TY 2017 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Associated Anesthesiologist Inc, 6839 S Canton TULSA,OK74136	Healthcare Services	526,484
Miller Architect Inc, 13401 N Western Ave Ste 302 OKLAHOMA CITY,OK73114	Architect Fees	163,750
Flintco LLC, 8800 Page Ave ST LOUIS,MO63114	Construction Svcs	9,131,038
Medefis Inc, 10826 Old Mill Road OMAHA,NE68164	Healthcare Services	316,212
Roark Landscaping Corporation, 5809 S 107th E Ave TULSA,OK74146	Landscaping Services	242,446
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 8

- TIN:

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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

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) 2019

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 (explain in Part VI). 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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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

Term 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 .....	6,788,474		6,788,474
b	Buildings ....	67,963,714	33,753,327	34,210,387
c	Leasehold improvements	4,107,403	1,624,035	2,483,368
d	Equipment ....	33,750,326	24,329,708	9,420,618
e	Other .....	21,134,713		21,134,713
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				74,037,560

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	4,619,744
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) 2019

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 Topic (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 determined that the position on uncertain tax positions is 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 Topic (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 determined that the position on uncertain tax positions is 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) 2019

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

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) . . .	2,877,792		2,877,792	3.810 %
b	Medicaid (from Worksheet 3, column a) . . . . .	8,313,680	6,881,267	1,432,413	1.900 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	11,191,472	6,881,267	4,310,205	5.710 %
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) . . . .	6,367,733	5,387,034	980,699	1.300 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	6,367,733	5,387,034	980,699	1.300 %
k	Total. Add lines 7d and 7j .	17,559,205	12,268,301	5,290,904	7.010 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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	86,439	86,439	0.110 %
2	Economic development
3	Community support	25,280	25,280	0.030 %
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	111,719	111,719	0.140 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

14,445,418

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. ......

12,278,605

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).....

26,786,068

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

35,994,555

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

-9,208,487

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) 2019

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?1Name, 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) 2019

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

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) 2019

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)

Was widely publicized 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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	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 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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 uses quantitative data derived from primary research and secondary data (American Community Survey data, Census Bureau data) obtained from the Tulsa-City County Health Department. 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	https://www.saintfrancis.com/about-us/commitment-to-community
Part V, Section B, Line 10a	https://www.saintfrancis.com/about-us/commitment-to-community
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 healthcare; tobacco use; lack of education; aging problems; safety/crime; poverty/unemployment; and mental health. Saint Francis Hospital South, LLC does not intend to address the health needs of lack due to education; aging problems; safety/crime; and poverty/unemployment due to lack of expertise in these areas. It is an unfortunate matter that certain socioeconomic burdens to the health of our community cannot be fully or effectively addressed by individual private institutions. The hospitals comprising Saint Francis Health System, Inc. 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 Medicaid beneficiaries. Saint Francis Hospital South, LLC, as well as Saint Francis Hospital, Inc., Laureate Psychiatric Clinic and Hospital, Inc., Saint Francis Hospital Vinita, Inc., Saint Francis Hospital Muskogee, Inc. and the senior leadership and Board of Directors of Saint Francis Health System, Inc. 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, Inc. 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, Inc. 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 Health System, Inc. and Saint Francis Hospital South, LLC, in their mission to extend the presence and healing ministry of Christ in all we do, address these community health needs by providing charity care to those families meeting the 225 percent Federal Poverty Guidelines criteria. Additionally, the Xavier Medical Clinic, an entity fully owned and operated by Saint Francis Health System, Inc. offers the resources of 50 volunteer physicians, pharmacists, nurses and other health professionals to women, children and men who are uninsured or underserved. The clinic has two components, Xavier Medical Clinic and Xavier Pregnancy Program. 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. The Xavier Pregnancy Program provides pregnancy screening services and prenatal services to expectant mothers, many of whom lack the financial means necessary to purchase insurance. They follow the mother and baby throughout the pregnancy and during the postpartum time, assisting when needed as any identifiable need surfaces. Patients are referred to Saint Francis Hospital, Inc. for inpatient care including childbirth, as well as surgery and ancillary services. In fiscal year 2018, Xavier Medical Clinic received 8,900 patient visits, aided over 140 patients to receive referrals outside of the clinic, provided over 180 prescriptions with an equivalent cost of over $201,197, dispensed over 11,479 prescriptions, and the Xavier Pregnancy Program assisted 472 women, resulting in 410 births at Saint Francis Hospital, Inc. Because of its dedicated and caring staff, Xavier Clinic is able to reach a group that might otherwise avoid or have difficulties accessing basic healthcare services. Saint Francis Health System, Inc. 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., Laureate Psychiatric Clinic and Hospital, Inc., Saint Francis Hospital Vinita, Inc., and Saint Francis Hospital Muskogee, Inc. will serve as acute care hubs for the patients that utilize the health system's primary, urgent, and specialty care at outlying locations. These are a few of the many ways Saint Francis Health System, Inc. 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 much 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 Saint Francis Health System, Inc. offers substance abuse counseling for adults on an inpatient basis, and adults and adolescents on an 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 Children's Services. Chronic disease In the US, chronic diseases are the main cause of poor health, disability, and death, account for most of healthcare expenditures. Chronic diseases are responsible for 7 of 10 deaths each year, and treating people with chronic diseases accounts for 86 percent of our nation's 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 sec
Part V, Section B, Line 13a	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 regarding income, assets, or other resources available to the patient or patients 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/patients-and-guests/for-patients/billing-and- insurance/
Part V, Section B, Line 16j	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 for uninsured patients.

Schedule H (Form 990) 2019

Page 9

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) 2019

Page 10

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. 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 magazine "Presence" that is made available to the public through the organization's website at https://www.saintfrancis.com/about-us/commitment-to-community
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 that 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 for additional information regarding Saint Francis Health System, Inc.s and Saint Francis Hospital South, LLCs 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 uncollectable receivables 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, LLC's policies.
Part III, Section A, Line 3	The provision for bad debt 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 organization's accounts receivable and allowance for doubtful accounts on pages 6 and 7. 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 the provision for bad debt 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 the provision for bad debt. Accounts receivable are valued at net realizable value. Saint Francis Hospital South, LLC estimates the allowances for uncollectable receivables 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 that 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 established the community benefit standard for hospitals and considers a hospital that serves patients covered by governmental health benefits (including Medicare) as operating to promote the health of the community and furtherance of its exempt purposes. Accordingly, treating Medicare patients is considered a community benefit.
Part III, Section C, Line 9b	Saint Francis Hospital South, LLC's 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, LLC's financial assistance 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, LLC's 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. 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 Saint Francis Health System, Inc.: 1. Gathers and obtains information identifying those needs; and 2. Develops programs and services that address and provides access to those in greatest need of healthcare services. Historically, Saint Francis Health System, Inc. and its entities focus have 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, Saint Francis Health System, Inc. must first identify priority health needs. During the fiscal year 2016, Saint Francis Health System, Inc. 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 within 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 Saint Francis Health System, Inc.'s website at https://www.saintfrancis.com/Documents/CHNA.pdf
Part VI, Line 3	Patient education of eligibility for Assistance Saint Francis Health System, Inc. and its entities are committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Saint Francis Health System, Inc. 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 Saint Francis Health System, Inc. and Saint Francis Hospital South, LLC websites. The brochure provides financial assistance program details. - The financial assistance policy, plain language summary, and application are posted on the Saint Francis Health System, Inc. and Saint Francis Hospital South, LLC websites in English and the Limited English Proficiency languages of the Primary Service Area (PSA). - Saint Francis Health System, Inc. 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 Saint Francis Health System, Inc.s financial assistance policy. - Saint Francis Health System, Inc. offers the financial assistance 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 Saint Francis Hospital South, LLC consists of Tulsa, Rogers, Wagoner, Creek, Muskogee and Mayes Counties, where a significant majority of inpatient admissions originate. The most recent 2018 Oklahoma Data report identified approximately 1,024,000 people in the PSA. The PSA is comprised of the following representation: - 72% Caucasian - 9% Hispanic or Latino - 8% African-American - 9% Native-American - 2% Asian In 2018, the median household income for the 6 counties was $50,700, (about 14 percent below the US median) and in 2017, the mean household income was $67,169 (about 21 percent below the US average of $81,283). The per capita income for the 6 counties is 24 percent below the national median and slightly lower than the average for Oklahoma. In 2017, approximately 15 percent of the PSA's population lives in poverty, with the number climbing to almost 22 percent for those under 18. Nearly 14 percent of households in the 6 counties received food stamps/Supplemental Nutrition Assistance Program (SNAP) benefits in 2017. The uninsured rate in the PSA was approximately 14 percent. Of those in the PSA that do have insurance, 79 percent hold private insurance policies. When narrowing focus to the PSA civilian population age 19 to 64 that participates in the labor force, the uninsured rate rises to nearly 17 percent. During Oklahoma's 2018 fiscal year, there were 1,020,726 unduplicated Medicaid enrollees, meaning over 25 percent of the state's population was enrolled in the Medicaid program at some point in time. The PSA was home to 165,085 of those unduplicated enrollees, or approximately 26 percent of the PSA's population.
Part VI, Line 5	Saint Francis Hospital South, LLC is part of an integrated healthcare delivery system with the mission of extending the presence and healing ministry of Christ in all we do. Saint Francis Health System, Inc., 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, LLC's promotion of community health through community events such as sponsored on-site educational seminars and classes on health issues. Saint Francis Health System, Inc. and Saint Francis Hospital South, LLC's 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, the clinical and the Mission of Saint Francis Hospital South, LLC and the other entities that are part of the Saint Francis Health System, Inc.'s 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 Saint Francis Health System, Inc. The goal of Saint Francis Health System, Inc. 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	Saint Francis Hospital South, LLC is part of Saint Francis Health System, Inc. Annually, Saint Francis Hospital South, LLC admits over 5,200 patients and provides approximately 50,900 outpatient visits, delivers 920 newborns, and provides approximately 27,500 emergency room visits. See Schedule O for additional information regarding Saint Francis Hospital South, LLC's role within Saint Francis Health System, Inc.
Part VI, Line 7	Saint Francis Health System, Inc., which includes Saint Francis Hospital South, LLC, publishes a community benefit report in Oklahoma. A written report that is included in the spring issue of the Saint Francis Health System, Inc. magazine "Presence" is distributed to 40,000 households across eastern Oklahoma and to all Saint Francis Health System, Inc. locations for display and pick up to help educate the community on the benefits that Saint Francis Hospital South, LLC and Saint Francis Health System, Inc. provide to the communities we serve in return for our not-for-profit status.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Saint Francis Hospital South LLC

Employer identification number
01-0603214

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Medical Supplies Network 1123 S Erie Ave Tulsa,OK741125307	73-1507095	501(c)(3)	6,999				General Support
(2) City of Broken Arrow 220 S First St Broken Arrow,OK74012	73-6005109	Govt	10,000				Pulsepoint Agreement

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2

Saint Francis Hospital South, LLC. provides grant funds to other 501(c)(3) exempt organizations that further the exempt purposes of Saint Francis Hospital South, LLC. The Saint Francis Health System, Inc. executive director of corporate communications and marketing arranges the sponsorships each year as determined by the communities in which Saint Francis Hospital South, LLC. has a presence. Saint Francis Hospital South, LLC. does not monitor the use of grants funds since grants are only made to section 501(c)(3) public charities that further the exempt purpose of Saint Francis Hospital South, LLC.

Schedule I (Form 990) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 on 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 on 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 nonfixed
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) 2019

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 Jr President/CEO/Director	(i) (ii)	0 ------------- 1,255,548	0 ------------- 3,950,000	0 ------------- 67,734	0 ------------- 35,140	0 ------------- 46,683	0 ------------- 5,355,105	-------------
2Barry L Steichen Vice President/COO/Director	(i) (ii)	0 ------------- 763,321	0 ------------- 224,646	0 ------------- 9,925	0 ------------- 131,417	0 ------------- 22,657	0 ------------- 1,151,966	-------------
3Jeffrey C Sacra Asst Secretary (Until 6/1/18)	(i) (ii)	0 ------------- 248,645	0 ------------- 66,120	0 ------------- 4,452	0 ------------- 50,399	0 ------------- 10,442	0 ------------- 380,058	-------------
4Eric E Schick Treasurer/CFO	(i) (ii)	0 ------------- 576,921	0 ------------- 193,737	0 ------------- 10,548	0 ------------- 113,370	0 ------------- 21,719	0 ------------- 916,295	-------------
5David Weil Administrator	(i) (ii)	303,117 ------------- 0	90,724 ------------- 0	8,712 ------------- 0	68,459 ------------- 0	6,831 ------------- 0	477,843 ------------- 0	-------------
6Conchita Woodruff MD Physician	(i) (ii)	22,200 ------------- 570,334	0 ------------- 0	0 ------------- 890	0 ------------- 33,340	0 ------------- 19,701	22,200 ------------- 624,265	-------------
7Thomas G Neff Secretary	(i) (ii)	0 ------------- 366,175	0 ------------- 106,266	0 ------------- 18,927	0 ------------- 35,140	0 ------------- 24,901	0 ------------- 551,409	-------------
8Mark Maguire MD Physician	(i) (ii)	15,198 ------------- 504,368	0 ------------- 0	0 ------------- 5,694	0 ------------- 33,340	0 ------------- 22,251	15,198 ------------- 565,653	-------------
9Steven Feher MD Physician	(i) (ii)	45,000 ------------- 515,341	0 ------------- 0	0 ------------- 0	0 ------------- 33,008	0 ------------- 19,162	45,000 ------------- 567,511	-------------
10Julun Hong MD Physician	(i) (ii)	3,500 ------------- 541,277	0 ------------- 25,833	0 ------------- 5,435	0 ------------- 33,340	0 ------------- 21,518	3,500 ------------- 627,403	-------------
11Nigel Naman MD Physician	(i) (ii)	359,506 ------------- 170,196	0 ------------- 13,750	0 ------------- 0	0 ------------- 0	6,600 ------------- 0	366,106 ------------- 183,946	-------------

Schedule J (Form 990) 2019

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, Saint Francis Hospital Vinita, Inc., and Saint Francis Hospital Muskogee, Inc., 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. Note: None of the individuals listed on schedule J are compensated as board members of the reporting entity. The reported compensation is for services as employees of the reporting entity or related organization.
Part II, Column B(ii)	The following individual received a one-time retention bonus during the year. These payments are included in Schedule J, Part II, column B(ii): Jake Henry Jr. $3,000,000

Schedule J (Form 990) 2019

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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. Saint Francis Health System, Inc. 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 includes 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 2018, Saint Francis Hospital South, LLC provided approximately $2,878,000 of charity care (measured at established rates) and $8,314,000 in unreimbursed Medicaid services (measured at established rates). Recognition: In the following, you will see many ways Saint Francis Health System, Inc. 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 the national healthcare research firm Professional Research Consultants, Inc. (PRC) based on performance in 2017. 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 percent of the country based on PRC's comparative database): overall inpatient services and medical/surgical 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: cardiac - inpatient mortality, sepsis - inpatient mortality, and respiratory care - inpatient mortality and 30 day mortality. Additionally, Healthgrades recognized Saint Francis Hospital South, LLC with its patient safety excellence award. Publicly reported quality data indicates high performance in the following measures: - Acute Myocardial Infarction survival rate - top five percent in the nation - Patients overall rating of the hospital - top five percent in the nation - Preventing complications associated with total hip and knee surgery - top five percent in the nation - Preventing central line associated bloodstream infections - Top five 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 Health System, Inc. 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 and Medicare withholding tax purposes for Saint Francis Health System, Inc. 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 Saint Francis Health System, Inc. 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 Saint Francis Health System, Inc. with Barry Steichen, an officer and director, and Eric Schick, an officer.
Form 990, Part VI, Section A, Line 3	The director functions are delegated to the Saint Francis Health System, Inc. 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 member has 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 - the amendment of bylaws
Form 990, Part VI, Section B, Line 11b	The finance committee, a sub-committee of the board of directors of Saint Francis Health System, Inc. has access to the password protected form 990 online prior to filing with the IRS.
Form 990, Part VI, Section B, Line 12c	The organization uses the conflict of interest, whistleblower and record retention policies of Saint Francis Health System, Inc. 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 is annually reviewed and approved by the compensation committee 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 $31,526,033 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) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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	(f) Direct controlling entity
(1) Oklahoma Cancer Center Realty LLC 6600 S Yale Ave Ste 400 Tulsa,OK74136 37-1517227	Holding Co	OK	435,243	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,OK74136 73-0700090	Health Svcs	OK	501(c)(3)	3	SFHS	Yes
(2)Laureate Psychiatric Clinic & Hosp Inc 6600 S Yale Ave Ste 400 Tulsa,OK74136 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,OK74136 20-2843418	Health Svcs	OK	501(c)(3)	12A Type I	SFHS	Yes
(4)Warren Clinic Inc 6600 S Yale Ave Ste 400 Tulsa,OK74136 73-1310891	Health Svcs	OK	501(c)(3)	3	SFHS	Yes
(5)Saint Francis Health System Inc 6600 S Yale Ave Ste 400 Tulsa,OK74136 73-1501972	Health Svcs	OK	501(c)(3)	12B Type II	N/A		No
(6)Saint Francis Hospital Vinita Inc 6600 S Yale Ave Ste 400 Tulsa,OK74136 81-3747248	Health Svcs	OK	501(c)(3)	3	SFHS	Yes
(7)Saint Francis Hospital Muskogee Inc 6600 S Yale Ave Ste 400 Tulsa,OK74136 81-4322087	Health Svcs	OK	501(c)(3)	3	SFHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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 LLC 6600 S Yale Ave Ste 400 Tulsa,OK741363319 45-0470422	Common Pay Agent	OK	SFHS	C Corp	0	0		Yes
(2) Saint Francis Hlth Sys Gen-Prof Lia 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	Captive Insurance	VT	SFHS	C Corp	0	0		Yes

Schedule R (Form 990) 2019

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) ............................

Yes

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	I	10,215,808	Trans Review
(2) Saint Francis Hospital Inc	M	4,249,411	Trans Review
(3) Saint Francis Hospital Inc	Q	104,227,751	Trans Review
(4) Saint Francis Hospital Inc	R	40,841,888	Trans Review
(5) Saint Francis Hospital Inc	S	15,574,699	Trans Review
(6) Saint Francis Hospital Inc	P	124,699,423	Trans Review
(7) Laureate Psychiatric Clinic & Hospital Inc	Q	107,745	Trans Review
(8) Laureate Psychiatric Clinic & Hospital Inc	P	89,207	Trans Review
(9) Warren Clinic Inc	J	421,091	Trans Review
(10) Warren Clinic Inc	M	150,212	Trans Review
(11) Warren Clinic Inc	Q	4,869,413	Trans Review
(12) Warren Clinic Inc	P	7,460,842	Trans Review
(13) Saint Francis Hospital Vinita Inc	Q	67,049	Trans Review

Schedule R (Form 990) 2019

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) 2019

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) 2019

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 2019 (Part V, line 2a) ......	5	743
6	Total number of volunteers (estimate if necessary) .............	6	77
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	7,214	43
9	Program service revenue (Part VIII, line 2g) .........	123,339,371	131,880,834
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,793	-11,882
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	909,844	-525,654
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	124,258,222	131,343,341
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	38,257	25,280
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)	35,548,804	38,418,471
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)....	51,003,551	51,467,894
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	86,590,612	89,911,645
19	Revenue less expenses. Subtract line 18 from line 12.......	37,667,610	41,431,696
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	89,644,913	91,585,543
21	Total liabilities (Part X, line 26).............	18,400,899	10,435,866
22	Net assets or fund balances. Subtract line 21 from line 20.....	71,244,014	81,149,677

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 77,890,306 including grants of $ 25,280 ) (Revenue $ 131,880,834 )
	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 expenses77,890,306

(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	5,273,282	81,823
(2) Barry L Steichen...................................................................... Vice President/COO/Director	1.0 ................. 39.0	X	X			0	997,892	154,074
(3) William R Lissau...................................................................... Director	1.0 ................. 0.0	X				0	0	0
(4) Jeffrey C Sacra...................................................................... Asst Secretary (Until 6/1/18)	1.0 ................. 39.0		X			0	319,217	60,841
(5) Eric E Schick...................................................................... Treasurer/CFO	1.0 ................. 39.0		X			0	781,206	135,089
(6) Thomas G Neff...................................................................... Secretary	1.0 ................. 39.0		X			0	491,368	60,041
(7) David Weil...................................................................... Administrator	39.0 ................. 1.0			X		402,553	0	75,290
(8) Conchita Woodruff MD...................................................................... Physician	1.0 ................. 39.0				X	22,200	571,224	53,041
(9) Mark Maguire MD...................................................................... Physician	1.0 ................. 39.0				X	15,198	510,062	55,591
(10) Steven Feher MD...................................................................... Physician	1.0 ................. 39.0				X	45,000	515,341	52,170
(11) Julun Hong MD...................................................................... Physician	1.0 ................. 39.0				X	3,500	572,545	54,858
(12) Nigel Naman MD...................................................................... Physician	35.0 ................. 5.0				X	359,506	183,946	6,600

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	847,957	10,216,083	789,418

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	43
e	Government grants (contributions)		1e

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

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		43

		Business Code
2a	PATIENT SERVICES,NET OF CONTRACTUAL ADJU	621110	126,227,960	126,227,960
b	HOSPITALIST	621300	5,652,874	5,652,874
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		131,880,834

3 Investment income (including dividends, interest, and othersimilar amounts) ......			10,970			10,970
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		719,262	6a
b	Less: rental expenses		2,002,445	6b
c	Rental income or (loss)	0	-1,283,183	6c
d	Net rental income or (loss).......			-1,283,183			-1,283,183
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,300		7a
b	Less: cost or other basis and sales expenses	25,152		7b
c	Gain or (loss)	-22,852		7c
d	Net gain or (loss).........			-22,852			-22,852
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	PHARMACY SALES		900099	1,787			1,787
b	CAFETERIA SALES		722210	322,673			322,673
c	AFFILIATE SERVICES		900099	113,834			113,834
d	All other revenue ....			319,235			319,235
e	Total. Add lines 11a–11d ......			757,529
12	Total revenue. See instructions.....			131,343,341	131,880,834		-537,536

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	25,280	25,280
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ...........	491,566		491,566
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........	31,463,245	29,525,625	1,937,620
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,853,691	1,632,866	220,825
9	Other employee benefits .......	2,473,918	2,107,396	366,522
10	Payroll taxes ...........	2,136,051	1,826,233	309,818
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	283	283
c	Accounting ...........	44,707		44,707
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)	3,791,315	2,739,974	1,051,341
12	Advertising and promotion ....	23,673	1,391	22,282
13	Office expenses .......	1,443,837	967,864	475,973
14	Information technology ......	1,229,771	77,071	1,152,700
15	Royalties ..	0
16	Occupancy ...........	1,139,526	1,104,486	35,040
17	Travel ............	19,148	17,465	1,683
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	12,718	10,699	2,019
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	4,636,815	4,120,463	516,352
23	Insurance ...	781,011	44,090	736,921
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	BAD DEBT EXPENSE	14,445,418	14,445,418
b	MAINTENANCE	2,477,411	2,327,812	149,599
c	MEDICAID SHOPP FEE	3,027,725		3,027,725
d	MEDICAL SUPPLIES	16,851,940	16,810,333	41,607
e	All other expenses	1,542,596	105,557	1,437,039
25	Total functional expenses. Add lines 1 through 24e	89,911,645	77,890,306	12,021,339	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 ........			1,912,983	1	334,645
2	Savings and temporary cash investments .........			281,067	2	181,977
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			10,807,160	4	13,135,514
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			2,100,008	8	2,023,615
9	Prepaid expenses and deferred charges ......			1,783,657	9	1,116,432
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	133,744,630
b	Less: accumulated depreciation	10b	59,707,070	72,028,130	10c	74,037,560
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 ...........			731,908	15	755,800
16	Total assets. Add lines 1 through 15 (must equal line 33)...			89,644,913	16	91,585,543

17	Accounts payable and accrued expenses .....	5,958,574	17	5,816,122
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		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	12,442,326	25	4,619,744
26	Total liabilities. Add lines 17 through 25..	18,400,899	26	10,435,866

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	71,244,014	32	81,149,677
33	Total liabilities and net assets/fund balances ........	89,644,913	33	91,585,543