TY 2021 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) PETER B DELANEY...................................................................... DIRECTOR	1.00 ................. 1.00	X		27,650	0
(2) NICO GOMEZ...................................................................... DIRECTOR	1.00 ................. 1.00	X		28,310	0
(3) NEAL HOGAN PHD...................................................................... DIRECTOR	1.00 ................. 1.00	X		34,495	0
(4) KARLA MARSHALL...................................................................... DIRECTOR	1.00 ................. 1.00	X		29,000	0
(5) FRANK MERRICK...................................................................... DIRECTOR	1.00 ................. 1.00	X		29,490	0
(6) JOEY SAGER...................................................................... DIRECTOR	1.00 ................. 1.00	X		28,140	0
(7) GEORGIANNE SNOWDEN MD...................................................................... DIRECTOR	1.00 ................. 1.00	X		29,472	0
(8) DAVID THOMPSON...................................................................... DIRECTOR	1.00 ................. 1.00	X		27,900	0
(9) CHRISTOPHER TURNER...................................................................... DIRECTOR & BOARD CHAIR	1.00 ................. 1.00	X	X	35,580	0
(10) LINDA VYTLACIL PHD...................................................................... DIRECTOR	1.00 ................. 1.00	X		30,822	0
(11) MARK WERNER MD...................................................................... DIRECTOR & VICE CHAIRMAN	1.00 ................. 1.00	X	X	29,080	0
(12) JIM COUCH...................................................................... DIRECTOR	1.00 ................. 1.00	X		8,510	0
(13) SAM COMBS...................................................................... DIRECTOR	1.00 ................. 1.00	X		8,510	0
(14) SHERRI LANCE...................................................................... DIRECTOR	1.00 ................. 1.00	X		7,950	0
(15) TIMOTHY PEHRSON...................................................................... DIRECTOR & PRESIDENT/CEO	1.00 ................. 39.00	X	X	1,942,216	298,275
(16) MARSHALL SNIPES...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0
(17) DOUGLAS M SMITH...................................................................... TREASURER & CFO	1.00 ................. 39.00		X	796,882	141,279

(A) Name and business address	(B) Description of services	(C) Compensation
CORE CLINICAL PARTNERS LLC 3330 CUMBERLAND BLVD 500 ATLANTA,GA30339	MEDICAL SERVICE	15,203,316
DICKERSON DESIGN BUILD INC 8333 DOUGLAS AVE STE 1300 LB 72 DALLAS,TX75225	CONSTRUCTION SERVICES	761,154
DIAGNOSTIC LAB OF OKLAHOMA 225 NE 97TH STREET OKLAHOMA CITY,OK73114	REFERENCE LAB	634,339
LIFECARE HEALTH SERVICES 4013 NORTHWEST EXPRESSWAY OKLAHOMA CITY,OK73116	MANAGED CARE CONSULTING	496,962
HKS INC 350 NORTH ST PAUL STREET STE 100 DALLAS,TX75201	ARCHITECTURE SERVICES	364,870
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 78

- TIN:

SCHEDULE A
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 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.") ..
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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 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.)

Section B. Total Support

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.)..

First 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 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

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) 2021

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	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.
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)
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.
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.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
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.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2021

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization INTEGRIS AMBULATORY CARE CORP

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization INTEGRIS AMBULATORY CARE CORP		Employer identification number 73-1192765

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization INTEGRIS AMBULATORY CARE CORP			Employer identification number 73-1192765
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

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

2021

Open to Public Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

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) 2021

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 .....	70,327		70,327
b	Buildings ....	13,792,150	4,592,051	9,200,099
c	Leasehold improvements	2,816,317	2,161,002	655,315
d	Equipment ....	23,971,411	20,148,412	3,822,999
e	Other .....	6,730,165	155,637	6,574,528
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				20,323,268

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) INVESTMENT IN BMCO FOUNDATION	140,389,622	F
(B) INVESTMENT IN WESTERN VILLAGE ACADEMY	26,835	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	140,416,457

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value

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

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	327,350,942
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) 2021

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:	INTEGRIS HEALTH, INC. AND ITS TAX-EXEMPT CONTROLLED AFFILIATES HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT UNDER THE PROVISION OF INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ENTITIES DESCRIBED UNDER IRC SECTION 501(C)(3). NO RESERVES FOR UNCERTAIN TAX POSITIONS HAVE BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

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 %

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: . . . . . . . .

Yes

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? . . . . . .

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) . . .	1,336,844	60,648	1,276,196	0.490 %
b	Medicaid (from Worksheet 3, column a) . . . . .	13,130,092	10,850,969	2,279,123	0.870 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	14,466,936	10,911,617	3,555,319	1.360 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,157,756		1,157,756	0.440 %
f	Health professions education (from Worksheet 5) . . .	11,228		11,228	0 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	3,628		3,628	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	14,216		14,216	0.010 %
j	Total. Other Benefits . .	1,186,828		1,186,828	0.450 %
k	Total. Add lines 7d and 7j .	15,653,764	10,911,617	4,742,147	1.810 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

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
2	Economic development	217	217	0 %
3	Community support	99,152	99,152	0.040 %
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	99,369	99,369	0.040 %

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? ..........................

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

6,044,282

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. ......

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).....

3,286,713

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

3,230,783

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

55,930

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 %	(e) Physicians' profit % or stock ownership %
11 LAKESIDE WOMEN'S	WOMEN'S HEALTH	75.000 %	25.000 %
22 MED PLAZA IMAGING	RADIOLOGY IMAGING CENTER	50.000 %	50.000 %
33 SW AMB SURG CTR	AMBULATORY SURGERY CTR.	25.100 %	49.900 %
44 COMM HOSP NORTH LLC	HEALTH CARE	25.500 %	49.000 %
55 OK CTR ORTHPDIC & MLTI-SPCLTY SURG	HEALTH CARE	50.100 %	47.170 %
66 INTEGRIS DDSI	HEALTH CARE	50.100 %	49.900 %
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

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?4Name, 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)						Facility reporting group
1	LAKESIDE WOMEN'S HOSPITAL LLC - FACILITY GROUP A 11200 N PORTLAND OKLAHOMA CITY,OK73120 WWW.INTEGRISOK.COM 2339	X	X	X		A
2	OK CTR ORTHPDIC & MLTI-SPCLTY SURG 8100 S WALKER OKLAHOMA CITY,OK73139 WWW.OCOMHOSPITAL.COM 2347	X	X		X	B
3	COMMUNITY HOSPITAL LLC 3100 SW 89TH OKLAHOMA CITY,OK73189 COMMUNITYHOSPITALOKC.COM 2341	X				C
4	TPG HOSPITAL LLC 9204 N MAY AVE OKLAHOMA CITY,OK73120 NWSURGICALOKC.COM 2329	X				C

Schedule H (Form 990) 2021

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)

	FACILITY REPORTING GROUP - A
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 21

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 PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

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 21

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

Yes

If "Yes" (list url): SEE 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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
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 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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 PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE 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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
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) 2021

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORTING GROUP - A
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) 2021

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)

	FACILITY REPORTING GROUP - B
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?........................

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 22

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. ............................

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 PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

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 22

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

Yes

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

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

10b

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - B
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 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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

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 PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE 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)

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - B
Name of hospital facility or letter of facility reporting group

Yes

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

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

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) 2021

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORTING GROUP - B
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 prospective Medicare or Medicaid method

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) 2021

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)

	FACILITY REPORTING GROUP - C
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?........................

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 21

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 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 21

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

Yes

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

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

10b

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - C
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 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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

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 PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE 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)

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - C
Name of hospital facility or letter of facility reporting group

Yes

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

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

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) 2021

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORTING GROUP - C
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 prospective Medicare or Medicaid method

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) 2021

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 A:	INTEGRIS AMBULATORY CARE CORP, (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IACC FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED BELOW.
PART V, SECTION B, LINE 3E	FACILITY REPORTING GROUP A:THE SIGNIFICANT HEALTH NEEDS OF IACC ARE PRESENTED AS A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.FACILITY REPORTING GROUP B:THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT FOR OKLAHOMA CENTER FOR ORTHOPAEDIC AND MULTI-SPECIALTY SURGERY, LLC (OCOM) ARE PRESENTED AS A PRIORITIZED DESCRIPTION OF THOSE NEEDS.FACILITY REPORTING GROUP C:THE SIGNIFICANT HEALTH NEEDS OF COMMUNITY HOSPITAL, LLC AND TPG HOSPITAL, LLC (HPI) ARE PRESENTED AS A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: LAKESIDE WOMEN'S HOSPITAL LLC - FACILITY GROUP
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	EACH COMMUNITY HEALTH NEEDS ASSESSMENT AIMS TO ALIGN LOCAL PLANNING EFFORTS WITH ASSESSMENTS AND INTERVENTIONS CONDUCTED BY COUNTY HEALTH DEPARTMENTS. THIS PLANNING PROCESS REPRESENTS A COMMITMENT TO A MORE DELIBERATE APPROACH TO WORKING TOGETHER. CENTRAL OKLAHOMA HEALTH IMPACT TEAM MEMBER: PHIL MAYTUBBY, DEPUTY CHIEF EXECUTIVE OFFICER, OKLAHOMA CITY COUNTY HEALTH DEPARTMENT IN CONDUCTING THE CHNA, THE HOSPITALS TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY STAKEHOLDER MEETINGS, SECONDARY DATA RESEARCH, COMMUNITY SURVEYS, COMMUNITY CHATS AND INFORMATIONAL INTERVIEWS WITH COMMUNITY LEADERS. ETHNICITIES INPUT WAS OBTAINED FROM SURVEYS BY TARGETING POPULATION GATHERING PLACES SUCH AS COMMUNITY CLINICS, CHURCHES, AFTER SCHOOL PROGRAMS, AND PUBLIC TRANSPORTATION SERVICES.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	FOUR NON-PROFIT HOSPITALS ENGAGED IN A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT: INTEGRIS HEALTH, MERCY HOSPITAL OKLAHOMA CITY, OU HEALTH, AND SSM HEALTH ST. ANTHONY. THIS ASSESSMENT EVALUATED THE HEALTH NEEDS OF OKLAHOMA COUNTY.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	THE FOUR NON-PROFIT HOSPITALS ENGAGING IN THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT FOR OKLAHOMA COUNTY ALSO PARTNERED WITH THE OKLAHOMA CITY COUNTY HEALTH DEPARTMENT TO ASSESS THE NEEDS OF THE COMMUNITY.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D:	THE CHNA IS WIDELY AVAILABLE TO THE COMMUNITY. THE PLANS WERE ALSO ADDED TO EACH FACILITY'S WEBSITE AND CLEARLY TITLED. THE PLANS WERE ALSO DISTRIBUTED TO ADMINISTRATION, LOCAL BOARDS AT COMMUNITY FORUMS, COALITIONS, OTHER LOCAL AGENCIES, AND ORGANIZATIONS. COPIES OF THE PLAN WERE PLACED IN EACH FACILITY'S ADMINISTRATION OFFICES FOR DISTRIBUTION AS WELL.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:	THE CHNA PROCESS ASSISTED IN DETERMINING AVAILABLE RESOURCES, GAPS IN SERVICES, AND BOTH PERCEIVED AND ACTUAL NEEDS WITHIN THE INTEGRIS HEALTH SERVICE AREAS. THIS PROCESS LED TO THE IDENTIFICATION OF FOUR PRIORITY AREAS. ALTHOUGH THERE IS NO SINGLE FACTOR THAT PREDICTS A HEALTH OUTCOME, THE AREAS IDENTIFIED AS PRIORITY FOR OKLAHOMA COUNTY, BY THE HOSPITAL SYSTEMS AND COMMUNITY STAKEHOLDERS, INCLUDE: ACCESS TO EDUCATION, ACCESS TO MEANINGFUL EMPLOYMENT, ACCESS TO HEALTHY FOOD, AND ACCESS TO HEALTHCARE.THE NEEDS IDENTIFIED BY THE CHNA WERE INITIALLY PRIORITIZED THROUGH COLLABORATION WITH THE LOCAL COMMUNITY COALITIONS. THE LOCAL PRIORITIZED NEEDS WERE THEN REEXAMINED BY INTEGRIS HEALTH THROUGH ADMINISTRATION OF THE DEVELOPED COMMUNITY HEALTH IMPROVEMENT PLAN AND WHICH, IF ANY OF THE REMAINING, WERE CURRENTLY BEING ADDRESSED THROUGH OTHER COMMUNITY RESOURCES AND/OR SERVICES. INTEGRIS HEALTH OPTED TO CONCENTRATE ON TWO OF THE FOUR PRIORITY AREAS IDENTIFIED IN EACH OF THE SERVICE AREAS- ACCESS TO HEALTHY FOOD AND ACCESS TO HEALTHCARE BELIEVING THAT A UNITED EFFORT WOULD ALLOW FOR A SHARING OF RESOURCES, PERSONNEL, PROGRAMS, ETC., AND ENSURE CONSISTENCY IN IMPLEMENTATION AND EVALUATION METHODS, THEREBY INCREASING POTENTIAL TO MORE EFFECTIVELY COMBAT THE ISSUES SYSTEM-WIDE. IN ADDITION TO THE TWO PRIORITY AREAS, TOBACCO USE WAS ALSO ADDED TO THE SYSTEM FOCUS AREAS TO CONTINUE TO ADDRESS THIS ISSUE IN ALL SERVICE AREAS. ACCESS TO HEALTHY FOOD IS BEING ADDRESSED BY THE FOLLOWING PROGRAM IMPLEMENTATION: INTEGRIS HEALTH I-CREW, FOOD BANK PROGRAMS, AND PARTNERSHIPS WITH LOCAL COALITIONS. THE INTEGRIS HEALTH I-CREW WILL ESTABLISH TWO PARTNERSHIP OPPORTUNITIES DIRECTLY TARGETING IMPROVING ACCESS TO HEALTHY FOOD. LAKESIDE WOMEN'S HOSPITAL WILL ALSO COORDINATE AT LEAST ONE FOOD DRIVE. IN ADDITION TO THE PROGRAMS MENTIONED, INTEGRIS HEALTH WILL SUPPORT LOCAL EFFORTS WITH COALITIONS WHO SUPPORT AND INCREASE ACCESS TO HEALTHY FOOD.ACCESS TO HEALTHCARE IS BEING ADDRESSED BY THE FOLLOWING PROGRAM IMPLEMENTATION: INTEGRIS HEALTH MOBILE CARE CLINIC AND PARTNERSHIPS WITH LOCAL COALITIONS. INTEGRIS HEALTH MOBILE CARE CLINIC SERVES 50 COMMUNITY MEMBERS. IN ADDITION, INTEGRIS HEALTH WILL SUPPORT LOCAL EFFORTS WITH COALITIONS WHO SUPPORT, PREVENT, AND EDUCATE ON INCREASING ACCESS TO CARE.TOBACCO USE PREVENTION IS BEING ADDRESSED BY THE FOLLOWING PROGRAM IMPLEMENTATION: OKLAHOMA TOBACCO HELPLINE REFERRALS, SOCIAL MEDIA CAMPAIGNS, AND PARTNERSHIPS WITH LOCAL COALITIONS. OKLAHOMA TOBACCO HELPLINE REFERRALS GOAL IS TO REFER 25 PERSONS FOR TOBACCO CESSATION SERVICES. INTEGRIS HEALTH WILL ESTABLISH TWO PARTNERSHIP OPPORTUNITIES FOR SOCIAL MEDIA CAMPAIGNS THAT SUPPORT AND PROMOTE TOBACCO USE PREVENTION. IN ADDITION TO THE PROGRAMS MENTIONED, INTEGRIS HEALTH WILL SUPPORT LOCAL EFFORTS WITH COALITIONS WHO SUPPORT, PREVENT, AND EDUCATE ON TOBACCO USE PREVENTION.IT WAS DETERMINED THAT THE REMAINING PRIORITY AREAS IDENTIFIED IN THE CHNA WERE ALREADY BEING ADDRESSED THROUGH LOCAL AGENCIES AND/OR COALITIONS AND PARTNERSHIP EFFORTS WITHIN THE COMMUNITY. AS SUCH, INTEGRIS HEALTH COMMITTED TO PROVIDE SUPPORT AND RESOURCES TO THE COMMUNITY PARTNERS TAKING THE LEAD ON THOSE PARTICULAR ISSUES.
PART V, SECTION B	FACILITY REPORTING GROUP B
FACILITY REPORTING GROUP B CONSISTS OF:	- FACILITY 2: OK CTR ORTHPDIC & MLTI-SPCLTY SURG
FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 5:	SEE SCHEDULE H, PART VI, LINE 2
FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6A:	DESCRIPTION:THE HOSPITAL FACILITIES INCLUDED IN THE JOINT CHNA ARE AS FOLLOWS:- COMMUNITY HOSPITAL NORTH- COMMUNITY HOSPITAL SOUTH- COMMUNITY HOSPITAL NORTHWEST SURGICAL- INTEGRIS COMMUNITY HOSPITAL - MOORE- INTEGRIS COMMUNITY HOSPITAL - DEL CITY- INTEGRIS COMMUNITY HOSPITAL - OKC WEST- INTEGRIS COMMUNITY HOSPITAL - COUNCIL CROSSING- OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY (OCOM)
FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 11:	SEE SCHEDULE H, PART VI, LINE 2
PART V, SECTION B	FACILITY REPORTING GROUP C
FACILITY REPORTING GROUP C CONSISTS OF:	- FACILITY 3: COMMUNITY HOSPITAL, LLC, - FACILITY 4: TPG HOSPITAL, LLC
FACILITY REPORTING GROUP - C PART V, SECTION B, LINE 6A:	DESCRIPTION:THE HOSPITAL FACILITIES INCLUDED IN THE JOINT CHNA ARE AS FOLLOWS:- COMMUNITY HOSPITAL NORTH- COMMUNITY HOSPITAL SOUTH- COMMUNITY HOSPITAL NORTHWEST SURGICAL- INTEGRIS COMMUNITY HOSPITAL - MOORE- INTEGRIS COMMUNITY HOSPITAL - DEL CITY- INTEGRIS COMMUNITY HOSPITAL - OKC WEST- INTEGRIS COMMUNITY HOSPITAL - COUNCIL CROSSING- OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY (OCOM)
PART V, SECTION B, LINE 7A, 7B, AND LINE 10A:	REPORTING GROUP A:HTTPS://INTEGRISOK.COM/ABOUT-INTEGRIS/SERVING-OUR-COMMUNITY/REPORTSHTTPS://WWW.MERCY.NET/ABOUT/OUR-COMMUNITIES/COMMUNITY-BENEFITS/REPORTING GROUP B:HTTPS://OCOMHOSPITAL.COM/HTTPS://INTEGRISOK.COM/ABOUT-INTEGRIS/SERVING-OUR-COMMUNITY/REPORTSHTTPS://OCOMHOSPITAL.COM/REPORTING GROUP C:HTTPS://COMMUNITYHOSPITALOKC.COM/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTHTTPS://NWSURGICALOKC.COM/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTHTTPS://WWW.INTEGRISCOMMUNITYHOSPITAL.COM/
PART V, SECTION B, LINES 16A, 16B, AND 16C	REPORTING GROUP AHTTPS://INTEGRISOK.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCEREPORTING GROUP BHTTPS://OCOMHOSPITAL.COM/FINANCIAL-ASSISTANCE-POLICY-2/REPORTING GROUP C:HTTPS://NWSURGICALOKC.COM/PATIENTS/ACCOUNT-ASSISTANCE
REPORTING GROUP B: PART V, SECTION B, LINE 5	OCOM HAS BEEN IN EXISTENCE SINCE 2002 AND IS COMPRISED OF TWO SURGICAL HOSPITALS, ONE OUTPATIENT PHYSICAL THERAPY LOCATION AND THREE OFF-SITE IMAGING CENTERS. ALL OF THE FACILITIES SERVICE OKLAHOMA CITY, IN OKLAHOMA COUNTY, OKLAHOMA.OCOM PRIDES ITSELF IN PROVIDING FIRST-CLASS SURGICAL SERVICES FOR THE LOCAL COMMUNITY IN A SAFE, COMFORTABLE, AND WELCOMING ENVIRONMENT; ONE IN WHICH HOSPITAL STAFF WOULD BE HAPPY TO TREAT THEIR OWN FAMILIES. OCOM STRIVES TO CREATE THE SURGICAL STANDARD ALL PHYSICIANS WANT FOR THEIR PATIENTS. OCOM EMPLOYS 224 TEAM MEMBERS INCLUDING FULLTIME, PART-TIME AND PRN WITH APPROXIMATELY 60 PHYSICIAN PROVIDERS.OCOM'S SOUTH HOSPITAL LOCATION INCLUDES NINE INPATIENT ROOMS, SIX OPERATING ROOMS, AND ONE ENDOSCOPIC/PAIN MANAGEMENT PROCEDURE ROOM. OCOM'S NORTH LOCATION INCLUDES THREE OPERATING ROOMS AND DOES NOT HAVE INPATIENT ROOMS. HOSPITAL OCOM'S STATE-OF-THE-ART EQUIPMENT ALLOWS SURGEONS TO PERFORM A VARIETY OF SURGICAL PROCEDURES IN THE SPECIALTY AREAS OF DENTISTRY, GENERAL SURGERY, GASTROENTEROLOGY (GI), GYNECOLOGY, IMAGING, OPTHALMALOGY, ORTHOPAEDIC, PAIN MANAGEMENT, PHYSICAL THERAPY, PLASTIC SURGERY, PODIATRY AND UROLOGY.OCOM HOLDS A TJC CERTIFICATE OF DISTINCTION FOR TOTAL HIP AND TOTAL KNEE PROGRAMS, IS A CMS FIVE-STAR RATED FACILITY, AND IS THE RECIPIENT OF THE PRESS GANEY GUARDIAN OF EXCELLENCE AND HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARDS.OKLAHOMA COUNTY IS IN THE CENTRAL PART OF OKLAHOMA AND IS THE LARGEST COUNTY IN OKLAHOMA IN TERMS OF POPULATION. OKLAHOMA CITY IS THE COUNTY SEAT AND IS THE LARGEST CITY IN THE STATE. THERE ARE 20 CITIES AND SMALL TOWNS LOCATED IN THE COUNTY. OKLAHOMA COUNTY EMPLOYS 379,291 PEOPLE. THE ECONOMY SPECIALIZES IN MINING, OIL, GAS, QUARRYING, EXTRACTION, MANAGEMENT OF COMPANIES AND ENTERPRISES, AND PUBLIC ADMINISTRATION. ACCORDING TO THE 2019 POPULATION ESTIMATES, THE POPULATION OF OKLAHOMA COUNTY WAS 797,434.OKLAHOMA COUNTY HAS 14 HOSPITALS, TWO FEDERALLY QUALIFIED HEALTH CENTERS WITH 14 SATELLITE CLINICS, APPROXIMATELY 17 FREE COMMUNITY CLINICS, ONE TRIBAL CLINIC, A CITY-COUNTY HEALTH DEPARTMENT WITH MULTIPLE LOCATIONS THROUGHOUT THE COUNTY, AND A STATE HEALTH DEPARTMENT. PUBLIC TRANSPORTATION, TAXI SERVICES, TWO PUBLIC AND SEVERAL PRIVATE AIRPORTS, AND PARAMEDIC LEVEL AMBULANCE SERVICES ARE ALSO LOCATED WITHIN THE COUNTY.ACCORDING TO THE OKLAHOMA CITY-COUNTY HEALTH DEPARTMENT 2021 DATA, THE MEDIAN AGE IN OKLAHOMA COUNTY WAS 34.5 YEARS, WHICH IS SLIGHTLY YOUNGER THAN THE STATE OF OKLAHOMA AT 36.4 YEARS. THE PERCENT LIVING IN POVERTY IN OKLAHOMA COUNTY IS 16.7% WHICH IS SLIGHTLY LOWER THAN THE STATE AT 16.0%. IN 2018, THE MEDIAN HOUSEHOLD INCOME IN OKLAHOMA COUNTY OF $52,855 WAS SLIGHTLY HIGHER THAN THE STATE OF $51,424. BOTH LAGGED BEHIND THE NATIONAL MEDIUM INCOME OF $60,293. OKLAHOMA COUNTY RESIDENTS RECEIVED SLIGHTLY MORE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN THE STATE RATE IN 2018 (13.3% VS. 13.1%.) THE RACIAL/ETHNIC BREAKOUT OF OKLAHOMA COUNTY WAS 56.0% WHITE, 14.8% BLACK OR AFRICAN AMERICAN, 17.4% HISPANIC OR LATINO, 6.7% AMERICAN INDIAN OR ALASKA NATIVE, AND 4.7% ASIAN AND PACIFIC ISLANDER.AMONG OKLAHOMA RESIDENTS 18 AND OLDER, 30% OF PERSONS HELD A BACHELOR'S DEGREE OR HIGHER AS OF 2019. ON SEPTEMBER 30, 2021, NEW UNEMPLOYMENT NUMBERS WERE RELEASED FROM THE U.S. BUREAU OF LABOR STATISTICS SHOWING OKLAHOMA CITY RANKS FIRST FOR METROPOLITAN COMMUNITIES WITH A 2010 CENSUS POPULATION OF ONE MILLION OR MORE. OKLAHOMA CITY HAD AN UNEMPLOYMENT RATE OF ONLY 2.6% AND IS THE LOWEST RATE SINCE 2019. THE PERCENT OF UNINSURED ADULTS (AGE 18-64), IN OKLAHOMA COUNTY, ACCORDING TO DATA FROM THE 2021 U.S. CENSUS BUREAU, WAS CONSISTENT WITH THE STATE RATE OF 16.8%. ACCORDING TO THE OKLAHOMA HEALTH CARE AUTHORITY FAST FACTS, JANUARY 2021, THERE WERE A TOTAL OF 200,287 PERSONS ENROLLED IN MEDICAID IN OKLAHOMA COUNTY AND 946,412 PERSONS ENROLLED IN MEDICAID IN THE STATE OF OKLAHOMA DURING THE SAME PERIOD. AS OF FEBRUARY 2021, THERE WERE 92,632 PERSONS IN OKLAHOMA COUNTY AND 572,942 PERSONS IN THE STATE OF OKLAHOMA ENROLLED IN MEDICARE ACCORDING TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICARE ENROLLMENT DASHBOARD. BETWEEN 2015 AND 2019, THE AVERAGE NUMBER OF PERSON PER HOUSEHOLD IN OKLAHOMA COUNTY WAS 2.56 WHICH WAS SLIGHTLY LOWER THAN THE STATE AT 2.58.DURING THE SAME PERIOD, THE PERCENT OF PERSONS, 5 YEARS OR OLDER, IN OKLAHOMA COUNTY WHO SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME WAS 17.4% COMPARED TO THE STATE RATE OF 10.5%. IN 2020, ACCORDING TO THE 2020 COUNTY HEALTH RANKINGS FOR OKLAHOMA COUNTY, ACCESS TO A PRIMARY CARE PHYSICIAN, PEOPLE PER ONE PROVIDER, WAS 1,170 COMPARED TO THE STATE OF OKLAHOMA WHICH WAS 1,620 PEOPLE PER ONE PROVIDER. ACCESS TO DENTISTS AND MENTAL HEALTH IN OKLAHOMA COUNTY, PEOPLE PER ONE PROVIDER, ACCORDING TO THE SAME SOURCE, WAS 980 AND 150, RESPECTIVELY AND 1640 AND 250, PEOPLE PER ONE PROVIDER FOR THE STATE OF OKLAHOMA. BETWEEN 2015-2017, THE AVERAGE LIFE EXPECTANCY IN OKLAHOMA COUNTY IS 74.9 YEARS WHEREAS THE AVERAGE IN THE U.S. IS 78.8 YEARS.BETWEEN 2016-2018, CARDIOVASCULAR DISEASE WAS THE LEADING CAUSE OF DEATH IN OKLAHOMA COUNTY. AT 337.7 DEATHS PER 100,000, MALES HAD 100 MORE DEATHS PER 100,000 COMPARED TO FEMALES WITH A RATE OF 235.9 DEATHS PER 100,000. CANCER WAS THE SECOND LEADING CAUSE OF DEATH IN OKLAHOMA CITY-COUNTY BETWEEN 2016-2018, THE AGE-ADJUSTED MORTALITY RATE IN OKLAHOMA COUNTY WAS 188.0 PER 100,000 DEATHS, ONLY SLIGHTLY HIGHER THAN THE STATE RATE OF 177.8 PER 100,000 DEATHS BUT 27.6 DEATHS PER 100,000 GREATER THAN THE NATIONAL CANCER DEATH RATE. OKLAHOMA COUNTY HAD HIGHER DIABETES MORTALITY BETWEEN 2016-2018 COMPARED TO THE STATE AND NATIONAL RATES. THE OVERALL AGE-ADJUSTED DIABETES MORTALITY RATE IN THE COUNTY WAS 34.6 DEATHS PER 100,000. OKLAHOMA IS THE NINTH MOST OBESE STATE IN THE NATION, OKLAHOMA'S OBESITY RATE AS OF 2021 WAS AT 36.4%. THE SUICIDE RATES IN OKLAHOMA COUNTY AND THE STATE OF OKLAHOMA WERE HIGHER THAN THE NATIONAL AVERAGE BETWEEN 2016-2018. THE AGE-ADJUSTED SUICIDE RATE IN OKLAHOMA COUNTY WAS 18 DEATHS PER 100,000 PEOPLE.A COMPREHENSIVE AND A COLLABORATIVE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY FOUR NON-PROFIT HEALTH SYSTEMS AS ALL FOUR HEALTH SYSTEMS DEFINE THEIR COMMUNITY AS OKLAHOMA COUNTY. THIS CHNA INCLUDED INTEGRIS HEALTH SYSTEM AND THEIR JOINT VENTURE HOSPITALS: HEALTHCARE PARTNERS (HIP), INTEGRIS COMMUNITY HOSPITALS AND OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI SPECIALTY SURGERY. THE CHNA UTILIZES RELEVANT HEALTH DATA TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS OF OKLAHOMA AND CLEVELAND COUNTIES IN THE STATE OF OKLAHOMA. ALL OF THE JOINT VENTURE HOSPITALS LIE WITHIN OKLHOMA COUNTY, EXCEPT FOR ONE SMALL CAMPUS OF THE INTEGRIS COMMUNITY HOSPITALS (MOORE), WHICH LIES ON THE NORTHERN EDGE OF CLEVELAND COUNTY. THE GOAL OF THIS REPORT IS TO PROVIDE RESIDENTS WITH A DEEPER UNDERSTANDING OF THE HEALTH NEEDS IN THEIR COMMUNITY AND TO HELP GUIDE THE HOSPITALS IN THEIR COMMUNITY BENEFIT PLANNING EFFORTS AND THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED NEEDS. COMMUNITY INPUT WAS RECEIVED DURING STAKEHOLDER MEETINGS, COMMUNITY SURVEYS COLLECTED DURING APRIL 2021-JULY 2021 AND ONLINE CHATS WHICH WERE CONDUCTED FROM MAY 23, 2021 - JUNE 30, 2021.THE AFFORDABLE CARE ACT (ACA) REQUIRES 501(C)(3), TAX-EXEMPT HOSPITALS TO CONDUCT A CHNA AT LEAST ONCE EVERY THREE TAX YEARS AND TO ADOPT A STRATEGIC IMPLEMENTATION PLAN FOR ADDRESSING IDENTIFIED NEEDS. INTEGRIS HEALTH LAST CONDUCTED A CHNA DURING FISCAL YEAR 2022.THE OCOM BOARD OF DIRECTORS REVIEWED AND ADOPTED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE IMPLEMENTATION PLAN ON JULY 25, 2022.
REPORTING GROUP B: PART V, SECTION B, LINE 5 CONTINUED	INTERVIEW METHODOLOGY:METHODS OF COLLECTING AND ANALYZING DATA AND INFORMATION INCLUDED ONLINE SURVEYS, FOCUS GROUPS, PUBLISHED DATA, AND HOSPITAL SPECIFIC DATA. FOCUS GROUPS AND SURVEYS WERE CONDUCTED TO DIALOGUE DIRECTLY WITH LOCAL COMMUNITY MEMBERS. COMMUNITY INPUT WAS GATHERED FROM OKLAHOMA COUNTY RESIDENTS OF ALL BACKGROUNDS, SOCIOECONOMIC STATUS, AND DEMOGRAPHICS THROUGH SURVEYS. INPUT INCLUDED MEMBERS OF UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THERE WAS ALSO A TARGETED EFFORT TO CONDUCT FOCUS GROUPS WITH AT-RISK POPULATIONS IN LOW SOCIOECONOMIC ZIP CODES.COMMUNITY PARTNERS THAT ASSISTED IN DATA COLLECTION FOR COMMUNITY CHATS INCLUDED STANLEY HUPFELD ACADEMY, CROSSINGS COMMUNITY CENTER, CROSSINGS COMMUNITY CLINIC AND THE MOORE FOOD RESOURCE CENTER. COMMUNITY SURVEYS WERE AVAILABLE ONLINE. EACH PARTNER UTILIZED SOCIAL MEDIA TO PUBLICIZE THE SURVEY TO RESIDENTS IN THEIR SERVICE AREA. PARTNERS ASSISTING IN THE DISSEMINATION OF THE ONLINE SURVEY INCLUDED CROSSINGS COMMUNITY CLINIC, HPI COMMUNITY HOSPITAL AND NORTHWEST SURGICAL HOSPITAL, INTEGRIS COMMUNITY HOSPITALS AND OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY.IN ADDITION TO THE INPUT FROM COMMUNITY CHATS, ONLINE SURVEYS AND DOT VOTING, THE COMPILATION OF PUBLIC HEALTH DATA, STATE AND NATIONAL DATA, GAVE A BROADER VIEW OF THE OVERALL HEALTH STATUS OF THE COUNTY. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE OKLAHOMA HEALTH CARE AUTHORITY, FAST FACTS, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. MEDICARE ENROLLMENT DASHBOARD, THE 2020 COUNTY HEALTH RANKINGS, OKLAHOMA COUNTY, THE 2020 COUNTY HEALTH RANKINGS. CLEVELAND COUNTY AND THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION. ADULT OBESITY PREVALENCE, MENTAL HEALTH AMERICA, THE STATE OF MENTAL HEALTH IN AMERICA AND CITY OF NORMAN. REQUESTS FOR PROPOSALS FOR A HOMELESSNESS STRATEGIC PLAN. POPULATION DEMOGRAPHIC INFORMATION WAS ALSO COLLECTED BY INTEGRIS HEALTH USING A NUMBER OF THE ABOVE SOURCES AND INCLUDED INFORMATION REGARDING POPULATION BY RACE, AGE, MEDIAN HOUSEHOLD INCOME AND EDUCATION AND ECONOMIC STATISTICS IN OKLAHOMA COUNTY.DUE TO THE COVID-19 PANDEMIC, LOCAL HEALTH DEPARTMENTS WERE UNABLE TO PUBLISH UPDATED PUBLIC HEALTH DATA. INTEGRIS HEALTH REVIEWED AND USED THE MOST CURRENT AVAILABLE DATA FOR THE PURPOSE OF PROVIDING A COMPREHENSIVE OVERVIEW OF THE COMMUNITY. WITH RESPECT TO THOSE PROVIDING INPUT, DUE TO THE COVID-19 PANDEMIC AND THE IMMENSE NEEDS AND REQUIRED FOCUS ASSOCIATED WITH IT, NO INPUT FROM OTHERS IN THE COMMUNTIY THAT HAD EXPERTISE IN PUBLIC HEALTH WAS OBTAINED. HOWEVER, SOME INPUT WAS PULLED FROM THE OKLAHOMA COUNTY CHNA COMPLETED TWO YEARS PRIOR WHICH DID INCLUDE INPUT FROM THE OKC COUNTY HEALTH DEPARTMENT, UNITED WAY OF CENTRAL OKLAHOMA AND THE OKLAHOMA STATE DEPARTMENT OF HEALTH. ADDITIONALLY, THE HOSPITALS PROVIDED INTERNAL DATA FOR ANALYSIS AND CONSIDERATION IN THE CHNA PROCESS.IN TOTAL, THE ONLINE SURVEY WAS ADMINISTERED TO 402 INDIVIDUALS, AND FOCUS GROUP SURVEYS WERE CONDUCTED AMONG 90 PARTICIPANTS TO GATHER QUALITATIVE DATA. THE FOCUS GROUPS WERE ADAPTED DUE TO COVID-19 RESTRICTIONS. INTEGRIS HEALTH REPRESENTATIVES PROVIDED OPEN-ENDED SURVEYS TO PARTICIPANTS VIA AN ONLINE PLATFORM, ASKING PARTICIPANTS TO ANSWER THE OPEN-ENDED QUESTIONS WHILE DISCUSSING TOPICS AS A GROUP. AFTER INTEGRIS HEALTH COLLECTED THIS QUALITATIVE AND QUANTITATIVE DATA, THEY RETURNED IT TO THE UNIVERSITY OF CENTRAL OKLAHOMA'S COMMUNITY INTERVENTION CLASS FOR ANALYSIS. WHEN REVIEWING THE QUANTITATIVE SURVEYS FROM THE 402 PARTICIPANTS AT FIVE SITES (I.E. HPI COMMUNITY HOSPITAL, INTEGRIS COMMUNITY HOSPITAL (CLEVELAND COUNTY), INTEGRIS COMMUNITY HOSPITALS (OKLAHOMA COUNTY), OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY OKLAHOMA COUNTY, AND CROSSINGS COMMUNITY CENTER), ALL LOCATIONS WERE ANALYZED TO FIND COMMONALITIES AND IMPORTANT FINDINGS.OVERALL, FEEDBACK FROM COMMUNITY MEMBERS IN THE QUANTITATIVE SURVEYS HIGHLIGHTED A NEED FOR HEALTHCARE ACCESS ESPECIALLY AS IT RELATES TO MENTAL HEALTH AND SICK VISITS, HEALTH EDUCATION AND PROMOTION (PARTICULARLY RELATED TO PHYSICAL HEALTH ISSUES THAT CAN BE ADDRESSED THROUGH EDUCATION AS WELL AS DETERMINANTS OF HEALTH IN THE COMMUNITY); AND AFFORDABLE MEDICATIONS AND FOOD.WHEN ANALYZING QUALITATIVE FEEDBACK FROM 90 PARTICIPANTS COMPLETING THEIR FOCUS GROUP SURVEYS (FROM MOORE FOOD & RESOURCE CENTER, STANLEY HUPFELD ACADEMY, AND CROSSINGS COMMUNITY CENTER), SEVERAL THEMES AROSE ACROSS THE THREE SITES AND SIX-OPEN-ENDED QUESTIONS. THESE INCLUDED: A NEED AND DESIRE FOR GREATER ACCESS TO HEALTHCARE SERVICES (INCLUDING BOTH PREVENTIVE CARE ON A MYRIAD OF ISSUES AS WELL AS PHYSICIAN APPOINTMENTS); MENTAL HEALTH SERVICES (INCLUDING COUNSELING AS WELL AS REHABILITATION PROGRAMS); EDUCATIONAL SERVICES (INCLUDING NUTRITION EDUCATION; HEALTH EDUCATION FOR A VARIETY OF HEALTH ISSUES AS WELL AS DISEASE PREVENTION AND TREATMENT; AND ACCESS TO CREDIBLE COVID-19 INFORMATION); ENVIRONMENTAL DETERMINANTS OF HEALTH (INCLUDING BUT NOT LIMITED TO FOOD SECURITY ISSUES, TRANSPORTATION AND HOUSING NEEDS, EDUCATION, AFFORDABLE CARE, AND ACCESS TO EMPLOYMENT OPPORTUNITIES); AND FINALLY, ENSURING THAT OLDER ADULTS IN COMMUNITIES ARE INCLUDED IN THE PLANNING AND IMPLEMENTATION OF PROGRAMS AND SERVICES PROVIDED.
REPORTING GROUP B: PART V, SECTION B, LINE 11	INTEGRIS HEALTH COLLABORATED WITH LOCAL COMMUNITY PARTNERS ON THE CHNA AND EVALUATED AND SYNTHESIZED PRIMARY AND SECONDARY DATA TO IDENTIFY SIGNIFICANT COMMUNITY HEALTH NEEDS IN OKLAHOMA AND CLEVELAND COUNTY. THROUGHOUT THE NEEDS PROCESS, FOCUS WAS GIVEN TO THE INTERCONNECTEDNESS OF SOCIAL DETERMINANTS AND HEALTH OUTCOMES IN OKLAHOMA COUNTY.UPON REVIEW AND ANALYSIS OF ALL QUANTITATIVE AND QUALITATIVE FEEDBACK AND DATA, THE MOST RECENTLY CONDUCTED CHNA FOCUSED ON THE SOCIAL DETERMINANTS AND HEALTH OUTCOMES IN OKLAHOMA COUNTY. SOCIAL DETERMINATES OF HEALTH (SDOH) ARE THE CONDITIONS IN WHICH PEOPLE ARE BORN, GROW, LIVE, WORK AND AGE THAT SHAPE HEALTH. SDOH ARE PRIMARY DRIVERS OF HEALTH DISPARITIES AND INCLUDE SIGNIFICANT FACTORS LIKE ECONOMIC STABILITY, EDUCATION ACCESS AND QUALITY, HEALTH CARE ACCESS AND QUALITY, NEIGHBORHOOD AND THE BUILT ENVIRONMENT AND SOCIAL AND COMMUNITY CONTEXT. THIS CHNA PROCESS WAS DESIGNED TO USE DATA TO IDENTIFY THOSE WHO MAY NOT BE THRIVING.INTEGRIS HEALTH THEN ANALYZED AND EVALUATED THE PRIMARY DATA AND THE SECONDARY PUBLIC HEALTH DATA COLLECTED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS PROCESS LED TO THE IDENTIFICATION OF FOUR PRIORITY AREAS BASED ON CURRENT SYSTEM WIDE EFFORTS AT INTEGRIS HEALTH AND ALIGNED WITH THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) GOALS AND OBJECTIVES IN THE OKLAHOMA CITY METRO.THE FOLLOWING FOUR PRIORITIZED NEEDS WERE DETERMINED:- ACCESS TO EDUCATION- ACCESS TO MEANINGFUL EMPLOYMENT- ACCESS TO HEALTHY FOOD- ACCESS TO HEALTHCAREINTEGRIS HEALTH CHOSE TO FOCUS ON ALL OF THE IDENTIFIED PRIORITY ISSUES.* WHILE TOBACCO WAS NOT SPECIFICALLY IDENTIFIED BY THE COMMUNITY AS A PRIORITY NEED, INTEGRIS HEALTH AND THEIR PARTNERS AGREE THAT IT IS A HEALTH ISSUE THAT SHOULD CONTINUE TO BE ADDRESSED. OKLAHOMA COUNTY IS STILL ABOVE THE NATIONAL AVERAGE FOR ADULTS WHO SMOKE. AMONG YOUTH, AS OF 2019, 30.8% OF OKLAHOMA HIGH SCHOOLERS REPORTED CURRENT USE OF ANY TOBACCO PRODUCT. THE STATE OF OKLAHOMA, WITH THE EXPANSION OF ELECTRONIC CIGARETTES AND VAPES, NICOTINE DEPENDENCY CONTINUES TO BE A WIDESPREAD PUBLIC HEALTH CONCERN FOR OKLAHOMA COUNTY RESIDENTS. INTEGRIS HEALTH TRACKS REFERRALS MADE TO THE OKLAHOMA TOBACCO HELPLINE AND REPORTS ARE MADE AVAILABLE QUARTERLY. INTEGRIS HEALTH PROVIDED 2,617 REFERRALS IN FY 2020 AND 2,002 REFERRALS IN FY 2021.EACH HOSPITAL THEN DEVELOPED AN INDIVIDUAL IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN IN A SEPARATE DOCUMENT TO ADDRESS THE NEEDS IDENTIFIED BASED ON THEIR INTERNAL PRIORITIES AND RESOURCES.ACCESS TO EDUCATIONEDUCATION AND HEALTH HAVE ALWAYS BEEN CONNECTED, BUT NEVER AS GREATLY AS THEY CURRENTLY ARE. AMERICANS WITH LESS EDUCATION ARE DYING EARLIER THAN THEIR PEERS. WHILE THE RELATIONSHIP BETWEEN HEALTH AND EDUCATION IS A COMPLEX ONE, IT IS CLOSELY TIED TO A PERSON'S INCOME, SKILLS, AND OPPORTUNITIES THEY HAVE TO LEAD HEALTHY LIVES WITHIN THEIR COMMUNITIES. WHILE EDUCATION, BOTH FORMAL AND INFORMAL, CAN CREATE OPPORTUNITIES FOR BETTER HEALTH, POOR HEALTH, ON THE OTHER HAND, CAN PUT EDUCATION AT RISK.THE CHNA COMMUNITY SURVEY REVEALED MONEY WAS A MAJOR STRESS FACTOR FOR NEARLY ONE IN FIVE RESPONDENTS. WHILE 35% OF THE RESPONDENTS FELT FINANCIALLY SECURE IN MEETING THEIR FAMILY'S NEEDS, ALMOST 30% OF RESPONDENTS REPORTED THEY LIVED PAYCHECK TO PAYCHECK. WHEN ASKED ABOUT BARRIERS TO ACCESS EDUCATION, RESPONDENTS NOTED FINANCIAL CHALLENGES, AND THAT THERE WERE FEW OR NO RESOURCES AT HIGH SCHOOLS TO HELP STUDENTS GO TO AND PAY FOR COLLEGE. COMMUNITY CHAT PARTICIPANTS NOTED THAT HIGHER EDUCATION IN MORE RURAL PARTS OF OKLAHOMA WAS SIMPLY NOT SOUGHT AFTER AND WAS LINKED TO BEING A GENERATIONAL DECISION BASED ON WHETHER THEIR PARENTS WENT TO COLLEGE. HOWEVER, RESPONDENTS FELT THAT EVERYONE SHOULD HAVE THE OPPORTUNITY TO GO TO COLLEGE AND HAVE ACCESS TO NECESSARY RESOURCES. THE RESOURCES IDENTIFIED INCLUDED THINGS SUCH AS CHILDCARE, FINANCES, HEALTHCARE RESOURCES, AND MORE EDUCATIONAL SUPPORT.
REPORTING GROUP B: PART V, SECTION B, LINE 11 CONTINUED	ACCESS TO MEANINGFUL EMPLOYMENTONE COMPONENT OF A THRIVING COMMUNITY IS THE AVAILABILITY OF QUALITY EMPLOYMENT OPPORTUNITIES. WHILE THE MAJORITY OF OKLAHOMA COUNTY RESPONDENTS SURVEYED WERE EMPLOYED FULL-TIME (53%), THE PERCENTAGES VARIED DRAMATICALLY BASED ON EDUCATION LEVEL. SIXTY-FIVE PERCENT OF OKLAHOMA COUNTY RESIDENTS WITH A COLLEGE DEGREE WERE EMPLOYED FULL-TIME COMPARED TO ONLY 28% WITH LESS THAN A HIGH SCHOOL DEGREE. RESPONDENTS ALSO NOTED THAT THE THINGS THAT MADE IT DIFFICULT TO WORK WERE THEIR HEALTH OR THE HEALTH OF A FAMILY MEMBER. THIS IMPORTANT FINDING SHOWED THE DIRECT IMPACT OF POOR HEALTH ON ACCESS TO EMPLOYMENT. COMMUNITY CHAT PARTICIPANTS NOTED THE NEED TO HAVE QUALITY JOBS AND JOBS THAT WERE MEANINGFUL AND FULFILLING. THE QUALITATIVE ANALYSIS TEAM FOUND FREQUENT ALIGNMENT BETWEEN A PERSON'S EMPLOYMENT STATUS AND JOB-SPECIFIC, WORK-RELATED RESOURCES AS WELL AS THE ABILITY TO ACHIEVE A HEALTHY WORK-LIFE BALANCE. MENTORSHIP WAS ALSO FREQUENTLY MENTIONED IN THE CONTEXT OF EMPLOYMENT. HAVING A JOB WHICH INCLUDED THE SUPPORT OF A MENTOR AS WELL AS A CLEAR CAREER LADDER COULD INCREASE EMPLOYEE RETENTION. COMMUNITY CHAT PARTICIPANTS ALSO FEQUENTLY BROUGHT UP INCOME WITH RESPECT TO WORKRELATED RESOURCES, EMPLOYMENT STATUS, AND FINANCIAL BARRIERS AS IT IS NATURALLY A MAJOR DETERMINATE AS TO WHETHER A PERSON SEEKS EMPLOYMENT. WHILE THE MEDIAN HOUSEHOLD INCOME IN OKLAHOMA COUNTY IS SLIGHTLY HIGHER THAN THE STATE ($52,855 VS $51,424) IT VARIES WIDELY BY RACE/ETHNICITY. MANY DISCUSSED HAVING FINANCIAL BARRIERS DUE TO THEIR INCOME, WAS MAKING IT DIFFICULT TO HAVE A GOOD QUALITY WORK-LIFE BALANCE.ACCESS TO HEALTHY FOODA HEALTHY DIET CAN PROTECT AGAINST MANY CHRONIC NONCOMMUNICABLE DISEASES, SUCH AS HEART DISEASE, DIABETES, AND CANCER. THESE CONDITIONS ARE AMONG THE DEADLIEST IN OKLAHOMA COUNTY AND DISPROPORTIONATELY AFFECT RESIDENTS IN CERTAIN ZIP CODES AND BY RACE/ETHNICITY. THE MAJORITY OF COMMUNITY SURVEY RESPONDENTS (54%), SAID THEY COULD ALWAYS GET HEALTHY FOOD FOR THEIR FAMILY, BUT THIS VARIED BY RACE, ETHNICITY, AND EDUCATION LEVEL. THE MOST FREQUENT RESPONSE (64%) COMMUNITY MEMBERS NOTED AS A BARRIER TO ACCESSING HEALTHY FOODS WAS THE COST OF HEALTHY FOOD IN THE COMMUNITY. NEARLY ONE IN FOUR FELT THEY DID NOT HAVE THE TIME TO BUY OR PREPARE HEALTHY MEALS. FOOD ACCESS INFRASTRUCTURE IN THE COMMUNITY, WHICH INCLUDED TRANSPORTATION AND SCHEDULING, WAS ALSO A BARRIER TO CLAIMING ACCESS TO HEALTHY FOOD. WHILE THE DEFINITION OF HEALTHY FOOD INCLUDED GROCERY STORES, COMMUNITY GARDENS, AND PRESENCE OF HEALTHY FOOD, AS THE ANALYSIS OF COMMUNITY CHATS CONTINUED, IT BECAME APPARENT THAT CHOICE OF FOOD WAS JUST AS CRITICAL FOR FOOD ACCESS AS WAS THE PRESENCE OF QUALITY FOODS. ADDITIONALLY, WHILE SOME PEOPLE WERE ABLE TO ACCESS HEALTHY FOODS, THEY LACKED THE NUTRITIONAL EDUCATION TO KNOW WHAT TO EAT OR HOW TO COOK HEALTHY FOODS. IT WAS ALSO NOTED THAT MANY PEOPLE LACKED THE INCOME TO PURCHASE HEALTHY FOODS BECAUSE OFTENTIMES HEALTHY, FRESH FOODS ARE MORE EXPENSIVE. ACCESS TO HEALTHCAREAS HEALTHCARE ORGANIZATIONS, IT IS IMPORTANT THAT EACH HOSPITAL CONTINUE TO BE ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF INSURANCE STATUS, RACE, SOCIOECONOMIC STATUS, AND OTHER FACTORS. ACCESS TO AFFORDABLE AND QUALITY HEALTHCARE WERE COMMON MESSAGES HEARD FROM COMMUNITY MEMBERS. RESPONDENTS REPORTED THE MOST DIFFICULT TYPE OF HEALTH SERVICES TO GET FOR THEIR HOUSEHOLD WERE DENTAL HEALTH SERVICES, PARTICULARLY AMONG HISPANICS. HEALTHCARE ACCESS IS A MAJOR CHALLENGE IN RACIAL MINORITY COMMUNITIES IN OKLAHOMA COUNTY DUE TO BARRIERS WHICH INCLUDE PERCEIVED FINANCIAL BARRIERS, TRANSPORTATION BARRIERS, SCHEDULING CHALLENGES, AND CULTURAL BARRIERS. AS NOTED ABOVE, ALTHOUGH TOBACCO WAS NOT SPECIFICALLY IDENTIFIED BY THE COMMUNITY AS A PRIORITY NEED, INTEGRIS HEALTH AND THEIR PARTNERS AGREE THAT IT IS A HEALTH ISSUE THAT SHOULD CONTINUE TO BE ADDRESSED. OKLAHOMA COUNTY IS STILL ABOVE THE NATIONAL AVERAGE FOR ADULTS WHO SMOKE. THE STATE OF OKLAHOMA CONTINUES TO HAVE A GRADE OF "F" IN HEART DISEASE DEATHS AND A GRADE OF "D" IN LUNG CANCER INCIDENCE. WITH THE EXPANSION OF ELECTRONIC CIGARETTES AND VAPES, NICOTINE DEPENDENCY CONTINUES TO BE A WIDESPREAD PUBLIC HEALTH CONCERN FOR OKLAHOMA COUNTY RESIDENTS.SIGNIFICANT COMMUNITY HEALTH NEEDS ADDRESSED BY OCOMINTEGRIS HEALTH WORKED WITH OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY, LLC (OCOM) TO DEVELOP AN IMPLEMENTATION STRATEGY TO PRIORITIZE AND ADDRESS NEEDS OF OCOM'S COMMUNITY, ENTITLED "COMMUNITY HEALTH IMPROVEMENT PLAN FOR FISCAL YEARS 2023, 2024, AND 2025." THE OCOM CHIP ADDRESSES THE FOLLOWING PRIORITY ISSUES OF OCOM:- ACCESS TO HEALTHY FOOD- OBESITY- TOBACCOPRIORITY NEED #1: ACCESS TO HEALTHY FOODOCOM ADDRESSED THIS NEED DURING THE TAX YEAR BY ORGANIZING MULTIPLE FOOD DRIVES IN ITS COMMUNITY, IN PARTNERSHIP WITH A REGIONAL FOOD BANK AND COMMUNITY DIETICIANS. IN ADDITION, OCOM SUPPORTED FOOD BANKS AND PANTRIES IN ITS COMMUNITY THROUGH DONATIONS, AND BY ENCOURAGING ITS HOSPITAL STAFF TO VOLUNTEER THEIR TIME AT LOCAL FOOD BANKS AND PANTRIES.PRIORITY NEED #2: OBESITYOCOM ADDRESSED THIS NEED DURING THE TAX YEAR BY PROVIDING PEDIATRIC HEALTHY LIVING EDUCATION, ADULT HEALTH LIVING EDUCATION, AND HEALTHY LIVING RESOURCES. FOR INSTANCE, OCOM PROVIDED EACH PEDIATRIC PATIENT WITH RESOURCES ON HEALTHY EATING EDUCATION, INCLUDED TSET EDUCATIONAL MATERIALS TO ALL PATIENTS IN DISCHARGE PACKETS, AND COMMUNICATED WITH STAFF ON HOW TO ADDRESS HEALTHY LIVING CHALLENGES WITH PATIENTS. OCOM ALSO PARTNERED WITH COMMUNITY CENTERS, SCHOOLS, POLICE DEPARTMENTS, FITNESS CENTERS, CAREER TECH CENTERS, QUALITY IMPROVEMENT ORGANIZATIONS, CHURCHES, LIBRARIES, CHRONIC DISEASE PREVENTION ORGANIZATIONS, AND SUPPORT GROUPS TO PROVIDE HEALTHY LIVING RESOURCES AND EDUCATION TO ITS COMMUNITY.PRIORITY NEED #3: TOBACCOOCOM ADDRESSED THIS NEED DURING THE TAX YEAR BY MAINTAINING A TOBACCO-FREE POLICY ON ITS CAMPUS, PROVIDING TSET EDUCATIONAL MATERIALS IN ALL PATIENT WAITING AREAS, AND OFFERING TSET EDUCATION AND OTHER SMOKING CESSATION RESOURCES TO PATIENTS WHO USE TOBACCO. IT DEVELOPED THESE RESOURCES IN PARTNERSHIP WITH YOUTH AND FAMILY SERVICES, UNITED WAY OF CENTRAL OKLAHOMA, THE OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE, THE OKLAHOMA CITY COUNTY HEALTH DEPARTMENT, AND LYNN INSTITUTES' NORTHEAST OKLAHOMA CITY COLLABORATIVE.SIGNIFICANT COMMUNITY HEALTH NEEDS NOT ADDRESSED BY OCOMOCOM CHOSE NOT TO FOCUS ON SOME OF THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA, IN PARTICULAR ACCESS TO CARE, MENTAL HEALTH, EMPLOYMENT, HOUSING, HEALTH EDUCATION AND PROMOTION, TRANSPORTATION, AND POVERTY, AND SAFETY, BECAUSE INTEGRIS HEALTH, WHICH SERVES OKLAHOMA COUNTY, WAS ALREADY TAKING ACTIONS TO ADDRESS ALL OF THESE COMMUNITY NEEDS. ADDITIONALLY, OCOM LACKED THE RESOURCES AND SOME OF THE EXPERTISE TO FOCUS ON THESE NEEDS.
REPORTING GROUP C: PART V, SECTION B, LINE 5	HEALTH VENTURES IS A PARTNERSHIP FORMED IN FY2019 BETWEEN IACC, AN OKLAHOMA NOT FOR PROFIT CORPORATION THAT IS TAX-EXEMPT UNDER SECTION 501(C)(3) AND USP OKLAHOMA, INC. (USP), AN UNRELATED OKLAHOMA FOR PROFIT CORPORATION FOR THE PURPOSE OF ACQUIRING OWNERSHIP IN OR DEVELOPLING FREESTANDING AMBULATORY SURGERY HOSPITALS. ON NOVEMBER 1, 2018, HEALTH VENTURES ACQUIRED 51% OF HPI HOLDINGS, LLC (HPI). HPI OWNS A 100% INTEREST IN COMMUNITY HOSPITAL, LLC AND TPG HOSPITAL, LLC. THIS JOINT VENTURE OPERATED THE COMMUNITY HOSPITAL AND TPG HOSPITAL FACILITIES DURING THE TAX YEAR. THE JOINT VENTURE IS A PARTNERSHIP FOR WHICH A FORM 1065 IS FILED. HOWEVER, WHEN HPI WAS ACQUIRED BY HEALTH VENTURES, COMMUNITY HOSPITAL AND TPG HOSPITAL BECAME SUBJECT TO THE 501(R) PROVISIONS.OKLAHOMA COUNTY IS IN THE CENTRAL PART OF OKLAHOMA. OKLAHOMA CITY IS THE COUNTY SEAT AND IS THE LARGEST CITY IN THE STATE. THERE ARE 20 CITIES AND SMALL TOWNS LOCATED IN THE COUNTY. OKLAHOMA COUNTY EMPLOYS 379,291 PEOPLE. THE ECONOMY SPECIALIZES IN MINING, OIL, GAS, QUARRYING, EXTRACTION, MANAGEMENT OF COMPANIES AND ENTERPRISES, AND PUBLIC ADMINISTRATION. ACCORDING TO THE 2019 POPULATION ESTIMATES, THE POPULATION OF OKLAHOMA COUNTY WAS 797,434.OKLAHOMA COUNTY HAS 14 HOSPITALS, TWO FEDERALLY QUALIFIED HEALTH CENTERS WITH 14 SATELLITE CLINICS, APPROXIMATELY 17 FREE COMMUNITY CLINICS, ONE TRIBAL CLINIC, A CITY-COUNTY HEALTH DEPARTMENT WITH MULTIPLE LOCATIONSTHROUGHOUT THE COUNTY, AND A STATE HEALTH DEPARTMENT. PUBLICTRANSPORTATION, TAXI SERVICES, TWO PUBLIC AND SEVERAL PRIVATE AIRPORTS, AND PARAMEDIC LEVEL AMBULANCE SERVICES ARE ALSO LOCATED WITHIN THE COUNTY.ACCORDING TO THE OKLAHOMA CITY-COUNTY HEALTH DEPARTMENT 2021 DATA, THE MEDIAN AGE IN OKLAHOMA COUNTY WAS 34.5 YEARS, WHICH IS SLIGHTLY YOUNGER THAN THE STATE OF OKLAHOMA AT 36.4 YEARS. THE PERCENT LIVING IN POVERTY IN OKLAHOMA COUNTY IS 16.7% WHICH IS SLIGHTLY LOWER THAN THE STATE AT 16.0%. IN 2018, THE MEDIAN HOUSEHOLD INCOME IN OKLAHOMA COUNTY OF $52,855 WAS SLIGHTLY HIGHER THAN THE STATE OF $51,424. BOTH LAGGED BEHIND THE NATIONAL MEDIUM INCOME OF $60,293. OKLAHOMA COUNTY RESIDENTS RECEIVED SLIGHTLY MORE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN THE STATE RATE IN 2018 (13.3% VS. 13.1%.) THE RACIAL/ETHNIC BREAKOUT OF OKLAHOMA COUNTY WAS 56.0% WHITE, 14.8% BLACK OR AFRICAN AMERICAN, 17.4% HISPANIC OR LATINO, 6.7% AMERICAN INDIAN OR ALASKA NATIVE, AND 4.7% ASIAN AND PACIFIC ISLANDER.AMONG OKLAHOMA RESIDENTS 18 AND OLDER, 30% OF PERSONS HELD A BACHELOR'S DEGREE OR HIGHER AS OF 2019. ON SEPTEMBER 30, 2021, NEW UNEMPLOYMENT NUMBERS WERE RELEASED FROM THE U.S. BUREAU OF LABOR STATISTICS SHOWING OKLAHOMA CITY RANKS FIRST FOR METROPOLITAN COMMUNITIES WITH A 2010 CENSUS POPULATION OF ONE MILLION OR MORE. OKLAHOMA CITY HAD AN UNEMPLOYMENT RATE OF ONLY 2.6% AND IS THE LOWEST RATE SINCE 2019.THE PERCENT OF UNINSURED ADULTS (AGE 18-64), IN OKLAHOMA COUNTY, ACCORDING TO DATA FROM THE 2021 U.S. CENSUS BUREAU, WAS CONSISTENT WITH THE STATE RATE OF 16.8%. ACCORDING TO THE OKLAHOMA HEALTH CARE AUTHORITY FAST FACTS, JANUARY 2021, THERE WERE A TOTAL OF 200,287 PERSONS ENROLLED IN MEDICAID IN OKLAHOMA COUNTY AND 946,412 PERSONS ENROLLED IN MEDICAID IN THE STATE OF OKLAHOMA DURING THE SAME PERIOD. AS OF FEBRUARY 2021, THERE WERE 92,632 PERSONS IN OKLAHOMA COUNTY AND 572,942 PERSONS IN THE STATE OF OKLAHOMA ENROLLED IN MEDICARE ACCORDING TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, MEDICARE ENROLLMENT DASHBOARD. BETWEEN 2015 AND 2019, THE AVERAGE NUMBER OF PERSON PER HOUSEHOLD IN OKLAHOMA COUNTY WAS 2.56 WHICH WAS SLIGHTLY LOWER THAN THE STATE AT 2.58. DURING THE SAME PERIOD, THE PERCENT OF PERSONS, 5 YEARS OR OLDER, IN OKLAHOMA COUNTY WHO SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME WAS 17.4% COMPARED TO THE STATE RATE OF 10.5%. IN 2020, ACCORDING TO THE 2020 COUNTY HEALTH RANKINGS FOR OKLAHOMA COUNTY, ACCESS TO A PRIMARY CARE PHYSICIAN, PEOPLE PER ONE PROVIDER, WAS 1,170 COMPARED TO THE STATE OF OKLAHOMA WHICH WAS 1,620 PEOPLE PER ONE PROVIDER. ACCESS TO DENTISTS AND MENTAL HEALTH IN OKLAHOMA COUNTY, PEOPLE PER ONE PROVIDER, ACCORDING TO THE SAME SOURCE, WAS 980 AND 150, RESPECTIVELY AND 1640 AND 250, PEOPLE PER ONE PROVIDER FOR THE STATE OF OKLAHOMA. BETWEEN 2015-2017, THE AVERAGE LIFE EXPECTANCY IN OKLAHOMA COUNTY IS 74.9 YEARS WHEREAS THE AVERAGE IN THE U.S. IS 78.8 YEARS.BETWEEN 2016-2018, CARDIOVASCULAR DISEASE WAS THE LEADING CAUSE OF DEATH IN OKLAHOMA COUNTY. AT 337.7 DEATHS PER 100,000, MALES HAD 100 MORE DEATHS PER 100,000 COMPARED TO FEMALES WITH A RATE OF 235.9 DEATHS PER 100,000. CANCER WAS THE SECOND LEADING CAUSE OF DEATH IN OKLAHOMA CITY-COUNTY BETWEEN 2016-2018, THE AGE-ADJUSTED MORTALITY RATE IN OKLAHOMA COUNTY WAS 188.0 PER 100,000 DEATHS, ONLY SLIGHTLY HIGHER THAN THE STATE RATE OF 177.8 PER 100,000 DEATHS,
REPORTING GROUP C: PART V, SECTION B, LINE 5 CONTINUED	ONLY SLIGHTLY HIGHER THAN THE STATE RATE OF 177.8 PER 100,000 DEATHS BUT 27.6 DEATHS PER 100,000 GREATER THAN THE NATIONAL CANCER DEATH RATE. OKLAHOMA COUNTY HAD HIGHER DIABETES MORTALITY BETWEEN 2016-2018 COMPARED TO THE STATE AND NATIONAL RATES. THE OVERALL AGE-ADJUSTED DIABETES MORTALITY RATE IN THE COUNTY WAS 34.6 DEATHS PER 100,000. OKLAHOMA IS THE NINTH MOST OBESE STATE IN THE NATION, OKLAHOMA'S OBESITY RATE AS OF 2021 WAS AT 36.4%. THE SUICIDE RATES IN OKLAHOMA COUNTY AND THE STATE OF OKLAHOMA WERE HIGHER THAN THE NATIONAL AVERAGE BETWEEN 2016-2018. THE AGE-ADJUSTED SUICIDE RATE IN OKLAHOMA COUNTY WAS 18 DEATHS PER 100,000 PEOPLE.A COMPREHENSIVE AND A COLLABORATIVE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY FOUR NON-PROFIT HEALTH SYSTEMS AS ALL FOUR HEALTH SYSTEMS DEFINE THEIR COMMUNITY AS OKLAHOMA COUNTY. THIS CHNA INCLUDED INTEGRIS HEALTH SYSTEM AND INCLUDES THE JOINT VENTURE HOSPITALS: HEALTHCARE PARTNERS (HIP), INTEGRIS COMMUNITY HOSPITALS AND OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI SPECIALTY SURGERY THE CHNA UTILIZES RELEVANT HEALTH DATA TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS OF OKLAHOMA AND CLEVELAND COUNTIES IN THE STATE OF OKLAHOMA. ALL OF THE JOINT VENTURE HOSPITALS LIE WITHIN OKLHOMA COUNTY, EXCEPT FOR ONE SMALL CAMPUS OF THE INTEGRIS COMMUNITY HOSPITALS (MOORE), WHICH LIES ON THE NORTHERN EDGE OF CLEVELAND COUNTY. THE GOAL OF THIS REPORT IS TO PROVIDE RESIDENTS WITH A DEEPER UNDERSTANDING OF THE HEALTH NEEDS IN THEIR COMMUNITY AND TO HELP GUIDE THE HOSPITALS IN THEIR COMMUNITY BENEFIT PLANNING EFFORTS AND THE DEVELOPMENT OF AN IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED NEEDS. COMMUNITY INPUT WAS RECEIVED DURING STAKEHOLDER MEETINGS, COMMUNITY SURVEYS COLLECTED DURING APRIL 2021-JULY 2021 AND ONLINE CHATS WHICH WERE CONDUCTED FROM MAY 23, 2021 - JUNE 30, 2021.THE AFFORDABLE CARE ACT (ACA) REQUIRES 501(C)(3), TAX-EXEMPT HOSPITALS TO CONDUCT A CHNA AT LEAST ONCE EVERY THREE TAX YEARS AND TO ADOPT A STRATEGIC IMPLEMENTATION PLAN FOR ADDRESSING IDENTIFIED NEEDS. HPI AND ITS COLLABORATORS LAST CONDUCTED A CHNA IN ITS 2021 TAX YEAR.
REPORTING GROUP C: PART V, SECTION B, LINE 11	THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED A NUMBER OF SIGNIFICANT NEEDS IN THE OKLAHOMA COUNTY COMMUNITY SERVED BY HPIAND THE OTHER COLLABORATORS FACILITIES, WHICH WERE DETERMINED BY EVALUATING AND SYNTHESIZING PRIMARY AND SECONDARY DATA TO IDENTIFY SIGNIFICANT COMMUNITY HEALTH NEEDS IN OKLAHOMA AND CLEVELAND COUNTY.UPON REVIEW AND ANALYSIS OF ALL QUANTITATIVE AND QUALITATIVE FEEDBACK AND SURVEYS THE FOLLOWING SIGNIFICANT NEEDS FOR OKLAHOMA COUNTY WERE IDENTIFIED:- EMPLOYMENT- FOOD INSECURITY- HOUSING- HEALTH EDUCATION AND PROMOTION- ACCESS TO HEALTHCARE- OBESITY- MENTAL HEALTH - TRANSPORTATIONTHE ABOVE NEEDS SPAN THE AREAS DENOTED BELOW AND WERE OFTEN INTERRELATED. ALL ARE SOCIAL DETERMINATES OF HEALTH.SIGNFICANT COMMUNITY HEALTH NEEDS WERE THEN IDENTIFIED AND PRIORITIZED IN ALL OF THE FOLLOWING AREAS:- ECONOMIC STABILITY- NEIGHBORHOOD AND BUILT ENVIRONMENT- HEALTH AND HEALTHCARE- SOCIAL AND COMMUNITY CONTEXT - EDUCATIONINTEGRIS HEALTH THEN ANALYZED AND EVALUATED THE PRIMARY DATA AND THE SECONDARY PUBLIC HEALTH DATA COLLECTED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE ISSUES WERE PRIORITIZED BASED ON CURRENT SYSTEM WIDE EFFORTS AT INTEGRIS HEALTH AND ALIGNED WITH THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) GOALS AND OBJECTIVES IN THE OKLAHOMA CITY METRO.THE IMPLEMENTATION PLAN FOR HPI, ENTITLED "FY 2022 COMMUNITY HEALTH IMPROVEMENT PLAN," SPECIFICALLY ADDRESSES THE FOLLOWING PRIORITY ISSUES:- ACCESS TO CARE- FOOD INSECURITY - TOBACCOHPI ADDRESSED THIS NEED DURING THE TAX YEAR BY PROVIDE RESOURCES AND HELP ENROLLING IN NEW MEDICAID EXPANSION. ALL CAMPUSES HAVE INFORMATION REGARDING THE FINANCIAL ASSISTANCE PROGRAMS. PROVIDE FREE HEALTH CLINIC SERVICE INFORMATION TO PATIENTS IN NEED.PRIORITY NEED #2: FOOD INSECURITYHPI ADDRESSED THIS NEED DURING THE TAX YEAR BY ORGANIZING FOOD DRIVE AND SUPPORTING FOOD BANK/PANTRIES FINANCIALLY THROUGH DONATIONS. ESTABLISH ONE FOOD DRIVE IN 2ND QUARTER (APRIL, MAY, AND JUNE 2022).PRIORITY NEED #3: TOBACCOHPI ADDRESSED THIS NEED DURING THE TAX YEAR BY HOSPITAL RESOURCES: EDUCATIONAL MATERIAL, REFERRAL SYSTEM, OKLAHOMA CITY COUNTY HEALTH DEPARTMENT PARTNERSHIP AND WELLNESS INITIATIVES, EMPLOYEE ASSISTANCE PROGRAM, FINANCIAL SUPPORT, MOBILE ASSESSMENT TEAM AND SCREENING TOOL IN PARTNERSHIP WITH YOUTH AND FAMILY SERVICES, UNITED WAY OF CENTRAL OKLAHOMA, OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE, AMERICAN FOUNDATION FOR SUICIDE PREVENTION, 211 REFERRAL SYSTEM, YWCA, OKLAHOMA CITY COUNTY HEALTH DEPARTMENT AND LIGHTHOUSE MEDICAL CLINIC. ALSO PROVIDING TSET EDUCATION TO ALL PATIENTS AND ENSURING SIGNAGE IS POSTED.
SCHEDULE H, PART V, SECTION B, LINE 20D	REPORTING GROUP B & C:NEITHER OCOM OR HPI MADE ANY PRESUMPTIVE ELIGIBILITY DETERMINATIONS. DURING THE TAX YEAR, ALL PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE APPLICATION AND A PLAIN LANGUAGE SUMMARY AT ADMISSION OR UPON REQUEST. ALL PATIENTS ARE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE DURING THE APPLICATION PERIOD, WHICH ENDS ON THE 240TH DAY AFTER OCOM MAILS OR ELECTRONICALLY PROVIDES THE INDIVIDUAL WITH THE FIRST BILLING STATEMENT. ONCE AN APPLICATION IS RECEIVED IT IS GIVEN TO A BUSINESS OFFICE REPRESENTATIVE TO REVIEW FOR PRE-APPROVAL PER FPL GUIDELINES IN THE FINANCIAL ASSISTANCE POLICY. IF PRE-APPROVED, AN ADJUSTMENT REQUEST IS THEN GIVEN TO THE CONTROLLER TO REVIEW FOR FIRST LEVEL APPROVAL. IF APPROVED FIRST LEVEL, THE FINANCIAL ASSISTANCE APPLICATION AND ADJUSTMENT REQUEST ARE SENT TO THE CEO FOR FINAL APPROVAL. THE PATIENT IS THEN NOTIFIED VIA CALL AND/OR LETTER THAT HIS OR HER APPLICATION HAS BEEN APPROVED.

Schedule H (Form 990) 2021

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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?2
Name and address		Type of Facility (describe)
1	1 - SOUTHWEST AMBULATORY SURGERY CENTER LLC 8125 SOUTH WALKER OKLAHOMA CITY,OK73139	AMBULATORY SURGERY CENTER
2	2 - MEDICAL PLAZA IMAGING CENTER 3330 NW 56TH OKLAHOMA CITY,OK73112	RADIOLOGY IMAGING CENTER
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2021

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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 6A:	INTEGRIS HEALTH, INC., (EIN: 73-1192764), THE PARENT ORGANIZATION OF INTEGRIS AMBULATORY CARE CORPORATION, PRODUCES A CONSOLIDATED COMMUNITY BENEFIT REPORT THAT IS MADE AVAILABLE TO THE PUBLIC.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY-BUILDING ACTIVITIES IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSE OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS AND EXPENSES FOR THE DEVELOPMENT OF A VARIETY OF COMMUNITY-BUILDING PROGRAMS AND PARTNERSHIPS.
PART III, LINE 2:	COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 16.14%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
PART III, LINE 3:	IACC DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
PART III, LINE 4:	IACC DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF INTEGRIS HEALTH, INC. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:A PORTFOLIO APPROACH BY MAJOR PAYOR CATEGORIES AND TYPES OF SERVICE WAS USED TO ESTIMATE THE HISTORICAL COLLECTIONS EXPERIENCE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED AT LEAST QUARTERLY BASED ON ACTUAL COLLECTIONS EXPERIENCE.INTEGRIS HEALTH BELIEVES THAT REVENUE RECOGNIZED BY UTILIZING THE PORTFOLIO APPROACH APPROXIMATES THE REVENUE THAT WOULD HAVE BEEN RECOGNIZED IF AN INDIVIDUAL CONTRACT APPROACH WAS USED. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE ASSESSED FIRST FOR ELIGIBILITY FOR CHARITY CARE OR RECORDED AS BAD DEBT EXPENSE.
PART III, LINE 8:	THE COST TO CHARGE METHODOLOGY WAS USED IN ORDER TO CALCULATE THE MEDICARE ALLOWABLE COSTS RELATED TO PAYMENTS RECEIVED FROM MEDICARE. ANY RESULTING SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4	REPORTING GROUP B:FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:OCOM DOES NOT HAVE A STAND-ALONE AUDIT AND IS INCLUDED IN THE CONSOLIDATED FINANCIALS OF INTEGRIS AMBULATORY CARE CORP, WHICH DOES NOT SPECIFICALLY ADDRESS BAD DEBT. OCOM ACCOUNTS FOR BAD DEBT EXPENSE AS FOLLOWS:-75% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE AGED 120 DAYS OR GREATER (EXCLUDING LEGAL LIABILITY), PLUS 25% OF ACCOUNTS RECEIVABLE NET OF THE CONTRACTUAL ALLOWANCE IN THE 90 DAY BUCKET. WE RESERVE 50% OF LEGAL LIABILITY OVER 120 DAYS.
PART VI, LINE 2:	REPORTING GROUP APART VI, LINE 2: NEEDS ASSESSMENT INTEGRIS HEALTH UTILIZES A VARIETY OF TOOLS TO DETERMINE THE HEALTH CARE NEEDS OF OUR COMMUNITIES. THESE INCLUDE PARTNERSHIPS WITH LOCAL COMMUNITY AGENCIES AND ORGANIZATIONS TO DETERMINE SPECIFIC TARGET MARKET NEEDS, PROGRAM SURVEYS AND COMMUNITY FOCUS GROUPS, PROGRAM EVALUATIONS FROM PARTICIPANTS IN OUR COMMUNITY HEALTH SCREENINGS, HEALTH EDUCATION AND SUPPORT GROUPS, THE COUNTY HEALTH RANKINGS REPORT AND THE OKLAHOMA STATE HEALTH DEPARTMENT'S "STATE OF THE STATE HEALTH REPORT."AFTER REVIEWING THESE MATERIALS FOR ISSUES CONCERNING ACCESS TO CARE, HEALTH EDUCATION NEEDS AND GAPS IN SERVICES IN OUR COMMUNITIES, INTEGRIS HEALTH DETERMINES HOW TO ADDRESS THESE ISSUES BY DEVELOPING PROGRAMS/SERVICES TO IMPLEMENT, INCLUDING, BUT NOT LIMITED TO, HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION AND WELLNESS PROGRAMS, SUPPORT GROUPS, AND ACCESS TO HEALTH CARE FACILITIES. INTEGRIS HEALTH UTILIZES OUR HEALTH SYSTEM RESOURCES, FACILITIES AND PERSONNEL FOR MANY OF THESE PROGRAMS, BUT ALSO PARTNERS WITH OUR COMMUNITIES AND DEVELOPS COLLABORATIONS WITH LOCAL NON-PROFIT AGENCIES, CIVIC ORGANIZATIONS, SCHOOLS, AND CHURCHES TO IMPROVE THE ISSUES IDENTIFIED.REPORTING GROUP BPART VI, LINE 2: NEEDS ASSESSMENT A COMPREHENSIVE AND A COLLABORATIVE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY FOUR NON-PROFIT HEALTH SYSTEMS AS ALL FOUR HEALTH SYSTEMS DEFINE THEIR COMMUNITY AS OKLAHOMA COUNTY. INTEGRIS HEALTH SYSTEM WAS ONE OF THE FOUR NON-PROFIT HEALTH SYSTEMS THAT CONDUCTED THIS CHNA. INTEGRIS HEALTH SYSTEM INCLUDES THEIR JOINT VENTURE HOSPITALS: HEALTHCARE PARTNERS (HIP), INTEGRIS COMMUNITY HOSPITALS, AND OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY BY INTEGRIS HEALTH DURING THE FISCAL YEAR ENDED JUNE 30, 2022.THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH INCLUDED OCOM, WAS APPROVED AND ADOPTED BY OCOM'S BOARD OF DIRECTORS ON JULY 25, 2022. ADDITIONALLY, THE RELATED IMPLEMENTATION STRATEGY, OCOM PREPARED, REFERRED TO AS THEIR COMMUNITY HEALTH IMPROVEMENT PLAN OR CHIP, WAS ALSO APPROVED AND ADOPTED BY THEIR BOARD ON JULY 25, 2022.AS DISCUSSED IN SCHEDULE H, SECTION B, PART V ABOVE, A COMPREHENSIVE AND A COLLABORATIVE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED FOR HEALTHCARE PARTNERS INVESTMENTS (HIP), INTEGRIS COMMUNITY HOSPITALS AND OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY BY INTEGRIS HEALTH DURING THE FISCAL YEAR ENDED JUNE 30, 2022. THE CHNA UTILIZES RELEVANT HEALTH DATA RECEIVED FROM THE HOSPITAL CHNA COLLABORATORS AND FROM OKLAHOMA COUNTY RESIDENTS OF ALL BACKGROUNDS, SOCIOECONOMIC STATUS, AND DEMOGRAPHICS TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS OF OKLAHOMA AND CLEVELAND COUNTIES IN THE STATE OF OKLAHOMA.INTEGRIS HEALTH THEN ANALYZED AND EVALUATED THE PRIMARY DATA AND THE SECONDARY PUBLIC HEALTH DATA COLLECTED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE ISSUES WERE PRIORITIZED BASED ON CURRENT SYSTEMWIDE EFFORTS AT INTEGRIS HEALTH AND ALIGNED WITH THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) GOALS AND OBJECTIVES IN THE OKLAHOMA CITY METRO. FOCUS WAS ALSO GIVEN TO THE INTERCONNECTEDNESS OF SOCIAL DETERMINANTS AND HEALTH OUTCOMES IN OKLAHOMA COUNTY.THE FOLLOWING FOUR PRIORITIZED NEEDS WERE DETERMINED:- ACCESS TO EDUCATION- ACCESS TO MEANINGFUL EMPLOYMENT- ACCESS TO HEALTHY FOOD- ACCESS TO HEALTHCARETOBACCO INTEGRIS HEALTH CHOSE TO FOCUS ON ALL OF THE IDENTIFIED PRIORITY ISSUES. AS ALSO NOTED IN SCHEDULE H, SECTION B, PART V, WHILE TOBACCO WAS NOT SPECIFICALLY IDENTIFIED BY THE COMMUNITY AS A PRIORITY NEED, INTEGRIS HEALTH AND THEIR PARTNERS AGREE THAT IT IS A HEALTH ISSUE THAT SHOULD CONTINUE TO BE ADDRESSED. OKLAHOMA COUNTY IS STILL ABOVE THE NATIONAL AVERAGE FOR ADULTS WHO SMOKE AND NICOTINE DEPENDENCY CONTINUES TO BEA WIDESPREAD PUBLIC HEALTH CONCERN FOR OKLAHOMA COUNTY RESIDENTS.EACH HOSPITAL THEN DEVELOPED AN INDIVIDUAL CHIP IN A SEPARATE DOCUMENT TO ADDRESS THE NEEDS IDENTIFIED, BASED ON THEIR INTERNAL PRIORITIES AND RESOURCES.THE IMPLEMENTATION PLAN FOR OCOM SPECIFICALLY ADDRESSES THE FOLLOWING PRIORITY ISSUES:- ACCESS TO HEALTHY FOOD- OBESITY- TOBACCOIN ORDER TO ADDRESS EACH PRIORITIZED NEED, HOSPITAL RESOURCES WERE ALLOCATED AND COMMUNITY PARTNERSHIPS WERE IDENTIFIED TO ASSIST. SPECIFIC PROGRAMS WERE IMPLEMENTED WITH SUPPORTING ACTIVITIES AND YEARLY TARGET GOALS.REPORTING GROUP CPART VI, LINE 2: NEEDS ASSESSMENTHPI COLLABORATED WITH INTEGRIS HEALTH IN A JOINT CHNA.HTTPS://COMMUNITYHOSPITALOKC.COM/APPLICATION/FILES/2916/2826/6047/CHNA2021.PDFHTTPS://NWSURGICALOKC.COM/APPLICATION/FILES/6016/2826/5929/CHNA2021.PDFHTTPS://WWW.INTEGRISCOMMUNITYHOSPITAL.COM/INT-ASSETS/UPLOADS/FORMS/INTEGRIS-HEALTH-JOINT-CHNA_2020-2021.PDF
PART VI, LINE 3:	REPORTING GROUP APART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCEINTEGRIS HEALTH USES A MULTI-FACETED APPROACH TO EDUCATE OUR PATIENTS ON THE AVAILABILITY OF CHARITY AS WELL AS STATE AND FEDERAL FINANCIAL ASSISTANCE. THIS INCLUDES:POSTERS CLEARLY DISPLAYED IN EVERY PATIENT REGISTRATION AREA SPEAKING TO OUR FINANCIAL ASSISTANCE PROGRAMS.A FINANCIAL RIGHTS AND RESPONSIBILITY BROCHURE GIVEN TO EVERY PATIENT AT THE TIME OF THEIR REGISTRATION WHICH PROVIDES FINANCIAL ASSISTANCE PROGRAM DETAILS.A CLEARLY MARKED PRESENCE ON THE INTEGRIS HEALTH ON-LINE BUSINESS OFFICE WEBSITE WITH A SECTION DEVOTED TO FINANCIAL ASSISTANCE PROGRAM DETAILS AS WELL AS AN ON-LINE CHARITY APPLICATION.A DESCRIPTION OF THE FINANCIAL ASSISTANCE PROGRAM AS WELL AS THE APPLICATION PROCESS IS INCLUDED ON EVERY PATIENT BILL.FINANCIAL COUNSELORS MEET WITH PATIENTS TO IDENTIFY ELIGIBILITY FOR FEDERAL AND STATE ASSISTANCE PROGRAMS.REPORTING GROUP BPART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCEOCOM PATIENTS WERE INFORMED AND EDUCATED OVER THE PHONE OR IN PERSON PRIOR TO MEDICAL SERVICES BEING PROVIDED ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE. IF A PATIENT DECIDED TO APPLY FOR FINANCIAL ASSISTANCE AFTER THE MEDICAL SERVICES WERE PROVIDED, PATIENTS WERE FURTHER EDUCATED OVER THE PHONE OR IN PERSON ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY APPLICATION INSRUCTIONS WERE ALSO MADE AVAILABLE ONLINE WITH THE ABILITY TO BE PRINTED DIRECTLY FROM THE OCOM WEBSITE, WITHOUT CHARGE. PATIENTS COULD ALSO REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY APPLICATION INSTRUCTIONS FROM OCOM'S WEBSITE OR BY MAIL BY CALLING THE OCOM BUSINESS OFFICE.REPORTING GROUP CPART VI, LINE 3: PATIENT EDUCATION - ELIGIBILITY FOR ASSISTANCE HPI FACILITY PATIENTS WERE INFORMED AND EDUCATED ONLINE, BY TELEPHONE, BY MAIL, ON POSTED SIGNS AND PAPER COPIES OR BROCHURES LOCATED IN ALL REGISTRATION AREAS THROUGHOUT THE FACILITIES, IN PERSON, AND IN BILLING STATEMENTS ABOUT THE AVAILABILITY AND ELIGIBILITY OF FINANCIAL ASSISTANCE. REGISTRATION STAFF REFERS PATIENTS TO WEBSITE AND TO THE BILLING DEPARTMENT AS NEEDED OR REQUESTED. THEY PRINT OFF CHARITY APPLICATIONS AND ASSISTS PATIENTS IN COMPLETING. IF TRANSLATION IS NEEDED TO HELP COMPLETE FORMS A CALL IS MADE INTO THE LANGUAGE LINE FOR ASSISTANCE. IF FINANCIAL NEED IS DETERMINED WHEN PATIENT IS IN PERSON AT FACILITY, EXAMPLE LACK OF INSURANCE OR UNABLE TO PAY, PATIENT IS ASSISTED WITH APPLICATION AND/OR REFERRED TO BILLING TO ASSIST. SCHEDULING, FINANCIAL COUNSELOR, REGISTRATION, AND AUTHORIZATION DEPARTMENT, REFER PATIENTS IN NEED OF ASSISTANCE TO WEBSITE AND TO BILLING AS NEEDED.
PART VI, LINE 4:	REPORTING GROUP APART VI, LINE 4: COMMUNITY INFORMATION INTEGRIS HEALTH SYSTEM IS THE STATE'S LARGEST OKLAHOMA-OWNED HEALTH CARE SYSTEM AND ONE OF THE STATE'S LARGEST PRIVATE EMPLOYERS, WITH HOSPITALS, REHABILITATION CENTERS, PHYSICIAN'S CLINICS, MENTAL HEALTH FACILITIES, CANCER CENTERS, INDEPENDENT LIVING CENTERS, AND HOME HEALTH AGENCIES THROUGHOUT MOST OF THE STATE. ALL COUNTIES IN WHICH INTEGRIS HEALTH OPERATES INCLUDE ONE OR MORE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS. INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS LOCATED IN OKLAHOMA CITY, WHICH IS IN OKLAHOMA COUNTY IN CENTRAL OKLAHOMA.REPORTING GROUP BPART VI, LINE 4: COMMUNITY INFORMATIONOCOM IS LOCATED IN OKLAHOMA CITY WITH AN HOPD LOCATION (OCOM NORTH) IN NORTHWEST OKLAHOMA CITY AND THREE FREESTANDING IMAGING FACILITIES TO SERVICE OKLAHOMA CITY, IN OKLAHOMA COUNTY, OKLAHOMA. OKLAHOMA CITY IS THE COUNTY SEAT AND THE LARGEST CITY IN THE STATE. THERE ARE 20 CITIES AND SMALL TOWNS LOCATED IN THE COUNTY. THE ECONOMY SPECIALIZES IN OIL, GAS, QUARRYING, EXTRACTION, MANAGEMENT OF COMPANIES AND ENTERPRISES, AND PUBLIC ADMINISTRATION. OKLAHOMA COUNTY'S POPULATION IS GROWING ACROSS ALL RACIAL AND ETHNIC GROUPS. THERE WAS A 5.9% INCREASE IN TOTAL POPULATION FROM 2014-2019. ACCORDING TO THE 2019 POPULATION ESTIMATES, THE POPULATION OF OKLAHOMA COUNTY WAS 797,434. AS OF 2019, THE MEDIAN AGE FOR OKLAHOMA COUNTY WAS 34.6 YEARS WHILE THE MEDIAN AGE FOR THE STATE OF OKLAHOMA WAS 34.1 YEARS. AS OF 2018, APPROXIMATELY 16.7% OF THE PEOPLE IN OKLAHOMA COUNTY LIVED BELOW THE POVERTY LEVEL AND WERE NOT ALWAYS ABLE TO MEET THEIR BASIC NEEDS LIKE AFFORDABLE HOUSING, HEALTH CARE, HEALTHY FOOD, TRANSPORTATION, AND SOCIAL SERVICES (2018). THE MEDIAN HOUSEHOLD INCOME FOR OKLAHOMA COUNTY WAS $52,855 COMPARED TO $51,424 FOR THE STATE OF OKLAHOMA AND $60,293 FOR THE NATIONAL AVERAGE (2021 WELLNESS SCORE FROM 2018). THE MAJORITY OF RESIDENTS IN OKLAHOMA COUNTY IDENTIFY AS WHITE (56%). THE NEXT LARGEST RACES/ETHNICITIES IN OKLAHOMA COUNTY ARE HISPANIC/LATINO (17.4%), BLACK OR AFRICAN AMERICAN (14.8%), AMERICAN INDIAN/ALASKAN NATIVE (6.7%), AND ASIAN/PACIFIC ISLANDER (4.7%) OR SOME OTHER RACE (4.1%).THE OVERALL MORTALITY RATES IN OKLAHOMA CITY COUNTY FROM 2016-2018 WAS 932.6 DEATHS PER 100,000 PEOPLE. THAT WAS GREATER THAN THE NATIONAL RATE OF 728.9 AND THE STATE RATE OF 894.7 DEATHS PER 100,000. MORTALITY RATES WERE HIGHEST AMONG AMERICAN INDIANS. NON-HISPANICS HAD A HIGHER MORTALITY RATE THAN HISPANICS. THE ZIP CODES WITH THE HIGHEST MORTALITY RATES WERE 73007, 73141, AND 73102. AMONG OKLAHOMA COUNTY RESIDENTS, 30% HELD A BACHELOR'S DEGREE OR HIGHER IN 2019. SINCE THE COVID-19 PANDEMIC, THE EMPLOYMENT SITUATION IN OKLAHOMA HAS IMPROVED. ON SEPTEMBER 30, 2019, THE UNEMPLOYMENT RATE FOR OKLAHOMA CITY WAS 2.6%. ACCORDING TO THE U.S. BUREAU OF LABOR STATISTICS, OKLAHOMA RANKED FIRST FOR METROPOLITAN CITIES WITH A CENSUS POPULATION OF GREATER THAN ONE MILLION OR MORE.REPORTING GROUP CPART VI, LINE 4: COMMUNITY INFORMATIONOKLAHOMA COUNTY IS IN THE CENTRAL PART OF OKLAHOMA. OKLAHOMA CITY IS THE COUNTY SEAT AND IS THE LARGEST CITY IN THE STATE. THERE ARE 20 CITIES AND SMALL TOWNS LOCATED IN THE COUNTY. (1) OKLAHOMA COUNTY EMPLOYS 379,291 PEOPLE. THE ECONOMY SPECIALIZES IN MINING, OIL, GAS, QUARRYING, EXTRACTION, MANAGEMENT OF COMPANIES AND ENTERPRISES, AND PUBLIC ADMINISTRATION. ACCORDING TO THE 2019 POPULATION ESTIMATES, THE POPULATION OF OKLAHOMA COUNTY WAS 797,434. (1) THE COUNTY OCCUPIES 708 SQUARE MILES. AS OF 2010 CENSUS, THERE WERE 1,013 PERSONS PER SQUARE MILE. (1) OKLAHOMA COUNTY HAS 14 HOSPITALS, TWO FEDERALLY QUALIFIED HEALTH CENTERS WITH 14 SATELLITE CLINICS, APPROXIMATELY 17 FREE COMMUNITY CLINICS, ONE TRIBAL CLINIC, A CITY-COUNTY HEALTH DEPARTMENT WITH MULTIPLE LOCATIONS THROUGHOUT THE COUNTY, AND A STATE HEALTH DEPARTMENT. PUBLIC TRANSPORTATION, TAXI SERVICES, TWO PUBLIC AND SEVERAL PRIVATE AIRPORTS, AND PARAMEDIC LEVEL AMBULANCE SERVICES ARE ALSO LOCATED WITHIN THE COUNTY.
PART VI, LINE 5:	REPORTING GROUP APART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHEVIDENCE OF THE ORGANIZATIONS' RESPONSIVENESS TO THE COMMUNITY, INCLUDING OPPORTUNITIES FOR COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS.IACC'S BOARD OF DIRECTORS IS APPOINTED BY INTEGRIS HEALTH, INC. INTEGRIS HEALTH, INC. IS GOVERNED BY A BOARD OF DIRECTORS SPECIFICALLY MADE UP OF MEN AND WOMEN WHO LIVE AND WORK IN THE COMMUNITY INCLUDING: LOCAL BUSINESS OWNERS, CIVIC LEADERS, COMMUNITY VOLUNTEERS, REPRESENTATIVES WORKING IN HIGHER EDUCATION, UTILITY COMPANIES, AND A VARIETY OF NON-PROFIT ORGANIZATIONS. PATIENT AND COMMUNITY ADVISORY GROUPS HAVE ALSO BEEN ESTABLISHED AT SEVERAL INTEGRIS FACILITIES ACROSS THE STATE. THESE GROUPS GIVE HOSPITAL LEADERS INPUT, SUGGESTIONS, AND FEEDBACK ON WAYS TO IMPROVE PROGRAMS, SERVICES, COMMUNITY NEEDS, AND PROCESS IMPROVEMENT IN CLINICAL AREAS.PROGRAMS ESTABLISHED TO MEET COMMUNITY NEEDS INCLUDE A FALLS PREVENTION PROGRAM FOR SENIOR CITIZENS, COMMUNITY HEALTH SCREENINGS AND PHYSICIAN LECTURES REQUESTED BY LOCAL SCHOOLS, CHURCHES, CIVIC GROUPS, AND COMMUNITY LEADERS TO ADDRESS SPECIFIC HEALTH ISSUES WHICH INCLUDE: DIABETES, CANCER DIAGNOSIS AND TREATMENT OPTIONS, OBESITY AND PHYSICAL FITNESS PROGRAMS, MEN'S UROLOGICAL HEALTH PROGRAMS AND PROSTATE SCREENINGS, CANCER SCREENINGS, SPANISH DIABETES EDUCATIONS, AND STROKE LECTURES.ADVOCACY INITIATIVES FOR PROMOTING COMMUNITY-WIDE, STATE OR NATIONAL EFFORTS TO IMPROVE HEALTH OF THE POPULATION AND INCREASE ACCESS.INTEGRIS HEALTH PARTNERS WITH THE OKLAHOMA LIONS CLUB MOBILE HEALTH UNIT, THE OKLAHOMA STATE HEALTH DEPARTMENT, AND THE OKLAHOMA TURNING POINT PROGRAM TO INCREASE HEALTH SCREENING OPPORTUNITIES AND HEALTH ACCESS FOR PEOPLE LIVING IN RURAL, UNDERSERVED AREAS OF OKLAHOMA. THE PARTNERSHIP INCLUDES DONATION OF RESOURCES AND MONEY TO SPONSOR THE OPERATION OF THE LIONS MOBILE HEALTH UNIT WHICH TRAVELS AROUND THE STATE OFFERING FREE HEALTH SCREENINGS AND MEDICAL INFORMATION. THE OKLAHOMA STATE HEALTH DEPARTMENT AND THE OKLAHOMA TURNING POINT PROGRAM ASSIST WITH HEALTH SCREENINGS AND HELP WITH REFERRALS TO MEDICAL HOMES AND CLINICS FOR PEOPLE WITHOUT A PHYSICIAN AND FOR THOSE UNINSURED OR UNDERINSURED.INTEGRIS HEALTH HAS ESTABLISHED THE INTEGRIS HEALTH COMMUNITY GIVING FUND GRANT TARGETING THE THREE PRIORITIZED HEALTH AREAS. INTEGRIS HEALTH'S 2023-2025 COMMUNITY HEALTH PRIORITIES ARE ACCESS TO CARE (INCLUDING MENTAL HEALTH, OBESITY AND CHRONIC DISEASE PREVENTION/MANAGEMENT), ACCESS TO HEALTHY FOOD, AND TOBACCO USE PREVENTION, THROUGH RISK REDUCTION AND BEHAVIOR CHANGE, SCREENING, AND TREATMENT STRATEGIES. EVIDENCE-BASED PROGRAMS THAT PROMOTE HEALTH AND WELLNESS OR CREATE ACCESS TO COMPREHENSIVE MEDICAL CARE CONTINUE TO BE A PRIORITY OF THE COMMUNITY GIVING FUND. IN ORDER TO QUALIFY FOR GRANT FUNDING, THE PROGRAM OR SERVICE MUST ALIGN WITH ONE OR MORE OF FOLLOWING HEALTH PRIORITIES AND PROVIDE EVIDENCE-BASED DATA TO SUPPORT THE PROGRAM STRATEGIES (REPORTED QUARTERLY TO INTEGRIS HEALTH DURING THE GRANT YEAR):ACCESS TO CARE (INCLUDES MENTAL HEALTH, OBESITY AND CHRONIC DISEASE PREVENTION/MANAGEMENT)- IMPROVE ACCESS TO MEDICAL CARE SERVICES, BEHAVIORAL HEALTH, OR SUBSTANCE USE TREATMENT. IMPROVE THE PREVENTION, DETECTION, TREATMENT AND/OR MANAGEMENT OF DEPRESSION, AND REDUCE THE SUICIDE RATES. ACCESS TO HEALTHY FOOD- IMPROVE ACCESS TO HEALTHY AND AFFORDABLE FOOD AND KNOWLEDGE OF HEALTHY FOOD AND LIFESTYLE CHOICES.TOBACCO USE- REDUCE VAPING, ELECTRONIC CIGS, TOBACCO USE AND SECONDHAND SMOKE EXPOSURE.INTEGRIS HEALTH PARTNERS WITH LOCAL CIVIC GROUPS, SUCH AS OUR CHAMBERS OF COMMERCE, TECHNOLOGY SCHOOLS, COMMUNITY COLLEGES, CHURCHES, AND LOCAL SCHOOLS IN A VARIETY OF EVENTS AND PROGRAMS TO EDUCATE THE COMMUNITY ON HEALTH/WELLNESS ISSUES, CREATE OPPORTUNITIES FOR HEALTH ACCESS, PROVIDE COMMUNITY SCREENINGS IN UNDERSERVED AREAS OF OKLAHOMA, AND TO GIVE STUDENTS AND COMMUNITY MEMBERS THE OPPORTUNITY TO VOLUNTEER FOR THESE EVENTS. THIS INCLUDES MEDICAL STUDENTS WHO WORK WITH INTEGRIS HEALTH ACROSS THE STATE AT OUR EVENTS TO LEARN MORE ABOUT PROVIDING HEALTH SERVICES TO THE COMMUNITY AND TO HELP TRAIN THEM FOR FUTURE WORK IN THE HEALTHCARE ARENA.INTEGRIS HEALTH WORKS WITH THE OKLAHOMA HOSPITAL ASSOCIATION, THE OKLAHOMA STATE MEDICAL ASSOCIATION, THE HEALTH ALLIANCE FOR THE UNINSURED, THE OKLAHOMA STATE HEALTH DEPARTMENT, THE OKLAHOMA MENTAL HEALTH ASSOCIATION, AND LOCAL NON-PROFIT ORGANIZATIONS SUCH AS THE OKLAHOMA CHAPTERS OF AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN DIABETES ASSOCIATION, AMERICAN CANCER SOCIETY, AND OTHER LOCAL HEALTH AND WELLNESS ORGANIZATIONS AND AGENCIES TO DETERMINE HEALTH CARE NEEDS IN THE STATE, ISSUES CONCERNING SPECIFIC CITIES, ACCESS TO HEALTH ISSUES, NEIGHBORHOOD AND ENVIRONMENT ISSUES, AND OTHER SOCIAL DETERMINANTS OF HEALTH THAT AFFECT THE LIVES OF OUR RESIDENTS. A VARIETY OF COALITIONS HAVE BEEN STARTED TO ADDRESS SPECIFIC HEALTH AND WELLNESS ISSUES AND TO DETERMINE INTERVENTIONAL STRATEGIES FOR IMPLEMENTATION.THE IMPACT PROGRAMS ARE HAVING ON COMMUNITY HEALTH, ESPECIALLY PREVENTION ACTIVITIES, EFFORTS TO IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES AND REDUCING HEALTH CARE COSTS.INTEGRIS HEALTH COMMUNITY HEALTH PROGRAMS ACROSS THE STATE ARE IMPLEMENTED TO EDUCATE OUR RESIDENTS AND HEALTH AND WELLNESS ISSUES AFFECTING THEM AND THEIR COMMUNITIES. WORKING WITH PARTNER AGENCIES AND ORGANIZATIONS IN THE COMMUNITIES WE SERVE GIVES US THE OPPORTUNITY TO CREATE PROGRAMS THAT SPECIFICALLY ADDRESS NEGATIVE HEALTH INDICATORS AFFECTING THE COMMUNITY. PREVENTION AND HEALTH EDUCATION HAVE BEEN THE PRIORITY FOR INTEGRIS HEALTH FOR MANY YEARS IN AN EFFORT TO BETTER EDUCATE THE PUBLIC ON TAKING CARE OF THEIR HEALTH AND CREATING AWARENESS ABOUT THEIR BEHAVIORS MAY NEGATIVELY AFFECT THEIR HEALTH AND THE HEALTH OF THEIR FAMILIES. WORKING WITH PARTNER AGENCIES, ORGANIZATIONS, PHYSICIANS, AND LOCAL CLINICS, INTEGRIS HEALTH HAS BEEN ABLE TO HELP SLOWLY IMPROVE THE ACCESS TO HEALTHCARE IN THE METROPOLITAN AREAS, INCREASING ACCESS BY DEVELOPING REFERRAL NETWORKS BETWEEN FREE CLINICS ACROSS OKLAHOMA CITY AND IN SOME RURAL AREAS.ALL OF THESE PROGRAMS AND PARTNERSHIPS, COUPLED WITH EDUCATING THE COMMUNITY ABOUT AVAILABLE SERVICES, CAN HELP US CONTINUE TO REDUCE SOME OF THE HEALTHCARE COSTS WE SEE IN OUR HOSPITALS, CLINICS, AND EMERGENCY DEPARTMENTS.REPORTING GROUP BPART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHOCOM IS A MEMBER OF THE OHA, WHICH ADVOCATES FOR AFFORDABLE, HIGH-QUALITY CARE FOR THE STATE OF OKLAHOMA AND SUPPORTING RURAL HEALTH. OCOM CONTRACTS WITH RESEARCH INTERNATIONAL TO PERFORM IMAGING STUDIES FOR PATIENTS INVOLVED IN RESEARCH. OCOM PARTICIPATED IN THE HEALTHY OVER HUNGRY CEREAL DRIVE WHICH SUPPORTS THE REGIONAL FOOD BANK OF OKLAHOMA TO HELP SUPPORT OKLAHOMA'S MOST VULNERABLE AND HUNGRY. OCOM ALSO PARTICIPATED IN THE OKLAHOMA BLOOD INSTITUTE BLOOD DRIVE QUARTERLY DURING 2022.
PART VI, LINE 6:	REPORTING GROUP APART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLES IACC IS A MEMBER OF INTEGRIS HEALTH SYSTEM, OF WHICH INTEGRIS HEALTH, INC. IS THE CONTROLLING MEMBER. INTEGRIS HEALTH SYSTEM IS AN OKLAHOMA HEALTH CARE SYSTEM WHICH SUPPORTS THE COMMUNITY NEEDS ACROSS THE STATE. THE MISSION OF INTEGRIS HEALTH IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. THE FACILITIES OF OTHER TAXPAYERS ARE LISTED ON THE SCHEDULE H OF THEIR RESPECTIVE FORMS 990.REPORTING GROUP BPART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLESAS DESCRIBED ABOVE, OCOM WAS RESTRUCTURED EFFECTIVE NOVEMBER 1, 2018 WHEN A NEW JOINT VENTURE WAS FORMED BETWEEN INTEGRIS AND USP OK. WHEN THE NEW JOINT VENTURE WAS FORMED WITH INTEGRIS, OCOM BECAME SUBJECT TO THE 501(R) PROVISIONS.REPORTING GROUP CPART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMHPI IS A JOINT VENTURE FORMED BETWEEN INTEGRIS AND USP OK. WHEN THE NEW JOINT VENTURE WAS FORMED WITH INTEGRIS, HPI BECAME SUBJECT TO THE 501(R) PROVISIONS.
PART VI, LINE 7, REPORTS FILED WITH STATES	OK
SCHEDULE H, PART VI	INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM (INTEGRIS HEALTH SYSTEM OR SYSTEM) CONTROLLED BY INTEGRIS HEALTH, INC. AS SUCH IACC FOLLOWS CERTAIN POLICIES AND PROCEDURES ESTABLISHED AT THE SYSTEM LEVEL, MANY OF WHICH ARE DESCRIBED ABOVE.IACC DOES NOT HAVE A DIRECTLY OWNED HOSPITAL FACILITY, BUT OWNS A MINORITY INTEREST IN FOUR HOSPITAL FACILITIES, OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY (OCOM), THROUGH ITS INVESTMENT IN SOUTHWEST AMBULATORY SURGERY CENTER, LLC, COMMUNITY HOSPITAL AND TPG HOSPITAL (D/B/A NW SURGICAL HOSPITAL (HPI FACILITIES), THROUGH ITS INVESTMENT IN HPI AND LAKESIDE WOMEN'S HOSPITAL, LLC (LWH). THE ACTIVITY REPORTED ON SCHEDULE H, PARTS I-III INCLUDES THE ACTIVITY OF OCOM, HPI FACILITIES & LWH AS WELL AS THE DIRECT ACTIVITY OF IACC AND IACC'S PROPORTIONATE SHARE OF THE ACTIVITY OF THE NON-HOSPITAL JOINT VENTURES LISTED ON SCHEDULE H, PART V, SECTION D.
SCHEDULE H, PART VI	REPORTING GROUP APART I, LINE 7: COSTING METHODOLOGY: THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF CHARITY ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON PART 1, LINE 7. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.REPORTING GROUP BPART I, LINE 7:OCOM'S TOTAL EXPENSE INCLUDED IN PART IX, LINE 25, COLUMN (A) OF FORM 990 WAS $261,891,489, WHICH WAS USED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).
SCHEDULE H, PART III, LINE 8	REPORTING GROUP ATHE AMOUNTS REPORTED ON PART III, LINES 5 AND 6 REPRESENT INTEGRIS AMBULATORY CARE CORPORATION'S (IACC) PROPORTIONATE SHARE OF THE ALLOWABLE COSTS AND MEDICARE REIMBURSMENTS THAT ARE REPORTED ON OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY'S (OCOM) MEDICARE COST REPORT & LAKESIDE WOMEN'S HOSPITAL LLC (LWH) MEDICARE COST REPORT.COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO AND THE MEDICARE FILED COST REPORT.REPORTING GROUP BTHE COST TO CHARGE METHODOLOGY WAS USED IN ORDER TO CALCULATE THE MEDICARE ALLOWABLE COSTS RELATED TO PAYMENTS RECEIVED FROM MEDICARE. ANY RESULTING SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 9B	REPORTING GROUP APATIENTS MAY, AT ANY TIME DURING THE COLLECTION CYCLE, SUBMIT FINANCIAL INFORMATION FOR FINANCIAL ASSISTANCE OR CHARITY CONSIDERATION PURSUANT TO INTEGRIS POLICY SYS-RCM-100 CHARITY SERVICES.ALL AVAILABLE AVENUES OF ASSISTANCE AND AVAILABLE PAYMENTS FROM THIRD PARTY PAYORS MUST BE EXHAUSTED BEFORE SUCH ASSISTANCE FOR CHARITY OR OTHER FINANCIAL ASSISTANCE IS CONSIDERED.IACC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE.
SCHEDULE H, PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT	REPORTING GROUP BOCOM WAS NOT REQUIRED TO FILE, AND DID NOT FILE, A COMMUNITY BENEFIT REPORT WITH THE STATE OF OKLAHOMA FOR THE FISCAL YEAR ENDED JUNE 30, 2022.501(R) ERRORS AND CORRECTIONSIN MARCH 2022, OCOM'S CONTROLLER AND BUSINESS MANAGER REVIEWED ITS FINANCIAL ASSISTANCE POLICY (FAP) IN CONSULTATION WITH ITS PROFESSIONAL TAX ADVISORS AND FOUND SEVERAL PARTS OF ITS FAP THAT WERE NOT FULLY COMPLIANT WITH SECTION 501(R)(4) OF THE INTERNAL REVENUE CODE. THESE ERRORS REFLECTED A MISUNDERSTANDING OF FINAL 501(R) REGULATIONS BY THOSE OCOM STAFF MEMBERS WHO DEVELOPED THE FAP. OCOM PROMPTLY WORKED WITH ITS PROFESSIONAL TAX ADVISORS TO REVISE THESE PARTS OF THE FAP TO BRING THEM INTO FULL COMPLIANCE WITH SECTION 501(R). OCOM MADE THESE REVISIONS TO THE FAP IN CONSULTATION WITH ITS PROFESSIONAL TAX ADVISORS IN APRIL 2022, ITS GOVERNING BODY APPROVED THE AMENDED FAP ON AND IT POSTED THE AMENDED FAP ON ITS WEB SITE ON APRIL 6, 2022. THESE FAP REVISIONS WERE COMPRISED OF:1. REVISING THE PARAGRAPH REGARDING AMOUNTS GENERALLY BILLED (AGB) TO PROVIDE GREATER SPECIFICITY REGARDING HOW THAT PERCENTAGE IS DETERMINED AND APPLIED AND INCLUDING A LINK TO THE PUBLICLY ACCESSIBLE WEB SITE URL THAT CONTAINS THE SPECIFIC AGB PERCENTAGE. THE REVISED PARAGRAPH NOW READS AS FOLLOWS:THE AMOUNTS BILLED FOR MEDICALLY NECESSARY AND GENERALLY AVAILABLE MEDICAL SERVICES TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NOT BE MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE COVERING SUCH CARE. IN ADDITION, AMOUNTS CHARGED FOR MEDICALLY NECESSARY AND GENERALLY AVAILABLE MEDICAL SERVICES TO UNINSURED PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NOT BE MORE THAN THE AGB. OCOM DETERMINES AGB BASED ON ALL CLAIMS PAID IN FULL TO OCOM BY MEDICARE AND PRIVATE HEALTH INSURERS (INCLUDING PAYMENTS BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS THEMSELVES), OVER A 12-MONTH PERIOD, DIVIDED BY THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS (LOOK-BACK METHOD). THE CURRENT AGB PERCENTAGE CAN BE FOUND AT HTTPS://OCOMHOSPITAL.COM/FINANCE-OPTIONS/. IN THE EVENT A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE HAS PAID MORE THAN THE AGB FOR A MEDICALLY NECESSARY AND GENERALLY AVAILABLE MEDICAL SERVICE, OCOM WILL REFUND THE PATIENT THE AMOUNT OVER THE AGB CALCULATED AMOUNT.OCOM HAS CHANGED ITS PROCEDURES TO PROVIDE THAT IT WILL POST THE UPDATED AGB PERCENTAGE EVERY 12 MONTHS, AFTER IT IS RE-CALCULATED BASED ON CLAIMS ALLOWED DURING THOSE 12 MONTHS. AS SUCH, THE NEXT UPDATE WILL BE DONE IN MAY OF 2023.2. REVISING APPENDIX A OF THE FAP-"PROVIDER LIST" TO SPECIFY WHICH OF THE NON-EMPLOYED PROVIDERS OF MEDICALLY NECESSARY AND GENERALLY AVAILABLE CARE ARE COVERED BY THE FAP, AND WHICH ARE NOT COVERED BY THE FAP. OCOM HAS CHANGED ITS PROCEDURES TO PROVIDE THAT IT WILL UPDATE THIS PROVIDER LIST AT LEAST ONCE EVERY THREE MONTHS TO REFLECT ANY CHANGES IN THE NON-EMPLOYED PROVIDERS COVERED AND NOT COVERED BY THE FAP. OCOM RECENTLY DISCOVERED THAT ITS LIST OF NON-EMPLOYED PROVIDERS OF MEDICALLY NECESSARY CARE IN ITS HOSPITAL FACILITY ("PROVIDER LIST"), WHICH IT MAINTAINS ON ITS WEB SITE, HAD NOT BEEN UPDATED SINCE APRIL 2022 DUE TO CHANGES THAT OCCURRED WITHIN THE ORGANIZATION'S LEADERSHIP. THIS ERROR WAS DISCOVERED BY OCOM'S CONTROLLER ON 04/13/2023 AND OCOM THEN UPDATED AND POSTED THIS LIST ON ITS WEB SITE ON 04/21/2023. OCOM HAS ESTABLISHED A PROCESS FOR THE CONTROLLER TO REVIEW AND UPDATE ITS PROVIDER LIST, AS APPLICABLE, AT LEAST QUARTERLY GOING FORWARD.3. REVISING THE PARAGRAPH REGARDING MEDICAL CARE DISCOUNTS AVAILABLE TO PATIENTS BASED ON THEIR INCOME LEVEL TO MORE SPECIFICALLY AND CLEARLY INDICATE THE ELIGIBILITY CRITERIA A PATIENT MUST MEET TO QUALIFY FOR EACH DISCOUNT; IN PARTICULAR, THE ANNUAL INCOME LEVEL (USING FEDERAL POVERTY GUIDELINES ("FPG") A PATIENT MUST FALL BELOW TO QUALIFY FOR EACH TYPE OF DISCOUNT. OCOM ADDED A CHART TO SHOW HOW EACH SPECIFIC PERCENTAGE DISCOUNT CORRESPONDS TO A FAP ELIGIBLE PATIENT'S ANNUAL FPG INCOME LEVEL. OCOM HAS CHANGED ITS PROCEDURES TO PROVIDE THAT IT WILL UPDATE THIS SECTION OF THE FAP TO REFLECT ANY CHANGES IN EITHER THE DISCOUNTS OR ELIGIBLE CRITERIA FOR THOSE DISCOUNTS THAT OCOM MAY MAKE.OCOM IS NOT AWARE OF ANY INDIVIDUALS WHO HAVE BEEN ADVERSELY AFFECTED BY THESE 501(R)- RELATED ERRORS IN ITS FAP, AND ACCORDINGLY HAS NOT TAKEN ANY ACTIONS TO RESTORE INDIVIDUALS TO THE POSITION THEY WOULD HAVE BEEN IN HAD THESE ERRORS NOT OCCURRED.4. INTEGRIS HEALTH SYSTEM, WHICH INCLUDES OCOM COMPLETED ITS PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), DURING ITS FISCAL YEAR 2021. OCOM'S BOARD APPROVED THE CHNA ON APRIL 29, 2021, AND POSTED ITS CHNA REPORT ONLINE ON THAT DATE. SUBSEQUENTLY, INTEGRIS HEALTH AND OCOM CONDUCTED ANOTHER CHNA WHICH IT COMPLETED, UPON APPROVAL BY THE INTEGRIS BOARD, ON JULY 25, 2022. OCOM COMPLETED ITS IMPLEMENTATION STRATEGY FOR THIS CHNA-TITLED "COMMUNITY HEALTH IMPROVEMENT PLAN" (CHIP) AND POSTED THAT CHIP ONLINE ON JULY 25, 2022. OCOM SUBSEQUENTLY REALIZED THAT IT HAD NOT POSTED ITS 2022 CHNA REPORT ONLINE, THEN PROMPTLY POSTED THIS REPORT ONLINE ON MAY 3, 2023.REPORTING GROUP C:HPI WAS NOT REQUIRED TO FILE, AND DID NOT FILE, A COMMUNITY BENEFIT REPORT WITH THE STATE OF OKLAHOMA FOR THE FISCAL YEAR ENDED JUNE 30, 2022.

Schedule H (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

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 .....

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? ....

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 ............

Yes

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1TIMOTHY PEHRSON DIRECTOR & PRESIDENT/CEO	(i) (ii)	0 ------------- 1,150,996	0 ------------- 659,360	0 ------------- 131,860	0 ------------- 280,336	0 ------------- 17,939	0 ------------- 2,240,491	0 ------------- 114,191
2JEREMY T PHELPS PHYSICIAN	(i) (ii)	851,538 ------------- 0	862,005 ------------- 0	4,315 ------------- 0	19,225 ------------- 0	0 ------------- 0	1,737,083 ------------- 0	0 ------------- 0
3SCOTT SHADFAR PHYSICIAN	(i) (ii)	996,976 ------------- 0	496,564 ------------- 0	1,433 ------------- 0	19,225 ------------- 0	0 ------------- 0	1,514,198 ------------- 0	0 ------------- 0
4HANI BARADI PHYSICIAN	(i) (ii)	1,146,055 ------------- 0	292,245 ------------- 0	3,062 ------------- 0	19,225 ------------- 0	0 ------------- 0	1,460,587 ------------- 0	0 ------------- 0
5MUZAFFAR HUSSAIN PHYSICIAN	(i) (ii)	690,999 ------------- 0	448,560 ------------- 0	6,686 ------------- 0	24,125 ------------- 0	0 ------------- 0	1,170,370 ------------- 0	0 ------------- 0
6CHRISTOPHER LENTZ PHYSICIAN	(i) (ii)	677,869 ------------- 0	435,727 ------------- 0	4,624 ------------- 0	18,500 ------------- 0	0 ------------- 0	1,136,720 ------------- 0	0 ------------- 0
7DOUGLAS M SMITH TREASURER & CFO	(i) (ii)	0 ------------- 553,425	0 ------------- 230,406	0 ------------- 13,051	0 ------------- 123,939	0 ------------- 17,340	0 ------------- 938,161	0 ------------- 0
8JEFFREY CRUZAN PRESIDENT PHYSICIAN ENTERPRISE	(i) (ii)	555,023 ------------- 0	128,224 ------------- 0	16,516 ------------- 0	95,722 ------------- 0	0 ------------- 0	795,485 ------------- 0	0 ------------- 0
9SUNNIE GLOVER VP PHYSICIAN ENTERPRISE	(i) (ii)	349,723 ------------- 0	177,700 ------------- 0	11,564 ------------- 0	59,400 ------------- 0	0 ------------- 0	598,387 ------------- 0	0 ------------- 0
10KATHERINE ANN MANSALIS VP & CHIEF MEDICAL OFFICER	(i) (ii)	267,630 ------------- 0	91,887 ------------- 0	1,246 ------------- 0	11,201 ------------- 0	0 ------------- 0	371,964 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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 3	INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IACC RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS OFFICERS. INTEGRIS UTILIZES A COMPENSATION COMMITEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THIS COMPENSATION.
PART I, LINE 4B	THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NON QUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT IN THE CURRENT REPORTING YEAR. DOUGLAS M. SMITH SUNNIE GLOVER JEFFERY CRUZAN KATHERINE ANNE MANSALIS THE FOLLOWING INDIVIDUAL LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN AND RECEIVED A PAYMENT IN THE CURRENT REPORTING YEAR: TIMOTHY PEHRSON - $114,191
PART I, LINE 7	THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS) INTEGRIS HEALTH HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. IN THE SECOND PLAN, CERTAIN EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION PURSUANT TO THEIR WRITTEN EMPLOYMENT AGREEMENTS. ALL INCENTIVE COMPENSATION IS SUBJECT TO A CAP AND DOES NOT EXCEED 50% OF THE PHYSICIAN'S TOTAL COMPENSATION. THERE ARE A VARIETY OF METHODS USED TO CALCULATE INCENTIVE COMPENSATION BASED ON THE PHYSICIAN'S PERSONAL PRODUCTION, RANGING FROM (I) A SPECIFIED PERCENTAGE OF NET INCOME LESS EXPENSES; (II) A SPECIFIED PERCENTAGE OF TOTAL COLLECTIONS LESS EXPENSES; (III) A SPECIFIED PERCENTAGE OF BASE SALARY BASED COMPLIANCE WITH CERTAIN QUALITY, PATIENT SATISFACTION, PRODUCTION AND FINANCIAL INDICATORS; (IV) A SPECIFIED PERCENTAGE OF BASE SALARY BASED ON COMPLIANCE WITH QUALITY, GUIDING VALUES, PATIENT SATISFACTION AND PRODUCTION CRITERIA; (V) A SPECIFIED PERCENTAGE OF FEE-BASED COLLECTIONS AND CAPITATION COLLECTIONS, IF APPLICABLE, IN EXCESS OF QUARTERLY SALARY; (VI) QUARTERLY BONUSES MEASURED BY RVUS THAT EXCEED A SPECIFIED TARGET PER QUARTER; AND (VII) PRO RATA SHARE OF ANNUAL INCENTIVE POOLS BASED ON PRODUCTION, COMPLIANCE WITH CLINICAL GUIDELINES, QUALITY AND PATIENT SATISFACTION CRITERIA.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

Return Reference	Explanation
FORM 990, BOX C: DOING BUSINESS AS	CHEST PAIN EMERGENCY CENTER PROHEALTH LABORATORY MEDICAL PLAZA IMAGING CENTER MERIDIAN OCCUPATIONAL HEALTH CENTER MERIDIAN PRIORITY OCCUPATIONAL HEALTH CENTER FAMILY PHYSICIANS OF OKLAHOMA CITY INTEGRIS HOMECARE PLUS SAMARITAN HOME INFUSION SAMARITAN HEALTH SERVICES INTEGRIS FAMILY CARE CENTER SOUTH PENN FAMILY MEDICINE CENTER SOUTH PENN FAMILY MEDICINE CLINIC INTEGRIS AMBULATORY CARE REHABILITATION SERVICES INTEGRIS FAMILY CARE CENTRAL BAPTIST COMMUNITY CLINIC INNER EAR RESEARCH TEAM INTEGRIS EXPRESS CARE INTEGRIS MEDICAL GROUP INTEGRIS JIM THORPE REHABILITATION INTEGRIS ADVANCED CARDIAC CARE INTEGRIS JIM THORPE OUTPATIENT REHABILITATION HEFNER POINTE INTEGRIS JIM THORPE REHABILITATION ENID INTEGRIS OCCUPATIONAL MEDICINE ENID INTEGRIS JIM THORPE REHABILITATION HOBBY LOBBY INTEGRIS MEDICAL GROUP OCCUPATIONAL MEDICINE INTEGRIS JIM THORPE REHABILITATION EARLYWINE PARK YMCA INTEGRIS JIM THORPE REHABILITATION MITCH PARK YMCA INTEGRIS MOBILE WELLNESS CLINIC INTEGRIS HEALTH URGENT CARE INTEGRIS JIM THORPE REHABILITATION BETHANY YMCA
PART III, LINE 4A: COMMUNITY BENEFIT REPORT	INTEGRIS COMMUNITY BENEFIT REPORT 2021 A MESSAGE FROM OUR PRESIDENT AND CEO: INTEGRIS HEALTH IS OKLAHOMA'S LARGEST NOT-FOR-PROFIT HEALTH SYSTEM AND HAS SERVED OKLAHOMA COMMUNITIES FOR MORE THAN 100 YEARS. OUR MISSION IS PARTNERING WITH PEOPLE TO LIVE HEALTHIER LIVES. BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS, INTEGRIS HEALTH PARTNERS WITH OTHER COMMUNITY ORGANIZATIONS TO IMPROVE ACCESS TO HEALTH CARE. SOME EXAMPLES OF THIS INCLUDE FUNDING FREE CLINICS, HEALTH SCREENINGS, WELLNESS PROMOTIONS, HEALTH EDUCATION, HEALTH SUPPORT GROUPS, MENTORING PROGRAMS FOR AT-RISK YOUTH, CLEAN UP AFTER NATURAL DISASTERS, ASSISTANCE FOR THE ELDERLY AND SERVING AS A LEADER DURING A PANDEMIC. THIS REPORT HIGHLIGHTS IN GREATER DETAIL A FEW WAYS INTEGRIS HEALTH POSITIVELY IMPACTED OUR COMMUNITIES LAST YEAR. WE ARE GRATEFUL AND HUMBLED TO BE OKLAHOMANS' MOST TRUSTED PARTNER FOR HEALTH. WARMLY, TIMOTHY PEHRSON PRESIDENT AND CEO MISSION: PARTNERING WITH PEOPLE TO LIVE HEALTHIER LIVES VISION: THE MOST TRUSTED PARTNER FOR HEALTH VALUES: ICARE-INTEGRITY. COMPASSION. ACCOUNTABILITY. RESPECT. EXCELLENCE. INTEGRIS HEALTH COMMUNITY GIVING FUND INTEGRIS HEALTH HAS LONG BEEN A LEADER IN COMMUNITY HEALTH OUTREACH. MANY ARE NOT AWARE OF THE COMMUNITY BENEFIT ASPECT OF OUR ORGANIZATION'S WORK. THIS GRANT INITIATIVE IS A GREAT OPPORTUNITY TO TELL THE STORY TO OUR INTERNAL AND EXTERNAL COMMUNITIES. INTEGRIS HEALTH HAS ESTABLISHED PRIORITIES FOR IMPROVING COMMUNITY HEALTH FOR 2020 THROUGH 2022. INTEGRIS HEALTH'S 2020-2022 COMMUNITY HEALTH PRIORITY IS TO ADDRESS OBESITY, MENTAL HEALTH, ACCESS TO CARE, FOOD INSECURITY AND TOBACCO THROUGH RISK REDUCTION AND BEHAVIOR CHANGE, SCREENING AND TREATMENT STRATEGIES. THE GRANTS ALLOW US TO PARTNER WITH OTHER ORGANIZATIONS, HELPING PEOPLE LIVE HEALTHIER LIVES AND MAXIMIZING THE IMPACT OF OUR COMMUNITY BENEFIT DOLLARS TO IMPROVE HEALTH OUTCOMES. FOR MORE INFORMATION CONTACT TOBI.CAMPBELL@INTEGRISOK.COM. VARIETY CARE NAME OF PROJECT: VARIETY CARE MAMMOGRAPHY PLAN IN PARTNERSHIP WITH THE URBAN LEAGUE PROJECT DESCRIPTION: VARIETY CARE AND THE URBAN LEAGUE WORK TOGETHER TO PROVIDE A PROGRAM OF OUTREACH, CLIENT NAVIGATION, CASE MANAGEMENT AND COUNSELING TARGETING AFRICAN AMERICAN WOMEN TO INCREASE ACCESS TO MAMMOGRAMS. PROGRESS: AS OF SEPTEMBER 2021, THE URBAN LEAGUE REFERRED 29 AFRICAN AMERICAN WOMEN TO VARIETY CARE FOR THEIR INITIAL HEALTH VISIT, WITH 16 OF THE 29 COMPLETING THEIR VISIT. FOURTEEN REFERRED BY THE URBAN LEAGUE ARE IN THE PROCESS OF OBTAINING AN APPOINTMENT. THE URBAN LEAGUE CONTINUES TO PROVIDE ENROLLMENT, CASE MANAGEMENT, PROMOTIONS AND FOLLOW-UP ACTIVITIES WITH CLIENTS. IN OCTOBER, THE URBAN LEAGUE HOSTED A "DAY OF PINK" BRUNCH EVENT FOR LOW-INCOME, UNINSURED AND UNDERINSURED AFRICAN AMERICAN WOMEN TO PROMOTE BREAST CANCER AWARENESS AND ASSIST CLIENTS TO REGISTER FOR THEIR VARIETY CARE OFFICE VISIT AND INTEGRIS HEALTH MAMMOGRAM. THE DAY OF PINK EVENT PROVIDED RESOURCES, SUPPORT AND INFORMATION FOR AFRICAN AMERICAN WOMEN WHO HAVE LOST LOVED ONES, ARE WORRIED ABOUT DEVELOPING BREAST CANCER OR NEED ANSWERS TO QUESTIONS ABOUT PREVENTING AND RECOGNIZING SYMPTOMS OF BREAST CANCER. IN ADDITION TO WOMEN IDENTIFIED BY THE URBAN LEAGUE, VARIETY CARE CARE MANAGEMENT STAFF LINK PATIENTS WITH RESOURCES FOR MAMMOGRAMS AND PERFORM IN-REACH WITH STAFF AND PATIENTS. BETWEEN JANUARY 1 AND SEPTEMBER 15, 2021, 3,165 WOMEN WERE REFERRED FOR MAMMOGRAMS, 279 (8.8%) OF WHICH WERE AFRICAN AMERICAN/BLACK, AN INCREASE FROM 7.9% AT THE SIX-MONTH MARK. UNINSURED WOMEN COMPRISED 1,382 (43.7%) OF THOSE REFERRED FOR MAMMOGRAMS. VARIETY CARE NAME OF PROJECT: MENTAL HEALTH AWARENESS AND REFERRAL TO TREATMENT PROJECT DESCRIPTION: VARIETY CARE MEDICAL ASSISTANTS SCREEN PATIENTS AGE 12 AND OLDER FOR DEPRESSION. IF THE SCREEN IS POSITIVE, THE MEDICAL PROVIDER WILL MAKE AN IN-HOUSE REFERRAL TO A BEHAVIORAL HEALTH PROVIDER. PROGRESS: IN THE FIRST NINE MONTHS OF THE GRANT YEAR, MEDICAL TEAMS SCREENED 22,609 (60.2%) OUT OF 37,574 MEDICAL PATIENTS FOR DEPRESSION AND DEVELOPED A TREATMENT PLAN FOR THOSE WITH A POSITIVE SCREEN. OF THOSE, 7,192 (31.8%) WERE UNINSURED. WE HAVE SEEN AN INCREASE IN THE NEED FOR BEHAVIORAL HEALTH DURING THE PANDEMIC. SOME THERAPISTS ARE SCHEDULED OUT FOUR TO FIVE WEEKS, WITH PSYCHIATRISTS BOOKED OUT ABOUT THREE WEEKS. IN ADDITION TO AN INCREASE IN THE NEED FOR TREATMENT OF DEPRESSION AND ANXIETY, WE SEE A CONTINUING NEED FOR MEDICATION ASSISTED TREATMENT. TELEHEALTH REMAINS AN ESSENTIAL METHOD OF SERVICE DELIVERY IN RESPONSE TO THE PANDEMIC. VARIETY CARE NAME OF PROJECT: OBESITY PREVENTION, REFERRAL TO TREATMENT AND HEALTHY FOOD ACCESS PROJECT DESCRIPTION: VARIETY CARE DIETITIANS AND BEHAVIORAL HEALTH STAFF WORK WITH OVERWEIGHT PATIENTS WITH DIABETES OR HYPERTENSION TO ATTAIN A HEALTHY WEIGHT. PROGRESS: IN THE FIRST NINE MONTHS OF THE GRANT YEAR, VARIETY CARE MEDICAL TEAMS DOCUMENTED BMI FOR 14,646 OUT OF 20,153 CHILDREN (72.7%) AND 14,689 OUT OF 31,232 ADULTS (47.0%), PROVIDING COUNSELING TO THOSE WHOSE WEIGHT WAS OUTSIDE NORMAL PARAMETERS. OF THE 14,646 CHILDREN WHOSE BMI WAS DOCUMENTED AND WHO RECEIVED COUNSELING, 395 (2.0%) MADE SUSTAINED PROGRESS TOWARD IDEAL WEIGHT. OF THE 14,689 ADULTS WHOSE BMI WAS DOCUMENTED AND WHO RECEIVED COUNSELING, 13,224 (90.0%) MADE PROGRESS TOWARD THEIR IDEAL WEIGHT. OF THOSE WHOSE BMI WAS DOCUMENTED AND WHO RECEIVED COUNSELING, 8.3% OF CHILDREN AND 19.6% OF ADULTS WERE UNINSURED. HEALTHY FOODS ARE AN ESSENTIAL PART OF A DAILY DIET. OBTAINING FRESH FRUITS AND VEGETABLES IS ESPECIALLY DIFFICULT FOR LOW-INCOME PATIENTS. VARIETY CARE REGISTERED DIETITIANS DISTRIBUTED 41 $50 GIFT CARDS TO LOW-INCOME PATIENTS WITH HYPERTENSION AND/OR PREDIABETES OR DIABETES TO REMOVE A BARRIER TO THEIR ABILITY TO CHOOSE FRESH FRUITS AND VEGETABLES. THIRTEEN OF THE PATIENTS THAT RECEIVED GIFT CARDS FOR HEALTHY FOOD WERE UNDER AGE 18.
PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED	YMCA OF GREATER OKLAHOMA CITY NAME OF PROJECT: EXERCISE IS MEDICINE PROJECT DESCRIPTION: THE EXERCISE IS MEDICINE PROGRAM INCORPORATES CARDIOVASCULAR, FLEXIBILITY, STRENGTH TRAINING AND MIND BODY EXERCISES, AWARENESS OF NUTRITIONAL IMPACT ON HEALTH, APPLICATION OF SUSTAINED HEALTHY HABITS, AND BEHAVIORAL AND ENVIRONMENTAL SUPPORT TO ELICIT LONG-TERM SUCCESS. PARTICIPANTS ARE REFERRED BY HEALTH CARE PROVIDERS. INSTRUCTION IS OVERSEEN BY A TEAM OF EXERCISE IS MEDICINE TRAINERS FOR 12 WEEKS, TWICE PER WEEK FOR A TOTAL OF 24 ONE-HOUR SESSIONS. THIS PROGRAM IS FACILITATED IN A SMALL GROUP SETTING WITH A RATIO OF 1:8 FOR OPTIMAL INSTRUCTION. PROGRESS: THE FIRST COHORT HAS FINALIZED THEIR PROGRAMMING AND ASSESSMENTS. WE ARE IN THE PROCESS OF RECRUITING FOR THE NEXT COHORT OF APPROXIMATELY 40 PARTICIPANTS THROUGH A PARTNERSHIP WITH LYNN INSTITUTE. THE NEXT QUARTER WILL BE THE LARGEST FOR PARTICIPATION AND EXPENDITURES. YWCA ENID NAME OF PROJECT: YWCA ENID'S SEXUAL ASSAULT NURSE EXAMINER (SANE) AND COUNSELING PROGRAMS. PROJECT DESCRIPTION: YWCA ENID'S SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM OFFERS FREE FORENSIC EXAMS TO ADULT VICTIMS OF SEXUAL ASSAULT. THE SPECIALLY TRAINED SANE NURSE PROVIDES AN EXAM AND PROTOCOL MEDICATIONS TO VICTIMS IN A COMFORTABLE AND CONFIDENTIAL MEDICAL ROOM ON-SITE AT THE YWCA. REQUESTS ARE RECEIVED FROM INDIVIDUALS FOR EXAMS, OR REFERRALS FROM LAW ENFORCEMENT. AFTER THE EXAM IS COMPLETE AND EVIDENCE IS TURNED OVER TO LAW ENFORCEMENT, THE SANE NURSE WILL THEN FOLLOW UP WITH THE VICTIM TWO WEEKS AFTER THE EXAM TO PROVIDE NEEDED RESOURCES AND ADDITIONAL MEDICAL ASSISTANCE. SEXUAL ASSAULT RESPONSE ADVOCATES (SARAS) ARE SPECIALLY TRAINED RECRUITED VOLUNTEERS PROVIDING EMOTIONAL SUPPORT AND RESOURCES TO VICTIMS AT THE TIME OF THE EXAM AND IN THE WEEKS FOLLOWING. THE STAFF COURT ADVOCATE IS ALSO AVAILABLE TO ACCOMPANY THE VICTIMS IN THE INSTANCE OF PROSECUTION. THE SANE NURSE REGULARLY TESTIFIES IN COURT TO AID IN THIS PROSECUTION. WITHOUT YWCA'S SANE PROGRAM, VICTIMS WOULD TRAVEL TO WOODWARD, STILLWATER OR PONCA CITY FOR AN EXAM IN THE MIDST OF THEIR TRAUMATIC INCIDENT. YWCA ENID'S COUNSELING PROGRAM OFFERS FREE INDIVIDUAL AND GROUP COUNSELING TO VICTIMS OF DOMESTIC VIOLENCE, SEXUAL ASSAULT AND STALKING, AS WELL AS THE COMMUNITY AT LARGE. REQUESTS COME FROM INDIVIDUALS FOR SERVICES, AND OCCASIONALLY OKDHS ARE RECEIVED WITH THIS PROGRAM. THE LICENSED PROFESSIONAL COUNSELOR WILL MEET WITH THOSE INDIVIDUALLY OR IN A GROUP SETTING TO FACILITATE AN UNDERSTANDING OF TRAUMA, NORMALIZE THEIR EXPERIENCE AND PROVIDE SUPPORT AND HEALTHY COPING SKILLS. OTHER SKILLS FOSTERED ARE APPROPRIATE PARENTING SKILLS AND TECHNIQUES TO MANAGE ANXIETY, DEPRESSION AND PTSD. PROGRESS: THE SANE NURSE PROVIDED ONE DOMESTIC VIOLENCE AND THREE SEXUAL ASSAULT EXAMS IN JULY 2021, TWO SEXUAL ASSAULT EXAMS IN AUGUST 2021, AND ONE SEXUAL ASSAULT EXAM IN SEPTEMBER. IN TOTAL, THE SANE NURSE PERFORMED SEVEN EXAMS THIS QUARTER. 100% OF INDIVIDUALS REQUESTING A SANE/DVNE EXAM WERE PROVIDED WITH ONE. 100% OF CLIENTS SERVED BY THE YWCA CRISIS CENTER SHELTER WERE ALSO OFFERED A SANE/DVNE EXAM. YWCA'S SANE NURSE ALSO FACILITATED 81 HOURS OF ADVOCACY SERVICES FOR THESE VICTIMS AND SUPPLIED FOUR LAW ENFORCEMENT DEPARTMENTS WITH FORENSIC EVIDENCE FOR PROSECUTION. ADDITIONALLY, THE SANE NURSE PROVIDED ONE TRAINING TO LAW ENFORCEMENT THIS QUARTER. YWCA HOSTED A SEXUAL ASSAULT RESPONSE ADVOCATE (SARA) OPEN HOUSE IN OCTOBER DURING DOMESTIC VIOLENCE AWARENESS MONTH TO RECRUIT MORE VOLUNTEERS TO ASSIST WITH THE SANE PROGRAM. YWCA ENID'S COUNSELING PROGRAM HAS BEEN EXTREMELY BUSY THIS QUARTER. IN FACT, AFTER REVIEWING METRICS FROM LAST FISCAL YEAR, COUNSELING SERVICES HAVE INCREASED BY 70% SINCE THE ONSET OF THE COVID-19 PANDEMIC. DURING THIS QUARTER (JULY- SEPTEMBER 2021), THE LICENSED PROFESSIONAL COUNSELOR PROVIDED 144 HOURS OF COUNSELING TO 70 CLIENTS. NINE OF THESE CLIENTS WERE NEW ADMISSIONS, AND 85% WERE NON-RESIDENTIAL COMMUNITY MEMBERS. 100% OF VICTIMS REQUESTING SERVICES IN ANY CAPACITY WERE OFFERED COUNSELING AT NO CHARGE. 92% OF CLIENTS SERVED ACQUIRED HEALTHY COPING SKILLS AND DEMONSTRATED IMPROVEMENT IN THEIR QUALITY OF LIFE.
PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED	NORTH ENID LIONS CLUB NAME OF PROJECT: EYEGLASSES FOR NEEDY RESIDENTS PROJECT DESCRIPTION: AS A CIVIC CLUB, THE GOAL IS TO PROVIDE SERVICE PROJECTS. THE PROJECT WE ARE WORKING ON IS TO PROVIDE EYE EXAMS AND GLASSES TO NEEDY INDIVIDUALS. PROGRESS: THE NORTH ENID LIONS CLUB HAS SPENT A TOTAL OF $1,115 ON EYEGLASSES FROM MAY THROUGH SEPTEMBER 2021. COMMUNITY DEVELOPMENT SUPPORT ASSOCIATION, INC. (CDSA) NAME OF PROJECT: EMERGENCY MEDICATION AND SHORT-TERM MEDICATION AND MEDICAL SUPPLIES SUPPORT PROJECT DESCRIPTION: PROGRAM SUPPORT TO ADDRESS THE LONG-STANDING NEED FOR EMERGENCY MEDICATIONS AND SHORT-TERM MEDICATION SUPPORT WHILE ACCESSING OTHER ASSISTANCE AND EMERGENCY MEDICAL SUPPLY NEEDS, INCLUDING THE NEED FOR ADULT INCONTINENCE SUPPLIES. PROGRESS: 1. PURCHASED INCONTINENCE SUPPLIES. 2. BEGAN MARKETING AVAILABILITY OF SUPPLIES. 3. DISTRIBUTED INCONTINENCE SUPPLIES TO FOUR INDIVIDUALS IN THE FIRST QUARTER AND SEVEN IN THE SECOND QUARTER DURING 2021. 4. DEVELOPED PARTNERSHIP WITH FAMILY PHARMACY FOR DISCOUNTED MEDICATION/SUPPLIES PRICING. 5. DISTRIBUTED TEST STRIPS AND TESTING MACHINE TO ONE DIABETIC PATIENT. 6. MARKETED SERVICES TO ENID COMMUNITY CLINIC, LOAVES AND FISHES, OUR DAILY BREAD, MEADOWS POINT APARTMENTS, AREA AGENCY ON AGING, ENID SENIOR CENTER AND TO RSVP TO DISTRIBUTE MATERIALS TO RECIPIENTS OF ENID MOBILE MEALS. 7. PROVIDED FIRST AID SUPPLIES (BANDAGES, ANTIBIOTIC OINTMENT, CLEANSING PADS, HOT/COLD PACKS AND TYLENOL FOR OUTREACH TO ENID SOS FOR HOMELESS OUTREACH. 8. ASSISTED 13 CLIENTS WITH MEDICATIONS CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OKLAHOMA CITY (CCAOKC) NAME OF PROJECT: COUNSELING SERVICES AND FAMILY SUPPORT SERVICES PROJECT DESCRIPTION: CATHOLIC CHARITIES OFFERS COUNSELING SERVICES THROUGH THEIR REGIONAL OFFICE. LICENSED PROFESSIONAL COUNSELORS OFFER AFFORDABLE OUTPATIENT COUNSELING FOR INDIVIDUALS, FAMILIES AND CHILDREN TO ADDRESS LIFE'S STRESSES AND PROBLEMS HINDERING THEIR DAILY FUNCTIONING. COUNSELORS PROVIDE A MENTAL HEALTH CONTINUUM OF CARE THAT INCLUDES SUPPORT, PREVENTION, INTERVENTION AND TREATMENT. THE SKILLED AND CARING STAFF ARE GUIDED BY EVIDENCE-BASED STRATEGIES AND WORK COLLABORATIVELY WITH THE CLIENT TO DEVELOP CARE PLANS THAT ARE INDIVIDUALIZED. ALSO OFFERED THROUGH THIS REGIONAL OFFICE IS THE FAMILY SUPPORT SERVICES PROGRAM, WHICH HAS TWO KEY COMPONENTS (EMERGENCY RENT AND UTILITY ASSISTANCE, AND FAMILY HOPE) THAT ADDRESS IMMEDIATE CLIENT NEEDS AND FACILITATE A PATH TO A STABLE AND ECONOMICALLY INDEPENDENT FUTURE. THROUGH THE EMERGENCY RENT AND UTILITY ASSISTANCE PROGRAM CLIENTS FACING A FINANCIAL CRISIS ARE ASSISTED WITH A PORTION OF THEIR PAST DUE RENT AND/OR UTILITY PAYMENT. THE PROGRAM OBJECTIVES ARE TO PREVENT HOMELESSNESS AND UNSAFE LIVING CONDITIONS BY HELPING CLIENTS AVOID EVICTION DUE TO OVERDUE RENT OR UTILITY SHUT-OFFS, WHICH IS GROUNDS FOR EVICTION IN OKLAHOMA. THE FAMILY HOPE (HELP, ORGANIZE, PRIORITIZE AND EMPOWER) PROGRAM PROMOTES INDEPENDENCE AND EQUIPS CLIENTS WITH THE SKILLS TO OVERCOME OBSTACLES AND GAIN ECONOMIC STABILITY. CASE MANAGERS WORK WITH CLIENTS TO CREATE ACTION-ORIENTED, GOAL- CENTERED SERVICE PLANS. SERVICE PLANS FOCUS ON UNMET NEEDS (E.G., FINANCIAL MANAGEMENT, EDUCATION, HEALTH AND WELLNESS, EMPLOYMENT, HOUSING AND MENTAL HEALTH) AND STEPS FOR GOAL COMPLETION. PROGRESS: COUNSELING SERVICES PROGRAM BENCHMARK PERCENTAGES HAVE BEEN MET, ADDING FIVE FAMILIES TO OUR COUNSELING PROGRAM, THUS IMPACTING THE LIVES OF 19 MORE PEOPLE. EMERGENCY RENT AND UTILITY ASSISTANCE PROGRAM WE HAVE MET OUT BENCHMARK PERCENTAGES IN EMERGENCY ASSISTANCE, INCLUDING COVID RELIEF. WE HAVE SERVED A TOTAL OF 254 PEOPLE WITH THESE SERVICES. FAMILY HOPE PROGRAM THE BENCHMARK PERCENTAGES CONTINUE TO BE MET FOR FAMILY HOPE. THERE ARE SIX NEW FAMILIES IN THIS PROGRAM, MAKING A TOTAL OF 10 ACTIVE CASES. DIABETES SOLUTIONS-OK, INC. NAME OF PROJECT: DSOK CAMP ENDRES PROJECT DESCRIPTION: THE DIABETES CAMPS, CAMP ENDRES, PROVIDE A CRUCIAL PART OF CHILDREN'S JOURNEY WITH DIABETES. WITH HELP FROM INTEGRIS HEALTH, WHEN WE FIRST FORMED DSOK IN 2000, WE HOSTED ONE 10-DAY SUMMER CAMP PROGRAM. CURRENTLY WE HOST SIX ANNUAL CAMPING PROGRAMS TO SUIT EVERYONE'S NEEDS. ROUGHLY 300 CHILDREN, TEENS, ADULTS AND FAMILIES ARE HOSTED DIRECTLY WITH CAMP ENDRES PROGRAMS THROUGHOUT THE CALENDAR YEAR. PROGRESS: DUE TO COVID-19, THE SPRING FLING FOR TEENS AND THE SEPTEMBER ADULT GETAWAY WERE CANCELLED. WE HOPE TO RESUME THESE TWO PROGRAMS IN 2022.
PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED	CHRISTIAN MEDICAL CLINIC OF GRAND LAKE, INC. NAME OF PROJECT: FILLING THE GAP IN THE COMMUNITY'S HEALTH CARE SYSTEM. PROJECT DESCRIPTION: HELP WITH PURCHASING MEDICATIONS FOR OUR PATIENTS. PROGRESS: OVER 500 PATIENTS ARE SEEN FROM OUR FOUR COUNTIES EVERY THREE MONTHS. DURING JULY THROUGH SEPTEMBER 2021, 1,733 PRESCRIPTIONS WERE FILLED AT NO COST TO THE PATIENTS. YOUTH & FAMILY SERVICES OF NORTH CENTRAL OKLAHOMA NAME OF PROJECT: CHAMPION DAY TREATMENT PROGRAM PROJECT DESCRIPTION: THE TREATMENT PROGRAM, CHAMPION, IS DESIGNED TO HELP STUDENTS WHO HAVE DIFFICULTY WITH SCHOOL DUE TO POSSIBLE MENTAL HEALTH SYMPTOMOLOGY RELATED TO ENVIRONMENTAL FACTORS, TRAUMA EXPOSURE, DEPRESSION AND ANXIETY, OR LACK OF EMOTIONAL REGULATION. OFTEN, THESE ARE CHILDREN WHO WOULD BE STEPPING DOWN FROM THE INTEGRIS HEALTH MEADOWLAKE FACILITY. FOR THESE PARTICULAR CHILDREN, THE SCHOOL SYSTEM SIMPLY CANNOT MEET THEIR NEEDS. THE PROGRAM PROVIDES COUNSELING, EDUCATION AND PROBLEM-SOLVING SKILLS WHILE COLLABORATING WITH THE TEACHER IN AN EFFORT TO REINTEGRATE STUDENTS INTO THE MAINSTREAM CLASSROOM SETTING. THE MODEL FOCUSES ON THE STUDENT'S PERSONAL STRENGTHS AND ABILITIES AS THEY RELATE TO ACADEMICS, SOCIAL SKILLS AND COLLABORATIVE PROBLEM SOLVING. PROGRESS: SINCE JUNE 2021, WE HAVE MAINTAINED SIX CHILDREN FROM THE PROGRAM AND WERE ABLE TO WORK WITH THEM IN PERSON OVER THE SUMMER AT OUR FACILITY. UNDERSTANDING HOSPITAL CHARGES CAN SOMETIMES BE CHALLENGING: AT INTEGRIS HEALTH OUR GOAL IS TO DELIVER THE HIGHEST QUALITY CARE AT THE MOST REASONABLE PRICES THROUGH OUTSTANDING CUSTOMER SERVICE. WE PLEDGE TO BE TRANSPARENT IN OUR COST, QUALITY AND CUSTOMER SERVICE REPORTING. THESE DAYS PATIENTS ARE SHARING MORE IN THE COSTS OF THEIR OWN HEALTH CARE, THEREFORE INTEGRIS HEALTH BELIEVES YOU SHOULD HAVE ACCESS TO THE INFORMATION YOU NEED TO MAKE INFORMED HEALTH CARE CHOICES. OUR PRICING PHILOSOPHY IS THIS: INTEGRIS HEALTH SEEKS TO ESTABLISH PRICES THAT ARE FAIR TO PATIENTS AND PAYORS, REASONABLE IN THE MARKETS WE SERVE, CONSISTENT WITH OUR PEERS WHO PROVIDE SIMILAR SERVICES WHILE IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. WE ALSO BELIEVE IT IS IMPORTANT FOR YOU TO UNDERSTAND HOW EACH DOLLAR OF BILLED CHARGES IS SPENT AT INTEGRIS HEALTH. AS A NOT-FOR-PROFIT COMPANY, INTEGRIS HEALTH REINVESTS ANY BUDGET SURPLUS BACK INTO THE ORGANIZATION TO IMPROVE THE LEVEL OF SERVICES THAT IT PROVIDES TO THE COMMUNITY. WHILE YOUR HEALTH PLAN OR PERSONAL PREFERENCE MAY DICTATE WHERE YOU DECIDE TO RECEIVE CARE, COMPARING CHARGES BETWEEN LOCAL PROVIDERS FOR SIMILAR PROCEDURES, COMBINED WITH QUALITY DATA, MAY BETTER PROVIDE YOU WITH AN OVERALL PICTURE OF THE TOTAL VALUE YOU WILL RECEIVE AT THE HOSPITAL OF YOUR CHOICE. INTEGRIS HEALTH HOSPITAL BILLS DO NOT INCLUDE FEES FOR PHYSICIAN SERVICES. YOU MAY RECEIVE MORE THAN ONE BILL FOR YOUR HOSPITAL VISIT. 2021 BENEFITS TO THE COMMUNITY BY THE NUMBERS INTEGRIS HEALTH PROVIDED $72,073,512.56 IN COMMUNITY BENEFITS. THIS INCLUDES OUR RETURNSHIP, COMMUNITY BUILDING EFFORTS, UNCOMPENSATED SERVICES AND MEDICAID SERVICES. RETURNSHIP RETURNSHIP EPITOMIZES OUR MISSION OF GIVING BACK TO OUR COMMUNITY. IT TAKES THE FORM OF HUNDREDS OF PROGRAMS AND ACTS OF CHARITY PROVIDED DAILY ACROSS THE STATE OF OKLAHOMA FREE HEALTH SCREENINGS, SUPPORT GROUPS, MEDICAL SERVICES, EDUCATIONAL PROGRAMS, HEALTH FAIRS AND MORE AS REFLECTED IN THE PREVIOUS PAGES. OUR RETURNSHIP EFFORTS EQUALED $5,656,217.41. COMMUNITY BUILDING COMMUNITY BUILDING IS ANOTHER VITAL WAY WE GIVE BACK. THESE EFFORTS ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. SOME OF OUR ACTIVITIES IN COMMUNITY BUILDING ARE PHYSICAL IMPROVEMENTS IN HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL ENHANCEMENTS AND ADVOCACY FOR ADVANCEMENTS IN COMMUNITY HEALTH. OUR COMMUNITY BUILDING EFFORTS EQUALED $107,306. UNCOMPENSATED SERVICES UNCOMPENSATED SERVICES ARE THE COSTS OF PROVIDING FREE AND REDUCED-COST CARE. AS A SYSTEM OF NOT-FOR-PROFIT HOSPITALS, INTEGRIS HEALTH PROVIDES SERVICES TO EVERYONE, REGARDLESS OF THE ABILITY TO PAY FOR THEIR INSURANCE COVERAGE. THUS, WE PROVIDE A MUCH-NEEDED SAFETY NET FOR MEMBERS OF OUR COMMUNITY WHO WOULD OTHERWISE HAVE NO ACCESS TO MEDICAL CARE. INTEGRIS HEALTH IS COMMITTED TO PROVIDING MEDICALLY NECESSARY CARE BY OFFERING FINANCIAL ASSISTANCE TO QUALIFYING PATIENTS. INTEGRIS HEALTH PROVIDED CHARITY CARE AT AN ESTIMATED COST OF $41,886,204.13. BAD DEBT IN ADDITION TO CHARITY CARE, INTEGRIS HEALTH INCURRED BAD DEBT WITH AN ESTIMATED COST OF $20,912,368.12 BASED ON THE OVERALL HOSPITAL COST-TO-CHARGE RATIO. BAD DEBT CONSISTS OF SERVICES FOR WHICH THE SYSTEM ANTICIPATED BUT DID NOT RECEIVE PAYMENT. THIS HAPPENS WHEN PATIENTS ARE UNABLE TO PAY THEIR BILLS BUT DO NOT APPLY FOR FINANCIAL ASSISTANCE OR ARE UNWILLING TO PAY THEIR BILLS. MEDICAID SERVICES INTEGRIS HEALTH ALSO PROVIDES CARE TO PATIENTS WHO QUALIFY FOR MEDICAID PROGRAMS. THIS INCLUDES THE ACTUAL UNPAID COST OF PROVIDING CARE TO MEDICAID PATIENTS AND REPRESENTS A SHORTFALL BETWEEN COST OF CARE AND PAYMENTS RECEIVED BY MEDICAID. INTEGRIS HEALTH PROVIDED MEDICAID SERVICES AT AN ESTIMATED COST OF $24,423,785.02.
PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED	INTEGRIS HEALTH OUTREACH EVENTS AND PROGRAMS A CHANCE TO CHANGE ACS - HOPE LODGE GROUNDBREAKING CEREMONY ACS - OK STATEWIDE BOARD CALL ACS - OK STATEWIDE BOARD MEETING ACS BOARD COMM ENGAGEMENT SUBCOMMITTEE MEETING ACS CATTLE BARON'S BRAINSTORMING MEETING ALA - 2021 FFAC PLANS & COMMITTEE MEETING ALA - FFAC COMMITTEE ALA - FFAC COMMITTEE MEETING ALA - FIGHT FOR AIR CLIMB MEETING ALA FFAC COMMITTEE ALA FIGHT FOR AIR CLIMB COMMITTEE MEETING ALZHEIMER'S ASSOCIATION OF OKLAHOMA AMERICAN CANCER SOCIETY AMERICAN CANCER SOCIETY - CHAD RICHISON LODGE - GROUNDBREAKING CEREMONY AMERICAN CANCER SOCIETY - OKTXNM AREA BOARD MEETING AMERICAN CANCER SOCIETY - OKTXPAN AREA BOARD MEETING AMERICAN CANCER SOCIETY MEETING AMERICAN CANCER SOCIETY STATEWIDE BOARD MEETING AMERICAN HEART ASSOCIATION AMERICAN LUNG ASSOCIATION AMERICAN LUNG ASSOCIATION - FFAC COMMITTEE AMERICAN LUNG ASSOCIATION - FIGHT FOR AIR CLIMB AMERICAN LUNG ASSOCIATION - FIGHT FOR AIR CLIMB BOOTH AT IBMC-NW AMERICAN LUNG ASSOCIATION - FIGHT FOR AIR LUNG CLIMB AMERICAN LUNG ASSOCIATION - LUNG FORCE GALA AN INTRODUCTION TO COMPASSION CULTIVATION ASK THE DIETITIAN DIETARY CONSULTS BAM INFUSIONS BRIGHT FUTURES MENTORING BUFFALO RUN CASINO HEALTH FAIR CALM WATERS CENTER FOR CHILDREN AND FAMILIES CARDIOLOGY EDUCATION TO GREAT PLAINS RESIDENTS CENTRAL OKLAHOMA HEALTH IMPACT TEAM CHANGING YOUR WEIGHS (SEVEN SESSIONS) WEIGHT MANAGEMENT CHANGING YOUR WEIGHS (EIGHT SESSION) WEIGHT MANAGEMENT CHILD ABUSE MEDICAL EXAMINER FOR DELAWARE COUNTY CHNA FOCUS GROUP CI HEALTH GROUP INTERNSHIP COMMUNITY CLINICS COMMUNITY COVID EDUCATION COMMUNITY EDUCATION STROKE AWARENESS COMMUNITY EDUCATION STROKE EDUCATION COMMUNITY FLU SHOTS AND BP READINGS COMMUNITY GRANT RECIPIENT - CATHOLIC CHARITIES OF OKC REGIONAL COMMUNITY GRANT RECIPIENT - CDSA COMMUNITY GRANT RECIPIENT - LIONS CLUB NORTH ENID COMMUNITY GRANT RECIPIENT - YWCA COMMUNITY HEALTH FAIR AT WILL ROGERS SENIOR CENTER COMMUNITY HOURS FOR TAMARA CLIFT, FY 2020-21 COMMUNITY HOURS FOR TIM PEHRSON, CEO, FY2020-21 COMMUNITY ROTATION FOR DIETETIC INTERNS FROM OUHS COMMUNITY WELLNESS BUDGET FY 2020-21 COPING SKILLS PRESENTATION MIAMI HIGH SCHOOL COVID VACCINATION CLINIC FOR PACIFIC ISLANDERS COVID VACCINATION SHOTS DAYCARE FLU SHOTS AND BP READINGS DCCAN FLU SHOTS AND BP READINGS DCCP COVID ANTIBODY TESTING DE MUJER A MUJER DELAWARE COUNTY ELDERS DRIVE THRU HEALTH FAIR DIABETES EDUCATION AT ICC DIABETES PREVENTION PROGRAM (DPP) EASTERN OKLAHOMA LIBRARY HEALTH SERIES EATING WELL WITH DIABETES MABEL C FRY LIBRARY ADULT PROGRAMS ECONOMIC DEVELOPMENT FOR RONDA LITTLE, FY20-21 ECONOMIC DEVELOPMENT FOR TIM PEHRSON, CEO FOR FY20 EMERGENCY MEDICAL SERVICE COMMUNITY SERVICE FACEBOOK LIVE INFORMATION SESSIONS IN SPANISH FOCUS GROUP MEETING FOR CHNA IN ENID, OK FOCUS GROUP MEETING FOR CHNA IN MUSTANG, OK FOOD DEMONSTRATION AT THE MOORE FOOD AND RESOURCE FOOD DISTRIBUTIONS FOR COMMUNITY MEMBERS FRANCIS TUTTLE CART ! SPRING 2021 RESPIRATORY THERAPY CLINICAL FRANCIS TUTTLE NICU RESPIRATORY THERAPY CLINICALS FRANCIS TUTTLE PFT RESPIRATORY THERAPY CLINICALS FRANCIS TUTTLE RESPIRATORY THERAPY STUDENTS (FALL 2020) FRANCIS TUTTLE RESPIRATORY THERAPY STUDENTS (FALL 220) CART 1 FRANCIS TUTTLE RESPIRATORY THERAPY STUDENTS CART 1 SUMMER 2020 FRANCIS TUTTLE RESPIRATORY THERAPY STUDENTS FALL 2020 FRANCIS TUTTLE SUMMER 2020 RESPIRATORY THERAPY STUDENTS FY21 EXPENSES FOR NON-EMPLOYED STUDENTS, RESIDENTS FY21 STUDENT, RESIDENT AND FELLOW EDUCATION HOURS FY21 STUDENT, RESIDENT AND FELLOW EDUCATION HOURS WITH PHYSICIANS GO RED FOR YOUR HEART/VESTIDO ROJO GRACELAND UNIVERSITY NURSING STUDENT GRADUATE MEDICAL EDUCATION SUPERVISOR SALARY GROVE PASTORAL CARE GROVE TWEEN FAIR HEALTH ALLIANCE FOR THE UNINSURED HEALTHY LIVING, LIVESTRONG AT THE YMCA HEDGES SILENT FILM SPONSORSHIP HES 200 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 HES 200 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 HISPANIC HERITAGE MONTH MEN'S HEALTH PRESENTATION HISPANIC RADIO, TELEVISION AND NEWSPAPER HOSPICE CIRCLE OF LOVE MINT JULEP JUBLIEE SPONSOR INTEGRIS HEALTH COMMUNITY CLINIC INTEGRIS HEALTH GROVE RESPIRATORY THERAPY STUDENTS (AUGUST 2020-MAY 2021) INTEGRIS HEALTH JIM THORPE REHAB STUDENT HOURS INTEGRIS HEALTH MOBILE CARE CLINIC INTEGRIS HEALTH PHARMACEUTICAL ASSISTANCE PROGRAM FY 2020-21 INTEGRIS HEALTH PHYSICIAN MEDICAL MEETINGS INTEGRIS HEALTH REHAB AND SPORTS MEDICINE STUDENTS HOURS J & M FARMS HEALTH FAIR JOHN ADAMS-OBI (OK BLOOD INSTITUTE) BOARD MEETINGS JOHN ADAMS-SOUTH OKC CHAMBER OF COMMERCE ADVISORY JOHN ADAMS-SOUTH OKLAHOMA CITY CHAMBER OF COMMERCE LEADERSHIP OKC BOARD MEETING
PART III, LINE 4A: COMMUNITY BENEFIT REPORT CONTINUED	LEADERSHIP OKLAHOMA CITY - EXECUTIVE COMMITTEE LEADERSHIP OKLAHOMA CITY EXECUTIVE COMMITTEE MEETING LEADERSHIP OKLAHOMA CITY HOLIDAY DRIVE THROUGH EVENT LEUKEMIA & LYMPHOMA SOCIETY LEUKEMIA & LYMPHOMA SOCIETY - LIGHT THE NIGHT KICK LYNN INSTITUTE LYNN INSTITUTE ON THE ROAD TO HEALTH WELLNESS PROGRAM MAKE-A-WISH SPONSORSHIP MEALS ON WHEELS FY 2020-21 MEDICAL STUDENT FAMILY MEDICINE ROTATION 20-21 MEDITATION MEETINGS WITH NON PROFIT ORGANIZATIONS MENTORING PROGRAM FY 2020-21 MIAMI FIRE DEPARTMENT REFRESHER COURSE MIAMI LIONS CLUB MIAMI RESPIRATORY THERAPY STUDENTS (AUGUST 2020-MAY 2021) MINI HEALTH FAIRS MONTHLY LECTURES / CONFERENCIAS MENSUALES MPS OSWE MT 200 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 NEO NURSING STUDENTS NON-REIMBURSED IRB FEES FY 2021 (JULY 2020-JUNE 2021) NORTHEAST TRIBAL HEALTH SYSTEM HEALTH AWARENESS NORTHEASTERN TRIBAL HEALTH SYSTEM (NTHS) DIABETES BOARD MEETINGS NTC AFTON NURSING STUDENTS NTC KANSAS NURSING STUDENTS NURSES, AUA, SURGICAL TECH AND PARAMEDIC STUDENTS NURSING STUDENTS IN A CLINICAL NURSE INTERN ROLE NUTRITION CLASS SERIES / CLASE DE NUTRICIN NUTRITION PROGRAM FOR OKC VILLAGES (ZOOM) OK ACS CAN NATIVE AMERICAN HEALTH DISPARITIES CONFERENCE OK BLACK PHYSICIAN'S ALLIANCE: HEART HEALTHY COOKING OK COLORECTAL CANCER COALITION MEETING OK SCHOOL OF SCIENCE AND MATHEMATICS BOARD MEETING OKC CHAMBER STATE OF HEALTH CONFERENCE OKLAHOMA BLOOD INSTITUTE - BLOODMOBILE OKLAHOMA MEN COUNT SPONSORSHIP OKLAHOMA SCHOOL OF SCIENCE AND MATHEMATICS FOUNDATION OSSM BOARD MEETING OSSM FOUNDATION OUTREACH COMMITTEE MEETING OSU COMMUNITY RURAL HEALTH ROTATION OT AND OTA 100 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 OT AND OTA 100 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 OT AND OTA 200 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 OT AND OTA 200 STUDENT INTERNSHIPS JULY 1 TO DEC 31, 2020 OTTAWA COUNTY FARMERS MARKET BOARD MEETINGS OTTAWA COUNTY UNITED WAY CORPORATE CHALLENGE COMMITTEE POSITIVE DIRECTIONS MENTORING PROGRAM FY 2020-21 PRE AND POST CONFERENCE ROOMS FOR CLINICAL NURSING PROJECT 31 PT 100 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 PT 100 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 PT AND PTA 200 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 PT AND PTA 200 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 RADIOLOGY STUDENTS RESOURCE ROOM ROOSEVELT ELEMENTARY COPING SKILLS PRESENTATION ROOSEVELT ELEMENTARY FIELD DAY ROSE STATE FALL 2020 RESPIRATORY THERAPY FLOOR ROSE STATE FALL 2020 RESPIRATORY THERAPY STUDENTS FLOOR ROSE STATE RESPIRATORY THERAPY CLINICALS SUMMER 2021 ROSE STATE RESPIRATORY THERAPY STUDENTS FALL 2020 ROSE STATE RESPIRATORY THERAPY STUDENTS NICU SUMMER 2020 ROSE STATE RESPIRATORY THERAPY STUDENTS SUMMER 2021 ROSE STATE SUMMER 2020 RESPIRATORY THERAPY STUDENT SCHOOL COOKS TRAINING INFORMATIONAL BAGS SHA COMMUNITY CLINIC SINK FOR PINK SPONSORSHIP SLP 100 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 SLP 100 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 SLP 200 STUDENT INTERNSHIPS JANUARY 1 TO JUNE 30, 2021 SLP 200 STUDENT INTERNSHIPS JULY 1 TO DECEMBER 31, 2020 SPANISH CANCER SUPPORT GROUP/GRUPO DE APOYO DE CANCER SPORTS PHYSICAL BY HEALTH DEPARTMENT SPORTS PHYSICALS FOR ENID HIGH SCHOOL STUDENTS STANLEY HUPFELD ACADEMY BUDGET FY 2020-21 STITCHING FOR SANITY STRESS COPING SKILLS PRESENTATION TERESA GRAY: YUKON CC 2021 THE FOUNDATION FOR OKCPS THE OKLAHOMA CARING FOUNDATION, INC. TOBACCO AND VAPE PRESENTATION MIAMI HIGH SCHOOL TURMERIC, THE SPICE OF LIFE UCO COMMUNITY & PUBLIC HEALTH INTERNSHIPS UNITED WAY GOLF TOURNAMENT SPONSOR UNITED WAY OF CENTRAL OKLAHOMA UNITED WAY OF CENTRAL OKLAHOMA SNOWFLAKE GALA VOLUNTEER CLINICAL INSTRUCTOR FOR APRN STUDENT WASHINGTON ELEMENTARY COPING SKILLS PRESENTATION YMCA YMCA GOLF TOURNAMENT SPONSORSHIP YODA NIDRA EXPERIENCE YOGA HEALING THROUGH MOVEMENT/SAFER AT HOME YOGA
PART V: QUESTION 1A	INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, PAYS ALL VENDORS FOR SERVICES PROVIDED TO ALL ENTITIES WITHIN THE SYSTEM. ACCORDINGLY, COMPENSATION PAID TO INDEPENDENT CONTRACTORS IS REPORTED ON THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S INFORMATION RETURNS OF INTEGRIS HEALTH, INC., EIN 73-1192764. EXPENSES ARE ALLOCATED TO AND REIMBURSED BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990, PART VII, SECTION B AND PART IX, AS APPROPRIATE.
PART V: QUESTION 2A	THE SALARIES REFLECTED ON FORM 990, PART IX, LINE 7, WERE ALL REPORTED ON THE FORM 941 EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, OF INTEGRIS HEALTH, INC., EIN 73-1192764. THESE SALARIES WERE REIMBURSED TO INTEGRIS HEALTH, INC. AND WERE INCLUDED IN THE NUMBER OF EMPLOYEES ON INTEGRIS HEALTH, INC.'S FORM W-3. THE NUMBER OF EMPOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2021 TAX YEAR.
FORM 990, PART VI, SECTION A, LINE 1A	THE HOSPITAL ADVISORY BOARD FULFILLS THE NECESSARY GOVERNANCE AUTHORITY FOR MEDICAL STAFF MEMBERSHIP AND QUALITY OF CARE OVERSIGHT AS REQUIRED BY THE CENTER FOR MEDICARE AND MEDICAID SERVICES CONDITIONS OF PARTICIPATION.
FORM 990, PART VI, SECTION A, LINE 2	THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE FOLLOWING OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BY VIRTUE OF THEIR POSITIONS AS OFFICERS, DIRECTORS, OR EMPLOYEES OF RELATED ENTITIES WITHIN THE SYSTEM: DOUGLAS M. SMITH TIMOTHY PEHRSON
FORM 990, PART VI, SECTION A, LINE 6	INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS AMBULATORY CARE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A	INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS AMBULATORY CARE CORPORATION. AS SUCH IT HAS THE POWER (1) TO ELECT THE DIRECTORS OF THE CORPORATION AND TO REMOVE THE ENTIRE BOARD OF DIRECTORS OR ANY INDIVIDUAL DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE, (2) TO APPROVE OR DISAPPROVE ANY ACTION TAKEN BY THE BOARD OF DIRECTORS AMENDING, ALTERING, CHANGING OR REPEALING THE BYLAWS, AND (3) TO VOTE ON ALL MATTERS WHERE THE AUTHORIZATION OR APPROVAL OF THE SOLE MEMBER IS REQUIRED BY THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR STATE LAW.
FORM 990, PART VI, SECTION A, LINE 7B	PLEASE SEE THE NARRATIVE FOR FORM 990, PART VI, SECTION A, LINE 7A.
FORM 990, PART VI, SECTION B, LINE 11B	THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE SYSTEM HAS A SINGLE AUDIT COMPLIANCE COMMITTEE WHICH OVERSEES THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AS WELL AS THE FILING OF FEDERAL AND STATE TAX FORMS. THE SYSTEM ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF FORM 990 TO PREPARE THE FORM. A DRAFT FORM 990 IS PROVIDED TO THE SYSTEM VICE PRESIDENT, FINANCE FOR REVIEW. A FINAL FORM 990 IS GIVEN TO THE SYSTEM CHIEF FINANCIAL OFFICER FOR REVIEW, APPROVAL, AND SIGNATURE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, AS WELL AS TO THE SYSTEM'S AUDIT/COMPLIANCE COMMITTEE, FOR REVIEW PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE INTEGRIS CODE OF CONDUCT. ALL SYSTEM EMPLOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION ARE INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS, AND REFER ANY CONFLICT OF INTEREST QUESTIONS TO THE SYSTEM'S COMPLIANCE OFFICER OR THROUGH THE ANONYMOUS INTEGRITY LINE. ALL NEW MANAGERS RECEIVE ADDITIONAL TRAINING ON CONFLICT OF INTEREST POLICIES DURING LEADERSHIP TRAINING. LEGAL SERVICES REVIEWS ALL CONTRACTS FOR CONFLICTS OF INTEREST. INTERNAL AUDIT CONDUCTS AUDITS FOR POSSIBLE CONFLICTS OF INTEREST BASED ON THEIR ANNUAL RISK ASSESSMENT. CORPORATE COMPLIANCE INCLUDES ASSESSMENTS FOR CONFLICTS OF INTEREST IN ITS ANNUAL WORK PLAN AND CONDUCTS SPECIALIZED TRAINING FOR HIGH RISK AREAS. THE GOVERANCE COMMITTEE, A COMMITTEE OF THE INTEGRIS HEALTH BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF INTEGRIS AND A DISQUALIFIED PERSON.
FORM 990, PART VI, SECTION B, LINE 15B	PART VI: QUESTION 15B - THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). COMPENSATION FOR VICE PRESIDENTS IS ANALYZED BY AN INDEPENDENT HEALTH CARE CONSULTING FIRM. THE ANALYSIS INCLUDES A FAIR MARKET VALUE ASSESSMENT AND ESTABLISHMENT OF A RANGE FOR EACH POSITION BASED ON RESEARCH OF COMPARABLE HEALTH CARE SYSTEMS OF SIMILAR SIZE. THE REPORT AND RECOMMENDED COMPENSATION LEVELS FOR EACH EXECUTIVE MANAGEMENT POSITION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE INTEGRIS HEALTH BOARD OF DIRECTORS AND ULTIMATELY THE FULL BOARD OF DIRECTORS. THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REFLECTS A REVIEW OF THE COMPARABILITY DATA, THE EXECUTIVE PERFORMANCE REVIEWS AND THE DECISION-MAKING PROCESS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR INTEGRIS HEALTH, INC., A RELATED CORPORATION. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION.
FORM 990, PART XI, LINE 9:	INCOME FROM SUBSIDIARY - FOUNDATION 100% 26,835. INCREASE IN CONTRIBUTIONS OF LONG-LIVED ASSETS 1,116.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

INTEGRIS AMBULATORY CARE CORP

Employer identification number

73-1192765

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CARAVAN HEALTH ACO 34 LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 30-0865115	ACO	DE	0	0	IACC

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)INTEGRIS HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1192764	HEALTH CARE	OK	501(C)(3)	LINE 12A, I	N/A		No
(2)INTEGRIS HOSPICE INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1369586	HEALTH CARE	OK	501(C)(3)	LINE 10	IH		No
(3)INTEGRIS BAPTIST MEDICAL CENTER INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1034824	HEALTH CARE	OK	501(C)(3)	LINE 3	IH		No
(4)INTEGRIS RURAL HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1444504	HEALTH CARE	OK	501(C)(3)	LINE 3	IH		No
(5)INTEGRIS SOUTHWEST MEDICAL CENTER INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1089149	HEALTH CARE	OK	501(C)(3)	LINE 3	IH		No
(6)INTEGRIS HEALTH FOUNDATION INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1047338	FUNDRAISING	OK	501(C)(3)	LINE 7	IH		No
(7)WESTERN VILLAGE ACADEMY INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1588764	SCHOOL	OK	501(C)(3)	LINE 2	IACC	Yes
(8)INTEGRIS HEALTH EDMOND INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 45-1027361	HEALTH CARE	OK	501(C)(3)	LINE 3	IH		No
(9)INTEGRIS MENTAL HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-0738716	HEALTH CARE	OK	501(C)(3)	LINE 3	IH		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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?		(k) Percentage ownership
(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	(k) Percentage ownership
(1) BMPA LTD 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1228665	MED. OFFICE BLDG.	OK	N/A	N/A				No			No
(2) QC-III 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 20-8723857	MEDICAL	OK	N/A	N/A				No			No
(3) DIAGNOSTIC LAB 500 PLAZA DR TAX DEPT FL 8 SECAUCUS,NJ07094 73-1560760	CLINICAL LAB	NJ	N/A	N/A				No			No
(4) LAKESIDE WOMEN'S HOSPITAL 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1493662	MEDICAL	OK	IACC	RELATED	5,326,130	19,744,304		No	844		No	78.080 %
(5) INTEGRISUSP HEALTH 14201 DALLAS PARKWAY DALLAS,TX75254 35-2632292	MEDICAL SERVICES	TX	IACC	RELATED	13,405,830	76,468,708		No			No	50.100 %
(6) INTEGRIS EMERGENCY HOSPITAL 8686 NEW TRAILS DRIVE THE WOODLANDS,TX77381 90-1215089	HEALTH CARE	TX	IACC	RELATED	-4,240,598	-7,519,831		No			No	51.000 %
(7) INTEGRIS DDSI ENDOSCOPY CENTERS LLC 3366 NORTHWEST EXPRESSWAY STE 400 OKLAHOMA CITY,OK73112 85-4253589	HEALTH CARE	OK	IACC	RELATED				No			No	51.000 %

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	(h) Percentage ownership	Yes	No
(1) INTEGRIS PROHEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1046179	RETAIL PHARMACY	OK	N/A	C					No
(2) THE STANLEY F HUPFELD CHARITABLE REMAINDER TRUST 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 26-6238051	FINANCIAL	OK	N/A	T					No
(3) QUALITY ALLIANCE ASSURANCE CO PO BOX 10027 GRAND CAYMAN KYI-1001 CJ 98-1060671	INSURANCE	CJ	N/A	C					No
(4) BAPTIST HEALTH SYSTEM INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 73-1477468	DORMANT	OK	N/A	C					No
(5) ONE CARE INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134	DORMANT	OK	N/A	C					No
(6) VADOVATIONS INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 27-0821922	HEALTH CARE	OK	N/A	C					No
(7) INTEGRIS HEALTH PARTNERS LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 45-3482852	HEALTH CARE	OK	N/A	C					No
(8) INTEGRIS CARDIOVASCULAR PHYSICIANS LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY,OK73134 45-2867352	HEALTH CARE	OK	N/A	C					No

Schedule R (Form 990) 2021

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

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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) LAKESIDE WOMEN'S HOSPITAL LLC	C	4,755,944	FMV
(2) LAKESIDE WOMEN'S HOSPITAL LLC	P	5,687,723	FMV
(3) LAKESIDE WOMEN'S HOSPITAL LLC	Q	63,369	FMV

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,744
6	Total number of volunteers (estimate if necessary) .............	6	224
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-3,476,145
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,353,073	5,688,360
9	Program service revenue (Part VIII, line 2g) .........	237,699,844	244,012,500
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	272,552	421,303
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	248,325	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	242,573,794	250,122,163
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	184,367,134	189,282,804
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)....	74,518,852	72,882,070
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	258,885,986	262,164,874
19	Revenue less expenses. Subtract line 18 from line 12.......	-16,312,192	-12,042,711
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	363,711,453	503,937,353
21	Total liabilities (Part X, line 26).............	419,040,576	571,281,236
22	Net assets or fund balances. Subtract line 21 from line 20.....	-55,329,123	-67,343,883

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 242,757,597 including grants of $ ) (Revenue $ 247,267,838 )
	INTEGRIS AMBULATORY CARE CORPORATION (IACC) IS INCLUDED IN THE INTEGRIS HEALTH SYSTEM. IACC PROVIDED CHARITY CARE AT COST OF $1,886,140 USING A COST TO CHARGE RATIO METHOD OF CALCULATION. IACC ALSO PROVIDED CARE FOR PATIENTS WHO DID NOT PAY AND MUST BE WRITTEN OFF AS BAD DEBT COST OF $6,044,282, BASED ON A COST TO CHARGE RATIO METHOD OF CALCULATION. FOR ADDITIONAL DETAILS REGARDING COMMUNITY BENEFIT, SEE THE COMPLETE COMMUNITY BENEFIT REPORT ON 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 expenses242,757,597

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) SUNNIE GLOVER........................................................................ VP PHYSICIAN ENTERPRISE	40.00 .......................0.00	X		538,987	0	59,400
(19) JEFFREY CRUZAN........................................................................ PRESIDENT PHYSICIAN ENTERPRISE	40.00 .......................0.00	X		699,763	0	95,722
(20) KATHERINE ANN MANSALIS........................................................................ VP & CHIEF MEDICAL OFFICER	40.00 .......................0.00	X		360,763	0	11,201
(21) HANI BARADI........................................................................ PHYSICIAN	40.00 .......................0.00		X	1,441,362	0	19,225
(22) CHRISTOPHER LENTZ........................................................................ PHYSICIAN	40.00 .......................0.00		X	1,118,220	0	18,500
(23) JEREMY T PHELPS........................................................................ PHYSICIAN	40.00 .......................0.00		X	1,717,858	0	19,225
(24) SCOTT SHADFAR........................................................................ PHYSICIAN	40.00 .......................0.00		X	1,494,973	0	19,225
(25) MUZAFFAR HUSSAIN........................................................................ PHYSICIAN	40.00 .......................0.00		X	1,146,245	0	24,125

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,518,171	3,094,007	706,177

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,892,320
e	Government grants (contributions)		1e	1,796,040

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.......		5,688,360

		Business Code
2a	NET PATIENT REVENUE	621990	214,238,514	214,238,514
b	INCOME FROM JOINT VENTURES	621990	20,195,339	23,672,328	-3,476,989
c	QUALITY INCENTIVES	900099	6,406,618	6,406,618
d	ELECTRONIC HEALTH RECORDS	900099	1,565,200	1,565,200
e	EMP WELLNESS SCREENINGS	900099	732,388	732,388
f	All other program service revenue.		874,441	652,790	844	220,807
g	Total. Add lines 2a–2f .....		244,012,500

3 Investment income (including dividends, interest, and othersimilar amounts) ......			529,318			529,318
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses	108,015		7b
c	Gain or (loss)	-108,015		7c
d	Net gain or (loss).........			-108,015			-108,015
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			250,122,163	247,267,838	-3,476,145	642,110

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	9,298,468	9,298,468
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	154,046,184	154,046,184
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,447,013	3,447,013
9	Other employee benefits .......	12,755,830	12,755,830
10	Payroll taxes ...........	9,735,309	9,735,309
11	Fees for services (non-employees):
a	Management ......	19,407,277		19,407,277
b	Legal .........	32,880	32,880
c	Accounting ...........	12,500	12,500
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,053,185	2,053,185
12	Advertising and promotion ....	31,326	31,326
13	Office expenses .......	11,146,281	11,146,281
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	11,916,329	11,916,329
17	Travel ............	416,199	416,199
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	439,655	439,655
20	Interest ...........	961,673	961,673
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,929,460	1,929,460
23	Insurance ...	3,277,878	3,277,878
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	PURCHASED SERVICES	20,168,590	20,168,590
b	DUES & MEMBERSHIPS	279,958	279,958
c	BANK FEES	217,050	217,050
d	LICENSES/PERMITS	199,918	199,918
e	All other expenses	391,911	391,911
25	Total functional expenses. Add lines 1 through 24e	262,164,874	242,757,597	19,407,277	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 ........			13,728	1	13,986
2	Savings and temporary cash investments .........			4,813	2	3,330
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			5,623,948	4	296,591,576
5	Loans and other receivables from 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 .......
					5
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) ...
					6
7	Notes and loans receivable, net ...........			8,414,379	7	11,474,379
8	Inventories for sale or use ............			110,267	8	110,382
9	Prepaid expenses and deferred charges ......			43,750	9	38,745
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	47,380,370
b	Less: accumulated depreciation	10b	27,057,102	12,478,815	10c	20,323,268
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			5,689,950	12	140,416,457
13	Investments—program-related. See Part IV, line 11 ..			149,790,554	13	10,861,864
14	Intangible assets ...............			2,864,626	14	2,864,626
15	Other assets. See Part IV, line 11 ...........			178,676,623	15	21,238,740
16	Total assets. Add lines 1 through 15 (must equal line 33)...			363,711,453	16	503,937,353

17	Accounts payable and accrued expenses .....	398,623,722	17	242,974,515
18	Grants payable ...		18
19	Deferred revenue .........	606,738	19	955,779
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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 .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	19,810,116	25	327,350,942
26	Total liabilities. Add lines 17 through 25..	419,040,576	26	571,281,236

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-55,329,123	27	-67,343,883
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 ...........	-55,329,123	32	-67,343,883
33	Total liabilities and net assets/fund balances ........	363,711,453	33	503,937,353