AVEDIS FOUNDATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
AVEDIS FOUNDATION (EIN 73-1347360)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-07-25
IRS object ID
201132069349300008
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-07-25T09:13:07-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16120 S Yale 1400AddressLine1
CityTulsaCity
StateOKState
ZIP Code741364223ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN731347360EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH PARTNERS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone4058788113Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11102 WEST MACARTHURAddressLine1
CitySHAWNEECity
StateOKState
ZIP Code74801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMELISSA WALKERName
TitleSR. VP FINANCE/CFOTitle
Date Signed2011-07-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameAnne M AdamsName
Phone9185842900Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1UNITY HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonMELISSA WALKERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11102 WEST MACARTHURAddressLine1
CitySHAWNEECity
StateOKState
ZIP Code74801ZIPCode
FieldValueIRS element (for citing)
Gross Receipts70575205GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.UNITYHEALTHCENTER.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicileOKStateLegalDomicile
Activity Or Mission DescriptionTO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACHActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees816TotalNbrEmployees
Total Nbr Volunteers92TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year272107ContributionsGrantsPriorYear
Contributions Grants Current Year541954ContributionsGrantsCurrentYear
Program Service Revenue Prior Year84429705ProgramServiceRevenuePriorYear
Program Service Revenue CY65267000ProgramServiceRevenueCY
Investment Income Prior Year302375InvestmentIncomePriorYear
Investment Income Current Year945968InvestmentIncomeCurrentYear
Other Revenue Prior Year138751OtherRevenuePriorYear
Other Revenue Current Year1316679OtherRevenueCurrentYear
Total Revenue Prior Year85142938TotalRevenuePriorYear
Total Revenue Current Year68071601TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10298GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY44591GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year33236338SalariesEtcPriorYear
Salaries Etc Current Year33091326SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year45174381OtherExpensePriorYear
Other Expenses Current Year29859168OtherExpensesCurrentYear
Total Expenses Prior Year78421017TotalExpensesPriorYear
Total Expenses Current Year62995085TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6721921RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5076516RevenuesLessExpensesCY
Total Assets BOY86751374TotalAssetsBOY
Total Assets EOY93966886TotalAssetsEOY
Total Liabilities BOY15858183TotalLiabilitiesBOY
Total Liabilities EOY17562772TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY70893191NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY76404114NetAssetsOrFundBalancesEOY
Mission DescriptionTO POSITIVELY IMPACT HUMAN LIFE THROUGH EXCEPTIONAL HEALTH CARE. OUR CORE VALUES ARE THE FOLLOWING: COMPASSIONATE CARE, CLINICAL EXCELLENCE, PEOPLE FIRST, RESOURCE STEWARDSHIP, AND COMMUNITY OUTREACH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense13974224Expense
Grants44591Grants
Revenue11076079Revenue
DescriptionACUTE AND INTENSIVE CAREDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense9098483Expense
Revenue17994880Revenue
DescriptionEMERGENCY CARE AND URGENT CARE CLINICDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense17378643Expense
Revenue31718083Revenue
DescriptionSURGERYDescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense6609212Expense
Revenue5613729Revenue
DescriptionWOMEN'S CENTERDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp6609212TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev5613729TotalOfOtherProgramServiceRev
Total Program Service Expense47060562TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096120NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees816NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledOKStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLINDA BROWN SECRETARYNamePerson
Telephone Number4058788110TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11102 WEST MACARTHURAddressLine1
CitySHAWNEECity
StateOKState
ZIP Code74801ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
CHARLES SKILLINGS
CEO, PRESIDENT40.0XX310385013200
MICHELLE BRIGGS
BOARD CHAIR1.0XX1408400
J MICHAEL ADCOCK
DIRECTOR1.0X995000
DARRELL COKER
DIRECTOR1.0X950000
MARK FINLEY
DIRECTOR1.0X2143400
SUDHIR GUPTA MD
DIRECTOR1.0X8821300
CHRIS HOWARD
DIRECTOR1.0X845000
KELLI KOONS MD
DIRECTOR1.0X1070000
KATHLEEN LASTER PHD
DIRECTOR1.0X995000
LINDA PRAYTOR
DIRECTOR1.0X885000
JOHN ROBINSON MD
DIRECTOR1.0X1499500
CHARLES SHIELDS
DIRECTOR1.0X995000
STEPHEN TROTTER MD
DIRECTOR1.0X885000
MICHAEL WARWICK
GOVERNANCE COMMITTEE CHAIR1.0XX1554900
ABBOT LAWRENCE STASYSZEN
DIRECTOR1.0X000
THOMAS KELLER
COO, EXEC VICE-PRESIDENT40.0X21575509755
LINDA E BROWN
SR. VICE-PRESIDENT/SECRETARY40.0X14140006745
VICKY FINE
SR. VICE-PRESIDENT/TREASURER40.0X19863506593
MELISSA WALKER
SR. VICE PRESIDENT/TREASURER40.0X96820163
DAVID HADLEY MD
HOSPITALIST40.0251305011780X
GAYNELL ANDERSON MD
HOSPITALIST40.0250139011733X
LARA MASHEK MD
HOSPITALIST40.024552708396X
CRAIG SUMMERS MD
PHYSICIAN40.01330880257108X
TARIZ NIAZI MD
PHYSICIAN40.0460887017831X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2447278TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation343304TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CLINICAL PARTNERS PA
PO BOX 4502LONGVIEWTX75606CRNAs1683560
WESTCHESTER DEVELOPMENT CO
1901 NORHT KICKAPOOSHAWNEEOK74801CONSTRUCTION1660346
JJ WILD INC OF NEW ENGLAND
POBOX 31498HARTFORDCT061051498COMPUTER MAINTENANCE696650
SODEXO INC AFFILIATES
PO BOX 360170PITTSBURGHPA152620001DIETARY1169639
SMITH PICKEL CONSTRUCTION
POST OFFICE BOX 21447OKLAHOMA CITYOK73156CONSTRUCTION425369
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Related Organizations163300RelatedOrganizations
Government Grants203654GovernmentGrants
All Other Contributions175000AllOtherContributions
Total Contributions541954TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Service Revenue6213006508609265086092
RENT REVENUE FROM SPECIALTY CLINIC531120180908180908
FieldValueIRS element (for citing)
Total Program Service Revenue65267000TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column870309TotalRevenueColumn
Exclusion$870,309ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2448901Securities
Other130362Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2277884Securities
Other225720Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities171017Securities
Other-95358Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column75659TotalRevenueColumn
Exclusion$75,659ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER REVENUE900099559306559306
Gift Shop Revenue900099204151204151
Joint Venture Income900099267852267852

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column285370TotalRevenueColumn
Related Or Exempt Function Income285370RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1316679TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column68071601TotalRevenueColumn
Related Or Exempt Function Income66583679RelatedOrExemptFunctionIncome
Exclusion$945,968ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total44591Total
Program Services44591ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total932684Total
Program Services655386ProgramServices
Management And General277298ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total25033959Total
Program Services17591060ProgramServices
Management And General7442899ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total668849Total
Program Services469992ProgramServices
Management And General198857ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4594288Total
Program Services3228351ProgramServices
Management And General1365937ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1861546Total
Program Services1308086ProgramServices
Management And General553460ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total82096Total
Management And General82096ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total160592Total
Management And General160592ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total118504Total
Management And General118504ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7679294Total
Program Services5396147ProgramServices
Management And General2283147ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total209097Total
Management And General209097ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total335519Total
Program Services235765ProgramServices
Management And General99754ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total181411Total
Program Services127475ProgramServices
Management And General53936ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total814502Total
Program Services572341ProgramServices
Management And General242161ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total33962Total
Program Services23865ProgramServices
Management And General10097ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total250970Total
Program Services250970ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total548034Total
Management And General548034ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4839166Total
Program Services3400423ProgramServices
Management And General1438743ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total769593Total
Program Services540784ProgramServices
Management And General228809ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies1102063611020636
Dietary Expense664613664613
Recruitment and Retention484988340795144193
Other Expenses692971486942206029
MINOR EQUIPMENT & TOOLS19466014048054180

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total778560Total
Program Services561860ProgramServices
Management And General216700ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total62995085Total
Program Services47060562ProgramServices
Management And General15934523ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY4321737EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4814928BOY
EOY7435340EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11238755BOY
EOY8044685EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY43750BOY
EOY28750EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1793591BOY
EOY1562405EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY541499BOY
EOY759895EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis77751331LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec38732979LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35146052BOY
EOY39018352EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY30336812BOY
EOY24907554EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1436286BOY
EOY6185040EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY513902BOY
EOY1603110EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY885799BOY
EOY100018EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY86751374BOY
EOY93966886EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6199327BOY
EOY5428012EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6684062BOY
EOY5682916EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2974794BOY
EOY6408591EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
EOY43253EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY15858183BOY
EOY17562772EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY70893191BOY
EOY76404114EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70893191BOY
EOY76404114EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86751374BOY
EOY93966886EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$7,493GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB7493TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis538372OtherCostOrOtherBasis
Book Value538372BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis32781921OtherCostOrOtherBasis
Depreciation8910431Depreciation
Book Value23871490BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis324156OtherCostOrOtherBasis
Depreciation49462Depreciation
Book Value274694BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis40189761OtherCostOrOtherBasis
Depreciation29376216Depreciation
Book Value10813545BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3917121OtherCostOrOtherBasis
Depreciation396870Depreciation
Book Value3520251BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings39018352TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionCorporate BondsDescription
Book Value6185040BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities6185040TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to third-party payersDescription
Amount$43,253Amount
FieldValueIRS element (for citing)
Total Of Amounts43253TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
Identifier1Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationManagement has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense738997TotalCommunityBenefitExpense
Direct Offsetting Revenue114825DirectOffsettingRevenue
Net Community Benefit Expense624172NetCommunityBenefitExpense
Percent Of Total Expense0.00990PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10764746TotalCommunityBenefitExpense
Direct Offsetting Revenue9807806DirectOffsettingRevenue
Net Community Benefit Expense956940NetCommunityBenefitExpense
Percent Of Total Expense0.01520PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense11503743TotalCommunityBenefitExpense
Direct Offsetting Revenue9922631DirectOffsettingRevenue
Net Community Benefit Expense1581112NetCommunityBenefitExpense
Percent Of Total Expense0.02510PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served1383PersonsServed
Total Community Benefit Expense97439TotalCommunityBenefitExpense
Net Community Benefit Expense97439NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs15NumberOfActivitiesOrPrograms
Persons Served330PersonsServed
Total Community Benefit Expense114878TotalCommunityBenefitExpense
Net Community Benefit Expense114878NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Total Community Benefit Expense196053TotalCommunityBenefitExpense
Net Community Benefit Expense196053NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs42NumberOfActivitiesOrPrograms
Persons Served1713PersonsServed
Total Community Benefit Expense408370TotalCommunityBenefitExpense
Net Community Benefit Expense408370NetCommunityBenefitExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs42NumberOfActivitiesOrPrograms
Persons Served1713PersonsServed
Total Community Benefit Expense11912113TotalCommunityBenefitExpense
Direct Offsetting Revenue9922631DirectOffsettingRevenue
Net Community Benefit Expense1989482NetCommunityBenefitExpense
Percent Of Total Expense0.03150PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense3280TotalCommunityBuildingExpense
Net Community Building Expense3280NetCommunityBuildingExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Total Community Building Expense7167TotalCommunityBuildingExpense
Net Community Building Expense7167NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense950TotalCommunityBuildingExpense
Net Community Building Expense950NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served974PersonsServed
Total Community Building Expense6518TotalCommunityBuildingExpense
Net Community Building Expense6518NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense1260TotalCommunityBuildingExpense
Net Community Building Expense1260NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served974PersonsServed
Total Community Building Expense19175TotalCommunityBuildingExpense
Net Community Building Expense19175NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$7,660,354BadDebtExpenseAmount
Amount Attributable To1149053AmountAttributableTo
Amount Reimbursed By Medicare21809407AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17288435CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall4520972MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicyfalseWrittenDebtCollectionPolicy

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
SHAWNEE SURGICAL
OWNS BUILDING THAT HOUSES OP
REALTY LLC
SURGERY DEPARTMENT0.250000.060000.19000

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH PARTNERS INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11102 W MACARTHURAddressLine1
CitySHAWNEECity
StateOKState
ZIP Code74801ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaThe organization uses the federal poverty guidelines in determining those eligible for charity care. The income as a percentage of the federal poverty level and charity percentage allowed is on a sliding scale. 100 & Below poverty level = 100% discount 101 - 200% of poverty level = 75% discount 201 - 300% of poverty level = 50% discountIncomeBasedCriteria
Bad Debt FootnoteUnity Health Care has applied the cost to charge ratio to bad debt expense for the current tax year.BadDebtFootnote
Needs AssessmentCommunity Partners utilizes internal patient data to better understand what types of health issues and societal trends are present in our community. The emergency department provides a great deal of information diseases, accidents and other health related challenges faced by our population. We also participate in our local community to represent the hospital and to gain an understanding of the opportunites for community building activities. Many of our professional and clinincal staff are active in their relevant professional organizations and in this way the hospital can determine what educational programs or services it will sponsor. It is our intent to perform a formal community needs assessment in the upcoming fiscal year.NeedsAssessment
Patient Education AssistanceCommunity Health Partners uses an outside company to review all patients seen in the hospital that do not have insurance or other coverage for their care. Accounts are reviewed and potential eligibility is determined by this company who then works with the patient to complete any necessary paperwork. If it appears there are no other programs available to the patient, the outside company educates the patient about the charity policy of the hospital and provides the necessary application.PatientEducationAssistance
Community InformationCommunity Health Partners serves a population of which 19% is over age 65 according to 2008 census information., Additionally we are a disproportionate share hospital so many of our constituents are lower income individuals. A significant portion of our service area is rural and it's population is dispersed geographically.CommunityInformation
Community Building ActivitiesCommunity Health Partners' staff participate in many community building activites such as Shawnee Economic Development Foundation, The Police Foundation, Chamber of Commerce and United Way. By staying involved in the community we understand what programs the hospital could offer or support to improve the health status of our community. One recent need that was identified in our community was the a place to house and care for the homeless in Shawnee. The hospital secured a building for the Shawnee Rescue Mission and maintain a critical support role in this endeavor.CommunityBuildingActivities
Other InformationCommunity Health Partners' board of directors include members from Shawnee and its surrounding communities as well as members of the hospital's medical staff. Any surplus funds are directed back to the hospital to purchase equipment, update the facilities or provide for operational support. Community Health Partners sponsor and support a variety of health programs in the community. Programs that the hospital offers include: Educational Programs: Better Breathers Club Childbirth classes Diabetes education Prostate screening Skin cancer screening Breast Cancer Educational programs Heart disease educational programs For Professionals: CPR training Community Outreach: Canadian Valley health information booth Shawnee Milling Wellness Shawnee Home & Garden event providing information on back safety and sun safety Physical Therapy education to area businesses and schools Cancer information to civic organization United Way of Pottawatomie County Salvation Army Volunteer Free ClinicOtherInformation
Affiliated Health Care SystemN/AAffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
Identifier1Identifier
Return ReferenceSchedule I, Part 1, Line 2ReturnReference
ExplanationThe organization granted money during the fiscal year to various tax-exempt organizations. The organization maintains records which shows the amount of money given to the various organizations, along with the purpose of why the money was granted. The organization makes a determination of which organizations will receive grant money during the year and donates the funds accordingly.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHARLES SKILLINGS
264345012500033540011376018240323585000
THOMAS KELLER
1927670002298807674020810225510000
VICKY FINE
1628220003581305169014240205228000
DAVID HADLEY MD
2513050000010119016610263085000
GAYNELL ANDERSON MD
2501390000010072016610261872000
LARA MASHEK MD
245527000006992014040253923000
CRAIG SUMMERS MD
13308800000255027020810390196000
TARIZ NIAZI MD
4608870000015750020810478718000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE OKLAHOMA DEVELOPMENT FINANCE AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN731083741IssuerEIN
CUSIP Number678910CN8CUSIPNumber
Date Issued2004-02-01DateIssued
Issue Price10475000IssuePrice
Description Of PurposeREFUND SERIES 1993 BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds10475000TotalProceeds
Amount In Reserve Fund1047500AmountInReserveFund
Amount Defeased11022203AmountDefeased
Issuance Costs From Proceeds75500IssuanceCostsFromProceeds
Year Of Subst Completion2004YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonTariq Niazi MDNamePerson
Purpose Of LoanCompensation PackagePurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$75,000OriginalPrincipalAmount
Balance Due28750BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due28750TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
1FORM 990, PART VI, LINE 11THE FORM 990 IS PREPARED AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. THE 990 IS THEN POSTED TO THE BOARD PAGE BEFORE THE MEETING AND ALSO REVIEWED IN THE BOARD MEETING BEFORE FILING WITH THE IRS.
2FORM 990, PART VI, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE COMPLETED AND REVIEWED BY THE BOARD ON AN ANNUAL BASIS. OFFICERS, DIRECTORS OR TRUSTEES AND KEY EMPLOYEES COMPLETE THE FORMS.
3FORM 990, PART VI, LINE 15COMPARABILITY DATA FROM INDEPENDENT SOURCES IS USED TO DETERMINE THE CEO'S COMPENSATION. EXECUTIVE COMPENSATION SURVEYS AND THE COMPENSATION SURVEY DONE BY OHA IS USED FOR SETTING COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARABILITY AND OTHER DATA AND APPROVES COMPENSATION ADJUSTMENTS.
4FORM 990, PART VI, LINE 19DOCUMENTS HAVE NOT HISTORICALLY BEEN MADE AVAILABLE TO THE PUBLIC.
5FORM 990, PART VI, LINE 2STEPHEN TROTTER AND JOHN ROBINSON HAVE A BUSINESS RELATIONSHIP.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1UNITY HEALTH FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11102 W MACARTHURAddressLine1
CitySHAWNEECity
StateOKState
ZIP Code74804ZIPCode
FieldValueIRS element (for citing)
EIN731421425EIN
Primary ActivitiesSUPPORT ORGPrimaryActivities
Legal Domicile StateOKLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Shawnee Surgical Realty LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12801 North SaratogaAddressLine1
CityShawneeCity
StateOKState
ZIP Code74804ZIPCode
FieldValueIRS element (for citing)
EIN432075456EIN
Primary ActivityRent Real EstatePrimaryActivity
Legal Domicile StateOKLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRental IncomePredominantIncomeType
Share Of Total Income78002ShareOfTotalIncome
Share Of EOY Assets904277ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner
FieldValueIRS element (for citing)
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg

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