2017-05-04T13:31:05-05:00 2016-06-30 KPMG LLP 210 Park Ave Suite 2850 Oklahoma City OK 73102 990 2015-07-01 731047338 INTEGRIS HEALTH FOUNDATION INC % CHERYL PERRY INTE 4059512747 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DANIEL DAVIS CFO 4059512736 2017-04-27 true MORGAN L SOUZA P00652612 4052396411 2017-04-24 2015 2021-01-29 14:40:06Z DANIEL DAVIS 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 15609044 false X WWW.INTEGRISOK.COM X 1978 OK THE FOUNDATION PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO IMPROVE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 9 9 11 9 0 0 2284561 14030014 0 0 5077590 1311215 -250779 -62952 7111372 15278277 3738165 4989318 0 0 1001744 1086484 0 0 2766555 865711 1793936 5605620 7869738 1505752 7408539 55578389 59825635 1286211 241304 54292178 59584331 X INTEGRIS HEALTH FOUNDATION, INC. PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO IMPROVE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. false false 4989318 4989318 SEE SCHEDULE O - GENERAL STATEMENT 1 4989318 true true false false false false false false true true true true false false false false false true false false false false false false true false false true true true false false false false false false false false true false false false false true true false false false true X 0 0 11 true false false false false false true true false false false false X 9 9 true false false false true true true true true false false true true true true true true false false false OK X CHERYL PERRY 4059512747 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 JOEL CHAMPLIN SECRETARY 1.0 0.0 X X 0 0 0 JO DOWNING CHAIRMAN 1.0 0.0 X X 0 0 0 JIM WALLIS VICE CHAIRMAN 1.0 0.0 X X 0 0 0 ARTHUR F HOGE III DIRECTOR 1.0 0.0 X 0 0 0 HARRISON LEVY DIRECTOR 1.0 0.0 X 0 0 0 RON MCCORD DIRECTOR 1.0 0.0 X 0 0 0 SUSAN MORITZ DIRECTOR 1.0 0.0 X 0 0 0 MARCEL WALTHER DIRECTOR 1.0 0.0 X 0 0 0 DIANE WEAVER DIRECTOR 1.0 0.0 X 0 0 0 DAVID HADLEY ASST. TREASURER 1.0 39.0 X 0 714874 111515 BETH PAUCHNIK ASST. SECRETARY 1.0 39.0 X 0 599379 118035 ANNE CLOUSE VICE PRESIDENT FOUNDATION 39.0 1.0 X 213130 0 5984 C BRUCE LAWRENCE FORMER DIRECTOR 0.0 40.0 X 0 1404018 387641 STANLEY F HUPFELD FORMER OFFICER & DIRECTOR 0.0 21.0 X 0 12380 11212 MARY ANN BAUMAN MD FORMER DIRECTOR 0.0 40.0 X 0 260324 49450 DAVID KALLENBERGER FORMER DIRECTOR 0.0 9.0 X 0 39228 0 213130 3030203 683837 1 true true false SEE SCHEDULE O GENERAL STATEMENT 8 360831 1 10000 1200704 35593 1029100 11754617 38525 14030014 0 1311215 1311215 0 0 0 0 0 0 267795 1200704 330767 -62972 -62972 0 0 MISC. INCOME 900099 20 20 20 15278277 1248263 4971893 4971893 17425 17425 0 0 236899 0 0 236899 0 649629 649629 45067 45067 94839 94839 60050 60050 113865 113865 0 0 0 0 0 352295 352295 0 262509 262509 0 0 135970 135970 15832 15832 0 30 30 0 0 5660 5660 12380 12380 PURCHASED SERVICES 182184 182184 PROVISION FOR BAD DEBT 966908 966908 RECLASS: EVENTS EXPENSE -330767 -330767 UNRELATED BUS.INCOME TAX 2650 2650 74420 74420 7869738 4989318 113865 2766555 0 0 9087502 13110998 1581167 10289847 0 11332 0 0 0 0 0 0 0 0 0 0 1397291 445725 953601 951566 0 0 43749197 35245435 0 0 0 0 206922 216457 55578389 59825635 1139579 109226 0 0 0 0 0 0 135927 132078 0 0 0 0 0 0 10705 0 1286211 241304 X 14157819 12961714 33891452 40455095 6242907 6167522 54292178 59584331 55578389 59825635 7408539 -2116386 X false true X true false X 1467003 3898349 2817303 2284561 14030014 24497230 0 0 1467003 3898349 2817303 2284561 14030014 24497230 0 24497230 1052265 1204996 791547 1097649 1144913 5291370 0 0 0 0 0 1315 3337 2499 21 20 7192 29795792 0.82217 0.66560 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true X 6242907 50696 -76659 49422 6167522 6307018 48780 25090 137981 6242907 5021733 938576 464828 118119 6307018 4061831 586066 376243 2407 5021733 3485995 690515 27925 142604 4061831 0.87440 0.12560 false false 925890 925890 39798 29895 9903 431603 415830 15773 951566 RESTRICTED FUND INVESTMENTS 197737 F POOLED FUND INESTMENTS 35047698 F 35245435 SUPPLEMENTAL INFORMATION 1 SCHEDULE D, PART IV, LINE 2B GIFT ANNUITIES AND CHARITABLE REMAINDER TRUSTS CONSIST OF CONTRIBUTED AMOUNTS SUBJECT TO OBLIGATIONS TO MAKE PERIODIC PAYMENTS TO BENEFICIARIES OVER A SPECIFIED PERIOD. THE LIABILITIES SHOWN ARE RECORDED AT THE ACTUARIAL PRESENT VALUES OF THE AGGREGATE LIABILITY BASED ON THE SPECIFIED PERIOD. A DISCOUNT RATE WAS USED TO DETERMINE THE PRESENT VALUE OF THE LIABILITIES. SUPPLEMENTAL INFORMATION 2 SCHEDULE D, PART V, LINE 4 THE MAJORITY OF THE ENDOWMENT FUNDS ARE RESTRICTED FOR USE IN FUNDING THE INTEGRIS HEALTH SYSTEM'S CENTERS FOR EXCELLENCE. SPECIALIZED CENTERS OF EXCELLENCE HAVE BEEN DEVELOPED THROUGH VARIOUS INTEGRIS ENTITIES TO PROVIDE THE HIGHEST STANDARD OF CARE FOR OUR COMMUNITIES. CENTERS OF EXCELLENCE INCLUDE THE PAUL SILVERSTEIN BURN CENTER, INTEGRIS HEART HOSPITAL, NAZIH ZUHDI TRANSPLANT INSTITUTE, TROY & DOLLIE SMITH CANCER CENTER, WOMEN'S CENTER, HENRY G. BENNETT JR. FERTILITY INSTITUTE, SLEEP DISORDERS CENTER OF OKLAHOMA, THE HOUGH EAR INSTITUTE, THE CENTRAL OKLAHOMA CANCER CENTER, SOUTHWEST BREAST HEALTH AND IMAGING CENTER, INTEGRIS JIM THORPE REHABILITATION NETWORK, INTEGRIS NEUROMUSCULAR CENTER, SLEEP DISORDERS CENTER OF OKLAHOMA AND THE JAMES R. DANIEL STROKE CENTER OF OKLAHOMA. IH FDN GALA 750415 636115 114300 4623 54792 10550 59149 JTR COURAGE 417010 334060 82950 9848 46541 2500 44494 3 301074 230529 70545 2906 6548 21213 2800 64803 1468499 1200704 267795 2906 21019 122546 15850 168446 330767 -62972 true INTEGRIS BAPTIST MEDICAL CENTER INC 5300 N INDEPENDENCE AVE OKC OK 73112 731034824 501(C)(3) 383741 2146118 FMV SUPPLIES & EQUIPMENT TO FUND OPERATIONS WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE OKC OK 73112 731588764 501(C)(3) 21473 4100 FMV SUPPLIES & EQUIPMENT TO FUND OPERATIONS INTEGRIS HOSPICE INC 5300 N INDEPENDENCE AVE OKC OK 73112 731369586 501(C)(3) 10500 5243 FMV EQUIPMENT TO FUND OPERATIONS INTEGRIS AMBULATORY CARE CORPORATION 5300 N INDEPENDENCE AVE OKC OK 73112 731192765 501(C)(3) 77594 21737 FMV EQUIPMENT TO FUND OPERATIONS INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORP 5300 N INDEPENDENCE AVE OKC OK 73112 731089149 501(C)(3) 98412 829751 FMV EQUIPMENT TO FUND OPERATIONS INTEGRIS HEALTH INC 5300 N INDEPENDENCE AVE OKC OK 73112 731192764 501(C)(3) 182762 206279 FMV EQUIPMENT TO FUND OPERATIONS INTEGRIS HEALTH EDMOND INC 5300 N INDEPENDENCE AVE OKC OK 73112 451027361 501(C)(3) 12112 19395 FMV EQUIPMENT TO FUND OPERATIONS INTEGRIS RURAL HEALTH INC 5300 N INDEPENDENCE AVE OKC OK 73112 731444504 501(C)(3) 337238 615439 FMV EQUIPMENT TO FUND OPERATIONS 8 LIVING EXPENSES DUE TO HEALTH ISSUES/HARDSHIPS 30 17425 SUPPLEMENTAL INFORMATION 1 SCHEDULE I, PART I, LINE 2 INTEGRIS HEALTH FOUNDATION, INC. (IH FDN OR FOUNDATION) WAS ESTABLISHED TO SUPPORT, THROUGH FUNDRAISING AND GRANT MAKING ACTIVITIES, THE NOT-FOR-PROFIT CHARITABLE AFFILIATES OF INTEGRIS HEALTH, INC. (AFFILIATE OR AFFILIATES OF INTEGRIS HEALTH SYSTEM), INCLUDING BUT NOT LIMITED TO INTEGRIS BAPTIST MEDICAL CENTER, INC. THE PROCESS FOR PROVIDING GRANTS TO AFFILIATES OF INTEGRIS HEALTH SYSTEM BEGINS WITH A REQUEST FOR FUNDING FROM THE AFFILIATE TO THE IH FDN. A DEPARTMENT DIRECTOR OF THE AFFILIATE MAKES AN INITIAL REQUEST TO THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT OF THE AFFILIATE. THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT VALIDATES THE DEPARTMENT'S NEED FOR THE FUNDS AND APPROVES THE REQUEST. THIS APPROVAL INDICATES THAT THE REQUESTED FUNDS ARE IN KEEPING WITH THE AFFILIATE'S OVERALL CHARITABLE GOALS. ONCE VALIDATED, THE REQUEST IS SENT TO IH FDN'S OFFICE TO VERIFY THE FUNDS ARE AVAILABLE. IH FDN'S PRESIDENT THEN REVIEWS THE REQUEST TO CONFIRM THE REQUESTED USE OF FUNDS ARE IN KEEPING WITH THE FOUNDATION'S CHARITABLE PURPOSES AND WITH THE INTENT OF DONORS TO THE FOUNDATION. ASSUMING THIS IS THE CASE, THE FOUNDATION PRESIDENT APPROVES THE REQUEST. FUNDS REQUESTED BY THE AFFILIATES GENERALLY FALL INTO TWO CATEGORIES: CAPITAL AND NON-CAPITAL. THE REQUEST FOR FUNDS FORM MEMORIALIZES THE MOVEMENT OF FUNDS FROM THE FOUNDATION TO THE AFFILIATE FOR REIMBURSEMENT OF ITEMS PURCHASED. false true false false false false false true false DAVID HADLEY ASST. TREASURER 0 511015 0 179513 0 24346 0 95862 0 15653 0 826389 0 0 BETH PAUCHNIK ASST. SECRETARY 0 431657 0 152210 0 15512 0 106280 0 11755 0 717414 0 0 C BRUCE LAWRENCE FORMER DIRECTOR 0 978354 0 390993 0 34671 0 375231 0 12410 0 1791659 0 0 STANLEY F HUPFELD FORMER OFFICER & DIRECTOR 0 1184 0 11196 0 0 0 2963 0 8249 0 23592 0 0 MARY ANN BAUMAN MD FORMER DIRECTOR 0 216463 0 34075 0 9786 0 37825 0 11625 0 309774 0 0 DAVID KALLENBERGER FORMER DIRECTOR 0 39228 0 0 0 0 0 0 0 0 0 39228 0 0 ANNE CLOUSE VICE PRESIDENT FOUNDATION 165531 0 40171 0 7428 0 1146 0 4838 0 219114 0 0 0 SUPPLEMENTAL INFORMATION 1 SCHEDULE J, PART I, LINE 3 INTEGRIS HEALTH FOUNDATION, INC. (IHF) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IHF RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIALS. INTEGRIS UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THIS COMPENSATION. SUPPLEMENTAL INFORMATION 2 SCHEDULE J, PART I, LINE 4B THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NON QUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. C. BRUCE LAWRENCE BETH A. PAUCHNIK DAVID R. HADLEY SUPPLEMENTAL INFORMATION 3 SCHEDULE J, PART I, LINE 7 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. X 5 5000 FMV X MEDICAL EQUIPMENT 118 33525 FMV false true false GENERAL STATEMENT 1 PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS HEALTH FOUNDATION, INC. WAS ESTABLISHED TO FACILITATE FINANCIAL SUPPORT FOR THE ORGANIZATION BY CONNECTING DONORS TO THEIR INTEGRIS PASSIONS AS IT RELATES TO THE MYRIAD OF PROGRAMS AND SERVICES OF INTEGRIS HEALTH, INC. AND ITS CHARITABLE AFFILIATES. THE INTEGRIS HEALTH FOUNDATION ACCOMPLISHED THE FOLLOWING FOR FY16: THE INTEGRIS GALA DREW A CROWD OF MORE THAN 750 GUESTS AND SECURED A RECORD-BREAKING TOTAL OF $750,415 FOR THE BENEFIT OF THE INTEGRIS CANCER INSTITUTE AND THE SARAH BRUMLEY SCHOLARSHIP FOR INTEGRATIVE MEDICINE. PROCEEDS FROM THE EVENT FUNDED A GENETICS COUNSELING PROGRAM AND HOLISTIC MEDICINE FOR 800 CANCER PATIENTS IN AN EFFORT TO EASE THEIR TREATMENT PROCESS. THE INTEGRIS GOLF CLASSIC HOSTED A SOLD-OUT TOURNAMENT TO BENEFIT THE INTEGRIS E-HEALTH PROGRAM. EVENT PROCEEDS BENEFITED E-HEALTH INITIATIVES INCLUDING THE ADDITION OF A ROBOT TO PROVIDE VIRTUAL SPECIALIST CARE TO PATIENTS AT INTEGRIS CANADIAN VALLEY HOSPITAL. THE FIFTH ANNUAL INTEGRIS YOU&I EMPLOYEE GIVING CAMPAIGN WELCOMED THE GIFTS OF MORE THAN 3,200 INTEGRIS EMPLOYEES AND PHYSICIANS. THIS GENEROSITY WAS MET BY MATCHING GIFTS OF INTEGRIS VOLUNTEER AUXILIARIES ACROSS THE STATE AMOUNTING TO $220,000 FOR A TOTAL OF MORE THAN $828,000 RAISED FOR VARIOUS CARE CENTERS THROUGHOUT THE SYSTEM. THE CAPITAL CAMPAIGN FOR ARCADIA TRAILS CENTER FOR ADDICTION RECOVERY RAISED $11.5 MILLION IN LEADERSHIP GIFTS TO THE PROJECT TOWARD A $21 MILLION GOAL. THE INTEGRIS FOUNDATION INVESTED MORE THAN $5.29 MILLION BACK TO OUR HOSPITALS, IMPACTING PATIENT CARE AND ADVANCING OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. GENERAL STATEMENT 2 PART V: QUESTION 1A AND 2A QUESTION 1A - INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, PAYS ALL VENDORS FOR SERVICES PROVIDED TO ALL ENTITIES WITHIN THE SYSTEM. ACCORDINGLY, COMPENSATION PAID TO INDEPENDENT CONTRACTORS IS REPORTED ON THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS OF INTEGRIS HEALTH, INC., EIN 73-1192764. EXPENSES ARE ALLOCATED TO AND REIMBURSED BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990, PART VII, SECTION B AND PART IX, AS APPROPRIATE. PART V: QUESTION 2A - THE SALARIES REFLECTED ON FORM 990, PART IX, LINE 7, WERE ALL REPORTED ON THE FORM 941 EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, OF INTEGRIS HEALTH, INC., EIN 73-1192764. THESE SALARIES WERE REIMBURSED TO INTEGRIS HEALTH, INC. AND WERE INCLUDED IN THE NUMBER OF EMPLOYEES ON INTEGRIS HEALTH, INC.'S FORM W-3. THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2015 TAX YEAR. GENERAL STATEMENT 3 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTION 2 - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE FOLLOWING 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: BETH A. PAUCHNIK DAVID R. HADLEY GENERAL STATEMENT 4 PART VI: SECTION A. GOVERNING BODY AND MANAGEMENT PART VI: QUESTIONS 6, 7A & 7B - INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HEALTH FOUNDATION, INC. AS SUCH IT HAS THE POWER (1) TO SELECT AND REMOVE ALL OFFICERS, AGENTS AND EMPLOYEES OF THE CORPORATION, PRESCRIBE SUCH POWERS AND DUTIES FOR THEM AS MAY BE CONSISTENT WITH LAW, WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, (2) TO CONDUCT, MANAGE AND CONTROL THE AFFAIRS AND BUSINESS OF THE CORPORATION, AND TO MAKE SUCH RULES AND REGULATIONS THEREFORE CONSISTENT WITH LAW, OR WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, AS THEY MAY DEEM BEST, SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, (3) TO FIX AND LOCATE FROM TIME TO TIME ONE OR MORE SUBSIDIARY OFFICES OF THE CORPORATION WITHIN OR WITHOUT THE STATE OF OKLAHOMA; AND TO ADOPT, MAKE AND USE A CORPORATE SEAL, AND TO ALTER THE FORM OF SUCH SEAL FROM TIME TO TIME, AS IN THEIR JUDGEMENT THEY MAY DEEM BEST, PROVIDED SUCH SEAL AT ALL TIMES COMPLY WITH THE PROVISIONS OF LAW, THE CERTIFICATE OF INCORPORATION AND THESE BYLAWS. GENERAL STATEMENT 5 PART VI: SECTION B. POLICIES PART VI: QUESTION 11B - THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE SYSTEM HAS A SINGLE AUDIT COMPLIANCE COMMITTEE WHICH OVERSEES THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AS WELL AS THE FILING OF FEDERAL AND STATE TAX FORMS. THE SYSTEM ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF FORM 990 TO PREPARE THE FORM. A DRAFT FORM 990 IS PROVIDED TO THE SYSTEM VICE PRESIDENT 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 6 PART VI: SECTION B. POLICIES PART VI: QUESTION 12C - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE INTEGRIS CODE OF CONDUCT. ALL SYSTEM EMPLOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION AND ARE INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS, TO REFER ANY CONFLICT OF INTEREST QUESTIONS TO THE SYSTEM'S COMPLIANCE OFFICER OR THROUGH THE ANONYMOUS INTEGRITY LINE. ALL NEW MANAGERS RECEIVE ADDITIONAL TRAINING ON CONFLICT OF INTEREST POLICES DURING LEADERSHIP TRAINING. LEGAL SERVICES REVIEWS ALL CONTRACTS FOR CONFLICTS OF INTEREST. INTERNAL AUDIT CONDUCTS AUDITS FOR POSSIBLE CONFLICTS OF INTEREST BASED ON THEIR ANNUAL RISK ASSESSMENT. CORPORATE COMPLIANCE INCLUDES ASSESSMENTS FOR CONFLICTS OF INTEREST IN ITS ANNUAL WORK PLAN AND CONDUCTS SPECIALIZED TRAINING FOR HIGH RISK AREAS. THE GOVERNANCE COMMITTEE, A COMMITTEE OF THE INTEGRIS HEALTH BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF INTEGRIS AND A DISQUALIFIED PERSON. GENERAL STATEMENT 7 PART VI: SECTION C. DISCLOSURE PART VI: QUESTION 19 - THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR INTEGRIS HEALTH, INC., A RELATED CORPORATION. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION. GENERAL STATEMENT 8 PART VII: SECTION B. INDEPENDENT CONTRACTORS DINI PARTNERS INC. FUNDRAISING $360,831 2727 ALLEN PARKWAY, SUITE 1650 CONSULTANTS HOUSTON, TX 77019 GENERAL STATEMENT 9 SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION INTEGRIS HEALTH FOUNDATION, 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, 2016. 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 FOUNDATION, INC. ADDRESS: 5300 N. INDEPENDENCE AVE., STE. 130 OKLAHOMA CITY, OK 73112 TAXPAYER IDENTIFICATION NUMBER: 73-1047338 SECTION 1.263(A)-3(N) ELECTION - BOOK CONFORMITY ELECTION INTEGRIS HEALTH FOUNDATION, 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, 2016. TAXPAYER NAME: INTEGRIS HEALTH FOUNDATION, INC. ADDRESS: 5300 N. INDEPENDENCE AVE., STE. 130 OKLAHOMA CITY, OK 73112 TAXPAYER IDENTIFICATION NUMBER: 73-1047338 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 9 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 11 -I NA false WESTERN VILLAGE ACADEMY INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC false INTEGRIS HEALTH EDMOND INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 451027361 HEALTH CARE OK 501(C)(3) LINE 3 IH false INTEGRIS MENTAL HEALTH INC 5300 N INDEPENDENCE AVE STE 130 OKLA CITY OK 73112 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH false BMPA LTD 73-1228665 OKLAHOMA CITY OK 73112 OKLA CITY OK 73112 MED. 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