2017-05-04T13:30:19-05:00 2016-06-30 KPMG LLP 210 Park Ave Suite 2850 Oklahoma City OK 73102 990 2015-07-01 451027361 INTEGRIS HEALTH EDMOND INC % CHERYL PERRY INTE 4059496026 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 DANIEL DAVIS CFO 4059512736 2017-04-30 true MORGAN L SOUZA P00652612 4052396411 2017-04-24 2015 2021-01-29 14:40:06Z SEE SCHEDULE O C BRUCE LAWRENCE 5300 N INDEPENDENCE AVE OKLAHOMA CITY OK 73112 122584580 false X WWW.INTEGRISOK.COM X 2011 OK TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. X 11 7 214 56 0 25419926 65521068 47784229 57047758 100 9155 0 0 73204255 122577981 0 0 0 0 15592366 17780833 0 0 0 28653424 37058334 44245790 54839167 28958465 67738814 98370862 99492856 80471084 13854264 17899778 85638592 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 46887538 57047758 SEE SCHEDULE O STATEMENTS 2 AND 3 46887538 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 0 214 true false false false false false false false false false false X 11 7 true false false false true true true true true false false true true true true true true true true false OK X CHERYL PERRY 4059512747 5300 N INDEPENDENCE AVE STE 130 OKLAHOMA CITY OK 73112 X LARITA ARAGON DIRECTOR 1.0 0.0 X 0 0 0 PETER DOBELBOWER CHAIRMAN 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 371894 21365 RAY HIBBARD VICE CHAIRMAN 1.0 0.0 X 0 0 0 WILLIAM E SMITH MD DIRECTOR 1.0 6.0 X 0 6910 9346 RANDY STAFFORD SECRETARY 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 7350 300 0 JANET YOWELL DIRECTOR 1.0 0.0 X 0 0 0 C BRUCE LAWRENCE EX-OFFICIO-PRESIDENT/CEO IH 1.0 39.0 X X 0 1404018 387641 AVILLA T WILLIAMS EX-OFFICIO-PRESIDENT IHE 40.0 0.0 X 354765 0 39740 CHRIS M HAMMES EX-OFFICIO-VP/COO IH 1.0 39.0 X 0 874874 163454 ANGIE KAMERMAYER VP CHIEF NURSING OFFICER 40.0 0.0 X 240484 0 40419 JONATHAN RULE VICE PRESIDENT 40.0 0.0 X 171024 0 14644 DJANGO BELOTE DIRECTOR PHARMACY 40.0 0.0 X 168058 0 14915 ANGELIQUE HEIGLE CLINICAL DIRECTOR I 40.0 0.0 X 121287 0 21069 NICOLETTE MOMAN CLINICAL DIRECTOR I 40.0 0.0 X 147714 0 12560 EVELYN RADICHEL CLINICAL DIRECTOR I 40.0 0.0 X 127994 0 26217 DANIEL SMITH CLINICAL DIRECTOR I 40.0 0.0 X 154548 0 0 SUDHIR KHANNA MD FORMER DIRECTOR 0.0 40.0 X 0 276975 10020 DENNIS PARKER MD FORMER DIRECTOR 1.0 3.0 X 15000 38378 0 1508224 2973349 761390 14 true true false SEE SCHEDULE O GENERAL STATEMENT 1 4232472 11 65521068 19395 65521068 NET PATIENT REVENUE 621990 54750419 54750419 ELECTRONIC HEALTH RECORDS 900099 1033809 1033809 RENTAL INCOME 532000 869480 869480 CAFETERIA 722320 258310 258310 GIFT SHOP 900099 113761 113761 21979 3420 18559 57047758 0 0 0 0 0 0 15754 6599 9155 9155 9155 0 0 0 0 122577981 56657128 399785 0 0 0 0 905083 905083 2500 2500 12921966 12921966 951064 951064 2001242 2001242 998978 998978 7951629 7951629 0 37 37 0 0 0 2531847 2531847 3117 3117 8695542 8695542 0 0 822854 822854 21512 21512 0 7130 7130 3086133 3086133 0 5539828 5539828 53374 53374 PURCHASED SERVICES 3456849 3456849 0 RIF & RECRUITMENT 2250133 2250133 0 CONTRACT LABOR 1641440 1641440 0 SHOPP FEE 791581 791581 0 205328 205328 54839167 46887538 7951629 0 0 0 0 0 0 0 5328759 6854981 0 0 0 0 0 0 818220 877807 0 49142 118457759 26875964 92223883 91581795 0 0 0 0 0 0 0 0 0 129131 98370862 99492856 80471084 13854264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80471084 13854264 X 17899778 85638592 0 0 0 0 17899778 85638592 98370862 99492856 67738814 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8187716 8187716 79637166 8489131 71148035 28725665 18051323 10674342 1907212 335510 1571702 91581795 true true X true X true X true true true false true true 1643384 0 1643384 0.03000 5447441 2799889 2647552 0.04830 7090825 2799889 4290936 0.07830 10256 0 10256 0.00020 22662 44 22618 0.00040 32918 44 32874 0.00060 7123743 2799933 4323810 0.07890 541 0 541 745 0 745 1286 0 1286 false 1877082 93854 10361558 14305934 -3944376 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 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 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 INTEGRISOK.COM/COMMUNITY-WELLNESS-SERVICES-OKLAHOMA-COMMUNITY-HEALTH-IMPRO VEMENT SUPPLEMENTAL INFORMATION 8 PART V, SECTION B, LINE 16B INTEGRISOK.COM/PRICING-FINANCIAL-ASSISTANCE 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) $54,839,167 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 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 $3,944,376 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 STATEMENT 3 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 274753 0 96504 0 637 0 14425 0 6940 0 393259 0 0 AVILLA T WILLIAMS EX-OFFICIO-PRESIDENT IHE 220346 0 118720 0 15699 0 33168 0 6572 0 394505 0 0 0 CHRIS M HAMMES EX-OFFICIO-VP/COO IH 0 629915 0 226957 0 18002 0 147611 0 15843 0 1038328 0 0 C BRUCE LAWRENCE EX-OFFICIO-PRESIDENT/CEO IH 0 978354 0 390993 0 34671 0 375231 0 12410 0 1791659 0 0 ANGIE KAMERMAYER VP CHIEF NURSING OFFICER 170902 0 59094 0 10488 0 29378 0 11041 0 280903 0 0 0 JONATHAN RULE VICE PRESIDENT 122400 0 35166 0 13458 0 8421 0 6223 0 185668 0 0 0 DJANGO BELOTE DIRECTOR PHARMACY 138223 0 29102 0 733 0 8725 0 6190 0 182973 0 0 0 NICOLETTE MOMAN CLINICAL DIRECTOR I 112593 0 32791 0 2330 0 5769 0 6791 0 160274 0 0 0 EVELYN RADICHEL CLINICAL DIRECTOR I 104037 0 23521 0 436 0 11960 0 14257 0 154211 0 0 0 DANIEL SMITH CLINICAL DIRECTOR I 123845 0 29921 0 782 0 0 0 0 0 154548 0 0 0 SUDHIR KHANNA MD FORMER DIRECTOR 0 258985 0 17990 0 0 0 10020 0 0 0 286995 0 0 DENNIS PARKER MD FORMER DIRECTOR 15000 38378 0 0 0 0 0 0 0 0 15000 38378 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 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: $150,436 (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: $194,238 (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: $95,446 (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, BOTH SUBSTANTIAL CONTRIBUTORS TO THE FILING ORGANIZATION. 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, EQUTY CONTRIBUTIONS AND DISTRIBUTIONS, AND OTHER INTERCOMPANY TRANSFERS. REIMBURSEMENT OF EXPENSES 44900988 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 GENERAL STATEMENT 1 FORM 990, BOX C: DOING BUSINESS AS INTEGRIS LIFE HEALTH INSTITUTE 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 $1,643,384. 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 $2,647,552. IN ADDITION IHE BAD DEBT COSTS ARE BASED ON THE OVERALL HOSPITAL COST TO CHARGE RATIOS. IHE'S BAD DEBT COSTS WERE $1,877,082. FOR ADDITIONAL DETAILS REGARDING COMMUNITY BENEFIT SEE THE ATTACHED COMPLETE COMMUNITY BENEFIT REPORT ON SCHEDULE O, GENERAL 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 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 2015 TAX YEAR. GENERAL STATEMENT 5 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 WILLIAM E. SMITH, M.D. JULIE HANSEN, M.D. 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 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 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 OF REFERENCE LAB $1,662,248 OKLAHOMA, LLC 225 N.E. 97TH STREET OKLAHOMA CITY, OK 73114 INTELISTAF OF OKLAHOMA CONTRACT STAFFING $1,038,900 HEALTHCARE LLC P.O. BOX 202996 DALLAS, TX 75320-1300 ANESTHESIA MEDICAL ANESTHESIOLOGY AND $ 910,488 PROFESSIONALS PLLC CRNA SERVICES P.O. BOX 1540 EDMOND, OK 73083-1540 INPATIENT CARE PHYSICIAN PHYSICIAN CALL PAY $ 374,886 SERVICES 5900 MEGANS WAY EDMOND, OK 73034 PULMONARY PHYSICIANS OF PHYSICIAN CALL PAY $ 245,950 OKLAHOMA CITY 3366 N.W. EXPRESSWAY, SUITE 660 OKLAHOMA CITY, OK 73112 GENERAL STATEMENT 12 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 13 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, 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 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, 2016. 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 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 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