2017-05-04T13:29:03-05:00 2016-06-30 KPMG LLP 210 Park Ave Suite 2850 Oklahoma City OK 73102 990 2015-07-01 731034824 INTEGRIS BAPTIST MEDICAL CENTER INC % CHERYL PERRY INTE 4059496026 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DANIEL DAVIS CFO 4059512736 2017-04-27 true MORGAN L SOUZA P00652612 4052396411 2017-04-17 2015 2021-01-29 14:40:06Z SEE SCHEDULE O C BRUCE LAWRENCE 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 761979326 false X WWW.INTEGRISOK.COM X 1977 OK TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. X 17 13 2563 533 3157703 2964885 983783 2529859 640770210 744230264 28390435 14753186 -25031145 280146 645113283 761793455 8230152 8359371 0 0 216708444 225115847 0 0 0 459791968 475085248 684730564 708560466 -39617281 53232989 1260318826 1307099737 759355157 877390613 500963669 429709124 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 590825692 8359371 744230264 SEE SCHEDULE O STATEMENTS 2 AND 3 590825692 true true false false false false false false false false true true false false true false false true false false false false false false false false true true true true true true false false false false false false false false false true true false false true true true true true false false true X 0 0 2563 true true true false false false false false false false false false X 17 13 true false false false true true true true true false false true true true true true true true true true true OK X CHERYL PERRY 4059512747 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 X HANI BARADI DIRECTOR 1.0 0.0 X 0 850 0 ALVIN BATES CHAIRMAN 1.0 0.0 X 0 0 0 LAURA BOYD DIRECTOR 1.0 0.0 X 0 0 0 ALINE BROWN MD DIRECTOR 1.0 0.0 X 22875 0 0 H EDWARD DEBEE DIRECTOR 1.0 0.0 X 0 0 0 BRYAN GARCIA DIRECTOR 1.0 0.0 X 0 0 0 BILL HULSE DIRECTOR 1.0 0.0 X 0 0 0 ROBERT KELLOGG DIRECTOR 1.0 0.0 X 0 0 0 SUDHIR KHANNA EX-OFFICIO CHIEF OF STAFF 40.0 0.0 X 276975 0 10020 STEPHEN MERRILL DIRECTOR 1.0 0.0 X 0 0 0 JAMES PARRACK DIRECTOR 1.0 0.0 X 0 0 0 MIKE ROSS DIRECTOR 1.0 0.0 X 0 0 0 JOEY SAGER DIRECTOR 1.0 1.0 X 0 28672 0 ROBERT SHELTON DIRECTOR 1.0 0.0 X 0 0 0 ALISON TAYLOR DIRECTOR 1.0 0.0 X 0 0 0 CHRISTOPHER TURNER DIRECTOR 1.0 1.0 X 0 28250 0 C BRUCE LAWRENCE EX-OFFICIO-PRES/CEO IH 1.0 39.0 X X 0 1404018 387641 DAVID R HADLEY ASSISTANT TREASURER 1.0 39.0 X 0 714874 111515 BETH A PAUCHNIK ASSISTANT SECRETARY 1.0 39.0 X 0 599379 118035 MARY K CALBONE VICE PRESIDENT 40.0 0.0 X 266593 0 38002 TIM JOHNSEN PRESIDENT IBMC 40.0 0.0 X 645627 0 95510 JAMES W LONG PHYSICIAN 40.0 0.0 X 1257248 0 23387 JACONNA R TILLER VP CHIEF NURSING OFFICER 40.0 0.0 X 308263 0 25080 DOUGLAS A HORSTMANSHOF PHYSICIAN 40.0 0.0 X 698510 0 32906 VIVEK KOHLI TRANSPLANT SURGEON 40.0 0.0 X 701644 0 33288 E SAMARA TRANSPLANT SURGEON 40.0 0.0 X 658523 0 45273 ALY EL BANAYOSY PHYSICIAN 40.0 0.0 X 796945 0 22133 MICHAEL KOERNER PHYSICIAN 40.0 0.0 X 602818 0 22196 CHRIS M HAMMES FORMER OFFICER & DIRECTOR 0.0 40.0 X 0 874874 163454 DAVID BOGGS FORMER DIRECTOR 0.0 0.0 X 51604 0 0 MICHAEL MCGEE MD FORMER DIRECTOR 20.0 0.0 X 36000 0 0 WILLIAM COOK MD FORMER DIRECTOR 10.0 0.0 X 59546 1200 0 CARL RACZKOWSKI MD FORMER DIRECTOR 0.0 12.0 X 0 235941 0 AZAR KHAN MD FORMER DIRECTOR 1.0 39.0 X 28865 125000 0 ERROL A MITCHELL FORMER KEY EMPLOYEE 0.0 40.0 X 0 339405 43731 JIM W PORTERFIELD FORMER KEY EMPLOYEE 0.0 40.0 X 0 258206 35163 6412036 4610669 1207334 218 true true false SEE SCHEDULE O GENERAL STATEMENT 1 41485796 59 2529859 2146118 2529859 NET PATIENT REVENUE 621990 701369428 701332919 36509 PARTNERSHIP INCOME 900099 14730697 11609503 3121194 CAFETERIA 722514 5248761 5248761 ELECTRONIC HEALTH RECORDS 900099 2262171 2262171 340B PHARMACY INCOME 446110 14074425 14074425 6544782 5148597 1396185 744230264 14928880 14928880 0 0 0 0 0 10177 185871 -175694 -175694 -175694 0 0 0 MISC. INCOME 900099 280146 280146 280146 761793455 734427615 3157703 21678278 8330371 8330371 29000 29000 0 0 2892722 2892722 113723 113723 174590117 174590117 12253829 12253829 23263203 23263203 12002253 12002253 117734792 18 117734774 0 1235 1235 0 0 0 10724280 10724280 291523 291523 162609694 162609694 0 0 6143522 6143522 649943 649943 0 487539 487539 5612558 5612558 0 23130629 23130629 4629153 4629153 PURCHASED SERVICES 55515090 55515090 0 0 RIF & RECRUITMENT 48481185 48481185 0 0 SHOPP FEE 18669081 18669081 0 0 UNRELATED BUS.INCOME TAXES 1461000 1461000 0 0 18944024 18944024 708560466 590825692 117734774 0 223301 213831 465712786 477789807 0 0 77414223 185759967 0 0 0 0 9030605 9030606 13909334 13408887 562985 476159 563806273 390673753 166162798 173132520 0 0 503434708 409650997 9123799 10704496 0 0 14744287 26932467 1260318826 1307099737 240916267 353323378 0 0 0 0 515655195 521350076 0 0 0 0 0 0 0 0 2783695 2717159 759355157 877390613 X 500963669 429709124 0 0 0 0 500963669 429709124 1260318826 1307099737 X 53232989 -43487551 -80999983 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 196573 196573 254713889 154740385 99973504 6811819 6790634 21185 283469178 224264954 59204224 18614814 4877780 13737034 173132520 INTEGRIS HEALTH FOUNDATION, 18579852 F CASH SURRENDER VALUE 1009279 F INTEREST RECEIVABLE LT NOTE 1042583 F POOLED FUND INVESTMENTS 389019283 F 409650997 0 ASSET RETIREMENT OBLIGATION 2717159 2717159 true true X true X true X true true true false true true 11081853 11081853 0.01560 54568357 62321735 0 65650210 62321735 11081853 0.01560 341158 341158 0.00050 7314548 1569210 5745338 0.00810 99900 99900 0.00010 281942 856 281086 0.00040 8037548 1570066 6467482 0.00910 73687758 63891801 17549335 0.02470 1788 1788 33801 33801 1198 1198 840 840 37627 37627 false 9700284 485014 181410977 199316402 -17905425 X true true SEE SCHEDULE H PART VI 1 1 INTEGRIS BAPTIST MEDICAL CENTER INC 3300 NORTHWEST EXPRESSWAY OKLAHOMA CITY OK 73112 WWW.INTEGRISOK.COM 2297 X X X INTEGRIS BAPTIST MEDICAL CENTER 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 true X SEE PART V, SECTION C X X X true X false X X X X true X false false SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART V: INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IBMC 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 INCLUDE: 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 INTEGRISOK.COM/COMMUNITY-WELLNESS-SERVICES-OKLAHOMA-COMMUNITY-HEALTH-IMPRO VEMENT SUPPLEMENTAL INFORMATION 8 PART V, SECTION B, LINES 16B INTEGRISOK.COM/PRICING-FINANCIAL-ASSISTANCE SUPPLEMENTAL INFORMATION 1 SCHEDULE H, PART VI: INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IBMC 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 INTEGRIS BAPTIST MEDICAL CENTER, INC., PRODUCES A CONSOLIDATED COMMUNITY BENEFIT 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) $708,560,466 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 $645,936,000 AND $551,223,000 AT JUNE 30, 2016 AND 2015, 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 BAPTIST MEDICAL CENTER, 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 $17,905,425 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. IBMC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. SUPPLEMENTAL INFORMATION 10 PART IV: MANAGEMENT COMPANIES AND JOINT VENTURES NAME OF ENTITY: QUALITY CARDIAC CARE CENTERS, LLC (DBA QC-III) DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: CARDIAC CARE ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 47.865200 OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEE'S PROFIT % OR STOCK OWNERSHIP %: 0.00000 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 52.134800 SUPPLEMENTAL INFORMATION 11 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 12 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 13 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 BAPTIST MEDICAL CENTER IS LOCATED IN OKLAHOMA CITY, WHICH IS IN OKLAHOMA COUNTY IN CENTRAL OKLAHOMA. THIS CAMPUS OFFERS MORE THAN 500 LICENSED BEDS AND HAS BEEN SERVING THE STATE SINCE 1959. SERVICES INCLUDE A BURN CENTER, TRANSPLANT CENTER, AND FERTILITY CENTER. SUPPLMENTAL INFORMATION 14 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 15 PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLES IBMC 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. INTEGRIS BAPTIST MEDICAL CENTER IS THE FLAGSHIP HOSPITAL OF THE SYSTEM. THE FACILITIES OF OTHER TAXPAYERS 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 STATEMENT 3 FOR ADDITIONAL INFORMATION REGARDING THE INTEGRIS HEALTH SYSTEM. SUPPLEMENTAL INFORMATION 16 PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT ALL STATES WITH WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: OK true INTEGRIS SOUTHWEST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE SUITE 13 OKLAHOMA CITY OK 73112 731089149 501(C)(3) 2566807 TO FUND OPERATIONS INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE SUITE 13 OKLAHOMA CITY OK 73112 731192765 501(C)(3) 2874855 TO FUND OPERATIONS INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE SUITE 13 OKLAHOMA CITY OK 73112 731444504 501(C)(3) 2399148 TO FUND OPERATIONS INTEGRIS HEALTH EDMOND INC 5300 N INDEPENDENCE AVE SUITE 13 OKLAHOMA CITY OK 73112 451027361 501(C)(3) 489561 TO FUND OPERATIONS 4 HIGH SCHOOL SCHOLARSHIPS 29 29000 SUPPLEMENTAL INFORMATION 1 SCHEDULE I, PART I, LINE 2 INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) PROVIDES FUNDS TO VARIOUS COMMONLY CONTROLLED HOSPITALS TO SUPPORT THEIR OPERATIONS. IBMC DETERMINES THE AMOUNT OF THE FUNDS PROVIDED ON AN ANNUAL BASIS. COLLEGE SCHOLARSHIPS ARE PROVIDED TO EMPLOYEES' CHILDREN WHO QUALIFY BASED ON CERTAIN CRITERIA. A COLLEGE TRANSCRIPT MUST BE PROVIDED FOR EACH SEMESTER AS LONG AS THE SCHOLARSHIP IS IN PLACE. true true false false false false false true false SUDHIR KHANNA EX-OFFICIO CHIEF OF STAFF 258985 0 17990 0 0 0 10020 0 0 0 286995 0 0 0 C BRUCE LAWRENCE EX-OFFICIO-PRES/CEO IH 0 978354 0 390993 0 34671 0 375231 0 12410 0 1791659 0 0 DAVID R HADLEY ASSISTANT TREASURER 0 511015 0 179513 0 24346 0 95862 0 15653 0 826389 0 0 BETH A PAUCHNIK ASSISTANT SECRETARY 0 431657 0 152210 0 15512 0 106280 0 11755 0 717414 0 0 MARY K CALBONE VICE PRESIDENT 193342 0 63085 0 10166 0 30917 0 7085 0 304595 0 0 0 TIM JOHNSEN PRESIDENT IBMC 484225 0 148119 0 13283 0 79181 0 16329 0 741137 0 0 0 JAMES W LONG PHYSICIAN 1247373 0 729 0 9146 0 10400 0 12987 0 1280635 0 0 0 JACONNA R TILLER VP CHIEF NURSING OFFICER 118198 0 60786 0 129279 0 13356 0 11724 0 333343 0 0 0 DOUGLAS A HORSTMANSHOF PHYSICIAN 645588 0 25708 0 27214 0 16936 0 15970 0 731416 0 0 0 VIVEK KOHLI TRANSPLANT SURGEON 674453 0 14488 0 12703 0 17025 0 16263 0 734932 0 0 0 E SAMARA TRANSPLANT SURGEON 576145 0 77000 0 5378 0 37825 0 7448 0 703796 0 0 0 ALY EL BANAYOSY PHYSICIAN 753184 0 38430 0 5331 0 6625 0 15508 0 819078 0 0 0 MICHAEL KOERNER PHYSICIAN 536244 0 60573 0 6001 0 6625 0 15571 0 625014 0 0 0 CHRIS M HAMMES FORMER OFFICER & DIRECTOR 0 629915 0 226957 0 18002 0 147611 0 15843 0 1038328 0 0 ERROL A MITCHELL FORMER KEY EMPLOYEE 0 263398 0 65765 0 10242 0 32625 0 11106 0 383136 0 0 JIM W PORTERFIELD FORMER KEY EMPLOYEE 0 185903 0 45818 0 26485 0 28901 0 6262 0 293369 0 0 DAVID BOGGS FORMER DIRECTOR 51604 0 0 0 0 0 0 0 0 0 51604 0 0 0 MICHAEL MCGEE MD FORMER DIRECTOR 36000 0 0 0 0 0 0 0 0 0 36000 0 0 0 WILLIAM COOK MD FORMER DIRECTOR 59546 1200 0 0 0 0 0 0 0 0 59546 1200 0 0 CARL RACZKOWSKI MD FORMER DIRECTOR 0 235941 0 0 0 0 0 0 0 0 0 235941 0 0 AZAR KHAN MD FORMER DIRECTOR 28865 125000 0 0 0 0 0 0 0 0 28865 125000 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART 1, LINE 3 INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IBMC RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIALS. INTEGRIS UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THIS COMPENSATION. SUPPLEMENTAL INFORMATION 2 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS WERE MADE TO KEY EMPLOYEES JACONNA R. TILLER AND JIM PORTERFIELD. $123,936 AND $18,611 OF THE CALENDAR YEAR 2015 COMPENSATION REPORTED FOR THESE TWO INDIVIDUALS, RESPECTIVELY, ON FORM 990, PART VII AND SCHEDULE J, PART II REPRESENTS SEVERANCE PAYMENTS. SUPPLEMENTAL INFORMATION 3 SCHEDULE J, PART I, LINE 4B THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NON QUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. DAVID R. HADLEY CHRIS M. HAMMES TIM JOHNSEN C. BRUCE LAWRENCE BETH A. PAUCHNIK SUPPLEMENTAL INFORMATION 4 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. A THE OK DEVELOPMENT FINANCE AGENCY 2015C 731083741 678908L28 2015-06-01 89880000 REFUND OF 2011A/B, ISSUED 7/6/11 false false false B THE OK DEVELOPMENT FINANCE AGENCY 2015B 731083741 67884XBV8 2015-04-15 48425000 REFUND OF 2007A, ISSUED 11/8/07 false false false C THE OK DEVELOPMENT FINANCE AGENCY 2015A 731083741 67884XBR7 2015-04-15 222198189 REFUND OF 2008B/C, ISSUED 7/30/08 false false false D THE OK DEVELOPMENT FINANCE AGENCY 2013A 731083741 67884XAZ0 2013-05-03 97945000 REFUND OF 2008A, ISSUED 5/6/08 false false false A 2060000 0 89880000 0 0 0 0 0 0 0 89880000 0 2011 true false true true B 1165000 0 48425000 0 0 0 521063 0 0 0 47903937 0 2010 true false true true C 7240000 0 222198189 0 0 209564536 1737424 0 0 0 10896229 0 2011 false true false true D 4900000 0 97945000 0 0 0 0 0 0 0 97945000 0 2009 true false true true A false true true true false 0.00010 0.00010 false false false true B false true true true false 0.00010 0.00010 false false false true C false true true true false 0 false false false true D false true true true false 0.00010 0.00010 false false false true A false true false false true true GOLDMAN SACHS 17.2 false false false 0 false true B false true false false true true JP MORGAN CHASE 17.33 false false false 0 false true C false true false false false false 0 false 0 false true D false true false false true true GOLDMAN SACHS 19.3 false false false 0 false true A true B true C true D true SUPPLEMENTAL INFORMATION 1 PART II, LINE 11, COLUMNS C&D: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS FROM THE ISSUE THAT ARE NO LONGER IN ESCROW. DRAWCO 1 LLC MUTUAL BOARD MEMBER 184683 LEASE PAYMENTS false X 1 5000 FMV X 40 FMV X MEDICAL EQUIPMENT 15 2141078 FMV false true false REIMBURSEMENT OF EXPENSES 662284046 COST 731192764 INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 501(C)(3) true true false false SUPPLEMENTAL INFORMATION 1 SCHEDULE N, PART II, LINES 2A AND 2B INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) IS A MEMBER OF INTEGRIS HEALTH (INTEGRIS), AN INTEGRATED HEALTHCARE SYSTEM. IBMC 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 TRANSACTIONS: DAVID R. HADLEY C. BRUCE LAWRENCE BETH A. PAUCHNIK JOEY SAGER CHRISTOPHER TURNER GENERAL STATEMENT 1 FORM 990, BOX C: DOING BUSINESS AS CANCER CENTER OF THE SOUTHWEST LIFEPASS OKLAHOMA TRANSPLANTATION INSTITUTE AMBULATORY INFUSION CENTER OF OKLAHOMA DIRECT CONNECT INTEGRIS MENTAL HEALTH CENTER - SPENCER MIRTH (MEDICAL INSTITUTE FOR RECOVERY THROUGH HUMOR) CHANGING YOUR WEIGHS NAZIH ZUHDI TRANSPLANTATION INSTITUTE CERTIFIED BREAST FEEDING EDUCATOR CERTIFIED LACTATION EDUCATOR THIRD AGE LIFE THIRD AGE LIFE CENTER THE CHILDREN'S PLACE INTEGRIS ONCOLOGY SERVICES INTEGRIS ONCOLOGY SERVICES, NORTH HENRY G. BENNETT, JR. FERTILITY INSTITUTE TROY AND DOLLIE SMITH CANCER CENTER INTEGRIS ONCOLOGY SERVICES, NORTH/SOUTH COMPREHENSIVE BREAST CENTER OF OKLAHOMA HEARTSCAN OKLAHOMA INTEGRIS MENTAL HEALTH - SPENCER INTEGRIS MENTAL HEALTH - INTEGRIS BEHAVIORAL SPECIALISTS INTEGRIS JOINT REPLACEMENT CENTER INTEGRIS HEARING RESOURCE CENTER OF OKLAHOMA AT HOUGH EAR INSTITUTE INTEGRIS DECISIONS DAY TREATMENT INTEGRIS CORPORATE ASSISTANCE PROGRAM INTEGRIS HEART CENTER HEARTSCAN COMPREHENSIVE BREAST CENTER INTEGRIS HEART HOSPITAL HEART FAILURE INSTITUTE MAT MOBILE ASSESSMENT TEAM SAMARITAN HOME BASED SERVICES INTEGRIS SLEEP DISORDERS CENTER - EDMOND INTEGRIS JIM THORPE REHABILITATION AT IBMC CANCER INSTITUTE - BAPTIST CANCER INSTITUTE OF BAPTIST INTEGRIS CANCER INSTITUTE OF OKLAHOMA PROTON CAMPUS INTEGRIS BAPTIST MEDICAL CENTER - PROTON CAMPUS INTEGRIS ADVANCED CARDIAC CARE SAMARITAN INFUSION SERVICES INTEGRIS CANCER INSTITUTE OF OKLAHOMA RESEARCH - METRO INTEGRIS MENTAL HEALTH PHYSICIANS INTEGRIS MEDICAL SUPPLY INTEGRIS HEART HOSPITAL INTEGRIS HEART HOSPITAL - DIAGNOSTIC CARDIOLOGY, NUCLEAR CARDIOLOGY INTEGRIS JIM THORPE OUTPATIENT REHABILITATION AT INTEGRIS BAPTIST MEDICAL CENTER INTEGRIS JIM THORPE OUTPATIENT REHABILITATION AT ICIO GENERAL STATEMENT 2 PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS BAPTIST MEDICAL CENTER, INC. (IBMC) IS A MEMBER OF THE INTEGRIS HEALTH SYSTEM (INTEGRIS HEALTH). INTEGRIS HEALTH IS THE STATE'S LARGEST OKLAHOMA-OWNED HEALTH CARE CORPORATION WITH HOSPITALS, PHYSICIAN CLINICS, MENTAL HEALTH FACILITIES, ASSISTED LIVING CENTERS AND HOME HEALTH AGENCIES THROUGHOUT THE STATE. AS A MEMBER OF INTEGRIS HEALTH AND A NOT FOR PROFIT ORGANIZATION, EACH YEAR IBMC PROVIDES MILLIONS OF DOLLARS OF CHARITY CARE TO PATIENTS THROUGHOUT THE STATE OF OKLAHOMA. WHILE THIS CARE REPRESENTS A LARGE PERCENTAGE OF IBMC'S GIFT BACK TO THE COMMUNITY, IT IS STILL ONLY PART OF WHAT IBMC CHOOSES TO CALL RETURNSHIP. RETURNSHIP EPITOMIZES IBMC'S MISSION OF GIVING BACK TO ITS 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. IN ADDITION, IBMC PROVIDES SIGNIFICANT AMOUNTS OF UNCOMPENSATED SERVICES. UNCOMPENSATED SERVICES ARE THE COSTS OF PROVIDING FREE AND REDUCED COST CARE. AS A NOT-FOR-PROFIT HOSPITAL, IBMC 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 IBMC COMMUNITY WHO WOULD OTHERWISE HAVE NO ACCESS TO MEDICAL CARE. CHARITY CARE COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IBMC PROVIDED CHARITY CARE OF $11,081,853. IBMC ALSO PROVIDES CARE TO PATIENTS WHO QUALIFY FOR MEDICAID PROGRAMS FOR WHICH THE ORGANIZATION HAD RECEIVED INADEQUATE PAYMENTS IN PRIOR YEARS. THE SUPPLEMENTAL HOSPITAL OFFSET PAYMENT PROGRAM (SHOPP) WAS CREATED AND IMPLEMENTED BY THE STATE OF OKLAHOMA IN FISCAL YEAR 2012 FOR THE PURPOSE OF ASSURING ACCESS TO QUALITY CARE FOR OKLAHOMA MEDICAID MEMBERS. THE PROGRAM IS DESIGNED TO ASSESS OKLAHOMA HOSPITALS, UNLESS EXEMPT, A SUPPLEMENTAL HOSPITAL OFFSET PAYMENT PROGRAM FEE. THE COLLECTED FEES ARE PLACED IN POOLS AND THEN ALLOCATED TO HOSPITALS AS DIRECTED BY LEGISLATION. THE OKLAHOMA HEALTH CARE AUTHORITY DOES NOT GUARANTEE THAT ALLOCATIONS WILL EQUAL OR EXCEED THE AMOUNT OF THE SUPPLEMENTAL HOSPITAL OFFSET PAYMENT PROGRAM FEE PAID BY THE HOSPITAL. THE SHOPP PROGRAM IS EXPECTED TO REMAIN IN EFFECT THROUGH FISCAL YEAR 2017. THIS FISCAL YEAR THE SHOPP PAYMENT HELPED OFFSET COSTS RELATED TO MEDICAID PATIENTS. IN ADDITION IBMC BAD DEBT COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IBMC's BAD DEBT COSTS WERE $9,700,284. FOR ADDITIONAL DETAILS REGARDING COMMUNITY BENEFIT SEE THE ATTACHED COMPLETE COMMUNITY BENEFIT REPORT ON SCHEDULE O STATEMENT 3. GENERAL STATEMENT 3 PART III, LINE 4A: COMMUNITY BENEFIT REPORT INTEGRIS COMMUNITY BENEFITS ANNUAL REPORT 2016 FROM OUR PRESIDENT AND CEO INTEGRIS IS WIDELY RECOGNIZED FOR ITS EXCELLENT HEALTH CARE AND CONTINUED COMMITMENT TO ENSURE ALL OKLAHOMANS HAVE EASY ACCESS TO THE MOST COMPREHENSIVE CONTINUUM OF CARE IN THE STATE. FROM OUR WORLD-CLASS BURN CENTER TO OUR PIONEERING TRANSPLANT AND IMPLANT PROGRAMS AND EVERY CENTER OF EXCELLENCE AND SPECIALTY WE OFFER BEGINNING WITH PRIMARY CARE INTEGRIS PHYSICIANS ARE ON THE FOREFRONT OF MEDICINE. LESS RECOGNIZED ARE THE DAY-TO-DAY COMMUNITY OUTREACH PROGRAMS INTEGRIS OFFERS THAT HELP ENCOURAGE EVERYONE, FROM SMALL CHILDREN TO SENIORS, TO LIVE EACH DAY IN A MORE HEALTHY WAY. OUR 2016 COMMUNITY BENEFIT REPORT HIGHLIGHTS A SAMPLING OF THOSE EFFORTS. IT PROVIDES A BRIEF OVERVIEW OF PROGRAMS OFFERED TO THE PEOPLE AND COMMUNITIES WE SERVE. AS YOU WILL SEE IN THESE PAGES, INTEGRIS IS FOCUSED ON KEEPING PEOPLE WELL AND NOT JUST ON CARING FOR THEM, IF AND WHEN THEY BECOME ILL. THE PROGRAMS FEATURED WITHIN THESE PAGES ARE BUT A HANDFUL OF EXAMPLES THAT SHOWCASE INTEGRIS AND ITS EMPLOYEES LIVING OUR MISSION. I AM PROUD TO BE PART OF SUCH A GIVING AND CARING TEAM OF PEOPLE. SINCERELY, BRUCE LAWRENCE, PRESIDENT AND CEO INTEGRIS FROM OUR CHAIRMAN OF THE BOARD AS CHAIRMAN OF THE INTEGRIS HEALTH BOARD, I AM PLEASED THIS YEARS COMMUNITY BENEFIT REPORT SHARES EXAMPLES OF COMMUNITY OUTREACH THAT ILLUSTRATE FOR YOU THE EVERYDAY EFFORTS TO ENCOURAGE FELLOW OKLAHOMANS TO LIVE MORE HEALTHY LIVES. EACH IS BUT ONE OF HUNDREDS OF EVENTS AND ACTIVITIES INTEGRIS OFFERS TO PROMOTE HEALTH AND WELLNESS. FROM A BIGGER-PICTURE PERSPECTIVE, AS OKLAHOMAS LARGEST, LOCALLY OWNED AND OPERATED NOT-FOR-PROFIT HEALTH CARE SYSTEM, I ALSO ENCOURAGE YOU TO CONSIDER THE FACT THAT, WHEN TOTALED, INTEGRIS RETURNSHIP AND COMMUNITY BUILDING EFFORTS EQUALED NEARLY $6 MILLION IN 2016. IF YOU FACTOR UNCOMPENSATED SERVICES THE SYSTEM PROVIDES INTO THAT EQUATION, THE NUMBER SWELLS NEARLY TENFOLD TO MORE THAN $55 MILLION. EACH DOLLAR REPRESENTS HIGH-QUALITY CARE AND THE INVESTMENT BY INTEGRIS OF SIGNIFICANT RESOURCES BACK TO THE MEN, WOMEN AND CHILDREN OF OKLAHOMA. DESPITE ECONOMIC AND INDUSTRY UNCERTAINTY AT TIMES, IT IS COMFORTING TO SEE THAT INTEGRIS CONTINUES TO DO WHATEVER IT CAN TO UPHOLD OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. SINCERELY, DAVID THOMPSON, CHAIRMAN INTEGRIS BOARD OF DIRECTORS INTEGRIS BAPTIST MEDICAL CENTER CHALLENGE YOURSELF: HEALTH AND FITNESS PROGRAM THE INTEGRIS CHALLENGE YOURSELF: HEALTH AND FITNESS PROGRAM FOCUSES ON THE PREVENTION OF OBESITY AND HYPERTENSION. THE PROGRAM INCREASES ACCESS TO CARE BY PROVIDING HEALTH LECTURES, EXERCISE CLASSES, NUTRITION CLASSES AND DEMONSTRATIONS. THE PROGRAM ALSO PROVIDES SCREENINGS AND REFERRAL RESOURCES FOR AT-RISK OKLAHOMA CITY RESIDENTS. SPECIFICALLY, THIS PROGRAM IS AIMED AT OKLAHOMA CITYS AFRICAN AMERICAN AND HISPANIC POPULATIONS WHO ARE AT-RISK NOT ONLY FOR OBESITY AND HEART DISEASE, BUT FOR MANY OTHER CHRONIC CONDITIONS. THE LACK OF ACCESS TO CARE REMAINS A BARRIER TO LIVING A HEALTHIER LIFESTYLE. THE PROGRAM HAS FOUR CORE TENETS: NUTRITION, PHYSICAL ACTIVITY, MENTAL HEALTH AND HEALTH SCREENINGS. WEEKLY SESSIONS ADDRESS HEALTH TOPICS INCLUDING NUTRITION, MENTAL HEALTH, HEALTHY WEIGHT AND ACTIVE LIFESTYLES. INCLUDED IS AN INTRODUCTION TO DIVERSE EXERCISE MODALITIES SUCH AS WALKING, CHAIR EXERCISES, RESISTANCE BANDS AND CARDIO CALISTHENICS THAT MOTIVATE PARTICIPANTS TO STAY ACTIVE AND MAKE HEALTHIER CHOICES. INTEGRIS BASS BAPTIST HEALTH CENTER (ENID) KIDS IN THE KITCHEN KIDS IN THE KITCHEN IS A PROGRAM OFFERED ONCE A MONTH FOR CHILDREN AGES 8 TO 12 YEARS. THE PROGRAM ENCOURAGES KIDS TO COOK BY TEACHING THEM TO MAKE SIMPLE, HEALTHY MEALS. PARTICIPATING KIDS PREPARE A HEALTHY MEAL DURING CLASS AND THEN THE PARENTS ARE INVITED TO EAT THE MEAL WITH THEIR CHILD. KIDS SHARE THE RECIPE WITH THE PARENTS AND TALK ABOUT WHAT THEY DID IN CLASS. THE IDEA IS TO ENCOURAGE FAMILIES TO EAT MORE MEALS AT HOME. THE PROGRAM TEACHES NUTRITION AND COOKING IN A FUN, HANDS-ON WAY. KIDS WHO LEARN ABOUT HEALTHY FOOD CHOICES WILL BE MORE LIKELY TO HAVE BETTER HABITS AS AN ADULT. THIS PROGRAM IS A COLLABORATIVE EFFORT OF INTEGRIS, THE OSU EXTENSION CENTER AND MULTIPLE CHURCHES. THE CHURCHES PROVIDE KITCHEN SPACE, WHICH HELPS US REACH THE UNDERSERVED CHILDREN AND FAMILIES WE ARE TARGETING. SINCE THE PROGRAM STARTED, 261 KIDS AND PARENTS HAVE PARTICIPATED. NEARLY 100 PERCENT OF KIDS SURVEYED SAY THAT AFTER TAKING THE PROGRAM, THEY WILL TRY TO EAT HEALTHIER. ON THE THREE MONTH FOLLOW UP, 85 PERCENT OF KIDS HAD MADE AT LEAST THREE MEALS AT HOME SINCE TAKING THE COURSE. INTEGRIS CANADIAN VALLEY HOSPITAL (YUKON) YOGA FOR KIDS YOGA FOR KIDS WAS DEVELOPED BY THE UNIVERSITY OF ARKANSAS DIVISION OF AGRICULTURE RESEARCH AND EXTENSION. THE PROGRAM IS INTENDED FOR AGES 5 TO 19 AND INCORPORATES ADULT YOGA POSES INTO KID-FRIENDLY YOGA ROUTINES AND GAMES. THE FOCUS OF YOGA FOR KIDS IS HELPING KIDS ACHIEVE OPTIMAL PHYSICAL, SOCIAL AND MENTAL HEALTH. PRACTICING YOGA BUILDS STRENGTH, FLEXIBILITY AND CONFIDENCE. ALSO, THE BREATHING PROMOTES RELAXATION AND QUIETS THE MIND. YOGA AND STRETCH BREAKS IN THE CLASSROOM 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. SINCE THE PROGRAM BEGAN, 649 STUDENTS HAVE PARTICIPATED. OVER 20 SCHOOL STAFF MEMBERS HAVE BEEN TRAINED AND 92 PERCENT OF TEACHERS ARE CONTINUING TO IMPLEMENT YOGA IN THE CLASSROOM AS OF A SIX MONTH FOLLOW UP. INTEGRIS CANCER INSTITUTE CELEBRATION OF LIFE: NATIONAL CANCER SURVIVORS DAY THE INTEGRIS CANCER INSTITUTE CELEBRATED NATIONAL CANCER SURVIVORS DAY WITH OUR 29TH ANNUAL CELEBRATION OF LIFE ON SUNDAY, JUNE 5, 2016, AT THE NATIONAL COWBOY AND WESTERN HERITAGE MUSEUM IN OKLAHOMA CITY. THE ANNUAL CELEBRATION OF LIFE WAS ALSO HELD IN HUNDREDS OF COMMUNITIES WORLDWIDE. CANCER SURVIVORS, CAREGIVERS, FAMILY MEMBERS, FRIENDS AND HEALTH CARE PROFESSIONALS ALL UNITE ON THE FIRST SUNDAY EVERY JUNE TO SHOW THAT LIFE AFTER A CANCER DIAGNOSIS CAN BE MEANINGFUL, PRODUCTIVE AND INSPIRING. THE INTEGRIS CANCER INSTITUTE RECOGNIZES OUR OWN EVER GROWING FAMILY OF CANCER SURVIVORS EACH YEAR WITH A COMPLIMENTARY COMMUNITY CELEBRATION. ORDAINED EPISCOPAL PRIEST NICK MEZACAPAS HUMOROUS AND INSPIRATIONAL MESSAGE IN 2016 FOCUSED ON OUR RESPONSIBILITY TO LIVE OUR LIVES AS FULLY AND RICHLY AS POSSIBLE. THE DAY INCLUDED A DELICIOUS MEAL, MUSICAL ENTERTAINMENT, A SURVIVOR RECOGNITION IN BOTH ENGLISH AND SPANISH AND A BUTTERFLY RELEASE FOR MORE THAN 400 CANCER SURVIVORS. INTEGRIS GROVE HOSPITAL SOUPER BOWL SATURDAY THE 2016 INTEGRIS GROVE SOUPER BOWL SATURDAY PROVIDED AN OPPORTUNITY FOR COMMUNITY MEMBERS TO VISIT THE INTEGRIS GROVE HOSPITAL CAMPUS, TALK WITH PHYSICIANS AND STAFF, AND LEARN ABOUT NEW EQUIPMENT AND SERVICES BEING OFFERED. FREE HEALTH SCREENINGS SUCH AS BLOOD PRESSURE, CHOLESTEROL, GLUCOSE AND EKGS WERE AVAILABLE. THE EVENT FEATURED HEALTH EDUCATION AND SERVICE INFORMATION. ENTERTAINMENT WAS PROVIDED BY THE GROVE HIGH SCHOOL JAZZ BAND, A LOCAL VENTRILOQUIST, A MAGICIAN AND A DEMONSTRATION BY CHEERS!, A CHEERLEADING AND GYMNASTICS GROUP. ATTENDEES COULD ALSO SUPPORT THE INTEGRIS GROVE HOSPITAL AUXILIARY BY PURCHASING A $5 LUNCH INCLUDING SOUP, DESSERT AND A DRINK. OVER 300 PEOPLE ATTENDED THE EVENT. MULTIPLE HEALTH SCREENINGS WERE PERFORMED INCLUDING 71 EKGS, 63 BONE DENSITY CHECKS, 60 EYE SCREENINGS, AND 90 CHOLESTEROL AND GLUCOSE SCREENINGS. INTEGRIS HEALTH EDMOND TOOLS FOR LIVING TOOLS FOR LIVING WITH CHRONIC CONDITIONS IS AN EVIDENCE BASED COURSE DEVELOPED AT THE STANFORD UNIVERSITY PATIENT EDUCATION RESEARCH CENTER AS A COLLABORATIVE RESEARCH PROJECT BETWEEN STANFORD AND THE NORTHERN CALIFORNIA KAISER PERMANENTE MEDICAL CARE PROGRAM. THE ONGOING SIX-WEEK PROGRAM TEACHES PARTICIPANTS HOW TO BECOME BETTER SELF-MANAGERS OF THEIR HEALTH. TOPICS INCLUDE GOAL SETTING, DEALING WITH DIFFICULT EMOTIONS, MEDICATION USAGE, PHYSICAL ACTIVITY AND NUTRITION, COPING WITH PAIN/DISCOMFORT, COMMUNICATION WITH HEALTH CARE PROVIDERS, MAKING INFORMED TREATMENT DECISIONS AND FACILITATING PEER SUPPORT. THE PROGRAM IS TAUGHT IN COLLABORATION WITH THE INTEGRIS COMMUNITY WELLNESS DEPARTMENT AND AN INTEGRIS MEDICAL GROUP CARE COORDINATOR. PARTICIPANTS COME FROM ALL AGES AND BACKGROUNDS. AS A RESULT OF COMPLETING THE PROGRAM, OVER 80 PERCENT OF THE PARTICIPANTS REPORT AN INCREASE IN HOW OFTEN THEY USE FORMS OF RELAXATION TO DEAL WITH PAIN AND DISCOMFORT AND 90 PERCENT REPORT THEY UNDERSTAND THEIR HEALTH BETTER. INTEGRIS MENTAL HEALTH AMERICAN FOUNDATION FOR SUICIDE PREVENTION: INTERNATIONAL SURVIVORS OF SUICIDE LOSS DAY INTERNATIONAL SURVIVORS OF SUICIDE LOSS DAY IS HOSTED BY THE CENTRAL OKLAHOMA SUICIDE PREVENTION TASK FORCE. THE EVENT IS DESIGNED TO PROVIDE AWARENESS AND COMMUNITY RESOURCES FOR SURVIVORS OF SUICID GENERAL STATEMENT 4 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 2015 TAX YEAR. GENERAL STATEMENT 5 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTION 2 RELATED PARTIES TYPE OF RELATIONSHIP --------------- -------------------- JOEY SAGER AND BUSINESS ALVIN BATES JOEY SAGER AND BUSINESS STEPHEN MERRILL 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: DAVID R. HADLEY JOEY SAGER C. BRUCE LAWRENCE CHRISTOPHER TURNER BETH A. PAUCHNIK GENERAL STATEMENT 6 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTIONS 6, 7A AND 7B - INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS BAPTIST MEDICAL CENTER, INC. AS SUCH IT HAS THE POWER (1) TO ELECT THE DIRECTORS AND TO REMOVE THE ENTIRE BOARD OF DIRECTORS OR ANY INDIVIDUAL DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE, (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. GENERAL STATEMENT 7 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 OF FINANCIAL REPORTING FOR REVIEW. A FINAL FORM 990 IS GIVEN TO THE SYSTEM CHIEF FINANCIAL OFFICER FOR REVIEW, APPROVAL, AND SIGNATURE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, AS WELL AS TO THE SYSTEM'S AUDIT/COMPLIANCE COMMITTEE, FOR REVIEW PRIOR TO FILING THE RETURN. GENERAL STATEMENT 8 PART VI: SECTION B. POLICIES PART VI: QUESTION 12C - THE FILING ORGANIZATION IS 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 9 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 10 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 11 PART VII: SECTION B. INDEPENDENT CONTRACTORS DIAGNOSTIC LABORATORY REFERENCE LAB $24,321,545 OF OKLAHOMA, LLC 225 N.E. 97TH STREET OKLA. CITY, OK 73114 INTELISTAFF OF OKLAHOMA CONTRACT STAFFING $ 9,795,211 HEALTHCARE LLC P.O. BOX 202996 DALLAS, TX 75320-1300 LIFESHARE TRANSPLANT DONOR ORGAN ACQUISITION $ 4,612,053 4705 N.W. EXPRESSWAY OKLA. CITY, OK 73132 OUHSC PHYSICIAN SERVICES $ 1,451,195 1100 N. LINDSAY SCB223 OKLA. CITY, OK 73126 NORTHWEST ANESTHESIA PC ANESTHESIA SERVICES $ 1,305,792 P.O. BOX 26168 OKLA. CITY, OK 73126 GENERAL STATEMENT 12 PART XI: RECONCILIATION OF NET ASSETS, LINE 9 EQUITY TRANSFER TO INTEGRIS HEALTH, INC. ($80,500,000) TRANSFER TO INTEGRIS CARDIOVASCULAR ($ 499,983) PHYSICIANS, LLC ------------- TOTAL ($80,999,983) ============= GREAT PLAINS MEDICAL FOUNDATION 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 731457016 MED.RES.PROG. 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