTHOUGH INTEGRIS HEALTH ESTIMATES UNCOLLECTIBLE ACCOUNTS ON A REASONABLE BASIS, THE NET PATIENT ACCOUNTS RECEIVABLE BALANCE IS SUBJECT TO AN ACCOUNTING LOSS IF PATIENTS AND THIRD-PARTY PAYORS ARE UNABLE TO MEET THEIR CONTRACTUAL OBLIGATIONS. THE ALLOWANCE AND RESULTING PROVISION FOR BAD DEBTS IS BASED UPON A COMBINATION OF THE AGING OF RECEIVABLES AND MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND PAYMENT TRENDS BY PAYOR CATEGORY. PATIENT ACCOUNTS ARE ALSO MONITORED, AND, IF NECESSARY, PAST DUE ACCOUNTS ARE PLACED WITH COLLECTION AGENCIES IN ACCORDANCE WITH GUIDELINES ESTABLISHED BY INTEGRIS HEALTH. ALL PATIENT BALANCES REGARDLESS OF PAYOR SOURCE ARE COLLECTED IN ACCORDANCE WITH A PREDEFINED TIME LIMITED PROCESS DESIGNED TO GIVE THE PATIENT AN OPPORTUNITY TO PAY THE BALANCE BEFORE WRITING OFF THE BALANCE TO BAD DEBT EXPENSE AND TURNING THE ACCOUNT OVER TO A COLLECTION AGENCY. INTEGRIS HEALTH EDMOND, INC. AND CERTAIN OTHER OF THE HEALTHCARE RELATED CONTROLLED ENTITIES OF INTEGRIS HEALTH, INC. PROVIDE CARE WITHOUT CHARGE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER INTEGRIS HEALTH'S CHARITY CARE POLICY. BECAUSE THESE ENTITIES DO NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET REVENUE OR INCLUDED IN NET ACCOUNTS RECEIVABLE. THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON PART III, LINE 2. DISCOUNTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. INTEGRIS HEALTH CONTRIBUTES RESOURCES, ADVOCACY AND COMMUNITY SUPPORT TO PROMOTE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. INTEGRIS HEALTH BELIEVES THAT MEDICALLY NECESSARY HEALTH CARE SERVICES SHOULD BE ACCESSIBLE TO ALL REGARDLESS OF RACE, ANCESTRY, RELIGION, NATIONAL ORIGIN, CITIZENSHIP STATUS, AGE, DISABILITY OR GENDER. INTEGRIS HEALTH IS COMMITTED TO PROVIDING HEALTH SERVICES AND ACKNOWLEDGES THAT IN SOME CASES THE PATIENT WILL NOT BE ABLE TO PAY FOR THE SERVICES RECEIVED AND IN THOSE CASES ASSOCIATED BAD DEBT COULD BE CONSIDERED AS A COMMUNITY BENEFIT. INTEGRIS HEALTH HAS ADOPTED A PRESUMPTIVE PROCESS TO ACCURATELY IDENTIFY THOSE PATIENTS WHO WOULD QUALIFY FOR CHARITY ASSISTANCE. THE PROCESS REVIEWS THE PATIENT'S ABILITY TO PAY BASED ON AN ALGORITHM DEVELOPED BY AN EXTERNAL VENDOR AND REVIEWED BY KPMG, THE EXTERNAL AUDITOR FOR INTEGRIS. ALL BAD DEBT ACCOUNTS ARE REVIEWED USING THIS ALGORITHM AND THOSE THAT MEET THE CHARITY THRESHOLD OF 150% OF THE FEDERAL POVERTY LEVEL ARE RECLASSIFIED AS CHARITY CARE. THE RESULTANT EFFECT IS THAT INTEGRIS BELIEVES THAT LESS THAN 5% OF BAD DEBT EXPENSE MIGHT BE ABLE TO BE CLASSIFIED AS CHARITY EXPENSE. SUPPLEMENTAL INFORMATION 8 PART III, LINE 8: COMMUNITY BENEFIT: ------------------ THE HOSPITAL BELIEVES THAT ALL OF THE $3,295,361 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. WE ARE RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE TO MEDICARE PATIENTS EVEN THOUGH OUR COST EXCEEDS REIMBURSEMENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING ELDERLY IN OUR COMMUNITY. TAX-EXEMPT HOSPITALS ARE EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. COSTING METHODOLOGY: -------------------- MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO AND THE MEDICARE FILED COST REPORT. SUPPLEMENTAL INFORMATION 9 PART III, LINE 9B: PATIENTS MAY, AT ANY TIME DURING THE COLLECTION CYCLE, SUBMIT FINANCIAL INFORMATION FOR FINANCIAL ASSISTANCE OR CHARITY CONSIDERATION PURSUANT TO INTEGRIS POLICY SYS-RCM-100 CHARITY SERVICES. ALL AVAILABLE AVENUES OF ASSISTANCE AND AVAILABLE PAYMENTS FROM THIRD PARTY PAYORS MUST BE EXHAUSTED BEFORE SUCH ASSISTANCE FOR CHARITY OR OTHER FINANCIAL ASSISTANCE IS CONSIDERED. IHE DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. SUPPLEMENTAL INFORMATION 10 PART VI, LINE 2: NEEDS ASSESSMENT INTEGRIS HEALTH UTILIZES A VARIETY OF TOOLS TO DETERMINE THE HEALTH CARE NEEDS OF OUR COMMUNITIES. THESE INCLUDE PARTNERSHIPS WITH LOCAL COMMUNITY AGENCIES AND ORGANIZATIONS TO DETERMINE SPECIFIC TARGET MARKET NEEDS, PROGRAM SURVEYS AND COMMUNITY FOCUS GROUPS, PROGRAM EVALUATIONS FROM PARTICIPANTS IN OUR COMMUNITY HEALTH SCREENINGS, HEALTH EDUCATION AND SUPPORT GROUPS, THE COUNTY HEALTH RANKINGS REPORT AND THE OKLAHOMA STATE HEALTH DEPARTMENT'S "STATE OF THE STATE HEALTH REPORT." AFTER REVIEWING THESE MATERIALS FOR ISSUES CONCERNING ACCESS TO CARE, HEALTH EDUCATION NEEDS AND GAPS IN SERVICES IN OUR COMMUNITIES, INTEGRIS HEALTH DETERMINES HOW TO ADDRESS THESE ISSUES BY DEVELOPING PROGRAMS/SERVICES TO IMPLEMENT, INCLUDING, BUT NOT LIMITED TO, HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION AND WELLNESS PROGRAMS, SUPPORT GROUPS, AND ACCESS TO HEALTH CARE FACILITIES. INTEGRIS HEALTH UTILIZES OUR HEALTH SYSTEM RESOURCES, FACILITIES AND PERSONNEL FOR MANY OF THESE PROGRAMS, BUT ALSO PARTNERS WITH OUR COMMUNITIES AND DEVELOPS COLLABORATIONS WITH LOCAL NON-PROFIT AGENCIES, CIVIC ORGANIZATIONS, SCHOOLS, AND CHURCHES TO IMPROVE THE ISSUES IDENTIFIED. SUPPLEMENTAL INFORMATION 11 PART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCE INTEGRIS HEALTH USES A MULTI-FACETED APPROACH TO EDUCATE OUR PATIENTS ON THE AVAILABILITY OF CHARITY AS WELL AS STATE AND FEDERAL FINANCIAL ASSISTANCE. THIS INCLUDES: *POSTERS CLEARLY DISPLAYED IN EVERY PATIENT REGISTRATION AREA SPEAKING TO OUR FINANCIAL ASSISTANCE PROGRAMS. *A FINANCIAL RIGHTS AND RESPONSIBILITY BROCHURE GIVEN TO EVERY PATIENT AT THE TIME OF THEIR REGISTRATION WHICH PROVIDES FINANCIAL ASSISTANCE PROGRAM DETAILS. *A CLEARLY MARKED PRESENCE ON THE INTEGRIS HEALTH ON-LINE BUSINESS OFFICE WEBSITE WITH A SECTION DEVOTED TO FINANCIAL ASSISTANCE PROGRAM DETAILS AS WELL AS AN ON-LINE CHARITY APPLICATION. *A DESCRIPTION OF THE FINANCIAL ASSISTANCE PROGRAM AS WELL AS THE APPLICATION PROCESS IS INCLUDED ON EVERY PATIENT BILL. FINANCIAL COUNSELORS MEET WITH PATIENTS TO IDENTIFY ELIGIBILITY FOR FEDERAL AND STATE ASSISTANCE PROGRAMS. SUPPLEMENTAL INFORMATION 12 PART VI, LINE 4: COMMUNITY INFORMATION INTEGRIS HEALTH SYSTEM IS THE STATE'S LARGEST OKLAHOMA-OWNED HEALTH CARE SYSTEM AND ONE OF THE STATE'S LARGEST PRIVATE EMPLOYERS, WITH HOSPITALS, REHABILITATION CENTERS, PHYSICIAN'S CLINICS, MENTAL HEALTH FACILITIES, CANCER CENTERS, INDEPENDENT LIVING CENTERS, AND HOME HEALTH AGENCIES THROUGHOUT MOST OF THE STATE. ALL COUNTIES IN WHICH INTEGRIS HEALTH OPERATES INCLUDE ONE OR MORE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS. INTEGRIS HEALTH EDMOND IS LOCATED IN THE CITY OF EDMOND, WHICH IS IN OKLAHOMA COUNTY IN CENTRAL OKLAHOMA. THIS CAMPUS OFFERS 40 INPATIENT BEDS, 4 SURGICAL SUITES, AND 17 EMERGENCY DEPARTMENT ROOMS. INTEGRIS HEALTH EDMOND OPENED IN 2011. THERE ARE THREE OTHER HOSPITALS SERVING THE COMMUNITY OF EDMOND. SUPPLEMENTAL INFORMATION 13 PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH EVIDENCE OF THE ORGANIZATIONS' RESPONSIVENESS TO THE COMMUNITY, INCLUDING OPPORTUNITIES FOR COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS. ALL INTEGRIS HEALTH FACILITIES ARE GOVERNED BY A BOARD OF DIRECTORS SPECIFICALLY MADE UP OF MEN AND WOMEN WHO LIVE AND WORK IN THE COMMUNITY INCLUDING: LOCAL BUSINESS OWNERS, CIVIC LEADERS, COMMUNITY VOLUNTEERS, REPRESENTATIVES WORKING IN HIGHER EDUCATION, UTILITY COMPANIES, AND A VARIETY OF NON-PROFIT ORGANIZATIONS. PATIENT AND COMMUNITY ADVISORY GROUPS HAVE ALSO BEEN ESTABLISHED AT SEVERAL INTEGRIS FACILITIES ACROSS THE STATE. THESE GROUPS GIVE HOSPITAL LEADERS INPUT, SUGGESTIONS, AND FEEDBACK ON WAYS TO IMPROVE PROGRAMS, SERVICES, COMMUNITY NEEDS, AND PROCESS IMPROVEMENT IN CLINICAL AREAS. PROGRAMS ESTABLISHED TO MEET COMMUNITY NEEDS INCLUDE A FALLS PREVENTION PROGRAM FOR SENIOR CITIZENS, COMMUNITY HEALTH SCREENINGS AND PHYSICIAN LECTURES REQUESTED BY LOCAL SCHOOLS, CHURCHES, CIVIC GROUPS, AND COMMUNITY LEADERS TO ADDRESS SPECIFIC HEALTH ISSUES WHICH INCLUDE: DIABETES, CANCER DIAGNOSIS AND TREATMENT OPTIONS, OBESITY AND PHYSICAL FITNESS PROGRAMS, MEN'S UROLOGICAL HEALTH PROGRAMS AND PROSTATE SCREENINGS, CANCER SCREENINGS, SPANISH DIABETES SUPPORT GROUP, AFRICAN AMERICAN MEN AND WOMEN'S HEART HEALTH, AND STROKE LECTURES. ADVOCACY INITIATIVES FOR PROMOTING COMMUNITY-WIDE, STATE OR NATIONAL EFFORTS TO IMPROVE HEALTH OF THE POPULATION AND INCREASE ACCESS. INTEGRIS HEALTH PARTNERS WITH THE OKLAHOMA LIONS CLUB MOBILE HEALTH UNIT, THE OKLAHOMA STATE HEALTH DEPARTMENT, AND THE OKLAHOMA TURNING POINT PROGRAM TO INCREASE HEALTH SCREENING OPPORTUNITIES AND HEALTH ACCESS FOR PEOPLE LIVING IN RURAL, UNDERSERVED AREAS OF OKLAHOMA. THE PARTNERSHIP INCLUDES DONATION OF RESOURCES AND MONEY TO SPONSOR THE OPERATION OF THE LIONS MOBILE HEALTH UNIT WHICH TRAVELS AROUND THE STATE OFFERING FREE HEALTH SCREENINGS AND MEDICAL INFORMATION. THE OKLAHOMA STATE HEALTH DEPARTMENT AND THE OKLAHOMA TURNING POINT PROGRAM ASSIST WITH HEALTH SCREENINGS AND HELP WITH REFERRALS TO MEDICAL HOMES AND CLINICS FOR PEOPLE WITHOUT A PHYSICIAN AND FOR THOSE UNINSURED OR UNDERINSURED. INTEGRIS HEALTH PARTNERS WITH THE OKLAHOMA TURNING POINT PROGRAM, LOCAL CIVIC GROUPS, SUCH AS OUR CHAMBERS OF COMMERCE, ROTARY, AND KIWANIS CLUBS, TECHNOLOGY SCHOOLS, COMMUNITY COLLEGES, CHURCHES, AND LOCAL SCHOOLS IN A VARIETY OF EVENTS AND PROGRAMS TO EDUCATE THE COMMUNITY ON HEALTH/WELLNESS ISSUES, CREATE OPPORTUNITIES FOR HEALTH ACCESS, PROVIDE COMMUNITY SCREENINGS IN UNDERSERVED AREAS OF OKLAHOMA, AND TO GIVE STUDENTS AND COMMUNITY MEMBERS THE OPPORTUNITY TO VOLUNTEER FOR THESE EVENTS. THIS INCLUDES MEDICAL STUDENTS WHO WORK WITH INTEGRIS ACROSS THE STATE AT OUR EVENTS TO LEARN MORE ABOUT PROVIDING HEALTH SERVICES TO THE COMMUNITY AND TO HELP TRAIN THEM FOR FUTURE WORK IN THE HEALTHCARE ARENA. THE HOSPITAL'S ROLE IN WORKING WITH OTHERS TO IDENTIFY COMMUNITY NEEDS AND ADDRESS COMMUNITY PROBLEMS. INTEGRIS HEALTH WORKS WITH THE OKLAHOMA HOSPITAL ASSOCIATION, THE OKLAHOMA STATE MEDICAL ASSOCIATION, THE ALLIANCE FOR THE UNINSURED, THE OKLAHOMA STATE HEALTH DEPARTMENT, THE OKLAHOMA MENTAL HEALTH ASSOCIATION, AND LOCAL NON-PROFIT ORGANIZATIONS SUCH AS THE OKLAHOMA CHAPTERS OF AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER SOCIETY, AND OTHER LOCAL HEALTH AND WELLNESS ORGANIZATIONS AND AGENCIES TO DETERMINE HEALTH CARE NEEDS IN THE STATE, ISSUES CONCERNING SPECIFIC CITIES, ACCESS TO HEALTH ISSUES, NEIGHBORHOOD AND ENVIRONMENT ISSUES, AND OTHER SOCIAL DETERMINANTS OF HEALTH THAT AFFECT THE LIVES OF OUR RESIDENTS. A VARIETY OF COALITIONS, TASK FORCES, AND COMMITTEES HAVE BEEN STARTED TO ADDRESS SPECIFIC HEALTH AND WELLNESS ISSUES AND TO DETERMINE INTERVENTIONAL STRATEGIES FOR IMPLEMENTATION. THE IMPACT PROGRAMS ARE HAVING ON COMMUNITY HEALTH, ESPECIALLY PREVENTION ACTIVITIES, EFFORTS TO IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES, AND REDUCING HEALTH CARE COSTS. INTEGRIS COMMUNITY HEALTH PROGRAMS ACROSS THE STATE ARE IMPLEMENTED TO EDUCATE OUR RESIDENTS ABOUT HEALTH AND WELLNESS ISSUES AFFECTING THEM AND THEIR COMMUNITIES. WORKING WITH PARTNER AGENCIES AND ORGANIZATIONS IN THE COMMUNITIES WE SERVE GIVES US THE OPPORTUNITY TO CREATE PROGRAMS THAT SPECIFICALLY ADDRESS NEGATIVE HEALTH INDICATORS AFFECTING THE COMMUNITY. PREVENTION AND HEALTH EDUCATION HAVE BEEN THE PRIORITY FOR INTEGRIS FOR MANY YEARS IN AN EFFORT TO BETTER EDUCATE THE PUBLIC ON TAKING CARE OF THEIR HEALTH AND CREATING AWARENESS ABOUT HOW THEIR BEHAVIORS MAY NEGATIVELY AFFECT THEIR HEALTH AND THE HEALTH OF THEIR FAMILIES. WORKING WITH PARTNER AGENCIES, ORGANIZATIONS, PHYSICIANS, AND LOCAL CLINICS, INTEGRIS HAS BEEN ABLE TO HELP SLOWLY IMPROVE HEALTH IN SOME INDICATORS, SUCH AS CHILDHOOD IMMUNIZATIONS, ADULT IMMUNIZATIONS, AND SMALL STEP TOWARD IMPROVING CHILDHOOD OBESITY WITH SEVERAL PROGRAMS IMPLEMENTED IN THE METROPOLITAN AREAS, INCREASING ACCESS BY DEVELOPING REFERRAL NETWORKS BETWEEN FREE CLINICS ACROSS OKLAHOMA CITY AND IN SOME RURAL AREAS. ALL OF THESE PROGRAMS AND PARTNERSHIPS, COUPLED WITH EDUCATING THE COMMUNITY ABOUT AVAILABLE SERVICES, CAN HELP US CONTINUE TO REDUCE SOME OF THE HEALTHCARE COSTS WE SEE IN OUR HOSPITALS, CLINICS, AND EMERGENCY DEPARTMENTS. SUPPLEMENTAL INFORMATION 14 PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLES IHE IS A MEMBER OF INTEGRIS HEALTH SYSTEM, OF WHICH INTEGRIS HEALTH, INC. IS THE CONTROLLING MEMBER. INTEGRIS HEALTH SYSTEM IS AN OKLAHOMA HEALTH CARE SYSTEM WHICH SUPPORTS THE COMMUNITY NEEDS ACROSS THE STATE. THE MISSION OF INTEGRIS HEALTH IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. OTHER FACILITIES OF THE TAXPAYER ARE LISTED ON SCHEDULE H, PART V AND THE FACILITIES OF OTHER TAXPAYERS ARE LISTED ON THE SCHEDULE H OF THEIR RESPECTIVE FORMS 990. SEE SCHEDULE O, GENERAL STATEMENTS 3 THROUGH 4 FOR ADDITIONAL INFORMATION REGARDING THE INTEGRIS HEALTH SYSTEM. SUPPLEMENTAL INFORMATION 15 PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT ALL STATES WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: OK false true false false false false false true false JULIE HANSEN MD DIRECTOR 0 263109 0 111885 0 607 0 12102 0 10625 0 398328 0 0 AVILLA T WILLIAMS EX-OFFICIO-PRESIDENT IHE 230990 0 40000 0 9864 0 46903 0 6434 0 334191 0 0 0 CHRIS M HAMMES EX-OFFICIO-VP/COO IH 0 617867 0 0 0 21222 0 170945 0 15610 0 825644 0 0 C BRUCE LAWRENCE EX-OFFICIO-PRESIDENT/CEO IH 0 992513 0 0 0 49276 0 371936 0 12064 0 1425789 0 0 ANGIE KAMERMAYER VP CHIEF NURSING OFFICER 167319 0 2000 0 14338 0 30455 0 11203 0 225315 0 0 0 JONATHAN RULE VICE PRESIDENT 126524 0 0 0 14869 0 7768 0 6098 0 155259 0 0 0 DJANGO BELOTE DIRECTOR PHARMACY 141817 0 0 0 894 0 8555 0 6209 0 157475 0 0 0 SUDHIR KHANNA MD FORMER DIRECTOR 0 191687 0 0 0 0 0 10078 0 0 0 201765 0 0 DAVID R HADLEY CHIEF FINANCIAL OFF. THRU 8/16 0 239281 0 197232 0 214745 0 12731 0 7582 0 671571 0 197232 TOM HONAN INTERIM CFO THRU 10/16 0 296574 0 0 0 0 0 0 0 0 0 296574 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART I, LINE 4B THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NON QUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. C. BRUCE LAWRENCE CHRIS M. HAMMES AVILLA T. WILLIAMS DAVID R. HADLEY RECEIVED A PAYMENT FROM THE PLAN IN THE CURRENT YEAR EQUAL TO $197,232. SUPPLEMENTAL INFORMATION 2 SCHEDULE J, PART I, LINE 7 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. IN THE SECOND PLAN, CERTAIN EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION PURSUANT TO THEIR WRITTEN EMPLOYMENT AGREEMENTS. ALL INCENTIVE COMPENSATION IS SUBJECT TO A CAP AND DOES NOT EXCEED 50% OF THE PHYSICIAN'S TOTAL COMPENSATION. THERE ARE A VARIETY OF METHODS USED TO CALCULATE INCENTIVE COMPENSATION BASED ON THE PHYSICIAN'S PERSONAL PRODUCTION, RANGING FROM (I) A SPECIFIED PERCENTAGE OF NET INCOME LESS EXPENSES; (II) A SPECIFIED PERCENTAGE OF TOTAL COLLECTIONS LESS EXPENSES; (III) A SPECIFIED PERCENTAGE OF BASE SALARY BASED COMPLIANCE WITH CERTAIN QUALITY, PATIENT SATISFACTION, PRODUCTION AND FINANCIAL INDICATORS; (IV) A SPECIFIED PERCENTAGE OF BASE SALARY BASED ON COMPLIANCE WITH QUALITY, GUIDING VALUES, PATIENT SATISFACTION AND PRODUCTRION CRITERIA; (V) A SPECIFIED PERCENTAGE OF FEE-BASED COLLECTIONS AND CAPITATION COLLECTIONS, IF APPLICABLE, IN EXCESS OF QUARTERLY SALARY; (VI) QUARTERLY BONUSES MEASURED BY RVUS THAT EXCEED A SPECIFIED TARGET PER QUARTER; AND (VII) PRO RATA SHARE OF ANNUAL INCENTIVE POOLS BASED UPON PRODUCTION, COMPLIANCE WITH CLINICAL GUIDELINES, QUALITY AND PATIENT SATISFACTION CRITERIA. SEE PART V false SUPPLEMENTAL INFORMATION 1 SCHEDULE L, PART IV: BUSINESSS TRANSACTIONS INVOLVING INTERESTED PERSONS (A) NAME OF INTERESTED PERSON: DIAGNOSTIC LABORATORY OF OKLAHOMA, LLC (B) RELATIONSHIP: SEE PART V, SUPPLEMENTAL INFORMATION 2 (C) AMOUNT: $903,425 (D) DESCRIPTION OF TRANSACTION: SEE PART V, SUPPLEMENTAL INFORMATION 2 (E) SHARING OF ORGANIZATION'S REVENUES: NO (A) NAME OF INTERESTED PERSON: INTEGRIS CARDIOVASCULAR PHYSICIANS, LLC (B) RELATIONSHIP: SEE PART V, SUPPLEMENTAL INFORMATION 2 (C) AMOUNT: $204,634 (D) DESCRIPTION OF TRANSACTION: SEE PART V, SUPPLEMENTAL INFORMATION 2 (E) SHARING OF ORGANIZATION'S REVENUES: NO (A) NAME OF INTERESTED PERSON: INTEGRIS PROHEALTH, INC. (B) RELATIONSHIP: SEE PART V, SUPPLEMENTAL INFORMATION 2 (C) AMOUNT: $108,920 (D) DESCRIPTION OF TRANSACTION: SEE PART V, SUPPLEMENTAL INFORMATION 2 (E) SHARING OF ORGANIZATION'S REVENUES: NO SUPPLEMENTAL INFORMATION 2 SCHEDULE L, PART IV: BUSINESSS TRANSACTIONS INVOLVING INTERESTED PERSONS THE FILING ORGANIZATION AND THE INTERESTED PERSON ARE BOTH AFFILIATES WITHIN AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. THE INTERESTED PERSONS REPORTED ON SCHEDULE L, PART V, SUPPLEMENTAL INFORMATION 1 ARE EACH GREATER THAN 35% CONTROLLED ENTITIES OF INTEGRIS HEALTH, INC. AND/OR INTEGRIS BAPTIST MEDICAL CENTER. THE TRANSACTIONS REPORTED CONSIST OF ROUTINE TRANSACTIONS WITHIN THE ACTIVITY OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE TRANSACTIONS INCLUDE EXPENSE REIMBURSEMENTS, LEASING OF FACILITIES, PURCHASE OF SERVICES, EQUITY CONTRIBUTIONS AND DISTRIBUTIONS, AND OTHER INTERCOMPANY TRANSFERS. REIMBURSEMENT OF EXPENSES 47580511 COST 731192764 INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE SUITE 13 OKLAHOMA CITY OK 73112 501(C)(3) true true false false SUPPLEMENTAL INFORMATION 1 SCHEDULE N, PART II, LINE 2A AND 2B INTEGRIS HEALTH EDMOND, INC. (IHE) IS A MEMBER OF INTEGRIS HEALTH (INTEGRIS), AN INTEGRATED HEALTHCARE SYSTEM. IHE IS REIMBURSING INTEGRIS FOR EXPENSES RELATED TO MANAGEMENT, HOUSEKEEPING, UTILITIES, SECURITY AND OTHER INTEGRATED SERVICES PROVIDED BY INTEGRIS. THE FOLLOWING INDIVIDUALS WERE OFFICERS, DIRECTORS, OR EMPLOYEES OF BOTH ORGANIZATIONS AT THE TIME OF THE TRANSACTIONS: C. BRUCE LAWRENCE CHRIS M. HAMMES DANIEL DAVIS TOM HONAN DAVID R. HADLEY GENERAL STATEMENT 1 FORM 990, BOX C: DOING BUSINESS AS INTEGRIS LIFE HEALTH INSTITUTE ARCADIA TRAILS GENERAL STATEMENT 2 PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS HEALTH EDMOND INC (IHE) IS A MEMBER OF THE INTEGRIS HEALTH SYSTEM (INTEGRIS HEALTH). INTEGRIS HEALTH IS THE STATE'S LARGEST OKLAHOMA-OWNED HEALTH CARE CORPORATION AND ONE OF THE STATE'S LARGEST PRIVATE EMPLOYERS (ABOUT 9,000 EMPLOYEES STATEWIDE), WITH HOSPITALS, REHABILITATION CENTERS, PHYSICIAN CLINICS, MENTAL HEALTH FACILITIES, FITNESS CENTERS, INDEPENDENT LIVING CENTERS AND HOME HEALTH AGENCIES THROUGHOUT MUCH OF THE STATE. AS A MEMBER OF INTEGRIS HEALTH AND A NOT FOR PROFIT ORGANIZATION, IHE PROVIDES THOUSANDS OF DOLLARS OF CHARITY CARE TO PATIENTS THROUGHOUT THE STATE OF OKLAHOMA. WHILE THIS CARE REPRESENTS A LARGE PERCENTAGE OF IHE'S GIFT BACK TO THE COMMUNITY, IT IS STILL ONLY PART OF WHAT IHE CHOOSES TO CALL RETURNSHIP. RETURNSHIP EPITOMIZES IHE'S MISSION OF GIVING BACK TO ITS COMMUNITY. IT TAKES THE FORM OF MANY PROGRAMS AND ACTS OF CHARITY PROVIDED DAILY ACROSS THE STATE OF OKLAHOMA - FREE HEALTH SCREENINGS, SUPPORT GROUPS, MEDICAL SERVICES, EDUCATIONAL PROGRAMS, HEALTH FAIRS AND MORE. IN ADDITION, IHE PROVIDES SIGNIFICANT AMOUNTS OF UNCOMPENSATED SERVICES. UNCOMPENSATED SERVICES ARE THE COSTS OF PROVIDING FREE AND REDUCED COST CARE, WHICH INCLUDES CHARITY CARE AND UNPAID COSTS OF MEDICAID PROGRAMS. AS A NOT-FOR-PROFIT HOSPITAL, IHE PROVIDES SERVICES TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE COVERAGE. THUS, IT PROVIDES A MUCH-NEEDED SAFETY NET FOR MEMBERS OF THE IHE COMMUNITY WHO WOULD OTHERWISE HAVE NO ACCESS TO MEDICAL CARE. CHARITY CARE COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IHE PROVIDED CHARITY CARE OF $928,522. IHE ALSO PROVIDES CARE TO PATIENTS WHO QUALIFY FOR MEDICAID PROGRAMS FOR WHICH THE ORGANIZATION RECEIVES INADEQUATE PAYMENTS. UNPAID COSTS OF MEDICAID PROGRAMS REFLECT THE DIFFERENCE BETWEEN COSTS TO PROVIDE PATIENT CARE SERVICES AND THE RATE AT WHICH THE HOSPITAL IS REIMBURSED. MEDICAID COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IHE'S UNPAID COSTS OF MEDICAID PROGRAMS EQUALED $4,356,412. IN ADDITION IHE BAD DEBT COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IHE'S BAD DEBT COSTS WERE $1,712,435. FOR ADDITIONAL DETAILS REGARDING COMMUNITY BENEFIT SEE THE ATTACHED COMPLETE COMMUNITY BENEFIT REPORT ON SCHEDULE O STATEMENTS 3 THROUGH 4. GENERAL STATEMENT 3 PART III, LINE 4A: COMMUNITY BENEFIT REPORT INTEGRIS COMMUNITY BENEFIT REPORT 2017 INTEGRIS BAPTIST MEDICAL CENTER PROSTATES AND PANCAKES: COME FOR ONE...STAY FOR THE OTHER INTEGRIS MENS HEALTH UNIVERSITY OFFERS A HEARTY PANCAKE DINNER AND ROUTINE SCREENINGS FOR PROSTATE CANCER. FREE PSA BLOOD TESTS ARE AVAILABLE FOR MEN 50 YEARS OF AGE AND OLDER UNLESS THEY HAVE A PREVIOUS FAMILY HISTORY. ONE IN SIX MEN WILL BE DIAGNOSED WITH PROSTATE CANCER DURING HIS LIFETIME. A LARGE PERCENTAGE OF MEN HAVE ONLY LIMITED CONTACT WITH PHYSICIANS AND THE HEALTH CARE SYSTEM AS A WHOLE. MEN NOT ONLY FAIL TO GET ROUTINE CHECK-UPS AND PREVENTIVE CARE, BUT OFTEN IGNORE SYMPTOMS OR DELAY SEEKING MEDICAL ATTENTION WHEN SICK OR IN PAIN. BLOOD PRESSURE, GLUCOSE AND CHOLESTEROL HEALTH SCREENINGS WERE ALSO OFFERED TO APPROXIMATELY 55 MEN THIS YEAR. INTEGRIS BASS BAPTIST HEALTH CENTER (ENID) MENTAL HEALTH FIRST AID MENTAL HEALTH FIRST AID IS AN INTERNATIONAL EVIDENCE-BASED PROGRAM MANAGED BY THE NATIONAL COUNCIL FOR BEHAVIORAL HEALTH. THE PROGRAM INTRODUCES PARTICIPANTS TO RISK FACTORS AND WARNING SIGNS OF MENTAL HEALTH PROBLEMS, BUILDS UNDERSTANDING OF THEIR IMPACT AND OVERVIEWS APPROPRIATE SUPPORTS. THIS EIGHT-HOUR COURSE USES ROLE-PLAYING AND SIMULATIONS TO DEMONSTRATE HOW TO OFFER INITIAL HELP IN A MENTAL HEALTH CRISIS AND CONNECT PEOPLE TO THE APPROPRIATE PROFESSIONAL, PEER, SOCIAL AND SELF-HELP CARE. THE PROGRAM ALSO TEACHES COMMON RISK FACTORS AND WARNING SIGNS OF SPECIFIC ILLNESSES LIKE ANXIETY, DEPRESSION, SUBSTANCE ABUSE, BIPOLAR DISORDER, EATING DISORDERS AND SCHIZOPHRENIA. MENTAL HEALTH FIRST AID TEACHES PARTICIPANTS A FIVE-STEP ACTION PLAN TO SUPPORT SOMEONE DEVELOPING SIGNS AND SYMPTOMS OF A MENTAL ILLNESS OR EXPERIENCING AN EMOTIONAL CRISIS. INTEGRIS CANADIAN VALLEY HOSPITAL (YUKON) DEEP: DIABETES EMPOWERMENT EDUCATION PROGRAM THE DEEP (DIABETES EMPOWERMENT EDUCATION PROGRAM) IS AN EVIDENCE BASED PROGRAM DEVELOPED TO PROVIDE THE COMMUNITY WITH THE TOOLS TO BETTER MANAGE THEIR DIABETES IN ORDER TO REDUCE COMPLICATIONS AND LEAD HEALTHIER, LONGER LIVES BASED ON PRINCIPLES OF EMPOWERMENT AND ADULT EDUCATION. THE PROGRAM WAS DEVELOPED BY THE MIDWEST LATINO HEALTH RESEARCH, TRAINING AND POLICY CENTER AT THE UNIVERSITY OF ILLINOIS AT CHICAGO IN ENGLISH AND SPANISH AS A CURRICULUM DESIGNED TO ENGAGE COMMUNITY RESIDENTS IN SELF-MANAGEMENT PRACTICES FOR THE PREVENTION AND CONTROL OF DIABETES. THE PROGRAM IS CURRENTLY BEING IMPLEMENTED ACROSS THE U.S., IN PUERTO RICO AND IN PERU. DEEP CURRICULUM EDUCATES PARTICIPANTS ON THE PRIORITY INDICATORS OF HEART DISEASE PREVENTION, NUTRITION AND PHYSICAL ACTIVITY/OBESITY. PROGRAM CURRICULUM ALSO COVERS MENTAL HEALTH ISSUES INCLUDING STRESS RELIEF, DEPRESSION AND COPING WITH DIABETES. INTEGRIS CANCER INSTITUTE 23RD ANNUAL CELEBRATION OF LIFE ART SHOW THE TROY AND DOLLIE SMITH WELLNESS CENTER AT THE INTEGRIS CANCER INSTITUTE CELEBRATED ITS 23RD ANNUAL ART EXHIBIT, DEDICATED TO THE CURATIVE POWERS OF CREATIVITY AND TO ALL WHOSE LIVES HAVE BEEN AFFECTED BY CANCER. THE EXHIBIT SHOWCASES ALL FORMS OF ART INCLUDING FIBER, GRAPHICS, OIL, WATERCOLOR, MIXED MEDIA, PHOTOGRAPHY, POTTERY, SCULPTURE, WRITING AND POETRY. WORK BY ARTISTS OF ALL AGES IS ON DISPLAY EXPRESSING HOW THEIR LIVES HAVE BEEN AFFECTED BY CANCER. MORE THAN 200 PIECES OF ART WERE INCLUDED THIS YEAR AND ARTISTS, CANCER SURVIVORS, FAMILIES AND FRIENDS WERE RECOGNIZED AT AN OPENING RECEPTION. INTEGRIS GROVE HOSPITAL COMMUNITY GARDEN NUTRITION TRAINING IN CONJUNCTION WITH THE DELAWARE COUNTY BOYS AND GIRLS CLUB AND THE DELAWARE COUNTY COMMUNITY COALITION, WE PARTICIPATED IN A NUTRITION TRAINING EVENT WITH APPROXIMATELY 70 CHILDREN FROM THE GROVE AREA. ON DAY ONE, WE VISITED THE COMMUNITY GARDEN. THE STUDENTS TOURED THE GARDEN, THEN GOT UP CLOSE AND PERSONAL WITH SEEDS, HERBS AND FRESH PRODUCE AS WELL AS PACKAGED ITEMS FROM THE GROCERY STORE. ON DAY TWO, WE WENT TO THE DELAWARE COUNTY BOYS AND GIRLS CLUB TO DEMONSTRATE HOW TO MAKE HEALTHY SNACKS WITH ITEMS FROM THE GARDEN. WE CREATED A "SUSHI" TURKEY AND VEGETABLE ROLL WITH CARROTS, CUCUMBERS, RADISHES AND A SPINACH TORTILLA. THE KIDS HAD A GREAT TIME LEARNING ABOUT THE GARDEN AND INCORPORATING THAT INTO MAKING A HEALTHY AND FUN SNACK! MANY OF THEM WERE VERY SURPRISED THEY ENJOYED THE SNACK WITH FRESH PRODUCE IN IT. THEY ALSO LEARNED ABOUT PORTION SIZES FOR EACH FOOD GROUP. INTEGRIS HEALTH EDMOND SUNSET ELEMENTARY SCHOOL MAY 5 CINCO DE MAYO FESTIVAL THE INTEGRIS COMMUNITY WELLNESS DEPARTMENT PARTICIPATED IN THE ANNUAL CINCO DE MAYO FESTIVAL AT SUNSET ELEMENTARY SCHOOL. MANY PARENTS OF THE STUDENTS ATTENDED. THE EVENT INCLUDED FUN PHYSICAL ACTIVITIES INCLUDING MAKING HEALTHY FRUIT SMOOTHIES USING BLENDERS POWERED BY PEDALING BICYCLES. THE RESPONSE FROM THE CHILDREN WAS GREAT, AS THEY COMPETED AGAINST THEIR TEACHERS TO SEE WHO COULD POWER THE BLENDER THE FASTEST. EVERYONE WATCHED HOW TO MAKE ONE, AND MANY SAID THEY WERE GOING TO TRY IT AT HOME. A SAMPLE OF THE SMOOTHIE WAS GIVEN TO APPROXIMATELY 500 CHILDREN AT THE SCHOOL FROM 1ST THROUGH 5TH GRADES. INTEGRIS COMMUNITY WELLNESS CONTINUES TO PARTNER WITH SUNSET ELEMENTARY SCHOOL. THE SCHOOL HAS ONE OF THE HIGHEST PERCENTAGES OF CHILDREN WHO ARE ELIGIBLE FOR FREE OR REDUCED COST LUNCHES IN THE EDMOND PUBLIC SCHOOLS. INTEGRIS MENTAL HEALTH MENTAL HEALTH SCREENING IN PARTNERSHIP WITH INTEGRIS, MEMBERS OF THE OKLAHOMA CITY COUNTY HEALTH DEPARTMENTS WELLNESS NOW MENTAL HEALTH AND ADDICTION RECOVERY WORK GROUP ACCEPTED THE FUTURE OF POPULATION HEALTH AWARD FROM THE PUBLIC HEALTH FOUNDATION IN MAY. THIS AWARD RECOGNIZES EXEMPLARY PRACTICE BY HOSPITALS AND HEALTH SYSTEMS THAT ARE COLLABORATING WITH PUBLIC HEALTH DEPARTMENTS AND OTHER COMMUNITY PARTNERS ON HEALTH IMPROVEMENT STRATEGIES AND IMPLEMENTATION EFFORTS. THE AWARDEES FOR THE 2016 PROGRAM WERE INTEGRIS HEALTH IN OKLAHOMA AND WELLSPAN HEALTH IN PENNSYLVANIA. THESE ORGANIZATIONS ARE ENGAGED IN INNOVATIVE AND AMBITIOUS LOCAL PARTNERSHIPS TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES IN THE COMMUNITIES THEY SERVE. "THESE HOSPITALS AND THEIR PARTNERS ARE BUILDING ON ONE ANOTHER'S STRENGTHS AS THEY TAKE ON TOUGH, LONGSTANDING COMMUNITY HEALTH PROBLEMS," SAID PHF PRESIDENT RON BIALEK. "OUR MISSION AT INTEGRIS IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE," SAID BRUCE LAWRENCE, PRESIDENT AND CHIEF EXECUTIVE OFFICER OF INTEGRIS. "IN ORDER TO MAKE A MEANINGFUL DIFFERENCE IN TODAY'S HEALTH CARE ENVIRONMENT WE HAVE TO CHANGE BEHAVIORS, AND THE ONLY WAY TO DO THAT IS THROUGH COLLABORATION." THE GROUP IS RECOGNIZED FOR THEIR JOINT EFFORTS TO PROMOTE THE FREE, ANONYMOUS, ONLINE SCREENINGS PROVIDED BY INTEGRIS THROUGH THE WEBSITE, MENTALHEALTHSCREENING.ORG, AND FOR THE GROUPS' EFFORTS TO PROVIDE MENTAL HEALTH FIRST AID TRAINING THROUGHOUT THE COMMUNITY. GENERAL STATEMENT 4 PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED INTEGRIS MIAMI HOSPITAL YOGA FOR KIDS YOGA FOR KIDS WAS DEVELOPED BY THE UNIVERSITY OF ARKANSAS DIVISION OF AGRICULTURE RESEARCH AND EXTENSION PROGRAM FOR AGES 5-19. IT INCORPORATES ADULT YOGA POSES INTO KID-FRIENDLY YOGA ROUTINES AND GAMES. THE YOGA FOR KIDS PROGRAM FOCUSES ON HELPING KIDS ACHIEVE OPTIMAL PHYSICAL, SOCIAL AND MENTAL HEALTH. PRACTICING YOGA BUILDS STRENGTH, FLEXIBILITY AND CONFIDENCE. IN ADDITION, THE BREATHING TECHNIQUES PROMOTE RELAXATION AND QUIET THE MIND. YOGA AND STRETCH BREAKS IN THE CLASSROOM ARE PROVEN TO IMPROVE CONCENTRATION. THIS FUN AND SIMPLE EXERCISE PROGRAM COMBINES BREATH, PHYSICAL POSTURES AND MINDFULNESS TO HELP STRENGTHEN AND CALM THE BODY AND MIND. YOGA FOR KIDS PROMOTES STRESS RELIEF AS WELL AS PHYSICAL ACTIVITY. SCHOOLS IN THE MIAMI AND GROVE AREA ARE SO EXCITED THAT WE OFFER THIS FOR THEM IN RURAL OKLAHOMA. MANY OF THE SCHOOLS WERE LOOKING FOR WAYS TO INCORPORATE MENTAL HEALTH AWARENESS, BUT WERE UNSURE WHERE TO TURN. WE NOW HAVE 13 SCHOOL DISTRICTS THAT HAVE YOGA FOR KIDS ON THE CALENDAR FOR THIS SCHOOL YEAR. WE ALSO SERVE EACH LOCAL BOYS AND GIRLS CLUB AT LEAST ONCE A MONTH AND THERE ARE MANY TEACHERS WHO NOW INCORPORATE SOME FORM OF YOGA IN THEIR CLASSROOMS. INTEGRIS SOUTHWEST MEDICAL CENTER GO RED FOR YOUR HEART/CHECK. CHANGE. CONTROL CHECK. CHANGE. CONTROL. IS AN AMERICAN HEART/ STROKE ASSOCIATION EVIDENCE-BASED HYPERTENSION MANAGEMENT PROGRAM THAT UTILIZES AN ONLINE HEALTH TRACKER TO EMPOWER PARTICIPANTS TO TAKE OWNERSHIP OF THEIR CARDIOVASCULAR HEALTH. THE PROGRAM INCORPORATES SELF-MONITORING, MENTORING AND ONLINE TRACKING AS KEY FEATURES TO IMPROVE OUTCOMES IN HYPERTENSION MANAGEMENT, PHYSICAL ACTIVITY AND WEIGHT REDUCTION. PARTICIPANTS ENGAGE IN LEARNING OPPORTUNITIES RELATED TO BLOOD PRESSURE MANAGEMENT SUCH AS HEART HEALTHY NUTRITION, INCREASING PHYSICAL ACTIVITY, REDUCING STRESS AND QUITTING SMOKING. THE PROGRAM HAS A GRAND FINALE WITH THE GO RED FOR YOUR HEART EVENT WHERE THE PARTICIPANTS SHARE THEIR LEARNING EXPERIENCE WITH OTHER PARTICIPANTS FROM ACROSS THE STATE. LAKESIDE WOMENS HOSPITAL RAISES $7,500 FOR MARCH OF DIMES PROGRAMS LAKESIDE WOMENS HOSPITAL PARTICIPATED IN THE 2017 MARCH OF DIMES WALK ON MAY 6 AT THE MYRIAD GARDENS IN OKLAHOMA CITY TO RAISE AWARENESS FOR PREVENTION OF PRE-TERM BIRTHS. THEY RAISED OVER $7,500 TO SUPPORT PROGRAMS THAT HELP PRETERM NEWBORN BABIES AND THEIR MOTHERS. THE MARCH OF DIMES MISSION IS TO WORK IN COMMUNITIES TO IMPROVE THE HEALTH OF MOTHERS AND BABIES THROUGH EDUCATION ON HEALTHY PREGNANCY, PRENATAL CARE AND OTHER SERVICES TO REDUCE THE RISK OF PREMATURE BIRTH AND OTHER POOR BIRTH OUTCOMES, AND TO PROVIDE SUPPORT FOR FAMILIES WHOSE BABIES NEED SPECIALIZED CARE IN THE NICU. LAKESIDE STAFF MEMBERS AND PHYSICIANS ALSO WORKED TO RAISE AWARENESS AND FINANCIAL SUPPORT THROUGH FUNDRAISING THAT INCLUDED A GIFT BASKET AUCTION, HOSTING JEANS DAYS AND SPONSORSHIP OF THE HOPE SECTION AT THE MARCH OF DIMES WALK. IT WAS A FULL EFFORT BY HOSPITAL AND CLINIC PHYSICIANS AND STAFF, AND LAKESIDE PATIENTS, TO RAISE THESE FUNDS TO HELP MEET AN URGENT NEED FOR NEWBORN BABIES AND MOTHERS FOR IMPORTANT RESOURCES AND EDUCATION TO HELP PREVENT PRETERM BIRTHS. SERVING OUR COMMUNITY OUR MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. WE LEARNED A LONG TIME AGO THAT WE CANT FULLY CARE FOR OUR COMMUNITY BY STAYING EXCLUSIVELY WITHIN THE WALLS OF OUR FACILITIES. THAT'S WHY "RETURNSHIP" IS SUCH AN IMPORTANT PART OF OUR PHILOSOPHY. WHAT IS RETURNSHIP? IT'S GIVING BACK PART OF OURSELVES TO THE COMMUNITIES WE SERVE. AT INTEGRIS HEALTH, THE PHYSICIANS, EMPLOYEES AND VOLUNTEERS TAKE THEIR EDUCATION AND SKILLS INTO THE COMMUNITY TO MAKE A DIFFERENCE IN THE LIVES OF FELLOW OKLAHOMANS. THEIR DEDICATION, COMBINED WITH OUR RESOURCES, HELPS ACCOMPLISH A VARIETY OF THINGS FROM PROVIDING FREE CLINICAL SERVICES, SCREENINGS AND EDUCATION PROGRAMS TO WORKING WITH JUVENILE OFFENDERS AND PROVIDING ACTIVITIES FOR SENIOR CITIZENS. WE ALSO REALIZE THAT THE HEALTH OF A COMMUNITY ISNT JUST PHYSICAL AND MENTAL ITS ECONOMIC AND SPIRITUAL AS WELL. THATS WHY WE OFFER A MYRIAD OF PROGRAMS THAT ADDRESS ALL OF THESE IMPORTANT ISSUES. INTEGRIS PROVIDED $47,862,516 IN COMMUNITY BENEFITS INCLUDING THE COST OF BAD DEBT. THIS INCLUDES OUR RETURNSHIP, COMMUNITY BUILDING EFFORTS, UNCOMPENSATED SERVICES AND MEDICAID SERVICES. RETURNSHIP RETURNSHIP EPITOMIZES OUR MISSION OF GIVING BACK TO OUR COMMUNITY. IT TAKES THE FORM OF HUNDREDS OF PROGRAMS AND ACTS OF CHARITY PROVIDED DAILY ACROSS THE STATE OF OKLAHOMA FREE HEALTH SCREENINGS, SUPPORT GROUPS, MEDICAL SERVICES, EDUCATIONAL PROGRAMS, HEALTH FAIRS AND MORE AS REFLECTED IN THE PREVIOUS PAGES. OUR RETURNSHIP EFFORTS EQUALED $5,032,848. COMMUNITY BUILDING COMMUNITY BUILDING IS ANOTHER VITAL WAY WE GIVE BACK. THESE EFFORTS ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. SOME OF OUR ACTIVITIES IN COMMUNITY BUILDING ARE PHYSICAL IMPROVEMENTS IN HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL ENHANCEMENTS AND ADVOCACY FOR ADVANCEMENTS IN COMMUNITY HEALTH. OUR COMMUNITY BUILDING EFFORTS EQUALED $198,041. UNCOMPENSATED SERVICES AND MEDICAID SERVICES UNCOMPENSATED SERVICES ARE THE COSTS OF PROVIDING FREE AND REDUCED-COST CARE. AS A SYSTEM OF NOT-FOR-PROFIT HOSPITALS, INTEGRIS PROVIDES SERVICES TO EVERYONE, REGARDLESS OF THE ABILITY TO PAY FOR THEIR INSURANCE COVERAGE. THUS, WE PROVIDE A MUCH NEEDED SAFETY NET FOR MEMBERS OF OUR COMMUNITY WHO WOULD OTHERWISE HAVE NO ACCESS TO MEDICAL CARE. CHARITY CARE COSTS ARE BASED ON THE OVERALL HOSPITAL COST-TO-CHARGE RATIOS. INTEGRIS ALSO PROVIDES CARE TO PATIENTS WHO QUALIFY FOR MEDICAID PROGRAMS. INTEGRIS PROVIDED CHARITY CARE AND MEDICAID SERVICES AT AN ESTIMATED COST OF $24,125,641. BAD DEBT IN ADDITION, INTEGRIS INCURRED BAD DEBT WITH AN ESTIMATED COST OF $18,505,986 BASED ON THE OVERALL HOSPITAL COST-TO-CHARGE RATIO. GENERAL STATEMENT 5 PART V: QUESTION 1A AND 2A PART V: QUESTION 1A - INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, PAYS ALL VENDORS FOR SERVICES PROVIDED TO ALL ENTITIES WITHIN THE SYSTEM. ACCORDINGLY, COMPENSATION PAID TO INDEPENDENT CONTRACTORS IS REPORTED ON THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS OF INTEGRIS HEALTH, INC., EIN 73-1192764. EXPENSES ARE ALLOCATED TO AND REIMBURSED BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990, PART VII, SECTION B AND PART IX, AS APPROPRIATE. PART V: QUESTION 2A - THE SALARIES REFLECTED ON FORM 990, PART IX, LINE 7, WERE ALL REPORTED ON THE FORM 941 EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, OF INTEGRIS HEALTH, INC.,EIN 73-1192764. THESE SALARIES WERE REIMBURSED TO INTEGRIS HEALTH, INC. AND WERE INCLUDED IN THE NUMBER OF EMPLOYEES ON INTEGRIS HEALTH, INC.'S FORM W-3. THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2016 TAX YEAR. GENERAL STATEMENT 6 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTION 2 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE FOLLOWING OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BY VIRTUE OF THEIR POSITIONS AS OFFICERS, DIRECTORS, OR EMPLOYEES OF RELATED ENTITIES WITHIN THE SYSTEM: C. BRUCE LAWRENCE CHRIS M. HAMMES JULIE HANSEN, M.D. DANIEL DAVIS TOM HONAN DAVID R. HADLEY GENERAL STATEMENT 7 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTIONS 6, 7A AND 7B - INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HEALTH EDMOND, INC. AS SUCH IT HAS THE POWER (1) TO CONFIRM OR DENY THE ELECTION OF EACH MEMBER OF THE BOARD OF DIRECTORS, (2) TO APPROVE OR DISAPPROVE ANY ACTION TAKEN BY THE BOARD OF DIRECTORS AMENDING, ALTERING, CHANGING OR REPEALING THE BYLAWS, (3) TO VOTE ON ALL MATTERS WHERE THE AUTHORIZATION OR APPROVAL OF THE SOLE MEMBER IS REQUIRED BY THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR STATE LAW AND (4) TO SET THE FEES AND COMPENSATION, IF ANY, FOR DIRECTORS AND MEMBERS OF THE COMMITTEES OF THE ORGANIZATION. GENERAL STATEMENT 8 PART VI: SECTION B. POLICIES PART VI: QUESTION 11B - THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE SYSTEM HAS A SINGLE AUDIT COMPLIANCE COMMITTEE WHICH OVERSEES THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AS WELL AS THE FILING OF FEDERAL AND STATE TAX FORMS. THE SYSTEM ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF FORM 990 TO PREPARE THE FORM. A DRAFT FORM 990 IS PROVIDED TO THE SYSTEM VICE PRESIDENT, FINANCE FOR REVIEW. A FINAL FORM 990 IS GIVEN TO THE SYSTEM CHIEF FINANCIAL OFFICER FOR REVIEW, APPROVAL, AND SIGNATURE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, AS WELL AS TO THE SYSTEM'S AUDIT/COMPLIANCE COMMITTEE, FOR REVIEW PRIOR TO FILING THE RETURN. GENERAL STATEMENT 9 PART VI: SECTION B. POLICIES PART VI: QUESTION 12C - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE INTEGRIS CODE OF CONDUCT. ALL SYSTEM EMPLOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION AND ARE INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS, TO REFER ANY CONFLICT OF INTEREST QUESTIONS TO THE SYSTEM'S COMPLIANCE OFFICER OR THROUGH THE ANONYMOUS INTEGRITY LINE. ALL NEW MANAGERS RECEIVE ADDITIONAL TRAINING ON CONFLICT OF INTEREST POLICES DURING LEADERSHIP TRAINING. LEGAL SERVICES REVIEWS ALL CONTRACTS FOR CONFLICTS OF INTEREST. INTERNAL AUDIT CONDUCTS AUDITS FOR POSSIBLE CONFLICTS OF INTEREST BASED ON THEIR ANNUAL RISK ASSESSMENT. CORPORATE COMPLIANCE INCLUDES ASSESSMENTS FOR CONFLICTS OF INTEREST IN ITS ANNUAL WORK PLAN AND CONDUCTS SPECIALIZED TRAINING FOR HIGH RISK AREAS. THE GOVERNANCE COMMITTEE, A COMMITTEE OF THE INTEGRIS HEALTH BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF INTEGRIS AND A DISQUALIFIED PERSON. GENERAL STATEMENT 10 PART VI: SECTION B. POLICIES PART VI: QUESTION 15A - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). COMPENSATION FOR THE CEO, MANAGING DIRECTORS AND VICE PRESIDENTS IS ANALYZED BY AN INDEPENDENT HEALTH CARE CONSULTING FIRM. THE ANALYSIS INCLUDES A FAIR MARKET VALUE ASSESSMENT AND ESTABLISHMENT OF A RANGE FOR EACH POSITION BASED ON RESEARCH OF COMPARABLE HEALTH CARE SYSTEMS OF SIMILAR SIZE. THE REPORT AND RECOMMENDED COMPENSATION LEVELS FOR EACH EXECUTIVE MANAGEMENT POSITION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE INTEGRIS HEALTH BOARD OF DIRECTORS AND ULTIMATELY THE FULL BOARD OF DIRECTORS. THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REFLECTS A REVIEW OF THE COMPARABILITY DATA, THE EXECUTIVE PERFORMANCE REVIEWS AND THE DECISION-MAKING PROCESS. PART VI: QUESTION 15B - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). ALL DEPARTMENT DIRECTORS COMPENSATION IS REVIEWED ANNUALLY BY THE INTEGRIS COMPENSATION DEPARTMENT OF HUMAN RESOURCES. INDEPENDENT SALARY SURVEY SOURCES FROM THIRD PARTY PROVIDERS ARE USED TO DETERMINE LOCAL AND REGIONAL FAIR MARKET COMPETITIVENESS. ADJUSTMENTS IN SALARIES BASED ON INDIVIDUAL PERFORMANCE STANDARDS OR ANY MARKET EQUITY ADJUSTMENTS ARE APPROVED BY THE RESPECTIVE VICE PRESIDENT OR MANAGING DIRECTOR. GENERAL STATEMENT 11 PART VI: SECTION C. DISCLOSURE PART VI: QUESTION 19 - THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR INTEGRIS HEALTH, INC., A RELATED CORPORATION. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION. GENERAL STATEMENT 12 PART VII: SECTION B. INDEPENDENT CONTRACTORS INTELISTAF OF OKLAHOMA CONTRACT STAFFING $1,787,181 HEALTHCARE LLC P.O. BOX 840292 DALLAS, TX 75284 DIAGNOSTIC LABORATORY OF REFERENCE LAB $1,763,677 OKLAHOMA, LLC 225 N.E. 97TH STREET OKLAHOMA CITY, OK 73114 OKLAHOMA HEALTHCARE SHOPP FEE $1,017,271 AUTHORITY (OHCA) 4345 N. LINCOLN BLVD. OKLAHOMA CITY, OK 73105 ANESTHESIA MEDICAL ANESTHESIA SERVICE $ 840,351 PROFESSIONALS PLLC P.O. BOX 1540 EDMOND, OK 73083 INPATIENT CARE PHYSICIAN CALL PAY $ 432,386 PHYSICIAN SERVICES 5900 MEGANS WAY EDMOND, OK 73034 GENERAL STATEMENT 13 PART XII: FINANCIAL STATEMENTS AND REPORTING PART XII: QUESTION 2A AND 2B - AN OUTSIDE ACCOUNTING FIRM PERFORMS AN ANNUAL AUDIT ON THE CONSOLIDATED FINANCIAL STATEMENTS OF INTEGRIS HEALTH, INC., A RELATED CORPORATION. THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FINANCIAL INFORMATION FOR INTEGRIS HEALTH EDMOND, INC. GENERAL STATEMENT 14 SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION INTEGRIS HEALTH EDMOND, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE FOR THE TAX YEAR ENDING JUNE 30, 2017. TAXPAYER HAS AN APPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM, AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I). TAXPAYER NAME: INTEGRIS HEALTH EDMOND, INC. ADDRESS: 5300 N. INDEPENDENCE AVE., STE. 130 OKLAHOMA CITY, OK 73112 TAXPAYER IDENTIFICATION NUMBER: 45-1027361 SECTION 1.263(A)-3(N) ELECTION - BOOK CONFORMITY ELECTION INTEGRIS HEALTH EDMOND, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL EXPENDITURES ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2017. TAXPAYER NAME: INTEGRIS HEALTH EDMOND, INC. ADDRESS: 5300 N. INDEPENDENCE AVE., STE. 130 OKLAHOMA CITY, OK 73112 TAXPAYER IDENTIFICATION NUMBER: 45-1027361 INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192765 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS HOSPICE INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731369586 HEALTH CARE OK 501(C)(3) LINE 10 IH false INTEGRIS BAPTIST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731034824 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731444504 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS SOUTHWEST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731089149 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731192764 HEALTH CARE OK 501(C)(3) LINE 12-I NA false INTEGRIS HEALTH FOUNDATION INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731047338 FUNDRAISING OK 501(C)(3) LINE 7 IH false WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC false INTEGRIS MENTAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH false BMPA LTD 73-1228665 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MED. OFFICE BLDG. OK NA N/A QC-III 20-8723857 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK NA N/A DIAGNOSTIC LAB 73-1560760 LYNDHURST NJ 07071 LYNDHURST NJ 07071 CLINICAL LAB NJ NA N/A MPI CENTER 73-1283942 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK NA N/A HILLCRESTINTEGRIS HEALTH LLC OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 DORMANT OK NA N/A LAKESIDE HOSPITAL 73-1493662 OKLAHOMA CITY OK 73112 OKLAHOMA CITY OK 73112 MEDICAL OK NA N/A INTEGRIS PROHEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731046179 RETAIL PHARMACY OK NA C Corp false THE STANLEY F HUPFELD CHAR REMAIN TRUST 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 266238051 FINANCIAL OK NA Trust false QUALITY ALLIANCE ASSURANCE CO PO BOX 10027 KYI-1001 GRAND CAYMAN CJ 981060671 INSURANCE CJ NA C Corp false BAPTIST HEALTH SYSTEM INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 DORMANT OK NA C Corp false ONE CARE INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 DORMANT OK NA C Corp false VADOVATIONS INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 270821922 HEALTH CARE OK NA C Corp false INTEGRIS HEALTH PARTNERS LLC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 453482852 HEALTH CARE OK NA C Corp false INTEGRIS CARDIOVASCULAR PHYSICIANS LLC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 452867352 HEALTH CARE OK NA C Corp false false false true false false false false false false true false true true false false true true false true