Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 3,991,468 | 7,062,106 | 6,200,474 | 11,367,155 | 14,438,721 | 43,059,924 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 3,991,468 | 7,062,106 | 6,200,474 | 11,367,155 | 14,438,721 | 43,059,924 |
| 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) .. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 43,059,924 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,991,468 | 7,062,106 | 6,200,474 | 11,367,155 | 14,438,721 | 43,059,924 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 48,084 | 130,865 | 138,085 | 149,020 | 170,131 | 636,185 |
| 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.).. | 305,183 | 2,126,492 | 5,020 | 2,436,695 | ||
| 11 | Total support. Add lines 7 through 10 | 47,153,483 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO BYLAWS: THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS: - THE FOLLOWING DEFINITIONS WERE ADDED AS TO THE TYPES OF DIRECTORS AND THEIR QUALIFICATIONS: CONSUMER DIRECTOR: SHALL HAVE RECEIVED AT LEAST ONE OF THE CORPORATIONS SERVICES WITHIN THE PAST TWENTY-FOUR MONTHS THAT GENERATED A HEALTH VISIT, WHERE BOTH THE SERVICE AND SITE AT WHICH THE SERVICE WAS PROVIDED ARE INCLUDED IN THE CORPORATION'S HRSA-APPROVED SCOPE OF PROJECT. A LEGAL GUARDIAN OF A CONSUMER WHO IS A DEPENDENT CHILD OR ADULT, A LEGAL SPONSOR OF AN IMMIGRANT WHO IS A CONSUMER, OR A PERSON WHO HAS LEGAL AUTHORITY TO MAKE HEALTH CARE DECISIONS FOR A CONSUMER MAY BE CONSIDERED A "CONSUMER" FOR PURPOSES OF BOARD REPRESENTATION. NON-CONSUMER DIRECTOR: SHALL BE DEFINED AS LIVING, WORKING IN OR HAVING A DEMONSTRABLE CONNECTION TO SUCH COMMUNITY(S), AND SHALL BE SELECTED FOR THEIR EXPERTISE IN AREAS SUCH AS COMMUNITY AFFAIRS, HEALTH, FINANCE AND BANKING, LEGAL AFFAIRS, TRADE UNIONS, SOCIAL SERVICES, BUSINESS, MANAGEMENT AND LOCAL GOVERNMENT. HEALTH CARE INDUSTRY REPRESENTATIVES: HEALTH CARE INDUSTRY INCLUDES BOTH PRIVATE AND PUBLIC SECTORS THAT PROVIDE HEALTH CARE-RELATED SERVICES, GOODS AND ITEMS TO TREAT PATIENTS, INCLUDING WITHOUT LIMITATION, PROVIDERS OF PRIMARY, SECONDARY AND TERTIARY HEALTH CARE AND ANCILLARY SERVICES AND THE PHARMACEUTICAL, HEALTH INSURANCE, AND MEDICAL EQUIPMENT SECTORS - THE FOLLOWING QUALIFICATIONS FOR DIRECTORS WAS ADDED: 1) TO THE EXTENT THAT THE CORPORATION RECEIVES FUNDING UNDER SECTION 330(G), (H) AND/OR (I) OF THE PUBLIC HEALTH SERVICE ACT, THE BOARD SHALL INCLUDE APPROPRIATE REPRESENTATION FROM EACH OF THE SPECIAL POPULATIONS FOR WHICH THE CORPORATION RECEIVES SUCH FUNDING, CONSISTENT WITH THE THEN CURRENT POLICIES OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). (2) NO MEMBER OF THE BOARD OF DIRECTORS SHALL BE AN EMPLOYEE OF THE CORPORATION, OR AN IMMEDIATE FAMILY MEMBER (SPOUSE, CHILD, PARENT, BROTHER OR SISTER, BY BLOOD, MARRIAGE OR ADOPTION) OF SUCH AN EMPLOYEE. - VACANCIES MAY BE FILLED BY A MAJORITY OF THE DIRECTORS. NO OTHER INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S) SHALL BE PERMITTED TO SELECT A MAJORITY OF THE TOTAL BOARD MEMBERS OR A MAJORITY OF THE NON-CONSUMER BOARD MEMBERS, NOR SHALL ANY OTHER INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S) PRECLUDE THE SELECTION OF MEMBERS NOT APPOINTED BY SUCH PARTY. - CAUSE FOR REMOVAL FROM THE BOARD OF DIRECTORS MAY INCLUDE, BUT IS NOT LIMITED TO, THE FOLLOWING: (I) FAILURE TO MEET THE ATTENDANCE REQUIREMENTS SET FORTH IN ARTICLE IV, SECTION E OF THESE BYLAWS; (II) TAKING ACTIONS THAT VIOLATE THE CORPORATION'S CONFLICT OF INTEREST POLICY OR ARE CONTRARY TO THE BEST INTERESTS OF THE CORPORATION AS DETERMINED BY THE BOARD; AND (III) BEING EXCLUDED OR SUSPENDED FROM ANY FEDERAL OR STATE HEALTH CARE PROGRAMS. ANY SUCH RESIGNATION OR REMOVAL SHALL TAKE EFFECT AT THE TIME SPECIFIED THEREIN. NO OTHER INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S) CAN REQUIRE THE REMOVAL OF ANY BOARD MEMBER NOT APPOINTED BY SUCH INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S). - THE FOLLOWING CHANGES WERE MADE TO MONTHLY MEETING REQUIREMENTS. (1) AS TO ATTENDANCE, OFFICERS MUST MAINTAIN AN ATTENDANCE OF >75% (PREVIOUSLY 70%) (2) AS TO NOTIFICATION, A LETTER WILL BE SENT AFTER 3 ABSENCES (PREVIOUSLY 2 ABSENCES) - IN THE EVENT THAT A MEETING OF THE BOARD OR OF ANY COMMITTEE DESIGNATED BY THE BOARD IS CONDUCTED FULLY THROUGH SUCH TELEPHONIC OR ELECTRONIC/VIRTUAL MEANS, ADVANCE WRITTEN NOTICE OF THE METHODOLOGY USED TO CONDUCT SUCH MEETING MUST BE PROVIDED IN ACCORDANCE WITH ARTICLE IV, SECTION J OF THESE BYLAWS. - MINUTES, INCLUDING A RECORD OF ATTENDANCE AND DOCUMENTATION AND VERIFICATION OF MAJOR ACTIONS AND DECISIONS BY THE BOARD, SHALL BE MAINTAINED OF ALL MEETINGS OF THE BOARD OF DIRECTORS, WHICH MINUTES SHALL BE SIGNED BY THE SECRETARY OR THEIR DESIGNEE, APPROVED BY THE BOARD AT A SUBSEQUENT MEETING, AND RETAINED AT THE OFFICE OF THE CORPORATION. - EXECUTIVE SESSIONS MAY BE HELD FOR SUCH PURPOSES INCLUDING, BUT NOT LIMITED TO, DISCUSSION OF LITIGATION (ACTUAL OR THREATENED), EVALUATION OF PERSONNEL OR DISCUSSION OF PERSONNEL ISSUES, OR RECEIPT OF THE RESULTS OF AN ANNUAL AUDIT. THE CHIEF EXECUTIVE OFFICER SHALL PARTICIPATE IN EXECUTIVE SESSIONS OF THE BOARD UNLESS THE BOARD REQUESTS THE CHIEF EXECUTIVE OFFICER'S ABSENCE. THE PRESIDENT OF THE BOARD MAY INVITE SUCH OTHER PERSONS AS THEY DEEM APPROPRIATE TO ATTEND AN EXECUTIVE SESSION. UNLESS INVITED BY THE PRESIDENT TO ATTEND, THE PUBLIC AND STAFF PERSONNEL WILL BE EXCLUDED FROM EXECUTIVE EXCEPT WHEN THEIR PRESENCE IS NECESSARY TO GIVE TESTIMONY OR ADVICE, AFTER WHICH THEY WILL BE EXCUSED. - AS TO THE OFFICE OF THE PRESIDENT: NO OTHER INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S) SHALL SELECT THE PRESIDENT OF THE BOARD; NOR SHALL ANY PERSON APPOINTED BY ANY OTHER INDIVIDUALS(S), ENTITY(S), OR COMMITTEE(S) SERVE AS PRESIDENT. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE DRAFT OF THE FORM 990 IS EMAILED TO BOARD MEMBERS AND FINAL COPY OF THE FORM 990 IS APPROVED AT THE BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE PURPOSES OF THE CORPORATION SHALL BE THOSE NON-PROFIT PURPOSES STATED IN THE ARTICLES OF INCORPORATION, AS THEY MAY BE AMENDED. NO PART OF THE NET EARNINGS OR OTHER ASSETS OF THE CORPORATION SHALL INURE TO THE BENEFIT OF, BE DISTRIBUTED TO OR AMONG, OR REVERT TO, ANY DIRECTOR, OFFICER, CONTRIBUTOR OR OTHER PRIVATE INDIVIDUAL HAVING, DIRECTLY OR INDIRECTLY, ANY PERSONAL OR PRIVATE INTEREST IN THE ACTIVITIES OF THE CORPORATION, EXCEPT THAT THE CORPORATION MAY PAY REASONABLE COMPENSATION FOR SERVICES RENDERED AND MAY MAKE PAYMENTS AND DISTRIBUTIONS IN FURTHERANCE OF THE NON-PROFIT PURPOSES STATED IN THE ARTICLES OF INCORPORATION. AT NO TIME SHALL ANY BOARD MEMBER BE AN EMPLOYEE OF THE CORPORATION. ALSO AT NO TIME SHALL THE SPOUSE, CHILD, PARENT, BROTHER, OR SISTER BY BLOOD OR MARRIAGE OF A BOARD MEMBER BE AN EMPLOYEE OF THE CORPORATION. ANNUALLY SHWC BOARD MEMBERS COMPLETE A SURVEY DESIGNED TO BRING TO LIGHT ANY CONFLICTS OF INTEREST. IF A CONFLICT SHOULD ARISE, THEN THE BOARD MEMBER WOULD ABSTAIN FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO COMPENSATION DETERMINATION: THE CEO'S SALARY MAY BE ADJUSTED BY THE BOARD OF DIRECTORS ANNUALLY DURING THE ANNUAL EMPLOYEE EVALUATION PERIOD. THE COMPENSATION IS COMPARED WITH OTHER DIRECTORS' SALARIES IN OKLAHOMA AND AGAINST NACHC'S SALARIES AND BENEFITS SURVEY. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. IF REQUESTED, THE PERSON WILL BE ASKED TO REVIEW THE DOCUMENTS ON SITE. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGE IN NET ASSETS: $ 141,994 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP |
| Software ID: | |
| Software Version: |