TY 2015 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
ASSOCIATED ANESTHESIOLOGISTS I, 6839 S CANTON TULSA,OK74136	HEALTHCARE SERVICES	1,346,971
Miller Architect Inc, 13401 N Western Ave Ste 302 OKLAHOMA CITY,OK73114	Architect Fees	475,760
Metro Landscaping Services Inc, PO Box 1767 BROKEN ARROW,OK74013	Landscaping	315,120
Daniel Yeager LLC, PO Box 635715 CINCINNATI,OH45263	Healthcare Services	243,477
Piccpros LLC, 7827 S Gary Pl TULSA,OK74136	Healthcare Services	182,150
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 9

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	8,089,874		8,089,874
b	Buildings	79,073,072	30,570,560	48,502,512
c	Leasehold improvements	4,113,903	1,219,899	2,894,004
d	Equipment ...	31,293,959	23,287,405	8,006,554
e	Other ...	2,059,223		2,059,223
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				69,552,167

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO MEDICARE	718,666
LONG TERM DEBT	7,352,500
FIN 45 INCOME GUARANTEE	94,102
PROFESSIONAL LIABILITY RESERVE	4,364,235
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	12,529,503
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2	ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, PROVIDES GUIDANCE REGARDING RECOGNITION, DE-RECOGNITION, MEASUREMENT, AND DISCLOSURE OF ALL TAX POSITIONS. IN ACCORDANCE WITH THE REQUIREMENTS OF ASC 740, SAINT FRANCIS HOSPITAL SOUTH, LLC IDENTIFIES AND DOCUMENTS UNCERTAIN TAX POSITIONS FOR ALL OPEN TAX YEARS. IF UNCERTAIN TAX POSITIONS ARE IDENTIFIED, THEY ARE ANALYZED TO DETERMINE THE PROPER UNIT OF ACCOUNT. NEXT, THEY ARE TESTED TO DETERMINE WHETHER A TAX ASSET OR A TAX LIABILITY SHOULD BE RECOGNIZED. SAINT FRANCIS HOSPITAL SOUTH, LLC HAS ASSESSED ITS UNCERTAIN TAX POSITIONS AND DETERMINED THEY ARE MORE LIKELY THAN NOT TO BE FULLY SUSTAINED UPON EXAMINATION. THEREFORE, NO LIABILITY OR ASSET FOR UNCERTAIN TAX POSITIONS NEEDS TO BE RECORDED.

Return Reference

Explanation

PART X, LINE 2

ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, PROVIDES GUIDANCE REGARDING RECOGNITION, DE-RECOGNITION, MEASUREMENT, AND DISCLOSURE OF ALL TAX POSITIONS. IN ACCORDANCE WITH THE REQUIREMENTS OF ASC 740, SAINT FRANCIS HOSPITAL SOUTH, LLC IDENTIFIES AND DOCUMENTS UNCERTAIN TAX POSITIONS FOR ALL OPEN TAX YEARS. IF UNCERTAIN TAX POSITIONS ARE IDENTIFIED, THEY ARE ANALYZED TO DETERMINE THE PROPER UNIT OF ACCOUNT. NEXT, THEY ARE TESTED TO DETERMINE WHETHER A TAX ASSET OR A TAX LIABILITY SHOULD BE RECOGNIZED. SAINT FRANCIS HOSPITAL SOUTH, LLC HAS ASSESSED ITS UNCERTAIN TAX POSITIONS AND DETERMINED THEY ARE MORE LIKELY THAN NOT TO BE FULLY SUSTAINED UPON EXAMINATION. THEREFORE, NO LIABILITY OR ASSET FOR UNCERTAIN TAX POSITIONS NEEDS TO BE RECORDED.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 225 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	2,835,664		2,835,664	4.000 %
b	Medicaid (from Worksheet 3, column a) . . . . .	8,009,419	7,294,139	715,280	1.010 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	10,845,083	7,294,139	3,550,944	5.010 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	4,643,429	3,614,071	1,029,358	1.460 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	4,643,429	3,614,071	1,029,358	1.460 %
k	Total. Add lines 7d and 7j .	15,488,512	10,908,210	4,580,302	6.470 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	44,939	44,939	0.060 %
2	Economic development
3	Community support	15,957	15,957	0.020 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	60,896	60,896	0.080 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

11,800,688

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

9,977,482

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

22,484,085

Enter Medicare allowable costs of care relating to payments on line 5.....

31,477,089

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-8,993,004

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SAINT FRANCIS HOSPITAL SOUTH LLC 10501 E 91ST STREET TULSA,OK74133 HTTP://WWW.SAINTFRANCIS.COM/SOUTH 2362	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SAINT FRANCIS HOSPITAL SOUTH LLC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H, PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SAINT FRANCIS HOSPITAL SOUTH LLC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 225.% and FPG family income limit for eligibility for discounted care of 0.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H, PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H, PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SCHEDULE H, PART V SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	SAINT FRANCIS HOSPITAL SOUTH LLC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B, Line 5	The Community Health Needs Assessment (CHNA) report, as contracted by the Tulsa County Health Department, uses quantitative data derived from primary research and secondary data (American Community Survey data, Census Bureau data). The survey instrument used for this study was created by the Tulsa City-County Health Department, Health Data and Evaluation Division, with input from community partners. Community input focus group sessions were conducted in each of the eight Tulsa Health Department defined regions.
Part V, Section B, Line 6A	Saint Francis Hospital South, LLC conducted the CHNA with Saint Francis Hospital, Inc. and Laureate Psychiatric Clinic and Hospital, Inc.
Part V, Section B, Line 6b	Saint Francis Hospital South, LLCs CHNA was conducted by the Tulsa County Health Department.
Part V, Section B, Line 7a	www.saintfrancis.com/Documents/CHNA.pdf
Part V, Section B, Line 10a	www.saintfrancis.com/Documents/CHNA.pdf
Part V, Section B, Line 11	The Community Health Needs Assessment (CHNA) identified the top ten needs (in order of highest priority) of the Tulsa community as poor diet/inactivity; chronic diseases; alcohol/drug abuse; access to health care; tobacco use; lack of education; aging problems; safety/crime; poverty/unemployment; and mental health. The Saint Francis health system (Saint Francis) does not intend to address the health needs of lack of education; aging problems; safety/crime; and poverty/unemployment due to lack of expertise in these areas. It is an unfortunate matter of course that certain socioeconomic burdens to the health of our community cannot be fully or effectively addressed by individual private institutions. The hospitals comprising the Saint Francis Health System provide millions of dollars each year in uncompensated care to the poor in the form of free or discounted care to the uninsured, the underinsured, and to Medicaid beneficiaries. Saint Francis Hospital South, LLC as well as Saint Francis Hospital, Inc. and Laureate Psychiatric Clinic and Hospital, Inc. and the senior leadership and Board of Directors of the Saint Francis Health System will continue to work with community and state-level policy and political leaders, safety net providers, and community advocates to build sustainable partnerships to better address these broader community needs. Saint Francis Health System and all of its entities, including those not covered by the CHNA implementation strategy, will continue to be an advocate for the poor, the vulnerable and the underserved. Saint Francis Hospital South, LLC and the other Saint Francis health system entities are addressing the community needs of access to healthcare; alcohol/drug abuse; chronic diseases; poor diet/inactivity; tobacco use; and mental health through various programs designed to improve access to healthcare, advance knowledge, identify root causes, and improve health status and quality of life. Access to healthcare Access to comprehensive, quality health services is necessary for health equity and a healthy quality of life for individuals in our community. Access to healthcare can impact physical, social and mental health, disease and disability prevention, and life expectancy, among other things. Not having healthcare coverage obstructs the ability to access medical care; reduces utilization of preventive services; and contributes greatly to the costs of healthcare. Uninsured people are also less likely to receive medical care, more likely to die early, and more likely to have poor health status as they tend to delay treatment; experience diagnoses at later stages of disease progression; and may receive less medical care than patients with health insurance. Current policy efforts focus on the provision of insurance coverage as the principal means of ensuring access to healthcare among the general population. Almost two-thirds of Tulsa County adults surveyed ages 18 64 reported they had employer provided or private insurance (63.1 percent). An additional 14.3 percent reported insurance through a government sponsored program (Medicaid, Medicare, military benefits, or tribal/Indian health benefits). This age group was defined in order to exclude the Medicare population age 65 and older. However, 13.4 percent of Tulsa County adults ages 18-64 reported having no health coverage. This was lower than both Oklahoma (17.2 percent) and the US (20.0 percent). None of these regions met the Healthy People 2020 goal of universal coverage (no one without insurance). Saint Francis and Saint Francis Hospital South, LLC in its mission to extend the presence and healing ministry of Christ in all we do, addresses these community health needs by providing charity care to those families meeting the 225% Federal Poverty Guidelines criteria. Additionally, the Xavier Medical Clinic, an entity fully owned and operated by Saint Francis Health System, offers the resources of volunteer physicians, pharmacists, nurses and other health professionals to women, children and men who are uninsured or underserved. Xavier Medical Clinic seeks to provide free, limited outpatient primary healthcare services, facilitate referrals to volunteer specialists, educate in good health practices and increase access to traditional healthcare. In addition, to help local women in need of prenatal care, the Xavier Medical Clinic also provides a pregnancy clinic with referrals for patients to local physicians for prenatal care. Patients at the Xavier Clinic are referred to Saint Francis Hospital for inpatient care including childbirth, as well as surgery and ancillary services. Saint Francis also holds several health fairs over the course of a year to disseminate health information and/or to provide health screenings to the community at large. Saint Francis Hospital South, LLC, Saint Francis Hospital, Inc., and Laureate Psychiatric Clinic and Hospital, Inc., will serve as acute care hubs for the patients that utilize the health systems primary, urgent, and specialty care at outlying locations. These are a few of the many ways the Saint Francis Health system is addressing the need for improving access to healthcare. Alcohol and drug use Substance abuse has a major impact on individuals, families, and communities, and contributes to poor public health outcomes. These costly social, physical, mental, and public health problems include teenage pregnancies, HIV/AIDS and other STDs, domestic violence, child abuse, motor vehicle accidents, physical fights, crime, homicide, and suicide. Estimates of individuals who have a substance abuse disorder are high, indicating the importance of prevention efforts and improved access to treatment for substance abuse. Overall, 2.3 percent of Tulsa County adults reported that they had been told by a healthcare or support service provider that they had an alcohol dependency, and a total of 2.3 percent of Tulsa County adults reported they had been told by a healthcare or support service provider that they had a drug dependency. These self-reported rates appear to be lower than most literature would suggest, lending support to the theory that mental health needs in general are a major area of need for both the service area and the nation as a whole. Saint Francis Hospital South, LLC is not addressing this issue; however, Laureate Psychiatric Clinic and Hospital, Inc., an entity of the Saint Francis Integrated health system, offers substance abuse counseling for adults on an inpatient basis, and adults and children on outpatient basis to address alcohol and drug abuse. Other entities in the community addressing this issue include Parkside Psychiatric Hospital, Brookhaven Hospital, Indian Healthcare Resource Center of Tulsa, Oxford House, St. John Health System, Hillcrest Health System, Alcoholics Anonymous, Shadow Mountain Behavioral Health System, Tulsa Center for Behavioral Health and Family and Childrens Services. Chronic disease In the US, chronic diseases are the main causes of poor health, disability, and death, and account for most of healthcare expenditures. Chronic diseases are responsible for 7 out of 10 deaths each year, and treating people with chronic diseases accounts for 86 percent of our nations healthcare costs per the Centers for Disease Control and Prevention (CDC). Around half of adults in the US have at least one chronic condition and 26 percent have two or more conditions. The chronic disease burden in the US largely results from a short list of risk factors including socioeconomic status, tobacco use, poor diet and physical inactivity (both strongly associated with obesity) that can be effectively addressed for individuals and populations. To effectively and equitably address the chronic disease burden, public health and healthcare systems need to deploy integrated approaches that bundle strategies and interventions, address many risk factors and conditions simultaneously, create population wide changes, help the population subgroups most affected, and rely on implementation by many sectors, including public private partnerships and involvement from all stakeholders. Saint Francis Health System offers a complete continuum of healthcare services. Almost 1,000 physicians on staff serve the patients of Saint Francis Health System through primary care medicine and advanced medical specialties. The physician providers of Saint Francis Hospital, Inc. and Saint Francis Hospital South, LLC will provide the service lines that cater to the needs of chronic disease patients which include: Cardiology, Oncology, Primary care, Pulmonology, Endocrinology, Mental health, Home health, Nephrology, Neurology and Radiology. Saint Francis is also increasing the number of employed physicians to manage the defined population in northeast Oklahoma. The affiliates within the Saint Francis Health system, including Saint Francis Hospital South, LLC, are addressing the community needs that contribute to the chronic diseases identifi
Part V, Section B, Line 13b	Patients who have been evaluated and identified to be financial assistance plan eligible and meet the criteria established by Saint Francis Hospital South, LLC According to relevant circumstances, such as income, assets, or other resources available to the patient or patient's family are considered charity and therefore by hospital policy are not billed for any services.
Part V, Section B, Lines 16a, b and c	https://www.saintfrancis.com/south/Pages/Patients-and-Visitors/ For-Patients/After-Your-Visit/Patient-Billing.aspx
Part V, Section B, Line 16i	The billing statement includes information regarding financial assistance availability. Additionally, MyChart, a secure online tool that allows patients to connect with their personal health information 24/7, provides a link which takes the patient to the financial assistance letter and application form.
Part V, Section B, Line 20e	Proactive phone calls and statements are sent before collection actions are taken.
Part V, Section B, Line 22d	Amounts generally billed (AGB) are determined under the prospective method using Medicaid reimbursement rates. Additionally, a self-pay discount of 20% is provided on all charges.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C	INCOME BASED CRITERIA IS USED AS THE BASIS IN DETERMINING ELIGIBILITY FOR FREE HEALTH SERVICES.
PART I, LINE 6A	Saint Francis Health System, Inc. (System) 73-1501972, the parent organization of Saint Francis Hospital South, LLC produces a consolidated community benefit report included in the Spring issue of the Saint Francis Health System Presence publication that is made available to the public through the organizations website at www.saintfrancis.com/Pages/About-Us/Media%20Gallery/Presence-Archives.aspx
PART I, LINE 7	Costing Methodology: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a 7c. For amounts reported on lines 7e 7i, actual expenses for each community benefit activity are tracked and reported using the organizations accounting general ledger and are not based on a cost to charge ratio. The number reflected on line 7, column (f) excludes bad debt expense. The supplemental hospital offset payment program (SHOPP) was created and implemented in calendar year 2011 for the purpose of assuring access to quality care for Oklahoma Medicaid members. The program is designed to assess Oklahoma hospitals, unless exempt, a supplemental hospital offset payment program fee. The collected fees are placed in pools and then allocated to hospitals based on Medicaid revenues as directed by legislation. The Oklahoma Health Care Authority (OHCA) does not guarantee the allocation will equal or exceed the amount of the supplemental hospital offset payment program fees that were paid by Saint Francis Hospital South, LLC.
PART II: Community Building Activities	Community building activities improve the communitys health and safety by addressing the root cause of health problems. These activities strengthen the communitys capacity to promote the health and well-being of its residents by offering the expertise and resources of the healthcare organization. Costs for these activities include cash donations and expenses for the development of a variety of community-building programs and partnerships. See Schedule O, General Statement 4 for additional information regarding the System and Saint Francis Hospital South, LLC community building activities aimed at promoting the health of the community.
PART III, SECTION A, LINE 2	Saint Francis Hospital South, LLC has an established process to determine the adequacy of the allowance for doubtful accounts that relies on a number of analytical tools and benchmarks to arrive at a reasonable allowance. No single statistic or measurement determines the adequacy of the allowance for doubtful accounts. Some of the analytical tools that Saint Francis Hospital South, LLC utilizes include, but are not limited to, historical cash collection experience, revenue trends by payer classification, and revenue days in accounts receivable. Accounts receivable are written off after collection efforts have been followed in accordance with Saint Francis Hospital South, LLCs policies.
PART III, SECTION A, LINE 3	The bad debt expense attributable to patients eligible under the organizations financial assistance policy is calculated from a sample review of all bad debt accounts and subsequent information.
PART III, SECTION A, LINE 4	The Saint Francis Health System, Inc. audited consolidated financial statements, which includes Saint Francis Hospital South, LLC; provide a separate footnote addressing the organizations accounts receivable and allowance for doubtful accounts on pages 7, 8 and 9. Saint Francis Hospital South, LLC reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP). HealthCare Financial Management Associate Statement 15 is followed to the extent that bad debt expense at cost is determined using the same cost to charge ratio that is used to calculate charity care and Medicaid shortfalls. Discounts and allowances are accounted for separately from bad debt expense. Accounts receivable are valued at net realizable value. Saint Francis Hospital South, LLC estimates the allowances for uncollectable accounts based on historic write-offs and the aging of the accounts.
PART III, SECTION B, LINE 8	Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio and the Medicare filed cost report. THE SHORTFALL ON SCHEDULE H, PART III, SECTION B, LINE 7 IS CONSIDERED COMMUNITY BENEFIT. Saint Francis Hospital South, LLC PROVIDES SERVICES TO MANY LOW-INCOME MEDICARE RECIPIENTS. THE MEDICARE LOSSES SUSTAINED AT THE HOSPITAL ARE A RESULT OF MEDICARE REIMBURSING AT LESS THAN OPERATING COSTS. The supplemental hospital offset payment program (SHOPP) was created and implemented in calendar year 2011 for the purpose of assuring access to quality care for Oklahoma Medicaid members. The program is designed to assess Oklahoma hospitals, unless exempt, a supplemental hospital offset payment program fee. The collected fees are placed in pools and then allocated to hospitals based on Medicaid revenues as directed by legislation. The Oklahoma Health Care Authority (OHCA) does not guarantee the allocation will equal or exceed the amount of the supplemental hospital offset payment program fees that were paid by Saint Francis Hospital South, LLC. IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR HOSPITALS, PROVIDES THAT IF A HOSPITAL SERVES PATIENTS COVERED BY GOVERNMENTAL HEALTH BENEFITS (INCLUDING MEDICARE), THEN THIS INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY IN TURN, TREATING MEDICARE PATIENTS IS CONSIDERED A COMMUNITY BENEFIT.
PART III, SECTION C, LINE 9B	Saint Francis Hospital South, LLCs debt collection policy is to pursue collections of patient balances from patients who have the ability to pay for the services. Saint Francis Hospital South, LLC applies its collections efforts consistently and fairly to all patients regardless of insurance. Saint Francis Hospital South, LLC works with those individuals who do not have the financial resources to pay outstanding balances to qualify for Saint Francis Hospital South, LLCs charity policy. Charges to patients qualifying for charity care under the Saint Francis Hospital South, LLC financial assistance policy are written-off 100 percent.
Part VI, Line 2	Needs Assessment One of Saint Francis Hospital South, LLCs fundamental operational goals is to identify and address the needs of the defined community that it serves. Justice is one of the core values of Saint Francis Hospital South, LLC and Saint Francis Health System, Inc. (System). It calls for the organization to advocate for systems and structures that are attuned to the needs of the vulnerable and disadvantaged and to promote a sense of community among all persons. To effectively do this requires that the System: 1. Gather and obtain information identifying those needs; and 2. Develop programs and services that address and provide access to those in greatest need of healthcare services. Historically, the Systems focus has been caring for those who are sick or vulnerable. In order to make informed decisions on how to care for the sick, at-risk and minority populations, the System must first identify priority health needs. During the fiscal year 2016, the System conducted a Community Health Needs Assessment (CHNA) to address the healthcare needs of the community for each of its licensed hospital facilities and developed an implementation strategy to address the needs identified in the CHNA. The assessment is a compilation of national survey results, health information databases, government data, and analytical feedback from state and local partners. This data is used to identify potential courses of action based on existing healthcare facilities, available resources with the community, and capabilities of the community in terms of both socioeconomic and education status. Providing access to comprehensive, quality health services; providing effective treatments and services in the community for substance abuse disorders and mental health disorders; promoting the prevention of disease; reducing obesity and promoting healthy eating; cessation of tobacco use; and promoting the health of low-income and at-risk communities are among the public health issues that the assessment seeks to prioritize. The CHNA and implementation strategies are available to the public on the Systems website at www.saintfrancis.com/Documents/CHNA.pdf.
Part VI, Line 3	Patient education of eligibility for Assistance The System is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. The System uses a multi-faceted approach to educate our patients on the availability of charity as well as state and federal financial assistance. This includes several ways including, but not limited to, the following: - A brochure titled "Patient Financial Policy" on financial rights and responsibility is provided to every patient at the time of their registration and is available on the System website. The brochure provides financial assistance program details. - The financial assistance policy, plain language summary, and application are posted on the Saint Francis Hospital South, LLC and System websites in English and the Limited English Proficiency languages of the Primary Service Area (PSA). - The System prints a phone number where patients can obtain information about financial assistance on the back of the billing invoices. - Self-pay patients are visited by a financial counselor upon admission to verify their self-pay status. The financial counselor works with the self-pay patients to determine if the patient may qualify for assistance under a government sponsored plan. If the patient does not qualify for a government sponsored plan then the financial counselor works with the patient to determine if they qualify for charity based on the Systems charity policy. - The System offers the charity policy, as well as payment options as part of the patient responsibility during the follow up collection calls.
Part VI, Line 4	Community Information The Primary Service Area (PSA) of the Hospital consists of Tulsa, Rogers, Wagoner, Creek, Muskogee and Mayes Counties, where a significant majority of inpatient admissions originate. The most recent 2016 US Census Bureau report identified approximately 988,000 people in the PSA. The PSA is comprised of the following representation: - 72% Caucasian - 9% Hispanic or Latino - 8% African-American - 9% Native-Americans - 2% Asian In 2014, the median household income for the 6 counties was $46,460, (about 13% below the US median) and the mean household income was $70,200 (about 7 percent below the US average). Over one-third of all households earn less than $35,000 per year. The per capita income is slightly below the national median, but higher than the average for Oklahoma. Approximately 15 percent of the PSAs population live in poverty, with the number climbing to almost 22 percent for those under 18. Nearly 13 percent of households in the county received food stamps/Supplemental Nutrition Assistance Program (SNAP) benefits within 2015. The uninsured rate in Tulsa County is approximately 15 percent. Of those in the PSA that do have insurance, 65 percent hold private insurance policies. Distressingly, when narrowing focus to the PSA civilian population age 18 to 64 that participates in the labor force, the uninsured rate rises to nearly 18 percent. During Oklahomas 2014 fiscal year, there were 1,033,114 unduplicated Medicaid enrollees; meaning over 26 percent of the states population was enrolled in the Medicaid program at some point in time. Tulsa County was home to 164,327 of those unduplicated enrollees.
Part VI, Line 5	Promotion of Community Health Saint Francis Hospital South, LLC is part of an integrated health care delivery system with the mission of extending the presence and healing ministry of Christ in all we do. The System, as a Catholic organization, seeks to reflect the presence of Christ in every personal and corporate encounter. Saint Francis Hospital South, LLC is dedicated to giving back to the community in which its employees live and work. This can be seen through Saint Francis Hospital South, LLCs promotion of community health through community events such as sponsored on-site educational seminars and classes on health issues. The System and South governing body is comprised of community representatives on the Board of Directors that provide leadership and governance for the organization. The Board of Directors has the overall responsibility for the charitable and the Mission of Saint Francis Hospital South, LLC and the other entities that are part of the Systems integrated health system. The members of the Board of Directors are selected based on their areas of expertise and experience including such areas as education, research, business and government. The members of the governing body contribute their wisdom, insights, and expertise to ensure the organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for the system. The goal of the System is to sustain and grow its technology, to attract talented healthcare professionals from across the country and to provide high quality patient care to all the residents of Northeastern Oklahoma and the neighboring states we serve.
Part VI, Line 6	Affiliated Health Care System Saint Francis Hospital South, LLC is part of the Systems integrated health system. Annually, Saint Francis Hospital South, LLC admits over 4,400 patients and provides approximately 49,000 outpatient visits, delivers 1,100 newborns, and provides approximately 27,000 emergency room visits. See Schedule O, General Statement 4 for additional information regarding the Saint Francis health system and their roles within the system.
Part VI, Line 7	State filing of community benefit report The System, which includes Saint Francis Hospital South, LLC, publishes a community benefit report in Oklahoma. A written report included in the Spring issue of the Saint Francis Health System Presence publication is distributed to households across Eastern Oklahoma and to all System locations for public display and pick up to help educate the community on the benefits that Saint Francis Hospital South, LLC and the System provide to the communities we serve in return for our not-for- profit status.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Jake Henry JrPresident/CEO/Director	(i) (ii)	0 ------------- 973,985	0 ------------- 1,100,291	0 ------------- 56,924	0 ------------- 65,274	0 ------------- 12,112	0 ------------- 2,208,586	0 ------------- 0
2Barry L SteichenVice President/COO/Director	(i) (ii)	0 ------------- 636,785	0 ------------- 286,465	0 ------------- 12,277	0 ------------- 148,153	0 ------------- 15,020	0 ------------- 1,098,700	0 ------------- 0
3Jeffrey C SacraAssistant Secretary	(i) (ii)	0 ------------- 214,496	0 ------------- 79,462	0 ------------- 4,135	0 ------------- 53,725	0 ------------- 3,914	0 ------------- 355,732	0 ------------- 0
4Eric E SchickTreasurer/CFO	(i) (ii)	0 ------------- 417,144	0 ------------- 175,413	0 ------------- 4,124	0 ------------- 186,254	0 ------------- 15,020	0 ------------- 797,955	0 ------------- 0
5David WeilAdministrator	(i) (ii)	289,543 ------------- 0	89,140 ------------- 0	8,708 ------------- 0	73,782 ------------- 0	1,956 ------------- 0	463,129 ------------- 0	0 ------------- 0
6Julun Hong MDPhysician	(i) (ii)	21,450 ------------- 490,027	0 ------------- 25,725	0 ------------- 18,000	0 ------------- 33,250	0 ------------- 20,228	21,450 ------------- 587,230	0 ------------- 0
7Steven Feher MDPhysician	(i) (ii)	34,000 ------------- 414,204	0 ------------- 2,226	0 ------------- 0	0 ------------- 31,222	0 ------------- 18,670	34,000 ------------- 466,322	0 ------------- 0
8Raymond Sanders MDPhysician	(i) (ii)	4,170 ------------- 604,589	0 ------------- 4,826	0 ------------- 18,289	0 ------------- 33,250	0 ------------- 20,228	4,170 ------------- 681,182	0 ------------- 0
9Thomas G NeffSecretary	(i) (ii)	0 ------------- 308,756	0 ------------- 147,609	0 ------------- 16,621	0 ------------- 79,345	0 ------------- 14,811	0 ------------- 567,142	0 ------------- 0
10Robert Eli Smithformer Assistant Secretary	(i) (ii)	0 ------------- 190,163	0 ------------- 0	0 ------------- 3,098	0 ------------- 25,805	0 ------------- 1,359	0 ------------- 220,425	0 ------------- 0
11John King Jr MDPHYSICIAN	(i) (ii)	25,000 ------------- 450,763	0 ------------- 2,226	0 ------------- 0	0 ------------- 33,250	0 ------------- 17,978	25,000 ------------- 504,217	0 ------------- 0
12Conchita Woodruff MDPHYSICIAN	(i) (ii)	23,600 ------------- 434,368	0 ------------- 2,226	0 ------------- 372	0 ------------- 31,365	0 ------------- 19,201	23,600 ------------- 487,532	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

PART I, LINE 1A

CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II PARTICIPATED IN KEY BUSINESS ACTIVITIES ACCOMPANIED BY THEIR SPOUSE. ADDITIONALLY, THESE SAME INDIVIDUALS MAY HAVE INCURRED PERSONAL EXPENSES RELATED TO THESE KEY BUSINESS ACTIVITIES. WITH PROPER DOCUMENTATION AND APPROVAL, SAINT FRANCIS HEALTH SYSTEM, INC., INCLUDES THESE REIMBURSEMENTS AS W-2 WAGES FOR THE EMPLOYEE. THESE WAGES ARE GROSSED UP TO PROVIDE TAX INDEMNIFICATION TO THE EMPLOYEE.

PART I, LINE 4B

A SELECT GROUP OF HIGHLY COMPENSATED EMPLOYEES OF SAINT FRANCIS HEALTH SYSTEM, INC., AND ITS RELATED ENTITIES, SAINT FRANCIS HOSPITAL, INC., LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL, INC., WARREN CLINIC, INC., SAINT FRANCIS HOSPITAL SOUTH, LLC, SAINT FRANCIS HOME HEALTH, INC., THE CHILDREN'S HOSPITAL FOUNDATION AT SAINT FRANCIS, AND WARREN CANCER RESEARCH FOUNDATION ARE ELIGIBLE TO PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN UNDER SECTION 457(B) AND 457(F) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED UNDER THE ECONOMIC GROWTH AND TAX RELIEF RECONCILIATION ACT OF 2001. NONE OF THE INDIVIDUALS LISTED ON SCHEDULE J ARE COMPENSATED AS BOARD MEMBERS OF THE REPORTING ENTITY OR THE RELATED ORGANIZATION. THE REPORTED COMPENSATION OF THE BOARD MEMBERS IS FOR SERVICES AS EMPLOYEES OF A RELATED ORGANIZATION.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Return Reference	Explanation
FORM 990, PART III, LINE 4A	SAINT FRANCIS HOSPITAL SOUTH, LLC IS A MEMBER OF SAINT FRANCIS HEALTH SYSTEM, INC. (SYSTEM). THE SYSTEM IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM WHOSE MISSION IS TO EXTEND THE PRESENCE AND HEALING MINISTRY OF CHRIST IN ALL WE DO. Saint Francis Hospital South, LLC'S ACCOMPLISHMENTS INCLUDE OPERATING AN ACUTE CARE HOSPITAL WHERE ADMITTING PHYSICIANS, WHO ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA, PROVIDE INPATIENT/OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF BROKEN ARROW AND TULSA, OKLAHOMA AND SURROUNDING AREAS. IN FISCAL YEAR 2016, Saint Francis Hospital South, LLC PROVIDED APPROXIMATELY $2,836,000 OF CHARITY CARE (MEASURED AT ESTABLISHED RATES) AND $8,009,000 IN UNREIMBURSED MEDICAID SERVICES (MEASURED AT ESTABLISHED RATES). RECOGNITION: IN THE FOLLOWING, YOU WILL SEE MANY WAYS THE SYSTEM AND Saint Francis Hospital South, LLC DISTINGUISH THEMSELVES THROUGH RECOGNITION BY NATIONAL ASSOCIATIONS AND PUBLICATIONS. Saint Francis Hospital South, LLC IS COMMITTED TO CONTINUAL IMPROVEMENT IN BOTH PATIENT SERVICE AND CLINICAL QUALITY IN ORDER TO BETTER SERVE OUR COMMUNITY. QUALITY COMMENDATIONS RECEIVED IN THE FISCAL YEAR INCLUDE: Saint Francis Hospital South, LLC WAS RECOGNIZED AS AN AWARD WINNER BY NATIONAL HEALTHCARE RESEARCH FIRM PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC) BASED ON PERFORMANCE IN 2015. THESE COMPETITIVE NATIONAL AWARDS RECOGNIZE ORGANIZATIONS WHO ACHIEVE EXCELLENCE THROUGHOUT THE YEAR BY IMPROVING PATIENT EXPERIENCES BASED ON SURVEYS OF THEIR PATIENTS. Saint Francis Hospital South, LLC RECEIVED 5 STAR AWARDS FOR THE FOLLOWING PATIENT SERVICES (SCORES IN THE TOP 10% OF THE COUNTRY BASED ON PRC'S COMPARATIVE DATABASE): OUTPATIENT SERVICES: OUTPATIENT SURGERY SERVICES. Saint Francis Hospital South, LLC ALSO EARNED A 4 STAR RECOGNITION FOR PATIENT SATISFACTION FROM PRC (SCORES IN THE TOP 25% OF THE COUNTRY BASED ON PRC'S COMPARATIVE DATABASE) FOR INPATIENT SERVICES. HEALTHGRADES, A WEBSITE DEVOTED TO PROVIDING INDEPENDENT RATINGS AND ASSESSMENTS OF HEALTHCARE PROVIDERS, RECOGNIZED Saint Francis Hospital South, LLC WITH 5 STAR RATINGS ON ITS WEBSITE FOR THE CONDITIONS AND PROCEDURES: SEPSIS - INPATIENT AND 30 DAY MORTALITY. ADDITIONALLY, HEALTHGRADES RECOGNIZED Saint Francis Hospital South, LLC FOR ITS PATIENT SAFETY EXCELLENCE AWARD. PREMIER, INC. RECOGNIZED Saint Francis Hospital South, LLC WITH ITS 2016 QUEST CITATION OF MERIT AWARD. PUBLICLY REPORTED QUALITY DATA INDICATES HIGH PERFORMANCE IN THE FOLLOWING MEASURES: - IMMUNIZING PATIENTS AGAINST THE FLU - TOP 5 PERCENT IN THE NATION - KEEPING PATIENTS SAFE FROM COMPLICATIONS - TOP 5 PERCENT IN THE NATION - HEART ATTACK SURVIVAL RATE - TOP 5 PERCENT IN THE NATION - PATIENTS OVERALL RATING OF THE HOSPITAL - TOP 25 PERCENT IN THE NATION - PATIENTS RATING OF DISCHARGE COMMUNICATION - TOP 25 PERCENT IN THE NATION
FORM 990, PART V, LINE 2B	SAINT FRANCIS PAYROLL SERVICES, LLC, EIN 45-0470422, HAS BEEN AUTHORIZED TO ACT AS A COMMON PAY AGENT UNDER SECTION 3504 OF THE INTERNAL REVENUE CODE FOR Saint Francis Hospital South, LLC EFFECTIVE JULY 1, 2002, IN ACCORDANCE WITH REVENUE PROCEDURE 70-6, 1970-1 C.B. 420. SAINT FRANCIS PAYROLL SERVICES, LLC ASSUMED REPORTING OBLIGATIONS FOR FEDERAL INCOME TAX, SOCIAL SECURITY, MEDICARE WITHHOLDING TAX PURPOSES AS WELL AS ADVANCE PAYMENT OF EARNED INCOME CREDIT FOR Saint Francis Hospital South, LLC AND YEAR-END REPORTING EFFECTIVE JULY 1, 2002.
FORM 990, PART VI, SECTION A, LINE 2	DESCRIPTION OF RELATIONSHIPS MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SERVING ON RELATED SYSTEM ENTITY BOARDS AND OTHER CORPORATION BOARDS. THE ORGANIZATION HAS DETERMINED THESE ASSOCIATIONS DO NOT PRESENT A CONFLICT OF INTEREST. JAKE HENRY JR., AN OFFICER AND DIRECTOR, SERVES ON OTHER BOARDS OUTSIDE OF THE SYSTEM WITH WILLIAM K. WARREN JR., A TRUSTEE, AND W.R. LISSAU, A DIRECTOR.
FORM 990, PART VI, SECTION A, LINE 3	THE DIRECTOR FUNCTIONS ARE DELEGATED TO THE SYSTEM BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 6	SAINT FRANCIS HEALTH SYSTEM, INC., IS THE SOLE MEMBER OF Saint Francis Hospital South, LLC.
FORM 990, PART VI, SECTION A, LINE 7A	SAINT FRANCIS HEALTH SYSTEM, INC., THE SOLE MEMBER OF Saint Francis Hospital South, LLC, ELECTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B	THE BOARD OF DIRECTORS AND A MAJORITY OF THE TRUSTEES APPROVE THE SALE OF CORPORATE ASSETS VALUED AT $10,000,000 OR MORE. THE MEMBERS HAVE SOLE AUTHORITY TO: - AMEND THE CERTIFICATE OF INCORPORATION - APPROVE MERGERS OR CONSOLIDATIONS - APPROVE THE SALE, LEASE OR TRANSFER OF ALL, OR SUBSTANTIALLY ALL, OF THE ASSETS OF THE CORPORATION - THE DISSOLUTION OF CORPORATION - AMENDMENT OF BYLAWS
FORM 990, PART VI, SECTION B, LINE 11B	THE FINANCE COMMITTEE, A SUB-COMMITTEE OF THE SAINT FRANCIS HEALTH SYSTEM INC., FOR WHICH Saint Francis Hospital South, LLC IS A MEMBER, HAS ACCESS TO REVIEW THE PASSWORD PROTECTED FORM 990 ON-LINE PRIOR TO THE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	A REQUEST FOR INFORMATION ON POTENTIAL CONFLICTS IS SOLICITED ANNUALLY FROM DIRECTORS, TRUSTEES AND ALL EMPLOYEES AT MANAGER LEVEL AND ABOVE TO MONITOR FOR PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND DEALING WITH POTENTIAL OR ACTUAL CONFLICTS. THERE ARE NO CONFLICTS REPORTED SPECIFIC TO THIS ORGANIZATION. CONFLICTS ARE REGULARLY DISCLOSED AND ADDRESSED.
FORM 990, PART VI, SECTION B, LINE 15A AND 15B	COMPENSATION OF OFFICIALS AND KEY EMPLOYEES ARE ANNUALLY REVIEWED AND APPROVED BY A COMMITTEE OF DIRECTORS WITH GUIDANCE FROM INDEPENDENT CONSULTANTS AND USE OF COMPARATIVE DATA.
FORM 990, PART VI, SECTION C, LINE 19	THESE REQUESTS ARE DETERMINED ON A CASE-BY-CASE BASIS.
FORM 990, PART VII, SECTION A	THE HOURS PER WEEK REPORTED ON FORM 990, PART VII FOR OFFICERS AND DIRECTORS ARE THE HOURS SPENT ON THE FILING ENTITY ONLY. THE REMAINING PORTION OF THE 40 HOURS PER WEEK OF THE OFFICERS AND DIRECTORS WITH RELATED COMPENSATION IS ALLOCATED AMONG THE ENTITIES REPORTED ON SCHEDULE R.
FORM 990, PART XI, LINE 9	THE CHANGE IN FUND BALANCE OF $(21,662,670) WAS A NET EQUITY TRANSFER.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Saint Francis Hospital South LLC

Employer identification number

01-0603214

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Oklahoma Cancer Center Realty LLC 6600 S Yale Ave Ste 400 Tulsa,OK74136 37-1517227	Holding Co	OK	876,492	11,024,871	SF SOUTH

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Saint Francis Hospital INC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 73-0700090	Health SVCS	OK	501(C)(3)	3	SFHS	Yes
(2)Laureate Psychiatric Clinic & Hosp INC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 73-1308273	Health SVCS	OK	501(C)(3)	3	SFHS	Yes
(3)The Children's Hosp Fdn at Saint Francis 6600 S Yale Ave Ste 400 Tulsa,OK741363319 20-2843418	Health SVCS	OK	501(C)(3)	11A TYPE I	SFHS	Yes
(4)Warren Clinic INC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 73-1310891	Health SVCS	OK	501(C)(3)	3	SFHS	Yes
(5)Saint Francis Health System INC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 73-1501972	Health SVCS	OK	501(C)(3)	11B TYPE II	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Saint Francis Payroll Services INC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 45-0470422	Common Pay Agent	OK	SFHS	C Corp	0	0		Yes
(2) Saint Francis Health System General PO BOX 3038 Milwaukee,WI532013038 75-6583874	Self Insurance	OK	SFHS	Trust	0	0		Yes
(3) ARROWHEAD RIDGE OWNERS ASSOCIATION 6600 S YALE AVE STE 400 TULSA,OK741363319 52-2418279	HOLDING COMPANY	OK	SFH SOUTH	C CORP	0	0	100.000 %	Yes
(4) XAVIER INSURANCE COMPANY INC 76 ST PAUL ST STE 500 BURLINGTON,VT05401 03-0333599	INSURANCE CO	VT	SFHS	C CORP	0	0		Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Saint Francis Hospital inc	J	454,223	Trans Review
(2) Saint Francis Hospital inc	M	5,440,995	Trans Review
(3) Saint Francis Hospital inc	Q	94,326,835	Trans Review
(4) Saint Francis Hospital inc	R	69,318,879	Trans Review
(5) Saint Francis Hospital inc	S	11,807,445	Trans Review
(6) Saint Francis Hospital inc	P	146,270,338	Trans Review
(7) Saint Francis Health System inc	B	25,659,167	Trans Review
(8) Laureate Psychiatric Clinic & Hospital inc	Q	148,254	Trans Review
(9) Laureate Psychiatric Clinic & Hospital inc	P	195,833	Trans Review
(10) Warren Clinic Inc	J	602,800	Trans Review
(11) Warren Clinic Inc	M	120,093	Trans Review
(12) Warren Clinic Inc	Q	4,510,632	Trans Review
(13) Warren Clinic Inc	P	5,455,364	Trans Review

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO EXTEND THE PRESENCE AND HEALING MINISTRY OF CHRIST IN ALL WE DO.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	1
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	721
6	Total number of volunteers (estimate if necessary) .............	6	89
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	472
9	Program service revenue (Part VIII, line 2g) .........	102,883,720	113,103,646
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-203,164	15,119
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,274,527	738,391
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	103,955,083	113,857,628
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	9,615	15,957
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	31,515,366	33,284,384
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	47,515,839	49,456,020
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	79,040,820	82,756,361
19	Revenue less expenses. Subtract line 18 from line 12.......	24,914,263	31,101,267
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	80,961,441	86,380,556
21	Total liabilities (Part X, line 26).............	21,574,880	17,555,398
22	Net assets or fund balances. Subtract line 21 from line 20.....	59,386,561	68,825,158

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 71,116,123 including grants of $ 15,957 ) (Revenue $ 113,103,646 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses71,116,123

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)					(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Jake Henry Jr...................................................................... President/CEO/Director	1.0 ................. 39.0	X	X				0	2,131,200	77,386
(2) Barry L Steichen...................................................................... Vice President/COO/Director	1.0 ................. 39.0	X	X				0	935,527	163,173
(3) William R Lissau...................................................................... Director	1.0 ................. 0.0	X					0	0	0
(4) Jeffrey C Sacra...................................................................... Assistant Secretary	1.0 ................. 39.0		X				0	298,093	57,639
(5) Janine Smith...................................................................... Asst Secretary(Until 12/31/15)	1.0 ................. 39.0		X				0	71,754	28,429
(6) Eric E Schick...................................................................... Treasurer/CFO	1.0 ................. 39.0		X				0	596,681	201,274
(7) Thomas G Neff...................................................................... Secretary	1.0 ................. 39.0		X				0	472,986	94,156
(8) David Weil...................................................................... Administrator	39.0 ................. 1.0			X			387,391	0	75,738
(9) Julun Hong MD...................................................................... Physician	5.0 ................. 35.0				X		21,450	533,752	53,478
(10) Steven Feher MD...................................................................... Physician	5.0 ................. 35.0				X		34,000	416,430	49,892
(11) Raymond Sanders MD...................................................................... Physician	5.0 ................. 35.0				X		4,170	627,704	53,478
(12) John King Jr MD...................................................................... PHYSICIAN	5.0 ................. 35.0				X		25,000	452,989	51,228
(13) Conchita Woodruff MD...................................................................... PHYSICIAN	5.0 ................. 35.0				X		23,600	436,966	50,566
(14) Robert Eli Smith...................................................................... former Assistant Secretary	0.0 ................. 40.0					X	0	193,261	27,164

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	495,611	7,167,343	983,601

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	472

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		472

			Business Code
2a	PATIENT SERVICES,NET OF CONTRACTUAL ADJU	621300	109,269,549	109,269,549
b	HOSPITALIST	621300	3,834,097	3,834,097
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			113,103,646

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			8,516			8,516
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		1,177,145
b	Less: rental expenses		1,822,327
c	Rental income or (loss)	0	-645,182
d	Net rental income or (loss)......			-645,182			-645,182
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	164,896
b	Less: cost or other basis and sales expenses	158,293
c	Gain or (loss)	6,603
d	Net gain or (loss).....			6,603			6,603
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	QUALITY INCENTIVE-MEANINGFUL USE		900099	724,854			724,854
b	CAFETERIA SALES		722210	361,974			361,974
c	AFFILIATE SERVICES		900099	134,748			134,748
d	All other revenue ....			161,997			161,997
e	Total. Add lines 11a–11d ......			1,383,573
12	Total revenue. See Instructions......			113,857,628	113,103,646		753,510

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	15,957	15,957
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	467,331		467,331
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	27,127,659	25,381,901	1,745,758
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,615,964	1,428,220	187,744
9	Other employee benefits .......	2,201,116	1,931,592	269,524
10	Payroll taxes ...........	1,872,314	1,632,706	239,608
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	864	15,721	-14,857
c	Accounting ...........	20,271		20,271
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	4,323,512	3,671,811	651,701
12	Advertising and promotion ....	29,487	3,286	26,201
13	Office expenses .......	1,449,503	1,157,724	291,779
14	Information technology ......	2,412,402	38,689	2,373,713
15	Royalties ..	0
16	Occupancy ...........	714,745	921,492	-206,747
17	Travel ............	22,907	17,758	5,149
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	29,224	26,119	3,105
20	Interest ...........	2,151,360	280,314	1,871,046
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	5,055,726	5,730,230	-674,504
23	Insurance ...	1,862,836	63,564	1,799,272
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	12,662,426	12,694,272	-31,846
b	BAD DEBT EXPENSE	11,800,688	11,800,688
c	MAINTENANCE	3,003,011	2,790,443	212,568
d	MEDICAID SHOPP FEE	2,275,150		2,275,150
e	All other expenses	1,641,908	1,513,636	128,272
25	Total functional expenses. Add lines 1 through 24e	82,756,361	71,116,123	11,640,238	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,258,910	1	1,591,457
2	Savings and temporary cash investments .........			257,147	2	265,384
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			8,519,858	4	10,672,522
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			2,051,808	8	2,143,854
9	Prepaid expenses and deferred charges ......			487,951	9	892,597
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	124,630,031
b	Less: accumulated depreciation	10b	55,077,864	66,811,249	10c	69,552,167
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			1,574,518	15	1,262,575
16	Total assets. Add lines 1 through 15 (must equal line 34)...			80,961,441	16	86,380,556

17	Accounts payable and accrued expenses .....	4,758,812	17	5,025,895
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	16,816,068	25	12,529,503
26	Total liabilities. Add lines 17 through 25..	21,574,880	26	17,555,398

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	59,386,561	27	68,825,158
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	59,386,561	33	68,825,158
34	Total liabilities and net assets/fund balances ........	80,961,441	34	86,380,556